Obstructive Disorders Research Articles

Two cases of airway dysfunction related to diacetyl exposure

Occupational exposure to diacetyl can lead to bronchiolitis obliterans. In this paper, two patients with severe obstructive ventilation disorder who were exposed to diacetyl at a fragrance and flavours factory were analyzed. The clinical manifestations were cough and shortness of breath. One of them showed Mosaic shadows and uneven perfusion in both lungs on CT, while the other was normal. Field investigation found that 4 of the 8 workers in the factory were found to have obstructive ventilation disorder, and 2 had small airway dysfunction. This paper summarizes the diagnostic process of patients in order to improve the understanding of airway dysfunction caused by occupational exposure to diacetyl and promote the development of relevant standards.

Exploring the immunological basis of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome: immunohistochemical staining features of palatine tonsils.

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is the most common periodic fever syndrome during early childhood period with regular febrile attacks of sterile upper airway inflammation. The cessation of attacks following tonsillectomy points to fundamental role of tonsil tissue on etiopathogenesis of disease, which is not clarified satisfactorily. The aim of this study is to explore the immunological basis of PFAPA by evaluating the cellular properties of tonsils, and microbial exposition such as Helicobacter pylori on tonsillectomy materials. The paraffinized tonsil samples of 26 PFAPA and 29 control patients with obstructive upper airway disorder were compared in terms of immunohistochemical staining features including CD4, CD8, CD123, CD1a, CD20, and H. pylori. The median number of CD8+ cells was 1485 (1218-1287) in PFAPA while it was 1003 (852-1261.5) in control group and the difference was statistically significant (p=0.001). Similarly, CD4+ cell counts were statistically higher in PFAPA group than control (833.5 vs 622). The ratio of CD4/CD8 did not differ between two groups; also, there was no statistically difference in terms of the other immunohistochemical staining results, such as CD20, CD1a, CD123 and H. pylori. This is the largest number of pediatric tonsillar tissue study of PFAPA patients in current literature and we emphasized the triggering effects of CD8+ and CD4+ T-cells on PFAPA tonsils. • The cessation of attacks following tonsillectomy points to fundamental role of tonsil tissue on etiopathogenesis of disease, which is not clarified satisfactorily. • In current study, 92.3% of our patients did not experience any attacks following operation similarly with literature. • We observed the increased number of CD4+ and CD8+ T cell counts on PFAPA tonsils compared to control group and emphasized the active role of both CD4+ and CD8+ cells localized on PFAPA tonsils in immune dysregulation. • Some other cell types evaluated in this study such as CD19+ (B cells), CD1a (dendritic cells), and CD123 (IL-3 receptors, for pluripotent stem cells) and H. pylori did not differ in PFAPA patients compared to the control group.

Management of difficult-to-treat asthma in adolescence and young adults.

The period of adolescence and young adulthood (AYA) has been proposed to extend from 11 to 25 years of age as patients in this age group face similar challenges. AYA is a time of fast and great physiological and psychological growth, in which an individual transitions from a young dependent child to a mature independent adult. Behaviour patterns during adolescence, such as risk taking and desire for privacy, can challenge parents or healthcare professionals' (HCPs') ability to help adolescents to manage their asthma. Asthma itself tends to remit, become milder or worsen into a severe variant during adolescence. The pre-pubertal male predominance of asthma switches to a female predominance in late teen years. ∼10% of AYA with asthma have "difficult-to-treat asthma (DTA)", characterised by poor asthma control despite treatment with inhaled corticosteroids (ICS) and other controller medications. DTA management in AYA requires a multidisciplinary team approach and systematic assessment that can address the key questions of objective confirmation of diagnosis, severity assessment, phenotyping, comorbidities, asthma mimickers or other drivers of poor control such as non-adherence to treatment. A key task for HCPs is to establish the magnitude of the severe asthma component versus other non-asthma drivers of symptoms (e.g. inducible laryngeal obstruction or breathing pattern disorder). Severe asthma is a subset of DTA and is determined once asthma diagnosis and its severity have been confirmed and adherence to controller (ICS) treatment has been assured. Severe asthma is a heterogeneous disease and appropriate phenotyping is necessary for the management of treatable traits and consideration for biologic therapies. Finally, an important part of successful management of DTA in the AYA group is the provision of an effective transition of asthma care from paediatric to adult asthma services through setting up a well-designed asthma transition pathway tailored to the individual patient needs.

