Breathing Function Research Articles

Effect of feeding in elevated side-lying and paced bottle feeding on swallow-breathe coordination in healthy preterm infants - First results.

Preterm infants face challenges in their suck-swallow-breathe coordination leading to an increased risk of aspiration. Key components of the swallowing process are present around 34 to 35weeks postmenstrual age (PMA), but preterm infants fatigue early affecting timing, quality and efficiency in swallowing and prolonging breathing pauses. Feeding strategies need to address these specific challenges in suck-swallow-breathe coordination. To objectively measure the effect of positioning and applying "paced bottle feeding" on swallowing and breathing function in preterm infants. Two separate groups of each 20 preterm infants were measured during a single bottle feed at the age of 34 to 35weeks PMA using a noninvasive measuring device combining bioimpedance, surface electromyography as well as a breathing belt. In the first study (S1) feeding in elevated side-lying was compared to elevated supine position for 2min each. In the second study (S2) 2min of paced bottle feeding was compared to 2min without paced bottle feeding. (S1): Feeding in elevated side-lying led to significantly fewer episodes of choking and coughing, significantly shorter breathing pauses and significantly less variation in swallowing movements than in elevated supine. Pharyngeal closure was significantly greater in supine at the start of the feed. (S2): The application of paced bottle feeding significantly reduced the length of breathing pauses. Feeding in elevated side-lying position and applying paced bottle feeding may support improved swallow-breathe coordination in healthy preterm infants at 34 to 35weeks PMA.

Amplification of the therapeutic potential of AMPA receptor potentiators from the nootropic era to today.

α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic receptors (AMPA receptors or AMPARs) are involved in fast excitatory neurotransmission and as such control multiple important physiological processes. AMPARs also are involved in the dynamics of synaptic plasticity in the nervous system where they impact neuroplastic responses such as long-term facilitation and long-term potentiation that regulate biological functions ranging from breathing to cognition. AMPARs also regulate neurotrophic factors that are strategically involved in neural plastic changes in the nervous system. As with other major ionotropic receptors, modulation of AMPARs can have prominent effects on biological systems that can include marked tolerability issues. AMPAR potentiators (AMPAkines) are positive allosteric modulators of AMPARs which have clear therapeutic potential. Medicinal chemistry combined with new pharmacological findings have defined AMPAkines with favorable oral bioavailability and pharmacological safety parameters that enable clinical advancement of their therapeutic utility. AMPAkines are being investigated in patients with diverse neurological and psychiatric disorders including spinal cord injury (breathing and bladder function), cognition, attention-deficit-hyperactivity disorder, and major depressive disorder. The present discussion of this class of compounds focuses on their general value as therapeutics through their impact on synaptic plasticity.

Strategi Prone Position Dan Breathing Exercise Dalam Menurunkan Sesak Napas Pada Pasien Pneumonia

Pneumonia is a significant health threat as it is frequently listed among the top ten leading causes of death. Some reports even indicate that pneumonia is the third leading cause of death after tuberculosis (TB). Common symptoms of pneumonia include cough and shortness of breath. To address the issue of shortness of breath in pneumonia patients, one solution is the application of prone positioning and breathing exercises. Objective: To describe the application of prone positioning and breathing exercises in reducing shortness of breath in pneumonia patients. Method: This descriptive case study included two respondents selected through purposive sampling. The criteria included patients diagnosed with pneumonia, aged 20-60 years, with a clear consciousness, hospitalized for at least three days, experiencing mild to moderate respiratory dysfunction, and without severe complications. Nursing care and the interventions of prone positioning and breathing exercises were conducted over three days. Results: After three days of nursing interventions, patient 1's respiratory rate decreased from 28 breaths per minute to 24 breaths per minute, with SpO2 reaching 98%. The patient felt relaxed and did not report shortness of breath. In patient 2, the respiratory rate decreased from 26 breaths per minute to 20 breaths per minute, with SpO2 also reaching 98%. The patient also felt relaxed and did not report shortness of breath. Conclusion: The application of prone positioning and breathing exercises can improve respiratory rates and reduce shortness of breath in pneumonia patients. This is because these interventions help enhance breathing, oxygen saturation, and lung function, thereby reducing the degree

Navigating adulthood: Exploring the transition needs of adolescents and young adults affected by Duchenne or Becker muscular dystrophy.

