Respiratory Function In Patients Research Articles

Effects of Home-based Pulmonary Rehabilitation Program Using The Talk Test in Patients with Chronic Obstructive Pulmonary Disease

Purpose : In this study, we aimed to determine the effects of a home-based pulmonary rehabilitation program using a talk test in patients with chronic obstructive pulmonary disease (COPD). Methods : The subjects in this study were 20 patients who were diagnosed COPD. We measured forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, peak expiratory flow (PEF), COPD assessment test (CAT), 6-minute walking test (6MWT), and left and right grip strengths before and after 4 weeks of training. We analyzed the data using a paired t test. Results : A significant increase in FVC, FEV₁, PEF, and left grip strength was observed. However, no significant differences in CAT, 6MWT, and right grip strength were noted. Conclusion : A home-based pulmonary rehabilitation program using the talk test positively affected respiratory function in patients with COPD.

Development of an algorithm for selecting the required frequency of injected current for multi-frequency electrical impedance tomography for tasksrelated to preoperative monitoring of human lung function

This paper proposes an algorithm for selecting the required frequency of injected current for problems of personalized multi-frequency electricalimpedance tomography. The essence of the algorithm is to calculate the rate of change in the recorded difference of potentials for the assigned range of frequencies of injected current, followed by determining the frequency after which the rate of a change in potentials is minimal. Subsequently, the injection parameters are readjusted to the chosen frequency and the complete process of electricalimpedance tomography is started. The proposed solutions were studied on four subjects with different fat mass, defined by bioimpedance analysis. Thus, it seems possible to track the dynamics of a change in the lungs of a certain patient by visualizing the reconstructed conductivity field, taking into consideration its internal features. It was established that in the course of studying lungsby using the method of electricalimpedance tomography, it is necessary to take into account the frequency of injected current at an increase in percentage of fat mass. The results of the studies showing a change in the quality of imaging the breathing process at different frequencies of injected current (from 50 kHz to 400 kHz, with a pitch of 50 kHz) are presented. For the test participants with a fat weight of 7.6 kg, 23.3 kg, 15.2 kg and 37.3 kg, the injection frequency was determined as 150 kHz, 200 kHz, 200 kHz, and 350 kHz, respectively. The proposed algorithm enables visual monitoring of lung function and can be used in the problems of pre- and postoperative monitoring of respiratory function of patients. Its use is particularly relevant for patients connected to an apparatus of artificial lung ventilation.

Medicolegal Evaluation of Long-Term Respiratory Functions in Patients Injured Due to Traffic Accidents.

AimBlunt chest trauma is a frequent injury in developing countries, with motor vehicle accidents being the most common cause. Most studies about the effects of post-traumatic injuries on pulmonary functions are related to the acute phase. The aim of this study is to compare the effect of injury type on pulmonary function tests as a long-term disability in patients with severe chest trauma due to traffic accidents.MethodsIn our study, 53 patients were admitted to the Forensic Expert Council with the aim of determining the disability ratio at least six months after the traffic accident. All patients who had a respiratory function test because of respiratory symptoms and whose reporting period was completed were appreciated. A retrospective examination of the forensic committee reports, types of injuries, and current pulmonary function test results were analyzed and the data were evaluated by using the Statistical Package for the Social Sciences (SPSS) 22.0 program (IBM Corp, Armonk, NY).ResultsThirty-two (32) of the patients were male while 21 were female. Their average age was 39.88 ± 15.29. Sixty-six percent (66%; n: 35) of the cases were injured due to in-vehicle traffic accidents, 18.9% (n: 10) due to motorcycle accidents, 15.1% (n: 8) due to non-vehicle traffic accidents. The number of cases with costa fractures was 47 and 74.4% of these cases had three or more rib fractures. The mean forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC-Tiffeneau-Pinelli index) was calculated as 85.3% ± 9.45, and the average FVC was 84.3 ± 14.98%. The average number of rib fractures in all patients was 3.41 ± 2.24. It was observed that tube thoracostomy was performed in seven of 12 cases with FEV1/FVC below 80%, and the average number of rib fractures was 3.75. In 20 cases where the FVC average was below 80%, the mean number of rib fractures was 3.8, and tube thoracostomy was performed in 10 of these cases. The highest FEV1 value was 116%, and the lowest FEV1 value was 35%. The FEV1 value of 23 cases was between 75% and 95%. The highest FEV1/FVC value was 113% and the lowest FEV1/FVC value was 50%. The FEV1/FVC values of 38 cases were between 80% and 100%. ConclusionsIn our study, most patients achieve near-complete recovery in pulmonary function tests; the impact of pre-existing pulmonary compromise on recovery is less known. The number of rib fractures can reflect the severity of the blunt trauma but it would not necessarily predict the resulting pulmonary function. These results are consistent with the previous studies. Further larger prospective studies are required to investigate different factors affecting prognosis.

