History Of Respiratory Disease Research Articles

Respiratory Symptoms and Paper Dust Exposure among Workers in the Paper Industry in Ethiopia: A Comparative Cross-Sectional Study

Chronic respiratory symptoms are a health concern in the paper industry. This study evaluates the association between personal inhalable paper dust exposure and chronic respiratory symptoms among workers in this industry. In total, 270 workers from the paper industry and 267 from a water bottling factory participated. Chronic respiratory symptoms were assessed using a standardized questionnaire, modified from the American Thoracic Society. A job exposure matrix, based on cross-sectional personal measurements of inhalable paper dust, was used to estimate the exposure–response relationship between cumulative dust exposure and chronic respiratory symptoms. There was a higher prevalence of chronic coughs (27.4% vs. 7.5%), breathlessness (25.6% vs. 11%), coughs with sputum (21.1% vs. 1.1%), and wheezing (25.6% vs. 5%) among paper workers compared to those in the water bottling industry. A Poisson regression analysis revealed that the prevalence ratios for chronic coughs (APR = 3.3 and 95% CI: 2.0–5.4), breathlessness (APR = 2.2 and 95% CI: 1.4–3.4), and wheezing (APR = 4.3 and 95% CI: 2.3–7.7) were significantly higher in paper workers than in water bottling workers. Among paper workers, a significant exposure–response relationship was observed between cumulative dust exposure and chronic coughs after adjusting for age, sex, history of respiratory illnesses, work in other dusty industries, and use of biofuels. As there were only four ever-smokers, smoking was not included in the regression analysis. The results show a significant association between dust exposure and coughing, highlighting the need for control measures to prevent the development of respiratory symptoms among workers.

The effect of allergen immunotherapy in patients with central compartment atopic disease post-surgery.

To assess the effect of allergen immunotherapy (AIT) on patients with central compartment atopic disease (CCAD) and house dust mite (HDM) sensitization post-surgery. A retrospective cohort of surgically treated, HDM-sensitized CRSwNP patients phenotyped as CCAD was assessed. Patients were divided into two groups based on whether they had AIT commenced as part of their surgical care. All AIT patients started immunotherapy prior to their surgery. The primary endpoint was reformation of middle turbinate (MT) edema 12 months postsurgery. Secondary endpoints were corticosteroid irrigation use (<4 times/week vs. ≥4 times/week, %) and the rhinologic domain of the 22-item sino-nasal outcome test (SNOT-22). Demographic characteristics, concomitant asthma, smoking status, history of aspirin-exacerbated respiratory disease, conjunctival symptoms, polysensitization, serum eosinophils (cell×109/L), tissue eosinophilia (%>100/HPF), and serum IgE (kU/L) were also recorded. Eighty-six CCAD patients were assessed (41±14yrs, 64% female). AIT was applied in 37% (n=32). Baseline features were similar apart from greater conjunctival symptoms (72 vs. 45%, p=0.02) in the AIT group. At 12 months post-surgery, the AIT group has less MT edema (%≥diffuse 15.6 vs. 52.9, p<0.01). Patients on AIT also had less pharmacotherapy requirements at 12 months (%≥4/week, 37.5 vs. 79.6%, p<0.01). The rhinologic symptoms were similar (21.1±17.1 vs. 20.1±21.6, p=0.83). Surgery and pharmacotherapy are effective in managing CCAD, but the addition of AIT improved allergic phenomenon and allowed de-escalation of topical therapy. Longer term studies are required to demonstrate further immunomodulation.

Lung function decline in people with serious mental illness: A call to action

This prospective observational study aimed to evaluate the rate of change in forced expiratory volume in the first second (FEV1) and to explore the factors associated with changes in FEV1 in people with serious mental illness (SMI). Sixty subjects diagnosed with schizophrenia or bipolar disorder who were smokers and without history of respiratory illness agreed to participate. The mean (range) follow-up period was 3.54 (3.00–4.98) years. The mean (standard deviation) annual rate of change in FEV1 decreased by 39.1 (105.2) mL/year. Thirty-one (51.7 %) patients experienced a decrease in the FEV1 ≥40 mL/year (i.e. a rapid decline). The factors associated with the absolute change in FEV1 were the baseline International Physical Activity Questionnaire activity score in metabolic equivalents of tasks (β 0.145, 95 % confidence interval [CI] 0.043 to 0.246; p = 0.005), baseline FEV1 (β -0.025, 95 % CI -0.076 to 0.027; p = 0.352), and the interaction term of both variables (β -3.172e-05, 95 % CI -6.025e-05 to -0.319e-05; p = 0.029). The factors associated with rapid FEV1 decline were income (odds ratio [OR] 0.999, 95 % CI 0.995 to 1.003; p = 0.572), the rate of change in abdominal circumference (OR 0.000, 95 % CI 0.000 to 0.890; p = 0.081), and the interaction term of both variables (OR 1.038, 95 % CI 1.010 to 1.082; p = 0.026). In conclusion, a substantial proportion of people with SMI experienced a rapid decrease in FEV1. If our results are confirmed in larger samples, the routine evaluation of lung function in people with SMI would be an opportunity to identify individuals at greater risk of morbidity and mortality.

