Respiratory Issues Research Articles

ASSOCIATION OF PELVIC FLOOR DYSFUNCTION WITH CHRONIC RESPIRATORY DISEASES

Cough associated with chronic respiratory issues leads to a decline in abdominal wall strength, disrupting breathing stability and impacting diaphragm and pelvic floor muscle function. Previous literature primarily addresses individual respiratory illnesses and their link to pelvic floor disorders; this study examines the severity of pelvic disorders across various chronic pulmonary diseases. By understanding this association, healthcare providers can enhance patient care and raise awareness about an under-recognized issue, ultimately reducing healthcare costs. Objective: To investigate the association of pelvic floor dysfunction with chronic respiratory diseases. Methods: Following ethical board approval from the University, a cross-sectional study was conducted involving 150 patients aged 35-50 with chronic respiratory diseases; those with a history of pregnancy, obesity, heart failure, urinary tract infections, or reproductive disorders were excluded. Data was collected from hospitals with official permissions. Bladder and bowel dysfunction were assessed using "The Australian pelvic floor" questionnaire, and data analyzed with SPSS version 21. Results: A total 81 males (54%) and 69 females (46%), with occupations predominantly in manual/labor work (69.33%), a mean age of 42 ± 4.2 years, and a mean BMI of 27 ± 3.5 kg/m², indicating over-weight were recruited. A significant correlation (p < 0.01) was found between pelvic floor dysfunction and chronic respiratory diseases, with correlation coefficients of r=0.744 for bladder dysfunction and r=0.494 for bowel dysfunction. Conclusion: This study found a positive association of pelvic floor dysfunction with chronic respiratory disease, highlighting strong correlations with bladder dysfunction and moderate correlations with bowel dysfunction. Keywords: Chronic Obstructive, Dysfunction, Lung Diseases, Pelvic Floor, Pelvic Floor Disorders, Respiratory

Mathematical modeling and strategy for optimal control of diphtheria

This research introduces a novel approach to combating diphtheria by presenting a comprehensive optimal control strategy focused on awareness campaigns to avoid direct contact with infected individuals and promote vaccinations. These campaigns highlight the severe complications of diphtheria, such as acute respiratory issues, myocarditis, and neurological paralysis. Additionally, the campaigns emphasize the negative impacts of an unbalanced lifestyle and environmental factors, as well as the importance of timely treatment and psychological support. The model aims to improve control strategies by reducing the number of infected individuals I(t) and exposed individuals E(t), as well as asymptomatic carriers A(t), which we have integrated into the model as an aspect that has been relatively unexplored in diphtheria transmission. The optimal controls are meticulously determined using Pontryagin’s maximum principle. The resulting optimality system is solved iteratively, ensuring precision and clarity in the results. Extensive numerical simulations rigorously support and confirm the theoretical analysis using MATLAB, providing concrete evidence of the strategy’s effectiveness. The broader implications and potential applications of this optimal control strategy extend to other infectious diseases, enhancing its relevance and utility in public health.

Deletion of maternal CD163 PSTII-domain-coding exon 13 protects fetuses from infection with porcine reproductive and respiratory syndrome virus (PRRSV)

Following infection of a porcine dam with PRRSV around 90 days of gestation, the virus crosses the placenta and starts to infect fetuses. This can lead to consequences such as abortions, stillbirths, and respiratory issues in newborn piglets. CD163 is an essential cellular viral entry receptor for porcine reproductive and respiratory syndrome virus (PRRSV). CD163 contains nine scavenger receptor cysteine-rich (SRCR) and two proline-serine-threonine (PST) domains. Gene-edited pigs possessing a complete deletion of CD163 are resistant to PRRSV infection. Recently, we demonstrated that pigs harboring a clean deletion of CD163 exon 13 (ΔExon13 CD163 pigs) which encodes the first 12 amino acids of the CD163 PSTII domain were not susceptible to PRRSV infection. In this study, ΔExon13 CD163 (−/−) gilts were bred with wildtype CD163 (+/+) boars producing heterozygous, CD163 (+/−) fetuses. We found that fetuses with a wildtype CD163, recovered between day 103 of gestation or 17 days after the maternal infection with PRRSV, were fully protected from PRRSV in dams containing a clean deletion of CD163 exon 13. These findings suggest a feasible approach for eliminating PRRSV-related reproductive illness, which is a significant cause of economic losses in agriculture.

