Improvement In FVC Research Articles

EFFECT OF BHASTRIKA PRANAYAMA ON “SHWASAN KARMA”

Pranayama is a breathing technique that produces many systemic and psychological effects in the body, specifically on the respiratory system. It is also an art to control the life force of breath. The aim and objective are to assess effect of breathing exercise i.e., Bhastrika Pranayama on ‘Shwasan Karma’, in individuals practicing regularly for continuous 12 weeks. This study was designed to study the effects of Pranayama on the pulmonary function parameters. Pranayama is one of the best lifestyle modifications which have ever been devised in the history of mankind. It is an ancient yoga technique, a spiritual and physical practice which integrates the mind and body. Pranayama is a type of yogic practice which produces many systemic psycho-physical effects in the body, besides its specific effects on the respiratory functions. The study group consisted of 32 volunteers. The participants were asked to undergo Pranayama training for 30 min daily, for 3 months. The results showed statistically significant improvement in FVC, FEV1, PEFR, MVV after pranayama. After analysing statistically results showed that, Shwasan Karma was significantly improved in individuals practicing Bhastrika Pranayama.

Dual bronchodilator versus inhaled corticosteroid/long-acting β2-agonist in patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials

BackgroundLong-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA, also known as dual bronchodilator) and inhaled corticosteroid/LABA (ICS/LABA) are the cornerstone of maintenance treatment for stable chronic obstructive pulmonary disease (COPD) patients. We aimed to comprehensively compare the efficacy and safety of the two maintenance treatment in COPD patients. MethodsWe searched the database Embase, Cochrane Library, PubMed, and Clinical Trials.gov systematically (from inception until September 2020). Randomized controlled trials (RCTs) comparing dual bronchodilator with ICS/LABA in the treatment of COPD were included. Efficacy and safety endpoints were pooled as mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs). This meta-analysis was registered with PROSPERO prospectively # CRD42020203314). ResultsFourteen RCTs including 21,496 patients were included. Dual bronchodilator showed a greater improvement in both trough FEV1 (MD = 0.06 L, 95% CI: 0.04–0.07, P < 0.001) and FVC (FVC: MD = 0.12 L, 95% CI: 0.07–0.16, P < 0.001), and a lower risk of pneumonia (RR = 0.62, 95% CI: 0.53–0.72, P < 0.001) in patients with COPD. There were no significant differences neither in the improvement of exacerbations, symptoms, and quality of life, nor in the incidence of cardiovascular events, serious adverse events, all-cause mortality, and withdrawals due to adverse events of treatment between these two maintenance treatments. ConclusionsDual bronchodilator is superior to ICS/LABA in improving lung function and is associated with a lower risk of pneumonia in patients with COPD. There are no significant differences in other efficacy and safety profiles between these two maintenance treatments.

Clinical features of anti-synthetase syndrome associated interstitial lung disease: a retrospective cohort in China

BackgroundAnti-synthetase syndrome (ASSD) is a chronic autoimmune condition characterized by antibodies directed against an aminoacycl transfer RNA synthetase (ARS) along with a group of clinical features including the classical clinical triad: inflammatory myopathy, arthritis, and interstitial lung disease (ILD). ASSD is highly heterogenous due to different organ involvement, and ILD is the main cause of mortality and function loss, which presents as different patterns when diagnosed. We designed this retrospective cohort to describe the clinical features and disease behaviour of ASSD associated ILD.MethodsData of 108 cases of ASSD associated ILD were retrospectively collected in Beijing Chaoyang Hospital from December 2017 to March 2019. Data were obtained from the Electronic Medical Record system. Patients were divided into 5 groups according to distinct aminoacyl tRNA synthetase (ARS) antibodies.ResultsOverall, 108 consecutive patients were recruited. 33 were JO-1 positive, 30 were PL-7 positive, 23 were EJ positive, 13 were PL-12 positive and 9 were OJ positive. The JO-1 (+) group had a significant higher rate of mechanic’s hand (57.6%) than other 4 groups. Polymyositis/dermatomyositis (PM/DM) was diagnosed in 25 (23.1%) patients and no difference was observed among the 5 groups. The PL-7 (+) group had a higher frequency of UIP pattern (13.3%) than the other 4 groups but the difference was not significant, and the EJ (+) group had the most frequent OP pattern (78.2%), which was significantly higher than the PL-7 (+) (P < 0.001) and PL-12 (+) groups (P = 0.025). The median follow-up time was 10.7 months, during which no patients died. All received prednisone treatment, with or without immunosuppressants. At the 6-month follow-up, 96.3% of all patients (104/108) had a positive response to therapy, the JO-1 (+) and EJ (+) groups had a significantly higher improvement of forced vital capacity than the other 3 groups (P < 0.05), and the PL-7 group had the lowest FVC improvement (P < 0.05). The JO-1 (+) group and EJ (+) group had significantly higher anti-Ro-52 positive occurrence than the other 3 groups (P < 0.05).ConclusionAnti PL-7 antibody had the same frequency as anti-JO-1 in ASSD-ILD, in which the ILD pattern was different with distinct anti-ARS antibodies. Most ASSD-ILD had a positive response to steroid therapies, with or without immunosuppressants. The PL-7 (+) group had the highest occurrence of UIP pattern, and a significantly lower response to therapy.