Buprenorphine with Bupivacaine 0.5% Heavy Versus Clonidine with Bupivacaine 0.5% Heavy Versus Bupivacaine 0.5% Heavy Alone in Patients Undergoing Total Abdominal Hysterectomy: A Comparative Study

Background and Aims: This research aimed to determine which of three spinal anaesthetic medication combinations—clonidine–bupivacaine, buprenorphine–bupivacaine and bupivacaine alone—is the most effective for total abdominal hysterectomy. Material and Methods: In this prospective study, approved by the Institutional Ethical Committee, 120 patients aged 35–60 years scheduled for elective total abdominal hysterectomy under spinal anaesthesia were included, following informed consent. Comprehensive pre-anaesthetic assessments, including detailed medical histories, clinical examinations and routine surgical investigations, were conducted. The study, spanning 24 months, utilised purposive sampling and a cross-sectional design. The inclusion criteria encompassed ASA I and II patients aged 35–60 years, undergoing elective total abdominal hysterectomy with a weight exceeding 45 kg, height over 150 cm, and valid informed consent. Exclusion criteria involved ASA Class III or higher, patient unwillingness for spinal anaesthesia, gross spinal deformities, bleeding diathesis, known allergy to the test drug, history of cardiac, respiratory, or central nervous system disease, hepatic or renal dysfunction and elevated intracranial pressure. Results: The onset time of sensory blockade was faster in the Bupivacaine + Buprenorphine group than in the Clonidine + Bupivacaine group, with the Bupivacaine group exhibiting the slowest onset. The Bupivacaine + Buprenorphine group had a significantly faster onset of motor block than the Clonidine + Bupivacaine and Bupivacaine groups. The total duration of motor block was shorter in both the Bupivacaine + Buprenorphine and Bupivacaine groups than in the Clonidine + Bupivacaine group. The Clonidine + Bupivacaine group showed higher incidences of bradycardia and hypotension than the other groups. The Bupivacaine + Buprenorphine group reported more side effects, including chest pain, cough, nausea and vomiting, than the other groups. Conclusion: This study found that spinal clonidine, in comparison to bupivacaine alone, gives better post-operative analgesia and sensory and motor blockage over a longer period of time.

Risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia.

To identify risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia and to construct a nomogram predictive model. This retrospective study included 292 patients who underwent gastrointestinal endoscopy under acupuncture anesthesia at the Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to May 2023. Logistic regression analysis was used to identify risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia. A nomogram prediction model was constructed using the RMS package of R4.1.2 software based on the independent risk factors identified. The predictive performance of the model was assessed using consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve. Seventy-five patients (25.68%) had complications. Body mass index (BMI), history of cardiovascular diseases, fasting time, history of respiratory diseases, and Sedation-Agitation Scale (SAS) score were identified as risk factors for complications. Based on this risk, a nomogram predictive model was constructed. The C-index of the nomogram model was 0.927. Calibration curve showed a good consistency between actual observations and nomogram predictions. The ROC curve area under curve (AUC) was 0.927 (95% CI: 0.895-0.959), indicating a certain predictive value for the occurrence of complications. When the optimal cut-off value was selected, the sensitivity and specificity of the model were 77.0% and 92.0%, respectively, indicating that the predictive model was effective. BMI, history of cardiovascular disease, fasting time, history of respiratory disease, and SAS score are independent risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia. The constructed nomogram predictive model has a good performance in predicting the occurrence of complications in patients undergoing gastrointestinal endoscopy with under acupuncture anesthesia.

