Reduction In Lung Capacity Research Articles

Polysomnography in patients with spinal cord injury who underwent robotic assisted gait training

IntroductionObstructive sleep apnea in spinal cord injured (SCI) patients is an important but underestimated clinical problem. Spinal cord injury weakens the muscles responsible for breathing, resulting in a reduction in lung capacity. Training of respiratory muscles may present an effective method of increasing respiratory muscle strength and lung volume.AimThe aim of study was to evaluate the effectiveness of robot-assisted gait training (RAGT) in 34 patients with SCI in sleep-disordered breathing (SDB) reduction.Material and methodsWe conducted a control trail to compare RAGT (exoskeleton EKSO-GT or Locomat Pro) with conventional gait training using conventional physiotherapy with dynamic parapodium. We included patients with SCI (above T8 level of injury) recruited between 3 months and 2 years post injury. Polysomnographic studies were performed before and after the completion of the 7-week rehabilitation program. Patients were divided into 2 groups above and up 40 years old.Results and discussionThe comparison of all polysomnographic parameters before and after rehabilitation with RAGT revealed the decline in all polysomnographic parameters (the apnea-hypopnea index – AHI; score reached statistically significant value – <i>P</i> < 0.02). In comparison in patients aged up to 40 years with conventional gait rehabilitation the number of apnoea’s and shortness of breath during sleep even increased: the AHI index increased after rehabilitation from 1.7 to 3.2 values.ConclusionsRAGT therapy should be considered as a therapeutic option for SDB reduction in patients after SCI. Additionally, the study identified the need to conduct further studies on larger groups of patients.

Assessment of the adverse effect of crop residue burning on respiratory health: a case study of Patiala, India

BackgroundCrop residue burning (CRB) is one of the top contributors to ambient air pollution (particulate matter 2·5 [PM2·5]) in north-western India. Despite the magnitude of the problems associated with high particulate amounts, there are few epidemiological data in India on the associated health effects of CRB, focusing on rural populations. The present study was conducted to quantify the effect of PM2·5 from CRB on the respiratory health of agricultural community in the Nabha block in Patiala, India. MethodsParticipants aged 10–60 years who were residents of six villages in the Nabha block in Patiala, India, who had resided in the area for at least 10 years and had self-reported as being in good health and non-pregnant women were enrolled in this cross-sectional study using purposive sampling. The participants were recruited from their residence, and all volunteered to participate in the study. The study population was surveyed for self-reported health symptoms and other exposure confounders. Lung function tests (LFTs) were done to examine forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), both during CRB and non-CRB periods. 24-h continuous PM2·5 monitoring was done using the modified low-volume Combo Dust Samplers and particles were collected in glass fiber filters. The PM2·5 mass concentrations were analysed using the standard gravimetric method. Multiple regression models were used to quantify the association of PM2·5 from CRB on respiratory health after controlling for other exposure variables; namely, cooking fuel, ventilation, and distance from the road. FindingsA total of 3644 participants were enrolled from Oct 16 to 26, 2018, and March 7 to April 3, 2019 (the non-CRB periods), and from Oct 27 to Nov 20, 2018 and from Nov 3 to 13, 2019 (CRB periods). The present study showed significant associations between PM2·5 exposure and poor respiratory health with an increased prevalence of respiratory symptoms and lung function decrement among the study population. The older group (>40–60 years) reported more respiratory complaints during CRB than the younger groups (10–18 and >18–40 years), including coughs (OR 1·57; 95% CI 1·14–2·16), phlegm (1·69; 1·19–2·16), and itchiness of the eyes (3·44; 2·54–4·66). The study found a decrease in the results of LFTs with increasing PM2·5 across all age groups during CRB compared with the non-CRB period. The youngest group (10–18 years) had the highest reduction in lung capacity based on LFT variables. In men, FEV1 declined 16% in those aged 10–18 years, 9% in those aged older than 18 to 40 years, and 10% in those older than 40 to 60 years; and in women, it declined 26% in those aged 10–18 years, 12% in those older than 18 to 40 years, and 7% in those older than 40 to 60 years, during CRB (with a mean PM2·5 increase of 167 μg/m3). Similar declines were noted for the other (FVC and PEF) lung function variables. InterpretationThis study, which shows the adverse effects on health from CRB (increases in respiratory symptoms and poor lung function), highlights to need to accelerate policy interventions and engage farmers in discussions on CRB elimination. FundingCentral Pollution Control Board of India (B-33014/40/2018/AQM-EPC 9836).