Detection and Classification of Obstructive Sleep Apnea Disorders: A Comparative Analysis of Various Deep Machine Learning Classifiers

Detection and Classification of Obstructive Sleep Apnea Disorders: A Comparative Analysis of Various Deep Machine Learning Classifiers

Impact of prenatal physical preparation program on respiratory parameters of pregnant women

Background/Aim: Pregnancy is a condition that alters a woman's respiratory parameters. We aimed to verify the impact of a prenatal physical preparation program on respiratory parameters of pregnant women. Methods: A quasi-experimental study was conducted with 38 pregnant women over a period of 8 months. It consisted of measuring the respiratory parameters (using the New MIR Spirolab Spirometer) of pregnant women who participated in the prenatal physical preparation program. Each session lasted 45 minutes and took place once a week. The sessions involved low to moderate intensity and assessed the forced expiratory volume second, the vital capacity force, and the peak expiratory flow. Results: After the intervention program in prenatal physical preparation, there was a significant change in the vital capacity force (74 (3.65) before vs 79 (0.54) after; P=0.003); forced expiratory volume (68 (0.63) vs 76 (0.45), P=0.002); and peak expiratory (69 (1.77) before vs 78 (1.12) after; P=0.001) The Tiffeneau index showed (72.8 (4.2) vs 76.19 (13.3), P=0.001). The number of pregnant women with normal spirometry doubled from 47.4% at the start of the program to 94.7% at the end of the program. Similarly, the proportion of pregnant women with mild restriction increased from 42.1% at the start of the program to 2.6% at the end, indicating a total improvement of the obstructive disorders. Conclusion: The regular practice of physical activity allows for improvement of the respiratory parameters of pregnant women. This program must continue to enable these women to maintain their respiratory capacity after childbirth.

Surgical management of chronic rhinosinusitis with nasal polyps under local anaesthesia: indications and results.

Our objective was to specify the indications and duration of effectiveness of Awake Patient Polyp Surgery (APPS) in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Secondary objectives were to evaluate complications and Patient-Reported Experience (PREMs) and Outcome Measures (PROMs). We collected information regarding sex, age, comorbidities and treatments. Duration of effectiveness was the duration of non-recurrence defined by the time between APPS and a new treatment. Nasal Polyp Score (NPS) and Visual Analogic Scales (VAS, from 0/10 to 10/10) for nasal obstruction and olfactory disorders were assessed preoperatively and one month after surgery. PREMs were evaluated using a new tool: the APPS score. Seventy-five patients were enrolled (SR = 3.1, mean age = 60.9 ± 12.3 years). 60% of patients had a previous history of sinus surgery, 90% had stage 4 NPS and more than 60% had overuse of systemic corticosteroids. Mean time of non-recurrence was 31.3 ± 2.3 months. We found a significant improvement (all p < 0.001) for NPS (3.8 ± 0.4 vs 1.5 ± 0.6), VAS obstruction (9.5 ± 1.6 vs 0.9 ± 1.7) and VAS olfactory disorders (4.9 ± 0.2 vs 3.8 ± 1.7). Mean APPS score was 46.3 ± 5.5/50. APPS is a safe and efficient procedure in the management of CRSwNP.

The impact of psychiatric comorbidities on emergency general surgical patients’ outcomes

BackgroundPsychiatric disorders are increasingly prevalent. Studies have demonstrated that the presence of comorbid psychiatric conditions (CPC) is associated with a number of worsening outcomes in hospitalised patients in general. The relationship between a wide range of psychiatric comorbidities and acute surgical presentations has not been studied to date. Study designThe Hospital In-Patient Enquiry (HIPE) system and prospectively maintained eHandover were used to identify all surgical emergency admissions to Mayo University Hospital, Ireland. Patient demographics, comorbidities, primary diagnoses, length of stay (LoS), and procedures undergone were recorded over a 12-months period. Subgroup analyses examining LoS variation in surgical presentation types were performed. Results1028 admissions occurred over this one year period, amongst 995 patients, the presence of psychiatric comorbidities increased the mean LoS by 1.9 days (p = 0.002). Comorbid depression, dementia, and intellectual disability conferred a significant increase in LoS by 2.4 days, 2.8 days and 6.7 days respectively. Subgroup analysis revealed greater LoS in patients with CPC diagnosed with non-specific abdominal pain (1.4 days, p = 0.019), skin and soft tissue infections (2.5 days, p = 0.040), bowel obstruction (4.3 days, p = 0.047), and medical disorders (18.6 days, p = 0.010). No significant difference was observed in mortality and readmission rates. ConclusionPsychiatric comorbidities significantly impact length of hospital stay and discharge planning in surgical inpatients. Greater awareness of this can facilitate better care delivery for this population to reduce the LoS and subsequent economic burden on the healthcare system.