For individuals with Duchenne or Becker muscular dystrophy (DMD and BMD, respectively), transitioning to adulthood presents significant challenges. Although considerable attention has been given to facilitating medical transitions due to the complexity of these conditions, less focus has been placed on other aspects of the transition, such as achieving independence. This study assessed the transition needs of people with DMD or BMD, exploring various domains including health, education, employment, living arrangements, transportation, daily activities, and independent personal life. Men with DMD or BMD participated in this cross-sectional study. Transition to adulthood was assessed using Transition Readiness Assessment for Young Adults with DMD. The questionnaire evaluates transitions in health care, education and employment, housing and transportation, activities of daily living, and independent life and autonomy. Factors associated with and predicting transition to adulthood were evaluated using Spearman's correlations and multiple regression analysis. Forty-two people with DMD or BMD (mean age: 24.3±5.3) participated in this study. The transition domains in which most participants needed help were education and employment (52.5%) and activities of daily living (57.0%). Transition needs that stood out included palliative care (66.6%), employment and education support (76.1%), social worker consultation for housing assistance (76.1%), and assistive device consultation (64.2%). Mobility and breathing function did not correlate with transition level. Number of siblings positively correlated with and predicted most transition domains. Older age predicted only education and employment status. In conclusion, the analysis showed that the most problematic transition domains among people with DMD or BMD were activities of daily living and education and employment. In most transition domains, help needed did not decrease with age and was not affected by function. However, adolescents and adults with more siblings typically reported being more ready to transit to adult life.

Strengthening educational support systems through breathing and art therapy: Impacts on college students’ well-being

Background: The prevalence of anxiety among college students is a growing global concern, with a median prevalence of 32%. This study addresses the need for effective interventions within an educational policy framework to alleviate anxiety and promote mental health among college students. Objective: The study aims to evaluate the impact of breathing relaxation exercises and tactile art therapy on college students’ self-understanding and psychological well-being, providing reference information for policies and practices in mental health education. Methods: We enrolled 10 college students from X University in South Korea, dividing them into an experimental group and a control group. The experimental group underwent 10 sessions of breathing exercises and tactile art therapy, while the control group received standard psychological counseling. Pre- and post-tests assessed breathing function, self-understanding, and psychological well-being. Results: The experimental group demonstrated significant improvements in breathing function, particularly in forced vital capacity (FVC), and in psychological well-being, as measured by the Psychological Well-Being Scale (PWBS). Sub-factors such as safety, goal orientation, and self-acceptance within self-understanding, self-acceptance, positive relationships, purpose in life, and environmental mastery within psychological well-being, showed notable enhancements. In contrast, the control group did not show significant effects in terms of FVC and FEV1（p > 0.05）, and there were no statistically significant differences in the various sub-factors of self-understanding and psychological well-being. Conclusion: The study demonstrates that integrating breathing relaxation exercises and tactile art therapy into educational policy can significantly reduce anxiety and enhance the psychological well-being of college students. These findings suggest that such interventions can be effective components of a comprehensive educational policy aimed at improving student mental health.

Sickle Lung Disease Long-Term Consequences and Prevention.

Sickle cell disease (SCD) is of global significance due to its severity and occurrence worldwide. Inheritance of the abnormal hemoglobin structure contributes to microvascular events that underlie the development of the multi-systemic complications seen in the disease pathogenesis. Pulmonary complications are common and heterogeneous including pulmonary hypertension, sleep-disordered breathing and lung function abnormalities. Lung function abnormalities commonly reported among children with SCD living in Africa are restrictive impairments. However, in high-income countries, reports suggest that obstructive lung function impairment is more predominant. The exact process that contributes to lung disease in SCD must be continuously explored and large-scale longitudinal studies employing multiple lung function methods are needed urgently. Lung disease-modifying agents need to be explored to help slow down or prevent the occurrence of pulmonary function abnormalities.

Brainstem C1 neurons mediate heart failure decompensation and mortality during acute salt loading.

