Respiratory System Research Articles

Skin-to-skin stabilisation and uninterrupted respiratory support for preterm infants after birth: feasibility of a new and simplified rPAP system

BackgroundThe rPAP respiratory support system, used for delivery room stabilisation with nasal prongs, has been shown to reduce the need for intubation in extremely preterm infants. A simplified version of...

Justification of the effective sequence of group fitness classes with second mature women (45-55 years old)

This article deals with issues that are aimed at the organization of strength training. First of all, it is necessary to note significant differences between women and men in terms of strength. In women, they are 15-20% lower than in men. Women have a lower tendency to gain muscle mass. This is primarily related to the hormonal background, since the male hormone testosterone is responsible for the growth of muscle mass, and its amount in the body of women is many times smaller than that of men. At the same time, women's ability to display strength indicators of leg muscles is close to men's. Experts in age-related physiology note that at the age of 40-45, reverse processes begin in a woman's body. The main metabolism slows down, the productivity of various organs and systems decreases, the possibility of various pathological processes, chronic diseases, etc. increases. In connection with the decrease in the hormonal background, negative changes are observed in all organs and systems of the body. Blood pressure often rises, a tendency to osteoporosis appears, fat metabolism is disturbed, which often leads to an increase in body fat. There are significant changes in the respiratory system, the vital capacity of the lungs decreases, the mobility of the chest decreases. After 40 years, there is a significant decrease in muscle strength in women. The elasticity of muscles, tendons, and joint performance is lost. At the same time, muscle tone decreases, which leads to negative changes in posture.

Particulate Matter-Induced Emerging Health Effects Associated with Oxidative Stress and Inflammation.

Environmental pollution continues to increase with industrial development and has become a threat to human health. Atmospheric particulate matter (PM) was designated as a Group 1 carcinogen by the International Agency for Research on Cancer in 2013 and is an emerging global environmental risk factor that is a major cause of death related to cardiovascular and respiratory diseases. PM is a complex composed of highly reactive organic matter, chemicals, and metal components, which mainly cause excessive production of reactive oxygen species (ROS) that can lead to DNA and cell damage, endoplasmic reticulum stress, inflammatory responses, atherosclerosis, and airway remodeling, contributing to an increased susceptibility to and the exacerbation of various diseases and infections. PM has various effects on human health depending on the particle size, physical and chemical characteristics, source, and exposure period. PM smaller than 5 μm can penetrate and accumulate in the alveoli and circulatory system, causing harmful effects on the respiratory system, cardiovascular system, skin, and brain. In this review, we describe the relationship and mechanism of ROS-mediated cell damage, oxidative stress, and inflammatory responses caused by PM and the health effects on major organs, as well as comprehensively discuss the harmfulness of PM.

Camera-Based Respiratory Imaging System for Monitoring Infant Thoracoabdominal Patterns of Respiration.

Existing respiratory monitoring techniques primarily focus on respiratory rate measurement, neglecting the potential of using thoracoabdominal patterns of respiration for infant lung health assessment. To bridge this gap, we exploit the unique advantage of spatial redundancy of a camera sensor to analyze the infant thoracoabdominal respiratory motion. Specifically, we propose a camera-based respiratory imaging (CRI) system that utilizes optical flow to construct a spatio-temporal respiratory imager for comparing the infant chest and abdominal respiratory motion, and employs deep learning algorithms to identify infant abdominal, thoracoabdominal synchronous, and thoracoabdominal asynchronous patterns of respiration. To alleviate the challenges posed by limited clinical training data and subject variability, we introduce a novel multiple-expert contrastive learning (MECL) strategy to CRI. It enriches training samples by reversing and pairing different-class data, and promotes the representation consistency of same-class data through multi-expert collaborative optimization. Clinical validation involving 44 infants shows that MECL achieves 70% in sensitivity and 80.21% in specificity, which validates the feasibility of CRI for respiratory pattern recognition. This work investigates a novel video-based approach for assessing the infant thoracoabdominal patterns of respiration, revealing a new value stream of video health monitoring in neonatal care.

