Risk factors of recurrence after incisional hernia preperitoneal repair: a long-term retrospective single-center cohort study.

PURPOSE: To explore the risk factors for incisional hernia (IH) recurrence following open prepertioneal repair. METHODS: Patients diagnosed with primary IH who underwent open preperitoneal repair at our hospital were enrolled. Patients were assessed, and perioperative factors were collected. Recurrence surveys were performed at regular intervals throughout the long-term postoperative follow-up. The risk factors for IH recurrence were identified using univariate and multivariate analyses. RESULTS: This study included 145 patients. Significant differences were found between recurrence and non-recurrence patients regarding pulmonary ventilation function (PVT), age, body mass index (BMI), mesh materials, type of surgery (clean, clean-contaminated, or contaminated), surgical site infections (SSIs), maximum width of the hernia defect (MWHD), and site of incisional hernia (P < 0.01). The univariate survival analysis revealed that PVT abnormalities, age > 70 years, BMI > 27 kg/m2, porcine small intestine submucosal (PSIS) mesh, non-clean surgery, SSIs, MWHD > 10 cm, and location in the lateral zones were significant factors for IH recurrence after open preperitoneal repair. The multivariate survival analysis showed that PVT abnormalities, age > 70 years, BMI > 27 kg/m2, and PSIS mesh were independent risk factors for IH recurrence after open preperitoneal repair. CONCLUSIONS: We identified PVT abnormalities, age > 70 years, BMI > 27 kg/m2, and PSIS mesh as novel risk factors for IH recurrence after open preperitoneal repair.

Assessment of ventilatory functions and associated inflammatory markers among workers in slaughterhouses.

OBJECTIVE: Meat processing is among the most extensive industries globally. However, data on the effects of occupational exposure on the pulmonary health of slaughterhouse workers is limited. Ascertaining the impact of the slaughterhouse atmosphere on the breathing habits of laborers exposed to it and the inflammatory markers associated with it was the aim of the current investigation. METHODS: A cross-sectional study was performed on 82 non-smoker subjects of 41 male workers working in one of the major slaughterhouses in Cairo, Egypt, matched to 41 controls of administrative personnel. An elaborate questionnaire encompassing medical and occupational history was administered to each participant in the research. General and local systemic examinations and ventilatory function tests were carried out, and serum levels of interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were measured. RESULTS: Respiratory symptoms were more prevalent with a statistically significant decline in ventilatory function parameters (FVC%, FEV1%, FEV1/FVC, FEF 25%, FEF 50%, FEF 75%, and PEF%) among the exposed group compared to those of control. In addition, there was a significantly higher serum level of inflammatory markers (IL-6 and hsCRP) among the exposed group compared to the control group, with a negative correlation with ventilatory functions. Moreover, there was a positive association between levels of serum IL-6 and hsCRP and the age and duration of employment of workers. CONCLUSION: There was a notable increase in the prevalence of respiratory disorders and inflammatory markers among slaughterhouse workers. Additionally, there was a substantial decrease in ventilatory function parameters, which could be attributed to the bioaerosols they encountered in the workplace.

Effects of an 8-Week Corrective Dance Exercises Intervention on Thoracic Hyperkyphosis, Scapular Position, Respiratory Function, and Happiness in Girls Aged 10-12 Years.

PURPOSE: This study examined the impact of an 8-week corrective dance intervention on thoracic hyperkyphosis, scapular position, breathing, and happiness in girls aged 10-12 years. METHODS: Sixty participants were randomly assigned to either an experimental (EX) or control (CO) group. The intervention involved rhythmic and corrective movements conducted 3 times a week. Measurements were taken before and after the intervention for thoracic hyperkyphosis angle, scapular position, lung function, and happiness levels. RESULTS: EX showed greater improvements (P = .001) than CO for the decrement of thoracic hyperkyphosis angle (48.20-42.80°) than in CO (47.66°-46.59°), and scapular position improved more (P = .003) in EX (1.48°-1.20°) than in CO (1.44°-1.42°). Forced vital capacity (P = .001) and forced expiratory volume in 1 second (P = .001) significantly increased in EX (FVC: 2.65-3.40 L; FEV1: 2.32-2.74 L), while they remained stable in CO. Happiness levels significantly improved (P = .001) in EX (42.20-49.79) and slightly decreased in CO (41.80-40.15). CONCLUSIONS: The 8-week dance program improved posture, scapular position, breathing, and happiness in girls aged 10-12 years. It enhances physical health, emotional well-being, and social skills in children and adolescents.

