Decrease In FVC Research Articles

Comparing the efficacy of cipaglucosidase alfa plus miglustat with other enzyme replacement therapies for late-onset Pompe disease: a network meta-analysis utilizing patient-level and aggregate data.

Aim: Late-onset Pompe disease is characterized by progressive loss of muscular and respiratory function. Until recently, standard of care was enzyme replacement therapy (ERT) with alglucosidase alfa. Second-generation ERTs avalglucosidase alfa (aval) and cipaglucosidase alfa with miglustat (cipa+mig) are now available. Without head-to-head trials comparing aval with cipa+mig, an indirect treatment comparison is informative and timely for understanding potential clinical differentiation. Materials & methods: A systematic literature review was performed to identify relevant studies on cipa+mig and aval. Using patient-level and aggregate published data from randomized controlled trials (RCTs) and phase I/II and open-label extension (OLE) trials, a multi-level network meta-regression was conducted, adjusting for various baseline covariates, including previous ERT duration, to obtain relative effect estimates on 6-minute walk distance (6MWD, meters [m]) and forced vital capacity (FVC, %predicted [pp]). Analyses of two networks were conducted: Network A, including only RCTs, and network B, additionally including single-arm OLE and phase I/II studies. Results: Network B (full evidence analysis) showed that cipa+mig was associated with a relative increase in 6MWD (mean difference 28.93m, 95% credible interval [8.26-50.11m]; Bayesian probability 99.7%) and FVC (2.88pp [1.07-4.71pp]; >99.9%) compared with aval. The comparison between cipa+mig and aval became more favorable for cipa+mig with increasing previous ERT duration for both end points. Analysis of network A showed that cipa+mig was associated with a relative decrease in 6MWD (-10.02m [-23.62 to4.00m]; 91.8%) and FVC (-1.45pp [-3.01 to0.07pp]; 96.8%) compared with aval. Conclusion: Cipa+mig showed a favorable effect versus aval when all available evidence was used in the analysis.

Unveiling the Respiratory Muscle Strength in Duchenne Muscular Dystrophy: The Impact of Nutrition and Thoracic Deformities, Beyond Spirometry.

Duchenne muscular dystrophy (DMD) is the most prevalent progressive muscular dystrophy, and the guidelines recommend the regular assessment of respiratory muscle function. This study aimed to assess the relationship between maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and sniff nasal inspiratory pressure (SNIP) measurements and upright-supine spirometry parameters in children with DMD, the predictability of upright-supine spirometry in terms of diaphragm involvement, and the impact of nutrition on muscle strength. This prospective cross-sectional study examined patients with DMD by comparing upright and supine FVC, MIP, MEP, and SNIP measurements. The effects of the ambulatory status, kyphoscoliosis, chest deformity, and low BMI on respiratory parameters were investigated. Forty-four patients were included in the study. The mean patient age was 10.8 ± 2.9 years. Twenty-five patients were ambulatory. A significant decrease in FVC, FEV1, and FEF25-75 values was detected in the supine position in both ambulatory and non-ambulatory patients (p < 0.05). All patients had low MIP, MEP, and SNIP measurements (less than 60 cm H2O). MIP, MEP, and SNIP values were significantly lower in patients with a low BMI than in those without (p < 0.05). To accurately assess respiratory muscle strength, supine FVC should be combined with upright FVC, MIP, MEP, and SNIP measurements. It is crucial to regularly screen patients for nutrition, as this can significantly affect respiratory muscle function during pulmonology follow-up.

Possibilities for predicting the course of fibrosing interstitial lung diseases based on a comprehensive study of the cardio-respiratory system