COMPLEX TREATMENT OF CHRONIC ADENOIDITIS IN CHILDREN

Background: Chronic adenoiditis in children is a prevalent condition that often leads to significant respiratory issues, including tubar dysfunction and snoring. Specific Background: The Bukhara Regional Children's Multidisciplinary Medical Center provides specialized ENT care, highlighting the need for effective treatment modalities in varying age groups. Knowledge Gap: Traditional therapeutic approaches exhibit limitations in their efficacy, particularly in rapidly alleviating symptoms and restoring normal respiratory function. Aims: This study aims to evaluate the effectiveness of photodynamic therapy (PDT) in comparison to conventional treatments for chronic adenoiditis among children aged 7 months to 11 years. Results: Analysis of 70 pediatric patients revealed that photodynamic therapy significantly improved nasal breathing, reducing snoring and tubar dysfunction five times faster than traditional methods. Additionally, it enhanced anterior active rhinomanometry outcomes, yielding a fourfold increase in total volume flow and a twentyfold reduction in total resistance. Novelty: This investigation is among the first to quantitatively assess the benefits of PDT in pediatric chronic adenoiditis, demonstrating its superior therapeutic efficacy. Implications: The findings suggest that incorporating photodynamic therapy into treatment protocols could offer significant advantages in managing chronic adenoiditis, warranting further exploration and potential integration into clinical practice to improve pediatric respiratory health outcomes.

Electrochemical removal of crystal violet dye from simulated wastewater by stainless steel rotating cylinder anode: COD reduction and decolorization

Crystal violet dye is a harmful organic pollutant when it exists in wastewater. It may potentially cause renal failure and respiratory issues in humans, while it is considered carcinogenic and mutagenic in aqua life. In this study, crystal violet dye was electrochemically removed from simulated wastewater using a stainless-steel rotating cylinder anode. Effects of anode rotation rate (250–500 rpm), applied current (400–750 mA), concentration of supporting electrolyte (0.3–0.6 M), and time (30–70 min) on chemical oxygen demand (COD) reduction and colour removal were studied. The experimental results were correlated by two quadratic regression models: one for COD reduction with R2 equals to 0.859, and one for colour removal with R2 equals to 0.934. Process optimization was conducted using the response surface methodology (RSM) with a rotatable central composite design CCD. The results showed that the optimum conditions for maximum COD reduction (86.89 %) and maximum colour removal (88 %) are as follows: anode rotation rate = 625 rpm, applied current = 658.568 mA, supporting electrolyte = 0.422 M and treatment time = 90 min. Generally, all the studied factors have a potential effect on the process efficiency.

Comparative Study of the Safety and Efficacy of Intramuscular Dexamethasone, Betamethasone Phosphate, and Standard Management Protocol in Early-Term Scheduled Caesarean Delivery.

Background Babies born between 37 weeks +0 days and 38 weeks +6 days by scheduled caesarean delivery before the onset of labour are more prone to developing respiratory complications than babies delivered between 39 weeks +0 days and 40 weeks +0 days. Antenatal corticosteroids have been used in preterm births for lung maturity. The advantages of administering antenatal corticosteroids before a scheduled caesarean delivery in the early term remain a subject of debate. While some studies have reported benefits, including a reduction in respiratory issues, the evidence is still inconclusive. The study's main objective is to compare the efficacy and safety of intramuscular dexamethasone and betamethasone phosphate with standard treatment protocols in early-term infants. Methodology A total of 241 pregnant women scheduled for caesarean delivery were screened for eligibility to participate in the study. Out of these, 192 women met the inclusion criteria and were enrolled in the study after providing written informed consent; they were randomised into three groups, with 64 in each group, and were given either betamethasone phosphate or dexamethasone intramuscularly or were considered under standard management protocol (no administration of corticosteroids). The primary comparison was done to observe the development of respiratory distress syndrome, transient tachypnoea in newborns, and the need for neonatal intensive care unit (NICU) admission. Results Among 192 pregnant females observed, the incidence of development of respiratory distress syndrome did not differ significantly between the betamethasone, dexamethasone, and standard management groups, with rates of 6.25%, 7.81%, and 4.7%, respectively.Additionally, out of the 192 infants, 15 required neonatal intensive care, including 6 (9.4%) from the betamethasone group, 5 (7.8%) from the dexamethasone group, and 4 (6.3%) from the standard management group. All of these infants had a maximum stay of four days in the NICU, did not require mechanical support, and improved with oxygen therapy. Conclusion In our study, in early-term gestation, both the corticosteroid groups showed similar effects to those of the standard management group in reducing neonatal morbidity, with no significant statistical difference. Hence, the choice lies with the treating obstetrician to consider the administration of corticosteroids in early-term caesarean deliveries.