Analysis of the positive expiratory pressure valves of coupled oronasal mask

Positive expiratory pressure (PEP) is a technique used in respiratory physiotherapy to treat diseases related to the respiratory system through spontaneous breathing. This equipment consists of an oronasal mask coupled to a T connector with a unidirectional valve. Studies that evaluate whether the pressure level in the one-way valve corresponds to the actual pressure level provided are scarce in the scientific literature. In order to investigate the failures, bench tests were carried out on the spring-loaded valves, using a U-tube manometer. This pressure was exerted on the valve using a syringe that generated air flow inside the U-tube, allowing analysis numerical value of the measured pressure and the specified values of the valve, thus verifying the disparity of these measured values in relation to the PEP values operated by valves (0 to 20 cmH2O) from the three manufacturers under study. PEPs generated by spring-loaded valves from all three manufacturers were higher than pressures in the range of 2.5 to 20 cmH2O, with significant differences between manufacturers. This bench study showed inaccurate operation of all spring-loaded PEP valves of the three manufactures. The results obtained and the performance of the valves require a reevaluation of manufacturing procedures to preserve product quality and efficacy in clinical application.

Polyphyllin VI Ameliorates Pulmonary Fibrosis by Suppressing the MAPK/ERK and PI3K/AKT Signaling Pathways via Upregulating DUSP6.

Pulmonary fibrosis (PF) is a lethal disease caused by inordinate repair of damaged lungs, for which limited strategies are available. Polyphyllin VI (PPVI), extracted and isolated from Paris polyphylla Smith var. chinensis (Franch.) Hara, has been regarded as an important traditional Chinese herbal medicine for the treatment of respiratory system diseases. This study evaluated effects of PPVI on PF and its underlying mechanism. Experimental procedure For evaluating the anti-PF effect of PPVI, we established an in vivo PF mouse model via intratracheal infusion of bleomycin (BLM) in mice and an in vitro PF model induced by TGF-β1 in NIH/3T3, HPF and A549, respectively. Subsequently, the mechanism of PPVI effects was further explored using RNA sequencing (RNA-Seq). The in vivo and in vitro results demonstrated that PPVI significantly inhibited inflammation, oxidative damage, and epithelial-mesenchymal transition. Furthermore, RNA sequencing indicated that PPVI ameliorated PF by modulating inflammation and oxidative stress responses. Furthermore, dual specificity phosphatase 6 (DUSP6), was the shared and most significant differentially expressed gene associated with inflammation and oxidative stress response after PPVI treatment. Mechanistically, silencing DUSP6 can eliminate the suppressive impact on PPVI for the activation of fibroblast and the phosphorylation of ERK and AKT. Summarily, our findings revealed the potential of PPVI in mitigating PF via upregulating DUSP6 and highlighted the regulatory function of DUSP6 in the pathogenesis of PF.

Methodological approaches to the creation of a biological model of smoke in landscape fires

Introduction. Long-term smoke from landscape fires causes various health problems, primarily affecting the respiratory, cardiovascular, and nervous systems. To substantiate safe levels of exposure to smoke from landscape fires, it is necessary to create an adequate biological model for smoke that is close to natural conditions. The aim of the study is to develop and test methodological approaches to creating a biological model for smoke during landscape fires to substantiate safe levels of exposure. Materials and methods. Using the developed biological model, we studied the effects of smoke from landscape fires on white rats. We assessed the functional state of the central nervous system based on rat behaviour and EEG examination results, conducted a morphological study of the cerebral cortex and testes of white rats, and examined the offspring immediately after birth and at puberty. Results. We studied the biological response of white rats exposed to inhalation smoke from landscape fires for different durations. The main criterion indicators of health disorders in the central nervous and reproductive systems of animals were identified. Limitations. The study is limited by the lack of data on safe levels of exposure to smoke from landscape fires on the central nervous system and reproductive toxicity. Conclusion. Testing of the developed method allowed identifying the exposure load of carbon monoxide and ultrafine particles PM2.5, at which changes in the nervous and reproductive systems are minimal. A method for calculating safe levels of exposure for the central nervous and reproductive systems, as well as for the effect on offspring, is proposed. An algorithm for conducting research in studying the effect of smoke from landscape fires on the body has been developed.

