Pulmonary Function Values Research Articles

GROWTH-FRIENDLY SPINAL SURGERY: REVIEW OF THE EFFECT ON TRUNCAL GROWTH

BackgroundPediatric spinal deformity surgery affects ultimate spinal height in the growing child. This effect on ultimate spinal height has also been shown to affect pulmonary development and ultimately pulmonary function. There has been an increasing trend toward growth-friendly spinal surgery in early onset scoliosis to minimize the negative consequences of early spinal fusion surgery. Such growth-friendly techniques include VEPTR, MCGR, and Shilla. Which technique allows for the most growth after initial implantation is still not clear. MethodsAn extensive literature review on the topic of pediatric spinal growth was undertaken. Topics reviewed include: normal growth, growth after intervention by various methods, and the effect on pulmonary function. We have summarized the literature for the techniques identified and compared these with normal population data.. ResultsThe data for various surgical techniques were reviewed. These included VEPTR, standard growing rods, and MCGR. The measurement techniques for determining ultimate spinal growth varied based upon the technique for measurement and the timing of initial and final measurements. The results of attained spinal growth were not directly correlated to pulmonary function values. ConclusionsThere is still no standardized ideal time or technique for assessing the best results in this area. We suggest that some of what is called growth from growth-friendly techniques is lengthening from the initial deformity correction. This nomenclature needs to be clarified. In addition, how and when to determine ultimate spinal growth from each surgical technique and by which radiographic technique needs to be standardized.

Differences in Diaphragmatic and Chest Wall Excursion During Quiet Breathing According to Body Position: Dynamic Analysis by MRI

Background and Purpose: The diaphragm is the largest contributor to respiration but is highly influenced by position. Therefore, despite understanding the importance of “positioning” in respiratory physiotherapy, research on diaphragmatic excursion between body positions remains insufficient. This study examined the differences in diaphragm and chest wall excursion between supine, prone, and left and right side-lying positions to investigate the most suitable position for ventilation. Methods: Diaphragmatic excursion, as well as the lateral and anteroposterior diameters of the chest walls of 40 healthy adults (20 males and 20 females), was dynamically imaged during quiet breathing in 4 positions using magnetic resonance imaging, and the amount of excursion was calculated. The Friedman test was used for statistical analysis to compare differences in diaphragmatic and chest wall excursions. Results: The median age was 21.0 years, the median BMI was 20.8 kg/cm2, and all pulmonary function values were normal and within the reference values based on Japanese predicted normal values. The diaphragm and chest wall exhibited significantly greater excursion in the prone position than in other positions (P < .001). In the side-lying position, the anteroposterior diameter excursion of the lower chest wall on the unloaded side was significantly greater (P < .005). However, there was no significant difference between the side-lying and supine positions (P > .05). Conclusions: Diaphragmatic and chest wall excursion during quiet breathing was found to be significantly greater in the prone position than in other positions. This suggests that the prone position is the optimal “positioning” for increased ventilation and may contribute to the prevention of respiratory complications.

Association of pulmonary function with functional capacity among middle-aged women

INTRODUCTION: Age-related decline in pulmonary function and functional capacity is seen in adults. The menopausal process leads to a decline in pulmonary function and functional capacity which is essential in maintaining independence in daily life. OBJECTIVE: The present study aimed to explore the association of pulmonary function with functional capacity among middle-aged women. METHODS: One hundred and eight female participants aged 40–55 years were included in this cross-sectional study; depending on their menstrual history participants were classified as premenopausal and postmenopausal. After initial screening and assessment, six-minute walk test (6MWT) and pulmonary function (FEV1, FVC, FEV1/FVC) were recorded as per standardised guidelines. The mean and standard deviation for all continuous variables were calculated. Correlations were estimated using Pearson’s coefficient of correlation. A comparison of premenopausal and postmenopausal groups was done by independent t-test. A two-tailed p-value < 0.05 was considered statistically significant. RESULTS: There were significant differences in values of six-minute walk distance (6MWD) and pulmonary function values of pre and postmenopausal women (p < 0.05). The Pearson coefficient of correlation showed t significant association of FEV1, FVC and FEV1/FVC with 6MWD among middle-aged women. There was fair positive correlation of FEV1 (r = 0.391, p = 0.002) and FEV1/FVC (r = 0.395, p = 0.002) with 6MWD among postmenopausal women. CONCLUSION: There exists a fair positive correlation of pulmonary function with 6MWD among middle-aged women particularly postmenopausal women. Early screening of respiratory health and functional capacity should be initiated for middle-aged women as a preventive strategy.

Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age.

Evaluation of pulmonary function in patients of non-specific low back pain

INTRODUCTION: Diaphragm is the primary inspiratory muscle and it plays an essential role in controlling the spine during postural control. In nonspecific low back pain, the diaphragm muscle becomes weak, due to which the pulmonary functions may decrease. To the best of our knowledge there is a scarcity of literature in regard to the effect of low back pain on pulmonary parameters. Thus, the study is aimed to evaluate the pulmonary function in patients with non-specific low back pain. METHODS: One hundred and thirteen patients with non-specific low back pain and 113 BMI matched normal individuals as a comparison group aged 18-40 years of male and female genders were recruited by purposive sampling method for this prospective cross-sectional study. The non-specific back pain group included participants diagnosed with non-specific low back pain with pain intensity > 3 on VAS scale and duration > 3 months. After initial screening and assessment, anthropometric characteristics were recorded. Then, the pulmonary function test (FEV1, FVC, FEV1/FVC, PEFR, SVC, MVV) were recorded in both groups. RESULT: Kolmogorov-Smirnov test was used for normality assessment and data was found to be not normally distributed. Non parametric data was represented as median and IQR (Inter Quartile Range). Between groups data analysis was performed by using Mann-Whitney U test and the effect size was computed for the study variables. P < 0.05 was considered as statistically significant. There was a significant difference in pulmonary function values of FEV1, FEV1/FVC, PEFR, SVC, MVV. There was no significant difference in age and BMI of the participants of both groups. CONCLUSION: There exist significant differences in pulmonary function in patients with non-specific low back pain.

Short-term effects of the chemical components of fine particulate matter on pulmonary function: A repeated panel study among adolescents

The effects of the chemical components of fine particulate matter (PM2.5) have been drawing attention. However, information regarding the impact of low PM2.5 concentrations is limited. Hence, we aimed to investigate the short-term effects of the chemical components of PM2.5 on pulmonary function and their seasonal differences in healthy adolescents living on an isolated island without major artificial sources of air pollution. A panel study was repeatedly conducted twice a year for one month every spring and fall from October 2014 to November 2016 on an isolated island in the Seto Inland Sea, which has no major artificial sources of air pollution. Daily measurements of peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) were performed in 47 healthy college students, and the concentrations of 35 chemical components of PM2.5 were analyzed every 24 h. Using a mixed-effects model, the relationship between pulmonary function values and concentrations of PM2.5 components was analyzed. Significant associations were observed between several PM2.5 components and decreased pulmonary function. Among the ionic components, sulfate was strongly related to decreases in PEF and FEV1 (−4.20 L/min [95 % confidence interval (CI): −6.40 to −2.00] and − 0.04 L [95 % CI: −0.05 to −0.02] per interquartile range increase, respectively). Among the elemental components, potassium induced the greatest reduction in PEF and FEV1. Therefore, PEF and FEV1 were significantly reduced as the concentrations of several PM2.5 components increased during fall, with minimal changes observed during spring. Several chemical components of PM2.5 were significantly associated with decreased pulmonary function among healthy adolescents. The concentrations of PM2.5 chemical components differed by season, suggesting the occurrence of distinct effects on the respiratory system depending on the type of component.

