A novel hyperbaric swimming respirometer allows the simulation of varying swimming depths in fish respirometry studies.

The understanding of swimming physiology and knowledge on the metabolic costs of swimming are important for assessing effects of environmental factors on migratory behavior. Swim tunnels are the most common experimental setups for measuring swimming performance and oxygen uptake rates in fishes; however, few can realistically simulate depth and the changes in hydrostatic pressure that many fishes experience, e.g. during diel vertical migrations. Here, we present a new hyperbaric swimming respirometer (HSR) that can simulate depths of up to 80 m. The system consists of three separate, identical swimming tunnels, each with a volume of 205 L, a control board and a storage tank with water treatment. The swimming chamber of each tunnel has a length of 1.40 m and a diameter of 20 cm. The HSR uses the principle of intermittent-flow respirometry and has here been tested with female European eels (Anguilla anguilla). Various pressure, temperature and flow velocity profiles can be programmed, and the effect on metabolic activity and oxygen consumption can be assessed. Thus, the HSR provides opportunities to study the physiology of fish during swimming in a simulated depth range that corresponds to many inland, coastal and shelf waters.

Effect of postoperative high load long duration inspiratory muscle training on pulmonary function and functional capacity after mitral valve replacement surgery: A randomized controlled trial with follow-up.

OBJECTIVES: Although, pre-operative inspiratory muscle training has been investigated and reported to be an effective strategy to reduce postoperative pulmonary complications, the efficacy of postoperative inspiratory muscle training as well as the proper load, frequency, and duration necessary to reduce the postoperative pulmonary complications has not been fully investigated. This study was designed to investigate the effect of postoperative high-load long-duration inspiratory muscle training on pulmonary function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries. DESIGN: Prospective randomized controlled trial. METHODS: A total of one hundred patients (mean age 38.3±3.29years) underwent mitral valve replacement surgery were randomized into experimental (n = 50) and control (n = 50) groups. The control group received conventional physiotherapy care, while experimental group received conventional care in addition to inspiratory muscle training, with 40% of the baseline maximal inspiratory pressure targeting a load of 80% by the end of the 8 weeks intervention protocol. Inspiratory muscle training started on the patient's first day in the inpatient ward. Lung functions, inspiratory muscle strength, and functional capacity were evaluated using a computer-based spirometry system, maximal inspiratory pressure measurement and 6MWT respectively at 5 time points and a follow-up assessment was performed 6 months after surgery. Repeated measure ANOVA and post-hoc analyses were used (p <0.05). RESULTS: Group-time interactions were detected for all the studied variables (p<0.001). Between-group analysis revealed statistically significant postoperative improvements in all studied variables in the experimental group compared to the control group (p <0.001) with large effect size of η2 ˃0.14. Within-group analysis indicated substantial improvements in lung function, inspiratory pressure and functional capacity in the experimental group (p <0.05) over time, and these improvements were maintained at follow-up. CONCLUSION: High intensity, long-duration postoperative inspiratory muscle training is highly effective in improving lung function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries.

Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century.

In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn-Jatima from Almeria, wrote "Treatise on the Plague", in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty.

Effect of tiger milk mushroom (Lignosus rhinocerus) supplementation on respiratory health, immunity and antioxidant status: an open-label prospective study.

Tiger milk mushroom (TMM; Lignosus rhinocerus) have been used for a long time by indigenous communities in South East Asia regions as traditional medicine for different ailments, including respiratory disorders. The beneficial effects of TMM have been proven through in vivo and in vitro models, but these effects have yet to be validated in a clinical study. In this study, the beneficial effects of TMM supplementation were investigated in 50 voluntary participants. Participants were required to take 300 mg of TMM twice daily for three months. Level of interleukin 1ß (IL-1ß), interleukin 8 (IL-8), immunoglobulin A (IgA), total antioxidant capacity, malondialdehyde (MDA), 3-nitrotyrosine (3-NT), 8-hydroxydeoxyguanosine (8-OHdG), pulmonary function and respiratory symptoms were assessed during baseline and monthly follow-up visits. Results demonstrated that supplementation of TMM significantly (p < 0.05) suppressed the level of IL-1ß, IL-8, MDA, as well as respiratory symptoms. In additional to that, TMM also significantly (p < 0.05) induced the level of IgA, total antioxidant capacity, as well as pulmonary function. Analyses of data indicated that gender and BMI were factors influencing the outcomes of antioxidant status. Collectively, our findings suggested that TMM supplementation effectively improves respiratory health, immunity and antioxidant status.

Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: a state-of-the-art review.

Breath-hold diving is an activity that humans have engaged in since antiquity to forage for resources, provide sustenance and to support military campaigns. In modern times, breath-hold diving continues to gain popularity and recognition as both a competitive and recreational sport. The continued progression of world records is somewhat remarkable, particularly given the extreme hypoxaemic and hypercapnic conditions, and hydrostatic pressures these athletes endure. However, there is abundant literature to suggest a large inter-individual variation in the apnoeic capabilities that is thus far not fully understood. In this review, we explore developments in apnoea physiology and delineate the traits and mechanisms that potentially underpin this variation. In addition, we sought to highlight the physiological (mal)adaptations associated with consistent breath-hold training. Breath-hold divers (BHDs) are evidenced to exhibit a more pronounced diving-response than non-divers, while elite BHDs (EBHDs) also display beneficial adaptations in both blood and skeletal muscle. Importantly, these physiological characteristics are documented to be primarily influenced by training-induced stimuli. BHDs are exposed to unique physiological and environmental stressors, and as such possess an ability to withstand acute cerebrovascular and neuronal strains. Whether these characteristics are also a result of training-induced adaptations or genetic predisposition is less certain. Although the long-term effects of regular breath-hold diving activity are yet to be holistically established, preliminary evidence has posed considerations for cognitive, neurological, renal and bone health in BHDs. These areas should be explored further in longitudinal studies to more confidently ascertain the long-term health implications of extreme breath-holding activity.

The Relationship between Resistance Exercise Performance and Ventilatory Efficiency after Beetroot Juice Intake in Well-Trained Athletes.

The assessment of ventilatory efficiency is critical to understanding the matching of ventilation (VE) and perfusion in the lungs during exercise. This study aimed to establish a causal physiological relationship between ventilatory efficiency and resistance exercise performance after beetroot juice (BJ) intake. Eleven well-trained males performed a resistance exercise test after drinking 140 mL of BJ (~12.8 mmol NO3-) or a placebo (PL). Ventilatory efficiency was assessed by the VE•VCO2-1 slope, the oxygen uptake efficiency slope and the partial pressure of end-tidal carbon dioxide (PetCO2). The two experimental conditions were controlled using a randomized, double-blind crossover design. The resistance exercise test involved repeating the same routine twice, which consisted of wall ball shots plus a full squat (FS) with a 3 min rest or without a rest between the two exercises. A higher weight lifted was detected in the FS exercise after BJ intake compared with the PL during the first routine (p = 0.004). BJ improved the VE•VCO2-1 slope and the PetCO2 during the FS exercise in the first routine and at rest (p < 0.05). BJ intake improved the VE•VCO2-1 slope and the PetCO2 coinciding with the resistance exercise performance. The ergogenic effect of BJ could be induced under aerobic conditions at rest.

Ansa Cervicalis Stimulation: A New Direction in Neurostimulation for OSA.

BACKGROUND: Hypoglossal nerve stimulation (HNS) is an alternative treatment option for patients with OSA unable to tolerate positive airway pressure but implant criteria limit treatment candidacy. Previous research indicates that caudal tracheal traction plays an important role in stabilizing upper airway patency. RESEARCH QUESTION: Does contraction of the sternothyroid muscle with ansa cervicalis stimulation (ACS), which pulls the pharynx caudally via thyroid cartilage insertions, increase maximum inspiratory airflow (VImax)? STUDY DESIGN AND METHODS: Hook-wire percutaneous electrodes were used to stimulate the medial branch of the right hypoglossal nerve and right branch of the ansa cervicalis innervating the sternothyroid muscle during propofol sedation. VImax was assessed during flow-limited inspiration with a pneumotachometer. RESULTS: Eight participants with OSA were studied using ACS with and without HNS. Compared with baseline, the mean VImax increase with isolated ACS was 298%, or 473 mL/s (95% CI, 407-539). Isolated HNS increased mean VImax from baseline by 285%, or 260 mL/s (95% CI, 216-303). Adding ACS to HNS during flow-limited inspiration increased mean VImax by 151%, or 205 mL/s (95% CI, 174-236) over isolated HNS. Stimulation was significantly associated with increase in VImax in both experiments (P < .001). INTERPRETATION: ACS independently increased VImax during propofol sedation and drove further increases in VImax when combined with HNS. The branch of the ansa cervicalis innervating the sternothyroid muscle is easily accessed. Confirmation of the ansa cervicalis as a viable neurostimulation target may enable caudal pharyngeal traction as a novel respiratory neurostimulation strategy for treating OSA.