PPG2RespNet: a deep learning model for respirational signal synthesis and monitoring from photoplethysmography (PPG) signal.

Breathing conditions affect a wide range of people, including those with respiratory issues like asthma and sleep apnea. Smartwatches with photoplethysmogram (PPG) sensors can monitor breathing. However, current methods have limitations due to manual parameter tuning and pre-defined features. To address this challenge, we propose the PPG2RespNet deep-learning framework. It draws inspiration from the UNet and UNet + + models. It uses three publicly available PPG datasets (VORTAL, BIDMC, Capnobase) to autonomously and efficiently extract respiratory signals. The datasets contain PPG data from different groups, such as intensive care unit patients, pediatric patients, and healthy subjects. Unlike conventional U-Net architectures, PPG2RespNet introduces layered skip connections, establishing hierarchical and dense connections for robust signal extraction. The bottleneck layer of the model is also modified to enhance the extraction of latent features. To evaluate PPG2RespNet's performance, we assessed its ability to reconstruct respiratory signals and estimate respiration rates. The model outperformed other models in signal-to-signal synthesis, achieving exceptional Pearson correlation coefficients (PCCs) with ground truth respiratory signals: 0.94 for BIDMC, 0.95 for VORTAL, and 0.96 for Capnobase. With mean absolute errors (MAE) of 0.69, 0.58, and 0.11 for the respective datasets, the model exhibited remarkable precision in estimating respiration rates. We used regression and Bland-Altman plots to analyze the predictions of the model in comparison to the ground truth. PPG2RespNet can thus obtain high-quality respiratory signals non-invasively, making it a valuable tool for calculating respiration rates.

Stakeholders’ perspective on the development of a virtual clinic for patients with spinal cord injury: a qualitative study

Purpose This study aims to explore the priorities, preferences, and feedback of multiple healthcare professionals to inform the future development of virtual clinics for community-dwelling adults with spinal cord injury (SCI) in Ontario, Canada. Methods Interpretive description methodology was used to guide our exploration. Semi-structured interviews were conducted with 15 expert healthcare professionals (HCPs) involved in the care of patients with SCI. Interviews were recorded and transcribed verbatim. Interview transcripts were then analyzed using a six-phase thematic analysis approach. Results HCPs perceived virtual care to improve access to care over the long term, particularly to those living in rural areas, as well as increase connections between different providers. However, participants highlighted that in-person care is still required for management of severe SCI-related sequelae that can be life-threatening, such as pressure ulcers, spasticity, respiratory issues, and bowel and bladder complications. Conclusion Our findings can be used to inform policymakers, HCPs, and stakeholders involved with SCI rehabilitation when establishing a virtual clinic for patients with SCI. Results of this study found that policymakers and HCPs should consider hybridized (blend of virtual and in-person) healthcare and uptake of multidisciplinary approaches within the virtual healthcare systems.