Respiratory features of centronuclear myopathy in the Netherlands

Centronuclear myopathy (CNM) is a heterogeneous group of muscle disorders primarily characterized by muscle weakness and variable degrees of respiratory dysfunction caused by mutations in MTM1, DNM2, RYR1, TTN and BIN1. X-linked myotubular myopathy has been the focus of recent natural history studies and clinical trials. Data on respiratory function for other genotypes is limited. To better understand the respiratory properties of the CNM spectrum, we performed a retrospective study in a non-selective Dutch CNM cohort. Respiratory dysfunction was defined as an FVC below 70% of predicted and/or a daytime pCO2 higher than 6 kPa. We collected results of other pulmonary function values (FEV1/FVC ratio) and treatment data from the home mechanical ventilation centres. Sixty-one CNM patients were included. Symptoms of respiratory weakness were reported by 15/47 (32%) patients. Thirty-three individuals (54%) with different genotypes except autosomal dominant (AD)-BIN1-related CNM showed respiratory dysfunction. Spirometry showed decreased FVC, FEV1 & PEF values in all but two patients. Sixteen patients were using HMV (26%), thirteen of them only during night-time. In conclusion, this study provides insight into the prevalence of respiratory symptoms in four genetic forms of CNM in the Netherlands and offers the basis for future natural history studies.

Seasonal effect on Physiological Parameters and PulmonaryFunction Test

Considerable information are accumulated about normal composition of blood. i80) males and (50) females attended this study aged from 18-40 years to investigate the effect of season on some blood parameters. The samples of venous blood were collected at the October 2A07 b May 2008. All blood parameters hemoglobin (Hb), packed cell volume (PC.V.), red blood cells (RBCs), mean corpuscular volume (MCV), mean cell hemoglobin (MCH) of males and females were within normal range of healthy subjects and also MCHC mean cell hemoglobin concentration was normal. There were significant different differences between the male and female students. There was no significant effect of season on blood parameters. The pulmonary function test included the measurement of peak flow meter and respiratory volume. There are significant differences in the value of pulmonary function between male and female students.

Penerapan Intervensi Pursed-Lips Breathing Meningkatkan Arus Puncak Ekspirasi pada Pasien Penyakit Paru Obstruksi Kronik

This study aims to determine the magnitude of the effect of pursed-lip breathing (PLB) exercises on increasing the highest flow achieved by maximal expiration peak expiratory flow (APE) in COPD patients at Jakarta Islamic Hospital Cempaka Putih based on the latest research results (evidence-based Nursing Practice). This study uses a quantitative method with a type of quantitative experimental research with a quasi-experimental approach. The results showed that the results of APE measurements before and after PLB breathing exercises to male COPD sufferers at the Jakarta Islamic Hospital showed that, in general, the effects of APE before and after PLB breathing exercises on Day-1 were 278.3 liters or minutes and general after PLB Day-1 breathing exercise was 290.0 greater. From the results of the T-Test experiment, it can be interpreted that there is a significant comparison between APE before and after PLB with the number P = 0.000 or statistically in general APE before and after PLB is smaller than in general in male respondents by (290.0– 278.3 =11.7). In conclusion, age is related to the increased value of pulmonary ventilation function in COPD patients. Age may explain the increased peak expiratory pulmonary flow in COPD patients. Thus there is a significant relationship between age and an increase in the height expiratory flow (APE) value of COPD patients after receiving pursed-lips breathing intervention.
 
 Keywords: Peak Expiratory Flow, Chronic Obstructive Pulmonary Disease, Pursed-Lip Breathing

Real-world utility of a genomic classifier in establishing a diagnosis of newly identified interstitial lung disease

BackgroundDiagnosing interstitial lung disease (ILD) remains challenging. Guidelines recommend utilizing a multidisciplinary discussion (MDD) to review clinical and radiographic data and if diagnostic uncertainty persists, then to obtain histopathology. Surgical lung biopsy and transbronchial lung cryobiopsy (TBLC) are acceptable methods, but risks of complications may be prohibitive. The Envisia genomic classifier (EGC) represents another option to determine a molecular usual interstitial pneumonia (UIP) signature to facilitate an ILD diagnosis at MDD with high sensitivity and specificity. We evaluated the concordance between TBLC and EGC at MDD and the safety of this procedure. MethodsDemographic data, pulmonary function values, chest imaging pattern, procedural information, and MDD diagnosis were recorded. Concordance was defined as agreement between the molecular EGC results and histopathology from TBLC in the context of the patient's High Resolution CT pattern. Results49 patients were enrolled. Imaging demonstrated a probable (n = 14) or indeterminate (n = 7) UIP pattern in 43% and an alternative pattern in 57% (n = 28). EGC results were positive for UIP in 37% (n = 18) and negative in 63% (n = 31). MDD diagnosis was obtained in 94% (n = 46) with fibrotic hypersensitivity pneumonitis (n = 17, 35%) and IPF (n = 13, 27%) most common. The concordance between EGC and TBLC at MDD was 76% (37/49) with discordant results seen in 24% (12/49) of patients. ConclusionsThere appears to be reasonable concordance between EGC and TBLC results at MDD. Efforts clarifying the contributions of these tools to an ILD diagnosis may help identify specific patient populations that may benefit from a tailored diagnostic approach.