Heart failure (HF) is an emerging epidemic worldwide. Despite advances in treatment, the morbidity and mortality rate of HF remain high, and the global prevalence continues to rise. Common clinical features of HF include cardiac sympathoexcitation, disordered breathing, and kidney dysfunction; kidney dysfunction strongly contributes to sodium retention and fluid overload, leading to poor outcomes of HF patients. We have previously shown that brainstem pre-sympathetic neurons (C1) from the rostral ventrolateral medulla (RVLM) play a key role in sympathetic regulation in experimental models of HF. However, the role of RVLM-C1 neurons during salt-loading in the context of HF is unknown. This study tests whether RVLM C1 neurons drive cardiorespiratory decompensation and ultimately lead to sudden death in HF rats. Adult male Sprague-Dawley rats underwent arteriovenous shunt to induce HF with preserved ejection fraction (HFpEF). Two weeks after HFpEF induction, bilateral selective ablation of RVLM C1 neurons was performed using anti-dopamine β-hydroxylase-saporin toxin. Animals were then fed a high Na+ diet (3% Na+ in food and 2% Na+ in water) for 3 weeks to induce compensated-to-decompensated HF state transition. Echocardiography, cardiac autonomic function, breathing function, and survival were assessed during the progression of HF. Salt loading resulted in marked decompensation in HF rats, as evidenced by a significant decrease in survival rates (survival: 10% vs. 100% HFpEF + Na+ vs. HFpEF). Furthermore, HFpEF + Na+ animals showed a further increase in cardiac sympathetic drive and more severe disordered breathing, including higher hypoxia-related epochs (i.e. apnoeas/hypopnoeas), compared with HF. Ablation of RVLM C1 neurons partly reduced the excessive cardiac sympathoexcitation during salt loading in HF, improved the exaggerated disordered breathing in HFpEF+ Na+ rats, and reduced decompensation-linked mortality. We found that hypoxia, but not high sodium, was the major contributor to impaired calcium handling in isolated adult cardiomyocytes. Our results strongly suggest that RVLM C1 neurons contribute to acute HF decompensation during salt loading by a mechanism encompassing further increases in sympathetic outflow and hypoxia-related breathing disorders. This mechanism may ultimately impact cardiac contractility through cardiomyocyte calcium mishandling, increasing morbidity and mortality.

THE SEVERITY OF THE COURSE, RATHER THAN IMPAIRED EXTERNAL RESPIRATORY FUNCTION, DETERMINES THE OUTCOME OF COPD TREATMENT

The prevalence of bronchopulmonary diseases resulting from protracted exposure to risk factors is on the rise, with these diseases now representing a primary cause of mortality on a global scale. According to the World Health Organization (WHO), 5% of deaths occur in individuals diagnosed with severe chronic obstructive pulmonary disease. The study aims to correlate the assessment of quality of life, severity of the course, and spirometry data in patients with chronic obstructive pulmonary disease (COPD). Mateials and methods: 23 patients of the control group, 23 patients with COPD II, 11 patients with COPD III, and group E took part in the study in real conditions. All patients underwent assessment of the function of external respiration, assessment of quality of life by SF-36, SGRQ questionnaires, severity of dyspnoea and severity of symptoms - mMRC and SBP test, BODE index and predicted survival for 4 years were calculated. Results. The BODE index score shows a high score in both test groups with the recommended GOLD 2024 treatment, comparing the predicted 4-year survival with the treatment of patients with stage II and III COPD, group E analyzed that patients with a diagnosis of stage II COPD who received the recommended treatment according to GOLD2024 had a higher predicted survival than those who did not. Moderate and high correlations were found between SGRQ, SF-36, and mMRC scores, BODE index, mMRC, and 4-year prognostic survival. The assessment of the treatment received by patients with COPD stage III, group E directly interacts with the assessment of dyspnoea severity. Conclusion: the correlation analysis showed the need for an integrated approach to assessing quality of life, disease severity, dyspnoea, and symptoms. For further classification of patients, special attention should be paid to the problem of joint assessment of dyspnoea severity and COPD symptom components.