Prone position ventilation for the relief of acute respiratory distress syndrome through improved pulmonary ventilation: Efficacy and safety.

BACKGROUND: At present, there is a preliminary clinical consensus that prone position ventilation (PPV) is beneficial to the treatment of acute respiratory distress syndrome (ARDS), and further research on the details of treatment and patients' benefits will help to assess its effectiveness and safety. AIM: To evaluate the timing, efficacy, and safety of different mechanical ventilation positions (MVP) in treating ARDS. STUDY DESIGN: The results of clinical trials were directly or indirectly compared by network meta-analysis to compare the effects of different MVP. Two authors independently searched the papers published in PubMed, Embase, Cochrane Library, China Knowledge Infrastructure (CNKI), China Biomedical Discs (CBM), WanFang, and VIP database from January 2000 to August 2022. The outcome indicators were oxygenation index, mechanical ventilation time, ICU hospitalization time, in-hospital mortality, and incidence of adverse events. Two authors independently screened the literature, evaluated the quality of the studies, and completed the data extraction. Stata 14.0 was used to conduct a network Meta-analysis, and the intervention measures were ranked according to the surface under the cumulative ranking curve (SUCRA). Funnel plots were drawn to evaluate publication bias. RESULTS: According to the inclusion and exclusion criteria, 75 studies (including 6333 patient data) were finally included. According to the analysis results, PPV was the best for improving the oxygenation index. The SUCRA values of mechanical ventilation time, ICU hospitalization time, and in-hospital mortality were ranked as PPV > lateral position ventilation (LPV) > supine position ventilation (SuPV) > semireclining position ventilation (SePV). The SUCRA values in the incidence of adverse events were ranked as LPV > PPV > SuPV > SePV. All outcome measures had good consistency and low statistical heterogeneity. Funnel plot analysis shows that papers reported within three days of mechanical ventilation time, over five days of mechanical ventilation time, and in-hospital mortality were more likely to have publication bias. CONCLUSIONS: PPV has the best effect on improving the oxygenation index, reducing mechanical ventilation time, shortening ICU hospitalization time, and reducing in-hospital mortality. Early and long-term use of PPV to improve pulmonary ventilatory function will be the key to improving patients' survival and quality of life with ARDS. RELEVANCE TO CLINICAL PRACTICE: PPV significantly affects patients with ARDS, which can shorten the treatment time and reduce hospital costs. During the treatment, nursing observation should be strengthened to prevent adverse events.

[Control status and follow-up of acute attacks in children with bronchial asthma with normal pulmonary ventilation function]. / è‚ºé€šæ°”åŠŸèƒ½æ­£å¸¸çš„å„¿ç«¥æ”¯æ°”ç®¡å“®å–˜æŽ§åˆ¶æƒ å†µåŠæ€¥æ€§å‘ä½œéšè®¿çš„ç ”ç©¶.

OBJECTIVES: To investigate the control status of bronchial asthma (referred to as "asthma") in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up. METHODS: A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021. Based on the measured value of one second rate (FEV1/FVC), the children were divided into the ≥80% group (267 cases) and the <80% group (60 cases). The pulmonary ventilation function, asthma control level, and occurrence of acute attacks within 1 year were compared between the two groups. RESULTS: The baseline pulmonary ventilation function in the <80% group was lower than that in the ≥80% group, and the proportion of small airway dysfunction was higher than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the small airway function indices in the <80% group improved but remained lower than those in the ≥80% group (P<0.05). The rate of incomplete asthma control at baseline was 34.6% (113/327), and the asthma control level in the <80% group was lower than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the asthma control level in the <80% group remained lower than that in the ≥80% group, and the proportion of acute asthma attacks was higher than that in the ≥80% group (P<0.05). CONCLUSIONS: Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal. Among them, children with measured FEV1/FVC<80% have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.