Blood pressure, lung function and muscular strength values in students with joint hypermobility

Introduction. Elastin and collagen are the key components of bones, cartilage, tendons, skin, lungs and arterial walls. Weak connective tissue disorders and joint hypermobility are pathological conditions where the structure of collagen fibers is changed, resulting in a number of symptoms. The objective of this study was to determine the prevalence of weak connective tissue disorder in second- and third-year students of the Faculty of Medicine of the University of Novi Sad, and to compare muscle strength, pulmonary function and blood pressure between individuals with and without hypermobility. Material and Methods. The study included 100 students (50 females and 50 males) divided into two groups: Group 1 with weak connective tissue and Group 2 with normal connective tissue. The subjects were assessed according to the Beighton score and the Brighton criteria to diagnose hypermobility. Values of blood pressure, pulmonary function and muscle strength were also measured. Results. Analysis of anthropometric parameters and blood pressure values showed significant difference between the groups, including the body height (p=0.014) and body weight (p=0.021) values and systolic (p<0.001) and diastolic (p=0.004) blood pressure values. Dynamometric parameters and lung function values were significantly different between the groups, with vital capacity (p<0.001), forced vital capacity (p=0.05), forced expiratory volume in the 1st second (p=0.025). Lower values were noted in group 1. Conclusion. Weak connective tissue was found with high percentage of students of the Faculty of Medicine of the University of Novi Sad (67%). Blood pressure, lung function vales and dynamometric parameters were significantly lower in group 1.

Accelerated loss of trunk muscle density and size at L1 vertebral level in male patients with COPD.

Weight loss and muscle mass loss are common in patients with chronic obstructive pulmonary disease (COPD). Muscle density and fat infiltration based on CT images may be more sensitive than muscle mass by DXA in the assessment of sarcopenia for COPD patients. However, the age-related changes of cross-sectional trunk muscle compositions based on lung CT scans are still unknown. Thus, we aimed to investigate over time the change in muscle density, size, and fat deposition of L1-level trunk muscles in patients with COPD. 129 male COPD patients with a second chest CT scan (from 2013-2019 to 2014-2020) were enrolled. The CT images at first and second CT scans are analyzed by OsiriX software. Trunk muscles at the level of the 1st lumbar vertebrae were selected for analysis. Attenuation of lumbar vertebrae 1 was also measured from chest CT images. The pulmonary function values were calculated based on forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). The mean age of the 129 patients with COPD was 69.7 years. The durations of COPD of this cohort were from 8-17 years. The mean area and density of L1 trunk muscles were 85.5 cm2 and 36.4 HU. At baseline, muscle area and density and vertebral density were negatively associated with age (p<0.0001), while the intermuscular fat area and the fat infiltration ratio were not significantly associated with age (p>0.05). The per-year loss of trunk muscle area was 2.83 cm2 (p<0.0001) which accounts for 3.3% decrease per year, and the per-year decrease of trunk muscle density was 2.41 HU (p<0.0001) which accounts for 6.6% decrease per year. The per-year increase of intermuscular fat in trunk muscles was 0.57 cm2 (p=0.006) which accounts for 11.1% increase per year. The bone density loss was 5.63 HU/per year (p<0.0001). Men with COPD had accelerated muscle loss as well as increased fat infiltration. Compared to muscle quantity loss, the decline in muscle quality is much larger, indicating the importance of relevant interventions focusing on improving muscle quality.

Radiological patterns and pulmonary function values of lung involvement in primary Sjögren's syndrome: A pilot analysis.

