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Introduction: Laparoscopic cholecystectomy is frequently performed in acute, chronic, symptomatic, and asymptomatic cholelithiasis. It is simple, safer, and requires less recovery time than open cholecystectomy, which is why this procedure is increasingly utilised for various abdominal surgeries. Patients may experience postoperative pulmonary problems during the recovery phase and as per available literature there is a noticeable decline in the vital capacity of the patient. It was observed that Buteyko breathing and breath stacking breathing techniques has a good impact on the physiological parameters and vital capacity of patients with hypertension, asthma, Chronic Obstructive Pulmonary Disease (COPD), and other respiratory conditions. Need of the study: Buteyko breathing and breath stacking breathing techniques are effective in different conditions like hypertension, asthma, and cardiac surgery. The need of the study is to compare both techniques and find out which one is more effective and implement that with the standard exercises in the patients to help them improve their quality of life, reduce hospital stay, and improve lung capacity. Aim: To compare the effects of the Breath Stacking Technique (BST) and Buteyko Breathing Technique (BBT) on the physiological parameters of patients undergoing laparoscopic cholecystectomy. Materials and Methods: This will be a randomised controlled trial in which 140 patients will be included using purposive sampling via block randomisation. The study will be conducted in Surgery Intensive Care Unit (SICU) of Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, from December 2023 to May 2024. Patients in Group-A will perform the BBT and Group-B will perform the BST. Each cycle of breathing consists of five repetitions with five sets and 30 seconds of rest in between. Outcome measures will be taken at baseline and after intervention on Postoperative Day 1 (POD). The normality of the data will be checked by Kolmogorov- Smirnov test. A paired t-test will be used if the data is normal, and the Wilcoxon Signed Rank test will be used if the data is non-normal. A p-value < 0.05 will be considered significant.

Introduction: Hyperbaric Oxygen Therapy (HBOT) consists of administering oxygen at pressures higher than atmospheric pressure. Though HBOT remains one of the safest therapies used today, it is not completely devoid of side effects. Pulmonary oxygen toxicity can result as a result of continuous exposure of elevated levels of oxygen for increased duration and at increased pressures. The main pathological manifestations occur as acute exudative phase followed by subacute proliferative phase. Effects of HBOT on pulmonary functions has not been studied in detail. This study was conducted to ascertain the effects of HBOT on pulmonary functions and determine if these changes are reversible in nature. Material and Method: A prospective observational study was conducted at a tertiary care hospital over a period of 02 years. A total of 72 patients who were undergoing HBOT for any indication normal chest radiograph and normal spirometry/DLCO were included in the study. Spirometry and DLCO was done initially at the time of inclusion and repeated after half of the total planned HBOT sessions and finally at the end of all sessions of HBOT. Spirometry and DLCO was also repeated 6 months post completion of HBOT. The HBOT protocol consisted of breathing 100% oxygen at 2.4 atmospheric absolute (ATA) for 90 minutes which was referred as one session. Total sessions varied from 20-30 based on indication and response of their primary disease to HBO. Results: The mean age score in study population was 47.12 ± 12.88. Among the study population, 12(24%) participants were male and 38(76%) participants were female. The mean BMI was 24.49 ± 5.45. The mean DLCO was 6.67 ± 1.45 ml/min/mm Hg pre intervention, it was 6.38 ± 1.43 ml/min/mm Hg at mid cycle and 6.21 ± 1.41 ml/min/mm Hg post intervention and at 6 months follow up it was 6.43 ± 1.46 ml/min/mm Hg. The difference in the DLCO at mid cycle, post intervention and 6 months follow up period with baseline value were statistically significant (P value 0.005). Conclusion: HBOT although a safe intervention, it is not totally devoid of complications. Although our study did reveal statistically significant changes in pulmonary function in most of the instances, it did not show any clinically significant changes in pulmonary function with use of HBOT protocol at 2.4 ATA. Studies with larger sample size will be required to ensure evidence based safety of HBOT use.