[Diagnostic efficacy of serum 14-3-3ß protein combined with fractional exhaled nitric oxide and conventional ventilatory lung function parameters for bronchial asthma in children]. / è¡€æ¸ 14-3-3ß蛋白联合呼出气一氧化氮及常规通气肺功能参数对儿童支气管哮喘的诊断效能.

OBJECTIVES: To explore the diagnostic efficacy of serum 14-3-3ß protein combined with fractional exhaled nitric oxide (FeNO) and conventional ventilatory lung function parameters in diagnosing bronchial asthma (referred to as "asthma") in children. METHODS: A prospective study included 136 children initially diagnosed with asthma during an acute episode as the asthma group, and 85 healthy children undergoing routine health checks as the control group. The study compared the differences in serum 14-3-3ß protein concentrations between the two groups, analyzed the correlation of serum 14-3-3ß protein with clinical indices, and evaluated the diagnostic efficacy of combining 14-3-3ß protein, FeNO, and conventional ventilatory lung function parameters for asthma in children. RESULTS: The concentration of serum 14-3-3ß protein was higher in the asthma group than in the control group (P<0.001). Serum 14-3-3ß protein showed a positive correlation with the percentage of neutrophils and total serum immunoglobulin E, and a negative correlation with conventional ventilatory lung function parameters (P<0.05). Cross-validation of combined indices showed that the combination of 14-3-3ß protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume had an area under the curve of 0.948 for predicting asthma, with a sensitivity and specificity of 88.9% and 93.7%, respectively, demonstrating good diagnostic efficacy (P<0.001). The model had the best extrapolation. CONCLUSIONS: The combination of serum 14-3-3ß protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume can significantly improve the diagnostic efficacy for asthma in children. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 723-729.

Neoadjuvant immune checkpoint inhibitor therapy and chemotherapy improve pulmonary ventilation and diffusion function in patients with lung cancer. / å ç–«æ£€æŸ¥ç‚¹æŠ‘åˆ¶å‰‚è”åˆåŒ–ç–—æ”¹å–„ä¸­æ™šæœŸè‚ºç™Œæ‚£è€ è‚ºé€šæ°”åŠŸèƒ½å’Œå¼¥æ•£åŠŸèƒ½.

OBJECTIVES: To investigate changes of pulmonary ventilation function and diffusion function in lung cancer patients after neoadjuvant immune checkpoint inhibitors (ICIs) therapy combined with chemotherapy treatment. METHODS: Patients with newly diagnosed lung cancer (Ⅱa-Ⅲb) admitted to Zhejiang Cancer Hospital from October 2021 to July 2022, who received ICIs combined with chemotherapy for more than two courses were enrolled. Patients underwent pulmonary ventilation function and diffusion function assessments before and after treatment. The demographic information, sizes and locations of cancer lesions, doses and duration of ICIs used, pulmonary function results before and after treatment, and the tumor regression were documented. The changes of pulmonary function parameters before and after the treatment were analyzed with paired t test and Wilcoxon rank-sum test. The factors influencing the pulmonary function changes were analyzed by multiple linear Lasso regression and ridge regression. RESULTS: Among the 52 patients, 50 cases were males (96.15%) and 43 cases were squamous carcinoma (82.69%). The medium age of the patients was 67 years. After neoadjuvant therapy, 36 patients (69.23%) showed remission of tumor lesions. After treatment, the parameters of pulmonary ventilation inspiratory vital capacity (IVC) and the area under the expiratory flow-volume curve (AREAex), and the parameter of pulmonary diffusion total lung capacity increased compared with the baseline (all P<0.05). Forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) also showed an increasing trend. Multivariate linear Lasso regression and ridge regression showed that baseline IVC had a significant negative effect on IVC improvement (Beta=－0.435, t=－2.968, P<0.01), baseline TLC had a significant negative effect on the improvement of TLC (Beta=－0.266, t=－2.474, P<0.05), and the remission of obstructive pneumonia favored the improvement of TLC (Beta=0.308, t=2.443, P<0.05). CONCLUSIONS: After ICIs neoadjuvant treatment combined with chemotherapy, the lung ventilation and diffusion function can be improved in lung cancer patients, particularly for those with reduced baseline ventilation and diffusion function.