Cardiopulmonary interactions in patients with juvenile idiopathic arthritis

Background. In patients with rheumatic diseases, the formation of cardiopulmonary continuum has been described, which includes chronic obstructive pulmonary disease in combination with various characteristic lesions of the cardiovascular system: chronic heart failure, especially right ventricular, ischaemic heart disease, arterial hypertension. It has been proven that a decrease in forced expiratory volume is a powerful predictor of an increased risk of cardiovascular diseases and premature death, regardless of age and other factors. Studies of the function of external respiration in paediatric patients with RD using spirometry showed that in a quarter (24.8%) there is a decrease and the formation of respiratory failure of the restrictive type. Purpose to establish the features of the relationships between morphofunctional disorders of the cardiovascular system and lungs in children with juvenile idiopathic arthritis (JIA), and to identify possible factors contributing to their formation. Materials and methods. 54 children with JIA (oligoarticular variant 12 patients, polyarticular 42 children) aged 10–18 (13.42 ± 0.22) years were examined. The control group consisted of 41 practically healthy children. To determine lung function, spirometry was performed. To determine the morphofunctional parameters of the heart, ultrasound was performed in the «M» and «B» modes. Assessment of tolerance to minimal physical activity and its impact on the state of the CVS in children, a six-minute walk test (MWT) was performed. Results. Іn children with JIA, against the background of reduced forced expiratory volume on the first second and forced vital capacity of the lungs, the Tiffno index was above 90%, which indicates a restrictive type of lung function disorders in this category of children. This parameter was highest in patients with II degree of activity of the JIA, which emphasizes the importance of the degree of activity of JIA in the formation of comorbid conditions. In patients with JIA, there is a significant increase in both diastolic and systolic sizes and volumes of the right ventricle. At the same time, its stroke volume also increases, and the ejection fraction is significantly lower. Against the background of these changes, a decrease in tolerance to minimal physical activity was established, as indicated by a significantly smaller distance covered in 6 minutes during the MWT. Conclusions. Рatients with JIA have a decrease in functional lung capacity indicators of the restrictive type. This occurs against the background of an increase in structural and volumetric indicators of the right ventricle of the heart with a parallel decrease in its pumping function, as well as a decrease in tolerance to minimal physical activity.

Asthma and COVID-19 in Children

The article is devoted to a review of scientific publications that describe the impact and long-term outcomes of COVID-19 on bronchial asthma (BA) in children. The COVID-19 pandemic has sparked debate in the scientific community. After the declaration of the COVID-19 pandemic many countries implemented public health measures aimed at limiting the spread of SARS-CoV-2, which also affected the prevalence of other respiratory viruses with similar transmission ways. It is known that during the period of COVID-19 the frequency of visits to the doctor of the children with BA has decreased significantly. A decrease in the level of hospitalizations due to exacerbation of BA in 2020–2022 was also determined. However, the results of studies by different authors regarding the relationship between BA and hospitalization among children with COVID-19 are controversial. The main reasons for reducing the frequency of asthma exacerbations and improving the control of the course of the disease during the period of COVID-19 are associated with a decrease allergens’ influence, an increase in adherence to treatment, and a decrease in the risk of other respiratory viral infections. However, after the quarantine restrictions were lifted, an increased frequency of hospitalizations and deterioration of disease control due to an increased number of exacerbations of asthma was determined. The COVID-19 epidemic has been a significant stimulus for the development of telemedicine, but there is no substitute for person visits for physical examinations and certain tests that are critical in BA. The results of some studies did not show changes in external respiratory function data during the examination of children after COVID-19. However, changes in spirometry data and the need to change treatment were observed in some patients with asthma, indicating that SARS-CoV-2, like other respiratory viruses, may impair asthma control. To date, the long-term outcomes of COVID-19 in children and adolescents remain insufficiently studied and characterized. The current literature presents several compelling risk factors for the development of persistent COVID-19 in the pediatric population. Unfortunately, to date there is no clear data on the impact of SARS-CoV-2 on the course of BA in children. Therefore, further research into the long-term outcomes of the coronavirus infection in children with BA is critically important.

