1
|
Goossens J, Jonckheere AC, Seys SF, Dilissen E, Decaesteker T, Goossens C, Peers K, Vanbelle V, Stappers J, Aertgeerts S, De Wilde B, Leus J, Verelst S, Raes M, Dupont L, Bullens DM. Activation of epithelial and inflammatory pathways in adolescent elite athletes exposed to intense exercise and air pollution. Thorax 2023; 78:775-783. [PMID: 36927754 PMCID: PMC10359548 DOI: 10.1136/thorax-2022-219651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/07/2023] [Indexed: 03/18/2023]
Abstract
RATIONALE Participation in high-intensity exercise in early life might act as stressor to the airway barrier. OBJECTIVES To investigate the effect of intense exercise and associated exposure to air pollution on the airway barrier in adolescent elite athletes compared with healthy controls and to study exercise-induced bronchoconstriction (EIB) in this population. METHODS Early-career elite athletes attending 'Flemish-Elite-Sports-Schools' (12-18 years) of 4 different sport disciplines (n=90) and control subjects (n=25) were recruited. Presence of EIB was tested by the eucapnic voluntary hyperventilation (EVH) test. Markers at mRNA and protein level; RNA-sequencing; carbon load in airway macrophages were studied on induced sputum samples. RESULTS 444 genes were differentially expressed in sputum from athletes compared with controls, which were related to inflammation and epithelial cell damage and sputum samples of athletes contained significantly more carbon loaded airway macrophages compared with controls (24%, 95% CI 20% to 36%, p<0.0004). Athletes had significantly higher substance P (13.3 pg/mL, 95% CI 2.0 to 19.2) and calprotectin (1237 ng/mL, 95% CI 531 to 2490) levels as well as IL-6, IL-8 and TNF-α mRNA levels compared with controls (p<0.05). The incidence of EIB in athletes was 9%. The maximal fall in forced expiratory volume in 1 s (%) after EVH test in athletes was significantly associated with prior PM10 and PM2.5 exposure. CONCLUSION Early-career elite athletes showed increased markers of air pollution exposure, epithelial damage and airway inflammation compared with controls. Acute exposure to increased air pollution PM10 levels was linked to increased airway hyper-reactivity. TRIAL REGISTRATION NUMBER NCT03587675.
Collapse
Affiliation(s)
- Janne Goossens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Anne-Charlotte Jonckheere
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Sven F Seys
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Ellen Dilissen
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Tatjana Decaesteker
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Camille Goossens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Koen Peers
- Sport Medical Advice Centre, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Sven Aertgeerts
- Academic Centre for General Practitioners, Catholic University, Leuven, Belgium
| | | | - Jasmine Leus
- Pediatric Allergy, AZ Maria Middelares, Sint-Niklaas, Belgium
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
| | - Sophie Verelst
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
- Pediatrics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - Marc Raes
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
- Pediatrics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - Lieven Dupont
- Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Dominique M Bullens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
| |
Collapse
|
2
|
Goossens J, Vandekerckhove J, Jonckheere AC, Dilissen E, Seys SF, Vanbelle V, Aertgeerts S, Stappers J, Peers K, Raes M, Verelst S, Leus J, Dupont LJ, Bullens DMA. Can AQUA© questionnaire and FeNO predict atopy in early-career athletes? Pediatr Allergy Immunol 2023; 34:e13936. [PMID: 36974645 DOI: 10.1111/pai.13936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Janne Goossens
- Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Josefien Vandekerckhove
- Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
| | | | - Ellen Dilissen
- Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Sven F Seys
- Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | | | - Sven Aertgeerts
- Academic Centre for General Practitioners, KU Leuven, Leuven, Belgium
| | | | - Koen Peers
- Sport Medical Advice Centre, UZ Leuven, Leuven, Belgium
| | - Marc Raes
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
- Pediatrics, Jessa Hospital Hasselt, Hasselt, Belgium
| | - Sophie Verelst
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
- Pediatrics, Jessa Hospital Hasselt, Hasselt, Belgium
| | - Jasmine Leus
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
- Pediatric Allergy, AZ Maria Middelares Gent, Ghent, Belgium
| | - Lieven J Dupont
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
- Clinical Division of Respiratory Medicine, UZ Leuven, Leuven, Belgium
| | - Dominique M A Bullens
- Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Stappers J, Herregods P, Chappel R, Surgeloose DD, Stassijns G. An Achilles tendinosis masking an intramedullary astrocytoma. J Back Musculoskelet Rehabil 2016; 28:599-602. [PMID: 25322734 DOI: 10.3233/bmr-140542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report the case of a 53-year-old male with a right Achilles tendinosis, who complains about a mild gait disorder starting after walking several kilometers. In the following months he develops neurological symptoms. MRI lumbar spine shows an intramedullary tumor at level Th12. A biopsy confirms the diagnosis of an intramedullary astrocytoma. Primary intramedullary tumors are relatively rare. Clinical presentation is often insidious. The authors want to make a point to reconsider a diagnosis in case it does not explain completely the anamnestic or clinical findings. According to the literature there is no optimal approach to the management of these tumors.