Функціональний стан дихальної системи у хворих із задишкою, які перенесли негоспітальну пневмонію, асоційовану з COVID-19

Функціональний стан дихальної системи у хворих із задишкою, які перенесли негоспітальну пневмонію, асоційовану з COVID-19

Features of respiratory impedance in patients with respiratory tuberculosis with bronchial patency disorders

SummaryAim. To establish the features of respiratory im-pedance deviations detected by the method of forced oscillations in patients with tuberculosis of the respiratory organs and bronchial patency disorders. Маterials and methods. The parameters of spirometry and the method of forced oscillations were studied in 310 patients and in healthy subjects (group 3, n=22). At 8, 12, 16 Hz (oscillation frequencies), the respiratory impedance (RI) was measured: RI with calm breathing at inspiration — Rin; RI with calm breathing at exhalation — Rex; RI with respiratory volume — Rfo. In group 1 (n=229), the following subgroups were identified: 1A subgroup — 62 patients with initial obstructive disorders, 1B — 108 people with moderate, and 1C — 59 patients with significant obstruction. Patients without obstructive disorders comprised group 2 (n=81). Results. In group 1: the parameters of RI were higher than in groups 2 and 3, the frequency dependence of the RI was established. In subgroup 3B values of the parameters of RI, index of the frequency dependence of the RI, the number of RI indicators with pathological changes were higher than in 3A subgroup. Conclusion. In patients with tuberculosis of the respiratory organs with obstructive disorders an increase in respiratory impedance and the frequency dependence of respiratory impedance were observed. With the aggravation of obstructive disorders, the respiratory impedance and frequency dependence increase, pathologically altered impedance parameters are more often recorded

Indicadores clínicos e laboratoriais preditivos do desfecho negativo de emergências gastrointestinais em bovino

Abstract This study aimed to identify clinical and laboratory variables that could help predict the negative outcome in cattle affected by gastrointestinal emergencies. A retrospective cohort study was carried out using multivariate logistic regression analysis based on data collected from the clinical records of cattle hospitalized at the Garanhuns Bovine Clinic, UFRPE campus. One hundred and twenty-two cattle met the inclusion criteria established for the study. Among the clinical variables, heart rate (HR) and abdominal distension are associated with the outcome in animals with right displaced abomasum (RDA), and anorexia and 10% dehydration in animals with an obstructive intestinal disorder. Among the laboratory variables, plasma fibrinogen (PF) and total leukocyte count were associated with the outcome in animals with RDA, while PF and plasma L-lactate were associated with animals with an obstructive intestinal disorder. HR and the total leukocyte count remained in the final model of the regression adjusted for animals with RDA. On the other hand, plasma L-lactate and PF remained in the final model in the adjusted model for animals with an obstructive intestinal disorder. Cattle with RDA and HR higher than 90 bpm present an increased chance of having a negative outcome whereas cattle with obstructive intestinal disorder and plasma L-lactate higher than 1.84 mmol/L or PF higher than 850 mg/dL have a higher chance of not survive. Therefore, clinical and laboratory variables such as HR, fibrinogen, and plasma L-lactate are useful to predict the negative outcome in cattle with gastrointestinal emergencies, especially RDA and obstructive intestinal disorders.