Adrenergic-Angiogenic Crosstalk in Head and Neck Cancer: Mechanisms and Therapeutic Implications.

Head and neck squamous cell carcinomas (HNSCC) are loco-regionally aggressive tumors that often lead to debilitating changes in appearance, speech, swallowing and respiratory function in patients. It is therefore critical to develop novel targeted treatment strategies that can effectively target multiple components within the tumor microenvironment. In this regard, there has been an increased recognition of the role of neural signaling networks as mediators of disease progression in HNSCC. Here, we summarize the current knowledge on the mechanisms of adrenergic signaling in HNSCC specifically focusing on neurovascular crosstalk and the potential of targeting the adrenergic-angiogenic axis through repurposing of FDA-approved drugs against HNSCC.

Airway Pressure Release Ventilation Mode Improves Circulatory and Respiratory Function in Patients After Cardiopulmonary Bypass, a Randomized Trial.

ImportancePostoperative pulmonary complications and cardiovascular complications are major causes of morbidity, mortality, and resource utilization in cardiac surgery patients.ObjectivesTo investigate the effects of airway pressure release ventilation (APRV) on respiration and hemodynamics in post cardiac surgery patients.Main Outcomes and MeasuresA single-center randomized control trial was performed. In total, 138 patients undergoing cardiopulmonary bypass were prospectively screened. Ultimately 39 patients met the inclusion criteria and were randomized into two groups: 19 patients were managed with pressure control ventilation (PCV) and 20 patients were managed with APRV. Respiratory mechanics after 4 h, hemodynamics within the first day, and Chest radiograph score (CRS) and blood gasses within the first three days were recorded and compared.ResultsA higher cardiac index (3.1 ± 0.7 vs. 2.8 ± 0.8 L⋅min–1⋅m2; p < 0.05), and shock volume index (35.4 ± 9.2 vs. 33.1 ± 9.7 ml m–2; p < 0.05) were also observed in the APRV group after 4 h as well as within the first day (p < 0.05). Compared to the PCV group, the PaO2/FiO2 was significantly higher after 4 h in patients of APRV group (340 ± 97 vs. 301 ± 82, p < 0.05) and within the first three days (p < 0.05) in the APRV group. CRS revealed less overall lung injury in the APRV group (p < 0.001). The duration of mechanical ventilation and ICU length of stay were not significantly (p = 0.248 and 0.424, respectively).Conclusions and RelevanceCompared to PCV, APRV may be associated with increased cardiac output improved oxygenation, and decreased lung injury in postoperative cardiac surgery patients.

Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial

BackgroundRespiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory function in patients with asthma and COPD. However, there have been no studies among CP. This study aimed to examine the effects of a six-week MDST course on respiratory function among CP. MethodsFifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion. ResultsMDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55–1.39 cm, p < 0.001) for the right side and 0.82 cm (95% CI 0.35–1.29 cm, p = 0.001) for the left side. MDST significantly improved chest wall expansion at the xiphoid process and umbilical levels, with between-group differences of 0.57 cm (95% CI 0.12–1.20 cm, p = 0.013) and 0.87 cm (95% CI 0.31–1.43 cm, p = 0.003), respectively. There was no significant difference in pulmonary function testing between the groups. ConclusionMDST could significantly improve diaphragmatic mobility, and lower and abdominal chest wall expansion, among children with CP. Therefore, MDST could be considered as an additional technique for physiotherapy programmes, to improve diaphragmatic function in spastic CP.

Is there a relationship between anxiety and depression with respiratory functions in patients with relapsing-remitting multiple sclerosis?