Adenosine in the lateral hypothalamus/perifornical area does not participate on the CO2 chemoreflex.

The Lateral Hypothalamus/Perifornical Area (LH/PFA) has been shown to be involved with the hypercapnic ventilatory response, in a state-dependent manner. We have demonstrated that purinergic signaling through ATP in the LH/PFA has an excitatory effect in ventilatory response to CO2 in awake rats in the dark phase of the diurnal cycle, but it is unknown whether the ATP metabolite adenosine, acting in the LH/PFA, modulates the ventilatory responses to hypercapnia. Here, we studied the effects of the microdialysis of adenosine (A1/A2 adenosine receptors agonist; 17 mM) and an A1 receptor antagonist (DPCPX; 0.1 mM) into the LH/PFA of conscious rats on ventilation in room air and in 7% CO2 during the light and the dark phases of the diurnal cycle. The microdialysis of adenosine and DPCPX caused no change in the CO2 ventilatory responses of rats during wakefulness or NREM sleep in either the dark or light period. Our data suggest that adenosine in the LH/PFA does not contribute to the hypercapnic ventilatory response in conscious rats.

The effects of acute yoga on anxiety symptoms in response to a carbon dioxide inhalation task in women.

PURPOSE: We investigated the efficacy of yoga for improving cognitive and physical anxiety symptoms, and its possible respiratory mechanism, in high-anxious women. METHODS: Eighteen participants completed 40 min of guided yoga and a light stretching protocol in a randomized, counterbalanced order.The 7.5%CO2-inhalation task was administered before, immediately after and 1 h after the experimental conditions.State anxiety and panic were measured before and after each inhalation task.Tidal volume, ventilation and respiratory rate were measured during every 7.5%CO2-inhalation tasks. RESULTS: There was no significant 3-way interaction(p > .05).There was a significant main effect of CO2-inhalation task on panic and respiratory measures(p < .05).When collapsed over inhalation task and condition, there was a small reduction in cognitive anxiety from baseline to immediately post and 1 -h post-condition(p < .05). CONCLUSIONS: There appears to be an overall effect of general physical activity for attenuating anxiety cognitions irrespective of the physiological changes, indicating possible dissociation between the cognitive and physical symptoms of anxiety among women with anxiety sensitivity.

Effects of inspiratory muscle-training intensity on cardiovascular control in amateur cyclists.

Chronic effects of inspiratory muscle training (IMT) on autonomic function and baroreflex regulation are poorly studied. This study aims at evaluating chronic effects of different IMT intensities on cardiovascular control in amateur cyclists. A longitudinal, randomized, controlled blind study was performed on 30 recreational male cyclists undergoing IMT for 11 wk. Participants were randomly allocated into sham-trained group (SHAM, n = 9), trained group at 60% of the maximal inspiratory pressure (MIP60, n = 10), and trained group at critical inspiratory pressure (CIP, n = 11). Electrocardiogram, finger arterial pressure, and respiratory movements were recorded before (PRE) and after (POST) training at rest in supine position (REST) and during active standing (STAND). From the beat-to-beat series of heart period (HP) and systolic arterial pressure (SAP), we computed time domain markers, frequency domain indexes in the low frequency (0.04-0.15 Hz) and high frequency (HF, 0.15-0.4 Hz) bands, an entropy-based complexity index (CI), and baroreflex markers estimated from spontaneous HP-SAP sequences. Compared with SHAM, the positive effect of MIP60 over the HP series led to the HF power increase during REST (PRE: 521.2 ± 447.5 ms2; POST: 1,161 ± 878.9 ms2) and the CI rise during STAND (PRE: 0.82 ± 0.18; POST: 0.97 ± 0.13). Conversely, the negative effect of CIP took the form of the decreased HP mean during STAND (PRE: 791 ± 71 ms; POST: 737 ± 95 ms). No effect of IMT was visible over SAP and baroreflex markers. These findings suggest that moderate-intensity IMT might be beneficial when the goal is to limit cardiac sympathetic hyperactivity at REST and/or in response to STAND.