Abstract The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognostic implications of a 1-year decline in DLCO in 319 patients newly diagnosed with IPF at a tertiary hospital between January 2010 and December 2020. Changes in FVC and DLCO over the first year after the initial diagnosis were reviewed; a decline in FVC ≥ 5% and DLCO ≥ 10% predicted were considered significant changes. During the first year after diagnosis, a significant decline in FVC and DLCO was observed in 101 (31.7%) and 64 (20.1%) patients, respectively. Multivariable analysis showed that a 1-year decline in FVC ≥ 5% predicted (aHR 2.74, 95% CI 1.88–4.00) and 1-year decline in DLCO ≥ 10% predicted (aHR 2.31, 95% CI 1.47–3.62) were independently associated with a higher risk of subsequent mortality. The prognostic impact of a decline in DLCO remained significant regardless of changes in FVC, presence of emphysema, or radiographic indications of pulmonary hypertension. Therefore, serial monitoring of DLCO should be recommended because it may offer additional prognostic information compared with monitoring of FVC alone.

Objective: This study investigates if an inpatient rehabilitation therapy (brace therapy and Schroth therapy) for six weeks contributes to an improvement in lung function of the patients. Design: Retrospective study. Setting: Scoliosis rehabilitation clinic “Asklepios Katharina-Schroth-Klinik” (Bad Sobernheim, Germany). Participants: In 253 female patients a lung function examination was performed at entry and at the end of their inpatient rehabilitation stay. Of these, 61 patients underwent Schroth therapy (group 1); 192 patients underwent the combination of brace and Schroth therapy (group 2). Intervention: Lung function parameters under the influence of Schroth and Schroth and brace therapy within a rehabilitative stay. Main measures: The parameters of IVC (inspiratory vital capacity), FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 s) and the Tiffeneau index (FEV/FVC) related to patient-specific reference values were evaluated with regard to potential ventilation disorders. Results: There were significant improvements for IVC +2.56 %, FVC +3.99 %, FEV1 +2.36 % for the first stay (IVC and FVC 2nd, 3rd stay). The comparison of patients with vs. without additional brace therapy showed no significances. For the long-term analysis the parameters approached the reference values of age-matched, healthy female subjects. The greater the Cobb angle in the thoracic region, the significantly worse almost each of the measured parameters are. Conclusion: An inpatient rehabilitation therapy contributes to an improvement in lung function (IVC, FVC and FEV1). A second, and even a third, follow-up stay still led to a measurable improvement in lung function, albeit to a lesser extent.

Vital capacity (VC) tests are an important tool in assessing the functioning of the respiratory system. Low levels of vital capacity can indicate health problems such as asthma, chronic obstructive pulmonary disease, and other respiratory conditions. The volume of VC depends on many factors, especially the strength of the respiratory muscles, body and chest structure, lung and chest compliance, airway patency, gender, environmental factors, and physical activity. The aim of this study is to determine the level of vital capacity (VC) in girls and boys aged 10-13 who practice trampoline jumping, and to compare the results with reference values for a given gender and age category. The research was conducted among 100 trampoline jumpers (including 57 girls and 43 boys) aged 10-13. As part of the research, spirometric measurement was performed using the portable EasyOne model 2001 spirometer. The obtained results were then compared to reference values calculated on the basis of a study by the European Respiratory Society. The average level of vital capacity in the girls aged 10 was 2.2 liters, in 11-year-olds - 2.45 l, in 12-year-olds 2.54 l, and in 13-year-olds it was 3.02 l. The average level of vital capacity of the examined boys aged 10 was 2.36 l, in 11-year-olds 2.56 l, in 12-year-olds 2.89 l, and in 13-year-olds 3.33 l. These research results indicate that trampoline jumpers show a VC value within the reference values (between the LLN and ULN values). The girls stand out with higher percentage of predicted values for VC at the age of 11 (95.26%) and 13 (100.34%), in comparison with boys at the age of 10 (96.38%) and 12 (96.23%).

