Study Of Respiratory Function Research Articles

The role of respiratory function tests in infants with stridor: diagnosis at glance and follow-up

BackgroundRecently, the development of advanced, noninvasive methods has allowed the study of respiratory function even in uncooperative infants. To date, there is still little data on the application of this technique in infants with suspected airway obstruction. The aims of our study were:- To evaluate the role of respiratory function testing (PFR) in the diagnosis and follow-up of infants with stridor- To evaluate the differences between patients with inspiratory stridor and expiratory stridor.- To evaluate the concordance between PFR and endoscopy.MethodsWe enrolled infants aged < 1 year with a diagnosis of inspiratory and/or expiratory chronic stridor and a group of healthy controls. For each patient we performed PFR at diagnosis (T0) and for cases at follow-up, at 3 months (T1), 6 months (T2), 12 months (T3). At T0, all patients were classified according to a clinical score, and at follow-up, stature-ponderal growth was assessed.When clinically indicated, patients underwent bronchoscopy.ResultsWe enrolled 48 cases (42 diagnosed with inspiratory stridor and 6 expiratory stridor) and 26 healthy controls. At T0, patients with stridor had increased inspiratory time (p < 0.0001) and expiratory time (p < 0.001) than healthy controls and abnormal curve morphology depending on the type of stridor. At T0, patients with expiratory stridor had a reduced Peak expiratory flow (p < 0.023) and a longer expiratory time (p < 0.004) than patients with inspiratory stridor.We showed an excellent concordance between PFR and endoscopic examination (k = 0.885, p < 0.0001). At follow-up, we showed a progressive increase of the respiratory parameters in line with the growth.ConclusionsPFR could help improve the management of these patients through rapid and noninvasive diagnosis, careful monitoring, and early detection of those most at risk.

Safety pharmacology of human endogenous retrovirus-enveloped baculoviral DNA vaccines against SARS-CoV-2 in Sprague-Dawley rats and beagle dogs

The coronavirus disease 2019 (COVID-19) emerged as a major global health crisis, posing significant health, economic, and social challenges. Vaccine development has been a crucial response to the severe-acute-respiratory-syndrome-related coronavirus-2 pandemic owing to the critical role of immunization in controlling infectious diseases, leading to the expedited development of several effective vaccines. Although mRNA platform-based COVID-19 vaccines authorized under emergency-use authorization have been administered globally, concerns regarding the vaccines have increased owing to the occurrence of various side effects. The present study aimed to evaluate the safety of a non-replicating recombinant baculovirus expressing the human endogenous retrovirus envelope gene (AcHERV) vaccine encoding SARS-CoV-2 antigens. Owing to the limited number of existing safety pharmacology studies on AcHERV as a viral vector vaccine, we conducted neurobehavior (Modified Irwin’s Test), body temperature, and respiratory function studies in rats and cardiovascular system studies in male beagle dogs, which were administered the AcHERV-COVID-19 vaccine using telemetry. The safety assessment revealed no significant toxicological alterations. However, in rats, both sexes administered with the AcHERV-COVID-19 vaccine exhibited a temporary increase in body temperature, which normalized or showed signs of recovery. In conclusion, AcHERV-COVID-19 demonstrates a sufficient safety profile that supports its potential evaluation in future clinical trials.

Study of respiratory function of the lungs in smokers and patients with chronic obstructive pulmonary disease

Study of respiratory function of the lungs in smokers and patients with chronic obstructive pulmonary disease

Surfactant protein D as a marker of persistent impairment of the lungs diffusion capacity in the long-term period in patients who had suffered from severe COVID-19

Introduction. The long-term consequences of COVID-19 (СOrona VIrus Disease 2019) for the respiratory system represent a socially significant problem. Long-lasting respiratory symptoms and functional changes in individuals who have suffered coronavirus infection justify the need to study pathogenetic mechanisms. There is little study of epithelial biomarkers and their potential role in the development of long-term respiratory complications.Аim. Тo study the level of the circulating marker surfactant protein-D (SP-D) in patients who suffered severe COVID-19-associated lung damage at 3 and 12 months after the acute form and its relation with indicators of respiratory function.Materials and methods. The study included 70 patients who were examined at 3 and 12 months after the acute phase of COVID-19, which occurred with severe and extremely severe lung damage. Patients underwent a comprehensive study of respiratory function (spirography, bodyplethysmography and diffusion test), a 6-minute step test with quantitative assessment of shortness of breath, both during exercise and in daily life; the study also determined the serum level of surfactant protein-D.Results. The results of the study indicate that 57% of patients who have suffered severe COVID-19-associated lung damage remain persistently impaired in the diffusion capacity of the lungs throughout the year. It was found that the level of SP-D was increased in all patients 3 months after the acute phase of the disease, but in the group with reduced DLco this level was significantly higher after 3 and 12 months (469 ng/ml and 295 ng/ml, respectively).Conclusion. Persistent impairments in the diffusion capacity of the lungs in some patients persist a year after suffering a severe form of COVID-19. Elevated SP-D levels have been found to be associated with decreased lung diffusion capacity. Thus, SP-D can be considered as a potential biomarker of lung injury severity in the long-term period of COVID-19.

