Pulmonary Function Values Research Articles

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.

Effectiveness of PNF stretch of pectoralis major muscle on pulmonary function in COPD patients

COPD is a common and a progressive disorder that is characterised by respiratory symptoms and airflow limitation due to the abnormalities of the airway or alveoli. Proprioceptive neuromuscular facilitation technique can increase the contractive capacity of muscles. The study aimed at assessing the effect of Proprioceptive neuromuscular facilitation stretch of pectoralis major muscle on chest expansion and pulmonary function values in COPD patients. Methods: hold relax PNF of pectoralis major muscle was given for a duration of 6 weeks on the particpants who are met with inclusion and exclusion criteria. Chest expansion was measured at axillary level and xiphisternal level, FEV1, FVC and FEV1/FVC were measured pre and the post intervention. Results: statistical analysis was done using paired t test (p&lt;0.05). the results of the study shows that there is increase in the chest expansion at axillary level and xiphisternal level and increase in the FEV1/FVC ratio following 6 weeks of hold relax PNF stretch of pectoralis major in COPD patients. Conclusion: the study concludes that with hold relax PNF stretch there is increase in chest expansion and pulmonary function values.

Transferring from moisture damaged school building to clean facilities – The avoidance of mold exposure induces a decline in symptoms and improvement in lung function among personnel

Working in a moisture-damaged building can cause different symptoms and effects on lung functions. Moving to a clean environment, it is believed to reduce symptoms and alleviate potential adverse health effects. This case study monitors the health effects of personnel in one school building before and after all school activities were transferred from a moisture-damaged school building to clean premises.The whole school staff was invited to attend this follow-up study. All participants (N = 45) were interviewed, and pulmonary functions were measured by spirometry and exhaled nitric oxide testing (FENO) before transferring the school activities to a new building and the control measurements were performed twice; three months and six months after the transfer.After transferring to temporary facilities, 82% of participants felt that their symptoms were improved or resolved and the pulmonary functions were improved; 50% of those who had decreased pulmonary functions at the beginning, their pulmonary function values returned to normal after three months. Over the next six months, the perceived symptoms continued to reduce so that 93% of the respondents felt fully asymptomatic with respect to indoor air, and the spirometry results improved further.Transferring workers from the damaged building to healthy environment provided beneficial health effects on pulmonary functions and to perceived symptoms even in a relatively short time period. Based on this study, and from the perspective of promoting and protecting the health and well-being of personnel, transferring school activities from a moisture damaged building to clean facilities brought considerable advantages, despite the possible cost and difficulties of finding replacement facilities.

Adults with well-healed burn injuries have lower pulmonary function values decades after injury.

Sub‐acute (e.g., inhalation injury) and/or acute insults sustained during a severe burn injury impairs pulmonary function. However, previous work has not fully characterized pulmonary function in adults with well‐healed burn injuries decades after an injury. Therefore, we tested the hypothesis that adults with well‐healed burn injuries have lower pulmonary function years after recovery. Our cohort of adults with well‐healed burn‐injuries (n = 41) had a lower forced expiratory volume in one second (Burn: 93 ± 16 vs. Control: 103 ± 10%predicted, mean ± SD; d = 0.60, p = 0.04), lower maximal voluntary ventilation (Burn: 84 [71–97] vs. Control: 105 [94–122] %predicted, median [IQR]; d = 0.84, p < 0.01), and a higher specific airway resistance (Burn: 235 ± 80 vs. Control: 179 ± 40%predicted, mean ± SD; d = 0.66, p = 0.02) than non‐burned control participants (n = 12). No variables were meaningfully influenced by having a previous inhalation injury (d ≤ 0.44, p ≥ 0.19; 13 of 41 had an inhalation injury), the size of the body surface area burned (R 2 ≤ 0.06, p ≥ 0.15; range of 15%–88% body surface area burned), or the time since the burn injury (R 2 ≤ 0.04, p ≥ 0.22; range of 2–50 years post‐injury). These data suggest that adults with well‐healed burn injuries have lower pulmonary function decades after injury. Therefore, future research should examine rehabilitation strategies that could improve pulmonary function among adults with well‐healed burn injuries.

Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease

IntroductionTransbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increased risk due to the patient’s underlying disease severity. Data evaluating the safety and efficacy of TBLC in hospitalized patients are limited. We present a comparison of TBLC for hospitalized and outpatients and provide the safety and diagnostic yields in these populations.MethodsDemographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded from enrolled patients. Complications from the procedure were the primary outcomes and diagnostic yield was the secondary outcome.Results77 patients (n = 22 hospitalized vs n = 55 outpatient) underwent TBLC during the study period. Comparing adverse events between hospitalized and outpatients revealed no statistically significant differences in pneumothorax (9%, n = 2 vs 5%,n = 3), tube thoracostomy placement (5%, n = 1 vs 2%, n = 1), grade 2 bleeding (9%, n = 2 vs 0%, n = 0), escalation in level of care (5%, n = 1 vs 0%, n = 0), 30-day mortality (9%, n = 2 vs 2%, n = 1), and 60-day mortality (9%, n = 2 vs 4%, n = 2) (p > 0.05 for all). No deaths were attributed to the procedure. 95% of cases received a multidisciplinary conference diagnosis (hospitalized 100%, n = 22 vs outpatients 93%, n = 51, p = 0.32).ConclusionOur experience supports that TBLC may be a safe and effective modality for acutely ill-hospitalized patients with DPLD. Further efforts to enhance procedural safety and to determine the impact of an expedited tissue diagnosis on patient outcomes are needed.

Effects of Non-intubated Video-Assisted Thoracic Surgery on Patients With Pulmonary Dysfunction.

Background: Non-intubated video-assisted thoracic surgery (NIVATS) can be safely performed in lung volume reduction surgery for patients with severe pulmonary dysfunction. However, there is still no cohort observation on the effects of NIVATS on patients with pulmonary dysfunction undergoing different types of thoracic procedures. This retrospective study aimed to observe the effects of NIVATS for this kind of patients.Methods: Three hundred and twenty-eight patients with moderate to severe obstructive pulmonary dysfunction, who underwent video-assisted thoracic surgery (VATS), were retrospectively collected from June 1st, 2017 to September 30th, 2019. Patients in NIVATS were case-matched with those in intubated video-assisted thoracic surgery (IVATS) by a propensity score-matched analysis. The primary outcome was the comparison of perioperative values, the secondary outcome was the risk factors for postoperative clinical complications (PCP) which were identified by binary logistic regression analysis.Results: After being matched, there were no differences in demographics and preoperative values of pulmonary function between NIVATS and IVATS groups. The duration of surgery and anesthesia had no difference (P = 0.091 and P = 0.467). As for the postoperative recovery, except for the mean intensive care unit (ICU) stay was longer in the IVATS group than in the NIVATS group (P = 0.015), the chest tube removal time and the postoperative hospital stay had no difference (P = 0.394 and P = 0.453), and the incidence of PCP also had no difference (P = 0.121). The binary logistic regression analysis revealed that the history of pulmonary disease, anesthesia method, and surgical location were risk factors of PCP.Conclusion: For patients with pulmonary dysfunction when undergoing different types of thoracic procedures, the NIVATS can be performed as effectively and safely as the IVATS, and can reduce the ICU stay.

Evaluation of the change in pain, dyspnea perception, and pulmonary function values with pain tape application in patients undergoing thoracotomy

Evaluation of the change in pain, dyspnea perception, and pulmonary function values with pain tape application in patients undergoing thoracotomy

Effect of Yogic Breathing Manoeuvre on Pulmonary Function and VO2 Max in Male Football Players

Introduction: Yoga has proven to improve spiritual as well as psychophysiological behaviour of a human being. This helps them to perform better in their game improving abdominal strength and gives benefits to every player’s need. It also helps improve both physical and mental health. Aim: To analyse the effects of yogic breathing manoeuvre on pulmonary functions and VO2 max in male football players. Materials and Methods: This quasi-experimental study was conducted in Department of Physiotherapy, School of Physiotherapy at D.Y. Patil University, Navi Mumbai, Maharashtra, India, from February 2019 to February 2020. The study included 60 male players within the age group from 18-25 years with at least 2 years of experience. They were divided into two groups - group A was experimental group and group B was control group. Group A performed pranayama along with routine football specific training and group B performed only football specific training for six weeks. Pre and post values for pulmonary functions and VO2 max were taken by Pulmonary Function Test (PFT) and Queens College step test as outcome measures. The data was analysed using Independent t-test. Results: Mean age of group A and group B was 19.7±1.69 years and 20.6±1.89 years, respectively. After doing yogic breathing maneuvers for 6 weeks, there was a significant (p-value&lt;0.001) improvement in pulmonary function and VO2 max values in male football players for experimental group as compared to control group. The mean difference for Forced Expiratory Volume in 1 second (FEV1) was 0.3% and 0.13% and for VO2 max was 0.71 mL/kg/min and 2.71 mL/kg/min for control and experimental group respectively. Conclusion: Implementing regular practice of yogic breathing manoeuvre along with football training improves pulmonary functions of the football players.