Introduction. The problem of predicting the course of fibrosing interstitial lung diseases (FILD) is extremely relevant for the timely initiation of the treatment. Aim. To build a prognostic model based on data from a comprehensive study of the cardiorespiratory system in patients with FILD. Material and methods. The study included a group of 40 patients: 18 men and 22 women (M±S 60±9.7 years old), with verified FILD, who completed a full range of clinical and instrumental studies of the cardiorespiratory system at the time of inclusion in the study and after 12 months of observation. Then the initial group was divided into 2 groups: group A (20 patients), which did not reach the combined point, and group B (20 patients), which reached the combined point after 12 months. The combined point consisted of several outcomes: an increase in the degree of dyspnea on the m-MRC scale to 4 points, a deterioration in the results of the 6-minute walk test ≥50 m, a decrease in FVC or TLC ≥10 %, a decrease in the diffusing capacity of the lung for carbon monoxide (DLСO) ≥15 %, the lung transplantation, a death due to the lung disease. Results. Groups A and B did not have any differences in gender, age (А group (M±S) 57±11.8 y. o.; B group (M±S) 63±7.6 y. o., (p=0.06)), structure of the FILD nosology, the therapy and the frequency of the antifibrotic drug prescription. The hard endpoint at 12 months was achieved in 20 of 40 patients (50 %). Patients who reached the combined point were characterized by initially lower lung volumes (VC(M±S) 2.09±0.56 (p=0.016)); FVC (M±S) 1.99±0.55 (p=0.029)), FEV1 (M±S) 1.67±0.37 (p=0.036)), according to the results of a comprehensive study of the pulmonary function; a higher oxygen desaturation index (ODI (M±S) 5.76±4.48 (p=0.022)) and a more pronounced decrease in nocturnal saturation according to the computer pulse oximetry and the cardiorespiratory monitoring (SpO2 (M±S) 81.01±6.74 (p&lt;0.029)). We developed a prognostic model that included such indicators as: post-bronchodilator MOC 75, TAPSE, VE/VCO2 (VO2 peak), desaturation index and minimum SPO2 % (AUC=0.949). Conclusion. The developed prognostic model for the course of FILD, based on the data from the comprehensive study of the cardiorespiratory system, demonstrated high sensitivity (93.8 %) and specificity (87.5 %).

Efficacy and safety of pirfenidone according to clinical trials

The results of clinical studies on the use of pirfenidone in idiopathic pulmonary fibrosis (IPF) are presented. The purpose of this study was to analyze the effectiveness and safety of pirfenidone in IPF according to clinical studies published in the scientific literature. IPF occupies an important place in the structure of interstitial lung diseases. Currently, IPF is understood as a condition in which there is chronic progressive fibrotic interstitial aseptic pneumonia of unknown etiology, quickly leading to disability and death. The antifibrotic drug pirfenidone has been approved by the EMA and FDA for use in patients with IPF. The clinical efficacy and safety of pirfenidone have been demonstrated in randomized clinical trials. When using pirfenidone, there were 47.9 % fewer patients with an absolute decrease in FVC ≥10 % or who died, and 132.5 % more patients with no decrease in FVC (p &lt;0.001). In addition, the pirfenidone group had significantly better 6-minute walk test scores (p=0.04) and significantly improved progression-free survival (p&lt;0.001). Long-term use of pirfenidone (up to 72 weeks) significantly reduced the rate of decline in FVC, prevented a reduction in distance traveled in the 6-minute walk test, and increased the time until signs of disease progression appeared compared with placebo. Pirfenidone demonstrated a good safety profile; in most cases, adverse effects were mild, disappeared when the drug dose was reduced, and had no adverse long-term consequences. As a result of a generalized analysis of adverse events recorded in the CAPACITY, ASCEND, and RECAP studies, it was found that long-term (maximum duration was 9.9 years) treatment with pirfenidone was accompanied by nausea in 37.6 % of cases, diarrhea in 28.1 %, dyspepsia — in 18.4 %, vomiting — in 15.9 %, and skin rashes — in 25.0 %.

Exercise capacity following SARS-CoV-2 infection is related to changes in cardiovascular and lung function in military personnel

BackgroundSince the COVID-19 pandemic, post-COVID syndrome (persistent symptoms/complications lasting >12 weeks) continues to pose medical and economic challenges. In military personnel, where optimal fitness is crucial, prolonged limitations affecting their ability to perform duties has occupational and psychological implications, impacting deployability and retention. Research investigating post-COVID syndrome exercise capacity and cardiopulmonary effects in military personnel is limited. MethodsUK military personnel were recruited from the Defence Medical Services COVID-19 Recovery Service. Participants were separated into healthy controls without prior SARS-CoV-2 infection (group one), and participants with prolonged symptoms (>12 weeks) after mild-moderate (community-treated) and severe (hospitalised) COVID-19 illness (group 2 and 3, respectively). Participants underwent cardiac magnetic resonance imaging (CMR) and spectroscopy, echocardiography, pulmonary function testing and cardiopulmonary exercise testing (CPET). Results113 participants were recruited. When compared in ordered groups (one to three), CPET showed stepwise decreases in peak work, work at VT1 and VO2 max (all p < 0.01). There were stepwise decreases in FVC (p = 0.002), FEV1 (p = 0.005), TLC (p = 0.002), VA (p < 0.001), and DLCO (p < 0.002), and a stepwise increase in A-a gradient (p < 0.001). CMR showed stepwise decreases in LV/RV volumes, stroke volumes and LV mass (LVEDVi/RVEDVi p < 0.001; LVSV p = 0.003; RVSV p = 0.001; LV mass index p = 0.049). ConclusionIn an active military population, post-COVID syndrome is linked to subclinical changes in maximal exercise capacity. Alongside disease specific changes, many of these findings share the phenotype of deconditioning following prolonged illness or bedrest. Partitioning of the relative contribution of pathological changes from COVID-19 and deconditioning is challenging in post-COVID syndrome recovery.

