Hanneke A C van Helvoort

Radboud University Medical Centre (Radboudumc) · Pulmonary Diseases

Background: Many adult patients with asthma have uncontrolled disease and impaired quality of life, despite current asthma-specific drug therapies. Objective: This study aimed to investigate the prevalence of nine traits in asthma patients, their associations with disease control and quality of life, and referral rates to non-medical healthcare...

Muscle weakness is a prominent symptom in post-acute sequelae of COVID-19 (PASC). However, few studies have objectively and longitudinally assessed muscle strength after varying COVID-19 severity grades. This observational study aimed to explore the prevalence, determinants, and 1.5 years change of quadriceps muscle weakness in 98 patients discharg...

Background Self-management is key for reducing the burden of disease in chronical illness. However, applying self-management presupposes behavioral change. Sufficient knowledge, skills, confidence and motivation to make the needed behavior changes are important prerequisites. During the past years the Integral Diagnostic Trajectory was developed fo...

Objective After mild COVID-19, a subgroup of patients reported post–acute-phase sequelae of COVID-19 (PASC), in which exertional dyspnea and perceived exercise intolerance were common. Underlying pathophysiological mechanisms remain incompletely understood. The purpose of this study was to examine outcomes from cardiopulmonary exercise testing (CPE...

Home-based lung function measurements can be used to capture day-to-day variations in symptoms in patients with chronic obstructive pulmonary disease (COPD). Although dynamic hyperinflation (DH) is clinically relevant, existing home-based measurements do not include its assessment. DH can be measured through inspiratory capacity (IC) measurements b...

OBJECTIVE: Asthma is frequently accompanied by dysfunctional breathing of which hyperventilation has been recognized as a subtype. The prevalence of hyperventilation in stable asthma has been scantily studied using blood gas analysis. Hence, a reliable estimate of its prevalence is lacking. It is unknown whether the Nijmegen Questionnaire (NQ) is a...

BACKGROUND The Hexoskin smart shirt (HX) is a shirt measuring continuously and objectively and could be a potential telemonitoring system. OBJECTIVE The main focus is to determine the accuracy of the calibrated HX to measure tidal volumes (TV) in comparison to spirometry (SPIRO) in various tasks. METHODS TV of fifteen healthy subjects were measur...

Background The Hexoskin is a smart shirt that can take continuous and objective measurements and could be part of a potential telemonitoring system. Objective The aim of this study was to determine the accuracy of the calibrated Hexoskin in measuring tidal volumes (TVs) in comparison to spirometry during various tasks. Methods In a cross-sectiona...

Background The endurance shuttle walk test (ESWT) is used to evaluate exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). The recommended pre-intervention tolerated duration (Tlim) is between 3-8 minutes for optimal interpretation of treatment effects. However, this window may be exceeded and factors determining ESWT T...

Background Long-term health sequelae of COVID-19 may be multiple but have thus far not been systematically studied. Methods All patients discharged after COVID-19 from the Radboud university medical centre, Nijmegen, The Netherlands, were consecutively invited to a multidisciplinary outpatient facility. Also, non-admitted patients with mild diseas...

Background Pharmacotherapy is key in asthma control, including preventing lung function decline, in primary care. However, patients' physical functioning (eg, physical capacity [PC] [=can do] and physical activity [PA] [=do do]) correlates poorly with lung function. Therefore, a better insight into the physical function of patients with asthma is n...

Telemonitoring becomes more important in pulmonary research. It can be used to decrease the pressure on the health care system, to lower the costs of health care and to increase quality of life of patients. Previous studies show contradictory results regarding the effectiveness of telemonitoring. According to multiple researchers, inefficiency can...

Home monitoring of patients with chronic obstructive pulmonary disease can increase quality of life and decrease health care costs. Despite the existence of an important relationship between lung hyperinflation (LH) and patient outcomes, LH is often ignored in home monitoring as it difficult to assess at home. A smart shirt containing respiratory i...

Background: A simple technique to measure dynamic hyperinflation (DH) in patients with chronic obstructive pulmonary disease (COPD) is the metronome-paced tachypnea test (MPT). Earlier studies show conflicting results about the accuracy of the MPT compared to cardiopulmonary exercise testing (CPET). Objectives: The focus was to investigate the d...

Background This study aimed to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the well-established benefits of pulmonary rehabilitation (PR) in patients with COPD. Methods 219 patients with COPD (FEV1: 42%±16% predicted) with inspiratory muscle weakness (PImax: 51±15 cm H2O) were randomised into an intervention group...

In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL an...

De zes-minutenlooptest (6MWT) meet de afstand die een patiënt kan lopen in een periode van zes minuten. De 6MWT wordt vaak toegepast bij patiënten met een milde tot ernstige long- of hartaandoening om het effect van medische interventies te evalueren. De test is sensitief voor het vaststellen van verbeteringen na interventie. De test kan ook gebrui...