Background/objective: Amyotrophic lateral sclerosis (ALS) is a diagnosis that incorporates a heterogeneous set of neurodegenerative processes into a single progressive and uniformly fatal disease making the development of a uniformly applicable therapeutic difficult. Recent multinational ALS natural history incidence studies have identified systemic chronic activation of the innate immune system as a major risk factor for developing ALS. Persistent immune activation in patients with ALS leads to loss of muscle and lowering of serum creatinine. The goal of the current study was to test whether the slowing of nerve and muscle destruction in NP001-treated ALS patients compared with controls in phase 2 studies would lead to extension of survival. Methods: Phase 2 clinical studies with NP001, an intravenously administered form of the innate immune system regulator NaClO2, are now reporting long-term survival benefits for drug recipients vs. placebo controls after only six months of intermittent treatment. As a prodrug, NP001 is converted by macrophages to taurine chloramine, a long-lived regulator of inflammation. We performed a pooled analysis of all patients who had completed the studies in two six-month NP001 phase 2 trials. Changes in respiratory vital capacity and the muscle mass product, creatinine, defined treated patients who, compared to placebo, had up to a year of extended survival. Conclusions: The observed longer survival in ALS patients with the greatest inflammation-associated muscle loss provides further evidence that ALS is a disease of ongoing innate immune dysfunction and that NP001 is a disease-modifying drug with sustained clinical activity.

IntroductionDysphagia is a common complication in patients with cervical spinal cord injury (C-SCI) and can cause various pulmonary complications, such as aspiration pneumonia and mechanical airway obstruction increasing mortality and morbidity. This study evaluated the clinical factors that predict dysphagia in patients with traumatic and non-traumatic C-SCI.MethodsNinety-eight patients with C-SCI were retrospectively enrolled in this study and were divided into those with and without dysphagia. Clinical factors such as age, sex, tracheostomy, spinal cord independence measure, pulmonary function test (PFT) including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FVC/FEV1, American Spinal Cord Injury Association score, Berg Balance Scale, and surgical approach were investigated retrospectively.ResultsMultivariate logistic regression analysis revealed that FVC and the presence of tracheostomy were significantly correlated with dysphagia in patients with C-SCI (p

Abstract Background The widely reported associations between body mass index (BMI) and various chronic diseases, such as hypertension and asthma, have garnered significant attention. Nonetheless, there remains a dearth of research dedicated to understanding the health impacts of medical school on the students, who experience considerable academic pressure. In that context, this study was driven by the goal of investigating the intricate interplay between BMI, blood pressure (BP), and vital capacity among medical students. Methods This study included a cohort of 843 medical students enrolled at Southern Medical University who were selected through random cluster sampling. Within this cohort, measurements of height, weight, BP, and vital capacity were taken. Subsequently, both BMI and vital capacity index (VCI) were calculated for each participant. By categorizing the subjects into four groups according to BMI classifications, a comprehensive analysis that included correlation assessments and binomial logistic regression was conducted. Results Within the participant pool, 9.4% and 3.8% of participants were classified as overweight and obese, respectively. Additionally, the prevalence of prehypertension, hypertension, and poor VCI was 18.1%, 2.7%, and 13.5%, respectively. Notably, male students exhibited a higher prevalence of the aforementioned health issues than their female counterparts. Correlation analysis revealed that BMI displayed positive associations with systolic blood pressure (SBP), diastolic blood pressure (DBP), and vital capacity (r = 0.372, 0.257, 0.428; P

Presently, in the research processes involved in analysing the relationship between smoking and vital capacity, most researchers use statistical software to analyse, count the differences of vital capacity between different groups and carry out linear analysis or regression analysis. They cannot deeply analyse the relationship between the data, nor can they get the correlation of the data itself. Considering these limitations, this paper studies the influence of adolescent smoking on physical training vital capacity in eastern coastal areas. Based on the brief introduction of the research progress of data mining algorithm, and taking the teenagers in the eastern coastal area as the research object, the k-means algorithm and decision tree algorithm are applied to the data mining of vital capacity of physical training, after which we classify and reclassify the data, mine the rules between the data and put forward improvement strategies for the shortcomings of the algorithm itself. Finally, experiments are designed to analyse the accuracy, running time and reliability of the algorithm. The experimental results show that the improved k-means algorithm and decision tree algorithm shorten the running time and enhance the stability, and can realise the classification and mining of vital capacity data of physical training, so as to improve the reliability of experimental result analysis.