Seizures and premature death in mice with targeted Kv1.1 deficiency in corticolimbic circuits.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related death, likely stemming from seizure activity disrupting vital brain centres controlling heart and breathing function. However, understanding of SUDEP's anatomical basis and mechanisms remains limited, hampering risk evaluation and prevention strategies. Prior studies using a neuron-specific Kcna1 conditional knockout mouse model of SUDEP identified the primary importance of brain-driven mechanisms contributing to sudden death and cardiorespiratory dysregulation; yet, the underlying neurocircuits have not been identified. Using the Emx1-Cre driver, we generated a new conditional knockout mouse model lacking Kcna1 in excitatory neurons of the cortex, hippocampus, amygdala and select vagal afferents. To test whether the absence of Kv1.1 in forebrain corticolimbic circuits is sufficient to induce spontaneous seizures, premature mortality and cardiorespiratory dysfunction, we performed survival studies and EEG, ECG, and plethysmography (EEG-ECG-Pleth) recordings. We demonstrate premature death and epilepsy in corticolimbic conditional knockout mice. During monitoring, we fortuitously captured one SUDEP event, which showed a generalized tonic-clonic seizure that initiated respiratory dysfunction culminating in cardiorespiratory failure. In addition, we observed that cardiorespiratory abnormalities are common during non-fatal seizures in conditional knockout mice, but mostly absent during interictal periods, implying ictal, not interictal, cardiorespiratory impairment as a more reliable indicator of SUDEP risk. These results point to corticolimbic excitatory neurons as critical neural substrates in SUDEP and affirm seizure-related respiratory and cardiac failure as a likely cause of death.

Bronchopulmonary pathology among egg poultry workers

Introduction. Poultry farming is one of the leading branches of agriculture, whose workers work under the influence of various factors that have a sensitizing, fibrogenic and toxic effect on the respiratory system. Materials and methods. As part of a cross-sectional study, the incidence of diseases of the respiratory system, medical and social factors of life, and the state of the respiratory system in one hundred thirty five egg poultry workers were studied. A hygienic assessment of the factors of the working environment and the labour process was carried out. The results of the study were statistically processed using the Statistica 10 software. Results. The air condition of the working area at the enterprise under study was established to meet sanitary and hygienic requirements. A high incidence of chronic bronchitis and a significant prevalence of respiratory dysfunction in egg poultry workers have been detected. With an increase in work experience, there is a decrease in the indices of external respiratory function and an increase in the level of allergic mood of the body of employees of the main occupationso. The use of smoking tobacco products is not a priority risk factor in the formation of diseases in workers of the main poultry farming occupations. Taking into account the results obtained it is planned to continue research on the study of working conditions that are risk factors for violations of the state of the respiratory system in egg poultry workers and the mechanism of their formation. Limitations. The study has regional (Saratov region) and occupational (poultry farm workers) limitations. Conclusion. The concentration of the dust in the air of the working area in workers in the main occupations of egg poultry does not exceed acceptable values. At the same time, a high incidence of chronic bronchitis was revealed, as well as a significant prevalence of respiratory dysfunction in workers, which is associated with an increase in occupational experience. The results of the assessment of the state of the respiratory system determine the expediency of studying modern working conditions in egg poultry workers and their influence on the formtation of bronchopulmonary pathology.

Assessment of Nasal Breathing Function and Tip Definition after the Implementation of the Cephalic Lateral Crural Advancement Flap Technique.