Impact of FESS on the Pulmonary Function of Patients with Chronic Rhinosinusitis.

There is interdependence between the upper and lower airway has led to the concept of a unified airway. Here we aim to study the impact of functional endoscopic sinus surgery (FESS) on the pulmonary function (PFT) of patients with chronic rhinosinusitis (CRS). The proposed study is undertaken in the department of ENT, PGIMER & Dr. RML Hospital, New Delhi. It is a prospective study of 34 patients fulfilling the clinical criteria for (CRS) from the study period of Oct 2015 to Dec 2017 not responding to medical management and taken up for fess and follow up done with (PFT). The maximum incidence of cases was seen in the age group > 40years. Chronic rhinosinusitis predominantly affected the male population. Nasal discharge was the commonest presenting complaint. A marked reduction is seen in the frequency of symptoms post-surgery. CRS affected persons of adult age with maximum number in the age group of > 40years, with a male:female ratio of approximately 2:1. Percentage improvement in FEV1 and FVC is more in age group > 40years while percentage improvement in FEV1/FVC ratio is more in age group 31-40years. Percentage increase in FEV1 and FVC is more in males while percentage increase in FEV1/FVC is more in females. Percentage increase in FEV1 and FVC is more in males and FEV1/FVC is more in females. Percentage increase in FEV1, FVC and FEV1/FVC ratio is more in cases of bilateral diseases then those with unilateral disease.

The St. George's Respiratory Questionnaire in Pulmonary Sarcoidosis.

The Saint George's Respiratory Questionnaire (SGRQ) is a frequently used tool to assess health status in pulmonary disease patients. However, its performance characteristics in sarcoidosis patients are not well characterized. Data from a clinical trial of 138 symptomatic adults with sarcoidosis were used to examine the performance characteristics of SGRQ. Data were available at both baseline and week 24. Other assessments included FVC, FEV1, ATS dyspnea score, Borg's CR 10 dyspnea score, 6-min walk distance (6MWD), and Short Form-36 Physical Component Summary (SF-36 PCS) score. Baseline SGRQ was 46.8, indicating impaired health status. At baseline, SGRQ total score correlated significantly with % predicted FVC, FEV1, ATS dyspnea score, Borg's CR 10 dyspnea score, 6MWD, and SF-36 PCS (r = - 0.37, - 0.32, 0.57, 0.40, - 0.55, and - 0.80, respectively, p < 0.001). Change from baseline in SGRQ score also statistically significantly correlated with change from baseline in these parameters at week 24: r = - 0.25, - 0.20, 0.30, 0.22, - 0.20, - 0.45, respectively (p < 0.05). The SGRQ correlated with other outcome measures in sarcoidosis initially and with treatment. Improvement in FVC % predicted correlated with improvement in SGRQ. These data suggest the SGRQ may function as a reliable endpoint in clinical sarcoidosis trials.