D-Dimer post-COVID19 in Karbala governorate, Iraq

After the Coronavirus epidemic, there are indications that a significant number of COVID-19 survivors experience long-term respiratory, cardiovascular, and psychological issues, necessitating the assessment of these complications for effective healthcare resource allocation. The test can help identify blood clotting problems. A positive result may suggest a blood clot has recently formed and broken down. In our study, the post-covid-19 d-dimer concentration was measured, and three groups were taken for each of males and females, with a total of 30 samples. The first group are those infected once with Covid-19 and then recovered included (5) males and (5) females, and the highest concentration found in the sample (10) was 211.2 μg FEU/ml in females, it within normal limits (500 μg FEU/ml). The second group are those hits twice with Covid-19 and then recovered, it consisted from 10 samples (5 males, 5 females). The highest concentration in sample (20) was 350.62 μg FEU/ml and it has short period between hits, also was the short period between hits higher concentration from long period between hits. In the last group, those hits three times with Covid-19, then recovered, included (10) samples (5 males, 5 females), maximum concentration in sample (30) was 386.7 μg FEU/ml, it has the short period between hits. In three group was d-dimer concentration higher in females from males, and in short period between hits higher long period. The factor can increase d-dimer age, Gender, diseases, treatment, pregnancy, trauma and the vaccine to covid-19

Viola stocksii: A rich source of antioxidant and anti-inflammatory flavonoid glycosides with converged therapeutic potential against SARS-CoV-2 MPro, spike trimer, and surface glycoproteins

This research presents the first comprehensive investigation into the phytochemical and nutraceutical properties of Viola stocksii. The study aimed to identify the therapeutic efficacy and bioactive constituents of this medicinal herb, traditionally used as an herbal tea for managing respiratory and abdominal issues in remote areas of Pakistan. The therapeutic efficacy of the plant was assessed as an anti-oxidant-rich health tonic coupled with anti-inflammatory and immunomodulatory activities against COVID-19 and its evolving variants. The study involved sequential extraction, bio-assay guided fractionation, isolation, characterization, and biological evaluation. Preliminary in vitro studies have demonstrated that polar fractions of the plant possess significant antioxidant and antiinflammatory potential. A diverse combination of chromatographic techniques (Diaion resin HP-20, Sephadex LH-20, ODS-C18, and RP-HPLC) facilitated the purification of active constituents of the plant. Comprehensive analysis of NMR (1H, 13C, and 2D NMR) and mass (EIMS, HR-EIMS, and FAB-HRMS) spectral data lead to characterize the isolated compounds (1–4) as flavonoid glycosides. Results from in vitro and in-silico evaluations revealed that the isolated glycosides exhibit high antioxidant, antiinflammatory, and immunomodulatory activities, which synergistically show promising potential in combating SARS-CoV-2 variants. Besides MPro, therapeutic potential against two unexplored proteins i.e. the spike trimer (7WZ1) and surface glycoproteins (7QTJ) was studied for the first time. Kaempferol (KamGluαRh) and quercetin (QurGluαRh) carrying rutinoside, were identified as the most active constituents of the plant, with the highest binding affinities in the range of −10 to −13 kcal/mol. Ten distinct active regions were explored on the spike trimer, including strong binding affinity with the essential RBD region, spike head, and tail of the protein. MD simulation validated the stability of Mpro-KamGluαRh and Mpro-QurGluαRh complexes evidenced by an average RMSD of 0.2 nm led to the mechanistic understanding of Mpro inhibition. ADMET and pharmacokinetic studies authenticated the therapeutic ability and drug-likeness profiling of all extracted compounds. Results revealed the beneficial role of glycosides in boosting the medicinal effectiveness of flavonoids and the potential of Viola stocksii as an immunity booster against respiratory infections like COVID-19.

328 Assessment of chronically ill or injured feedlot cattle populations at eight United States and nine Canadian feedlots and implications for cattle welfare