Analysis of the pulmonary function in patients undergoing vertebral body tethering for adolescent idiopathic scoliosis.

The literature concerning the effects of scoliosis correction on pulmonary function (PF) is scarce and solely related to spinal fusion. Vertebral body tethering (VBT) represents a new option for scoliosis correction; however, its effects on PF have not yet been investigated. As VBT is a fusion-less technique that does not limit the dynamics of the chest wall, it is expected not to have a negative impact on PF despite the anterior surgical approach. We analyzed the PF preoperatively and compared it with the PF at 6-weeks, 6-months and 12-monthts postoperatively. Considered parameters were total lung capacity (TLC), forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) expressed as percentages. A change of more than 10% was considered clinically significant. Before VBT, overall TLC, FEV1 and FVC measured 98 ± 15%, 85 ± 16% and 91 ± 17%, respectively. Six weeks after surgery, all parameters were comparable to the preoperative values (TLC 96 ± 17%, FEV1 84 ± 14%, FVC 90 ± 16%) and remained so at the last follow-up (TLC 99 ± 15%, FEV1 89 ± 9%, FVC 86 ± 9). While a reduction in FEV1 and FVC was observed at 6-weeks and 6-months in patients with thoracic or double curves compared to thoracolumbar curves, no significant differences were observed at the 12-months follow-up. VBT does not cause a reduction in PF values at a short-term follow-up.

Wheezing trajectories from childhood to adulthood in a population-based cohort

BackgroundWheezing may lead to asthma and reduced pulmonary function in later life. The study aims to identify wheezing trajectories and investigate their relation with pulmonary function and asthma-related outcomes at 22 years of age. MethodsIndividuals from a population-based cohort in Brazil (1993 Pelotas Birth Cohort) with post-bronchodilator pulmonary function data at 22 years (3350) were included in the study. From parentally reported (4 and 11 years) and self-reported (15, 18 and 22 years) history of wheezing in the last 12 months, we used a group-based trajectory modelling approach to derive wheezing trajectories. ResultsFour trajectories were identified: never/infrequent, transient-early, late-onset and persistent wheeze. After adjustments, wheezing trajectories remained associated with lower post-bronchodilator values of pulmonary function. Individuals in the persistent wheeze trajectory had a markedly poorer pulmonary function and also showed greater odds of asthma-related outcomes compared to other trajectories groups. Those following this trajectory had on average −109 ml (95% CI: −188; −35), −1.80 percentage points (95% CI: −2.73; −0.87) and −316 ml/s (95% CI: −482; −150) lower FEV1, FEV1/FVC ratio and FEF25–75% respectively; higher odds of self-reported medical diagnosis of allergy (OR 6.18; 95% CI: 3.59; 10.61) and asthma (OR 12.88; 95% CI: 8.91; 18.61) and asthma medication use (OR 9.42; 95% CI: 5.27; 16.87) compared to the never/infrequent group. ConclusionsWheezing trajectories, especially the persistent wheeze trajectory, were related to lower pulmonary function values and increased risk of asthma and allergy diagnosis in early adulthood.

Cone Beam CT Guidance Improves Transbronchial Lung Cryobiopsy Safety.