Pedicled flap transfer after chest wall malignant tumor resection and potential risk of postoperative respiratory problems for patients with low FEV1.0.

Musculoskeletal transfer for chest wall tissue defects is a crucial method, and pedicled flaps around the chest wall are preferred in terms of location and simplicity of transfer. These require special care because of complications such as partial necrosis, fistula, wound dehiscence, infection, hematoma and restricted function of the arm or shoulder. However, studies of respiratory function are rare. In the present study, we investigated the complications including respiratory problems after wide resection for malignant chest wall tumors with musculoskeletal pedicle transfer. A total of 13 patients (15 operations) who underwent wide resection of primary, recurrent, or metastatic malignant chest wall tumors and musculoskeletal pedicle transfer for coverage of tissue defects were enrolled in the present study. A retrospective review of all patients was performed using data collected from hospital records and follow-up information. The complications of musculoskeletal transfer after chest wall wide resection, including respiratory problems, are evaluated. Rib or sternal resection was performed in 12 operations, and only soft tissue resection was performed in 3 operations. Latissimus dorsi (LD) pedicle transfer was performed in 13 operations, and pectoralis major (PM) pedicle transfer was performed in 2 operations; basically, wounds were closed primarily. Surgical complications were observed following 5 of the 15 operations (33.3%). Respiratory complications were seen in 7 of the 15 operations (46.7%). Patients with respiratory complications showed significantly lower preoperative FEV1.0% values than those without respiratory complications (p = 0.0196). Skin resection area tended to be higher in the complication group than in the no complication group (p = 0.104). Pedicled myocutaneous flap transfers such as LD, PM, and rectus abdominus can be used following multiple resections. After harvesting LD or PM, the wound can be closed primarily for an 8-10-cm skin defect in patients with normal respiratory function. However, for patients with low FEV1.0%, after primary closure of LD or PM transfer for wide soft tissue defects, attention should be paid to postoperative respiratory complications.

Assessment of the respiratory function of patients after COVID-19 pneumonia for medical rehabilitation

Aim. To study the indicators of external respiration function in older patients after coronavirus pneumonia (COVID-19) with the purpose of creating personalized rehabilitation programs.Materials and methods. A study of respiratory function after coronavirus pneumonia (COVID-19) was conducted in 109 patients with the average age of 63.7 ± 2.2 (51.3% men and 48.7% women) and the lung damage of more than 25%.Results. The patients after coronavirus pneumonia (COVID-19) show a decrease in respiratory function indicators, such as VC, FVC, FEV1, and SPO2, as well as an increased Tiffeneau –Pinelli index.Conclusion. Timely detection of respiratory disorders in patients after COVID-19 pneumonia allows timely diagnosis of respiratory failures and selection of adequate rehabilitation measures.

The study of respiratory function of the lungs in patients with Bronchial Asthma

The article discusses the possibilities of functional assessment of the state of the respiratory function of the lungs in patients with bronchial asthma.The purpose of the study: a comparative assessment of the information content of capnometry, spirometry, the method of multiple breath nitrogen washout and the diffusion test in patients with asthma.Results and conclusions: 2 groups of patients were examined: I — 30 patients with asthma of 3–4 degrees of severity, II — 30 healthy volunteers. Capnometry showed a statistically significant increase in the slope of the alveolar phase in patients with asthma compared to the control group with quiet breathing, both before and after the use of a bronchodilator. According to spirometry data, in patients, the FEV1 /FVC ratio was statistically significantly lower compared to the control group, both before and after bronchodilator use. In a comparative analysis of the diffusion capacity of the lungs, there was a trend towards lower DLCO values in patients with asthma. A statistically significant difference was obtained in relation to the lung clearance index between the group of patients with asthma and the control group, in which the index was significantly lower. There were no statistically significant differences between the FRC (%) estimates obtained using the diffusion test and the method of the multiple breath nitrogen washout in patients with asthma. Thus, the informative methods in patients with asthma were not only the method of spirometry, but also the method of capnometry and the method of multiple breath nitrogen washout, which revealed uneven ventilation and distribution of ventilation-perfusion ratios in the lungs.