Potential Involvement of NHE1 in COVID‐19 Related Pulmonary Damage

In some moderate and severe COVID‐19 infections lung scarring similar to fibrosis have been observed in survivors, many of which have persistent functional and radiographic abnormalities at the initial follow‐up suggesting a possible shared pathobiology between fibrotic lung disease and COVID‐19‐ lung disease. Fibrosis is an inflammatory response to pulmonary infections that activates fibroblasts and produces excessive extracellular matrix proteins that stiffen cells, leading to reduction in lung capacity and breathing deficiency. Several factors involved in the “cytokine storm” also are pre‐fibrotic leading to the advanced disease. This includes interleukin 6 and others. The focus of this study is on sodium hydrogen exchanger isoform 1 (NHE1) that plays a key role in intracellular pH regulation and cell movement and its effect on fibrosis development. Both cytokines IL‐1 and IL‐6 are used to show one measure of cell restructuring and stiffness by measuring stress fiber formation. To examine the role of NHE1 in fibroblast response, both IL‐1 and IL‐6 cells were treated with proinflammatory cytokines in the presence and absence of NHE1 inhibitor (EIPA). This study will provide an initial insight to the relationship between NHE1 and proinflammatory response for future experiments.

Одышка в практике терапевта: развитие пареза диафрагмы у больного бронхиальной астмой

Objective of the Paper: To demonstrate peculiar properties of dyspnoea, challenges with diagnosis and functional contribution of herpetic (Herpes zoster) and post-traumatic diaphragm paresis (DP) to respiratory disorders in a patient with bronchial asthma (BA). Key Points. We described peculiar properties of dyspnoea in DP in a patient with BA. Functional contribution from DP was measured using spirometric methods: reduction in lung capacity and forced vital capacity by more than 35% when the patient body position became horizontal. Combined DP genesis caused incomplete recovery of phrenic nerve during follow-up. Conclusion. In unspecified dyspnoea, a GP should be vigilant and should check diaphragm function. In diagnosis of DP, X-ray, ultrasound and functional examinations are of utmost importance. Keywords: dyspnoea, diaphragm paresis, bronchial asthma, shingles.

PECULIARITIES OF PSYCHOPHYSIOLOGICAL STATUS OF BIOLOGICAL AND MEDICAL SECOND-YEAR STUDENTS

The paper deals with psychophysiological features of biological and medical second-year students. Parameters of physical development and cardiovascular system were measured in 88 medical students (52 men and 36 women) and 89 biological students (36 men and 53 women). Peculiarities of psychoemotional status of the women, studying both in biological and medical universities, have been examined with the help of the standard methods. Underweight was detected in 1/3 men studying in medical university and in 1/4 men studying in biological university, in 1/5 women studying in both universities. In more than a half of cases, reduction of lung capacity and muscle strength of the hand was found in biological and medical students of both sexes. Cardiohemodinamic markers in all participants met the normative standards. Balanced state of intro-extroversive attitude, medium level of neuroticism and personal anxiety, hyperthymic type of character accentuation were revealed in most cases in women. At the same time, elevated levels of reactive anxiety and high risk of coronary-prone behavior was higher in women studying in medical university as compared to biological students. The paper discusses possible causes of mentioned specific differences and degree of physiological adequateness of the psychoemotional pattern in women studying in medical university.

