Mode Of Breathing Research Articles

Study of gas exchange under different modes of ventilation in yoga breathing exercises

Yoga breathing exercises that develop the ability to voluntarily regulate the minute volume of respiration (MV) and maintain the state of hypoventilation, hypoxia and hypercapnia, can be considered as a way of hypoxic-hypercapnic training, potentially capable of influencing cerebral circulation and neuroprotective factors. However, at the moment, individual anthropometric features that affect the ability to develop a hypoventilation mode of breathing have not been studied, and methodological criteria for training have not been developed.Methods: The study involved 44 people (32 men and 12 women) who regularly practice yoga breathing techniques with a voluntary decrease in respiratory rate using maximum tidal volume (TV). Free breathing was recorded for 2 minutes, then each subject performed the respiratory hypoventilation pattern available to him or her (minimum RR values with maximum TV, inhalation and exhalation were of equal duration). The following parameters of external respiration were determined: respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO2 in the exhaled air at the end of exhalation (PetCO2 ), percentage of O2 in the exhaled air (FeO2) and hemoglobin saturation (SpO2 ).Results: Compared to breathing at rest (MV = M±SD 8.51 ± 2.57 (95% CI 7.72–9.29) l/min; PetCO2 = M±SD 36.98 ± 3.71 (95% CI 35.85–38.11) mm Hg), the mode with RR = 3 times/min (inspiration and expiration for 10 s), n = 44, leads to an increase in MV up to M±SD 12.02 ± 3.42 (95% CI 10.98–13.06) l/min (p < 0.001) and a decrease of CO2 : PetCO2 = M±SD 33.99 ± 3.59 (95% CI 32.90–35.08) mm Hg (p < 0.001) — that is, to development of alveolar hypocapnia. The mode with RR = 1.5 times/min (inhalation and exhalation for 20 s), n = 44, demonstrates a decrease in MV to M±SD 5.95 ± 1.59 (95% CI 5.46–6.43) l/min (p < 0.001) and growth of PetCO2 up to M±SD 41.19 ± 3.71 (95% CI 40.06–42.32) mm Hg (p < 0.001). The mode with RR = 1 time/min (inspiration and exhalation for 30 s), n = 24: with a decrease in RR to 1 time/min, a decrease in MV was observed to M±SD 4.22 ± 0.92 (95% CI 3.83–4.61) l / min (p < 0.001) and an increase in PetCO2 up to M±SD 44.05 ± 3.05 (95% CI 42.76–45.33) mm Hg (p < 0.001). The breathing pattern with RR = 1 r/min is accompanied by a statistically significant decrease in MV compared to rest, as well as an increase in PetCO2 and a decrease in FeO2 , that is, it is hypoventilation. We have proposed a ventilation coefficient (Qvent), which is the ratio MV/VC, which allows us to judge at what values of MV an individual reaches a state of hypoventilation. It was previously shown in this sample that the breathing exercise becomes hypoventilation when Qvent values are equal to or less than 1. With Qvent in the range from 1 to 2, the ventilation mode is within normal values, and when Qvent is more than 2, hyperventilation occurs.Conclusion: when performing yoga breathing exercises, variations in MV are observed both in the direction of hyperventilation and in the direction of hypoventilation with corresponding shifts in gas exchange (hypocapnia with hyperventilation, hypercapnia with hypoventilation). The MV values at which an individual reaches hypoventilation vary from person to person and can be predicted using the ventilation coefficient (Qvent).

The Effects of Mouth Breathing on Maxillofacial Growth in Children and Adolescents with Adenoid Hypertrophy: A Scoping Review

Introduction: Mouth breathing is a mode of breathing that replaces normal breathing through the nose, which is usually caused by an obstruction of the respiratory tract. The habit of breathing through the mouth can cause changes in maxillofacial morphology. Methods: Article searches were done on PubMed, EBSCO Essentials, and Google Scholar electronic databases. Inclusion criteria included study subjects aged 3-18 years old who had a habit of breathing through their mouths due to adenoid hypertrophy. Articles that were reviewed were published from 2017 to October 2022. Results: With a total of 1107 articles, 2 articles were identified through PubMed, 663 articles were identified through EBSCO Essentials, 424 articles were identified through Google Scholar, and 18 articles were identified through handsearching. After the selection process using the PRISMA-ScR flow diagram, 13 articles were taken for review. extract gel in experimental animals. Conclusion: Children and adolescents with adenoid hypertrophy experience several changes in the maxillofacial structure due to the habit of mouth breathing. Children and adolescents with adenoid hypertrophy experience several changes in the maxillofacial structure due to the habit of mouth breathing. Keywords: Adenoid hypertrophy, airway obstruction, maxillofacial growth, mouth breathing