СТАН СЕРЦЕВО-СУДИННОЇ СИСТЕМИ У ХВОРИХ ІЗ ЗАДИШКОЮ, ЯКІ ПЕРЕНЕСЛИ ПНЕВМОНІЮ, АСОЦІЙОВАНУ З COVID-19

The aim of this study is to determine the contribution of cardiovascular system impairment to the development of dyspnea in post-acute COVID-19 pneumonia patients. Materials and methods. A total of 108 patients with dyspnea in the post-acute phase of COVID-19 (at 47 (38; 62) days after the onset of symptoms) were examined. These patients had experienced COVID-19associated pneumonia between April and November 2021. 21 patients were excluded due to comorbidities that could be a potential cause of dyspnea in the post-COVID-19 period. Thus, a group of 87 patients was formed, with an average age of 56 (49; 65) years, including 42 (48.3%) males. Patients were divided into three subgroups based on the severity of their acute COVID-19 illness: subgroup 1 (35 patients) — moderate, subgroup 2 (37 patients) — severe and subgroup 3 (15 patients) with critical. Investigation methods included clinical examinations, the mMRC dyspnea questionnaire, chest CT scans (both anamnestic and during examination), spirometry, ECG, echo-Doppler, serum NT-proBNP levels. Results. Patients in subgroups 1 and 2 in the post-acute phase of COVID-19 had less pronounced dyspnea compared to patients in subgroup 3 (1 (1; 2) and 2 (1; 3) vs. 3 (2; 4), respectively) (p &lt; 0.001). Residual changes on chest CT scans were more frequently observed in subgroup 3 than in subgroups 1 and 2 (15 (100%) vs. 7 (20.0%) and 20 (54.1%), respectively) (p &lt; 0.001). Obstructive ventilation disorders were only observed in subgroups 1 and 2 (in 15 (42.9%) and 6 (16.2%) patients, respectively), while restrictive disorders were found in subgroups 2 and 3 (in 14 (37.8%) and 12 (80.0%) patients, respectively). Clinically significant rhythm or conduction disturbances were not detected on ECG in any patient. According to echo-Doppler, subgroup 1 had diastolic dysfunction of the left ventricle (LV) in 3 (8.5%) patients; subgroup 2 had diastolic dysfunction of both the LV and right ventricle (RV) in 5 (13.5%) and 4 (10.8%) patients, respectively; and subgroup 3 had diastolic dysfunction of both the LV and RV in 4 (26.7%) patients. Mild pulmonary hypertension was observed only in subgroups 2 and 3 (in 13 (35.1%) and 14 (93.3%) patients, respectively). Elevated NT-proBNP levels were found in 22.9% of patients, with no significant differences between subgroups (p &gt; 0.05). Conclusions. The severity of dyspnea in the post-acute phase of COVID-19 is related to the duration of lung involvement and the severity of the acute illness. In patients with moderate-severity acute COVID-19, dyspnea in the post-acute phase is primarily due to residual respiratory system changes (in 20.0% of patients) and mild obstructive ventilation disorders (in 42.9% of patients). Cardiovascular system involvement in these patients is mainly detected by elevated serum NT-proBNP levels (in 22.9% of patients), which may serve as a marker for the heart failure onset, necessitating consultation with a cardiologist. In patients with severe- acute COVID-19, dyspnea in the post-acute phase is due to residual morphological lesions in the respiratory system based on chest CT findings (in 54.1% of patients) and cardiovascular pathology (in 45.9% of patients). Therefore, managing this patient cohort in the post-acute phase requires collaboration between pulmonologists and cardiologists, especially when dyspnea does not correlate with morphological lesions in the respiratory system on chest CT. In patients with critical acute COVID-19, dyspnea in the post-acute phase is consistently caused by both residual morphological lesions in the respiratory system (in 100% of patients) and cardiovascular pathology (in 93.3% of patients). This substantiates the imperative for joint management by pulmonologists and cardiologists.

ФАКТОРЫ РИСКА УВЕЛИЧЕНИЯ ОБЪЕМА ЛЕКАРСТВЕННОЙ ТЕРАПИИ У ПЕДИАТРИЧЕСКИХ ПАЦИЕНТОВ С БРОНХИАЛЬНОЙ АСТМОЙ (ПО РЕЗУЛЬТАТАМ ДЕСЯТИЛЕТНЕГО ПРОСПЕКТИВНОГО НАБЛЮДЕНИЯ)