Immune Checkpoint Inhibitors in the Emergency Department

Immune-checkpoint inhibitors (ICIs) have transformed the landscape for cancer treatment by enhancing the endogenous immune system’s ability to eliminate cancer cells. Tumor cells evade the body’s immune response by blocking T cell activation; ICIs function by blocking this inhibition, thereby boosting the immune system’s ability to kill tumor cells. Despite producing astonishing improvements in prognosis and remission-free time frames for cancer patients, ICIs carry risks for well documented treatment-related complications and immune-related adverse events (irAEs) that can be life-threatening. IrAEs can occur in almost any organ system, and they usually occur early in treatment, typically within the first three months. Some common complications involve the cutaneous, gastrointestinal tract, pulmonary, and endocrine organ systems. Guidelines outlining the general treatment algorithms for irAEs have been published by the Society for Immunotherapy of Cancer (SITC) and the National Comprehensive Cancer Network (NCCN). When patients present to the Emergency Department with symptoms consistent with irAEs, a rigorous and thorough infectious work-up is required, and treatment usually begins. This includes immunosuppression with corticosteroids, symptomatic treatment, and/or discontinuation of the ICI depending on the grade and severity of presentation. Early recognition and management of irAEs among ED providers, in conjunction with treating oncologists, are imperative to improve patient outcomes in the Emergency Department.

Outcome of Targeted Driving Pressure Mechanical Ventilation in ARDS patients

Background: Lung protective strategy in acute respiratory distress syndrome (ARDS) patients is based on low tidal volume (VT), lower end-inspiratory (plateau) pressure and higher positive end-expiratory pressure (PEEP). But to predict body weight adjusted tidal volume, heterogeneous pathology of the lung in ARDS with different respiratory system compliance (CRS) is not considered. In driving pressure (ΔP=VT / CRS) tidal volume (VT) is normalized to functional lung size. It is unclear whether mechanical ventilation targeting driving pressure (ΔP) is more effective than low tidal volume ventilation (LTVV) in patients with ARDS. Materials and Methods: An open labelled randomized controlled trial was conducted at Intensive Care Unit of Dhaka Medical College Hospital, a tertiary care referral hospital over 12 months from March 2021 to February 2022. Ninety two patients with ARDS, defined by the Berlin criteria, requiring mechanical ventilation were randomized to 1:1 ratio after enrollment in the study using simple random sampling, one group receiving targeted driving pressure (ΔP) that is </=14cm of H2O ventilation another group receiving low tidal volume ventilation (LTVV) that is 4-6ml/kg PBW. Results: The study found no significant differences between the two groups in terms of clinical variables and laboratory parameters (p > 0.05), except for the duration of mechanical ventilation (MV), which was significantly shorter in the Targeted ΔP group (p<0.05). Aspiration pneumonia was the most common cause of ARDS, occurring in 34.8% of the Targeted ΔP group and 39.1% of the LTVV group. The Targeted ΔP group demonstrated a significant increase in mean respiratory system compliance compared to the LTVV group (p<0.001), and a significantly shorter length of ICU stay (p <0.001). Additionally, the PaO2/FiO2 ratio was significantly higher in the Targeted ΔP group on Days 3, 5, and 7 (p<0.05). Mean exhaled tidal volume was also significantly higher in the Targeted ΔP group on these days (p<0.05). In the Targeted ΔP group, mean driving pressure significantly decreased on Days 3, 5, and 7 (p <0.001), along with a significant reduction in mean plateau pressure (PPlt) (p <0.001). Mean positive end-expiratory pressure (PEEP) significantly decreased on Days 3, 5, and 7 (p <0.001). Respiratory rate significantly decreased on Day 7 (p <0.05). Mean set tidal volume (VT) significantly increased on Days 3, 5, and 7 (p <0.001). Moreover, the 28-day mortality incidence was significantly lower in the Targeted ΔP group compared to the LTVV group (8.7% vs. 26.1%, p <0.05). Conclusion: Targeted Driving pressure (ΔP) guided ventilation offers significant clinical benefits over LTVV in managing ARDS patients in terms of increased respiratory system compliance (CRS), shorter lengths of hospital and ICU stays, and lower in-hospital mortality. Bangladesh Crit Care J September 2024; 12 (2): 81-88

Exploring the potential role of microbiota and metabolites in acute exacerbation of chronic obstructive pulmonary disease.