Joint association of air pollution exposure and inflammation-related proteins in relation to infant lung function

Background and aimSystemic inflammation is one potential mechanism underlying negative impact of air pollution on lung function. Levels of inflammation-related proteins have the potential to characterize infants’ susceptibility to air pollution induced lung function impairment. This study aimed to examine the interplay between air pollution exposure and inflammation-related proteins on lung function in 6-months-old infants. MethodsIn the EMIL birth cohort from Stockholm (n = 82), dynamic spirometry, along with measurement of plasma levels of 92 systemic inflammation-related proteins (Olink Proseek Multiplex Inflammation panel) have been carried out in infants aged six months. Time-weighted average exposure to particles with an aerodynamic diameter of <10 μm (PM10), <2.5 μm (PM2.5), and nitrogen dioxide (NO2) at residential addresses from birth and onwards was estimated via validated dispersion models. To characterize the abnormality of inflammation-related protein profile, for each protein in each infant, we calculated the relative deviance of the protein level from age- and sex-specific median in terms of its age- and sex-specific interquartile range (IQR), followed by computing the absolute value of the smallest relative deviance, “minimum absolute deviance”. Using linear regression models, interaction of air pollution and the abnormal inflammatory profile on lung function was estimated on the additive scale. ResultsWe found joint association of PM exposure and an abnormal inflammatory protein profile in relation to FEV0.5 and FVC. For 0.1 unit increase in minimum absolute deviance, one IQR increase in PM10 was associated with 85.9 ml (95% CI: −122.9, −48.9) additional decrease in FEV0.5, and 72.3 ml (95% CI: −121.5, −23.2) additional decrease in FVC. Similar results were obtained with PM2.5 exposure, while less apparent for NO2. ConclusionsEarly life air pollution exposure and abnormal inflammation-related protein profiles may interact synergistically towards lower lung function in infants.

Evaluation of diaphragm functions with diaphragm ultrasound and pulmonary function tests in individuals with Friedreich's ataxia.

It is known that the correlation of pulmonary function tests (PFT) with muscle dysfunction is insufficient. Here, we aimed to evaluate the diaphragm functions in individuals with Friedreich's ataxia (FRDA) and to examine its relationship with respiratory parameters and disease severity. This prospective study, conducted between November and December 2022, at Erciyes University, included 14 individuals with genetically confirmed FRDA and an age- and gender-matched healthy control group of eight individuals. We examined pulmonary functions with spirometric methods and evaluated diaphragm excursion, and diaphragm thickness-expiratory (Tde) and - end of inspiration (Tdi) with ultrasonography during calm breathing. Thickening fraction (TF) calculated. Also, we examined PaCO2 at rest. The neurological status of individuals was assessed using the Scale for the Assessment and Rating of Ataxia (SARA). The mean values of FEV1(lt), FEV1(%), FVC (lt), and FVC (%) were higher in the control group (p; <0.001, 0.013, <0.001, and 0.009, respectively). Also, mean Tdi, Tde, excursion and TF were lower in the FRDA group compared to the control group (p = 0.005, 0.294,0.005, and 0.019, respectively). The mean excursion value was 1.13 ± 0.54cm in the FRDA group and 1.71 ± 0.49cm in the control group. There is a strong, negative, and statistically significant correlation between SARA total score with excursion and TF (r = -0.7432, p = 0.002; r = -0.697, p = 0.008). There is no statistically significant relationship between excursion and BMI, standing-to-supine decrease in FVC, FEV1, and PaCO2. Also, the relationship between maximal inspiratory pressure (PImax) and excursion was moderate. Diaphragm ultrasound may reveal respiratory dysfunction better than PFT. Diaphragm excursion and TF are associated with disease scores in individuals with FDRA. Further studies are needed regarding the detection of alveolar hypoventilation.