Abstract Cattle health management in the feedlot sector continues to evolve and improve cattle welfare by promoting an understanding of illness and injury to minimize their effects. Many papers have focused on treating individual ill or injured cattle in cattle feeding facilities. However, care, treatment, and outcomes for chronically ill or injured cattle (“chronic cattle”) have received little attention in the literature. The purpose of this descriptive study was to present demographics, diagnoses, and outcomes of chronic cattle in 17 feedlots in the U.S. and Canada and discuss potential risk factors and welfare implications. Individual chronic cattle information and treatment records from 17 feedlots (U.S.: 8; Canada: 9) over 7 yr (2014 – 2020) were retrospectively retrieved from a large feedlot consulting and data-management service (Feedlot Health Management Services, a division of TELUS Agriculture Solutions Inc.). Chronic cattle were defined as those that had spent time in a feedlot’s designated chronic pen. Descriptive results are presented as means ± standard deviations. U.S. feedlots averaged 31,280 ± 23,231 cattle/yr, had an average chronicity rate of 2.24 ± 2.42 % (median 1.53%), and contributed 52,709 chronic cattle to the dataset. Canadian feedlots averaged 21,913 ± 10,497 cattle/yr, had an average chronicity rate of 1.41 ± 0.82% (median 1.10%), and contributed 15,940 chronic cattle to the dataset. U.S. chronic cattle were sourced across all seasons primarily from auctions and ranches, had an average arrival weight of 163 ± 59 kg, and an average days on feed (DOF) of 362 ± 172 d. Canadian chronic cattle were primarily auction-sourced in the fall, weighed 272 ± 95 kg at arrival, and averaged 246 ± 141 DOF. Chronic cattle were treated at least once for respiratory issues (U.S.: 46.3%; Canada: 26.9%), bullers (U.S.: 34.5%; Canada: 5.8%), musculoskeletal issues (U.S.: 2.2%; Canada: 1.4%), lameness (U.S.: 1.7%; Canada: 28.1%), metabolic issues (U.S.: 0.5%; Canada: 4.5%), or other diagnoses (U.S.: 2.2%; Canada: 6.3%), with many cattle treated for multiple issues (U.S.: 12.5%; Canada: 27.0%). Outcomes for chronic cattle were shipped (U.S.: 73.1%; Canada: 52.5%), railed (U.S.: 8.1%; Canada: 20.7%), euthanized (U.S.: 0.7%; Canada: 9.9%) died unassisted (U.S.: 18.1%; Canada: 16.2%), or transferred (U.S.: < 0.1%; Canada: 0.8%). These results are some of the first to describe chronic cattle populations and present interesting trends for further analysis. For example, differences in buller and lameness rates could reflect actual differences but may be artifices of the dataset and feedlot definitions. Additionally, high marketed cattle rates (shipped and railed) indicate positive outcomes for most cattle, but variable mortality rates merit further scrutiny.

Health Impacts of Pre-eclampsia: A Comprehensive Analysis of Maternal and Neonatal Outcomes.

Background and Objectives: Hypertensive disorders, particularly pre-eclampsia, pose significant risks during pregnancy, affecting both maternal and neonatal health. The study aims to analyze short- and long-term health implications for mothers and their children, comparing those with pre-eclampsia to those without, to improve understanding of risk factors, diagnostic markers, and outcomes. Materials and Methods: This retrospective observational study involved 235 patients, 98 with pre-eclampsia and 137 without, monitored from 2015 to 2018 at the Obstetrics and Gynecology Department of the "Pius Brînzeu" Emergency County Clinical Hospital in Timișoara, Romania. Results: Women with pre-eclampsia were older, had higher BMIs, and more frequently had a family history of pre-eclampsia, hypertension, and diabetes. They also had lower educational and socioeconomic levels and fewer prenatal visits. Biochemical markers such as higher proteinuria, elevated sFlt-1, and lower PlGF were significant in diagnosing pre-eclampsia. Short-term maternal complications like eclampsia, HELLP syndrome, and acute kidney injury were more prevalent in the pre-eclampsia group. Neonatal outcomes included higher rates of preterm birth, low birth weight, and NICU admissions. Long-term mothers with a history of pre-eclampsia had higher incidences of chronic hypertension, cardiovascular disease, kidney problems, diabetes, and mental health disorders. Their children faced increased risks of neuropsychological delays, chronic respiratory issues, behavioral disorders, learning difficulties, and frequent infections. Conclusions: The study highlights the significant short- and long-term health impacts of pre-eclampsia on both mothers and their children. Early monitoring, intervention, and comprehensive management are crucial in mitigating these risks. These findings underscore the need for personalized care strategies to improve health outcomes for affected individuals.