Serum intracellular adhesion molecule-1 and interleukin-8 as predictors of pulmonary impairment among workers in secondary copper smelters.

OBJECTIVE: Copper smelter workers are exposed to harmful chemical agents in dust and fumes which contain harmful metals such as copper and arsenic. These substances are known to be respiratory irritants. METHODS: This study aimed at investigating the effect of occupational exposure to copper and arsenic on the respiratory system. A group of 75 male exposed workers, and 75 male administrative employees (control group) were recruited from a secondary copper smelting factory. Full history, complete clinical examination, ventilatory function parameters (FVC, FEV1, FVC/FEV1 and FEF), and chest X-ray were done for both groups. Serum levels of ICAM-1 and IL8 (as markers of epithelial injury) were measured by ELISA. Serum copper and arsenic were measured by atomic absorption spectrophotometer. RESULTS: The exposed group was associated with increased respiratory symptoms, higher serum copper, arsenic, and ICAM-1and Il-8 as compared to the control group. There was a significant decrease in ventilatory parameters among the exposed group: 58.7% of the exposed group had restrictive lung impairment, 40% had obstructive impairment. In the exposed group a positive correlation between serum copper, arsenic and serum ICAM and IL8 was found. While a negative correlation was observed between both serum ICAM, IL8 and ventilatory parameters among the exposed group. Moreover, 36% of the exposed group had radiological infiltrates on chest X.ray. CONCLUSION: Occupational exposure to copper and arsenic was associated with ventilatory and radiological impairment, with a corresponding increase in the serum level of ICAM-1 and IL8, which can be used as biomarkers for pulmonary impairment among copper smelter workers.

A randomized placebo-controlled study investigating the efficacy of inspiratory muscle training in the treatment of children with bronchial asthma.

OBJECTIVE: To investigate the efficacy of inspiratory muscle training (IMT) on respiratory functions, respiratory muscle strength, and asthma symptoms in asthmatic children. METHODS: In a randomized placebo-controlled assessor-blinded study, 34 children with asthma were randomized to receive either the IMT at 40% of the maximal inspiratory pressure (IPmax) for 20 min/session, thrice/week, over 12 consecutive weeks (IMT group; n = 17) or placebo IMT at 5% of IPmax (placebo group; n = 17). Additionally, both groups received the conventional respiratory rehabilitation (CRR) program. Outcome measurements performed pre- and post-treatment, included respiratory functions [forced expiratory volume at the first second (FEV1), forced vital capacity (FEV), and FEV1/FVC], respiratory muscle strength [represented by IPmax and maximal expiratory pressure (EPmax), and asthma control test (ACT). RESULTS: At a significance level adjusted to P<.008, there were significant post-treatment differences between the IMT and placebo groups in FEV1 (P=.003), FVC (P=.001), FEV1/FVC (P=.004), IPmax (P=.002), EPmax (P=.004), and ACT (P=.001) adjusted to the pretreatment values, in favor of the IMT group. CONCLUSION: Incorporation of IMT in the CRR program for children with asthma can improve respiratory function, enhance respiratory muscle strength, and improve children's perception of asthma symptoms.

The effectiveness of short-term high-intensity exercise on ventilatory function, in adults with a high risk of chronic obstructive pulmonary disease.