Post-Infection Oscillometry and Pulmonary Metrics in SARS-CoV-2 Patients: A 40-Day Follow-Up Study.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had significant impacts on pulmonary function. This study aimed to comprehensively evaluate pulmonary function and structure in patients 40 days post-SARS-CoV-2 infection, employing an array of testing methodologies including spirometry, plethysmography, forced oscillometry, and CT scanning. It also sought to establish potential correlations between these metrics and evaluate if forced oscillometry could provide additional value in post-infective lung function assessment. A 40-day post-infection follow-up observational study was conducted involving 66 patients with confirmed SARS-CoV-2 infection. The results revealed decreases in FVC and FEF25-75 with the increasing severity of COVID-19. Specifically, patients with severe symptoms exhibited statistically significant decreases in FVC (mean = 86.8) compared with those with mild symptoms (mean = 106.0; p = 0.018). The FEF25-75 showed a similar trend, with severe patients exhibiting a mean of 77.7 compared with 82.9 in the mild group (p = 0.017). Furthermore, resonant frequency (RF) increased with disease severity, with the severe group exhibiting a statistically significant increase (mean = 17.4) compared with the mild group (mean = 14.3; p = 0.042). CT scans showed an increase in ground-glass opacities with disease severity, with 81.8% of severe patients demonstrating this finding (p = 0.037). Multiple regression analysis revealed that Reactance at 4 Hz (X4), Forced Expiratory Flow 25-75% (FEF25-75), and Resonant Frequency (RF) were significantly related to COVID-19 severity. Specifically, for each unit increase in these factors, the risk of the event was estimated to increase by a factor of 3.16, 2.09, and 1.90, respectively. Conversely, Resistance at 4 Hz (R4) and Airway Resistance (RAW) were found to significantly decrease the event hazard, highlighting their potential protective role. Spirometry, plethysmography, and forced oscillometry are effective in assessing these changes. Forced oscillometry may be particularly beneficial in identifying subtle changes in lung function post-COVID-19. Further studies are warranted to validate these findings and develop strategies to manage post-infective pulmonary changes in SARS-CoV-2 patients.

Blood multiple heavy metals exposure and lung function in young adults: A prospective Cohort study in China

The content of single heavy metal in blood is associated with lung function decline, but there is little evidence on the joint effect of multiple heavy metals on lung function. To explore whether heavy metal mixture exposure is associated with lung function reduction among young adults. The study based on a cohort of 518 students recruited from a college in Shandong, China. We measured their lung function and blood heavy metal concentrations. The BKMR model was used to analyse the association between blood heavy metals mixture levels and lung function, and to identify the critical single heavy metal which contributes most to joint effects. As the sensitivity analysis, we used quantile g-computation model and GLM to explore the joint effect and independent effects of heavy metals. Our findings revealed a significant reduction of FVC and FEV1 levels after exposure to heavy metals mixture. An IQR increase in Cu was associated with a 0.079 L and 0.083 L decrease in FEV1 and FVC, respectively. And an IQR increase in Fe was associated with 0.036 L higher FEV1 and 0.033 L higher FVC. For adults, reducing blood heavy metals concentration might be an effective intervention to protect lung function.

Organophosphate esters, airway inflammation, and lung function among U.S. participants: A nationally representative cross-sectional study from NHANES, 2011–2012

BackgroundHuman beings are widespread exposed to organophosphate esters (OPEs), but little is known about their effects on respiratory health. ObjectivesTo investigate the associations of exposure to OPEs with lung function and airway inflammation among U.S. participants from NHANES, 2011–2012. MethodsA total of 1636 participants aged 6–79 years were included. Concentrations of OPE metabolites were measured in urine and lung function was assessed with spirometry. Fractional exhaled nitric oxide (FeNO) and blood eosinophils (B-Eos), two important inflammatory biomarkers, were also measured. Linear regression was performed to examine the relationships of OPEs with FeNO, B-Eos and lung function. Bayesian kernel machine regression (BKMR) was used to evaluate the joint associations between OPEs mixtures and lung function. ResultsThree of seven OPE metabolites had detection frequencies > 80 %, including diphenyl phosphate (DPHP), bis (1,3-dichloro-2-propyl) phosphate (BDCPP), bis-2-chloroethyl phosphate (BCEP). A 10-fold increase in DPHP concentrations were associated with 1.02 mL decreases in FEV1 (β = −0.01, 95 % CIs = −0.02, −0.003) and FVC (β = −0.01, 95 % CIs = −0.02, −0.003), respectively, and the similar, modest decreases were seen for BDCPP. For each 10-fold increase in BCEP concentration, FVC was also reduced by 1.02 mL (β = −0.01, 95 % CIs = −0.02, −0.002). Moreover, the negative associations were only found in non-smokers aged >35 years. The aforementioned associations were confirmed by BKMR, but we cannot definitively identify a constituent driving this association. B-Eos was negatively associated with FEV1 and FEV1/FVC, but not with OPEs. No associations were found of FeNO with OPEs and lung function. ConclusionsExposure to OPEs was associated with modest decrements in lung function, although the observed decrease in FVC and FEV1 is unlikely to be of real clinical relevance for the majority of subjects in this series. Moreover, those associations presented age and smoking status-dependent pattern. Unexpectedly, the adverse effect was not mediated by FeNO/B-Eos.