Lung involvement in primary Sjögren's syndrome (pSS) may vary from 9 to 90%. Interstitial lung disease and tracheobronchial alterations are the most typical findings. The evidence of primarily emphysematous changes at computed tomography of the chest of pSS patients has occasionally been described but poorly characterized. This study aims to assess pulmonary involvement and the impact on respiratory function in a cohort of pSS patients. A total of 22 consecutive patients diagnosed with pSS underwent pulmonary function tests to investigate the presence of ventilatory impairment and evaluate the exchanges of alveolar gases. All patients underwent a chest high-resolution computed tomography (HRTC). Dynamic volumes were within the normal range in 21 patients (95.4%). A reduction in the diffusing capacity of the lung for carbon monoxide (DLCO) was observed in 18 patients (81.8%). Ten (45.5%) patients showed a mild degree deficit, while 8 patients (36%) showed a moderate degree deficit. Analysis of DLCO revealed a significant difference between pSS patients and controls [t(30.98) = -10.77; p < 0.001], showing a higher DLCO value for the healthy controls (mean ± SE; 101.27 ± 6.08) compared to pSS patients (mean ± SE; 65.95 ± 12.78). Emphysema was found in 21 (94.5%) patients and was the most widespread pulmonary injury. Tracheal thickness was reduced in 15 (67%) patients. Micronodules were observed in 10 (45%) patients in all the pulmonary fields. Bronchial wall thickening and bronchiectasis were observed in 8 (36%) patients, mainly in the lower lobes. Ground glass was found in 5 (22.5%) patients in lower and higher lobes. Cysts were observed in two patients (9%). The reduction of the DLCO could be related to early emphysematous alterations in the absence of spirometric alterations and relevant respiratory symptoms. In conclusion, emphysema might be seen as an early pulmonary involvement mark in patients suffering from pSS.

Effects of inhaled furosemide on dyspnea and pulmonary function in people with COPD: A literature review.

To determine whether inhaled furosemide can be effectively used in patients with chronic obstructive pulmonary disease (COPD) to improve feelings of dyspnea and improve pulmonary function values. This literature review was conducted using randomized control trials and a literature review in which the participants consisted of or included patients with COPD receiving inhaled furosemide as a potential treatment option for their dyspnea and low pulmonary function values. Searches in four databases and secondary sources using five key terms yielded 83 unduplicated articles. Ultimately, four studies, one of which was a literature review, were included which studied the short-term result of inhaled furosemide on dyspnea and pulmonary function values. All studies measured dyspnea as an outcome and three found a statistically significant improvement in patient reported symptoms. Pulmonary function values were measured in all studies which all found improvements. The effect of inhaled furosemide on the dyspnea and pulmonary function values in people with COPD remains uncertain, and questions have emerged regarding the long-term impact on these patients. While this therapy is promising for dyspnea relief and improvement of pulmonary function values in people with COPD, further consideration and additional data still need to be gathered.

Extension of mepolizumab injection intervals as potential of saving costs in well controlled patients with severe eosinophilic asthma

BackgroundPresent guidelines recommend a life-long therapy with mepolizumab in patients suffering from severe eosinophilic asthma as several studies proved the disadvantages of treatment cessation. This study evaluated the possibility of extending the dosage intervals of mepolizumab in those patients with severe eosinophilic asthma after being well controlled. MethodsEighteen patients diagnosed with severe eosinophilic asthma were started on treatment with mepolizumab in regular 4-week intervals. Symptom control was measured using the asthma control test (ACT) and pulmonary function test every 3 months. The amount of oral corticosteroids needed to maintain symptom control was monitored at every visit. After achieving good symptom control, defined as well controlled ACT ≥20, injection intervals were prolonged from 4 up to 6 to 8 weeks. The evaluation of this data was approved by the ethics committee. ResultsACT and pulmonary function values significantly improved after initiating therapy with mepolizumab on a regular 4-weekly injection interval. After extending the dosage intervals, both ACT and pulmonary function remained on a stable level without significant changes during the follow-up visits for 1 year. Median dosage of prednisolone declined significantly in the studied group under mepolizumab therapy and stayed on a low level during the follow-up visits with only a single patient using prednisolone after 1 year. ConclusionIn patients with fully or well controlled eosinophilic asthma treated with mepolizumab extending the dosage intervals between the injections up to 8 weeks bears the potential to save costs for the health care system.