Effect of Yoga (Pranayama) in Improving Pulmonary Function Tests In Pediatric Age Group: a One Year Prospective Study

Aim: The aim of the study is to find out the effect of pranayama in improving the values of pulmonary function tests, in school going children (of adolescent age group between 12 years to 15 years) having mild to moderate asthma and also not being on any long term medication for the same.&#x0D; Method: After taking a written informed consent from the school teacher in charge, the parents and the children group from a government high school in Bengaluru, the screening of the children for asthma was done. Initial pulmonary function tests were done after inhaling a bronchodilator for the diagnosis of mild and moderate asthma. The diagnosed children were not put on any long term medication. They were educated about pranayama and were also taught the methodology of performing pranayama and other yoga asanas. They were made to perform pranayama every day for 20-30 minutes, for a period of 1 year (during June 2017 – June 2018) under the teacher’s guidance and during this period they were examined periodically(every 3 months) for the improvement in their pulmonary function tests.&#x0D; Results: FEV% deteriorated in 16 children in the second visit and 20 children in the last visit. This could be explained by the disproportionate increase of FVC compared to FEV1.FEV% improved better than FVC in 40% (20) of the children while the rest 60% (29) children’s improvement in FVC was better than FEV%. In the final visit around 11 children had no change in the PEFR values, which was significantly high when other lung functions were considered.&#x0D; Conclusion: FEV1 has increased from first visit to fourth visit, but at each visit the increase was not significant. This suggests the beneficial effect of pranayama in improving FEV1 when it is practised regularly for prolonged duration. Thus our prospective study confirms that Pranayama could be one of the better alternative therapies that should be considered in adolescent asthma.&#x0D;

Effects of Stretch Pole Exercises on Pulmonary Functions among Smartphone Users

Aim: To determine the effects of stretch pole exercises on pulmonary functions among smartphone users. Objective: To evaluate the effects of stretch pole exercises on FEV1, FVC, and FEV1/FVC. Method: A total of 10 patients were selected based on the inclusion and exclusion criteria. Detailed procedure was explained to the patient in colloquial terms, and informed consent was obtained. They were allocated in a single group and were treated with stretch pole exercises. After four weeks forced vital capacity, forced expiratory volume in one second and the ratio of forced expiratory volume in one second to forced vital capacity was measured as a post test. Result: Based on the obtained statistics, there was significant improvement in FVC, FEV1 and FEV1/FVC ratio at the end of four weeks within the group when compared to the pre-test values (p<0.05). Conclusion: The study concluded that the stretch pole exercises both clinically and statistically have significant effect in improving forced vital capacity, forced expiratory volume in one second and their ratio among smartphone users.Therefore, the implementation of these exercises is recommended in clinical practice.

Study of pulmonary function test in chronic renal failure and the effect of hemodialysis

Aim & objective: In this present study pulmonary function tests of chronic renal failure patients were compared with the normal healthy adults by the computerized spirometric values. Results: The lung function parameters in chronic renal failure are significantly reduced than the normal subjects. The lung function parameters were also measured in chronic renal failure who were undergoing regular hemodialysis A small but significant improvement in FVC, FEV1, FEV1%, PEF and FEF25- 75% was noticed consistently in most of the patients after hemodialysis. Though the improvement is more marked during 1 week of hemodialysis therapy, the values steadily and slowly improved after 3 months of hemodialysis therapy but was significantly lower than the normal values. None of our patients attained even near normal values at the end of 3 months of hemodialysis. Blood parameters like blood urea and serum creatinine levels were significantly reduced in repeated hemodialysis. Conclusion: This study reconfirms the already established fact of restrictive type of ventilatory defect in chronic renal failure patients this study has reflected the effects of hemodialysis on pulmonary function test in chronic renal failure patients over a short duration.

Outcome of pulse oral cyclophosphamide therapy in scleroderma interstitial lung disease.