BackgroundPsychiatric symptoms are common in multiple sclerosis. The relationship of emotional state with respiratory function is unclear in these patients. We aimed to evaluate the relationship between the clinical characteristics, anxiety and depression status, and respiratory functions of patients with relapsing-remitting multiple sclerosis (RRMS). MethodThe research was planned as a prospective case-control study. Ninety RRMS patients and 50 healthy controls were included in the study. The MS diagnosis was confirmed according to the revised 2017 McDonald's criteria. Disability was divided into two subgroups according to the Expanded Disability Status Scale (EDSS) (under 3.5 and 3.5-5.5). Beck anxiety and Beck depression inventories evaluated. A pulmonary function test was performed with a computerized spirometry device. Forced expiratory volume-1st second (FEV1), forced vital capacity (FVC), FEV/FVC, peak expiratory flow (PEF), maximal expiratory flow (MEF), peak inspiratory flow (PIF), and maximal inspiratory flow (MIF) values were obtained. ResultsThere were 90 RRMS patients with a mean age of 38.68±10.95 years, and 58 (64.40%) were female in the study. The anxiety and depression scores of the patients were significantly higher than the control group (p=0.02, 0.002). FVC and FEV1 values were lower in patients with higher Beck depression scores (p=0.012, 0.007). FVC, FEV1, MEF50, and PIF values were lower in patients with higher Beck anxiety scores (p=0.002, 0.002, 0.030, 0.027). When EDSS and number of attacks were fixed, there was a low to moderate correlation between anxiety and FEV1-FVC (p=0.001, r=-367, -0.360 respectively), and a low negative correlation between depression and FEV1 (p=0.045, r=-0.214). ConclusionAnxiety and depression scores are higher in patients with RRMS. Depression and anxiety are particularly associated with low FVC and FEV1 in patients.

Evaluación de la función respiratoria en pacientes con patologías neuromusculares

Introducción: La Enfermedades Neuromusculares se caracterizan por la pérdida progresiva de la fuerza muscular, la morbi-mortalidad aumenta con la exageración de la debilidad muscular determinando mayor riesgo de complicaciones respiratorias. Es de suma importancia evaluar e interpretar adecuadamente la función pulmonar y ventilatoria para poder realizar intervenciones que pueda prevenir dichas complicaciones.

Testosterone deficiency promotes the development of pulmonary emphysema in orchiectomized mice exposed to elastase

Testosterone deficiency is commonly observed in male patients with chronic obstructive pulmonary disease (COPD), which is characterized by chronic inflammation of the airways and pulmonary emphysema. Although clinical trials have indicated that testosterone replacement therapy can improve respiratory function in patients with COPD, the role of testosterone in the pathogenesis of COPD remains unclear. The aim of this study was to explore the effect of testosterone deficiency on the development of pulmonary emphysema in orchiectomized (ORX) mice exposed to porcine pancreatic elastase (PPE). ORX mice developed more severe emphysematous changes 21 d after PPE inhalation than non-ORX mice. Testosterone propionate supplementation significantly reduced PPE-induced emphysematous changes in ORX mice. PPE exposure also increased the number of neutrophils and T cells in bronchoalveolar lavage fluid (BALF) of mice that had undergone ORX and sham surgery. T cell counts were significantly higher in the BALF of ORX mice than of sham mice. Testosterone supplementation reduced the infiltration of T cells into BALF and alleviated emphysematous changes in the lungs of ORX mice. Our findings suggest that testosterone, a male-specific hormone, may suppress the development of pulmonary emphysema through the regulation of T cell-mediated immunity.

Effects of an optimised approach to home-based respiratory care in individuals with amyotrophic lateral sclerosis: a study protocol for a randomised controlled trial

IntroductionThis study aims to investigate the effects of an optimal home-based respiratory care protocol in individuals with amyotrophic lateral sclerosis (ALS).Methods and analysisThis is a randomised, blinded controlled trial involving...

The effect of Acapella trainer on respiratory function of patients after thoracoscopic lung cancer surgery

AbstractObjectiveTo investigate the effect of Acapella training on respiratory function in patients undergoing video‐assisted thoracic surgery (VATS).MethodsA total of 60 patients undergoing VATS surgery for lung cancer in the department of thoracic Surgery of our hospital from August 2018 to February 2019 were selected as study subjects, and were divided into observation group (n = 30) and control group (n = 30) according to the random number table method. The control group received routine pulmonary rehabilitation exercise after surgery, and the patients in the observation group received postoperative respiratory function exercise with Acapella therapeutic apparatus on the basis of the control group. Respiratory function, including forced vital capacity (FVC), forced expiratory capacity in the first second (FEV1), peak expiratory flow (PEF), and length of hospital stay, were observed and compared between the two groups before and after using Acapell trainer.ResultsThere was no significant difference in FEV1, FVC, and PEF between the two groups before treatment with Acapella (P &gt;.05), the difference between the above indicators after treatment and before treatment was statistically significant (P &lt;.05); After Acapella treatment, FEV1, FVC, and PEF were significantly different between the two groups (P = .04, P = .047, P = .047).The postoperative hospital stay in the experimental group was shorter than that in the control group, and the difference was statistically significant (P = .028).ConclusionAcapella trainer can improve patients' respiratory function and shorten postoperative hospital stay.

