Face mask use during the COVID-19 pandemic was associated with breathing difficulties in adolescent patients with asthma.

AIM: Face masks have been used to prevent severe acute respiratory syndrome coronavirus-2 transmission. We investigated the impact of face mask use on paediatric patients with asthma. METHODS: Between February 2021 and January 2022, we surveyed adolescents aged 10-17 attending the paediatric outpatient clinic at the Lillebaelt Hospital, Kolding, Denmark with asthma, other breathing problems or no breathing problems. RESULTS: We recruited 408 participants (53.4% girls) with a median age of 14 years: 312 in the asthma group, 37 in the other breathing problems group and 59 in the no breathing problems group. Most participants experienced mask-related breathing impairment. The relative risk (RR) of experiencing severe breathing problems, compared to no problems, was more than four times as high for adolescents with asthma (RR 4.6, 95% CI 1.3-16.8, p = 0.02) than adolescents with no breathing problems. More than a third (35.9%) of the asthma group experienced mild asthma and 3.9% had severe asthma. Girls experienced more mild (RR 1.9, 95% CI 1.2-3.1, p < 0.01) and severe (RR 6.6, 95% CI 3.1-13.8, p < 0.01) symptoms than boys. Age had no effect. Adequate asthma control minimised negative effects. CONCLUSION: Face masks caused significant breathing impairment in most adolescents, particularly in those with asthma.

Seasonal variation in the non-specific effects of BCG vaccination on neonatal mortality: three randomised controlled trials in Guinea-Bissau.

The BCG vaccine protects non-specifically against other diseases than tuberculosis. Three randomised controlled trials of early BCG in Guinea-Bissau found a 38% reduction in all-cause neonatal mortality. Little is known about the underlying mechanisms. In Guinea-Bissau, prevalent infectious diseases display distinct seasonality. Revisiting the three trials (>6500 infants) comparing early BCG versus no early BCG in low weight infants on all-cause neonatal mortality over 12 consecutive years, we explored the seasonal variation in BCG's effect on mortality. In a subgroup of participants, adaptive and innate cytokine responses were measured 4 weeks after randomisation. Consistently over the course of the three trials and 12 years, the effect of BCG on all-cause neonatal mortality was particularly beneficial when administered in November to January, coincident with peaking malaria infections. During these months, BCG was also associated with stronger proinflammatory responses to heterologous challenge. Recent studies have suggested a protective effect of BCG against malaria. BCG may also ameliorate immune-compromising fatal effects of placental malaria in the newborn.

[Two cases of neonatal meningitis after new gentamicin dosing guidelines]. / To tilfaelde af neonatal meningitis efter indførelse af nyt gentamicinregime

Neonates with suspected or proven sepsis are treated with ampicillin and until recently with 5 mg gentamicin/kg every 24 h. New guidelines recommend the same gentamicin dose, but with longer intervals depending on gestational age. Two neonates receiving gentamicin every 48 h improved initially, but both deteriorated again before the second dose. In both infants ampicillin-resistant but gentamicin-sensitive Escherichia coli was found. In one of the infants a resistant/less sensitive E. coli strain was also found in the cerebrospinal fluid. The rationale for the new dosing guidelines is discussed.