Standard regimens for scleroderma interstitial lung diseases (SSc-ILDs) are pulse intravenous (IV) and oral daily cyclophosphamide (CYC). However, IV CYC has limited access to diffuse cutaneous SSc, and oral daily CYC is associated with febrile neutropenia and hemorrhagic cystitis. Pulse oral CYC regimen has never been studied. To determine the effectiveness of pulse oral CYC therapy in SSc-ILDs, predictors of effectiveness, and side-effects. A historical cohort study enrolled SSc-ILDs from the SSc database registry at Srinagarind Hospital, Thailand from 1 January 2012 to 1 October 2018. All patients received monthly oral dosages of CYC 600-750mg/m2, Mesna, and daily prednisolone of 10mg for 2years. Changes of FVC, chest radiography, HRCT, 6MWT, and side effects were recorded for the baseline and at the end of the treatment. Response to treatment was defined by (a) stable FVC or a decline ≤ 10% of predicted, (b) unchanged or improved radiographic findings, or (c) a decline 6MWT of ≤ 30m compared with the baseline. A total of 76 patients with female 52 patients (68.4%) and with a median age of 54.2years (IQR 46.6-59.6). The majority was dcSSc subset (59 patients; 78.6%). Fifty-four patients (71%) were defined as responsive to therapy. The mean FVC improvement was 1ml (SD 9.5). The only factor associated with treatment response was limited cutaneous SSc (OR 7.69, 95% CI (1.01, 339.68), p = 0.029). Hemorrhagic cystitis was found in 1 patient. Nearly three-quarters of SSc-ILDs patients had a good response to the pulse oral CYC therapy for 2years with a few serious side effects. Pulse oral CYC therapy had been effective for SSc-ILDs in case of difficult IV access. Key Point • Pulse oral cyclophosphamide has been used for scleroderma lung disease. It has shown efficacy and safety in scleroderma patients. In patients who have difficulty with intravenous access, pulse oral cyclophosphamide can be an alternative regimen.

The Impact of Short-term Combination of Limb Training and Pursed-lip Breathing in Chronic Obstructive Pulmonary Disease

AIM: The aim of this study is to determine the impact of short-term combination of upper and lower limb training on lung functions, functional capacity, and quality of life in stable chronic obstructive pulmonary disease (COPD).&#x0D; METHODS: This quasi-experimental study held in 2017 and included 20 participants diagnosed with COPD (forced expiratory volume in 1 second/forced volume capacity [FEV1/FVC] ≤70%). Combination of limb training with pursed-lip breathing held twice a week for 8 weeks. Lung functions, functional capacity, dyspnea scale, and quality of life were measured before, 1 month, and 2 months after training.&#x0D; RESULTS: In this study, there was a significant improvement of FVC after 2 months after training (p-value: 0.04), but not in FEV1. There was a significant improvement of CAT (p-value: 0.00) and modified medical research council (p-value: 0.04) after 1 month of training. There was a significant improvement of 6-min walking test mean after 2 months of training (p-value: 0.00).&#x0D; CONCLUSIONS: Short-term combination of limb training and pursed-lip breathing impacted positively on FVC, functional capacity, dyspnea scale, and quality of life in patients with COPD, but not in FEV1.

Effects of a Virtual Reality Dance Training Program on Kyphosis Angle and Respiratory Parameters in Young Women With Postural Hyperkyphosis: A Randomized Controlled Clinical Trial.

Thoracic hyperkyphosis, one of the most common spinal deformities, may lead to undesirable pulmonary outcomes. To study, the efficacy of virtual reality exercise training on thoracic hyperkyphosis and respiratory parameters in young women. Randomized clinical trial. Laboratory setting. Participants were randomly assigned to one of two 4-week exercise training groups: regular training (RT), which involved stretch and strength training, or virtual reality with RT (VRRT), which involved dance training with the Xbox 360 Kinect® game in addition to the exercises, which the RT group received. The authors measured kyphosis angle with a Flexicurve ruler and recorded respiratory parameters (forced vital capacity [FVC] and forced expiratory volume in 1s [FEV1]) with a spirometer in each participant at baseline and postintervention. Separate 2 × 2 repeated-measure analysis of variances were used to analyze differences between means for kyphosis angle, FEV1, and FVC. Based on the significant interactions between time and group, the paired t test was used to compare the results at baseline and postintervention, and the independent sample t test was used to compare the differences in changes between groups. Level of significance was considered at P < .05 except for paired t test that was adjusted to P < .025 for each variable in 2 groups. The results showed statistically significant interactions between time and group for kyphosis angle, FEV1, and FVC. Postintervention thoracic kyphosis angle decreased and FVC increased significantly in both groups and FEV1 improved significantly in virtual reality with RT group. The improvements in thoracic kyphosis, FVC, and FEV1 in the virtual reality with RT group were significantly greater (P < .001) than in the RT group. Dance training with the Xbox 360 Kinect game was an effective therapy in improving thoracic kyphosis angle, FVC, and FEV1 in young women with thoracic hyperkyphosis.