Comparison of training effects between underwater treadmill gait training and overground gait training on the walking ability and respiratory function in patients with chronic severe hemiplegic stroke: A randomized, controlled, preliminary trial

ABSTRACT Background The need to develop a more effective intervention to obtain a functional recovery of stroke patients who are unable to perform land-based treadmill gait training has been widely reported. Thus, this pilot study aimed to identify a gait training type that could lead to improved gait and respiratory functioning in adult patients with chronic severe hemiplegic stroke. Objectives To examine whether underwater treadmill or/and overground gait training could be more effective in stroke patients. Methods In this single-blinded, randomized, controlled, comparative study, 22 patients with severe hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental (underwater treadmill gait training) or control group (overground gait training). All participants performed a 60-min neurodevelopmental treatment (five times/week for 12 weeks). Each group performed 30-min underwater or overground gait training (two times/week for 12 weeks). Gait and respiratory function were measured before and after the 12-week training. Results For the walking variables, step-time difference changes post-training showed significant differences between the groups (−.06 vs. +.04 s, p < .05). Both groups showed significant increases in the maximal voluntary volume (MVV) at post compared to pre training (p < .05). The post-training MVV values were significantly different between the two groups (+23.35 vs. +4.76 L, p < .05). Conclusions In severe stroke patients, underwater treadmill gait training can be more effective in improving gait and respiratory function than overground gait training and could be an effective clinical intervention tool for the training of such patients.

Tocilizumab in COVID-19 interstitial pneumonia.

BackgroundPublished reports on tocilizumab in COVID‐19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues.MethodsThis open‐label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti‐IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID‐19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response.ResultsTwenty‐one patients fulfilled pre‐defined response criteria. Lower levels of IL‐6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response.ConclusionsObjective clinical response rate overcame the pre‐defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials.

Pulmonary function assessment in patients with type 2 diabetes mellitus

Introduction: Diabetes mellitus is a leading public health problem all over the world. Diabetesmellitus is a risk factor that precipitating microvascular as well as macro-vascular pathologies.Several respiratory alterations have been reported in associations with Diabetes Mellitus. Therefore,the present study was designed to determine the effect of the disease on respiratory function inpatients with diabetes. Method &amp; material: For this study 54 Diabetes Mellitus patients wereselected using simple random sampling from the diabetic clinic. 54 Non-diabetic, age &amp; sex-matchedsubjects were also taken from teaching and non-teaching employees of the hospital for comparison.Result: In our study there was a statistically significant decrease in the level of FVC in DM patientscompared to healthy male subjects. There was a statistically significant increase in the level of ratioof FEV1/FVC. A more sensitive index of early disease is FEV1/ FVC ratio. Conclusion: Spirometricvalues were consistently lower in subjects with diabetes mellitus than in non-diabetics. Subjects withpoorer diabetic control have a worse spirometric function. We conclude that strict glycaemic control&amp; regular breathing exercises to strengthen the respiratory muscles may improve the pulmonaryfunction test in patients.

Effect of 4 weeks resistive inspiratory muscle training on respiratory functions in patients with tetraplegia during in-patient rehabilitation

There is reduction in lung compliance in first week after spinal cord injury (SCI) that deteriorates further and neuroprotective therapies like strength training of respiratory muscles should begin in first month after SCI since both motor and sensory scores at baseline and their further recovery is maximum during this phase. Few studies on SCI subjects within first month of injury have supported use of resistive inspiratory muscle training (RIMT), but have advocated the need for further research in this patient population owing to pitfalls in these studies. The present study was a prospective randomized control trial being carried out to determine whether RIMT programme of four weeks duration is effective in improving respiratory functions and strength in motor complete cervical SCI patients (AIS grade A, B) during in-patient rehabilitation. Patients within first week of cervical SCI (C4-C7 level) were assigned to RIMT (48 patients) and Control (48 patients) group and completed 40 supervised training sessions over a period of four weeks. Outcome measures included: - Spirometry, inspiratory and expiratory muscle strength. No significant differences of Chi-square test (P &lt; 0.05) and unpaired “t” test (P &lt; 0.05) were found between RIMT and Control group for all demographic and pre-training measurements. Following results were recorded after 2 weeks and 4 weeks of training on all outcome measures: - Highly significant difference (P&lt;0.01) within both groups with One–way ANOVA; Highly significant difference (P&lt;0.01) with unpaired “t-test” between RIMT and control group. Cohen “d” effect sizes for RIMT vs. Control group were in large effect size zone i.e. greater than 0.8. The findings of present study show beneficial effect of RIMT on respiratory functions and strength in patients with tetraplegia in first month post injury and we propose that RIMT should be included early in acute phase rehabilitation of these patients.