A case report of human infection with avian influenza H10N3 with a complex respiratory disease history

BackgroundOn March 16th 2024, the first case of Human infection with avian influenza H10N3 since the end of the global COVID-19 Pandemic was reported in Kunming, China. To enhance comprehension of the source of infection and risk factors of the H10N3 virus infection, this case report summarizes the clinical features, epidemiological investigation, and laboratory test results. Provides recommendations for the prevention and control of Human infection with avian influenza H10N3.Case presentationA 51-year-old male with a history of COVID-19 infection and a smoking habit of 30 years, worked in livestock breeding and was exposed to sick and dead poultry before falling ill with fever and chills on 28th February 2024. A week later, he was diagnosed with severe pneumonia, influenza, and respiratory failure by the Third People's Hospital of Kunming(KM-TPH). He was discharged on 17th April and none of his 6 close contacts showed any symptoms of illness. Environmental samples taken from the epidemic spot revealed that peacock feces tested positive for avian influenza sub-type H9 and waterfowl specimens showed positive results for avian influenza sub-type H5. Gene sequencing conducted on positive specimens from the patient's respiratory tract by the Chinese Centre for Disease Control and Prevention (CCDC) showed a high degree of similarity (98.6–99.5%) with the strain responsible for the second global case of human infected with H10N3 (reported from Zhejiang, China 2022).ConclusionsAccording to the available epidemiological information, there is limited evidence to suggest that H10N3 viruses are excessively lethal. However, adaptive site mutations have been observed in the H10N3 isoform of mammals. While it is unlikely that the H10N3 virus will spread among humans, the possibility of additional cases cannot be entirely ruled out. Symptoms of human infection with H10N3 avian influenza are similar to those of common respiratory infections, which may result in them being overlooked during initial clinical consultations. Therefore, it is essential to improve surveillance of the H10 sub-type of avian influenza and to increase the awareness of hospital-related workers of cases of pneumonia of unknown origin.

Three-Dimensional Morphological Changes in the Upper Airway After Maxillary Reconstruction With an Anterolateral Thigh Flap

BackgroundReconstruction of maxillary defects may lead to changes in the upper airway. These changes may cause postoperative airway obstruction issues. PurposeThe purpose was to evaluate the postoperative changes in the upper airway following maxillary reconstruction with an anterolateral thigh flap (ALTF) and to identify the factors associated with these changes. Study design, setting, sampleThis retrospective cohort study involved 26 patients who underwent maxillectomy for maxillary tumors, followed by reconstruction using an ALTF. Patients with a history of upper respiratory system disease and sleep-disorder breathing were excluded. Predictor variableThe predictor variable was the residual rate of ALTF volume (ALTF-RS), calculated as the ratio of ALTF volume at 6 months post-surgery (T2) to that at 2 weeks post-surgery (T1). The outcome variablesThe outcome variables were the upper airway parameters. The upper airway was assessed at 3 time points: one week preoperatively (T0), T1, and T2. Ratios were used to represent airway changes over time. CovariatesThe covariates are age, sex, Brown classification, body mass index (BMI), hypertension, neck dissection, and tracheostomy, etc. AnalysesAirway measurement differences between the three time points were analyzed by one-way ANOVA. Pearson correlation and Spearman correlation analysis were used to analyze the correlation coefficients between airway changes and ALTF-RS. Statistical significance was established at a P value < 0.05. ResultsThe sample included 26 subjects with a mean age of 55.6±15.2 years and 15/26 (57.7%) were male. Compared to T0, the nasopharyngeal and retropalatal airway volumes at T1 significantly decreased (P<0.05) but recovered or surpassed preoperative levels by T2. The minimum cross-sectional airway area (S-min) significantly decreased by T1 (P < 0.05), but increased by T2 (P<0.05). The narrowest airway section was predominantly in the palatopharyngeal airway. The airway changes of T2/T1 and ALTF-RS were not correlated (P > 0.05) except for anterior-inferior point of CV4 cross-sectional area (P < 0.05). Conclusions and RelevanceThe volumetric changes in the airway were not associated with ALTF-RS. The substantial narrowing of S-min at T1 emphasized the need for vigilant airway management in these patients.

Recognizing clinical features of primary ciliary dyskinesia in the perinatal period.

Primary ciliary dyskinesia (PCD) is a rare, motile ciliopathy inherited through mostly autosomal recessive variants that results in chronic ear, sinus, and respiratory disease. Despite neonatal respiratory distress being a common presenting symptom in term infants with PCD, the diagnosis is often delayed due to non-familiarity of neonatal caregivers with phenotypic and diagnostic features of this disease. Organ laterality defects, prenatal cerebral ventriculomegaly, and a family history of suppurative respiratory disease may occur in PCD and should prompt neonatal testing for this condition. In this review of neonatal PCD diagnoses in a large PCD clinic, prevalence and details of neonatal PCD issues are presented, highlighting the typically delayed onset of neonatal respiratory distress and lobar atelectasis on chest radiography, specific presentations in premature neonates, and responses to perinatal therapies.