Assessment of long-term clinical and functional changes in patients recovering from severe COVID-19-associated lung damage

The problem of long COVID-19 (COronaVIrus Disease 2019) has been highly relevant for the healthcare system in the last three years. The persistence of respiratory symptoms, radiological and functional changes in COVID-19 patients brings new challenges to the entire medical community. The aim of the study is to explore long-term clinical and functional changes in patients with severe COVID-19-associated lung injury, including assessment of functional and radiological abnormalities of the respiratory system, as well as persistent clinical symptoms a year after the acute phase of the disease. Methods. The study included 45 patients who were examined 3, 6 and 12 months after COVID-19 with severe lung damage (more than 50% according to chest CT in the acute phase of the disease). Patients underwent multispiral computed tomography of the chest organs, a comprehensive study of respiratory function (spirography, body plethysmography and diffusion test); the clinical symptoms were assessed. Results. Chest CT scans showed gradual regression of pathological changes during the follow-up. However, radiographic changes of varying severity persisted after 12 months of follow-up in 51% of patients. A year later, restrictive disorders persisted in 20% of patients and the diffusion capacity of the lungs was reduced in 69% of patients. At the same time, a statistically significant difference in the DLСО level was observed between 3, 6 and 12 months. The severity of dyspnea decreased 1 year after hospitalization in 48% of patients. Conclusion. The obtained results demonstrate a gradual regression of both radiological and functional pathological changes during the 1st year. However, CT changes and deviations of the respiratory function persist in some patients, mainly in the form of a decrease in DLСО, which necessitates further monitoring of this group of patients.

Short communication: Acute hypoxia does not alter mitochondrial abundance in naked mole-rats

Hypoxia poses a significant energetic challenge and most species exhibit metabolic remodelling when exposed to prolonged hypoxia. One component of this remodelling is mitochondrial biogenesis/mitophagy, which alter mitochondrial abundance and helps to adjust metabolic throughput to match changes in energy demands in hypoxia. However, how acute hypoxia impacts mitochondrial abundance in hypoxia-tolerant species is poorly understood. To help address this gap, we exposed hypoxia-tolerant naked mole-rats to 3 h of normoxia or acute hypoxia (5% O2) and measured changes in mitochondrial abundance using two well-established markers: citrate synthase (CS) enzyme activity and mitochondrial DNA (mtDNA) abundance. We found that neither marker changed with hypoxia in brain, liver, or kidney, suggesting that mitochondrial biogenesis is not initiated during acute hypoxia in these tissues. Conversely in skeletal muscle, the ratio of CS activity to total protein decreased 50% with hypoxia. However, this change was likely driven by an increase in soluble protein density in hypoxia because CS activity was unchanged relative to wet tissue weight and the mtDNA copy number was unchanged. To confirm this, we examined skeletal muscle mitochondria using transmission electron microscopy and found no change in mitochondrial volume density. Taken together with previous studies of mitochondrial respiratory function, our present findings suggest that naked mole-rats primarily rely on tissue-specific functional remodelling of metabolic pathways and mitochondrial respiratory throughput, and not physical changes in mitochondrial number or volume, to adjust to short-term hypoxic exposure.

Toward automated prediction of sudden unexpected death in epilepsy.

Sudden unexpected death in epilepsy (SUDEP) is a devastating yet overlooked complication of epilepsy. The rare and complex nature of SUDEP makes it challenging to study. No prediction or prevention of SUDEP is currently available in a clinical setting. In the past decade, significant advances have been made in our knowledge ofthe pathophysiologic cascades that lead to SUDEP. In particular, studies of brain, heart, and respiratory functions in both human patients at the epilepsy monitoring unit and animal models during fatal seizures provide critical information to integrate computational tools for SUDEP prediction. The rapid advances in automated seizure detection and prediction algorithms provide a fundamental framework for their adaption in predicting SUDEP. If a SUDEP can be predicted, then there will be a potential for medical intervention to be administered, either by their caregivers or via an implanted device automatically delivering electrical stimulation or medication, and finally save lives from fatal seizures. This article presents recent developments of SUDEP studies focusing on the pathophysiologic basis of SUDEP and computational implications of machine learning techniques that can be adapted and extended for SUDEP prediction. This article also discusses some novel ideas for SUDEP prediction and rescue including principal component analysis and closed-loop intervention.