Pulmonary functions in patients with diabetes mellitus

Background:A reduction in lung capacity has been reported previously among diabetics. According to WHO estimates, Pakistan is currently eighth in the prevalence of diabetes mellitus (DM) and will become fourth by the year 2025 with over 15 million individuals. This study was designed to see the impairment of lung functions on spirometry in DM patients.Objective:Our aim was to investigate the pulmonary functions tests of Pakistani patients with DM.Materials and Methods:Between January to July 2004, 128 subjects who were never-smokers and had no acute or chronic pulmonary disease were recruited. Sixty-four of these subjects had DM and 64 were healthy matched controls. All underwent screening with detailed history, anthropometry, lipid profile, and spirometric measurements at the Aga Khan University Hospital, Karachi, Pakistan.Results:The mean age of diabetics and matched control were 54.3±9 and 54.0±8 (P<0.87) years, respectively. Diabetes patients showed a significant reduction in the forced vital capacity (FVC) [mean difference (95% CI) – 0.36 (–0.64, –0.07) P<0.01], forced expiratory volume in one second (FEV1) [– 0.25(–0.50, –0.003) P<0.04], and slow vital capacity (SVC) [– 0.28(–0.54, –0.01) P<0.04], relative to nondiabetic controls. There was no significant difference noted in the forced expiratory ratio and maximum mid-expiratory flow between the groups. There was also a significant higher level of triglycerides noted among diabetics (P<0.001).Conclusion:Diabetic patients showed impaired lung function independent of smoking. This reduced lung function is likely to be a chronic complication of diabetes mellitus.

Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cystic echinococcosis in a wild population of the brush-tailed rock-wallaby (Petrogale penicillata), a threatened macropodid

Infection of small macropodids with the larval stage of Echinococcus granulosus can cause fatalities as well as significant pulmonary impairment and other adverse sequelae. The brush-tailed rock-wallaby (Petrogale penicillata) is a small macropodid listed as vulnerable on the IUCN's Red List of Threatened Species. This study used radiographic techniques to determine the prevalence and severity of pulmonary hydatid infection and growth rates of hydatid cysts in a wild population of this macropodid. The overall prevalence was 15.3% (9/59 animals) with 20.0% (8/40 animals) of adults infected. During the study period, the death of at least 1 infected animal was directly attributed to pulmonary hydatidosis. Rapid cyst growth occurred in some animals (up to 43% increase in cyst volume in 3 months). Cyst volume reduced lung capacity by up to 17%. Secondary pulmonary changes were uncommon but, in 1 animal, resulted in reduction in lung capacity by approximately 50%. Infection was associated with a higher blood urea concentration, but no significant differences in other blood variables were detected. These results indicate that hydatid infection may be a significant risk to threatened populations of small macropodids and should be addressed in conservation management plans for these animals.

Respiratory mechanics in adolescents with idiopathic scoliosis.

Mechanisms causing the reduction in lung capacity commonly found in adolescents with idiopathic scoliosis (IS) have not been understood. In 29 patients with typical thoracic curvatures of mild to moderate degree (less than 60 degrees), total lung capacity (TLC) was a mean 75 +/- 13% (SD) of predicted. The patients could generate only -70 +/- 26 cm H2O (SD) maximal inspiratory airway pressure at function residual capacity, as compared with -102 +/- 28 cm H2O in 21 normal control subjects (p less than 0.001). Studies of lung mechanics in 15 of the patients showed that maximal transpulmonary pressure at TLC was also reduced. Static pressure volume curves were shifted to the right, and both static and dynamic lung compliance were significantly reduced. Although both upstream conductance per TLC and anatomic dead space per TLC were abnormally high, relationships between maximal expiratory flow and static lung recoil were appropriate for age, indicating a normal growth of airway dimensions. From results of the single-breath nitrogen washout procedure, amounts of trapped nitrogen were also normal, indicating that the low lung compliance is not caused by airway closure. After a 5-min period of positive pressure (25 cm H2O) breathing, dynamic compliance increased by a mean of 34% in subjects with low TLC, and by a significantly smaller (p less than 0.05) mean increase of 14% in subjects with normal TLC. The 15 patients were restudied 1 yr after corrective surgery by the Harrington procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Physiologic adjustment in sublethal reduction of lung capacity in dogs

Physiologic adjustment in sublethal reduction of lung capacity in dogs