Pulmonary function trajectories in COVID-19 survivors with and without pre-existing respiratory disease

A significant proportion of COVID-19 survivors still experience a reduced diffusion capacity three and twelve months after discharge. We aimed to compare pulmonary function trajectories between hospitalized COVID-19 patients with pre-existing respiratory disease (PRD) and patients without pre-existing respiratory disease (Non-PRD) at three and twelve months after hospital discharge. This single-centre retrospective cohort study included COVID-19 patients admitted to the VieCuri Medical Centre (Venlo, the Netherlands) between February and December 2020 that were invited to the outpatient clinic at three and twelve months after discharge. During this visit, pulmonary function tests were performed and impairments were based on lower limit of normal. Data of 239 patients were analysed (65% male, 66 ± 10 years, and 26% with a history of respiratory disease). Three months after discharge, 49% and 64% of the Non-PRD patients (n = 177) and PRD patients (n = 62) had a low diffusion capacity, respectively. This improved over time in Non-PRD patients (p = 0.003), but not in PRD patients (p = 0.250). A low diffusion capacity was still observed in 34% and 57% of the Non-PRD and PRD group, respectively, twelve months after discharge. Pulmonary function impairments, mainly a reduced diffusion capacity, are observed among hospitalized COVID-19 patients with PRD and Non-PRD, at three and twelve months follow-up. Although diffusion capacity impairments restore over time in Non-PRD patients, poor recovery was observed among PRD patients.

Prevalence of Chronic Obstructive Pulmonary Disease and Its Associated Risk Factors in Yunnan Province, China: A Population Based Cross-Sectional Study.

Chronic obstructive pulmonary disease (COPD) is a significant disease impacting health and quality of life. Yunnan Province, a major tobacco producer, lacks comprehensive COPD studies. The purpose of this study is to describe the epidemic situation of COPD in Yunnan province and explore its influencing factors. This study is a cross-sectional research conducted in a representative sample of adults aged 20 and older from 13 prefectures and cities in Yunnan Province, China. COPD was diagnosed using post-bronchodilator pulmonary function tests. Demographics were analyzed with descriptive statistics. The influencing factors of COPD were examined by using the multivariate logistic regression models. Our study found that high-risk individuals for COPD accounted for 20.30% of the screened population aged 20 and above, with a COPD prevalence of 27.18% among this high-risk group. Male had a higher prevalence (33.01%) than did female (16.35%; p<0.001 for sex difference). Additionally, the proportion of severe and extremely severe COPD cases in Yunnan Province was higher than the national average and other provinces. After considering the potential confounding variables, male (OR=2.291, 95% CI: 1.584-3.313), age (OR=1.501, 95% CI: 1.338-1.685), underweight (OR=1.747, 95% CI: 1.225-2.491), previous smoking (OR=1.712, 95% CI: 1.182-2.478), passive smoking (OR=1.444, 95% CI: 1.159-1.800), and a history of respiratory system diseases in childhood (OR=2.010, 95% CI: 1.346-3.001) were significantly associated with an increased risk of COPD. Conversely, being overweight (OR=0.636, 95% CI: 0.489-0.828), and residing in high-altitude counties (OR=0.445, 95% CI: 0.263-0.754) were negatively correlated with the risk of COPD. There is significant prevalence of COPD (27.18%) among high-risk population aged 20 and above in Yunnan Province, China. Apart from male, smoking, BMI and other known risk factors for COPD. We found that high-altitude residence had a lower prevalence of COPD. There is no significant difference in COPD prevalence between Han and ethnic minority populations.

Risk factors of acute exacerbation and disease progression in young patients with COPD

ObjectiveWe aimed to elucidate the clinical factors associated with acute exacerbation and disease progression in young patients with chronic obstructive pulmonary disease (COPD).MethodsThis retrospective longitudinal observational study included patients with...

Prevalence of influenza and other acute respiratory illnesses in patients with acute myocardial infarction in Bangladesh: A cross-sectional study.

Several studies imply that influenza and other respiratory illnesses could lead to acute myocardial infarction (AMI), but data from low-income countries are scarce. We investigated the prevalence of recent respiratory illnesses and confirmed influenza in AMI patients, while also exploring their relationship with infarction severity as defined by ST-elevation MI (STEMI) or high troponin levels. This cross-sectional study, held at a Dhaka tertiary hospital from May 2017 to October 2018, involved AMI inpatients. The study examined self-reported clinical respiratory illnesses (CRI) in the week before AMI onset and confirmed influenza using baseline real-time reverse transcription polymerase chain reaction (qRT-PCR). Of 744 patients, 11.3% reported a recent CRI, most prominently during the 2017 influenza season (35.7%). qRT-PCR testing found evidence of influenza in 1.5% of 546 patients, with all positives among STEMI cases. Frequencies of CRI were higher in patients with STEMI and in those with high troponin levels, although these relationships were not statistically significant after adjusting for other variables. The risk of STEMI was significantly greater during influenza seasons in the unadjusted analysis (relative risk: 1.09, 95% confidence interval [CI]: 1.02-1.18), however, this relationship was not significant in the adjusted analysis (adjusted relative risk: 1.03, 95% CI: 0.91-1.16). In Bangladesh, many AMI patients had a recent respiratory illness history, with some showing evidence of influenza. However, these illnesses showed no significant relationship to AMI severity. Further research is needed to understand these relationships better and to investigate the potential benefits of infection control measures and influenza vaccinations in reducing AMI incidence.