PULMONARY FUNCTION CHANGES IN SANITARY WORKERS OF KANCHIPURAM POPULATION

Objectives: The main objective of this study is to evaluate the respiratory function of sanitary workers as they are most exposed to environmental air pollutants. Methods: The study was done among sanitary workers of Kanchipuram Municipality, Tamil Nadu, with 190 subjects, who were divided into two groups such as Group I and Group II. Group I with 96 sanitary workers and Group II with 94 as the control group with age- and morphometric-matched subjects. The subjects involved are both gender with the age group between 20 and 60 years. Various functional parameters, namely FVC, FEV1, FVC/ FEV1, FEF 25%, FEF50%, and FEF75%, were done using RMS Helios 3.1.37 in the Physiology Department, Meenakshi Medical College and Research Institute. Institutional Ethical Committee approval was obtained from Institutional Human Ethical Committee. Results: The pulmonary findings showed a significant decrease in FVC, FEV1, FVC/FEV1, FEF 25%, FEF50%, and FEF75% when compared to the control group. Conclusion: The sanitary workers showed a significant decrease in the pulmonary function tests as they were exposed to a variety of solid waste particles which might have caused inflammatory and immunological responses with the small and large airways of the respiratory tract.

The effect of deep tissue massage on respiratory parameters in healthy subjects—A non-randomised pilot study

BackgroundDeep tissue massage (DTM), based on deep palpation and elimination of fascia restrictions, can reduce symptoms resulting from fascial disorders. The goal of this study was the analysis of the DTM effect on respiratory parameters in healthy people. Material and methodsThe study involved a group of 40 people divided into two subgroups. The experimental group underwent a single DTM session. Classic massage was performed in the control group. Before and after treatment the chest circumference and oxygen saturation were measured and a spirometry test was performed. ResultsThe chest expandability significantly increased in both groups with greater effect in DTM group. Vital capacity and saturation, significantly increased in the experimental group. No significant changes in dynamic parameters were noticed in the control group, while FVC slightly decreased in the experimental group. ConclusionsIn this study, deep tissue massage appeared to improve chest expendability and vital capacity with simultaneous decrease of FVC in healthy subjects. Further studies are needed to specify the effect of DTM on the respiratory system.

Effect of Club cell secretory proteins on the association of tobacco smoke and PAH co-exposure with lung function decline: A longitudinal observation of Chinese coke oven workers.

Exposure to polycyclic aromatic hydrocarbons (PAH) and tobacco smoke is associated with epithelial damage and reduced lung function. Club cell secretory protein (CC16) is a known biomarker for lung epithelial cells. However, the potential relationships between PAH and tobacco smoke exposure, CC16 levels, and reduced lung function remain unclear. This longitudinal study aimed to explore the potential role of CC16 in the association of tobacco smoke and PAH co-exposure with lung function. We enrolled 313 workers from a coking plant in China in 2014 and followed them up in 2019. The concentrations of PAH and nicotine metabolites in urine were determined using high-performance liquid chromatography (HPLC) with a fluorescence detector and HPLC-tandem mass spectrometry, respectively. The plasma CC16 concentration was determined using an enzyme-linked immunosorbent assay. An analysis of the generalized estimating equation showed that each 1-unit increase in log-transformation of the last tertile of trans-3'-hydroxycotinine (3HC) was associated with a 3.30ng/ml decrease in CC16. Restricted cubic spline analysis revealed a significant nonlinear dose-effect association between cotinine (COT) and CC16 (Pnonlinear=0.018). In the low- CC16 subgroup, we found a significant association between total nicotine metabolites and forced vital capacity (FVC%) (β: 1.45, 95% CI: 2.87, -0.03), and the associations of nicotine (NIC), COT, and 3HC with FVC% were all of marginal significance. High levels of total hydroxyl polycyclic aromatic hydrocarbons (ΣOH-PAH) and NIC in the urine had an interactive effect on the decline of CC16 (P<0.05). Cross-lagged panel analysis indicated that the decrease in CC16 preceded the decrease in FVC%. CC16 mediated the association between elevated nicotine metabolites and decreased FVC% in the low- CC16 subgroup. CC16 plays an essential role in the association of PAH and tobacco smoke exposure with reduced lung function. Coke oven workers with low plasma CC16 levels are more likely to experience decreased lung function after tobacco smoke exposure.

