Obstructive Respiratory Disease Research Articles

Morbidity Profile of Workers in a Sponge Iron Industry in Goa: A Retrospective Record-based Study

Introduction The Sponge iron industries are categorized as red industries (i.e. highly polluted industries) with the major pollutants including particulate matter and gaseous pollutants, the toxic effects of which are often rapid. Prolonged exposure to such pollutants leads to obstructive lung diseases such as asthma or chronic obstructive respiratory disease. The current study aims to assess the morbidities prevalent among the workers in the Sponge iron industry in Goa and help them minimize those with suitable measures. Objective To study the morbidity profile of workers in a Sponge iron industry in Goa. Materials and Methods A retrospective record-based study was conducted on 217 workers. Selected health parameters were studied: socio-demographic details, anthropometry, blood pressure, serum Creatinine, Total cholesterol, vision tests, ECG, Spirometry, urine microscopy, and audiometry readings. Results Among the 217 workers that were studied, 8% had Hypertension, 40% workers had a refractive error, 31% had Dyslipidemia, 14.7% had mild restriction, 0.9% had moderate restriction, and 1.3% had a severe restriction in Spirometry testing, 10.1% had elevated Creatinine, 2.7% had mild to moderate hearing loss, 0.9% had changes in ECG and was referred to do echo. Conclusion The study revealed that the conditions of employment had caused numerous comorbidities among the sponge iron industry workers, several of which had spirometry restrictions suggesting pulmonary changes, which may lead to eventual respiratory deterioration and the advent of diseases such as COPD. The study revealed issues about overall health parameters, including but not limited to other intricate issues. Consequently, further tests will have to be conducted along with the use of protective equipment to reduce and limit the effects of such occupational outcomes.

Influence of Hypoxia on the Airway Epithelium

The necessity of oxygen for metabolic processes means that hypoxia can lead to serious cell and tissue damage. On the other hand, in some situations, hypoxia occurs under physiological conditions and serves as an important regulation factor. The airway epithelium is specific in that it gains oxygen not only from the blood supply but also directly from the luminal air. Many respiratory diseases are associated with airway obstruction or excessive mucus production thus leading to luminal hypoxia. The main goal of this review is to point out how the airway epithelium reacts to hypoxic conditions. Cells detect low oxygen levels using molecular mechanisms involving hypoxia-inducible factors (HIFs). In addition, the cells of the airway epithelium appear to overexpress HIFs in hypoxic conditions. HIFs then regulate many aspects of epithelial cell functions. The effects of hypoxia include secretory cell stimulation and hyperplasia, epithelial barrier changes, and ciliogenesis impairment. All the changes can impair mucociliary clearance, exacerbate infection, and promote inflammation leading to damage of airway epithelium and subsequent airway wall remodeling. The modulation of hypoxia regulatory mechanisms may be one of the strategies for the treatment of obstructive respiratory diseases or diseases with mucus hyperproduction.

Dry powder inhaler deposition in the larynx and the risk of steroid inhaler laryngitis: A computational fluid dynamics study

Dry Powder Inhalers (DPIs) are a mainstay in the treatment of obstructive respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Deposition of inhaled corticosteroids in the larynx elicits local side effects, potentially leading to steroid inhaler laryngitis. The objective of this study was to estimate the dose of DPIs that are deposited in the larynx relative to other regions of the respiratory tract using computational fluid dynamics (CFD). An anatomically accurate model of the airways (mouth to main bronchi) was constructed based on medical imaging of a healthy adult. Respiratory airflow and particle transport were simulated for constant inhalation rates of 30, 45, and 60 L/min. Two turbulence models were compared, namely the large eddy simulation (LES) and the k−ωSST models. DPIs were assumed to generate an aerosol cloud with a log-normal particle size distribution characterized by the mass median aerodynamic diameter (d50) and geometric standard deviation (σg). We compared two commercial DPIs, namely DPI 1 had a large particle size (d50 = 50 μm, σg=2.55) and DPI 2 had a small particle size (d50 = 2 μm, σg=1.99). The laryngeal dose was 1.6-to-3.8-fold higher than the bronchial dose for DPI 1, while the laryngeal and bronchial doses (units of mass per unit surface area) were similar for DPI 2 for both turbulence models and all inhalation rates. The choice of turbulence model had little impact on the total extrathoracic deposition, but a significant impact on regional doses, with the LES model predicting higher larynx-to-bronchi relative doses than the k−ω model. Our prediction that the larynx is a hotspot for DPI deposition is consistent with the observation of laryngeal side effects in DPI users. Importantly, our simulations suggest that DPIs with larger particles (d50 = 50 μm) may increase the risk of steroid inhaler laryngitis.