Respiratory modulation of intensity ratings and psychomotor response times to acoustic startle stimuli.

Respiratory interoception may play an important role in the perception of respiratory symptoms in pulmonary diseases. As the respiratory cycle affects startle eye blink responses, startle modulation may be used to assess visceral-afferent signals from the respiratory system. To ascertain the potential impact of brainstem-relayed signals on cortical processes, we investigated whether this pre-attentive respiratory modulation of startle (RMS) effect is also reflected in the modulation of higher cognitive, evaluative processing of the startle stimulus. Twenty-nine healthy volunteers received 80 acoustic startle stimuli (100 or 105 dB(A); 50 ms), which were presented at end and mid inspiration and expiration, while performing a paced breathing task (0.25 Hz). Participants first responded to the startle probes by 'as fast as possible' button pushes and then rated the perceived intensity of the stimuli. Psychomotor response time was divided into 'reaction time' (RT; from stimulus onset to home button release; represents stimulus evaluation) and 'movement time' time (MT; from home button release to target button press). Intensity judgments were higher and RTs accelerated during mid expiration. No effect of respiratory cycle phase was found on eye blink responses and MTs. We conclude that respiratory cycle phase affects higher cognitive, attentional processing of startle stimuli.

Condições funcionais e respiratórias no pós-operatório de cirurgia bariátrica / Functional and respiratory conditions in the postoperative bariatric surgery

O número de cirurgias bariátricas nos últimos anos vem crescendo gradativamente. Entretanto, estudos mostram que esta alternativa de tratamento torna os indivíduos mais suscetíveis a alterações pulmonares. O objetivo foi avaliar as condições funcionais e respiratórias ocasionadas pela cirurgia bariátrica. Foi realizado teste para avaliação da capacidade funcional de membros inferiores a partir do teste do degrau de seis minutos, força muscular periférica conforme escala Medical Research Council e também teste de manovacuometria para avaliação de força muscular respiratória no pré-operatório e no 5º pós-operatório. Foram avaliados 25 pacientes durante o estudo. Houve uma diminuição da capacidade funcional de membros inferiores e uma perda da força muscular respiratória expiratória dos pacientes no pós-operatório. Foi concluído que ha uma diminuição da capacidade funcional e da força muscular expiratória no pós-operatório de cirurgia bariátrica, sugere-se um protocolo de treinamento respiratório e periférico para esses pacientes.(AU)

The number of bariatric surgeries in recent years has been growing steadily, however, studies shows that this alternative treatment makes individuals more susceptible to lung changes. The objective was to evaluate the functional and respiratory conditions caused by bariatric surgery. We performed a test to evaluate functional capacity of lower limbs from the six-minute step test, peripheral muscle strength according to the Medical Research Council scale and also a manovacuometry test to evaluate respiratory muscle strength in the preoperative and in the 5th postoperative period. Twenty-five patients were evaluated during the study. There was a decrease in functional capacity of lower limbs and a loss of expiratory respiratory muscle strength in the postoperative period. It was concluded that there is a decrease in functional capacity and expiratory muscle strength in the postoperative period of bariatric surgery, it is suggested a respiratory and peripheral training protocol for these patients.(AU)

The effects of oil induced respiratory impairment on two indices of hypoxia tolerance in Atlantic croaker (Micropogonias undulatus).