Collapse
Affiliation(s)
- Jeroen Stappers
- Department of Physical Medicine and Rehabilitation, Antwerp University Hospital, Edegem, Belgium
| | - Piet Herregods
- Department of Physical Medicine and Rehabilitation, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Rudi Chappel
- Department of Physical Medicine and Rehabilitation, ZNA Middelheim Hospital, Antwerp, Belgium
| | | | - Gaëtane Stassijns
- Department of Physical Medicine and Rehabilitation, Antwerp University Hospital, Edegem, Belgium
| |
Collapse
|
4
|
Timmermans C, Rodriguez LM, Reuter D, Stappers J, Barenbrug PJ, Cheriex EC, Wellens HJ. Management of atrial arrhythmias secondary to severe congenital heart disease with the Atrioverter. Pacing Clin Electrophysiol 2000; 23:1181-3. [PMID: 10914379 DOI: 10.1111/j.1540-8159.2000.tb00924.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An atrial defibrillator was implanted in a patient with congenitally corrected transposition of the great arteries, associated cardiac abnormalities, and persistent atrial arrhythmias. During a 15-month follow-up, 14 of 20 spontaneous episodes of his arrhythmias were successfully treated with the device. Two of these episodes were converted to sinus rhythm during ambulatory use of the device. Successful use of the device required implantation of a third defibrillation lead in the persistent left-sided superior caval vein and rigid control of congestive heart failure. An atrial defibrillator may be a valid treatment option in patients with congenital heart disease crippled by atrial fibrillation.
Collapse
Affiliation(s)
- C Timmermans
- Department of Cardiology, Academic Hospital Maastricht, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
5
|
Abstract
AIMS To get insight into the quality of life of a clinical practice sample of patients with heart failure that are admitted to the hospital. Secondly to determine differences between patients with systolic and diastolic dysfunction and finally to describe factors relating to quality of life. METHODS Three dimensions of quality of life (functional capabilities, symptoms and psychosocial adjustment to illness) were assessed during interviews of 186 patients with chronic heart failure. In addition, data on demographic, clinical and self-care characteristics were collected and patients completed a 6-min walk. RESULTS On average patients walked 172 m in 6 min and reported functioning in daily life at a mean level of 4.5 MET. Patients experienced four different symptoms of heart failure. Most of them described dyspnea, fatigue, sleep disturbance and ankle oedema. Problems with psychosocial adaptation occurred mostly in social and vocational domains. Overall well-being of patients was rated as 6.4 on a 10-point scale. In regard to quality of life, the only differences between patients with systolic and diastolic heart failure was the occurrence of ankle oedema and health-care orientation. The variance in components of quality of life were partly explained by demographics and clinical characteristics. All three dimensions of quality of life were related to ability for self-care. CONCLUSION Patients with heart failure seen in clinical practice are often not comparable to patients described in major clinical trials or patients that are admitted for transplant evaluation. Their functional capabilities are more compromised, but they may have fewer problems with psychosocial adjustment. Patients with normal systolic dysfunction also report a low quality of life. It could be important to enhance self-care abilities of patients to improve psychosocial adaptation to illness.
Collapse
Affiliation(s)
- T Jaarsma
- University of Maastricht, The Netherlands
| | | | | | | | | | | |
Collapse
|
6
|
Jaarsma T, Halfens R, Huijer Abu-Saad H, Dracup K, Gorgels T, van Ree J, Stappers J. Effects of education and support on self-care and resource utilization in patients with heart failure. Eur Heart J 1999; 20:673-82. [PMID: 10208788 DOI: 10.1053/euhj.1998.1341] [Citation(s) in RCA: 229] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS To test the effect of education and support by a nurse on self-care and resource utilization in patients with heart failure. METHODS A total of 179 patients (mean age 73, 58% male, NYHA III-IV) hospitalized with heart failure were evaluated prospectively. Patients were randomized to the study intervention or to 'care as usual'. The supportive educative intervention consisted of intensive, systematic and planned education by a study nurse about the consequences of heart failure in daily life, using a standard nursing care plan developed by the researchers for older patients with heart failure. Education and support took place during the hospital stay and at a home visit within a week of discharge. Data were collected on self-care abilities, self-care behaviour, readmissions, visits to the emergency heart centre and use of other health care resources. RESULTS Education and support from a nurse in a hospital setting and at home significantly increases self-care behaviour in patients with heart failure. Patients from both the intervention and the control group increased their self-care behaviour within 1 month of discharge, but the increase in the intervention group was significantly more after 1 month. Although self-care behaviour in both groups decreased during the following 8 months, the increase from baseline remained statistically significant in the intervention group, but not in the control group. No significant effects on resource utilization were found. CONCLUSIONS Intensive, systematic, tailored and planned education and support by a nurse results in an increase in patients' self-care behaviour. No significant effects were found on use of health care resources. Additional organisational changes, such as longer follow-up and the availability of a heart failure specialist would probably enhance the effects of education and support.
Collapse
Affiliation(s)
- T Jaarsma
- University of Maastricht, Maastricht, The Netherlands
| | | | | | | | | | | | | |
Collapse
|