[Purpose] This study sets out to investigate whether a short-term high-intensity arm ergometer exercise plan can be of benefit to adults whose poor ventilatory function places them at risk of developing chronic obstructive pulmonary disease. [Subjects and Methods] A pre-experimental design with a convenience sample was employed. The study enrolled 30 adult smokers, aged between 18-25 years old, all of whom were at a high risk of chronic obstructive pulmonary disease. The participants did a daily 20-minute high-intensity arm ergometer exercise, at 75% target heart rate, at the same time over a period of three days. The forced vital capacity test manoeuvre was carried out before the sessions, and once all three had been done. [Results] The study demonstrated a sizeable increase in the mean values of forced vital capacity and forced expiratory volume in one second. The mean values of expiratory volume in one second/forced vital capacity as well as peak expiratory flow rate were not significant statistically. [Conclusion] Although further studies, using larger sampling groups, need to be carried out, this research demonstrates that adults at high risk of chronic obstructive pulmonary disease improve lung function by following short-term high-intensity arm ergometer exercise.

GAL-021, a new intravenous BKCa-channel blocker, is well tolerated and stimulates ventilation in healthy volunteers.

BACKGROUND: Potassium-channels in the carotid body and the brainstem are important regulators of ventilation. The BKCa-channel contains response elements for CO, O2, and CO2. Its block increases carotid body signalling, phrenic nerve activity, and respiratory drive. GAL-021, a new BKCa-channel blocker, increases minute ventilation in rats and non-human primates. This study assessed the single-dose safety, tolerability, pharmacokinetics (PKs), and pharmacodynamics (PDs) of GAL-021 in healthy volunteers. METHODS: Thirty subjects participated in a nine-period, randomized, double-blinded, placebo-controlled, crossover, ascending dose, first-in-human study with i.v. infusions of 0.1-0.96 mg kg(-1) h(-1) for 1 h and intermediate doses up to 4 h. RESULTS: Adverse event rates were generally similar among dose levels and between placebo- and GAL-021-treated subjects. At higher GAL-021 doses, a mild/moderate burning sensation at the infusion site occurred during the infusion. No clinically significant changes in vital signs or clinical chemistries were noted. Minute ventilation increased (AUE0-1 h ≈ 16%, P<0.05) and end-tidal carbon dioxide ([Formula: see text]) decreased (AUE0-1 h ≈ 6%, P<0.05) during the first hour at 0.96 mg kg(-1) h(-1) with 1/2-maximal [Formula: see text] and [Formula: see text]-change occurring by 7.5 min. Drug concentration rose rapidly during the infusion and decreased rapidly initially (distribution t1/2 of 30 min) and then more slowly (terminal t1/2 of 5.6 h). CONCLUSIONS: GAL-021 was safe and generally well tolerated with adverse events comparable with placebo except for an infusion site burning sensation. GAL-021 stimulated ventilation at the highest doses suggesting that greater infusion rates may be required for maximum PD effects. GAL-021 had PK characteristics consistent with an acute care medication.

Comparison of the International Classification of High-resolution Computed Tomography for occupational and environmental respiratory diseases with the International Labor Organization International Classification of Radiographs of Pneumoconiosis.

The International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases (ICOERD) has been developed for screening and diagnosis of occupational lung diseases. We evaluated the association of icoerd with the International Labor Organization (ILO) classification and respiratory functions in pneumoconiosis. Chest x-rays of patients with pneumoconiosis were classified with ilo and icoerd using hrct, irregular opacity, pleural pathology, and emphysema was detected in 78, 19, and 53 patients, and using chest x-rays in 47, 4, and 14 patients, respectively. There was a significant correlation between ILO categories and ICOERD grades. There was a negative correlation between ILO categories and FEV1% and FVC%, whereas, ICOERD grades were not correlated with FEV1% and FVC%. HRCT was superior to chest x-rays to detect pneumoconiosis in early stage, but not in evaluating pulmonary functions.

A restrictive ventilatory pattern is common in patients with univentricular heart after Fontan palliation and associated with a reduced exercise capacity and quality of life.