ASSESSMENT OF THE IMPACT OF ANTIREFLUX THERAPY ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The aim: To examine the effect of antireflux therapy on the course of COPD. Materials and methods: Under observation were 60 patients who were hospitalized in the «Transcarpathian Regional Clinical Hospital named after Andrei Novak» with a diagnosis of COPD II gr B in combination with GERD and 36 patients diagnosed with GERD who were treated on an outpatient basis. To study the effectiveness of antireflux therapy and its impact on the course of COPD, patients are divided into 2 groups: 1 group (main) (n = 60) – patients with COPD in combination with GERD, group 2 (control) (n = 36) – patients with isolated GERD. Patients with positive Helicobacter pylori status received antihelicobacter therapy. Patients in group 1 were divided into subgroups: 1a (n = 34) – COPD in combination with esophageal manifestations of GERD and 1b (n = 26) – COPD in combination with extraesophageal manifestations of GERD. Group 1a received complex therapy, which consisted of basic therapy of COPD in combination with antireflux and with rebapimide, group 1b – only basic therapy of COPD in combination with antireflux. Results: After treatment, the clinical signs of GERD significantly decreased in all patients receiving complex therapy, improved the course of respiratory symptoms of COPD. After treatment, patients showed a clinically significant reduction in systemic inflammation, which is best seen in the group with the use of rabipimide. Conclusions: Comprehensive treatment of combined pathology with the use of antireflux therapy has a positive effect not only on the clinical symptoms of the disease, but also on the indicators of external respiratory function in patients with combined COPD and GERD.

Safety of Orexin Receptor Antagonist on Cardiac and Respiratory Function in Patients who Underwent Off-pump Coronary Artery Bypass Grafting

Safety of Orexin Receptor Antagonist on Cardiac and Respiratory Function in Patients who Underwent Off-pump Coronary Artery Bypass Grafting

Investigation of inspiratory intercostal muscle activity in patients with spinal cord injury: a pilot study using electromyography, ultrasonography, and respiratory inductance plethysmography.

[Purpose] The respiratory function in patients with cervical spinal cord injury is influenced by inspiratory intercostal muscle function. However, inspiratory intercostal muscle activity has not been conclusively evaluated. We evaluated the inspiratory intercostal muscle activity in patients with cervical spinal cord injury by using inspiratory intercostal electromyography, respiratory inductance plethysmography, and ultrasonography. [Participants and Methods] Three patients with cervical spinal cord injury were assessed. The change in mean amplitude (rest vs. maximum inspiration) was calculated by using intercostal muscle electromyography. Changes in intercostal muscle thickness (resting expiration and maximum inspiration) were also evaluated on ultrasonography. The waveform was converted to spirometry ventilation with respiratory inductance plethysmography, and the waveform at the xiphoid was considered to determine the rib cage volume. Each index was compared with the inspiratory capacities in each case. [Results] Intercostal muscle electromyography failed to measure the notable myoelectric potential in all the patients. The rib cage volume was higher at higher inspiratory capacities. The changes in muscle thickness were not significantly different between the patients. [Conclusion] The rib cage volume (measured with inductance plethysmography) was greater in the patients with cervical spinal cord injury when inspiratory intercostal muscle activity was high. Respiratory inductance plethysmography can capture inspiratory intercostal muscle function in patients with cervical spinal cord injury.

Chronic obstructive pulmonary disease and smoking in COVID-19.

COPD is a chronic disease that progressively worsens the patient's respiratory function. Infection with SARS-CoV-2 in a patient with COPD with initially low respiratory rates should theoretically lead to a more severe course and a high probability of lethal outcome. However, at present, no direct connection has been found between the presence of COPD, smoking and a high risk of being infected or severe course of SARS-CoV-2 infection. Of great importance in the study of these paradoxical facts is the interaction between the reninangiotensin and nicotinic cholinergic systems. In this review, we perform an extensive literature search for studies of the relationship between COPD, smoking, and SARS-CoV-2 infection.

Effects of Spine Mobilization on Cobb’s Angle and Respiratory Function in Patients with Adolescent Idiopathic Scoliosis

Effects of Spine Mobilization on Cobb’s Angle and Respiratory Function in Patients with Adolescent Idiopathic Scoliosis