Monitoring asthma in children.

The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma. 22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus. This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised. Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.

European consensus statement on leptospirosis in dogs and cats.

Leptospirosis is a zoonotic disease with a worldwide distribution affecting most mammalian species. Clinical leptospirosis is common in dogs but appears to be rare in cats. Both dogs and cats, however, can shed leptospires in the urine. This is problematic as it can lead to exposure of humans. The control of leptospirosis, therefore, is important not only from an animal but also from a public health perspective. The aim of this consensus statement is to raise awareness of leptospirosis and to outline the current knowledge on the epidemiology, clinical features, diagnostic tools, prevention and treatment measures relevant to canine and feline leptospirosis in Europe.

Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013.

Bacterial infections are very common and represent one of the most important reasons of progression of liver failure, development of liver-related complications, and mortality in patients with cirrhosis. In fact, bacterial infections may be a triggering factor for the occurrence of gastrointestinal bleeding, hypervolemic hyponatremia, hepatic encephalopathy, kidney failure, and development of acute-on-chronic liver failure. Moreover, infections are a very common cause of repeated hospitalizations, impaired health-related quality of life, and increased healthcare costs in cirrhosis. Bacterial infections develop as a consequence of immune dysfunction that occurs progressively during the course of cirrhosis. In a significant proportion of patients, infections are caused by gram-negative bacteria from intestinal origin, yet gram-positive bacteria are a frequent cause of infection, particularly in hospitalized patients. In recent years, infections caused by multidrug-resistant bacteria are becoming an important clinical problem in many countries. The reduction of the negative clinical impact of infections in patients with cirrhosis may be achieved by a combination of prophylactic measures, such as administration of antibiotics, to reduce the occurrence of infections in high-risk groups together with early identification and management of infection once it has developed. Investigation on the mechanisms of altered gut microflora, translocation of bacteria, and immune dysfunction may help develop more effective and safe methods of prevention compared to those that are currently available. Moreover, research on biomarkers of early infection may be useful in early diagnosis and treatment of infections. The current manuscript reports an in-depth review and a position statement on bacterial infections in cirrhosis.

GOCE: precise orbit determination for the entire mission

The Gravity field and steady-state Ocean Circulation Explorer (GOCE) was the first Earth explorer core mission of the European Space Agency. It was launched on March 17, 2009 into a Sun-synchronous dusk-dawn orbit and re-entered into the Earth’s atmosphere on November 11, 2013. The satellite altitude was between 255 and 225 km for the measurement phases. The European GOCE Gravity consortium is responsible for the Level 1b to Level 2 data processing in the frame of the GOCE High-level processing facility (HPF). The Precise Science Orbit (PSO) is one Level 2 product, which was produced under the responsibility of the Astronomical Institute of the University of Bern within the HPF. This PSO product has been continuously delivered during the entire mission. Regular checks guaranteed a high consistency and quality of the orbits. A correlation between solar activity, GPS data availability and quality of the orbits was found. The accuracy of the kinematic orbit primarily suffers from this. Improvements in modeling the range corrections at the retro-reflector array for the SLR measurements were made and implemented in the independent SLR validation for the GOCE PSO products. The satellite laser ranging (SLR) validation finally states an orbit accuracy of 2.42 cm for the kinematic and 1.84 cm for the reduced-dynamic orbits over the entire mission. The common-mode accelerations from the GOCE gradiometer were not used for the official PSO product, but in addition to the operational HPF work a study was performed to investigate to which extent common-mode accelerations improve the reduced-dynamic orbit determination results. The accelerometer data may be used to derive realistic constraints for the empirical accelerations estimated for the reduced-dynamic orbit determination, which already improves the orbit quality. On top of that the accelerometer data may further improve the orbit quality if realistic constraints and state-of-the-art background models such as gravity field and ocean tide models are used for the reduced-dynamic orbit determination.

Rapport sur une mission en Angleterre

par Arsène Darmesteter

Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit.

Chronic obstructive pulmonary disease (COPD), lung cancer, asthma and pulmonary tuberculosis are common pulmonary diseases that are caused or worsened by tobacco smoking. Growing observational evidence suggests that symptoms and prognosis of these conditions improve upon smoking cessation. Despite increasing numbers of (small) randomised controlled trials suggesting intensive smoking cessation treatments work in people with pulmonary diseases many patients are not given specific advice on the benefits or referred for intensive cessation treatments and, therefore, continue smoking. This is a qualitative review regarding smoking cessation in patients with COPD and other pulmonary disorders, written by a group of European Respiratory Society experts. We describe the epidemiological links between smoking and pulmonary disorders, the evidence for benefits of stopping smoking, how best to assess tobacco dependence and what interventions currently work best to help pulmonary patients quit. Finally, we describe characteristics and management of any "hardcore" smoker who finds it difficult to quit with standard approaches.

GOCE precise orbit determination for the entire Mission – challenges in the final mission phase

The Gravity field and steady-state Ocean Circulation Explorer (GOCE), ESA’s first Earth Explorer core mission, was launched on March 17, 2009 into a sunsynchronous dusk-dawn orbit and eventually re-entered into the Earth’s atmosphere on November 11, 2013. A precise science orbit (PSO) product was provided by the GOCE High-level Processing Facility (HPF) from the GPS high-low Satellite-to-Satellite Tracking (hl-SST) data from the beginning until the very last days of the mission. We recapitulate the PSO procedure and refer to the results achieved until the official end of the GOCE mission on October 21, 2013, where independent validations with Satellite Laser ranging (SLR) measurements confirmed a high quality of the PSO product of about 2 cm 1-D RMS. We then focus on the period after the official end of the mission, where orbits could still be determined thanks to the continuously running GPS receivers delivering high quality data until a few hours before the re-entry into the Earth’s atmosphere. We address the challenges encountered for orbit determination during these last days and report on adaptions in the PSO procedure to also obtain good orbit results at the unprecedented low orbital altitudes below 224 km.

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax.

Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required.

Strengthening the Reporting of Observational Studies in Epidemiology for respondent-driven sampling studies: "STROBE-RDS" statement.

OBJECTIVES Respondent-driven sampling (RDS) is a new data collection methodology used to estimate characteristics of hard-to-reach groups, such as the HIV prevalence in drug users. Many national public health systems and international organizations rely on RDS data. However, RDS reporting quality and available reporting guidelines are inadequate. We carried out a systematic review of RDS studies and present Strengthening the Reporting of Observational Studies in Epidemiology for RDS Studies (STROBE-RDS), a checklist of essential items to present in RDS publications, justified by an explanation and elaboration document. STUDY DESIGN AND SETTING We searched the MEDLINE (1970-2013), EMBASE (1974-2013), and Global Health (1910-2013) databases to assess the number and geographical distribution of published RDS studies. STROBE-RDS was developed based on STROBE guidelines, following Guidance for Developers of Health Research Reporting Guidelines. RESULTS RDS has been used in over 460 studies from 69 countries, including the USA (151 studies), China (70), and India (32). STROBE-RDS includes modifications to 12 of the 22 items on the STROBE checklist. The two key areas that required modification concerned the selection of participants and statistical analysis of the sample. CONCLUSION STROBE-RDS seeks to enhance the transparency and utility of research using RDS. If widely adopted, STROBE-RDS should improve global infectious diseases public health decision making.