The Gulf of Mexico was home to the Deepwater Horizon oil spill, and is also known to exhibit seasonal declines in oxygen availability. Oil exposure in fish is known to impact oxygen uptake through cardiac impairment, which raises questions about the additive effects of these two stressors. Here we explore this question on the Atlantic croaker using two measures of hypoxia tolerance: critical oxygen threshold (Pcrit), and time to loss of equilibrium (LOE). We first demonstrated that 24 h exposure to 10.1 and 23.2 µg l-1 ΣPAH50 significantly impaired oxygen uptake. There was no effect of exposure on Pcrit or LOE. Exposure did result in significantly different repeatability between pre- and post-exposure Pcrit, suggesting that hypoxia tolerant individual may see greater impacts following exposure. These results suggest oil exposure does not have wide scale detrimental outcomes for hypoxia tolerance in fish, yet there may be fine scale impairments of ecological significance.

Yoga in Arterial Hypertension.

BACKGROUND: Yoga seems to exert its effect against arterial hypertension mainly through the associated breathing and meditation techniques, and less so through yoga postures. The goal of this trial was to compare the blood pressure-lowering effect of yoga interventions with and without yoga postures in patients with arterial hypertension. METHODS: 75 patients taking medications for arterial hypertension (72% women, mean age 58.7 ± 9.5 years) were randomized into three groups: a yoga intervention group with yoga postures (25 patients, of whom 5 dropped out of the trial before its end), a yoga intervention group without yoga postures (25 patients, 3 dropouts), and a wait list control group (25 patients, one dropout). The interventions consisted of 90 minutes of yoga practice per week for twelve weeks. The data collectors, who were blinded to the intervention received, assessed the primary outcome measures "systolic 24-hour blood pressure" and "diastolic 24-hour blood pressure" before and after the intervention. In this report, we also present the findings on secondary outcome measures, including follow-up data. RESULTS: After the intervention, the systolic 24-hour blood pressure in the yoga intervention group without yoga postures was significantly lower than in the control group (group difference [Δ]= -3.8 mmHg; [95% confidence interval (CI): (-0.3; -7.4) p = 0.035]); it was also significantly lower than in the yoga intervention group with yoga postures (Δ = -3.2 mmHg; 95% CI: [-6.3; -0.8]; p = 0.045). Diastolic blood pressures did not differ significantly across groups. No serious adverse events were encountered in the course of the trial. CONCLUSION: In accordance with the findings of earlier studies, we found that only yoga without yoga postures induced a short-term lowering of ambulatory systolic blood pressure. Yoga is safe and effective in patients taking medications for arterial hypertension and thus can be recommended as an additional treatment option for persons in this category.

[Manual airway clearance techniques in adults and adolescents: What level of evidence?] / Techniques manuelles de drainage bronchique des adultes et adolescents : quel niveau de preuve ?

BACKGROUND: The aim of this systematic literature review was to grade the levels of evidence of the most widely used manual airway clearance techniques. METHODS: A literature search was conducted over the period 1995-2014 from the Medline, PEDro, ScienceDirect, Cochrane Library, REEDOC and kinedoc databases, with the following keywords: "postural drainage", "manual vibrations", "manual chest percussion", "directed cough", "increased expiratory flow", "ELTGOL", "autogenic drainage" and "active cycle of breathing technique". RESULTS: Two-hundred and fifty-six articles were identified. After removing duplicates and reading the titles and abstracts, 63 articles were selected, including 9 systematic reviews. This work highlights the lack of useful scientific data and the difficulty of determining levels of evidence for manual airway clearance techniques. Techniques were assessed principally with patients with sputum production (cystic fibrosis, DDB, COPD, etc.). It also shows the limited pertinence of outcome measures to quantify congestion and hence the efficacy of airway clearance techniques. CONCLUSION: The 1994 consensus conference summary table classifying airway clearance techniques according to physical mechanism provides an interesting tool for assessment, grouping together techniques having identical mechanisms of action. From the findings of the present systematic review, it appears that only ELTGOL, autogenic drainage and ACBT present levels of evidence "B". All other techniques have lower levels of evidence. LEVEL OF EVIDENCE: II.