Cephalic trimming of the lower lateral cartilage (LLC) can result in the collapse of the internal and external nasal valves, pinched nose, and alar retraction. The cephalic lateral crural advancement flap (CLCAF) technique is introduced as a method to prevent these complications by avoiding grafts in the LLC. A retrospective study was conducted on 126 open-approach rhinoplasties (82 female and 44 male) employing the CLCAF technique between January 2021 and March 2022. Preoperatively, 20 patients exhibited collapse of the internal nasal valve. CLCAF was performed in all patients following cephalic incision, leaving 7 to 8 mm horizontally and caudally of LLC, and preserving the scroll ligament. The CLCAF was advanced onto the lateral crura to reinforce it and tension the scroll ligament. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess the technique. The average postoperative follow-up period was 14 months. Overall, 114 patients (90.5%) experienced improved nasal breathing on the NOSE scale, and the overall NOSE score significantly decreased from a mean of 30.4 to 14.0 (p < 0.001). A statistically significant reduction in NOSE scores was observed in groups with moderate, severe, and extreme obstruction (p < 0.001), with greater improvement seen in the patients with more severe preoperative nasal breathing obstruction. Postintervention, no patient exhibited collapse of the internal valve, and all patients with preoperative collapse of the internal nasal valve showed an increase of at least 40 points in the NOSE scale. Two patients required revision due to tip asymmetry related to CLCAF. Pinched nose or alar retraction was not observed postoperatively in any patient. The implementation of CLCAF, combined with other techniques, enhances nasal breathing function, prevents the collapse of the internal nasal valve, and leads to optimal nasal tip definition, resulting in a better-shaped and functioning nose.

Adverse reactions in the treatment of patients with non-tuberculous lung mycobacterial pulmonary disease and the possibility of their solution

To study the adverse reactions that develop as a result of complex antibiotic therapy in patients with non-tuberculous lung mycobacterial (NTML) and to determine methods for their elimination without compromising the effectiveness of NTML treatment. Examined 147 patients with confirmed NTML, for which they received treatment in accordance with the results of drug susceptibility of the pathogen. Before and during treatment, a study of clinical, biochemical blood tests, urinalysis, electrocardiogram, external respiration function, ultrasound of the abdominal organs and kidneys was performed. Under the conditions of antimicrobial therapy (AMT) for non-tuberculous mycobacteriosis of the lungs, 41 (27.9%) patients developed adverse drug reaction (ADR). The most frequent adverse reactions were: allergic reactions in the form of urticaria, nausea, vomiting, arthralgia, nephro- and ototoxic reactions; 34 (82.9%) patients required treatment adjustment without discontinuation of AMT, and only in 7 (17.1%) cases, AMT was discontinued. A full course of multicomponent AMT was completed in 124 (84.4%) patients with NTML. An algorithm for monitoring therapy in NTML patients from the standpoint of preventing ADR has been developed. The categories of patients with potential risks of developing ADR under AMT were determined. Patients without the development of ADR had a positive radiological dynamics in 27.9% of cases, sputum conversion - in 42%. Patients with ADR had positive clinical dynamics in 39% of cases, radiological - in 31.7% of cases, sputum conversion - in 36.6% of cases. The incidence of ADR development remains high when complex AMT is administered to patients with NTML. The patient's comorbid background is the main risk factor for the development of ADR when prescribing multicomponent AMT. A multivariate analysis of the effectiveness of treatment in NTML patients showed comparable data among patients taking complex AMT and receiving only alternative therapies. The success of NTML treatment depends on a comprehensive personalized approach.

Assessment of Human External Respiration Parameters in Simulated Lunar Gravity and Microgravity

The paper presents main results of experiments devoted to studying the influence of simulated microgravity and lunar gravity on the function of external respiration in humans. It has been shown that influence of human exposure to head-down bed rest (a model of the physiological effects of microgravity) and head-up bed rest (a model of the physiological effects of lunar gravity), similar to the influence of a horizontal position (bed rest), leads to a clinically insignificant decrease in the main respiratory parameters in the first hours of these analogue ground-based investigations. Subsequently, during hypokinesia, the marked changes are gradually levelled out. After cessation of experimental exposures, parameters of external respiration function are at the level of background values.

Influence of intestinal permeability and endotoxinemia on the course of asthma in obese patients