Influence of working conditions on the function of external respiration in underground oil mine workers

Introduction. The article presents a non-combined observational cross-sectional retrospective study, which studied the functions of respiration of 3 categories of workers (sinkers, woodworkers, underground miners) depending on working conditions. Materials and methods. Analyzed depersonalized data from outpatient records of periodic medical examinations of underground workers from 2013 to 2017. The article presents only the analysis of spirograms. The study of respiratory function was carried out using an expert class spirometer SpiroLab III (MIR, Italy). The results were assessed by a doctor of functional diagnostics. Production factors were studied according to the results of a special assessment of working conditions carried out in oil mines according to the methodology for conducting a special assessment of working conditions, approved by order of the Ministry of Labour of Russia No. 33n dated January 24, 2014. Statistical methods were used to analyze the material: methods of parametric statistics (mean (M), standard deviation, error of the mean (m), Student’s test), the data are presented in the format M ± m, the differences were considered significant at p &lt; 0.05. Results. An analysis of occupational morbidity among oil miners has been carried out, risk groups have been identified by profession, length of service and age. It was revealed that after 4-5 years of work in the profession, there is a tendency to impairment of the function of external respiration according to the obstructive type (decrease in forced expiratory volume in the first second (FEV1), formed vital capacity of the lungs (FVC), peak expiratory flow rate (PEF) , Tiffno index). This is suggested to be due to a combination of factors of the production environment such as oil hydrocarbons and the severity of labour. The analysis of working conditions made it possible to determine the list of harmful production factors affecting the development and occurrence of occupational diseases by workers involved in thermal mining of high-viscosity oil. Limitations. The smoking factor in the work is considered as a qualitative one, it is probably more logical to consider it as a quantitative one - smoking experience (number of years), then a connection with changes in the functions of external respiration may be revealed. Conclusion. After 4-5 years of work, oil miners show a tendency to obstructive disorders of the respiration function. The genesis of the identified changes requires further clarification.

Epidemiology, clinical and physiological manifestations of dust lung disease in major industrial centers

BackgroundThe present study aims to determine the structure of morbidity in workers contacting industrial aerosols, assess the timeliness of diagnosing dust-induced lung disease in major industrial centers, and optimize diagnostics for early detection of occupational lung diseases in workers exposed to industrial dust hazards.MethodsThe study on the structure and incidence of occupational lung diseases was carried out in 2016–2020 based on the Moscow Centre for Occupational Pathology data. For a more in-depth clinical examination, 114 patients who were first admitted to the Occupational Pathology Centre with diagnosed pneumoconiosis (PC), chronic dust-induced bronchitis (CDB), and chronic obstructive pulmonary disease (COPD) were selected. All patients were subjected to a complex clinical-functional, spirographic, echocardiographic, fibroscopic, radiological, and CT lung examination, with subsequent analysis of the results obtained. The pathology caused by exposure to industrial aerosols within the studied period was first diagnosed in 344 workers. Most patients (64%) with newly detected pathologies were 50–59 years of age, with work experience in adverse conditions of 21–25 years (41%).ResultsThe spirographic study of respiratory function revealed decreased forced vital capacity (FVC) indices in CDB and COPD patients. Changes in expiratory flow rates suggest occupational bronchitis at an earlier stage, whereas no apparent results were noted for the PC diagnosis. The results of fibroscopic examination in PC patients revealed atrophic processes of the bronchial mucosa in 46 (88.5%) of them, and 6 (11.5%) patients had a subtropic process. The results of echocardiographic examination allowed diagnosing pulmonary heart disease in 83 patients (72.8%). Of them, 42 (80.8%) were revealed in the group of patients with PC, 18 (50.0%) in the COB group, and 14 (53.8%) in the COPD group.ConclusionsComputed tomography (CT) detected pathological changes in 52 patients, while the X-ray examination in six people showed no evidence of lung destruction. CT scan also showed that the number of patients with fibrotic PC (including silicosis) in the study groups increased. Timely clinical and functional examination (spirography, fibroscopy, echocardiography) of patients allows detecting PC (including silicosis), CDB, and COPD at an early stage of disease progression.