Bepaling van arteriële bloedgassen speelt een belangrijke rol bij de analyse van stoornissen in het zuur-base-evenwicht, de oxygenatie en de ventilatie. Er wordt in dit hoofdstuk ingegaan op de afnametechniek van arterieel bloed en de mogelijke complicaties daarbij, gevolgd door een overzicht van oorzaken van hypoxemie. De vier primaire stoornissen...

Hyperventilatie is een overmatige alveolaire ventilatie in verhouding tot de CO2-productie op hetzelfde moment. Het gevolg is dat er meer CO2 wordt uitgewassen dan wordt geproduceerd, wat resulteert in een daling van de Pa,co2 (hypocapnie). Er zijn verschillende oorzaken van hyperventileren, grofweg onder te verdelen in somatische en psychische oor...

Statische hyperinflatie is het verschijnsel waarbij een patiënt met een luchtwegobstructie onvoldoende tijd heeft om voldoende uit te ademen. Bij inspanning neemt het probleem van de hyperinflatie verder toe omdat de ademhalingsfrequentie omhoog moet, er minder tijd is om goed uit te ademen en het residuale volume (RV) verder toeneemt. We spreken d...

Meting van statische (of absolute) longvolumes is vooral behulpzaam in het onderscheid tussen restrictieve en obstructieve aandoeningen. We onderscheiden: totale longcapaciteit (TLC), functionele residuale capaciteit (FRC), expiratoir reservevolume (ERV), inspiratoir reservevolume (IRV), (geforceerde) vitale capaciteit ((F)VC), inspiratoire capacit...

Praktische handleiding longfunctietesten Dit boek levert een bijdrage aan het beter begrijpen van de longfunctie, vergroot de fysiologische kennis en helpt bij de interpretatie van de meest uitgevoerde longfunctietesten. Aan de hand van voorbeelden wordt de praktische uitvoering van deze testen/ onderzoeken beschreven. In Praktische handleiding lon...

In this edition of Doing Science, we will address abstract writing, with a focus on conference abstracts. By providing an opportunity for discussing your work with your peers in specialised meetings, writing and submitting an abstract is often the very first step when you want to show the world the results of your work; be it your research, a clin...

the respiratory system is composed of a conducting part and a respiratory part. The conducting airways, i.e., the trachea, bronchi, and bronchioles, differ in architecture. Both trachea and bronchi are surrounded by rings of hyaline cartilage for support, whereas the bronchiolar wall does not

Background: Identification of patients with chronic obstructive pulmonary disease (COPD) who develop dynamic hyperinflation (DH) during activities in daily life (ADL) is important, because of the association between DH and dyspnea and exercise limitation. Objective: We aimed to answer the question whether measurements of DH during metronome-pace...

Inspiratory muscle training (IMT) has been applied during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear if the addition of IMT to a general exercise training programme leads to additional clinically relevant improvements in patients with COPD. In this study, we will investigate w...

- The classification of COPD based only on the presence of airway obstruction fails to provide insight into the burden of the disease, quality of life and prognosis. The severity of symptoms, degree of exercise intolerance and presence of comorbidity are also determinants for classifying the severity of the disease.- COPD starts with abnormalities...

Background: Physical activity and health status deteriorate early in the course of chronic obstructive pulmonary disease (COPD). This can only partially be explained by the degree of airflow limitation. Changes in (resting and dynamic) lung volumes are known to be associated with functional impairments and thus might influence physical activity le...

This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this is assessed by measuring change in inspiratory capacity (IC) du...

Systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) has been related to the development of comorbidities. The level of systemic inflammatory mediators is aggravated as a response to exercise in these patients. The aim of this study was to investigate whether unloading of the respiratory muscles attenuates the inflamm...

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and death worldwide. Although COPD is considered to be a preventable and treatable disease, there are concerns that COPD remains substantially underdiagnosed and undertreated. Even in mild disease, patients suffer from significant impairments in health status, w...

PURPOSE Dynamic hyperinflation (DH), progressive airtrapping during exercise, is related to dyspnea in COPD patients. A subgroup of COPD patients divided over all GOLD stages suffer from dynamic hyperinflation. This study relates automatically extracted measures of airway morphology, airtrapping and emphysema to dynamic hyperinflation. METHOD AND M...

To compare conventional exercise-based assessment of pulmonary rehabilitation (PR) with improvement in training exercises employed during a PR program, and to describe the cardiopulmonary response of different training exercises during PR of patients with chronic obstructive pulmonary disease (COPD). Observational study. Inpatient PR. Patients with...

Uitgebreide longfunctiemeting omvat de aanvullende meting van statische (of absolute) longvolumes. Deze zijn vooral behulpzaam in het onderscheid tussen restrictieve en obstructieve aandoeningen. De belangrijkste volumes zijn de volgende.