Smokeless tobacco use and its associated factors among secondary school students of Rangeli Municipality of Morang district, Nepal.

The tobacco epidemic is one of the biggest public health threats and the world's leading cause of preventable death which is responsible for killing 8 million people every year. Adolescents are the vulnerable age group and are at greater risk of any tobacco use including smokeless tobacco (SLT) and nicotine addiction. Tobacco use at a young age increases the risk of various non-communicable diseases (NCDs) such as respiratory illness, asthma, chronic obstructive respiratory disease (COPD), reduced pulmonary function, and cancers. This study aimed to determine the prevalence of smokeless tobacco and its associated factors among secondary school students of grades 11 and 12 in Rangeli Municipality, Nepal. A cross-sectional study was conducted among 355 students from the selected secondary schools. A self-administered questionnaire was used to collect the data. Data was cleaned and then exported to IBM SPSS Statistics 20 for analysis. Participants' characteristics were described using frequencies, percentages, mean, and standard deviation. Multivariate logistic regression was conducted to determine the association between individual characteristics and prevalence of smokeless tobacco. All the tests were performed at a 95% Confidence Interval (CI) and a p-value less than 0.05. The mean (±SD) age of the participants was 18.0±1.3 years. Most participants were female (61.1%). The majority of the participants were from grade 11 (58.3%), government schools (60%), and nuclear families (64.8%). This study found that 38.4% and 61.6% of the participants were SLT ever users and never users respectively. Among the ever users, 29.5% were current users and most tried (47.7%) at the age of 10-14 years. Most participants revealed that homes and public places were common sites for SLT use. Paan Masala and Gutkha were the most commonly preferrable SLTs. This study found that age (AOR = 1.5, CI: 1.2-2.2), sex (AOR = 2.6, CI:1.6-4.4), and school type (AOR = 1.8, CI:1.1-3.0) were significantly associated with the prevalence of SLT. This study found that the prevalence of current SLT users is higher than the national survey. This study concludes that males, young adolescents, and students from private schools are at greater risk of SLT use and are unaware of the consequences on their health. Concerned stakeholders must expand awareness and promote educational programs on the harmful use of tobacco targeting secondary school students. The government organizations, educational institutions, and private organizations jointly work to strengthen the implementation of tobacco cessation programs and tobacco control strategies.

Sulfur hexafluoride multiple breath washin and washout outcomes in infants are not interchangeable

Objective.Sulfur hexafluoride (SF6) multiple-breath washout (MBW) assesses ventilation inhomogeneity, as an early marker of obstructive respiratory diseases. Primary outcomes are customarily washout-derived, and it is unclear whether the preceding SF6-washin can provide similar estimates. We aimed to assess comparability of primary SF6-MBW outcomes between washin and washout phases of infant SF6-MBW data measured with the WBreath (ndd Medizintechnik AG, Zurich, Switzerland) and Spiroware (Eco Medics AG, Duernten, Switzerland) MBW-setups, respectively.Approach.We assessed mean relative differences in lung clearance index (LCI) and functional residual capacity (FRC) between the washin and washout of existing SF6-MBW data from healthy infants and infants with cystic fibrosis (CF). We assessed whether these differences exceeded the mean relative within-test between-trial differences of washout-derived outcomes, which can be attributed to natural variability. We also explored non-physiological factors using a pediatric lung simulator.Main results.LCI and FRC from washin and washout were not comparable, for both setups. The mean difference (SD) in LCI between washin and washout was 2.3(10.8)% for WBreath and -9.7(8.0)% for Spiroware, while in FRC it was -4.7(8.4)% for WBreath and -2.3(9.7)% for Spiroware. These differences exceeded the within-test between-trial differences in washout-derived outcomes. Outcomes from washin and washout were also not comparable in a pediatric lung simulator.Significance.Outcomes of the washin and washout were not comparable due to an interplay of physiological and non-physiological factors, and cannot be used interchangeably.