The study aims to determine the anamnestic, functional, and laboratory factors affecting the load of basic drug therapy in children with bronchial asthma during a ten-year regular dynamic monitoring of their height, body weight, spirometry data, the nature of the ongoing treatment of asthma, and the drug doses. An open, prospective monitoring trial included 131 patients, each of whom attended a hospital at least 20 times every 6 months. The data obtained was not used to correct the therapy method and regular medical check-up. By the end of the tenth year, 98 patients had demonstrated the following results: 57.1 % of children maintained a stable load of basic therapy, while the load of drug therapy was increased in 24.5 % of patients, and decreased in 18.4 % of them. The likelihood of a drug load reduction was statistically significantly reduced in patients with a body mass index greater than 90 weight percentile for 18 months or longer in comparison with patients who had never been overweight. Patients with the obstructive disorders detected with spirometry during two or more consecutive visits had a statistically significantly higher risk of drug therapy overload or a lower likelihood of its reduction in comparison with those without any external respiration malfunctions. The allergen-specific therapy made it possible to significantly lower the risk of drug overload and increase the possibility of its reduction. The allergen-specific immunotherapy, body weight management, and absence of obstructive disorders in spirometry all contribute to reducing the drug therapy load while maintaining a controlled course of the disease.

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Abstract. The aim: to study the prevalence of respiratory symptoms and pulmonary function (PF) in patients with various chronic lymphoproliferative diseases (CLPD) in the Dnipro region of Ukraine. Methods. In all patients who were included in this prospective single-center study, complaints and anamnesis data were collected, anthropometric and general physical examinations, mMRC and CAT questionnaires, analysis of the results of high-resolution computed tomography of the chest organs to determine the presence of intrathoracic lymphadenopathy (ITLAP) were performed. In all patients, parameters of PF were determined using computer spirometry, and when signs of bronchial obstruction were detected, a test with a bronchodilator was performed to determine its reversibility. We analyzed the level of FEV1 , FVC and the ratio of FEV1 /FVC, PEF, MEF25, MEF50 and MEF75. Patients with a confirmed diagnosis of bacterial or viral pneumonia (including patients with COVID-19) were excluded from the study. The methods of descriptive and analytical statistics of the software product STATISTICA v.6.1 (Statsoft Inc., USA) (license number AGAR909E415822FA) were used to process the obtained results. Results. The study found that 37.8 % of patients had complaints from the respiratory system, and 42 % of all patients had significant severity of respiratory symptoms according to the CAT questionnaire. At the same time, only 4.4 % of patients, according to the anamnesis, had established diagnoses of respiratory comorbidity. Among the examined patients with CLPD, 54.4 % had PF disorders, and 81.6 % of them had only obstruction or mixed disorders with a predominance of obstruction (52.5 % mild obstruction, 37.5 % moderate obstruction, and 10 % severe obstruction) and 12.5 % of cases had a positive bronchodilation test. The ratio of FEV1 /FVC was found to be significantly lower in patients with multiple myeloma than in patients with chronic lymph leucosis and lymphomas, which may hypothetically be related to the formation of fibrosis of the bronchial wall; however, the proportions of patients with obstructive PF disorders were equivalent in the groups. ITLAP was detected in 42.2 % of patients. The presence of ITLAP in patients with lymphomas was significantly associated with a lower FEV1 , while in patients with chronic lymph leucosis, who had bronchial obstruction in 43.4 % of cases, the presence of ITLAP had a tendency, but was not statistically significantly associated with the presence obstruction or a lower FEV1 level. Conclusions The obtained results indicate the need for a thorough examination of the respiratory organs, including chest computed tomography and spirometry, in all patients with CLPD, even in the absence of known respiratory comorbidity. According to the obtained results, the presence of PF violations of the obstructive type and the presence of ITLAP are among the main factors that affect the severity of respiratory symptoms in CLPD, therefore, they require careful diagnosis and, in the presence of bronchial obstruction, the appointment of appropriate broncholytic therapy, which can potentially improve the quality life of this category of patients. Key words: multiple myeloma, chronic lymphocytic leukemia, lymphoma, pulmonary function, respiratory symptoms.