Neuroinflammation and Brain Health Risks in Veterans Exposed to Burn Pit Toxins.

Military burn pits, used for waste disposal in combat zones, involve the open-air burning of waste materials, including plastics, metals, chemicals, and medical waste. The pits release a complex mixture of occupational toxic substances, including particulate matter (PM), volatile organic compounds (VOCs), heavy metals, dioxins, and polycyclic aromatic hydrocarbons (PAHs). Air pollution significantly impacts brain health through mechanisms involving neuroinflammation. Pollutants penetrate the respiratory system, enter the bloodstream, and cross the blood-brain barrier (BBB), triggering inflammatory responses in the central nervous system (CNS). Chronic environmental exposures result in sustained inflammation, oxidative stress, and neuronal damage, contributing to neurodegenerative diseases and cognitive impairment. Veterans exposed to burn pit toxins are particularly at risk, reporting higher rates of respiratory issues, neurological conditions, cognitive impairments, and mental health disorders. Studies demonstrate that Veterans exposed to these toxins have higher rates of neuroinflammatory markers, accelerated cognitive decline, and increased risks of neurodegenerative diseases. This narrative review synthesizes the research linking airborne pollutants such as PM, VOCs, and heavy metals to neuroinflammatory processes and cognitive effects. There is a need for targeted interventions to mitigate the harmful and escalating effects of environmental air pollution exposures on the CNS, improving public health outcomes for vulnerable populations, especially for Veterans exposed to military burn pit toxins.

Frequency of E-cigarette and Cigarette Smoking and Associated Health Symptoms among the Youth

Purpose: To determine the prevalence of e-cigarette and traditional cigarette use among Pakistani youth and to identify the associated health symptoms. Methodology: This cross-sectional study was conducted using a sample size of 178 respondents aged 15-25, selected through non-probability convenience and snowball sampling methods. Data were collected over five days (1st September 2023 to 6th September 2023) using a questionnaire adapted from validated studies (GATS and YUPESS) and distributed via Google Forms. Findings: The study population consisted of 178 respondents, with a gender distribution of 72.1% males and 27.9% females. Among the respondents, 41.2% had tried either e-cigarettes or traditional cigarettes. The age of first smoking experience varied, with many trying their first cigarette between ages 15 and 18. Significant health symptoms associated with smoking included respiratory issues, general malaise, and worsened asthma. Unique Contribution to Theory, Policy and Practice: The research highlights the prevalence and health impacts of e-cigarette and traditional cigarette use among Pakistani youth. It underscores the need for targeted public health interventions and stricter regulations to mitigate these health risks.

Systematic Review on Mortality in the Elderly on Methadone Maintenance Treatment.

Opioid dependence is a serious public health concern, particularly for older individuals who have a high prevalence of comorbid conditions. To effectively manage opioid use disorder (OUD), methadone maintenance treatment (MMT) is crucial; however, the MMT poses certain challenges for the aging population. The purpose of this review is to evaluate the impact of MMT on health outcomes, identify predictive factors for mortality, and assess mortality rates among older individuals receiving MMT. A systematic search was performed across databases, including PubMed, Scopus, Web of Science, and Google Scholar, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included were published between January 2000 and December 2023, focused on elderly patients (60 years of age and older) receiving MMTand provided information on death rates. A total of 15 studies were examined. The main causes of death for older MMT patients were overdose, respiratory issues, and cardiovascular diseases. The annual mortality rates for these patients ranged from 2% to 10%. Treatment outcomes and mortality were significantly impacted by comorbid conditions. Greater treatment adherence and longer care periods were observed in older individuals, which correlated with better health outcomes and lower mortality. This review makes clear how elderly MMT patients with addiction and chronic health issues require integrated care models. Treatment effectiveness may be further increased by gender-specific interventions. For this aging population, policy reforms and enhanced healthcare support are essential. To enhance clinical results and lower mortality rates among older individuals enrolled in MMT programs, comprehensive age-appropriate care models are crucial. Long-term health outcomes should be investigated further and evidence-based treatments for older individuals with OUD should be developed.