Determining the cause of diffuse parenchymal lung disease (DPLD) is challenging. While surgical lung biopsy has been the standard approach, transbronchial lung cryobiopsy (TBLC) represents a minimally invasive alternative with an acceptable safety profile and reasonable accuracy. In this study, we prospectively assessed whether the use of cone beam CT (CBCT) coupled with a novel bronchoscope holder and prophylactic administration of vasoconstricting medications decreases potential complications and improves diagnostic accuracy when performing TBLC. 33 patients presenting for evaluation of newly diagnosed DPLD were enrolled. Demographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded. Mean patient age was 67, with the majority Caucasian (n = 26, 79%) and male (n = 20, 61%). Mean pulmonary function values revealed restrictive lung disease (76 ± 14% predicted) and diffusing capacity impairment (52 ± 16%). A non-usual interstitial pneumonia imaging pattern was commonly seen (n = 20, 61%). CBCT guided TBLC was performed in one lobe (n = 29, 88%) or two lobes (n = 4, 12%) with mean probe-to-pleura distance of 4.2 ± 1.3mm. No peri or post procedural complications occurred. 32 patients (97%) received a histological diagnosis with a final multidisciplinary conference diagnosis possible for 32 (97%). CBCT guided TBLC coupled with a novel articulating scope holder and prophylactic phenylephrine administration has the potential to increase safety and diagnostic yield for patients with newly identified DPLD. Future studies comparing different aspects of this approach in isolation and with other modalities have the potential to refine this procedure to improve patient care.

Assessment of the Relationship between Therapeutic Alliance and Pulmonary Function Recovery in Cardiac Surgery Patients Undergoing Physical Therapy

Objective of the study was to assess the relationship between the indicators of therapeutic alliance and pul- monary function recovery in patients undergoing physical therapy after cardiac surgery (СS). 80 patients, who were submitted to СS (performed by median sternotomy on cardiopulmonary bypass) and standardized phys- ical therapy program thereafter. Therapeutic alliance was assessed with the help of Working Alliance Inventory (SF Hatcher Client form) questionnaire. The questions were split into three domains: "goal items", "task items" and "bond items". The questionnaire was filled in on the 7th postoperative day (POD). Pulmonary function test was done before the surgery and on the 7th POD. The results of assessment confirmed a rather high level of therapeutic alliance between cardiac surgery patients and their physical therapists. Lung volumes and flow rates were worse after surgery. According to the analysis of correlation relationships between “task items” indi- cators and FVC, FIVC, FIV1 reduction rates, patients with less reduction of these volumeshad better “task items” results. According to the analysis of correlation relationships between a number of pulmonary function test in- dicators on the 7th POD and “goal items”, “task items”, totalquestionnaire score,patients with higher postoper- ative pulmonary function values had better therapeutic alliance. The obtained correlation relationships were significant, but weak or very weak. The results confirmed the relationships between postoperative pulmonary function values, their dynamic and therapeutic alliance.

Pulmonary function, muscle strength, and quality of life have differed between chronic kidney disease patients and healthy individuals

Chronic kidney disease (CKD) patients have lower pulmonary function, respiratory and peripheral muscle strength values when compared to the general population, which reflects negatively in the quality of life (QoL). The aim of this study was to compare the pulmonary function, respiratory and peripheral muscle strength, and QoL between CKD patients and healthy individuals. Cross-sectional study with a consecutive sample of 39 individuals separated into three groups: nondialysis-dependent CKD in stage 5 (CKD-5), HD group (CKD-HD), and healthy individuals. The tests performed were spirometry, manovacuometry, handgrip strength (HGS), and Medical Outcomes Short-Form Health Survey (SF-36). A significant difference between groups was observed in forced expiratory volume in 1second (FEV1 ) and its predicted value (p=0.004 and p < 0.001, respectively), forced vital capacity (FVC), and its predicted value (p=0.008 and p < 0.001, respectively), peak expiratory flow (PEF) and its predicted value (p=0.004 and p < 0.001, respectively), maximal inspiratory pressure (MIP) and its predicted value (p=0.022), maximal expiratory pressure (MEP) and its predicted value (p=0.030 and p=0.009, respectively) in which CKD-5 presented the worst values, followed by CKD-HD and healthy group. The CKD-5 had worse pulmonary function, respiratory muscle strength, and QoL. Moreover, CKD-HD also showed some impairment in pulmonary function and QoL when compared with healthy individuals. Even with the peripheral muscle strength preserved, its decrease is proportional to the pulmonary impairment in the evaluated CKD patients.

A randomized trial comparing inspiratory training and positive pressure training in immediate lung recovery after minor pleuro-pulmonary surgery.