Mesenchymal stem cell therapy improves pulmonary function and exercise tolerance in patients with chronic obstructive pulmonary disease (copd) and high baseline inflammation

Background & Aim Background Mesenchymal stem cells (MSC) respond to activation by pro-inflammatory cytokines by secreting anti-inflammatory mediators which downregulate multiple immune pathways. Aim To evaluate whether inflammation at baseline, as measured by C-reactive protein (CRP), predicts clinical responses in COPD patients to the allogeneic mesenchymal stem cell product candidate remestemcel-L. Methods, Results & Conclusion Methods 62 patients with moderate to severe COPD were randomized in a double-blind manner to 4 monthly intravenous infusions of either allogeneic MSCs (remestemcel-L, 100 × 106 cells/infusion) or vehicle control. Subjects were followed for 2 years after the first infusion for safety and efficacy endpoints, including pulmonary function testing, 6-minute walk distance (6MWD) and assessments of systemic inflammation. While full study results were previously reported (DOI: 10.1378/chest.12-2094), here we report post-hoc analyses comparing outcomes of remestemcel-L and controls in patients with CRP levels < 2 and in those with CRP levels ≥2, ≥3, and ≥4 mg/mL. Results At day 120 (first visit after completing infusions), remestemcel-L treated patients with baseline CRP ≥2, ≥3 or ≥4 mg/mL had significantly greater improvement in FEV1, FVC or 6MWT than controls (Table 1). In contrast, there was no improvement with MSC treatment in patients with CRP<4. Degree of improvement with MSC increased with progressive increases in baseline CRP level. In those with CRP≥4, significant reductions in FEV1 and increases in 6MWT were observed in MSC compared to controls at each study visit (overall) and at the Day 120 follow-up visit following the monthly infusions (Figure 1). Conclusion Stratification of COPD patients by degree of elevated baseline CRP level identifies patients most likely to respond to MSC treatment with improvement in pulmonary and overall physical function. The correlation between highest CRP levels and greatest degree of response suggests that the inflammatory component of the lung disease may trigger and be amenable to the immunomodulatory effects of MSC treatment. Mesenchymal stem cells (MSC) respond to activation by pro-inflammatory cytokines by secreting anti-inflammatory mediators which downregulate multiple immune pathways. To evaluate whether inflammation at baseline, as measured by C-reactive protein (CRP), predicts clinical responses in COPD patients to the allogeneic mesenchymal stem cell product candidate remestemcel-L. 62 patients with moderate to severe COPD were randomized in a double-blind manner to 4 monthly intravenous infusions of either allogeneic MSCs (remestemcel-L, 100 × 106 cells/infusion) or vehicle control. Subjects were followed for 2 years after the first infusion for safety and efficacy endpoints, including pulmonary function testing, 6-minute walk distance (6MWD) and assessments of systemic inflammation. While full study results were previously reported (DOI: 10.1378/chest.12-2094), here we report post-hoc analyses comparing outcomes of remestemcel-L and controls in patients with CRP levels < 2 and in those with CRP levels ≥2, ≥3, and ≥4 mg/mL.