Cross-sectional and Longitudinal Associations Between Propylene Oxide Exposure and Lung Function Among Chinese Community Residents: Roles of Oxidative DNA Damage, Lipid Peroxidation, and Protein Carbonylation

Toxicologic studies have reported propylene oxide (PO) exposure may harm the respiratory system, but the association between PO exposure and lung function and potential mechanism remains unclear. What is the association between PO exposure and lung function and potential mediating mechanism? Urinary PO metabolite [N-Acetyl-S-(2-hydroxypropyl)-L-cysteine (2HPMA)] as PO internal exposure biomarker and lung function were measured for 3,692 community residents at baseline and repeated at 3-year follow up. Cross-sectional and longitudinal associations between urinary 2HPMA and lung function were assessed by linear mixed model. Urinary 8-hydroxy-deoxyguanosine, urinary 8-iso-prostaglandin-F2α, and plasma protein carbonyls as biomarkers of oxidative DNA damage, lipid peroxidation, and protein carbonylation, respectively, were measured for all participants to explore their potential roles in 2HPMA-associated lung function decline by mediation analysis. After adjustment for potential covariates, each threefold increase in urinary 2HPMA was cross sectionally associated with a 26.18mL (95%CI,-50.55 to-1.81) and a 21.83mL (95%CI,-42.71 to-0.95) decrease in FVC and FEV1, respectively, at baseline (all P< .05). After 3 years of follow up, 2HPMA was observed to be longitudinally associated with FEV1/FVC decline. No significant interaction effect of smoking or passive smoking was observed (Pinteraction > .05), and the associations between 2HPMA and lung function indexes were persistent among participants who were not smoking and those who were not passive smoking in both baseline and follow-up evaluations. We observed urinary 8-hydroxy-deoxyguanosine partially mediated the associations of 2HPMA with FVC (mediation proportion, 5.48%) and FEV1 (mediation proportion, 6.81%), and plasma protein carbonyl partially mediated the association between 2HPMA and FEV1 (mediation proportion, 3.44%). PO exposure was associated with lung function decline among community residents, and oxidative DNA damage and protein carbonylation partially mediated PO exposure-associated lung function decline. Further attention on respiratory damage caused by PO exposure is warranted.

Personal exposure to household air pollution and lung function in rural Bangladesh: A population-based cross-sectional study

ABSTRACT We assessed whether personal exposure to household air pollution [PM2.5 and black carbon (BC)] is associated with lung functions (FEV1, FVC, and their ratio) in non-smoking adults in rural Bangladesh. We measured personal exposure to PM2.5 using gravimetric analysis of PM2.5 mass and BC by reflectance measurement between April 2016 and June 2019. The average 24-hour PM2.5 and BC concentration was 141.0μgm−3 and 13.8μgm−3 for females, and 91.7 μgm−3 and 10.1 μgm−3 for males, respectively. A 1 μgm−3 increase in PM2.5 resulted in a 0.02 ml reduction in FEV1, 0.43 ml reduction in FVC, and 0.004% reduction in FEV1/FVC. We also found a similar inverse relationship between BC and lung functions (9.6 ml decrease in FEV1 and 18.5 ml decrease in FVC per 1μgm−3 increase in BC). A higher proportion of non-smoking biomass fuel users (50.1% of the females and 46.7% of the males) had restrictive patterns of lung function abnormalities, which need further exploration.