Pilates en pacientes con espondilitis anquilosante: repercusión en la función pulmonar / Pilates physiotherapy for ankylosing spondylitis patients: Impact on lung function

Objetivo: Evaluar el impacto de la fisioterapia basada en el método de Pilates en la función pulmonar de pacientes con espondilitis anquilosante (EA). Material y método: Se realiza un ensayo clínico aleatorizado (ECA) con 49 pacientes diagnosticados de EA según los criterios de Nueva York modificados. Se establecen al azar 2 grupos de trabajo. Se aplicó ejercicio terapéutico en 26 pacientes, 17 semanas, días alternos y 1h de duración, supervisado por un fisioterapeuta. El grupo control (23 pacientes) realizó un programa de ejercicios convencionales en el domicilio. Terminan el estudio 45 de los 49 pacientes que iniciaron el ECA. Las variables analizadas son: expansión costal, capacidad vital forzada (CVF), volumen espirado forzado (FEV1) y el cociente FEV1/CVF. Resultados: No hay diferencias significativas en los valores de expansión costal entre ambos grupos (p valor=0,686) ni diferencias en el grupo experimental antes y después de la intervención (p valor=0,780). Los valores de la espirometría se comportan de forma similar. La CVF aumenta de forma discreta en el grupo experimental no de forma significativa (p valor = 0,122). Conclusiones: El impacto de los ejercicios basados en pilates sobre los valores espirométricos y la expansión costal es escaso, a pesar de la tendencia del grupo experimental a mejorar su CVF después de la intervención. Se debe considerar, para su aplicación clínica, implementar este tipo de protocolos con fisioterapia respiratoria específica

Aim: To evaluate the impact of physiotherapy, based on the Pilates Method, on the lung function of patients with Ankylosing Spondylitis (AS). Material and methods: A randomised clinical trial (RCT) was performed with 49 patients diagnosed with AS according to the modified New York criteria. Two groups were randomly established. Therapeutic Pilates-based exercise was performed by 26 patients for 17 weeks, in 90minute sessions on alternative days, supervised by a physiotherapist. The control group (23 patients) used a conventional exercise program at home. The variables analysed were: rib cage expansion, forced vital capacity (FVC), forced expiratory volume (FEV1), and the FEV1/FVC ratio. Results: No significant differences were found in the values of rib cage expansion between control and experimental groups (P=.686), while there were differences before and after intervention in the experimental group (P=.780). The values of spirometry were similar in both control and experimental groups. No-significant increase in FVC was observed in the experimental group (P=.122). Conclusions: The impact of Pilates-based exercises on spirometry values and rib cage expansion is limited, although there was a tendency to improve FVC after Pilates exercises. These types of exercise protocols should be considered, for their clinical application, in specific respiratory physiotherapy

Comparison of lung function values of trained divers in 1.5 ATA hyperbaric chamber after inhaling 100% oxygen and regular air: a crossover study.

INTRODUCTION: Diving is an activity performed in more than 1 atmosphere absolute pressure (ATA) either underwater or in a hyperbaric chamber. We aimed to compare lung function values of trained divers in 1.5 ATA hyperbaric chambers after inhaling 100% oxygen and regular air. METHODS: This experimental study with crossover design involved 18 trained divers in 1.5 ATA hyperbaric room, which is equivalents to a 5-meter depth. The eighteen subjects as the supplementation group, using oro-nasal mask, inhaled 100% oxygen for 30 minutes followed by a one-day washout period. The subjects were then crossed-over into control group inhaling only regular air for 30 minutes. Lung function test was performed before and after supplementation. RESULTS: In eighteen subjects inhaling regular air, there was a significant difference (p < 0.05) in FEV1/FVC, PEF, FEF25, FEF50, and FEF75. Whereas in eighteen subjects inhaling 100% oxygen, significant difference (p < 0.05) was observed not only in FEV1/FVC, PEF, FEF25, FEF50 and FEF75, but also in FEV1. CONCLUSIONS: There were significant differences in lung function, especially in dynamic volume of trained divers in 1.5 ATA hyperbaric chamber after inhaling 100% oxygen and regular air for 30 minutes; while there were no significant differences in lung capacity (VC and FVC) in the both groups. Lung function returned to normal following supplementation with a 1-day washout period.