Asthma is the most common respiratory disease. It has multiple phenotypes thatcan be partially differentiated by measuring the disease’s specific characteristics—biomarkers. The pathogenetic mechanisms are complex, and it is still a challenge to choose suitable biomarkers to adequately stratify patients, which became especially important with the introduction of biologicals in asthma treatment. Usage of biomarkers and an understanding of the underlying pathobiological mechanisms lead to the definition of endotypes. Asthma can be broadly divided into two endotypes, T2-high and T2-low. The right combination of various biomarkers in different phenotypes is under investigation, hoping to help researchers and clinicians in better disease evaluation since theindividual approach and personalized medicine are imperative. Multiple biomarkers are superior to a single biomarker.

Introduction: Lung function testing is an irreplaceable tool in assessing adult cystic fibrosis (CF) patients, and spirometry is still the gold standard. Aims and objectives: The aim of this study was to evaluate the correlation of forced oscillation technique (FOT) in adults on CF transmembrane conductance regulator modulator therapies, and to investigate the impact of P. aeruginosa colonisation on selected lung function parameters. Methods: We included 55 patients with genetically confirmed CF in regular check-ups at our Center in this retrospective study. Spirometry and FOT (ResmonTM Pro) were performed, along with sputum analysis for P. aeruginosa. Statistical analyses were conducted in MedCalc version 20.011. Measured FOT parameters were respiratory resistance (Rrs), reactance (Xrs), resonant frequency (Fres) and area of reactance (AX). Spearman correlation was used to elucidate relationship between FOT and spirometry, and Mann-Whitney U test to evaluate the impact of P. aeruginosa colonization on lung function. P<0.05 was considered statistically significant. Results: The median age of participants was 25.5 ± 5.4617 years, most were female (29;53.7%), 70% were homozygous for F508del, and mostly had normal lung function measured with spirometry (35; 64%). A statistically significant moderate correlation was observed between FOT parameters (AX, Fres, Rinsp, Rexp at 5Hz), and selected spirometric values (FEV1, FVC, FEF25-75). Fres in P. aeruginosa colonized patients was higher compared to non-colonized patients (p 0.01), as well as AX (p 0.037). Conclusion: Forced oscillation technique is a valuable additional tool in the assessment process of adult cystic fibrosis patients.

Background/Objectives: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. Methods: In this retrospective study, we investigate the incidence and characteristics of tremor in kidney transplant patients and analyze its occurrence with respect to a multitude of demographic and clinical parameters, thereby aiming to confirm the role of calcineurin inhibitor-induced neurotoxicity and to identify other putative predictive factors. Furthermore, we characterize post-transplant tremor with the goal of identifying its clinical features and determining the impact on quality of life. Results: A total of 129 kidney transplant recipients were screened; six patients were excluded due to a history of movement disorders prior to kidney transplantation. In total, 123 patients were included in the final analysis—69 male (56%) and 54 female patients (44%), with a median age of 50. A total of 36% (46 patients) developed tremor in the post-transplant period. Using both univariable and multivariable analyses, we found that female sex and tacrolimus use were independently associated with the development of post-transplant tremor. In addition, multivariable analysis identified an association between younger age and post-transplant tremor. Furthermore, we observed a trend in the duration of symptoms in relation to the calcineurin inhibitor choice. Conclusions: Despite a relatively high prevalence (36%), post-transplant tremor does not significantly impact the QoL and spontaneously resolves within 1 year in adult kidney transplant recipients. Female sex and tacrolimus were identified as independent predictors of post-transplant tremor in renal transplant recipients.

Background: The cough variant asthma (CVA) is characterized by non-specific symptoms and normal spirometric values, which makes diagnosis challenging. To diagnose CVA it is necessary to document airway hyperreactivity (AHR). The aim of our study was to evaluate the diagnostic value of body plethysmography in the assessment of AHR by methacholine challenge test (MCT). Methods: In CVA-suspected patients, a bronchodilation test (BDT), MCT with spirometry, and body plethysmography were performed. MCT was considered positive if there was a 20% decrease in forced expiratory volume in 1 second from the baseline value (PC20FEV1) or a 40% reduction in specific conductance (PC40sGaw) after inhaling methacholine concentration < 8 mg/mL. Sensitivity and specificity were generated for different cut off points of sGaw (PC40sGaw, PC45sGaw, PC50sGaw). Anti-asthma treatment was started for those with proven AHR. The diagnosis of asthma was made after one year of follow-up based on response to treatment. Results: AHR was diagnosed in 83.5% (91/109) of patients by either BDT, PC20FEV1, or PC40sGaw. After one year of follow-up asthma was confirmed in 76 patients. The sensitivity of BDT, PC20FEV1, and PC40sGaw was 25%, 64%, and 97%, respectively. The specificity of BDT, PC20FEV1 and PC40sGaw was 94%, 88%, and 67%, respectively. The sensitivity for PC45sGaw and PC50sGaw was 88% and 63%, and the specificity was 82% and 91%, respectively. Conclusions: Body plethysmography is a valuable tool in the assessment of AHR in CVA, with the best sensitivity-to-specificity ratio for PC45sGaw.

Background/Objectives: Cough variant asthma (CVA) is characterized by nonspecific symptoms and normal spirometric values, which makes diagnosis challenging. To diagnose CVA it is necessary to document airway hyperreactivity (AHR). The aim of our study was to evaluate the diagnostic value of body plethysmography in the assessment of AHR using the methacholine challenge test (MCT). Methods: In CVA-suspected patients, a bronchodilation test (BDT), an MCT with spirometry, and body plethysmography were performed. The MCT was considered positive if there was a 20% decrease in forced expiratory volume in 1 s from the baseline value (PC₂₀FEV₁) or a 40% reduction in specific conductance (PC₄₀sGaw) after inhaling methacholine of concentration < 8 mg/mL. Sensitivity and specificity were generated for different cut off points of sGaw (PC₄₀sGaw, PC₄₅sGaw, PC₅₀sGaw). Anti-asthma treatment was started for those with proven AHR. The diagnosis of asthma was made after one year of follow-up based on the response to treatment. Results: AHR was diagnosed in 83.5% (91/109) of patients by either a BDT, PC₂₀FEV₁, or PC₄₀sGaw. After one year of follow-up, asthma was confirmed in 76 patients. The sensitivities of the BDT, PC₂₀FEV₁, and PC₄₀sGaw were 25%, 64%, and 97%, respectively. The specificities of the BDT, PC₂₀FEV₁ and PC₄₀sGaw were 94%, 88%, and 67%, respectively. The sensitivities for a PC₄₅sGaw and PC₅₀sGaw were 88% and 63%, and the specificities were 82% and 91%, respectively. Conclusions: Body plethysmography is a valuable tool in the assessment of AHR in CVA, with the best sensitivity-to-specificity ratio found at a PC₄₅sGaw.