Fluid Responsiveness in Critically Ill Patients Using Carotid Peak Systolic Velocity Variability: A New Frontier.

Background and objectives A fluid responder is a patient who can increase his stroke volume/ cardiac output by more than 10%-15% after a fluid bolus. Left ventricular outflow tract (LVOT) velocity time integral (VTI) variability is widely used as an adynamic parameter of fluid responsiveness, but a transthoracic echo view of LVOT VTI is often time-consuming and, at times, difficult to achieve. So, in the quest for another parameter that might equally be a good surrogate marker of stroke volume variation, carotid peak systolic velocity (CPSV) variation has been studied. The objective was to assess CPSV variation in patients who are already fluid responders. Methods The sample size was calculated considering a minimum correlation coefficient of 0.5. Adult patients in whom the physician wanted to give a fluid bolus and whose average LVOT VTI was more than 15% over 3 respiratory cycles were included in the study. Demographic variables, along with hemodynamic parameters such as heart rate, blood pressure, the need for vasopressors, mode of breathing (spontaneous or mechanical ventilation), andCPSV variation,were noted and averaged over three respiratory cycles. Fluid bolus (Plasmalyte) 6 ml/kg bolus over 10-15 minutes. Post-fluid hemodynamic variables, along with averaged LVOT VTI over three respiratory cycles and averaged CPSV variation over three respiratory cycles, are noted. Results Thirty adult patients were evaluated in the study. In spontaneously breathing patients (n=12), the average CPSV variation expressed as mean + standard deviation before and after fluid administration of 6ml/kg of ideal body weight was 14.1 ± 3.4 and 5.4 ± 2.6, respectively (p < 0.05). In mechanically ventilated patients (n=18), the average CPSV variation expressed as mean + standard deviation before and after fluid administration of 6ml/kg of ideal body weight fluid was 15 ± 5.3 and 6.5 ± 3.1, respectively (p <0.005). Overall, there was a statistically significant positive correlation between LVOT VTI variation and CPSV variation before fluid therapy (correlation coefficient 0.56 and p-value 0.001) and a statistically significant moderate positive correlation post-fluid therapy (correlation coefficient 0.37 and p-value 0.043). Conclusion We found a significant decrease in CPSV variation post-fluid administration in patients who are fluid responders, which mimics a decrease in stroke volume variation after fluid administration in patients who are fluid responsive.

Laryngeal cancer treatment decision making: A conjoint analysis of general public attitudes and priorities.

Patients with advanced laryngeal cancer are typically presented with divergent treatment options, namely chemoradiation versus total laryngectomy. This study aims to understand general perspectives of the factors involved in this decision-making process. Surveys were constructed using specialized conjoint analysis software. Seven attributes integral to the decision-making process for advanced laryngeal cancer treatment were included. Three hundred one healthy adult volunteers completed the decision-making program. The relative impact of each treatment attribute on decision making across all participants was scored with an average importance score (standard deviation) as follows: Lifespan 22.2% (±8.5), Voicing 21.4% (±5.9), Swallowing 19.1% (±7.3), Cancer Cure 14.9% (±6.2), Mode of Breathing 11.0% (±3.7), Self-Image 6.7% (±2.9), and Treatment Type 4.8% (±3.0). General public opinion ranked lifespan, voicing, and swallowing aspects as similarly important, and all were ranked more important than probability of cure. These data demonstrate a variety of priorities among participants and the need for tailored discussions when determining treatment choice for advanced laryngeal cancer. Level 4.