Assessment of Environmental Pollutants and their Relationship with Chronic Respiratory Disease Exacerbations in Jamshoro: A Cross-Sectional Study

Background: COPD and Asthma are a burden to our society and in a city like Jamshoro having industries and power plants in close vicinity, this becomes a greater concern. The objective of this cross-sectional study was to evaluate the relationship between air quality indices (AQIs) and exacerbations in chronic obstructive respiratory diseases such as asthma and COPD, prevalent among the general population in Jamshoro. Methods: This cross-sectional study, conducted from August 2023 to February 2024 at LUMHS, Jamshoro (ERC approval: 14287/23/081), used purposive sampling to recruit 300 adults with asthma or COPD. Air quality data (PM10, PM2.5, NO2, SO2) were collected, and respiratory outcomes were measured via spirometry and a validated questionnaire. Pearson’s correlation and multiple regression analyzed the association between air quality and exacerbations. Ethical approval and informed consent were obtained. Results: There was a significant inverse relationship between PM10, NO2, and FEV1 (r = -0.45, p < 0.01; r = -0.40, p < 0.01). Chi-square analysis indicated a strong association between AQI categories and exacerbation rates (χ² = 25.6, df = 3, p < 0.001). Multiple regression showed that PM10 and NO2 were significant independent predictors of respiratory exacerbation (β = 0.049, p < 0.01; β = 0.038, p < 0.01). Conclusion: The study underscores the adverse respiratory health consequences of poor air quality in Jamshoro and recommends the implementation of effective air quality management policies.

Zinc fever in a painter and varnisher: a case report

BackgroundZinc fever is well described in medical literature, particularly in workers after handling zinc-containing materials at high temperatures e.g., in the welding of hot-dip galvanized steel sheets. It is not known whether zinc fever also occurs at low temperatures.Case presentationWe present the case of a 33-year-old Caucasian atopic painter and varnisher with work-related dyspnea, sweating, as well as multiple occurrences of fever. He was sent to Institute for Prevention and Occupational medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA) for the evaluation of isocyanate asthma, but an inhalative challenge with hexamethylene diisocyanate was negative. Since symptoms were closely related to the use of zinc coatings at room temperature without adequate protective measures, the diagnosis of zinc fever was made. After exposure cessation the worker immediately became symptom-free. The work as painter and varnisher may be associated with various exposures to hazardous substances. Besides solvents, epoxy compounds and isocyanates, which can cause obstructive respiratory diseases; additionally, zinc-containing agents should be considered as health hazards.ConclusionsThis case demonstrates that zinc fever may occur also after application of zinc coatings by spray painting at low temperatures.

Obstructive respiratory disease in U.S. veterans: Prevalence, characteristics, and health burden

ObjectiveTo examine the psychiatric and physical health burden of obstructive respiratory disease in a nationally representative sample of U.S. Veterans. MethodsSecondary data analyses were conducted using data from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. Veterans. Participants self-reported health professional-diagnosed obstructive respiratory disease (i.e., asthma, chronic bronchitis or chronic obstructive pulmonary disease). Veterans who reported obstructive respiratory disease (n = 502) were compared to veterans without this disease but with at least one or more other medical conditions—controls (n = 3169) on measures of sociodemographic, trauma, psychiatric, and physical health characteristics. Multivariable regression analyses examined independent associations between obstructive respiratory disease and psychiatric conditions and physical characteristics. ResultsA total 12.5% of the sample reported a diagnosis of obstructive respiratory disease. Compared to controls, veterans with obstructive respiratory disease were more likely to be female, unmarried/partnered, lower income, residing in the Midwest, receiving VA healthcare, and had greater lifetime and childhood trauma burden. In adjusted analyses, veterans with respiratory disease had 47–91% greater odds of screening positive for current posttraumatic stress, major depressive, and generalized anxiety disorders, and had 48% greater odds of current suicide ideation. They were also more likely to have lifetime nicotine use disorder and had more medical comorbidities and more severe somatic symptoms. ConclusionsObstructive respiratory disease is prevalent among U.S. veterans and associated with significant mental and physical health burden. Results highlight the need for timely screening and treatment for psychiatric and medical conditions that are highly comorbid with obstructive respiratory disease in this population.