Variation Of Fev1 Andfvc With Body Mass Index In Healthy Individuals

Background:The association between body mass index and lung function have been established mainly on obese individuals but however very few studies have been done in people with normal BMI or overweight group.Objective:The study is aimed to find out the association between body mass index and lung functions in non-asthmatics healthy individuals. The study data reveals the variation of FEV1 and FVC in normal healthy subjects with respect to increase in the BMI.Methodology: Sixty individuals who were healthy without any respiratory illness were selected. Their anthropometric measurements were taken. They were grouped into Group I with BMI 18.5 - 20, Group II with BMI 20 – 25, Group III with BMI 25 – 30 and Group IV with BMI &gt;30. Their FVC and FEV1 was determined using Medispiror. The variation in FEV1 and FVC was compared with respect to BMI using appropriate statistical method.Result:The results showed that there was a decrease in the FEV1 and FVC as there is increase in the BMI. However, the decrease in FVC was relatively more than the decrease in FEV.This study shows that the decrease in the FVC is responsible for the dyspnoea as the BMI increases. Conclusion: It also demonstrates that obese individuals are at a lower risk of airflow obstruction, which means that asthma might be over diagnosed in the obese population.

Progressive Disease With Low Survival in Adult Patients With Pulmonary Fibrosis Carrying Surfactant-Related Gene Mutations: An Observational Study

In some patients with progressive fibrosing interstitial lung disease (ILD), disease is caused by carriage of a mutation in a surfactant-related gene (SRG) such as SFTPC, SFTPA2, or ABCA3. However, no aggregated data on disease evolution and treatment outcome have been presented for these patients. In adult patients with ILD with an SRG mutation, what is the course of lung function after diagnosis and during treatment and the survival in comparison with patients with sporadic idiopathic pulmonary fibrosis (sIPF) and familial pulmonary fibrosis (FPF)? We retrospectively examined the clinical course of a cohort of adults with an SRG mutation by screening 48 patients from 20 families with an SRG mutation for availability of clinical follow-up data. For comparison, 248 patients with FPF and 575 patients with sIPF were included. Twenty-three patients with ILD (median age: 45 years; 11 men) with an SRG mutation fulfilled criteria. At diagnosis, patients with an SRG mutation were younger and less often male, but had lower FVC (72%predicted) and diffusing capacity of the lungs for carbon monoxide (46%predicted) compared with patients with FPF or sIPF. In the SRG mutation group, median FVC decline 6months after diagnosis was -40mL and median transplant-free survival was 44months and not different from patients with FPF or sIPF. FVC course was not different among the three cohorts; however, a significantly larger decrease in FVC was found while patients received immunomodulatory or antifibrotic treatment compared with those receiving no treatment. Subsequent analysis in the SRG group showed that patients with a surfactant mutation (n= 7) treated for 6months with antifibrotic drugs showed stable lung function with a median change in FVC of+40mL (interquartile range, -40 to 90mL), whereas patients with an SRG mutation treated with immunomodulatory drugs showed a variable response dependent on the gene involved. This study showed that patients with ILD carrying an SRG mutation experience progressive loss of lung function with severely reduced survival despite possible beneficial effects of treatment.

Development of a screening protocol to identify persons who are responsive to wood smoke particle-induced airway inflammation with pilot assessment of GSTM1 genotype and asthma status as response modifiers

Background We are currently screening human volunteers to determine their sputum polymorphonuclear neutrophil (PMN) response 6- and 24-hours following initiation of exposure to wood smoke particles (WSP). Inflammatory responders (≥10% increase in %PMN) are identified for their subsequent participation in mitigation studies against WSP-induced airways inflammation. In this report we compared responder status (N = 52) at both 6 and 24 hr time points to refine/expand its classification, assessed the impact of the GSTM1 genotype, asthma status and sex on responder status, and explored whether sputum soluble phase markers of inflammation correlate with PMN responsiveness to WSP. Results Six-hour responders tended to be 24-hour responders and vice versa, but 24-hour responders also had significantly increased IL-1beta, IL-6, IL-8 at 24 hours post WSP exposure. The GSTM1 null genotype significantly (p < 0.05) enhanced the %PMN response by 24% in the 24-hour responders and not at all in the 6 hours responders. Asthma status enhanced the 24 hour %PMN response in the 6- and 24-hour responders. In the entire cohort (not stratified by responder status), we found a significant, but very small decrease in FVC and systolic blood pressure immediately following WSP exposure and sputum %PMNs were significantly increased and associated with sputum inflammatory markers (IL-1beta, IL-6, IL-8, and PMN/mg) at 24 but not 6 hours post exposure. Blood endpoints in the entire cohort showed a significant increase in %PMN and PMN/mg at 6 but not 24 hours. Sex had no effect on %PMN response. Conclusions The 24-hour time point was more informative than the 6-hour time point in optimally and expansively defining airway inflammatory responsiveness to WSP exposure. GSTM1 and asthma status are significant effect modifiers of this response. These study design and subject parameters should be considered before enrolling volunteers for proof-of-concept WSP mitigation studies.