Impact of functional endoscopic sinus surgery for cases with nasal polypi on pulmonary function tests

Background: The upper and lower airways form one contiguous and functionally related organ, and are frequently exposed to similar inflammatory stimuli. There is increasing interest in the possibility that disease processes in one part of the airway may be reflected or manifest in another, thereby providing opportunities for dual diagnosis and therapy. Aim of this work: is to study the effect of removal of nasal polypi by functional endoscopic sinus surgery on pulmonary function tests. Patients and methods: This prospective study was carried out at Al-Azhar University hospitals (Al-Hussein and Bab El-Shaaria) in the period between December 2018 to December 2019 on 30 patients attended to outpatient clinics of ENT department to assess the effect of FESS on pulmonary functions of patients with a chronic rhinosinusitis with nasal polyposis without any other lung diseases. Results: In the present study, we noted a significant improvement in mean FVC by (0.25 L =7.6 %) one month post operatively and by (0.43 L=13 % ) three months post operatively. Also, there is a significant improvement in mean FEV1 by (0.59 L=27.6%) one month post operatively and by (0.92 L =43.2%) three months post operatively. Also, there is a significant improvement in mean FEV1/FVC % ratio by (19.3%) one month post operatively and by (28.3%) three months post operatively. Conclusion: This prospective randomized study showed that FESS have a positive effect on the pulmonary function of patients with chronic sinusitis with nasal polypi.

Efficacy of bronchial thermoplasty in patients with severe asthma

Objective: To investigate the efficacy and safety of bronchial thermoplasty (BT) in clinical practice in adults with severe, refractory asthma.Methods: Prospective, single-center, open, observational study comprising patients with uncontrolled asthma (asthma control questionnaire (ACQ) >1.5) and/or frequent exacerbations despite treatment with at least high dose inhaled corticosteroids plus a second controller. Efficacy outcomes was change from baseline 4, 8, 12 and 24 months in FEV1, FVC and FEV1/FVC ratio, asthma control questionnaire (ACQ) score and asthma quality of life score (mini-AQLQ). Results are presented as median with interquartile ranges (IQR). The following were recorded as adverse events: Un-scheduled health care contacts, rescue courses of oral corticosteroid (OCS) and/or antibiotics for exacerbation for exacerbations/respiratory tract infections (RTI).Results: Six-teen patients were enrolled (nine males, median age 50 years; 14 followed for 24 months). Compared to baseline, an improvement in FEV1, FVC, FEV1/FVC ratio, mini-AQLQ and ACQ was observed, i.e.FEV1 (IQR) 1.98 L (1.65-2.45) vs. 2.45 L (2.09-2.93) (p = 0.006), FVC (IQR) 3.23 L (2.76-4.05) vs. 3.75 L (3.22-4.36) (p = 0.041), FEV1/FVC 0.60 (IQR: 0.55-0.70) vs. 0.66 (IQR: 0.63-0.71) (p = 0.016), mini-AQLQ 4.0 (IQR: 3.2-4.9) vs. 5.6 (IQR 4.5-6.5) (p = 0.008, and ACQ 2.9 (IQR: 2.1-3.7) versus 1.5 (IQR 1.0-2.4) (p = 0.004). On the other hand, an increase was observed in unscheduled visits (p = 0.005), as well as use of OCS and antibiotics (p = 0.009 and p = 0.003, respectively).Conclusion: BT in adults with severe asthma improved ACQ, mini-AQLQ and lung function, but resulted in an increased frequency of unscheduled doctor-visits and rescue courses of OCS and antibiotics.

Omalizumab treatment in Samter's triad: case series and review of the literature.

Samter's triad is the combination of asthma, aspirin sensitization, and nasal polyposis. Few data are available on the use of omalizumab in this disease. The study aimed to describe the impact of omalizumab on clinical and functional parameters and the quality of life of a series of patients with Samter's triad. Moreover, we aimed to provide a review of the literature on this topic. We retrospectively described four patients with Samter's triad undergoing omalizumab therapy. Clinical, functional, and immunological data of these patients were collected at baseline and follow-up. Reduction of asthma exacerbations and salbutamol rescue therapy were observed in all patients after anti-IgE treatment together with an improvement in the quality of life. A significant improvement in FEV1, FVC, and FEF25-75 was observed. No major side-effects were observed. A total of 14 studies regarding omalizumab in aspirin-exacerbated respiratory diseases were included in the review, comprising 78 patients. All studies reported a good efficacy in improving asthma control; restoration of aspirin tolerance was repeatedly reported. The results of our case series and review of the literature suggest that omalizumab effectively improves asthma control, lung function tests, and quality of life in patients with Samter's triad.