Effects of combustible cigarettes and heated tobacco products on immune cell-driven inflammation in chronic obstructive respiratory diseases.

Since long-term effects of heated tobacco products (HTP) on the progression of chronic obstructive pulmonary disease (COPD) are unknown, we used COPD mice model to compare immune cell-dependent pathological changes in the lungs of animals which were exposed to HTP or combustible cigarettes (CCs). We also performed intracellular staining and flow cytometry analysis of immune cells which were present in the blood of CCs and HTP users who suffered from immune cell-driven chronic obstructive respiratory diseases. CCs enhanced NLRP3 inflammasome-dependent production of inflammatory cytokines in lung-infiltrated neutrophils and macrophages and increased influx of cytotoxic Th1, Th2, and Th17 lymphocytes in the lungs of COPD mice. Similarly, CCs promoted generation of inflammatory phenotype in circulating leukocytes of COPD patients. Opposite to CCs, HTP favored expansion of immunosuppressive, IL-10-producing, FoxP3-expressing T, NK, and NKT cells in inflamed lungs of COPD mice. Compared with CCs, HTP had weaker capacity to promote synthesis of inflammatory cytokines in lung-infiltrated immune cells. Significantly lower number of inflammatory neutrophils, monocytes, Th1, Th2, and Th17 lymphocytes were observed in the blood of patients who consumed HTP than in the blood of CCs users, indicating different effects of CCs and HTP on immune cells' phenotype and function.

Anoctamin pharmacology

TMEM16 proteins, also known as anoctamins, are a family of ten membrane proteins with various tissue expression and subcellular localization. TMEM16A (anoctamin 1) is a plasma membrane protein that acts as a calcium-activated chloride channel. It is expressed in many types of epithelial cells, smooth muscle cells and some neurons. In airway epithelial cells, TMEM16A expression is particularly enhanced by inflammatory stimuli that also promote goblet cell metaplasia and mucus hypersecretion. Therefore, pharmacological modulation of TMEM16A could be beneficial to improve mucociliary clearance in chronic obstructive respiratory diseases. However, the correct approach to modulate TMEM16A activity (activation or inhibition) is still debated. Pharmacological inhibitors of TMEM16A could also be useful as anti-hypertensive agents given the TMEM16A role in smooth muscle contraction.In contrast to TMEM16A, TMEM16F (anoctamin 6) behaves as a calcium-activated phospholipid scramblase, responsible for the externalization of phosphatidylserine on cell surface. Inhibitors of TMEM16F could be useful as anti-coagulants and anti-viral agents. The role of other anoctamins as therapeutic targets is still unclear since their physiological role is still to be defined.

Assessment of Lung Health Status by Analyzing Cough Sound Using Swaasa Artificial Intelligence Technology