Risk factor analysis and nomogram prediction model construction of postoperative complications of thoracoscopic non-small cell lung cancer.

A series of complications will inevitably occur after thoracoscopic pulmonary resection. How to avoid or reduce postoperative complications is an important research area in the perioperative treatment of thoracic surgery. This study analyzed the risk factors for thoracoscopic postoperative complications of non-small cell lung cancer (NSCLC) and established a nomogram prediction model in order to provide help for clinical decision-making. Patients with NSCLC who underwent thoracoscopic surgery from January 2017 to December 2021 were selected as study subjects. The relationship between patient characteristics, surgical factors, and postoperative complications was collected and analyzed. Based on the results of the statistical regression analysis, a nomogram model was constructed, and the predictive performance of the nomogram model was evaluated. A total of 872 patients who met the study criteria were included in the study. A total of 171 patients had complications after thoracoscopic surgery, accounting for 19.6% of the study population. Logistic regression analysis showed that thoracic adhesion, history of respiratory disease, and lymphocyte-monocyte ratio (LMR) were independent risk factors for complications after thoracoscopic surgery (P<0.05). Variables with P<0.1 in logistic regression analysis were included in the nomogram model. The verification results showed that the area under curve (AUC) of the model was 0.734 [95% confidence interval (CI): 0.693-0.775], and the calibration curve showed that the model had good differentiation. The decision curve analysis (DCA) curve showed that this model has good clinical application value. In subgroup analysis of complications, gender, history of respiratory disease, body mass index (BMI), type of surgical procedure, thoracic adhesion, and Time of operation were identified as significant risk factors for prolonged air leak (PAL) after surgery. Tumor location and forced expiratory volume in the first second (FEV1) were identified as important risk factors for postoperative pulmonary infection. N stage and thoracic adhesion were identified as significant risk factors for postoperative pleural effusion. The AUC for PAL was 0.823 (95% CI: 0.768-0.879). The AUC of postoperative pulmonary infection was 0.714 (95% CI: 0.627-0.801). The AUC of postoperative pleural effusion was 0.757 (95% CI: 0.650-0.864). The calibration curve and DCA curve indicated that the model had good predictive performance and clinical application value. This study analyzed the risk factors affecting the postoperative complications of NSCLC through thoracoscopic surgery, and the nomogram model built based on the influencing factors has certain significance for the identification and reduction of postoperative complications.

Adherence, burden, and morbidity of chronic diseases in an outpatient clinic: A-CaMo I

Introduction: Chronic non-communicable diseases (NCDs) are a significant global health challenge due to their prolonged duration and varied progression rates, leading to increased noncompliance, especially in developing nations. Pharmacological adherence, defined by WHO, is crucial for maintaining patients' quality of life and reducing morbidity, yet it remains inadequate, with about 50% non-adherence in developed countries, 30% of which is unintentional. Understanding disease burden is vital, but research on medication adherence, burden, and morbidity in the Dominican Republic and Latin American countries is lacking, necessitating comprehensive studies. Objectives: Ascertaining the degree of pharmaceutical adherence, disease burden, and morbidity amongst individuals with chronic illnesses were the study’s primary endpoints. Methodology: The project was a cross-sectional, prospective study that examined the sociodemographic data, past medical history, and medication regimens of a sample of 284 patients attending an outpatient clinic. Patients were selected using convenience sampling, to be later screened and interviewed after consultation for any of the diseases present on the MAR-Scale or the DBMA questionnaires. The screening sought only those individuals who met inclusion criteria (&gt; 18 years old, diagnosed with a disease present on either scale) and did not meet exclusion criteria (not being able to fill the questionnaire due to language barrier). Data collected was stored using the KoboToolBox program and later summarized with mean and standard deviation for further processing using STATA BE. Statistical tests were programmed with an alpha of 5%, 95% CI, and p &lt; 0.05 for statistical significance. Results: The sample, comprising 133 individuals, had a mean age of approximately 58.4 years, with a majority of female participants. Most participants were married, Dominican, and of Hispanic Latino ethnicity, with Christianity being the predominant religion. Regarding past medical history, while a substantial portion had no prior respiratory or cardiovascular ailments, diabetes mellitus was prevalent, indicating potential implications for current health status and treatment adherence. Adherence, measured by daily and weeklyscores, ranged from 1.0 to 3.8, with the burden score per patient averaging 50.1 and per disease averaging 2.6. The analysis revealed that 16.9% of participants were monomorbid, while 83.1% were multimorbid, showcasing the complexity of health conditions within the cohort. Conclusion: The study's key results reveal a significant portion of patients without a history of respiratory or cardiovascular diseases, suggesting a relatively healthy baseline. However, a notable proportion had diabetes, potentially impacting their current health status and treatment adherence. Furthermore, the study delves into factors influencing adherence, burden levels, and reasons for nonadherence. Findings indicate unmarried patients and those with lower education levels tend to exhibit higher burden levels and lower adherence scores. Mental health conditions like depression or anxiety, osteoporosis, and heart failure are associated with elevated burden levels. The study also assesses the reliability of adherence and burden measurement tools, emphasizing the importance of considering population variability in interpreting results. Limitations include challenges in patient selection and data collection, particularly regarding patients with multimorbidity. Overall, the study highlights the need for comprehensive exploration of adherence, burden, and morbidity to predict disease control, progression, and patient quality of life effectively in future research endeavors.

Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran

Background: Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined. Objective: To investigate the association between CAC score and in-hospital mortality of COVID-19 patients Method: This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes. Results: The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70–10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13–1.53, P value &lt; 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47–2.77, P value &lt; 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79–18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18–40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value &lt; 0.001). Conclusion: Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.

Satisfaction, Qol and adherence of patients allergic to dust mites and/or pollens undergoing sublingual immunotherapy.

Aim: Sublingual immunotherapy (SLIT) changes history of allergic respiratory disease (ARD). However, adherence is a barrier for optimal outcomes.Patients & methods: In the QUALI study, 859 patients with house-dust mite (HDM) and/or pollen induced ARD uncontrolled with symptomatic treatment and undergoing SLIT for at least 6 months or including one pre-coseason (pollen) were collected.Results & conclusion: SLIT significantly improved allergic rhinoconjunctivitis (ARC) and asthma symptom control, leading to reduced medication, meaningful health-related quality of life gain, improved nasal, ocular and bronchial symptoms and everyday life activities. Patients were highly satisfied and most of them adhered to SLIT, being forgetfulness the main non-adherence motive. SLIT is a quick effective treatment against persistent moderate-to-severe symptoms in ARC and asthma but it should been improve forgetfulness, as non-adherence reason.

#1708 Mortality and kidney function recovery in patients with sepsis-associated vs non-septic acute kidney injury treated with CRRT

Abstract Background and Aims It was recently suggested that sepsis-associated acute kidney injury (SA-AKI) is characterized by different pathogenesis and outcomes compared to non-Septic AKI (NS-AKI). However, limited data are available focusing on the clinical outcomes of SA-AKI versus NS-AKI. The aim of this study is to examine risk factors and outcomes of SA-AKI vs NS-AKI among critically ill patients who developed AKI requiring renal replacement therapy (RRT). Methods We performed a single-center retrospective analysis, examining all patients admitted to ICU who developed AKI requiring RRT at Policlinico of Bari, from January 2021 to July 2023. We classified patients in two groups based on the leading cause of AKI: NS-AKI and SA-AKI. We collected clinical and laboratory data, including maximum AKI stage reached during hospitalization, RRT indications, modality and duration. The primary outcome was to assess mortality rate between SA-AKI and NS-AKI groups. The cumulative 28-day survival probability was calculated using the Kaplan–Meier method. The analysis of the risk factors associated with in-hospital mortality was performed using Cox's proportional hazard regression models. Kidney Functional Recovery (KFR) from, RRT discontinuation and length of ICU and hospital stay were also analyzed. Results 320 patients were included in the study; 131 patients developed SA-AKI (40.9%), while the remaining 189 were classified as NS-AKI (59.1%). Median age was 67 years (IQR 57-73) with a predominance of male gender (67.8%), without significant differences between groups. A significant percentage of patients had an history of cardiovascular disease in NS-AKI group compared to SA-AKI group (54.5% vs 29%, p &amp;lt; 0.001). Conversely, the proportion of patients with a history of chronic respiratory disease was significantly higher in the SA-AKI group (23.7% vs 9.5%, p = 0.001). 268 patients (83.8%) developed AKI Stage 3 and 40 patients AKI stage 2 (12.5%) at RRT initiation. All patients were treated with continuous modalities (CRRT). There was no significant difference in CRRT duration between groups (median days 5, IQR 2-12) (Table 1). The timing of CRRT initiation from ICU admission was significant different and we reported a late CRRT initiation in the SA-AKI group (3 vs 1 days, p = 0.002). The median length of ICU stay was 12 days (IQR 4-25) and did not differ between groups. 184 patients (57.5%) died at 28 days, with a higher percentage in the SA-AKI (70.2 vs 48.6%, p &amp;lt; 0.001). Similarly, in-hospital mortality was reported in 221 patients (69%), with impressive percentages in the SA-AKI group (82.45 vs 69.3%, p &amp;lt; 0.001) (Fig. 1). KFR at 28 days from CRRT initiation was significantly higher in the NS-AKI (28.5%) compared to the SA-AKI group (13.7%, p = 0.002). Median time of KFR was similar between groups (p = 0.833). Multivariate Cox Regression analysis showed that only SA-AKI (HR 1.442, 95% CI 1.052-1.978, p = 0.023) was independently associated with increased risk of mortality. Conclusions Sepsis-associated AKI was associated with high mortality rate and lower likelihood of renal recovery compared to non-septic AKI in critically ill patients requiring RRT. These findings emphasize the importance of identifying specific AKI phenotypes characterized by different pathophysiology and clinical outcomes.