The acute exacerbation of chronic obstructive pulmonary disease seriously affects the respiratory system function and quality of life of patients. This study employed 16S rRNA sequencing and metabolomics techniques to analyze the respiratory microbiota and serum metabolites of COPD and AECOPD patients. The results showed that the microbial diversity in the respiratory tract of AECOPD patients was significantly lower than that of COPD patients, and the relative abundance of Bacteroidetes, Prevotella and Neisseria in the respiratory tract of AECOPD patients was significantly lower than that of COPD patients. However, the relative abundance of Haemophilus_D, Veillonella_A and Pseudomonas_E, in AECOPD patients was significantly higher than that of COPD patients, and the ability of respiratory microbiota in AECOPD patients to participate in alanine metabolism was significantly lower than that of COPD patients. Metabolome results further revealed that the serum alanine levels in AECOPD patients were significantly lower than those in COPD patients, and these differential metabolites were mainly involved in linoleic acid metabolism, protein digestion and absorption and regulation of lipolysis in adipocytes. In summary, the structural characteristics of respiratory microbiota in COPD and AECOPD patients are different from those in healthy populations, and their microbiota diversity decreases and microbial community structure and function will also undergo changes when acute exacerbations occur. In addition, the predicted microbial community function and metabolomics results indicate that the onset of AECOPD is mainly related to energy and amino acid metabolism disorders, especially alanine metabolism.

The effectiveness of the synbiotic Maxilac<sup>®</sup> for the new coronavirus infection after antibacterial therapy

The new coronavirus infection (COVID-19) that emerged in 2019 is a infection caused by the SARS-CoV-2 virus. Although SARS-CoV-2 predominantly affects the respiratory system, numerous studies suggest significant gastrointestinal involvement in COVID-19, particularly in children. Aim. To evaluate the effect of the synbiotic Maxilac® in children with COVID-19 after antibacterial therapy (ABT). Materials and methods. A clinical post-approval open-label observational prospective single-center study with minimal intervention was conducted. The microbiome of children with COVID-19 was studied. Twelve children with COVID-19 complicated by a bacterial infection (pneumonia, sinusitis, otitis) were included, receiving ABT and then taking the synbiotic Maxilac® for 4 weeks. Patient data were collected: symptoms, medical history, clinical status, study of intestinal microbiota (IM) by 16S sequencing, stool test for zonulin, and review of drug therapy. The material was sampled in patients with COVID-19 at 3 time points: at the time of acute COVID-19 disease, at the time of recovery from COVID-19, and 4 weeks after starting the synbiotic therapy. Results. The administration of the synbiotic Maxilac® to patients who received ABT for bacterial complications of COVID-19 relieves clinical gastroenterological symptoms, prevents the development of dysbiosis, and normalizes intestinal permeability. The results indicated significant changes in IM after ABT in complicated COVID-19 and the normalizing effect of synbiotic Maxilac® on IM during administration for 30 days. The synbiotic Maxilac® in the group of children with COVID-19 who received ABT had no side effects and was safe. Conclusion. Children with COVID-19, complicated by a bacterial infection, treated with ABT are recommended to receive the synbiotic Maxilac® for at least 30 days after recovery.

Dyspnea, respiratory muscle strength, cough capacity, and sleep quality in individuals with substance use disorder

There is evidence that substance use and smoking cause some adverse effects on the respiratory system. The aim of this study was to assess dyspnea severity, respiratory muscle strength, cough capacity, and sleep quality in people with substance use disorder (SUD). Forty eight individuals with SUD and 28 active cigarette smokers participated in the study. Participants’ dyspnea severity was assessed using the Modified Medical Research Council Scale, respiratory muscle strength was measured with a portable electronic mouth pressure device, peak cough flow was assessed with a Peak Flow Meter, and sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The amount of daily cigarette smoking and dyspnea severity were significantly higher in individuals with SUD (p < .001). Peak cough flow values, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), MIP (%predicted), and MEP (%predicted) were not significantly different between the SUD patients and the active cigarette smokers (p > .05). However, PSQI sub-parameters such as subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, and total scores showed significant differences between the SUD patients and the active cigarette smokers (p < .05, p < .001, p = .03, p < .001, p < .001, respectively). Individuals with SUD were found to have higher dyspnea and poorer sleep quality than active smokers. However, respiratory muscle strength and cough capacities were similar.