Introduction: The crucial function of the respiratory system is the facilitation of blood gas exchange process. Spirometry is the diagnostic tool to detect and differentiate obstructive and restrictive respiratory diseases that impair this vital function. The need for a clinical setup, technical expertise, and patient compliance are certain limitations for utilizing spirometry in remote areas. Swaasa® artificial intelligence (AI) platform, which has a Class B manufacturing license from India’s Central Drugs Standard Control Organization, is a validated “software as a medical device,” which aids in screening and diagnosis of respiratory diseases, unbounded by location, equipment and technical expertise. Objectives: The objectives of the study were to determine the “lung health index” and the “pattern of lung health” conditions among nursing students. Materials and Methods: A cross-sectional study was conducted utilizing the Swaasa® AI platform among students of a nursing college in Central Karnataka in June 2023. Based on audiometric analysis of cough sounds, parameters such as underlying respiratory condition, cough count values, and respiratory symptoms experienced, ‘Swaasa’ AI platform derives pattern of respiratory condition (normal/obstructive/restrictive/mixed), ‘Lung Health Index,’ and presence or absence of lung health risk. Data collected in the Swaasa app were downloaded and analyzed using SPSS.v. 20. Results: Lung health risk was present in 58.2% of participants. Abnormal lung pattern was noted in 21.3% of participants (obstructive: 14.8%, restrictive: 2.5%, and mixed pattern: 4.1%). Conclusion: The Swaasa AI platform was utilized in this study to self-test lung health in real time without the need for a clinical setting. A high lung health index was found among 18% of participants. Studies adopting such cough sound analysis involving a larger population from wider geographic areas have to be conducted to detect and monitor respiratory diseases to increase its usage among the medical community in everyday clinical practice and also in remote areas.

Wireless Sensing System Based on Biodegradable Triboelectric Nanogenerator for Evaluating Sports and Sleep Respiratory.

The rapid growth of the Internet of Things and wearable sensors has led to advancements in monitoring technology in the field of health. One such advancement is the development of wearable respiratory sensors, which offer a new approach to real-time respiratory monitoring compared to traditional methods. However, the energy consumption of these sensors raises concerns about environmental pollution. To address the issue, this study proposes the use of a triboelectric nanogenerator (TENG) as a sustainable energy source. The electrical conductivity of the TENG is improved by incorporating chitosan and carbon nanotubes, with the added benefit of chitosan's biodegradability reducing negative environmental impact. A wireless intelligent respiratory monitoring system (WIRMS) is then introduced, which utilizes a degradable triboelectric nanogenerator for real-time respiratory monitoring, diagnosis, and prevention of obstructive respiratory diseases. WIRMS offers stable and highly accurate respiratory information monitoring, while enabling real-time and nondestructive transmission of information. In addition, machine learning technology is used for sleep respiration state analysis. The potential applications of WIRMS extend to wearables, medical monitoring and sports monitoring, thereby presenting innovative ideas for modern medical and sports monitoring.

Modified Frailty Index Associates With Transoral Robotic Surgery Complications and Survival: A National Database Study.

The modified frailty index (mFI-5) is a National Surgical Quality Improvement Program-derived 5-factor index that has been proven to reflect frailty and predict morbidity and mortality. We hypothesize that mFI-5 is a valid predictive measure in the transoral robotic surgery (TORS) population. Retrospective study utilizing the TriNetX US-collaborative health records network querying for TORS patients. Cohorts were stratified by mFI-5 score which uses five ICD-10 codes: nonindependent functional status, hypertension, obstructive respiratory disease, heart failure, and diabetes mellitus. Cohorts were matched by age using propensity score matching. Outcome measures included survival, infection, pneumonia, tracheostomy dependence, and percutaneous endoscopic gastrostomy dependence. Reported odds ratios were normalized to mFI-5 = 0. A total of 9,081 patients were included in the final analysis. Greater mFI-5 scores predicted decreased survival and increased incidence of postoperative infection and pneumonia. Odds of 5-year mortality were 1.93 (p = 0.0003) for mFI-5 = 2 and 1.90 (p = 0.0002) for mFI-5 = 3. Odds of 2-year mortality were 1.25 (p = 0.0125) for mFI-5 = 1, 1.58 (p = 0.0002) for mFI-5 = 2, and 1.87 (p = 0.003) for mFI-5 = 3. Odds of postoperative infection were 1.51 (p = 0.02) for mFI-5 = 2 and 1.78 (p = 0.05) for mFI-5 = 3. Two-year odds of developing pneumonia were 1.69 (p = 0.0001) for mFI-5 = 2 and 2.84 (p < 0.0001) for mFI-5 = 3. Two-month odds of pneumonia were 1.50 (p = 0.0259) for mFI-5 = 2 and 2.55 (p = 0.0037) for mFI-5 = 3. mFI-5 = 4 or 5 had too few patients to analyze. Using polynomial regression to model age versus incident 5-year post-TORS death (R2 = 0.99), mFI-5 scores better predicted survival than age alone. This study demonstrates that mFI-5 predicts mortality, pneumonia, and postoperative infection independently of age. 4 Laryngoscope, 134:4278-4283, 2024.