The reaction of blood microcirculation in the skin of various parts of the body after performing yoga breathing exercises

Introduction. Yoga breathing exercises make it possible to change the minute ventilation (MV) within a wide range, reaching states of hyper- and hypoventilation with corresponding shifts in gas exchange. In this work, the interrelations between external respiration, parameters of gas metabolism and the skin microcirculation were evaluated. Materials and methods: 22 experienced volunteers performed yoga breathing exercises at a frequency of 3–3.5 times per minute and 1–1.5 times per minute for 5 minutes, as well as free breathing for 6 minutes before and after breathing exercises. Respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO2 in exhaled air at the end of exhalation (PetCO2), percentage of O2 in exhaled air (FeO2 ) were recorded using spirometry and gas analysis; by laser Doppler flowmetry and a distributed system of wearable analyzers parameters of skin microcirculation such as index of microcirculation (IM), nutritive blood flow (Imn ), amplitudes of endothelial (Ae), neurogenic (An), myogenic (Am), respiratory (Ar) and cardiac (Ac) oscillations were recorded in six body areas. Results. After the breathing exercises, the index of microcirculation of the supraorbital artery pool increased from 14.7 p. u. to 16.7 p. u., in the fingers from 24.8 p. u. to 29.4 p. u. and in toes from 8.2 p. u. to 10.2 p. u. with hypoventilation (RR=1–1.5 ­times/ minute) and in the skin of the supraorbital artery pool from 14.7 p. u. to 16.0 p. u., in the fingers from 27.1 p. u. to 29.8 p. u. and in toes from 11.5 p. u. to 13.5 p. u. with hyperventilation (RR=3–3.5 times / minute), nutritional blood flow increased from 14.4 p. u. and 14.3 p. u. to 17.8 p. u. and 16.9 perf.u. on the upper and from 4.7 p. u. and 6.1 p. u. to 6.8 p. u. and 7.5 p. u. on the lower extremities with hypo- and hyperventilation, respectively; an increase of the amplitude of endothelial blood oscillations after a hypoventilation and an increase of the amplitude of neurogenic oscillations after both types of breathing in the forehead skin were observed. Conclusion. The absence of differences between the effect of hypo- and hyperventilation exercises on Im suggests that the main mechanism of action may not be shifts in MV and gas exchange, but the depth of breathing; the influence of cognitive mechanisms (conscious control of breathing in both modes) is also discussed. The absence of changes in nutritive blood flow in the head can be explained by regional features of microcirculation regulation. The hypoventilatory mode of breathing significantly activates the endothelial mechanism of regulation; the neurogenic (sympathetic) mechanism of regulation is activated by both hypo- and hyperventilation respiratory modes.

Comparison of Effectiveness of Pressure Support and Mandatory Ventilation Modes at the End of General Combined Anesthesia

The objective: to compare effectiveness of pressure support and mandatory ventilation modes at the final stage of general anesthesia.Subjects and Methods. 58 patients were included in the study. All patients underwent laparoscopic or open surgery under combined general anesthesia with muscle relaxants and tracheal intubation. At the end of the operation, after suturing the muscle layer, patients were randomly divided into two groups, depending on the further mode of ventilation: the mandatory mode group with dual control until extubation (n = 29) and the spontaneous breathing mode group with pressure support (n = 29). The time of awakening, the severity of post-extubation cough, hemodynamic parameters and oxygenation immediately before and 5 minutes after extubation were assessed.Results. In the groups of patients, statistically significant differences were observed in the time of awakening (252 ± 67 sec and 426 ± 71 sec in PSV and PCV-VG Groups, respectively), extubation (287 ± 55 sec and 464 ± 67 sec in the PSV and PCV-VG groups, respectively), and transfer from the operating room (473 ± 60 sec and 687 ± 77 sec in the PSV and PCV-VG groups, respectively) (p &lt; 0.0001). Also, patients receiving PSV respiratory support had higher saturation levels 5 minutes after extubation (p &lt; 0.0001), and heart rate and mean arterial pressure immediately before extubation were lower than in the mandatory ventilation group (p = 0.013 and p &lt; 0.0001, respectively). In addition, in the mode of spontaneous breathing with pressure support, a lower severity of post-extubation cough was observed (p = 0.003).Conclusion. The use of a spontaneous breathing mode with pressure support at the end of general combined anesthesia has several advantages versus mandatory ventilation mode. These advantages include faster awakening, extubation and transfer of the patient to the ward, lower severity of post-extubation cough, as well as better gas exchange after extubation, lower intensity of hypertension and tachycardia before it.