Patients with chronic obstructive pulmonary disease (COPD) report more dyspnea during arm than during leg exercise. One of the major causes of dyspnea is dynamic hyperinflation (DH), which is caused by airflow limitation as well as increase in ventilation. The aims of our study were to compare DH at equal ventilation (isoventilation) during arm and...

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are both common diseases with major impact and seem to coexist more frequently than expected from their separate population prevalences. However, estimates of combined prevalence must be interpreted carefully because of imperfections and difficulties in assessment of both diseases....

In contrast to the decline in FEV(1), the behavior of dynamic hyperinflation (DH) over time is unknown in patients with COPD. Metronome-paced hyperventilation (MPH) is a simple applicable surrogate for exercise to detect DH. To evaluate changes in MPH-induced DH during two years follow-up in mild-to-severe COPD patients. Additionally, influence of...

Dyspnoea and diminished functional status are pivotal features of the health status (HS) in chronic obstructive pulmonary disease (COPD). However, it is still not fully understood how pulmonary function tests and cardiopulmonary exercise testing relate to these aspects. This may be due to incomplete assessment and/or deficient definitions of HS. Es...

Patients with COPD are known to be limited in their performance of activities of daily life (ADL). This observational study aims to investigate the ventilatory and metabolic demand of ADL in home settings of patients and evaluate possible mechanisms involved in physiological limitation during ADL in COPD. In their home settings, 21 stable patients...

Inspiratory capacity (IC) assessments have been performed mainly in laboratory settings, because of fixed measurement devices. Oxycon Mobile (OM) is the mobile and wireless version of Oxycon Pro (OP), a commonly used fixed measurement device. The purpose of this study was to examine IC agreement between OM and OP at rest and during steady-state exe...

Uitgebreide longfunctiemeting omvat de aanvullende meting van statische (of absolute) longvolumes. Deze zijn vooral behulpzaam in het onderscheid tussen restrictieve en obstructieve aandoeningen. De belangrijkste volumina zijn de volgende.

Hyperventilatie (HV) staat voor een verhoogde ventilatie – hoger dan voor het metabolisme op dat moment noodzakelijk is. Met andere woorden: te snel en/of te diep ademen. Op zichzelf is dit geen ziekte maar een verstoord adempatroon met meer dan normaal in- en uitademen. Omdat het lichaam daarop niet is ingesteld en zich probeert aan te passen, kan...

Exercise testing can be used (i) to evaluate functional limitations of systemic sclerosis (SSc) and (ii) to study whether the inflammatory and oxidative systems are activated after a physical stimulus. The aim of this study was to determine exercise-induced inflammatory and oxidative responses in SSc compared with healthy subjects. Eleven patients...

One of the contributors to exercise limitation in COPD is dynamic hyperinflation. Although dynamic hyperinflation appears to occur during several exercise protocols in COPD and seems to increase with increasing disease severity, it is unknown whether dynamic hyperinflation occurs at different severity stages according to the Global initiative for c...

Systemic inflammation and oxidative stress are potential mechanisms for muscle wasting in COPD patients. Six-minute walking testing (6MWT) has been suggested as simple and valid exercise test in COPD that is well tolerated, and reflective of activities of daily living. The present study investigated physiologic and systemic immunologic responses to...

Physical exercise is known to induce an acute inflammatory response and oxidative stress in healthy subjects and patients with chronic obstructive pulmonary disease (COPD). Increasing evidence associates systemic inflammation and oxidative stress with muscle wasting and muscle dysfunction in COPD. In the present study, it was hypothesized that exer...

Although oxygen therapy is of clear benefit in patients with severe chronic obstructive pulmonary disease (COPD), recent studies have shown that short-term supplementary oxygen may increase oxidative stress and inflammation within the airways. We investigated whether systemic inflammation and oxidative stress at rest and during exercise in patients...

Chronic obstructive pulmonary disease (COPD) is no longer seen as a pulmonary disease, but is increasingly associated with systemic effects with important clinical relevance. Systemic immunological changes in COPD patients are characterized by an increased number of circulating inflammatory cells, functional changes of the inflammatory cells, eleva...

Systemic inflammation may be present in patients with chronic obstructive pulmonary disease (COPD). Exercise is known to elicit an inflammatory response. We hypothesized that the systemic inflammatory response to exercise might be exaggerated in COPD patients compared to healthy subjects. Sixteen COPD patients and 11 healthy subjects performed a ma...

The application of sandwich-cultured rat hepatocytes for the identification of the hepatic intrinsic clearance of compounds with widely varying extraction ratios was investigated. We previously showed the applicability of this in vitro system, in combination with a model describing molecular diffusion, hepatocyte/medium partition, and nonsaturated...

High concentrations (up to 600 pg/ml) of corticotropin-releasing hormone (CRH) were detected in plasma of the teleost fish Oreochromis mossambicus (tilapia) when screening peripheral tissues of tilapia exposed to stress. Notably, the plasma CRH response to stressors in tilapia is much more pronounced than that in higher vertebrates, such as rats. A...