The impact of segmentectomy versus lobectomy on pulmonary function in patients with non-small-cell lung cancer: a meta-analysis

ObjectiveSegmentectomy has been reported as an alternative to lobectomy for small-sized NSCLC without detriment to survival. The long-term benefits of segmentectomy over lobectomy on pulmonary function have not been firmly established. This meta-analysis aims to compare postoperative changes in pulmonary function in NSCLC patients undergoing segmentectomy or lobectomy.MethodsMedline, Embase, Web of Science and Scopus were searched through March 2021. Statistical comparisons were made when appropriate.ResultsFourteen studies (2412 participants) out of 324 citations were included in this study. All selected studies were high quality, as indicated by the Newcastle–Ottawa scale for assessing the risk of bias. Clinical outcomes were compared between segmentectomy and lobectomy. ΔFEV1 [10 studies, P < 0.01, WMD = 0.40 (0.29, 0.51)], ΔFVC [4 studies, P < 0.01, WMD = 0.16 (0.07, 0.24)], ΔFVC% [4 studies, P < 0.01, WMD = 4.05 (2.32, 5.79)], ΔFEV1/FVC [2 studies, P < 0.01, WMD = 1.99 (0.90, 3.08)], and ΔDLCO [3 studies, P < 0.01, WMD = 1.30 (0.69, 1.90)] were significantly lower in the segmentectomy group than in the lobectomy group. Subgroup analysis showed that in stage IA patients, the ΔFEV1% [3 studies, P < 0.01, WMD = 0.26 (0.07, 0.46)] was significantly lower in the segmentectomy group. The ΔDLCO% and ΔMVV% were incomparable.ConclusionSegmentectomy preserves more lung function than lobectomy. There were significantly smaller decreases in FEV1, FVC, FVC%, FEV1/FVC and DLCO in the segmentectomy group than in the lobectomy group.

The effectiveness of rehabilitation of patients after covid pneumonia with osteopathic methods

Introduction. The new coronavirus infection (COVID-19) pandemic has affected the lives of many people. Any infectious and infl ammatory process in the lungs can lead to adverse consequences for the whole organism. The pathological process affecting the respiratory structures of the lungs, bronchi leads to disruption of various links of the external respiration system; therefore, timely effective rehabilitation for such patients can improve the quality of life, reduce the period of temporary disability, and most importantly, restore the function of external respiration.The aim was to prove the effectiveness of the osteopathic methods application in the rehabilitation of patients after coronavirus pneumonia.Materials and methods. On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO2), pulse oximetry was performed. Rehabilitation included in the main group osteopathic correction (2 procedures), breathing exercises (4 procedures) and chest massage (4 procedures); in the control group there were breathing exercises (4 procedures) and chest massage (4 procedures). The rehabilitation course lasted 14 days. For the statistical analysis of the obtained data the Statistica-10 software package was used.Results. The studies revealed a pronounced change in the function of external respiration in patients who had undergone coronavirus pneumonia. According to the results of spirometry, more than 90 % of patients showed a statistically signifi cant (p=0.006) decrease in VC compared to the physiological norm — both in the main group (VC down to 80.7 %) and in the control group (VC down to 87.6 %), as well as a signifi cant (p=0.0001) decrease in FVC to 77.7 % in the main group and to 79.1 % in the control group. After rehabilitation, patients in the main group showed a statistically signifi cant improvement in the function of external respiration, manifested in an increase in VC by 12.3 % (p&lt;0.0001), FVC by 12.1 %. In patients in the control group (without osteopathic correction), after the rehabilitation, the main indicators of the function of external respiration also improved, but the changes were not statistically signifi cant. As a result of rehabilitation, the patients of the main group showed a statistically signifi cant SpO2 increasing (from 96.6±0.2 to 97.5±0.2 %, p=0.0013); in the control group, there was also a positive dynamics of these indicators, but the changes were not statistically signifi cant.Conclusion. The results of the study allow to conclude that the inclusion of osteopathic correction methods in the rehabilitation of patients after coronavirus pneumonia has a positive effect on their state, improves the external respiration function indicators — VC and FVC, and also increases the SpO2. The obtained results allow to recommend the inclusion of osteopathic methods in the rehabilitation programs for patients who have undergone coronavirus infection.