CHARACTERISTICS OF THE HOSPITALIZATION PERIOD IN PATIENTS WHO DIED AS A RESULT OF COVID-19 WITH ACUTE CARDIOVASCULAR COMPLICATIONS

The aim. To identify adverse risk factors in hospitalized patients with fatal consequences of the coronavirus disease-2019 and its acute cardiovascular complications. Materials and methods. A retrospective study was conducted of 66 people in the study group with acute respiratory failure and cardiovascular complications due to COVID-19. The comparison group was 48 people who died of acute cardiovascular events without SARS-CoV-2 infection or other bacterial or viral diseases. The criteria for inclusion in the study group were the presence of confirmed SARS-CoV-2 infection by the polymerase chain reaction method, the presence of acute cardiovascular complications during COVID-19, and patients hospitalized during its treatment. Inclusion criteria for the comparison group were hospitalized patients with acute cardiovascular diseases that led to death without SARS-CoV-2 infection. The exclusion criteria for both groups were: age before 18 years old; absence of informed consent of the authorized person of dead person or the decision of the authorized person to withdraw from the study at any of the stages; the presence of other co-infections that could have a cumulative negative effect on the state of the respiratory and cardiovascular systems (flu virus, hepatitis virus, human immunodeficiency virus, pathogens that led to symptoms of acute intestinal infections). Age and gender distribution, comorbidities, length of hospitalization, and laboratory markers were evaluated in both cohorts. Cardiovascular complications were confirmed by the results of ultrasound examinations, computed tomography angiography and comparison with postmortem morphological findings in autopsy reports for the analysis of the current study,. The results. There were 48 men (72.7%) and 18 women (27.3%) in the study group of 66 patients who developed cardiovascular complications at the background of COVID-19, and in the comparison group – 39 men (81.3%) and 9 women (18.7%), which indicates acceptable comparability of the groups among themselves due to sex (p=0.374) and age (p=0.338). In particular, the age median for men in the study group was 65 years (IQR - 21 years), with minimum and maximum age values ​​– 36 and 83 years, respectively; the median age for women in the study group was also 65 years (IQR – 12.5 years), with the lower and upper age limits in the group being 41 and 78 years. The age median for men in the comparison group was 62 years (IQR 15 years), with a lower and upper age range of 54 and 81 years. The age median for women in the comparison group was 68 years (IQR – 16.5 years), with the lower and upper age values ​​in the group being 55 and 79 years. Men and women of the comparison group did not statistically differ from each other in terms of age (р=0.412). A significant difference was found between the length of hospitalization in both cohorts (р˂0.00001) – the median length of stay in hospital for the study group was 15 days, and for the comparison group – 10 days. It was established that malignant diseases were an additional concomitant factor of mortality in the group of patients with COVID-19 (р=0.043). The percentage ratio of neutrophils (p=0.048) and lymphocytes (p=0.031) in patients of the study group significantly differed. Conclusions. Unfavorable risk factors in patients with fatal consequences of Coronavirus disease-2019 and acute cardiovascular complications were concomitant oncological pathology, a long period of hospitalization, and changes in the percentage ratio of neutrophils and lymphocytes.

Single-Cell Antigen Receptor Sequencing in Pigs with Influenza.