Effects of Pursed Lip Breathing with Arm Ergometry after Chin Support Position in Copd Patients

Background: COPD is the 4th leading cause of mortality around the globe and is expected to be the 3rdleading cause of mortality by 2020. It is a life limiting condition with symptoms of distress such as dyspnea, fatigue, pain and depression as it reaches the terminal stage. The condition decreases the pulmonary function values and QoL. Aerobic training and breathing maneuvers are essential components of pulmonary rehab improving pulmonary function values and QoL. Objective: To find out the effects of pursed lip breathing with arm ergometry after chin support position on respiratory parameters, spirometry tests and quality of life in patients of COPD.. Methods: It was a Randomized control Trial conducted on mild to moderate stage COPD patients. Purposive sampling was used to gain the study sample and then allocated randomly into two groups by coin toss method. The sample size calculated was 74 with 37 subjects in control group and 37 subjects in interventional group. It was conducted at Rehman Medical Institute Peshawar. Spirometer Testing (FEV1,FVC,PEF), HR,SPO2, RR, BORG dyspnea scale and CAT questionnaire were used as outcome measures to measure breathlessness and QoL respectively. Results: Mann-Whitney U test was used between the two groups to measure the effect of the two interventions. There was significant difference between group results (p-value&lt;0.05) were found post-intervention for HR, FEV1, FVC, PEF, BORG score and CAT score. Freidmann test was used for within group analysis and reported significant results (p-value &gt;0.05) for RR, oxygen saturation along with significant BORG and CAT results. Conclusion: It was concluded that there were significant effects of pursed lip breathing with arm ergometry after chin support position on respiratory parameters, spirometry tests and QoL in patients with COPD. Keywords: Chin Support Position, Arm Ergometry, Oxygen Saturation.

Reliability of dynamic perfusion digital radiography as an alternative to pulmonary perfusion scintigraphy in predicting postoperative lung function and complications.

BackgroundAccurate perioperative risk assessment can enhance the perioperative management of patients undergoing radical surgery for lung cancer. In this study, we compared the accuracy of predicting perioperative complications by lung function values, estimated by blood flow ratios (BFRs), to determine whether dynamic perfusion digital radiography (DPDR) could substitute for pulmonary perfusion scintigraphy (PPS).MethodsPatients scheduled for radical surgery for lung cancer who underwent simultaneous dynamic chest radiography (DCR) and lung perfusion scintigraphy were assessed. We confirmed the agreement between two methods in the assessment of the BFR and its predicted postoperative (ppo) value. Besides, the best spirometry thresholds for the risk of perioperative respiratory or cardiovascular complications were calculated from a receiver operating characteristic (ROC) analysis. The imaging methods were compared for sensitivity and specificity.ResultsAmong the 44 cases enrolled, DPDR and PPS showed high correlations in BFR (r=0.868, P<0.01) and its postoperative value (r=0.975, P<0.01) and between the predicted and measured spirometry values. In both imaging modalities, the estimated postoperative diffusing capacity test for carbon monoxide (DLco) had the best prediction [area under the curve (AUC) >0.7] for respiratory complications within 1 month (with different cut-offs for same target cases). For predicting, respiratory complications within 1–3 months after surgery, these values were similar between two modalities. Furthermore, the ppoDLco values from both imaging methods were excellent indicators of the induction of postoperative long term oxygen therapy, with the AUC greater than 0.8.ConclusionsThis study showed that simple and less invasive DPDR can be a good alternative to PPS for predicting postoperative pulmonary function values and the risk of postoperative respiratory complications. This new imaging modality will offer new insights and possible functional analyses of pulmonary circulation.

Effects of Simulated Laughter Therapy Using a Breathing Exercise: A Study on Hospitalized Pulmonary Tuberculosis Patients.