Objective. To study the characteristics of asthma with a severe course in obese patients and to evaluate the relationship of the level of intestinal endotoxin (ET) and fecal zonulin with clinical, laboratory and instrumental indicators in such patients. Materials and methods. The study included 98 patients with asthma combined with obesity (group 1 – mild asthma (n = 47), group 2 – severe asthma (n = 51)) and 45 obese patients without asthma composed the comparison group. A complete standard examination and tests were conducted in all the patients. Intestinal ET, fecal zonulin, TNF-a, IFN-g, IL-4, 6, 10, 17, total IgE levels were assessed as well. The IBM SPSS Statistics 26.0 application software package was used for statistical calculations. The results were considered as statistically significant at the level of p 0,05. Results. In patients of both groups, the average age of onset was 43 years. The median duration of BA characteristics was higher in patients of group 2: 14 [10; 19] years (p = 0.013). In all groups, CRPhs values increased significantly and the highest ones were in patients with severe asthma (p 0.001). Significantly lower levels of FVC, FEV1, FEV1/FVC, IL-10 (p0.001) with uncontrolled course of asthma (p = 0.008) and rare control (p = 0.009) occurred in patients of group 2. Higher levels of TNF-a, IFN-g, IL-6,17, intestinal ET, fecal zonulin were revealed in patients of group 2 (p≤0.001). The level of fecal zonulin positively correlated with the level of intestinal ET in patients of group 2 (p0.001, rs=0.813). In patients of group 2 direct correlations of the fecal zonulin and intestinal ET with BMI, WC, HC, WC/HC, lack of BA control, CRPhs, TNF-a, IL-6,17, IFN-g, LDL were established and inverse correlations were with IL-10, HDL, FEV1, AST; a negative correlation of fecal zonulin levels with FVC was also revealed. Conclusions. The obtained results allow us to speak about the existence of a clinical complex “severe asthma – obesity – intestinal endotoxemia and increased intestinal permeability” which is characterized by the predominance of pro-inflammatory markers, increased levels of intestinal ET and fecal zonulin, reduced function of external breathing.

Efficacy of acute intermittent hypoxia in improving the motor and respiratory functions of individuals with spinal cord injury: a systematic review of randomised controlled trials

Background/Aims Spinal cord injury affects individuals’ mobility, balance and respiratory functions. Acute intermittent hypoxia is a novel intervention that is reported to have positive effects on neuroplasticity and synaptic transmission in individuals with spinal cord injury, which may result in positive effects on motor functions of individuals with spinal cord injury. The aim of this systematic review was to examine the evidence of the safety and efficacy of acute intermittent hypoxia on spinal plasticity, walking performance, balance, breathing function and hand use in individuals with spinal cord injury. Methods Five databases were searched from inception until 7 February 2024 for randomised trials investigating the effects of acute intermittent hypoxia on motor functions in spinal cord injuries. After checking the retrieved trials against the eligibility criteria, a risk of bias assessment using the Risk of Bias 2.0 tool was conducted by two authors independently. In addition, data extraction was conducted by two authors independently, which included the study design, participants’ characteristics, intervention characteristics, outcome measures and results. Results The systematic search retrieved 1120 records, of which only 11 studies were included in the analysis. Nine of the included studies were randomised crossover trials, while two were randomised controlled trials. Acute intermittent hypoxia may have a significant effect on walking performance (ie speed and endurance, ankle strength, dynamic balance, hand strength and function, breathing functions and corticospinal function), but not on intralimb motor coordination, static balance and muscle activity. Conclusions Despite the high risk of bias, small sample sizes, high heterogeneity and inconsistency of the results across the included studies, acute intermittent hypoxia may be a valuable intervention in addressing spinal cord injury motor deficiencies. Larger and well-designed randomised controlled trials are required to reach a definitive conclusion regarding its efficacy. Implications for practice Acute intermittent hypoxia could be considered with caution for inclusion in the management plan for individuals with spinal cord injuries who are aiming for immediate and short-term motor improvement.

Why do pacifiers/dummies have a protective effect in sudden infant death Syndrome? A new hypothesis

The American Academy of Pediatrics recommends pacifier/dummy use to help prevent sudden infant death syndrome (SIDS). This recommendation is based on studies that have shown pacifier use reduces the risk of SIDS even under conditions regarded as increasing the risk of SIDS. Several unrelated mechanistic explanations have been used to explain this. These prior suggested mechanisms purported to underly the observed protective effect of pacifiers have not proven satisfactory and highlight the need for a more plausible explanation. Pacifier use is associated with increased salivary production. Saliva contains numerous antibacterial compounds that could provide a protective effect against bacterial colonisation. Infection is considered a key player in SIDS pathogenesis given that most SIDS risk factors relate to or align with infection, whereas mainstream research focusses on central homeostatic control of breathing, arousal and heart function. These, however, lack association with risk factors. Given infection is significant in the SIDS story, the increased production and antibacterial effect of saliva could provide an alternative mechanism worthy of consideration in the context of known preventable risk factors in the drive to reach a better understanding of SIDS pathogenesis and further decrease the incidence of SIDS.