Understanding the pulmonary adaptive immune system of pigs is important as respiratory pathogens present a major challenge for swine producers and pigs are increasingly used to model human pulmonary diseases. Single-cell RNA sequencing (scRNAseq) has accelerated the characterization of cellular phenotypes in the pig respiratory tract under both healthy and diseased conditions. However, combining scRNAseq with recovery of paired T cell receptor (TCR) α and β chains as well as B cell receptor (BCR) heavy and light chains to interrogate their repertoires has not to our knowledge been demonstrated for pigs. Here, we developed primers to enrich porcine TCR α and β chains along with BCR κ and λ light chains and IgM, IgA, and IgG heavy chains that are compatible with the 10x Genomics VDJ sequencing protocol. Using these pig-specific assays, we sequenced the T and B cell receptors of cryopreserved lung cells from CD1D -expressing and -deficient pigs after one or two infections with influenza A virus (IAV) to examine whether natural killer T (NKT) cells alter pulmonary TCR and BCR repertoire selection. We also performed paired single-cell RNA and receptor sequencing of FACS-sorted T cells longitudinally sampled from the lungs of IAV-vaccinated and -infected pigs to track clonal expansion in response to IAV exposure. All pigs presented highly diverse repertoires. Pigs re-exposed to influenza antigens from either vaccination or infection exhibited higher numbers of expanded CD4 and CD8 T cell clonotypes with activated phenotypes, suggesting potential IAV reactive T cell populations. Our results demonstrate the utility of high throughput single-cell TCR and BCR sequencing in pigs.

The Effect of Stretching Exercises Applied to Caregivers of Children with Development Disabilities on Musculoskeletal Muscle Mobility and Respiratory Function.

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children with developmental delays using a crossover randomized study design. Posterior muscle chain mobility was assessed using the popliteal angle test (PAT) for the hamstring muscle, the mobility of the lumbar muscles was assessed using the Schober test (ST), and the mobility of the posterior chain muscles as a whole was assessed using the finger-to-floor distance test. Chest mobility was measured using chest circumference measurements and lung volumes were measured using the pulmonary function test (PFT). The results showed that stretching exercises applied to the hamstrings led to significant improvements in PAT, ST, and chest mobility in the direction of maximal expiration (p < 0.05), without being superior to each other. Ten males (33.3%) and twenty females (66.7%) who met the inclusion criteria were analyzed. The mean age of the participants was 26.6 ± 5.9 years, the mean height was 169.53 ± 8.67 cm, the mean weight was 65.26 ± 12.03 kg, and the mean body mass index was 22.58 ± 3 kg/m2. Chest inspiratory mechanics also showed a low positive correlation with posterior muscle mobility (r = 0.381; p = 0.038). There was no significant change in PAT. Within the framework of the myofascial theory, stretching exercises that can contribute positively to the musculoskeletal and respiratory system structures of healthcare professionals can be recommended and encouraged to healthcare professionals.

Song-like activation of syringeal and respiratory muscles during sleep in canaries.

Sleep replay activity involves the reactivation of brain structures with patterns similar to those observed during waking behavior. In this study, we demonstrate that adult male canaries exhibit spontaneous, song-like peripheral reactivation during night sleep. Our findings include: (1) the presence of activity in respiratory muscles, leading to song-like air sac pressure patterns of low amplitude, (2) the simultaneous occurrence of respiratory replay events and reactivation of syringeal muscles, and (3) the reactivation of syringeal muscles without concurrent respiratory system activity. This song-like reactivation of peripheral motor systems enables the identification of specific motor patterns, with replay events preserving individual morphological and temporal properties. The activation of peripheral motor systems in songbirds and the differences in activation patterns between species give unique insights into the fictive behavioral output of activation of a complex learned motor behavior during sleep, shedding light on the neural control mechanisms and potential functions.

Nanoplastics in the Human Respiratory System.

Nanoplastics in the Human Respiratory System.

Analysis of the impact of pre-professional education on the health of medical students