254. 3D spinal alignment, thoracic volume and pulmonary function in surgical correction of AIS: a five-year follow-up study

BACKGROUND CONTEXT Surgical correction of adolescent idiopathic scoliosis is advocated for severe curves to preserve or improve pulmonary function, prevent progressive deformity and pain, and improve self-appearance. Restoration of sagittal and 3D alignment, in particular thoracic kyphosis (TK), has become increasingly emphasized in efforts to improve pulmonary function, thoracic volumes, provide improved sagittal balance, and prevent adjacent segment degeneration and deformity. PURPOSE To study the effects of thoracic kyphosis restoration in AIS type 1 and 2 curves on postoperative thoracic volume and pulmonary function. STUDY DESIGN/SETTING Retrospective review of prospective multicenter database. PATIENT SAMPLE Thirty-nine AIS patients with Type 1 and 2 curves with 5Y postoperative stereo-radiographic data and pulmonary function tests (PFTs). OUTCOME MEASURES Five-year spinal and rib cage measures and PFTs. METHODS A multicenter prospective registry of patients undergoing surgical correction of Type 1- and 2- AIS curves was queried for patients with 5-year postoperative visits including stereoradiographic assessment and PFTs. 3-dimensional (3D) radiographic analysis was performed to assess spinal alignment and chest wall dimensions at preoperative, first erect and 5 year postoperative time points. Variables were analyzed between time points with a one-way ANOVA and post-hoc Tukey analysis, and between variables with linear regression analysis. RESULTS A total of 39 patients met the inclusion criteria (37F, age 14.4±2.2). 3D spine alignment analyses demonstrated significant reduction in pre-op to 1st erect upper thoracic (41.3° to 11.6°), mid-thoracic (48.6° to 9.55°) and lumbar Cobb angles (19.7° to 8.9°), an increase in TK:T2-12 (20.0° to 39.8°) and TK:T5-12 (9.8 to 28.2°), and reduction in proximal and mid-thoracic apical vertebral rotation (9.5° to 2.1°) from preoperative to 1st erect postoperative (p 0.05 for all). 3D rib cage analysis demonstrated there was a small reduction in maximal depth (144 mm to 138 mm), maximum width (235 mm to 232 mm), and increase in thoracic height (220 mm to 230 mm, p CONCLUSIONS While thoracic kyphosis increases, coronal Cobb and apical vertebral rotation decrease postoperatively, these do not directly influence chest wall volume. Chest wall volume continues to increase between from first erect to 5 years due to presumed growth, which corresponds with an improvement in FEV1 and FVC at 5 year follow-up. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Prospective Effects of Manual Diaphragmatic Release and Thoracic Lymphatic Pumping in Childhood Asthma.

Manual noninvasive respiratory techniques have traditionally been used to treat respiratory pathologies. The aim of this study was to analyze the effects of the diaphragmatic release technique and the thoracic lymphatic pump technique versus conventional respiratory retraining in children with asthma. Using a quasi-experimental design, 60 children with asthma were allocated to undergo the diaphragmatic release technique (n = 20), thoracic lymphatic pump technique (n = 20), or conventional respiratory retraining (n = 20) in this study. Serum immunoglobulin E levels, diaphragmatic mobility, pulmonary function, and P(A-a)O2 were assessed before and after 12 treatment sessions that were conducted over nonconsecutive days in a 4-week program. After 12 treatments, the changes in the serum immunoglobulin E level for each group was not significantly different from the other groups. Compared with conventional respiratory retraining, the diaphragmatic release technique was associated with a significant improvement in FVC (P = .001) and FEV1 (P = .002); the thoracic lymphatic pump technique showed no differences. With regard to diaphragmatic mobility, both the diaphragmatic release technique and the thoracic lymphatic pump technique yielded significantly favorable effects when compared with conventional respiratory retraining (P < .001 and P = .01, respectively). Further, no significant between-group differences were detected in terms of the P(A-a)O2 (P = .07). The thoracic lymphatic pump technique and conventional respiratory retraining approaches were helpful interventions that could be used to alleviate the symptoms of childhood asthma. Nevertheless, the diaphragmatic release technique was a potentially more effective intervention.