A Retrospective Analysis: Investigating Factors Linked to High Lung-RADS Scores in a Nonsmoking, Non-Family History Population.

Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency's low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20-80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.

The impact of lung transplantation on esophageal motility and inter-relationships with reflux and lung mechanics in patients with restrictive and obstructive respiratory disease.

For many patients with lung disease the only proven intervention to improve survival and quality of life is lung transplantation (LTx). Esophageal dysmotility and gastroesophageal reflux (GER) are common in patients with respiratory disease, and often associate with worse prognosis following LTx. Which, if any patients, should be excluded from LTx based on esophageal concerns remains unclear. Our aim was to understand the effect of LTx on esophageal motility diagnosis and examine how this and the other physiological and mechanical factors relate to GER and clearance of boluses swallowed. We prospectively recruited 62 patients with restrictive (RLD) and obstructive (OLD) lung disease (aged 33-75 years; 42 men) who underwent high resolution impedance manometry and 24-h pH-impedance before and after LTx. RLD patients with normal motility were more likely to remain normal (p = 0.02), or if having abnormal motility to change to normal (p = 0.07) post-LTx than OLD patients. Esophageal length (EL) was greater in OLD than RLD patients' pre-LTx (p < 0.001), reducing only in OLD patients' post-LTx (p = 0.02). Reduced EL post-LTx associated with greater contractile reserve (r = 0.735; p = 0.01) and increased likelihood of motility normalization (p = 0.10). Clearance of reflux improved (p = 0.01) and associated with increased mean nocturnal baseline impedance (p < 0.001) in RLD but not OLD. Peristaltic breaks and thoraco-abdominal pressure gradient impact both esophageal clearance of reflux and boluses swallowed (p < 0.05). RLD patients are more likely to show improvement in esophageal motility than OLD patients post-LTx. However, the effect on GER is more difficult to predict and requires other GI, anatomical and pulmonary factors to be taken into consideration.

Respiratory Abnormalities Among Elderly Women in Urban Slums: A Comprehensive Analysis of Contributing Factors

Background: India experiences a growing aging population and prioritizing the comprehension of respiratory health concerns among the elderly becomes crucial. Those in the elderly demographic residing in urban slums confront notable socioeconomic obstacles and encounter restricted healthcare accessibility, heightening their vulnerability to respiratory illnesses. Therefore, examining respiratory health in this specific urban context provides insights into how living conditions impact the health of vulnerable populations. Objectives: The present study aims to evaluate the occurrence of respiratory abnormalities among slum-dwelling elderly women and also to determine the concomitant factors responsible for respiratory abnormalities among them. Material and Methods: The study includes a total of 261 elderly women aged 60 years and above living in slum areas of Kolkata. The standard protocols were followed to collect spirometry and anthropometric data. Descriptive and inferential statistical analyses were performed to satisfy the study objectives. Results: The majority of the participants show forced vital capacity (FVC) and forced expiratory volume in one second (FEV0.1) below the predicted level, indicating the presence of mild-to-moderate respiratory abnormality. Chronic obstructive respiratory disease (COPD) was observed in 15.2% of elderly women, significantly higher than the national average. The study identified significant correlations between age and respiratory abnormalities. Factors such as overcrowded living conditions, the absence of a separate kitchen, and the use of certain cooking fuels increased the likelihood of COPD. Body fat percentage was found to be inversely related to FVC, FEV0.1, and COPD. Conclusion: The poor living conditions and a few other associated factors are indicative of developing respiratory problems among elderly individuals. As the global population ages, this study contributes valuable insights for public health strategies, emphasizing the need for tailored approaches to address the specific challenges faced by elderly women in urban slums in the megacity of Kolkata.