Spin-wave modes of elliptical skyrmions in magnetic nanodots

Magnetic skyrmions, whose shapes are ellipse due to the presence of anisotropic Dzyaloshinskii–Moriya interaction (DMI), have already been discovered in experiments recently. By using micromagnetic simulations, we discuss the ground state and the spin-wave modes of a single elliptical skyrmion in a confined nanodot. It is found that the shapes of skyrmion are stretched into a horizontal ellipse, vertical ellipse, or stripe shape under different strengths of anisotropic DMI. When elliptical skyrmions are excited by in-plane ac magnetic fields, the spin-wave mode contains a counterclockwise rotation mode at high frequencies and a clockwise (CW) rotation mode at low frequencies, and the CW mode depends on the strength of anisotropic DMI. When elliptical skyrmions are excited by out-of-plane ac magnetic fields, the spin-wave mode is split from a simple breathing mode into two complex breathing modes, including a mixed mode of CW rotation and breathing, and another anisotropic breathing mode. Our results provide an understanding of the rich spin-wave modes for skyrmions, which may contribute to the applications in magnonics.

Incidence and risk factors for pneumomediastinum in COVID-19 patients in the intensive care unit.

OBJECTIVESThe incidence of pneumomediastinum (PNMD), its causes of development and its effect on prognosis in the coronavirus disease 2019 (COVID-19) are not clear.METHODSBetween March 2020 and December 2020, 427 patients with real-time reverse transcriptase-polymerase chain reaction-confirmed COVID-19 admitted to the intensive care unit were analysed retrospectively. Using receiver operating characteristic analysis, the area under the curve (AUC) for initial invasive mechanical ventilation (MV) variables such as initial peak inspiratory pressure (PIP), PaO2/FiO2 (P/F ratio), tidal volume, compliance and positive end-expiratory pressure was evaluated regarding PNMD development.RESULTSThe incidence of PNMD was 5.6% (n = 24). PNMD development rate was 2.7% in non-invasive MV and 6.2% in MV [odds ratio (OR) 2.352, 95% confidence interval (CI) 0.541–10.232; P = 0.400]. In the multivariate analysis, the independent risk factors affecting the development of PNMD were PIP (OR 1.238, 95% CI 1.091–1.378; P < 0.001) and P/F ratio (OR 0.982, 95% CI 0.971–0.994; P = 0.004). P/F ratio (AUC 0.815, 95% CI 0.771–0.854), PIP (AUC 0.780, 95% CI 0.734–0.822), compliance (AUC 0.735, 95% CI 0.677–0.774) and positive end-expiratory pressure (AUC 0.718, 95% CI 0.668–0.764) were the best predictors for PNMD development. Regarding the multivariate analysis, independent risk factors affecting mortality were detected as age (OR 1.015, 95% CI 0.999–1.031; P = 0.04), comorbidity (OR 1.940, 95% CI 1.100–3.419; P = 0.02), mode of breathing (OR 48.345, 95% CI 14.666–159.360; P < 0.001), PNMD (OR 5.234, 95% CI 1.379–19.857; P = 0.01), positive end-expiratory pressure (OR 1.305, 95% CI 1.062–1.603; P = 0.01) and tidal volume (OR 0.995, 95% CI 0.992–0.998; P = 0.004).CONCLUSIONSPNMD development was associated with the initial P/F ratio and PIP. Therefore, it was considered to be related to both the patient and barotrauma. PNMD is a poor prognostic factor for COVID-19.

Breathing mode influence on craniofacial development and head posture

ObjectiveThe incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. MethodNinety‐eight 7–16 year‐old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7–9) (G2: 10–16) to account for normal age‐related facial growth. ResultsOral breathing children (8.0±0.7 years) showed less nasopharyngeal cross‐sectional dimension (MPP) (p=0.030), whereas other structures were similar to their nasal breathing counterparts (7.6±0.9 years). However, oral breathing teenagers (12.3±2.0 years) exhibited a greater palate length (ANS‐PNS) (p=0.049), a higher vertical dimension in the lower anterior face (Xi‐ANS‐Pm) (p=0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H‐MP) (p=0.017) than their nasal breathing counterparts (12.5±1.9 years). No statistically significant differences were found in head posture. ConclusionEven in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position.