Extending the horizon in cardiovascular risk prediction: A synergy of conventional predictors and spirometry data

Aim. To assess a correlation between conventional cardiovascular risk factors and unprovoked pulmonary volumes and flows.Material and methods. The subjects (n = 153, median age 43 [32; 51] years) were divided into two groups depending on age. Questionnaires, anthropometry, biochemical blood analysis, spirometry without bronchodilation test, calculation of the lower limit of normal (LLN – low limit of normal) were carried out. Using the Mann – Whitney U-test, the two groups were compared quantitatively. When analyzing four-field conjugacy tables, a comparison was performed using the Pearson criterion χ2. The direction and closeness of the correlation were estimated using Spearman’s rank correlation coefficient. A predictive model was developed using the linear regression method. The differences were considered statistically significant at p &lt; 0.05.Results. In group I (median age 29 [26; 33] years), reliable connections were established between the volume of forced expiratory volume in one second and high-sensitivity C-reactive protein (hsCRP); modified Tiffno index (m-TI) and total cholesterol, lowdensity lipoproteins, glucose. When analyzing the LLN data, reliable associations between m-IT and glucose (p = 0.004), hsCRP (p = 0.011) were obtained. In persons over 40 years of age with a smoking index of more than 10 packs/year, a relationship was found between a decrease in LLN m-TI and LLN of forced expiratory flow between 25 and 75% of forced vital capacity and an increase in creatinine (p &lt; 0.001) and lipoprotein (a) (p = 0.03), respectively. Conclusion. There are differences in the relationship between the function of external respiration and laboratory indicators of cardiovascular risk in people before and after 40 years of age, which makes it possible to individualize the prediction of chronic non-communicable diseases.

Enhancing respiratory function through Yoga and Pilates in women aged 45-50

Background and Study Aim. Respiratory function in women aged 45-50 often declines due to natural physiological changes associated with aging. These changes include reduced lung elasticity, decreased diaphragm efficiency, and a general reduction in physical activity. The purpose of this study was to assess the impact of a combined yoga and Pilates program on respiratory function in women aged 45-50. Material and Methods. The study involved 38 women with an average age of 47.7 ± 2.5 years. A pedagogical experiment was conducted over six months. The experimental group (n=19) participated in a training regimen focused on improving respiratory function through a combination of yoga and Pilates. The control group (n=19) followed a yoga-based training program. Both groups completed an equal number of sessions—72 in total. The external respiratory function of the participants was assessed using spirometry at two key points: at the beginning of the study and after six months. Results. The comparison of respiratory function indicators between the experimental and control groups after 6 months of training revealed significant differences across most parameters. The actual value of Vital Capacity was significantly greater in the experimental group compared to the control group by 0.17 L (p &lt; 0.01), forced vital capacity by 0.30 L (p &lt; 0.01), forced expiratory volume by 0.19 L (p &lt; 0.01), peak expiratory flow by 0.23 L/sec (p &lt; 0.01), maximum expiratory flow at 25% of Forced Vital Capacity by 0.96 L/sec (p &lt; 0.001), maximum expiratory flow at 50% of Forced Vital Capacity by 0.59 L/sec (p &lt; 0.001), expiratory reserve volume by 0.47 L (p &lt; 0.001), and maximal voluntary ventilation by 17.00 L/min (p &lt; 0.001). Conclusions. The combined Yoga and Pilates training regimen was more effective in improving external respiratory function than Yoga alone. This result highlights the benefits of an integrated approach to respiratory health for women aged 45-50. The study demonstrates the potential advantages of combining different types of exercise to counteract age-related declines in respiratory function. Such programs could play a significant role in promoting overall well-being in this age group.