This study evaluated the effects of simulated laughter therapy on physical symptoms, pulmonary function, depression, and health-related quality of life (HRQOL) among pulmonary tuberculosis patients. This quasi-experimental study assigned tuberculosis patients of hospital A to a laughter group (n = 26) and those of hospital B to a control group (n = 26). The eight-week laughter therapy, held twice a week in a 60-min group session, included laughter, entertainment, music-related chorusing, breathing exercises, and meditation. The values of physical symptoms, pulmonary function, depression, and HRQOL from before and after the therapy were analyzed using the paired t-test and the Mann–Whitney U-test. To verify group differences between the experiment and control group, the Wilcoxon signed-rank test and the analysis of covariance (ANCOVA) were employed. Unlike the control group, laughter therapy decreased physical symptoms (t = 7.30, p < 0.01) and increased pulmonary function (t = −3.77, p < 0.01). Psychological health also improved, including depression (t = 10.46, p < 0.01) and HRQOL (t = −9.31, p < 0.01) in the experimental group but not in the control group. Group differences of changes in physical symptoms, pulmonary function, depression, and HRQOL were also significant. Simulated laughter therapy can help moderate depression and physical symptoms and enhance pulmonary function among tuberculosis patients.

Reference values of impulse oscillometry (IOS) for healthy Chinese children aged 4–17 years

ObjectiveTo establish the predicted value of pulmonary function determined by impulse oscillometry (IOS) in children (4–17 years old) in China.MethodsA total of 6270 healthy children aged 4–17 years in China were included. The Master Screen IOS pulmonary function device (Jaeger Co, Germany) was used to detect the respiratory impedance (Zrs), resonant frequency (Fres), respiratory system resistance (Rrs) and respiratory system reactance (Xrs) at various oscillation frequencies, and the indices above were analysed. Stepwise multivariate regression was used to establish the regression equation of related parameters of IOS in different sexes, ages, height, and weight.ResultsThe differences in the main IOS parameters between different age stages were statistically significant regardless of sex (P < 0.05). The stepwise multivariate regression analysis showed that IOS parameters were related to height, age, and weight, and most IOS parameters were most closely related to height (the absolute value of the regression coefficient was the largest). With increasing age and height, the values of Z5, R5, R20, R5–R20, and Fres decreased, while the value of X5 increased. Through height, age, and weight, we obtained the normal predicted values equation of children’s IOS parameters. Compared with the other reference equations, our reference equation is more suitable for Chinese children.ConclusionsThe study revealed the reference values of IOS parameters in healthy Chinese children. In the evaluation of results for lung function measurements, this predicted value equation is more consistent with the characteristics of Chinese children than other reference equations.Clinical Trial: ChiCTR: 1800019029.

Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up.

BackgroundHalo gravity traction (HGT) has been reported to be a safe and effective adjunctive method for the management of scoliosis. However, the direct effects of HGT on the lung recovery of adult patients with scoliosis remain obscure.ObjectiveTo investigate changes in lung volume and pulmonary function in adult patients with severe scoliosis who underwent posterior spinal fusion concomitant with preoperative halo gravity traction.MethodsA total of 47 patients with a minimum 5-year follow-up who underwent posterior spinal instrumentation and fusion using preoperative halo–gravity traction were analyzed. Pulmonary function tests and three-dimensional CT were performed to evaluate changes in lung function and lung volume, respectively.ResultsThere was significant change in the Cobb angle of the major curve after halo gravity traction (P < 0.0001). Significant improvement in both Cobb angle (P < 0.0001) and thoracic kyphosis (P = 0.034) after corrective surgery was observed. Pulmonary function did not change significantly during traction. However, a significant decline in absolute and percent-predicted pulmonary function values was noted following surgery. The average change in lung volume did not show statistical differences during traction. At 5-year postoperative follow-up, the mean values revealed a significant increase in total lung volume (P < 0.0001) and concave lung volume (P < 0.0001) with surgical correction, but no statistically significant change in lung volume on the convex side (P = 0.57). Postoperative pulmonary complications occurred in nine cases with lower preoperative pulmonary function, indicating the importance of performing spirometry before corrective surgery.ConclusionsWe found that halo gravity traction prior to corrective surgery was less useful in improving pulmonary function in adult patients with severe scoliosis. However, these patients were expected to have increased lung volume after correction of the deformity.