BackgroundTwo respiratory physiotherapy modalities were compared in a randomized controlled trial on patients undergoing minor pleuro-pulmonary surgery.MethodsForty-five patients were randomly allocated into positive expiratory pressure (PEP) therapy (n=23) and inspiratory muscle training (IMT) groups (n=22). Individualized group specific physiotherapeutic guidance was administered preoperatively, and once a day postoperatively. Patients also performed independent exercises and kept a logbook. Pain was assessed on a numerical reference scale (NRS). Volumetric pulmonary function values and walking distance were recorded preoperatively, and on first (POD1) and second postoperative days (POD2). Pre- and postoperative values were compared using two-way repeated measures analysis of variance.ResultsPatient characteristics and pleuro-pulmonary interventions were similar between the groups. Thoracotomy was performed in 14/45 and video assisted surgery (VATS) in 31/45 of cases. Preoperative volumetric pulmonary functions were normal or slightly decreased in 29/45, and fell significantly (P<0.001) on the first postoperative day (POD1) and improved but remained significantly lower on the second postoperative day. The recovery of mean FEV1, FIV1 and FIVC values was greater in the IMT than in the PEP group between POD1 and POD2, but without significant difference. The corresponding relative to preoperative values were higher in the IMT group, with a significant difference in FEV1 (P=0.045). Also relative PEF and FIV1 values seemed to be slightly higher in the IMT compared to the PEP group, but not significantly. Average NRS values for pain were lower in the IMT group (P=0.010) but only on POD1. Air leak was noted in 4/45 patients, two in each group, on POD1, and two in PEP groups and one in IMT group on POD2. Mean measured walking distances between groups did not differ. Mean hospital stay was 4 days in the PEP group and 3 days in the IMT group. There was no hospital mortality.ConclusionsPulmonary function values decreased significantly after minor lung resections, supporting rehabilitative respiratory physiotherapy to avoid postoperative pulmonary complications (PPCs). Both PEP and IMT training were well tolerated and equally efficient when comparing spirometry values at three time points. IMT appeared advantageous regarding relative FEV1 recovery and immediate postoperative pain.

Automated Digital Quantification of Pulmonary Fibrosis in Human Histopathology Specimens.

Pulmonary fibrosis is characterized by abnormal interstitial extracellular matrix and cellular accumulations. Methods quantifying fibrosis severity in lung histopathology samples are semi-quantitative, subjective, and analyze only portions of sections. We sought to determine whether automated computerized imaging analysis shown to continuously measure fibrosis in mice could also be applied in human samples. A pilot study was conducted to analyze a small number of specimens from patients with Hermansky-Pudlak syndrome pulmonary fibrosis (HPSPF) or idiopathic pulmonary fibrosis (IPF). Digital images of entire lung histological serial sections stained with picrosirius red and alcian blue or anti-CD68 antibody were analyzed using dedicated software to automatically quantify fibrosis, collagen, and macrophage content. Automated fibrosis quantification based on parenchymal tissue density and fibrosis score measurements was compared to pulmonary function values or Ashcroft score. Automated fibrosis quantification of HPSPF lung explants was significantly higher than that of IPF lung explants or biopsies and was also significantly higher in IPF lung explants than in IPF biopsies. A high correlation coefficient was found between some automated quantification measurements and lung function values for the three sample groups. Automated quantification of collagen content in lung sections used for digital image analyses was similar in the three groups. CD68 immunolabeled cell measurements were significantly higher in HPSPF explants than in IPF biopsies. In conclusion, computerized image analysis provides access to accurate, reader-independent pulmonary fibrosis quantification in human histopathology samples. Fibrosis, collagen content, and immunostained cells can be automatically and individually quantified from serial sections. Robust automated digital image analysis of human lung samples enhances the available tools to quantify and study fibrotic lung disease.