Treatment principles of Ayurveda to manage Kamala (Jaundice): A case study

Abstract Jaundice is a condition, in which hyperbilirubinemia is found along with yellowish discoloration of the sclera, skin, mucous membrane, and interstitial fluid. The causes of jaundice are hemolytic diseases, hepatocellular dysfunction, and obstructive disorders of the hepatobiliary system. Clinical manifestations of jaundice arise when the blood bilirubin level exceeds 2.5 mg/dL. Jaundice can be put under the heading of Kamala described in Ayurvedic texts. A 12-year-old girl was visited in the outpatient department of the Kayachikitsa department at Ch. Brahm Prakash Ayurved Charak Sansthan with the chief complaints of low appetite, gaseous abdomen, yellowish discoloration of sclera, weakness, and vertigo for 1 week. The patient was investigated in the hospital and was diagnosed Jaundice with investigation. The patient was effectively managed by the combination of Phaltrikadi Kwath 20 mL empty stomach in the morning, combined powder of Katuki Churna 1 g and Bhumi Amalaki Churna 1 g after food with lukewarm water twice a day, and 15 mL of Abhyarishta at night with normal water was given. The outcome was assessed based on symptoms, and lab investigations showed profound results. Therefore, it can be said that these medications are quite successful in treating jaundice.

Risk factors for the development of bronchopulmonary pathology in workers producing synthetic polyacrylonitrile fiber

Aim of the study was to assess the risk of bronchopulmonary pathology in workers of the production of synthetic polyacrylonitrile fiber as a result of exposure to harmful chemicals and smoking tobacco products . Material and methods . During the periodic medical examination , the function of external respiration and adherence to smoking in 137 employees were studied , medical records were analyzed (025/u accounting form ). Hygienic assessment of working conditions was carried out on the basis of the results of in-situ sanitary and hygienic studies . Results and discussions . As a result of a hygienic assessment of working conditions , it was found that workers engaged in the production of polyacrylonitrile fiber are subject to the combined intermittent effects of harmful chemicals of hazard classes 1–3 ( acrylonitrile , methyl acrylate , hydrocyanide , ammonia , sodium rhodanide , sulfuric acid , methanol , isopropyl alcohol , ethylene glycol ), the content of which in the working area exceeded the maximum permissible concentrations in 1.6% of samples . The occupational risk of developing bronchopulmonary diseases in groups of workers who smoke is assessed as unacceptably high , while in people exposed to harmful chemicals , its level is 28.46 times higher than in people who are not exposed to these effects . The risk of the formation of ventilation disorders in groups of smoking workers is unacceptably high , while its level is 2.46 times higher in workers exposed to harmful chemicals than in non-workers in such conditions . In groups of workers exposed to harmful chemicals , the occupational risk of obstructive disorders is unacceptably high , in the group of smokers the risk is 2.32 times higher . Conclusions . Among the employees of the enterprise producing synthetic polyacrylonitrile fiber , the influence of tobacco smoking on the development of bronchopulmonary pathology is higher than the influence of harmful working conditions , and the use of smoking tobacco products significantly increases the negative effect of chemical pollutants .

Sialography: a pictorial review.

Non-tumour inflammatory and obstructive salivary gland pathologies such as sialadenitis, sialolithiasis, sialadenosis, ductal strictures, etc. require precise radiological evaluation and mapping of salivary gland ductal system for better treatment outcome. Conventional sialography is considered as a useful and reliable technique in evaluation of salivary glands especially intrinsic and acquired abnormalities involving the ductal system and is useful for detection of non-radiopaque sialoliths which are invisible on routine plain radiographs. Primarily sialography is used as a diagnostic tool, additionally it plays an important therapeutic role as salivary gland lavage in cases of recurrent salivary gland infections and in obstructive salivary gland disorders by helping in clearance of mucous plugs or small sialoliths within the ducts. Recently, diagnostic performance of computed tomography (CT) sialography is being explored and has been reported to have high sensitivity in detection of small sialoliths and allows differentiation of sialoliths from other calcifications in glandular ductal system. Multiplanar three dimensional (3D) reconstructed CT images have been reported to play a key role in determination of anatomical location or extent of salivary gland disease without superimposition or distortion of structures. This review aims to discuss the disease specific applications of sialography and CT Sialography in particular for visualization of salivary gland disorders.