Assessment of the respiratory system in children with congenital scoliosis by impulse oscillometry and computed tomography (preliminary results)

BACKGROUND: Segmentation disorder of the vertebral body lateral surfaces and rib synostosis are severe variants of congenital pathology of the spine and thorax. They lead to the development of thoracic insufficiency syndrome and are manifested by the inability of the thorax to provide normal respiratory mechanics.&#x0D; AIM: This study presents the preliminary results of functional and radiological (CT-morphometric) methods of lung examinations in patients with congenital thoracic spine scoliosis with impaired segmentation of the lateral surfaces of the vertebral bodies and unilateral rib synostosis.&#x0D; MATERIALS AND METHODS: This design is represented by a small clinical series. This study is a prospective study of 10 patients aged 3 to 7 years with congenital spinal deformity, with impaired segmentation of the lateral surfaces of vertebral bodies and unilateral rib synostosis. This paper presents the preliminary results of the pulmonary function assessment by pulse oscillometry and CT morphometry in a 3D reconstruction of multispiral computer tomography (MSCT) of the thorax.&#x0D; RESULTS: The study of respiratory function using pulse oscillometry revealed no respiratory impairment in seven observations, also reflected in the CT morphometry results. According to the Institute of Medicine (IOM), three children with detected ventilatory abnormalities showed the following parameters with the most significant changes: total respiratory impedance, resonance frequency, and frequency dependence of the resistive component. In all patients, the morphometric indexes of the lung scoring revealed during 3D modeling of the lung were completely consistent with the results of the lung function study by the IOM method.&#x0D; CONCLUSIONS: Further study of the problem of respiratory function assessment in children with congenital scoliosis seems promising in diagnostic terms and for evaluating effective surgical treatment.

ЭФФЕКТИВНОСТЬ РЕСЛИЗУМАБА В ЛЕЧЕНИИ АСТМЫ И КОМОРБИДНОГО ХРОНИЧЕСКОГО РИНОСИНУСИТА С ПОЛИПАМИ

Introduction. Chronic rhinosinusitis with polyps and asthma are comorbid, mutually aggravating, and difficult to treat diseases. The correlation between the severity of chronic rhinosinusitis with polyps and eosinophilic asthma, the similarity of the endotypes of these diseases and the success of humanized monoclonal antibodies for the treatment of severe asthma explain the interest in studying the possibility of using this group of drugs in patients with chronic rhinosinusitis with polyps. Aim. The aim of the study was to assess changes in the severity of symptoms of chronic rhinosinusitis in patients with comorbid asthma against the background of reslizumab treatment. We evaluated clinical effect of treatment, dynamics of subjective and objective characteristics of symptoms of chronic rhinosinusitis and asthma, indices of total and local eosinophilia. Material and methods. The study involved 18 patients with severe eosinophilic asthma selected for treatment with reslizumab. Study protocol: The first examination, performed before starting reslizumab treatment, included assessment of clinical symptoms using the standardized Sino-nasal Outcome Test-22 (SNOT-22) and Asthma Control Test (ACT) questionnaires, endoscopic nasal cavity examination, spiral computed tomography of the paranasal sinuses, rhino cytogram, determination of eosinophils and eosinophilic cationic protein (ECP) in blood, allergological examination using ImmunoCAP method, and external respiratory function study. The results of treatment were evaluated after 6 injections of reslizumab at the dose of 3 mg/kg weight once every 4 weeks. The obtained data were processed using Statistica 12.0 program (StatSoft, USA). The differences were considered statistically significant at p&lt;0,05. Results and discussion. When assessing the outcomes of treatment after 6 injections of reslizumab, both a marked improvement in asthma control (Asthma Control Test – increase from 7,0 [6–8] to 22,0 [16–22]) and a decrease in nasal symptoms (SNOT-22 was 78,0 [62–81] and 39,0 [29–49], respectively) were noted. There was a significant improvement in the Lund-Mackay spiral computed tomography data of the paranasal sinuses (16,0 [11–19] and 7,0 [5–12], respectively), spirometry values, and a decrease in eosinophils and eosinophilic cationic protein content in the blood. In the presence of polyposis rhinosinusitis in patients with severe eosinophilic asthma, a more pronounced effect of reslizumab on the attenuation of asthma symptoms was obtained comparing to patients without polyps. Conclusions. Treatment with reslizumab in patients with eosinophilic asthma and concomitant chronic rhinosinusitis with polyps and eosinophilic chronic rhinosinusitis leads not only to better control of asthma symptoms but also to a significant regression of nasal symptoms.

КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЕ И ФУНКЦИОНАЛЬНЫЕ ПОСЛЕДСТВИЯ БРОНХОЛЕГОЧНОЙ ДИСПЛАЗИИ У ДЕТЕЙ ДОШКОЛЬНОГО И МЛАДШЕГО ШКОЛЬНОГО ВОЗРАСТА В ЗАВИСИМОСТИ ОТ МАССЫ ТЕЛА ПРИ РОЖДЕНИИ

Advances in medical technology are leading to the survival of very premature infants, who often develop bronchopulmonary dysplasia (BPD). In this regard, the health problem of children with extremely low birth weight (ELBW) and BPD is relevant, since there is insufficient domestic experience in monitoring such patients. The outcomes of the disease among deeply premature infants with ELBW at school age have not been fully studied in comparison with peers with BPD, but born with a greater body weight. Objective of the study: to assess the clinical, radiological and functional consequences of BPD in children of preschool and early school age, depending on body weight at birth. Materials and methods of research: the design of the study – a non-randomized retrospective single-center comparative pilot study. We examined 73 children with a history of BPD, aged from 5 to 8 years (median – 7 years). The boys/girls ratio is 38/35. Children were divided into 2 groups: 1st group – 50 children born with low body weight (LBW) and very low body weight (VLBW), and 2nd group – 23 children with ELBW, most of them had a mild form of the disease. Respiratory symptoms were studied, computed tomography (CT) of the chest organs was performed to assess structural changes and the study of external respiratory function (ERF). Results: 1/3 of children of the 1st and 2nd groups had prolonged episodes of bronchial obstruction. The vast majority of children, regardless of their birth weight, had structural changes in the lungs – 96% of children of the 1st group and 94% of children of the 2nd group, p=0,888. Most often, the results of CT revealed fibrotic changes, collapse/hypoventilation, ventilation inhomogeneity, somewhat less often – emphysema, peribronchial changes, without differences between groups (p&gt;0,05). Children with ELBW had statistically insignificantly less frequent occurrence of the air trap symptom (12% and 26%, p=0,314) compared with children with VLBW and LBW. The study of ERF revealed a decrease in speed indicators, an increase in bronchial resistance and a slight decrease in the diffusion capacity of the lungs in children of both groups without statistically significant differences (p&gt;0,05). Conclusion: children with ELBW who underwent BPD demonstrate persistence of clinical symptoms, structural and functional disorders, like their peers with BPD in anamnesis, but born with a greater body weight.

Physiologic-range flow and pressure sensor for respiratory systems

A low-cost but reliable flow and pressure sensor is an impediment to development of medical equipment, and studies of human respiratory function, which is characterised by relatively low pressures and flows. A Venturi tube (D1=15mm,D2=10mm) connected to a differential pressure sensor (SDP816-125 Pa) allows accurate measurement of flow between 5-75L·min-1, with Pearson Correlation over 4 min at 50Hz⩾0.97, and distance correlation ⩾0.96. The pressure measurement was similarly accurate using a MPVZ4006GW7U. Both sensors provide an analogue output from a 5.0V supply, aiding compatibility and customisation. Each populated PCB costs approximately $50USD, and each Venturi sensor costs approximately $1USD. Multiple configurations exist, allowing flow rates up to 250L·min-1, increased resolution for specific ranges, and different physical characteristics.