BACKGROUND: Education in a higher educational institution is critical for students due to the vulnerability of the young body and the exposure of young men and women to the impact of adverse factors that contribute to health disorders. The solution to the problem of the observed deterioration of the health of students of medical higher educational institutions is currently very acute, since this problem is directly related to the health of future health workers and determines the future of the country. AIM: To assess the health status of students of the Institute of Clinical Medicine named after N.V. Sklifosovsky of Sechenov University on the example of graduates of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) in a comparative aspect with graduates of other educational institutions. METHODS: A single-stage selective comparative study of the morbidity rate of students of the N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University was carried out. The data of the registration form «No 025/у» 1–6-year students for the period from 2018 to 2024 (n=2229, including 414 graduates of the Pre-University) were used. Data analysis was performed using Pearson's χ2 test with Yates correction. The significance level was set as p 0.05. Numerical data are presented with absolute and relative values. RESULTS: It was shown that the number of students assigned to the first and second health groups among Pre-University graduates was higher overall, and the number of those assigned to the third health group was lower compared to their peers who were not Pre-University graduates (p 0.01). An increase in the overall morbidity of students by the sixth year was noted, but to a lesser extent among Pre-University graduates (p 0.001). All students have more frequent eye and apparatus diseases. The second and third places were occupied by diseases of the nervous system and diseases of the respiratory organs. Diseases of the musculoskeletal system and connective tissue were less common. CONCLUSION: The lower morbidity rate among the graduates of the Pre-University is presumably due to the promotion of a healthy lifestyle and rejection of harmful habits during the pre-professional education phase. The data obtained show the need to strengthen work on the identification and prevention of factors of educational environment, reducing the effectiveness of medical and educational measures for the formation of health status of students at the stage of pre-specific education.

Effects of antenatal corticosteroids on outcomes of very premature infants and neurodevelopment during infancy

To explore the effects of antenatal corticosteroids (ACS) on the outcomes of very premature infants (VPIs) and neurodevelopment during infancy. A retrospective study was conducted on 190 VPIs admitted to the Department of Pediatrics of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2022. The infants were categorized into four groups based on ACS usage and dosage: no ACS group (n=18), single-course group (n=88), multi-course group (n=40), and partial-course group (n=44). The clinical outcomes, Neonatal Behavioral and Neurological Assessment (NBNA) scores at 40 weeks of corrected age, and Gesell Developmental Schedule (Gesell) scores at 1 year of corrected age were compared among the four groups. The impact of timing of ACS use on the Gesell scores of infants at 1 year of corrected age in VPIs with specific gestational ages was analyzed. The incidence rates of neonatal respiratory distress syndrome, bronchopulmonary dysplasia, transient tachypnea of the newborn, and neonatal pneumonia were significantly lower in the partial-course, single-course, and multiple-course groups compared with the no ACS group (P<0.008). However, there was no significant difference among the partial-course, single-course, and multiple-course groups (P>0.008). The NBNA scores (behavioral ability, active muscle tone, primitive reflexes, and general assessment) at 40 weeks of corrected age were significantly higher in the no ACS, partial-course, and single-course groups than in the multiple-course group (P<0.008). The proportion of VPIs with normal neurodevelopment at 1 year of corrected age was significantly higher in the no ACS, partial-course, and single-course groups than in the multiple-course group (P<0.008). The timing of ACS use had no significant effect on neurodevelopment at a corrected age of 1 year in infants with various gestational ages (P>0.05). ACS is crucial for the development of the respiratory system in VPIs, but multiple courses of ACS may cause neurodevelopmental abnormalities. The impact of ACS use on neurodevelopment is independent of gestational age and the timing of ACS use.

The association between smoking/vaping habits and self-reported respiratory symptoms.

Smoking is well known for its harmful effect on the respiratory system, but whether vaping is less harmful is unknown. Therefore, the aim of this study was to assess the association of smoking/vaping habits with self-reported respiratory symptoms in vapers and cigarette smokers. An online survey was developed and shared on different vaping and smoking social media platforms and communities. Out of the 891 respondents, 788 were vapers (77 pure vapers and 711 ex-smokers) and 103 were cigarette smokers. Smokers reported more frequently respiratory symptoms such as chest pain, wheezing and whistling, sputum production, cough, dry mouth, and smokers suffered from more shortness of breath, sore throat and disturbed sleep compared to vapers. The self-reported respiratory symptoms in vapers were mainly related to the nicotine strength of the product and number of puffs per use. There were no significant differences between pure vapers and vapers who were ex-smokers. Self-reported severe respiratory symptoms were less frequent in vapers than smokers, irrespective of their smoking history. This suggests that vaping is less harmful than cigarette smoking.