Knockdown of the SDHB Subunit Induces Mitochondrial Remodeling in Human Airway Smooth Muscle Cells

Succinate dehydrogenase (SDH) is a mitochondrial enzyme that serves a dual role in mitochondrial respiration: catalyzing the oxidation of succinate to fumarate in the tricarboxylic acid (TCA) cycle and transferring electrons from succinate to ubiquinone as complex II in the electron transport chain (ETC). SDH is composed of four subunits (SDHA-SDHD) and the loss of SDHB subunit, specifically, has been shown to increase oxidative stress. As a part of the catalytic core of the SDH complex, the SDHB subunit mediates electron transfer to ubiquinone. In human airway smooth muscle (hASM) cells with siRNA-mediated knockdown of SDHB, the maximum velocity of the SDH reaction (SDHmax) is decreased. Moreover, SDHB-knockdown leads to an increase in mitochondrial volume density, indicating a role of SDH in mitochondrial remodeling. However, the impact of SDHB-knockdown on mitochondrial dynamics has not been explored. Therefore, we hypothesize that SDHB-knockdown promotes mitochondrial fragmentation as part of mitochondrial remodeling in hASM cells. To investigate this hypothesis, bronchiolar tissue samples were collected in female and male patients undergoing lung surgery with no current history of smoking or respiratory diseases, the smooth muscle layer was dissected and hASM cells were dissociated. The targeted knockdown of SDHB was achieved by siRNA-mediated knockdown. Mitochondria in hASM cells were labeled with MitoTracker Green (200 nM) and imaged in 3D with a Z optical slice of 0.5 μm using an oil-immersion ×60/1.4 NA objective on a Nikon Eclipse A1 laser scanning confocal system. Optical slices were deconvolved to enhance contrast and the MitoTracker labeling was thresholded to create binary images, which were then reconstructed in 3D. From these images, the mitochondrial complexity index (MCI) was calculated to quantify the extent of fragmentation. To identify the signaling pathway involved in mitochondrial fragmentation, the expression and phosphorylation of dynamin-related protein 1 (DRP1) was quantified by Western blot. Mitochondrial fragmentation is associated with increased phosphorylation of DRP1 at Ser616 (pDRP1s616). Furthermore, mitophagy was assessed by determining the mitochondrial expression of PINK1 and the phosphorylation of Parkin at Ser65 (pParkinS65). Mitochondrial biogenesis was also evaluated through the expression of PGC1α, NRF1/2 and TFAM. Our results show that SDHB-knockdown increased mitochondrial fragmentation (reduced MCI) in hASM cells, and increased pDRP1s616 phosphorylation and its translocation to mitochondria. SDHB-knockdown also increased mitochondrial expression of PINK1 and pParkins65 phosphorylation indicating activation of mitophagy. We also confirmed that SDHB-knockdown increased expression of PGC1α, NRF1/2 and TFAM consistent with mitochondrial biogenesis. These findings unveil the mechanisms underlying SDHB-knockdown-mediated mitochondrial remodeling. Supported by NIH grant R01-HL157984 (GCS). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Investigation and Analysis of Lung Cancer Risk Factors in the Health Check-Up Population