AIM: The Fontan circulation is highly dependent on ventilation, improving pulmonary blood flow and cardiac output. A reduced ventilatory function is reported in these patients. The extent of this impairment and its relation to exercise capacity and quality of life is unknown and objective of this study. METHODS: This multicenter retrospective/cross-sectional study included 232 patients (140 females, age 25.6 ± 10.8 years) after Fontan palliation (19.8% atrioventricular connection; 20.3% atriopulmonary connection; 59.9% total cavopulmonary connection). Resting spirometry, cardiopulmonary exercise tests, and quality-of-life assessment (SF-36 questionnaire) were performed between 2003 and 2015. RESULTS: Overall, mean forced expiratory volume in one second (FEV1 ) was 74.7 ± 17.8%predicted (%pred). In 59.5% of the patients, FEV1 was <80%pred., and all of these patients had FEV1 /forced vital capacity (FVC) > 80%, suggestive of a restrictive ventilatory pattern. Reduced FEV1 was associated with a reduced peakVO2 of 67.0 ± 17.6%pred. (r = 0.43, P < .0001), even if analyzed together with possible confounding factors (sex, BMI, age, years after palliation, number of interventions, scoliosis, diaphragmatic paralysis). Synergistically to exercise capacity, FEV1 was associated to quality of life in terms of physical component summary (r = 0.30, P = .002), physical functioning (r = 0.25, P = .008), bodily pain (r = 0.22, P = .02), and general health (r = 0.16, P = .024). Lower FEV1 was associated with diaphragmatic paralysis (P = .001), scoliosis (P = .001), higher number of interventions (P = .002), and lower BMI (P = .01). No correlation was found to ventricular morphology, type of surgeries, or other perioperative/long-term complications. CONCLUSIONS: This study shows that the common restrictive ventilatory pattern in Fontan patients is associated with lower exercise capacity and quality of life. Risk factors are diaphragmatic paralysis, scoliosis, a high total number of interventions and low BMI.

Changes in Lung Function Measures Following Bhastrika Pranayama (Bellows Breath) and Running in Healthy Individuals.

BACKGROUND: The purpose of this study was to observe the effect of bhastrika pranayama (bellows breath) and exercise on lung function of healthy individuals. MATERIALS AND METHODS: A total of thirty male participants were recruited and randomly divided into two groups, i.e., yoga breathing group (YBG, n = 15) and physical exercise group (PEG, n = 15), and the participants' ages ranged between 18 and 30 years (group age mean ± standard deviation, 22.5 ± 1.9 years). YBG practiced bhastrika pranayama for 15 min, whereas PEG practiced running for 15 min, 6 days in a week, over a period of 1 month. The participants were assessed for (i) forced vital capacity (FVC), (ii) forced expiratory volume in the first second (FEV1), (iii) peak expiratory flow rate (PEFR), and (iv) maximum voluntary ventilation (MVV) functions of lungs. RESULTS: Repeated-measures analyses of variance with Bonferroni adjustment post hoc analyses of multiple comparisons showed that there was a significant increase in YBG for all variables, i.e., FVC, FEV1, PEFR, and MVV (P < 0.001, P < 0.001, P < 0.01, and P < 0.001, respectively), whereas there was a significant increase in PEFR and MVV (P < 0.05 and P < 0.01, respectively) only, among PEG. However, the change in PEG was less of magnitude as compared to YBG. CONCLUSIONS: These findings demonstrate that incorporating pranayama in sports can enhance the efficiency of healthy individuals and athletes by enhancing the ventilatory functions of lungs, especially for those who partake in aerobic-based sports and require efficient lungs to deliver sufficient oxygen uptake.

Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study.