Silicoarthritis: issues of early diagnosis, prevention

Background. The severity of the course of silicosis is aggravated by the addition of complications; one of the serious and rare complication of silicosis is silicoarthritis or Kaplan’s syndrome (KS), which accounts for 0.1-0.6% of all cases of silicosis. Silicoarthritis significantly reduces the quality of the life of patients and leads to early and persistent disability.Aim. To establish the most significant methods of diagnosing silicoarthritis for early detection of the disease and prevention of complications.Materials and methods. The article presents clinical cases of silicosis and its rare complication - SC. The basis for the diagnosis of this pathology is X-ray, immunological and functional methods.Results. In patients with more than 5 years of experience exposed to aerosols of fibrogenic action, crystalline silicon dioxide, with an excess of the MPC level from 2.3 to 4 times on the basis of MSCT of the lungs, during which multiple polymorphic foci with a diameter of 2 up to 10 mm, partly merging with each other into peribronchovascular couplings, as well as perifocal areas of reduced airiness like ground glass and thickening of the axial interstitium, a diagnosis of late silicosis, stage 2 nodular form was established, the diagnosis was confirmed by biopsy data. In dynamics, after 5 years, arthralgic complaints joined. On the basis of immunological (increased TNF-alpha, IL-1b), X-ray examination (osteoarthritis of the distal and proximal interphalangeal, wrist, metatarsophalangeal joints), the diagnosis was clarified as Silicoarthritis: Kaplan’s syndrome.Conclusion. Diagnosis of silicosis and its complications at the preclinical stage in workers who have been in contact with silica dust for 5 years or more should include: MSCT of the lungs, determination of TNF-alpha, IL-1b, rheumatoid factor, and a study of respiratory function.

Features of medical rehabilitation of patients who have suffered an ischemic stroke and have a history of obstructive chronic disorders of the respiratory system without exacerbation.

Background. To date, the study of respiratory function in the clinic is limited, as a rule, to the determination of bronchial conduction indicators, as well as bronchodilation tests, which at the present stage is insufficient for a deep assessment of the functional state of patients with chronic obstructive pulmonary disease.&#x0D; Aims. The development of personalized medical rehabilitation programs for patients who have undergone ischemic stroke at various stages of rehabilitation, including spa.&#x0D; Materials and methods. The article considers the effectiveness of the new method of treating neurological disorders in patients suffering from acute cerebral circulation disorder and having respiratory system function disorder at different stages of rehabilitation, based on the complex application of physiobalneotherapy, LFC and mechanotherapy in sanatorium and resort conditions.&#x0D; Results. After the course of using physical methods of treatment, patients with comorbid pathology showed improvement in health, relief of breathing, reduction of shortness of breath, cough, sputum production, disappearance of wheezing in the lungs.&#x0D; Conclusion. Patients in the early and late recovery period after acute cerebral circulation disorder with accompanying clinical-functional manifestations of respiratory pathology are shown to include in the rehabilitation complex general gasair carbon dioxide baths, nebulizer inhalations of broncho- and mucolytic preparations, as well as classes on a rowing simulator (rowing) against the background of standard drug therapy and therapeutic exercise in the hall.

Respiratory sound recorder – continued Innovation

The study of external respiratory function (ERF) is important in the diagnosis of respiratory tract abnormalities in various diseases. In children, especially at an early age, there are many difficulties in conducting studies. In recent decades, due to the development of computer technology, there is great interest in the study of respiratory sounds, methods of their registration, processing and use in the assessment of the respiratory system in children and adults. Russian scientists have developed the method of respiratory airway sound investigation, which has proved its effectiveness, reliability and necessity of use in practice. Computer bronchophonography is based on the analysis of time and frequency characteristics of the spectrum of respiratory noises, arising from changes in the bronchial diameter due to increase in the stiffness of their walls or decrease in the inner diameter. Computed bronchophonography may be used for diagnostics of EFD disorders in patients of all age groups both in the in-patient and out-patient treatment.

A follow-up study of respiratory and physical function after discharge in patients with redetectable positive SARS-CoV-2 nucleic acid results following recovery from COVID-19

ObjectiveThe aim of this study was to evaluate the respiratory and physical function of patients who retested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA during post-coronavirus disease 2019 (COVID-19) rehabilitation. MethodsA total of 302 discharged COVID-19 patients were included. Discharged patients were followed up for 14 days to 6 months. The modified Medical Research Council (mMRC) dyspnea scale, Borg rating of perceived exertion, and manual muscle testing (MMT) scores on day 14 and at 6 months after discharge were compared between the redetectable positive (RP) and non-RP (NRP) groups. Prognoses of respiratory and physical function were compared between patients who recovered from moderate and severe COVID-19. ResultsOf the study patients, 7.6% were RP. The proportion of patients who used antiviral drugs was significantly lower in the RP group than in the NRP group. There were no differences in mMRC, Borg, or MMT scores within the RP and NRP groups. The mMRC, Borg, and MMT scores were worse for patients with severe disease when compared to those with moderate disease at both follow-up time points. ConclusionsCOVID-19 patients who did not take antiviral drugs were more likely to be RP after discharge. The recovery of respiratory and physical function was not related to re-positivity during rehabilitation, but was related to disease severity during hospitalization.