Objective: To investigate and analyze the risk factors of lung cancer in the population of health checkups. Methods: A total of 500 cases of the health check-up population were selected for data study. Surveyed showed that 19 cases of lung cancer were grouped as the lung cancer group and the remaining 481 cases made up the control group, and the risk factors were analyzed. Results: Among men, there was a significant proportion of individuals aged 60–69 years old, and women aged 30–39 years old. Additionally, individuals aged 60 and above were at increased risk of developing lung cancer. The results of the multifactorial analysis were that the risk factors affecting the detection of lung cancer in healthy people were smoking history, family history of lung cancer, secondhand smoke, history of respiratory diseases, psychosomatic factors, living environment, and kitchen fumes. Conclusion: People over 60 years of age were prone to early lung cancer, followed by individuals aged 30–39 years. It is important to identify the risk factors of lung cancer to strengthen the screening of high-risk groups for early detection and treatment.

Safety of a controlled human infection model of tuberculosis with aerosolised, live-attenuated Mycobacterium bovis BCG versus intradermal BCG in BCG-naive adults in the UK: a dose-escalation, randomised, controlled, phase 1 trial

Mycobacterium tuberculosis is the main causative agent of tuberculosis. BCG, the only licensed vaccine, provides inadequate protection against pulmonary tuberculosis. Controlled human infection models are useful tools for vaccine development. We aimed to determine a safe dose of aerosol-inhaled live-attenuated Mycobacterium bovis BCG as a surrogate for M tuberculosis infection, then compare the safety and tolerability of infection models established using aerosol-inhaled and intradermally administered BCG. This phase 1 controlled human infection trial was conducted at two clinical research facilities in the UK. Healthy, immunocompetent adults aged 18-50 years, who were both M tuberculosis-naive and BCG-naive and had no history of asthma or other respiratory diseases, were eligible for the trial. Participants were initially enrolled into group 1 (receiving the BCG Danish strain); the trial was subsequently paused because of a worldwide shortage of BCG Danish and, after protocol amendment, was restarted using the BCG Bulgaria strain (group 2). After a dose-escalation study, during which participants were sequentially allocated to receive either 1 × 103, 1 × 104, 1 × 105, 1 × 106, or 1 × 107 colony-forming units (CFU) of aerosol BCG, the maximum tolerated dose was selected for the randomised controlled trial. Participants in this trial were randomly assigned (9:12), by variable block randomisation and using sequentially numbered sealed envelopes, to receive aerosol BCG (1 × 107 CFU) and intradermal saline or intradermal BCG (1 × 106 CFU) and aerosol saline. Participants were masked to treatment allocation until day 14. The primary outcome was to compare the safety of a controlled human infection model based on aerosol-inhaled BCG versus one based on intradermally administered BCG, and the secondary outcome was to evaluate BCG recovery in the airways of participants who received aerosol BCG or skin biopsies of participants who received intradermal BCG. BCG was detected by culture and by PCR. The trial is registered at ClinicalTrials.gov, NCT02709278, and is complete. Participants were assessed for eligibility between April 7, 2016, and Sept 29, 2018. For group 1, 15 participants were screened, of whom 13 were enrolled and ten completed the study; for group 2, 60 were screened and 33 enrolled, all of whom completed the study. Doses up to 1 × 107 CFU aerosol-inhaled BCG were sufficiently well tolerated. No significant difference was observed in the frequency of adverse events between aerosol and intradermal groups (median percentage of solicited adverse events per participant, post-aerosol vs post-intradermal BCG: systemic 7% [IQR 2-11] vs 4% [1-13], p=0·62; respiratory 7% [1-19] vs 4% [1-9], p=0·56). More severe systemic adverse events occurred in the 2 weeks after aerosol BCG (15 [12%] of 122 reported systemic adverse events) than after intradermal BCG (one [1%] of 94; difference 11% [95% CI 5-17]; p=0·0013), but no difference was observed in the severity of respiratory adverse events (two [1%] of 144 vs zero [0%] of 97; 1% [-1 to 3]; p=0·52). All adverse events after aerosol BCG resolved spontaneously. One serious adverse event was reported-a participant in group 2 was admitted to hospital to receive analgesia for a pre-existing ovarian cyst, which was deemed unrelated to BCG infection. On day 14, BCG was cultured from bronchoalveolar lavage samples after aerosol infection and from skin biopsy samples after intradermal infection. This first-in-human aerosol BCG controlled human infection model was sufficiently well tolerated. Further work will evaluate the utility of this model in assessing vaccine efficacy and identifying potential correlates of protection. Bill & Melinda Gates Foundation, Wellcome Trust, National Institute for Health Research Oxford Biomedical Research Centre, Thames Valley Clinical Research Network, and TBVAC2020.