Respiratory Health and Underlying Tobacco Use Motives Among Cigarette Smokers and Hubble-Bubble Pipe Consumers: A Comparative Study

ABSTRACT Background Tobacco use, whether through hubble-bubble pipes or conventional cigarettes, poses significant risks to respiratory health. Purpose Researchers aimed to assess the respiratory health and underlying tobacco use motives among hubble-bubble pipe consumers and cigarette smokers. Methods A comparative cross-sectional study involved 340 smokers from Pakistan. A self-administered questionnaire included demographic-related questions and two validated tools, i.e. Questionnaire for Ease of Cough and Sputum Clearance and Tobacco Motives Inventory. Data analysis utilized SPSS involving descriptive statistics, Mann Whitney U test, and Kruskal Wallis tests. Results In comparison to hubble-bubble pipe consumers, cigarette smokers had significantly poor respiratory health (p = .001, median = 8 vs. 10). Moreover, cigarette smokers reported higher social, self-enhancement, boredom relief, and affect regulation motives (p < .001). Respiratory health was also significantly different across gender, age, qualification, occupational status, marital status, lifestyle, and family history of smoking. Tobacco motives differed across gender, age, qualification, occupational status, socioeconomic status, lifestyle, and family history. Discussion Although hubble-bubble pipe consumers reported lower respiratory health issues, consuming it is still a critical health concern. Translation to Health Education Practice Planning targeted education programs and interventions could address the underlying motives of tobacco consumption and thus can effectively improve respiratory health and promote smoking cessation.

Real-World Study of Ragweed Sublingual Immunotherapy in Hungary.

Ragweed (Ambrosia elatior) has become invasive in Europe, causing significant respiratory issues. Subcutaneous allergen immunotherapy (SCIT) has long been used to manage pollen allergies, but sublingual immunotherapy (SLIT) has gained interest. This study aimed to evaluate the clinical benefits of ragweed SLIT under real-world in a cohort of Hungarian patients allergic to ragweed pollen. We retrospectively reviewed the clinical records of 57 patients during the 2015 and 2016 ragweed pollen seasons. Patients were divided into two groups: Group 1 (n = 29), who had not received immunotherapy, and Group 2 (n = 28), who had previously undergone immunotherapy with another sublingual preparation. All patients were treated with Oraltek® ragweed for 4-6 months, initiating 2-4 months before the pollen season and rest of the period was 2 months of the 2016 pollen season. Symptom score (SS), medication score (MS), and combined symptom and medication score (CSMS) were evaluated intra- and intergroup. Pollen counts were consistent between 2015 and 2016. All patients showed significant improvement in SS, MS, and CSMS, with a large effect size (>0.8). Group 2 had significantly lower SS and CSMS in 2015 because of prior immunotherapy. By 2016, both groups exhibited marked improvements, with Group 1 showing a 75% improvement in CSMS. No local or systemic reactions were recorded, indicating a high safety profile. Ragweed SLIT significantly improved symptoms and reduced use of medication in patients allergic to ragweed pollen. The treatment was effective even in patients with previous immunotherapy, with a high benefit-risk ratio demonstrated by the absence of adverse reactions. These findings support the use of Oraltek SLIT for managing ragweed pollen allergy.

Respiratory issues and current management in neuromuscular diseases: a narrative review.