Assessment of Treatment Response in Collagen Vascular Disease Associated Interstitial Lung Disease with Combination of Prednisolone and Azathioprine

Background: Collagen vascular diseases are a heterogenous group of autoimmune disorders of unknown etiology of which ILD is the most common pulmonary complication. Treatment is usually aimed at slowing or preventing progression rather than in the hope of a striking short-term response.&#x0D; Materials and Methods: The aim of the study is to assess response to treatment in patients with collagen vascular disease associated Interstitial lung disease who were started on combination of Azathioprine and Prednisolone.&#x0D; Results: Majority of patients remained stable following 6 months of treatment.&#x0D; Improvement in FVC in millilitres showed a trend towards significant difference between UIP and NSIP patterns of ILD.&#x0D; Conclusion:Treatment response in collagen vascular disease associated ILD is largely dependent on the type of underlying lung disease.

A clinical study of hyperreactive airway disease with wheeze in children aged five to twelve years with special reference to pulmonary function test

Background: Pulmonary function test is the easiest and most cost-effective method to evaluate respiratory functions. PFT can be measured by a simple instrument spirometer. Measuring PFT has been suggested as an important tool in understanding HRAD and its complications and management by all international guidelines. The objectives of this study were to clinically diagnose the hyperreactive airway disease in children coming to Navodaya Medical College, Raichur, of age group 5 to 12 years. And to perform pulmonary function test before and after the use of a bronchodilator.Methods: PFT was measured in 100 children who came with HRAD with wheeze using Spiro lab III spirometer. The child was given then nebulization with salbutamol and PFT was performed again after 30 min.Results: A total of 100 clinically diagnosed cases of HRAD of age group 5 to 12 years of both the gender was taken into the study, of which more than 44% of the children showed more than 20% improvement in parameters FEV1, PEF, FVC and marginal improvement in EV1/FVC post bronchodilator compared to their prebronchodilator parameters. The young children of both the gender showed better improvement than elder children.Conclusions: Spirometry is the best tool to assess HRAD even in younger children, early diagnosis and regular follow up with PFT helps to understand and prevent the progression of the disease with prompt treatment.

The Impact of Upper Limb Training with Breathing Maneuver in Lung Function, Functional Capacity, Dyspnea Scale, and Quality of Life in Patient with Stable Chronic Obstructive of Lung Disease.

BACKGROUND:Exercise tolerance is one of the main impacts of COPD. COPD patients often experience dyspnea and fatigue after doing daily activities using their limb parts, even in simple thing such as lifting or grooming. Nowadays, many pulmonologists concerned in pulmonary rehabilitation to modify some limb training with breathing manoeuvre to get positive impact in stable COPD patient.AIM:The purpose of this study is to examine the impact of this modified upper limb training in lung function, functional capacity, dyspnea scale, and quality of life in patients with stable COPD.METHOD:This was a quasi-experimental study held in 2017 on 22 stable COPD patients (based on GOLD 2018 criteria). Patients were given modified upper limb training with breathing manoeuvre that leads and monitored by a physiotherapist and physician in 10-20 minutes twice a week for 8 weeks. Before and after completed all sessions of training, we measured pulmonary functions test include FEV1 and FVC, functional capacity by 6 MWT, dyspnea scale by mMRC, and quality of life by CAT assessment. Statistical analysis was performed by Wilcoxon and paired t-test.RESULTS:There was an improvement of lung function, both FEV1 (40.7 ± 13.8 to 47.3 ± 14.2; p-value 0.001) and FVC (50.7 ± 14.1 to 54.1 ± 14.7; p-value: 0.207) after training. There was a significant change of functional capacity in 6 MWT mean (277.3 ± 80.8 to 319.1 ± 78.3; p-value: 0.001). There was an improved quality of life after training, measured by decreasing in CAT score (23.9 ± 5.5 to 18.3 ± 5.2; p-value: 0.000). There was no significant change in the mMRC scale (p-value: 0.429)CONCLUSION:There was an improvement of lung function, functional capacity, and quality of life in stable COPD after upper limb training with breathing manoeuvre in stable COPD patients.