Bronquiolitis obliterante posinfecciosa secundaria a adenovirus

Bronchiolitis obliterans is a rare chronic obstructive respiratory disease secondary to damage of the lower respiratory tract causing inflammation and partial or total obliteration of it. There are different causes, being infectious the most frequent in pediatrics, mainly due to adenovirus. We present the case of an 18-month-old male infant with a history of admission to the Pediatric Intensive Care Unit at 8 months of age due to bronchitis secondary to respiratory syncytial virus and adenovirus. After this episode, he presented persistent respiratory distress and pathological pulmonary auscultation. High resolution pulmonary computed tomography showed a mosaic pattern with areas of air trapping and decreased vascular caliber in the affected areas, findings suggestive of bronchiolitis obliterans.

Neural network analysis of pharyngeal sounds can detect obstructive upper respiratory disease in brachycephalic dogs.

Brachycephalic obstructive airway syndrome (BOAS) is a highly prevalent respiratory disease affecting popular short-faced dog breeds such as Pugs and French bulldogs. BOAS causes significant morbidity, leading to poor exercise tolerance, sleep disorders and a shortened lifespan. Despite its severity, the disease is commonly missed by owners or disregarded by veterinary practitioners. A key clinical sign of BOAS is stertor, a low-frequency snoring sound. In recent years, a functional grading scheme has been introduced to semi-objectively grade BOAS based on the presence of stertor and other abnormal signs. However, correctly grading stertor requires significant experience and adding an objective component would aid accuracy and repeatability. This study proposes a recurrent neural network model to automatically detect and grade stertor in laryngeal electronic stethoscope recordings. The model is developed using a novel dataset of 665 labelled recordings taken from 341 dogs with diverse BOAS clinical signs. Evaluated via nested cross validation, the neural network predicts the presence of clinically significant BOAS with an area under the receiving operating characteristic of 0.85, an operating sensitivity of 71% and a specificity of 86%. The algorithm could enable widespread screening for BOAS to be conducted by both owners and veterinarians, improving treatment and breeding decisions.

Associations of Depressive and Anxiety Disorders with Pulmonary Disorders in the Community: The PneumoLaus and PsyCoLaus Studies

Introduction: Mental health disorders figure among the many comorbidities of obstructive respiratory diseases. The multisystemic characteristics of chronic respiratory disease and its impact on quality of life could affect depressive and/or anxiety disorders. We aimed to evaluate the association of spirometric indices, ventilatory disorders, and self-reported respiratory diseases with psychiatric disorders considering potential confounders. Methods: We analysed data from CoLaus|PsyCoLaus, a Swiss population-based cohort study, consisting of 2’774 participants (56% women; mean age: 62.3 (standard deviation = ±9.9) years) who performed spirometry and completed semi-structured psychiatric interviews. We defined ventilatory disorders using GLI-2012 references. Major depressive episode (MDE) and anxiety disorders were defined using the DSM-IV (Diagnostic and Statistical Manual). Results: 630 subjects (22.7%) presented a recent MDE. Reversible obstructive ventilatory disorders were associated with recent MDE (OR = 1.94, 95% confidence interval (95% CI) 1.10–3.43) and recent anxiety disorders (2.21 [1.16–4.22]) only in unadjusted model. Self-reported chronic obstructive pulmonary (COPD) and asthma were associated with MDE with ORs of 2.49 (95% CI, 1.19–5.27) and 1.56 (95% CI, 1.04–2.35) after adjustment, respectively. Possible restrictive ventilatory impairment was positively associated with recent anxiety disorders (OR = 2.46, 1.10–5.51). Z-scores of FEV1, FVC, and maximal mid-expiratory flow were not associated with psychiatric disorders. There was no association between ventilatory disorders and MDE in adjusted models. Conclusions: In this cross-sectional population-based study, the association between respiratory disorders and depressive disorders was observed for self-reported COPD and asthma, but not with objective diagnoses based on spirometry. Lung volumes are not associated with psychiatric disorders. Further prospective studies will be necessary to understand the significance of the association.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.