Respiratory care is often embedded as a component of the overlapping management strategies in many patients with neuromuscular disease (NMD). Implementation of respiratory care strategies requires a sensitivity to the nature of the disease, the vulnerability during rapid eye movement (REM) sleep and complicating comorbidities specific to each patient. Care must adjust to progression of the disease as well as the comfort and preferences of the patient. Clinical presentations are usually heterogenous based on the specific NMD and overall course of the disease making diagnosis and respiratory care challenging. The aim of this review was to review the state-of-the-art evidence-based clinical practices and updates in the management of respiratory complications in patients with NMDs. We conducted a search on the PubMed and Medline databases using these keywords: secretions, neuromuscular disease, neuromuscular disorders, non-invasive ventilator, neuromuscular respiratory weakness, respiratory failure. The specified timeframe began from 1980 to 2024. Timely use of non-invasive ventilation and overall respiratory care is most important as emerging evidence shows some benefits with improved mortality in this group of patients. In some settings, comorbid complications that dictate need for airway management and oral diversion may have a more profound impact on mortality than the effectiveness of ventilatory support that are chosen. A multidisciplinary team approach to care has been shown to improve the quality of life and survival in these patients in centers of excellence. Patients should have the ability to access services provided by neurology, pulmonology, speech pathology, sleep medicine, cardiology and respiratory therapy services. The cornerstone for management of respiratory failure and sleep disordered breathing in NMD is non-invasive ventilation (NIV). Initiation of this support and other respiratory cares need to be timely, and patients may have very subtle symptoms during the early stages of the disease which makes it challenging in recognizing the onset of respiratory muscle stress and fatigue. Close attention to these symptoms as well as respiratory and radiologic parameters is essential for appropriate incorporation of these cares.

Assessment of Respiratory Health Implications of Vaping: A Systematic Review of Toxicity Mechanisms and Adverse Effects of Electronic Nicotine Delivery Systems.

E-cigarettes are thought to aid in tobacco smoking cessation, but there are concerns about their overall effectiveness and safety for the general population, particularly adults. This review aims to investigate the mechanisms of toxicity and adverse effects of e-cigarettes on the respiratory system, comparing these effects with those of conventional smoking. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed on PubMed, Embase, and the Cochrane Library using keywords, controlled vocabulary, and text words, with the following criteria: studies published in English from 2014 to 2024, open access, peer-reviewed, and full-text availability. Study selection, quality assessment, and data extraction were carried out by two independent reviewers. The Cochrane Risk of Bias 2.0 tool was used to evaluate the risk of bias in included randomized controlled trials, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was employed to assess the strength of evidence and determine its generalizability. Electronic nicotine delivery systems (ENDS) have diverse mechanisms of toxicity, including inflammation, hypoxia, cardiovascular stress, and metabolic changes. Reported adverse effects include cough, throat irritation, nausea, and hemodynamic changes. However, ENDS are associated with fewer risks compared to conventional cigarette smoking. ENDS users experience fewer respiratory and cardiovascular issues and have lower levels of biomarkers such as NNAL and CO compared to traditional smokers. Additionally, ENDS are more effective than nicotine replacement therapy (nicotine patches) for smoking cessation, particularly in pregnant women. The side effects of ENDS and nicotine-free vaping are similar to those of conventional smoking in pregnant women, with the exception of a lower birth weight among newborns exposed to ENDS (p < 0.05). ENDS present a complex balance of benefits and risks regarding respiratory health. While there are adverse effects, ENDS are considered less detrimental than conventional smoking and a viable option for smoking cessation. Longitudinal studies are needed to evaluate their safety with long-term use (>16 weeks). Policymakers and health practitioners should use these findings to develop balanced public health policies that weigh the benefits of ENDS against potential health risks, enabling informed decision-making for users.

Impact of Earthquakes on Lung Health.

Earthquakes are catastrophic natural disasters that cause extensive damage to infrastructure and disrupt the lives of millions worldwide. Beyond the immediate physical and psychological damage caused by earthquakes, these events can significantly impact respiratory health. The inhalation of dust, smoke, particulates, toxic gases, and asbestos exposure can lead to various respiratory health pathologies. These include respiratory infections, exacerbations of pre-existing respiratory diseases, chest traumas, and pulmonary and venous thromboembolism. Longitudinal studies are necessary to assess the long-term respiratory health effects in affected populations. By addressing these knowledge gaps, future mitigation strategies and preparedness measures can be developed to minimize the respiratory health impacts of earthquakes and improve the well-being of affected communities. Robust building infrastructure and comprehensive earthquake preparedness are emerging as the most important determinants for not only mitigating building collapse but also significantly reducing the potential health impacts that follow. This comprehensive review aims to provide a systematic overview of the lung health impacts of earthquakes. It highlights the need for further research to identify specific pollutants, air contaminants, and environmental factors contributing to respiratory health issues following earthquakes.