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion.

SUMMARYThe purpose of this cephalometric study was to evaluate the craniofacial changes induced by functional treatment of mandibular advancement with special regard to pharyngeal sagittal airway dimensions, tongue and hyoid bone position in subjects with sleep-disordered breathing (SDB) and dentoskeletal Class II malocclusions compared with an untreated Class II control group. 51 subjects (24 female, 27 male; mean age 9.9 ± 1.3 years) with Class II malocclusion and SDB consecutively treated with a functional appliance (Modify Monobloc, MM) were compared with a control group of 31 subjects (15 males, 16 females; mean age 10.1 ± 1.1) with untreated Class II malocclusion. For the study group, mode of breathing was defined by an otorhinolaryngologist according to complete physical examination. The parents of all participants completed a modified version of the paediatric sleep questionnaire, PSQ-SRBD Scale, by Ronald Chervin (the Italian version in 22 items form) before and after the trial. Lateral cephalograms were available at the start and end of treatment with the MM. Descriptive statistics were used for all cephalometric measurements in the two groups for active treatment changes. Significant, favourable skeletal changes in the mandible were observed in the treated group after T2. Significant short-term changes in sagittal airway dimensions, hyoid position and tongue position were induced by functional therapy of mandibular advancement in subjects with Class II malocclusion and SDB compared with untreated controls. After orthodontic treatment, a significant reduction in diurnal symptoms was observed in 45 of the 51 participants who had received an oral appliance. Orthodontic treatment is considered to be a potential therapeutic approach for SDB in children. Orthodontists are playing an increasingly important role in managing snoring and respiratory problems by oral mandibular advancement devices and rapid maxillary expansion.

Breathing mode influence on craniofacial development and head posture

ObjectiveThe incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. MethodNinety-eight 7–16 year-old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7–9) (G2: 10–16) to account for normal age-related facial growth. ResultsOral breathing children (8.0±0.7 years) showed less nasopharyngeal cross-sectional dimension (MPP) (p=0.030), whereas other structures were similar to their nasal breathing counterparts (7.6±0.9 years). However, oral breathing teenagers (12.3±2.0 years) exhibited a greater palate length (ANS-PNS) (p=0.049), a higher vertical dimension in the lower anterior face (Xi-ANS-Pm) (p=0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H-MP) (p=0.017) than their nasal breathing counterparts (12.5±1.9 years). No statistically significant differences were found in head posture. ConclusionEven in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position.

Predictors of sleep disordered breathing in children: the PANIC study.

We studied longitudinally the associations of craniofacial morphology, mouth breathing, orthodontic treatment, and body fat content with the risk of having and developing sleep disordered breathing (SDB) in childhood. We hypothesized that deviant craniofacial morphology, mouth breathing, and adiposity predict SDB among children. The participants were 412 children 6-8 years of age examined at baseline and 329 children aged 9-11 years re-examined at an average 2.2-year follow-up. An experienced orthodontist evaluated facial proportions, dental occlusion, soft tissue structures, and mode of breathing and registered malocclusions in orthodontic treatment. Body fat percentage was assessed by dual-energy X-ray absorptiometry and SDB symptoms by a questionnaire. Children with SDB more likely had convex facial profile, increased lower facial height, mandibular retrusion, tonsillar hypertrophy, and mouth breathing at baseline and convex facial profile, mandibular retrusion, and mouth breathing at follow-up than children without SDB at these examinations. Male gender and body adiposity, mouth breathing, and distal molar occlusion at baseline were associated with SDB later in childhood. Adipose tissue under the chin, mandibular retrusion, vertically large or normal throat and malocclusion in orthodontic treatment at baseline predicted developing SDB during follow-up of among children without SDB at baseline. We could not conduct polysomnographic examinations to define sleep disturbances. Instead, we used a questionnaire filled out by the parents to assess symptoms of SDB. The results indicate that among children, deviant craniofacial morphology, mouth breathing, body adiposity, and male gender seem to have implications in the pathophysiology of SDB.