Objective This observational cohort study aimed to evaluate ventilatory function (VF) and functional exercise capacity (FEC) in mild adolescent idiopathic scoliosis (AIS). Methods Seventy-three adolescents with idiopathic scoliosis, aged approximately 10 to 17 years (mean age: 13.43 ± 1.27 years), with a Cobb angle less than 20° (mean: 16.44° ± 1.59°), met the inclusion criteria and were assigned to group A. Another 34 healthy adolescents with normal VF and FEC served as controls (group B). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV), and FEC (by the 6-minute walk test [6MWT]) were the main outcome measures. Results Post-study mean values of FVC, FEV1, FEV1/FVC, MVV, and the 6MWT were 2.42 ± 0.36 L and 3.26 ± 0.59 L, 2.14 ± 0.31 L and 3.03 ± 0.43 L, 88.13% ± 3.89% and 91.14% ± 4.67%, 76.96 ± 6.85 L/m and 107.61 ± 11.44 L/m, and 581.12 ± 12.25 m and 627.74 ± 15.27 m in groups A and B, respectively. Between-group comparisons showed significant differences in FVC, FEV1, FEV1/FVC, MVV, and the 6MWT. Conclusion Mild pulmonary and functional restrictions start early in mild AIS. This issue requires immediate intervention to prevent further deterioration.

Nanoconjugate-bound adenosine A1 receptor antagonist enhances recovery of breathing following acute cervical spinal cord injury.

Respiratory complications in patients with spinal cord injury (SCI) are common and can have a negative impact on the quality of patients' lives. Previously, we found that intradiaphragmatic administration of the nanoconjugate-bound A1 adenosine receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) induced recovery of diaphragm function following SCI in rats. When administered immediately following the injury, recovery was observed as early as 3days following SCI and it persisted until the end of the study, 28days after the drug delivery. The recovery was observed using diaphragmatic electromyography (EMG) as well as phrenic nerve recordings; both of which were conducted under anesthetized conditions. Confounding effects of anesthetic may make data interpretation complex in terms of the impact on overall ventilatory function and clinical relevance. The objective of the present study was to test the hypothesis that intradiaphragmatic administration of nanoconjugate-bound DPCPX, enhances recovery of ventilation following SCI in the unanesthetized rat. To that end, Sprague-Dawley rats underwent C2 spinal cord hemisection (C2Hx) on day 0 and received either: (i) 0.15µg/kg of nanoconjugate-bound DPCPX or (ii) vehicle control (50µl distilled water). To assess ventilation, unrestrained whole body plethysmography (WBP) was performed on day 0 (immediately before the surgery) and 3, 7, 14, 21 and 28days following the SCI. Frequency, tidal volume, and minute ventilation data were analyzed in two minute bins while the animal was calm and awake. We found that a single administration of the nanoconjugate-bound A1 adenosine receptor antagonist facilitated recovery of tidal volume and minute ventilation following SCI. Furthermore, the treatment attenuated SCI-associated increases in respiratory frequency. Taken together, this study suggests that the previously observed DPCPX nanoconjugate-induced recovery in diaphragmatic and phrenic motor outputs may translate to a clinically meaningful improvement in ventilatory function in patients with SCI.

Ventilatory Dysfunction in Parkinson's Disease.

In contrast to some other neurodegenerative diseases, little is known about ventilatory dysfunction in Parkinson's disease (PD). To assess the spectrum of ventilation disorders in PD, we searched for and reviewed studies of dyspnea, lung volumes, respiratory muscle function, sleep breathing disorders and the response to hypoxemia in PD. Among the studies, we identified some limitations: (i) small study populations (mainly composed of patients with advanced PD), (ii) the absence of long-term follow-up and (iii) the absence of functional evaluations under "off-drug" conditions. Although there are many reports of abnormal spirometry data in PD (mainly related to impairment of the inspiratory muscles), little is known about hypoventilation in PD. We conclude that ventilatory dysfunction in PD has been poorly studied and little is known about its frequency and clinical relevance. Hence, there is a need to characterize the different phenotypes of ventilation disorders in PD, study their relationships with disease progression and assess their prognostic value.

Occupational exposure to asthmagens and adult onset wheeze and lung function in people who did not have childhood wheeze: A 50-year cohort study.