Effects of different occupational exposure factors on the respiratory system of farmers: the case of Central Anatolia

Past studies show that farmers are especially at risk for respiratory diseases due to occupational exposure and not using protective equipment. This study aimed to provide information about the effects of occupational pesticide exposures on the respiratory system of farmers working in Central Anatolia from a wider perspective to gain insight into the effects of pesticides and other occupational exposures on the respiratory system of farmers. A cross-sectional study was conduct with a representative sample size of 380 agricultural workers living in the Central Anatolia region. Data were collected with a face-to-face questionnaire and spirometry. The chi-square test was used for testing relationships between categorical variables. The Shapiro–Wilk test was conducted to investigate the distribution characteristics of FVC, FEV1, FEV1/FVC and FEF25–75 (p > 0 .050), and nonparametric Mann–Whitney U tests (MW) and Kruskal–Wallis tests were used to examine differences in FVC, FEV1, FEV1/FVC and FEF25–75 between groups. Univariate analysis was performed before multiple logistic regression analyses to identify candidate variables for the final model. The median duration of pesticide use was 25.00 years. According to the FEV1 of agricultural workers, 23.16% had an FEV 1 ≤ 80% predicted. The odds for FEV1 ≤ 80% predicted was 2.44 times higher for smokers (95% CI 1.2–5.0), 1.74 times higher for those with respiratory symptoms in the past 3 months (95% CI 1.1–2.9) and 5.01 times higher for those farming 30 years and more (95% CI 1.8–14.1). The results of the study found that pulmonary function values of agricultural workers were lower compared to reference values. Lower FEV1 was associated with the duration of farming and smoking.

Milk Consumption and Respiratory Function in Asthma Patients: NHANES Analysis 2007-2012.

Per the Centers for Disease Control and Prevention, asthma prevalence has steadily risen since the 1980s. Using data from the National Health and Nutrition Examination Survey (NHANES), we investigated associations between milk consumption and pulmonary function (PF). Multivariable analyses were performed, adjusted for a priori potential confounders for lung function, within the eligible total adult population (n = 11,131) and those self-reporting asthma (n = 1,542), included the following variables: milk-consumption, asthma diagnosis, forced vital capacity (FVC), FVC%-predicted (%), forced expiratory volume in one-second (FEV1), FEV1% and FEV1/FVC. Within the total population, FEV1% and FVC% were significantly associated with regular (5+ days weekly) consumption of exclusively 1% milk in the prior 30-days (β:1.81; 95% CI: [0.297, 3.325]; p = 0.020 and β:1.27; [0.16, 3.22]; p = 0.046). Among participants with asthma, varied-regular milk consumption in a lifetime was significantly associated with FVC (β:127.3; 95% CI: [13.1, 241.4]; p = 0.002) and FVC% (β:2.62; 95% CI: [0.44, 4.80]; p = 0.006). No association between milk consumption and FEV1/FVC was found, while milk-type had variable influence and significance. Taken together, we found certain milk consumption tendencies were associated with pulmonary function values among normal and asthmatic populations. These findings propound future investigations into the potential role of dairy consumption in altering lung function and asthma outcomes, with potential impact on the protection and maintenance of pulmonary health.

Preoperative maximal voluntary ventilation, hemoglobin, albumin, lymphocytes and platelets predict postoperative survival in esophageal squamous cell carcinoma.

BACKGROUNDPreoperative pulmonary function plays an important role in selecting surgical candidates and assessing postoperative complications. Reduced pulmonary function is associated with poor survival in several cancers, but the prognostic value of preoperative pulmonary function in esophageal squamous cell carcinoma (ESCC) is unclear. Nutritional and systemic inflammation parameters are vital to cancer survival, and the combination of these parameters improves the prognostic value. The hemoglobin, albumin, lymphocytes and platelets (HALP) score is a novel prognostic indicator to reflect the nutritional and inflammation status, but the clinical effects of the HALP score combined with maximal voluntary ventilation (MVV), an important parameter of pulmonary function, have not been well studied in ESCC.AIMTo investigate the prognostic value of MVV and HALP score for assessing postoperative survival of ESCC patients.METHODSData from 834 ESCC patients who underwent radical esophagectomy with R0 resection were collected and retrospectively analyzed. Preoperative MVV and HALP data were retrieved from medical archives. The HALP score was calculated by the formula: Hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/platelets (/L). The optimal cut-off values of MVV and HALP score were calculated by the receiver operating characteristic curve analysis. The Kaplan-Meier method with log-rank test was used to draw the survival curves for the variables tested. Multivariate Cox proportional hazard regression models were used to analyze the independent prognostic factors for overall survival.RESULTSMVV was significantly associated with gender (P < 0.001), age at diagnosis (P < 0.001), smoking history (P < 0.001), drinking history (P < 0.001), tumor length (P = 0.013), tumor location (P = 0.037) and treatment type (P = 0.001). The HALP score was notably associated with gender (P < 0.001), age at diagnosis (P = 0.035), tumor length (P < 0.001) and invasion depth (P = 0.001). Univariate Cox regression analysis showed that low MVV and low HALP score were associated with worse overall survival (all P < 0.001). Multivariate analysis showed that low MVV and the HALP score were both independent risk factors for overall survival (all P < 0.001). The combination of MVV and HALP score improved the prediction performance for overall survival than tumor-node-metastasis. Also, low combination of MVV and HALP score was an independent risk factor for poor overall survival (P < 0.001).CONCLUSIONMVV, HALP score and their combination are simple and promising clinical markers to predict overall survival of ESCC patients.