Traitement primaire des fentes labio-palatines. Ses grands principes

If the multiplicity of functional protocols of cleft lip and palate treatment has been bewildering, it is now a source of learning. The lessons we can draw from them assist us to choose the best age for the primary surgery and a chronology that prevents the palate from the worst scaring. Eventually, with 18years of follow-up, the best functional achievement comes unexpectedly from an ambitious primary rhinoplasty that had till now been condemned. Not only do the patients have good appearance and social integration, but the nasal mode of breathing established at the time of the primary surgery favors a good facial growth without any compromise. Reciprocally, all the interacting functions benefit from a nasal ventilation.

Maxillary dentoskeletal changes 1-year after adenotonsillectomy

ObjectiveTo measure the maxillary dentoskeletal and soft tissue changes of severely obstructed mouth breathing (MB) young children who had their mode of breathing normalized after adenotonsillectomy (T&A), in comparison with a matched group of severely obstructed untreated MB children (CG). MethodsSeventy patients who had an Ear, Nose, and Throat examination (ENT), including flexible nasal endoscopy, to confirm the severe obstruction of the upper airways and the indication of T&A composed the sample. Cephalograms and dental casts were available from the patient's orthodontic records. Treatment group (TG) and CG included 35 children each. Groups were matched by gender (24 males and 11 females in each group), age (TG, 6.7 ± 1.8 years; CG, 6.9 ± 2.3 years), tooth development (TG, 13 primary dentition, 22 mixed dentition; CG, 14 primary dentition, 21 mixed dentition), and skeletal maturation status. Records were taken at baseline (T0) and 1-year after T&A (T1) for TG; while CG records were taken with a 1-year interval. Dentoskeletal measurements were performed in the lateral cephalograms, and dental casts were used to assess the palatal volume and occlusal changes. ResultsTG showed a significant increase (503.3 mm3, P < 0.001) in the palatal volume (10% of change), while CG palatal volume was stable. No dimensional occlusal changes were detected between T0 and T1 in both groups. Significant downward (point A, 2.1 mm; ANS, 2.1 mm) and forward displacements (point A, 0.7 mm; ANS, 1 mm) of the anterior region of the maxilla were observed in the TG, but CG presented only significant downward displacement (point A, 1.8 mm; ANS, 1.4 mm). The maxillary posterior region (PNS, PTM, and Molar) displaced downward in both groups (P < 0.05), however no sagittal change was found. The palatal plane inclination was stable in both groups. ConclusionsTG presented significant increase in the palatal volume and in the forward displacement of the maxilla. No other significant maxillary dentoskeletal changes were found.

Yoga protocol for treatment of breast cancer-related lymphedema.

Introduction:Vaqas and Ryan (2003) advocated yoga and breathing exercises for lymphedema. Narahari et al. (2007) developed an integrative medicine protocol for lower-limb lymphedema using yoga. Studies have hypothesized that yoga plays a similar role as that of central manual lymph drainage of Foldi's technique. This study explains how we have used yoga and breathing as a self-care intervention for breast cancer-related lymphedema (BCRL).Methods:The study outcome was to create a yoga protocol for BCRL. Selection of yoga was based on the actions of muscles on joints, anatomical areas associated with different groups of lymph nodes, stretching of skin, and method of breathing in each yoga. The protocol was piloted in eight BCRL patients, observed its difficulties by interacting with patients. A literature search was conducted in PubMed and Cochrane library to identify the yoga protocols for BCRL.Results:Twenty yoga and 5 breathing exercises were adopted. They have slow, methodical joint movements which helped patients to tolerate pain. Breathing was long and diaphragmatic. Flexion of joints was coordinated with exhalation and extension with inhalation. Alternate yoga was introduced to facilitate patients to perform complex movements. Yoga's joint movements, initial positions, and mode of breathing were compared to two other protocols. The volume reduced from 2.4 to 1.2 L in eight patients after continuous practice of yoga and compression at home for 3 months. There was improvement in the range of movement and intensity of pain.Discussion:Yoga exercises were selected on the basis of their role in chest expansion, maximizing range of movements: flexion of large muscles, maximum stretch of skin, and thus part-by-part lymph drainage from center and periphery. This protocol addressed functional, volume, and movement issues of BCRL and was found to be superior to other BCRL yoga protocols. However, this protocol needs to be tested in centers routinely managing BCRL.