BACKGROUND: There are few prospective studies that relate the development of adult respiratory disease with exposure to occupational asthmagens. OBJECTIVE: To evaluate the risk of adult onset wheeze (AOW) and obstructive lung function associated with occupational exposures over 50years. METHODS: A population-based randomly selected cohort of children who had not had asthma or wheezing illness, recruited in 1964 at age 10-15years, was followed-up in 1989, 1995, 2001 and 2014 by spirometry and respiratory questionnaire. Occupational histories were obtained in 2014 and occupational exposures determined with an asthma-specific job exposure matrix. The risk of AOW and lung function impairment was analysed in subjects without childhood wheeze using logistic regression and linear mixed effects models. RESULTS: All 237 subjects (mean age: 61years, 47% male, 52% ever smoked) who took part in the 2014 follow-up had completed spirometry. Among those who did not have childhood wheeze, spirometry was measured in 93 subjects in 1989, in 312 in 1995 and in 270 subjects in 2001 follow-up. For longitudinal analysis of changes in FEV1 between 1989 and 2014 spirometry records were available on 191 subjects at three time points and on 45 subjects at two time points, with a total number of 663 records. AOW and FEV1

Abnormal ventilatory response to exercise in young adults operated for ventricular septal defect in early childhood: A long-term follow-up.

BACKGROUND: Ventricular septal defects (VSDs) are normally closed in early childhood, and postsurgical physical capacity is generally considered normal. Despite an increasing understanding of late cardiac morbidity among these patients, long-term pulmonary function remains to be investigated. Therefore, the aim of this prospective follow-up study was to describe ventilatory function during exercise in VSD-repaired adults operated in early life. METHODS: We tested cardiopulmonary exercise capacity in 27 patients and 30 healthy control subjects on an ergometer cycle. Each test was preceded by a standard spirometry, and the exercise test was performed as a maximal incremental test. Pulmonary ventilation and gas exchange were simultaneously measured breath-by-breath with minute ventilation at peak exercise as our main endpoint. RESULTS: In the VSD-group the median surgical age was 1.9 (95% CI 1.1-2.8 years) and the mean age at time of examination was 21.1 ± 3.1 years in the VSD-group vs. 21.2 ± 2.5 years in the control group. Mean minute ventilation at peak exercise was significantly lower in the VSD-group compared with the controls: 1.4 ± 0.4 L/kg/min vs. 1.8 ± 0.4 L/kg/min, p<0.01. Likewise, mean oxygen uptake was reduced: 38.0 ± 8.2 ml/kg/min in the VSD-cohort vs. 47.9 ± 6.5 ml/kg/min among controls, p<0.01. In terms of breath rate and ventilatory equivalents (O2 and CO2) there were no differences between the groups. CONCLUSIONS: Patients with a surgically closed VSD have a markedly abnormal ventilatory response to exercise with significantly reduced minute ventilation despite a similar breath rate. With a follow-up of almost two decades our finding most certainly reflects an unknown but persisting abnormality.

Sonotubometry, a useful tool for the evaluation of the Eustachian tube ventilatory function.

From the three Eustachian tube (ET) functions: middle ear protection, secretion clearance and middle ear ventilation, the ventilatory function is unanimously considered the most important one, because proper hearing is established only when tympanic membrane compliance is normal. This requires equilibrium between the middle ear and ambient gas pressure, which makes the normal functioning of active ET opening of critical importance. There are several methods and tests that can assess such a complex and variable mechanism. Sonotubometry is one such method; despite the fact that it has been continuously improved in the last 20 years, it is not yet systematically used to evaluate the ET ventilatory function, because its measurement pattern, context mapping (patient, clinic data, medication, treatment), validation, reproducibility and value for clinic practice, have not yet been fully consolidated and integrated in a knowledge-based, service-oriented system, that can provide decision support or even diagnostic. The paper reviews the role of tubal sonometry as a non-invasive, physiologic and easy to use method in assessing the ventilatory function and investigates the validity and reproducibility of a measuring pattern and test in a group of children. The paper describes the test pattern used, and the computer-based platform based on: (1) Digital Signal Processing (DSP) for sound acquisition and low-level processing; (2) Artificial Intelligence techniques to extract significant sound features from sonotubograms and learn a manifold context database. Results are reported from test series carried out in healthy children; a similar study between tests is included in the final Discussions section.