Piezo2 channels expressed by colon-innervating TRPV1-lineage neurons mediate visceral mechanical hypersensitivity

Inflammatory and functional gastrointestinal disorders such as irritable bowel syndrome (IBS) and obstructive bowel disorder (OBD) underlie the most prevalent forms of visceral pain. Although visceral pain can be generally provoked by mechanical distension/stretch, the mechanisms that underlie visceral mechanosensitivity in colon-innervating visceral afferents remain elusive. Here, we show that virally mediated ablation of colon-innervating TRPV1-expressing nociceptors markedly reduces colorectal distention (CRD)-evoked visceromotor response (VMR) in mice. Selective ablation of the stretch-activated Piezo2 channels from TRPV1 lineage neurons substantially reduces mechanically evoked visceral afferent action potential firing and CRD-induced VMR under physiological conditions, as well as in mouse models of zymosan-induced IBS and partial colon obstruction (PCO). Collectively, our results demonstrate that mechanosensitive Piezo2 channels expressed by TRPV1-lineage nociceptors powerfully contribute to visceral mechanosensitivity and nociception under physiological conditions and visceral hypersensitivity under pathological conditions in mice, uncovering potential therapeutic targets for the treatment of visceral pain.

Clinicopathological and radiographic indicators for orogastric decompression in rabbits presenting with intestinal obstruction at a referral hospital (2015-2018).

Orogastric decompression is regularly recommended as a part of both medical and pre-surgical treatment for small intestinal obstruction in rabbits. However, guidelines as to when orogastric decompression is indicated are sparse. The medical records of 35 rabbits diagnosed with gastrointestinal obstruction over a 3-year period were examined. Differences in presentation, clinicopathological and radiographic examination findings, treatments and outcome were evaluated. Approximately 49% of the cases evaluated were considered to have non-life-threatening disease, while 51% were considered to have life-threatening disease. The severity of gastric obstruction was correlated with the severity of hyperglycaemia (average 25.7mmol/L; 463mg/dl) and corresponding hyponatraemia (Na < 138mmol/L; 138mEq/L). These patients were treated with orogastric decompression and medical management only. This is a retrospective study and there are inherent limitations involving the quality of the data and data collection. Additional studies should be completed that strive for larger sample sizes to compare the differences in outcome between surgical and medical management, as well as investigate the outcomes of rabbits with hyperglycaemia and hyponatraemia that did not have an orogastric decompression performed. Blood glucose and sodium concentrations, in combination with radiographic findings, may aid clinicians in determining if orogastric decompression is indicated to stabilise rabbits with small intestinal obstructive disorders.

Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease.

Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage. To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it. We included 21 patients with idiopathic PD and 20 healthy control subjects. The participants were submitted to spirometry and impulse oscillometry assessments. The PD patients were evaluated during the "off" and "on" phases of their anti-PD medication, which was was converted to levodopa in an equivalent daily dose. A statistical analysis was performed with cross-sectional (PD patients "off" medication versus controls) and paired (PD patients "off" medication versus PD patients "on" medication) tests. The effect of levodopa was calculated with partial Eta-squared (η2 ρ). Significance was set at 5%. The PD patients presented normal values in the impulse oscillometry. Regarding spirometry, the results indicated an incipient obstructive ventilatory disorder in the PD group - confirmed by patients' flow-volume curves. The PD patients received a daily dose of 354.7 ± 148.2 mg of levodopa. The paired analyses showed a small effect of anti-PD medication on pulmonary parameters (η2 ρ = 0.197 for spirometry and η2 ρ= 0.043 for impulse oscillometry). Patients with PD in the mild stage of the disease present pulmonary compliance and resistance compatible with normal parameters. The differences regarding the spirometric results indicate an incipient obstructive ventilatory disorder in patients with PD. Levodopa had small effect on pulmonary function in the mild stage of the disease.

Global psychological assessment with the evaluation of life and sleep quality and sexual and cognitive function in a large number of patients with acromegaly: a cross-sectional study.

Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays, limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in patients with acromegaly. In 223 acromegaly patients from 5 referral centres, global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated. Depression was found in ~30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnoea syndrome risk and sleep disorders were found in >50% of patients and daily sleepiness in ~20%. Sexual dysfunction was reported in most of the patients, with the most severe impairment in women. Cognitive functions were compromised in ~10% of cases. Disease duration and patient's age and gender were the main determinants of these psychopathological conditions. Depression (P = 0.047), somatic-affective mood lowering (P = 0.021), state (P < 0.001) and trait (P = 0.013) anxiety, and body image distortion in body uneasiness test A (P < 0.001) and B (P = 0.006) were significantly worsened in patients <45 years and slightly worsened in those with disease duration less than 2 years. Male (P < 0.001) and female (P < 0.001) sexual function scores were significantly worsened in patients aged >64 years and slightly worsened in those with disease duration for more than 10 years, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease duration. Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.