Fast and accurate exhaled breath ammonia measurement.

This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations.

Factors influencing breath ammonia determination

Amongst volatile compounds (VCs) present in exhaled breath, ammonia has held great promise and yet it has confounded researchers due to its inherent reactivity. Herein we have evaluated various factors in both breath instrumentation and the breath collection process in an effort to reduce variability. We found that the temperature of breath sampler and breath sensor, mouth rinse pH, and mode of breathing to be important factors. The influence of the rinses is heavily dependent upon the pH of the rinse. The basic rinse (pH 8.0) caused a mean increase of the ammonia concentration by 410 ± 221 ppb. The neutral rinse (pH 7.0), slightly acidic rinse (pH 5.8), and acidic rinse (pH 2.5) caused a mean decrease of the ammonia concentration by 498 ± 355 ppb, 527 ± 198 ppb, and 596 ± 385 ppb, respectively. Mode of breathing (mouth-open versus mouth-closed) demonstrated itself to have a large impact on the rate of recovery of breath ammonia after a water rinse. Within 30 min, breath ammonia returned to 98 ± 16% that of the baseline with mouth open breathing, while mouth closed breathing allowed breath ammonia to return to 53 ± 14% of baseline. These results contribute to a growing body of literature that will improve reproducibly in ammonia and other VCs.

Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, 14.2 ± 1.3 years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, 13.8 ± 1.5 years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group (mean = 1.3 mm) compared to the control group (mean = 0.5 mm), P = 0.016. However, there was no significant difference in the lower pharyngeal airway measurement between the RME group (mean = 0.2) and the control group (mean = 0.4), P = 0.30. There was no significant difference with respect to mode of breathing between the two groups (P = 0.79). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.

Evaluation of changes in the dentoalveolar morphology in children with asthma

Abstract Hereditary, environmental and developmental factors play an important role in dentofacial development as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induce an alternative mode of breathing in patients is a contributing factor in malocclusion. Our objective in this study was to evaluate the dentoalveolar morphology in asthmatic children. This study is centered on 44 asthmatic children aged between 6–12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non asthmatic group, which comprised of 44 non asthmatic children. Selected parameters were arch width, arch length and palatal depth. Differences in arch widths, arch lengths and palatal depths between asthmatics and non asthmatics, and between subjects under regular and irregular medication in the asthmatic groups were evaluated by independent sample's ‘ t ' tests. The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non asthmatic groups for both age group (6–8 year old males and females, 10–12 year old males and females). Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10–12 year old females. Inter incisal width showed a significant lower value in 10–12 year old female asthmatics in the maxillary arch ( P

Effects of Asthma and Inhalation corticosteroids on the dental arch morphology in children

Hereditary, environmental and developmental factors play an important role in dentofacial development, as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induces an alternative mode of breathing in patients is a contributing factor in development of the dental arch. Our aim in this study was to evaluate the dentoalveolar morphology in asthmatic children and to analyze the effects of asthmatic medications on the dental arch. This study is centered on 44 asthmatic children aged between 6-12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non-asthmatic group, which comprised of 44 non-asthmatic children. Selected parameters were arch width, arch length and palatal depth. Impressions of upper and lower arches were made with rubber based impression material. A sliding digital caliper was used to measure the casts for arch width and arch length. A palatal depth gauge was used to measure the palatal depth. Differences in arch widths, arch lengths and palatal depths between asthmatics and non-asthmatics groups were evaluated by independent sample t-tests. Chi-square test was applied to assess the frequency of occurrence of malocclusion in the asthmatic children. The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non-asthmatic groups for both age groups (6 to 8-year-old males and females, 10 to 12-year-old males and females). Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10 to 12-year-old females. Fifty percent of the asthmatic children aged 10 to 12-years had open-bite. Children under regular medication showed significant deviation in the dentoalveolar morphology as compared to those under irregular medication. The present study proves a strong relation between asthma and dentoalveolar morphology.