Anthropometric determinants of lung function in apparently healthy individuals.

BackgroundForced vital capacity (FVC) and peak expiratory flow rate (PEFR) are used to assess and monitor the management of lung pathology.ObjectivesOur study documented spirometry reference values for apparently healthy Nigerians and developed predictive equations for pulmonary function.MethodA cross-sectional survey involving healthy adult Nigerians included anthropometric measurements of weight, height, waist, hip circumference (HC), sagittal abdominal diameter (SAD) and percentage body fat. Anthropometric indices (body mass index [BMI] and waist-to-hip ratio [WHR]) were estimated and pulmonary function tests (FVC, forced expiratory volume in 1 s [FEV1], PEFR, FEV1/FVC ratio) measured. The association amongst selected anthropometric and socio-demographic variables and pulmonary function test parameters were established using t-tests and Pearson’s product moment correlation tests. The predictors of pulmonary function were established using stepwise multiple linear regression models.ResultsFour hundred and forty-four adults (156 [35.1%] men) were included, mean age 37.3 ± 8.25 (range 22–25) years. Male participants had significantly higher lung volumes than females (p < 0.05). Age, height, weight and percentage body fat had significant low correlations with lung function test parameters (p < 0.05). Fat-free mass (FFM), fat mass (FM), SAD, height and age of participants were main predictors of FVC and FEV1 (R2 = 0.43 and 0.41, respectively). Fat-free mass and SAD were main predictors of PEFR (R2 = 0.53). Sagittal abdominal diameter and age were main predictors of FEV1/FVC ratio (R2 = 0.34).ConclusionFat-free mass, FM, height, age and SAD are important determinants of lung volumes and key variables for predictive equations of pulmonary function.Clinical implicationsAn accurate documentation of pulmonary function values for apparently healthy Nigerian adults may be useful in identifying deviations from normative values thereby giving an index of suspicion for the diagnosis of pulmonary dysfunction.Keywordsanthropometric; lung function; spirometry; fat-free mass; apparently healthy.

PREVALENCE OF RESPIRATORY SYMPTOMS AND PULMONARY FUNCTION STATUS OF RESTAURANT WORKERS

The cooking process may emit toxic compounds and airway irritants from both the fuel combustion and cooking fumes which is harmful to the respiratory health among the restaurant workers. A cross-sectional study of 243 restaurant workers from the selected restaurants in Sungai Long, Malaysia was conducted. The standardized British Medical Research Council questionnaire on Respiratory Symptoms (1986) was used during the interview to access the symptoms and the spirometry test was performed to evaluate the pulmonary functions of the participants. The data of socio-demography and occupational characteristics were also collected. The most complaint respiratory symptoms by the restaurant workers were breathlessness, which accounted for 33.7%, followed by wheezing (14%). The mean values of all pulmonary function tests (PFT) of the restaurant workers were within the normal range (&gt;80%), except for the Peak Expiratory Flow (PEF) (79.09%). The results of the bivariate statistical analysis, Chi-square, ANOVA and t-test, showed the determining factors of the respiratory health among the workers were workers’ age and gender in addition to the working duration and the ethnicity. The restaurant workers in Sungai Long were at risk of developing respiratory symptoms and lower pulmonary function values due to prolonged exposure to cooking fumes. Emphasis should be given to the safety and health of restaurant workers and health education should be provided to the restaurant workers and owners. Strategies to increase notification of such occurrences among these workers should be looked into by related agencies in the country.