BackgroundStroke disrupts the functions carried out by the brain such as the control of movement, sensation, and cognition. Disruption of movement control results in hemiparesis that affects the function of the diaphragm. Impaired function of the diaphragm can in turn affect many outcomes such as respiratory, cognitive, and motor function. The aim of this study is to carry out a systematic review and meta-analysis to determine the efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor outcomes after stroke.MethodThe study was registered in PROSPERO (CRD42023422293). PubMED, Embase, Web of Science (WoS), PEDro, Scopus, and CENTRAL databases were searched until September 2023. Only randomized controlled trials comparing diaphragmatic breathing exercise with a control were included. Information on the study authors, time since stroke, mean age, height, weight, sex, and the protocols of the experimental and control interventions including intensity, mean scores on the outcomes such as respiratory, cognitive, and motor functions were extracted. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were used to summarize the results, which were then presented in tables, risk-of-bias graph, and forest plots. The meta-analysis was carried out on respiratory function [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF)] and motor function (trunk impairment, and internal and external oblique muscles activity).ResultsSix studies consisting of 151 participants were included. The results of the meta-analyses showed that diaphragmatic breathing exercise is only superior to the control at improving respiratory function, FVC (MD = 0.90, 95% CI = 0.76 to 1.04, P < 0.00001), FEV1 (MD = 0.32, 95% CI = 0.11 to 0.52, P = 0.002), and PEF (MD = 1.48, 95% CI = 1.15 to 1.81, P < 0.00001).ConclusionThere is limited evidence suggesting that diaphragmatic breathing exercise may help enhance respiratory function, which may help enhance recovery of function post stroke.Systematic Review RegistrationPROSPERO, identifier CRD42023422293.

Background: Preoxygenation during anesthesia can be done by 3 min tidal volume breath and eight vital capacity breath in 1 min, conventionally. Population of our country is not homogenous. Aims and Objectives: The present study was conducted to validate preoxygenation processes in people of eastern India. Materials and Methods: Total 140 patients of ASA grade I and II, age group 20–50 posted for surgeries under GA were allotted in TV and VC group. Every odd number and even number patient was tested for TV method and VC method, respectively, with a Magill circuit and airtight face mask with 100% oxygen flow at a rate of 10 L/min. Time and number of breaths were noted when end tidal oxygen concentration ≥90% in TV and VC group, respectively. Results: In TV method, the mean time (in minute) was 3.10±0.27 and 3.13±0.24 for tribal and non-tribal sub-group (P=0.80); 3.02±0.37 and 3.10±0.27 for tribal and non-tribal male (P=0.57); and 3.18±0.05 and 3.16±0.21 for tribal and non-tribal female (P=0.57). In VC method, mean number of VC breaths was 8.32±0.60 and 8.43±0.74 for tribal and non-tribal sub-group (P=0.76); 8.75±0.49 and 8.23±0.70 for tribal and non-tribal male (P=0.42); and 8.20±0.60 and 8.60±0.72 for tribal and non-tribal female (P=0.16). Patients completing preoxygenation in TV and VC method – tribal: 22% and 53%, non-tribal: 4% and 62%, tribal male: 22% and 20%, non-tribal male: 8% and 68%, tribal female: 0% and 60%, and non-tribal female: 0 and 57%, respectively. Conclusion: No significant difference found between tribal and non-tribal groups of both sexes in each method. Completion of preoxygenation was higher in VC group, though not tested statistically.

Abstract Objective The effects of preoperative respiratory muscle training (RMT) on postoperative complications in patients surgically treated for myasthenia gravis (MG) remain unclear. The present study therefore evaluated the effects of preoperative moderate-to-intense RMT and aerobic exercise, when added to respiratory physiotherapy, on respiratory vital capacity, exercise capacity, and duration of hospital stay in patients with MG. Methods Eighty patients with MG scheduled for extended thymectomy were randomly divided into two groups. The 40 subjects in the study group (SG) received preoperative moderate-to-intense RMT and aerobic exercise in addition to respiratory physiotherapy, whereas the 40 subjects in the control group (CG) received only chest physiotherapy. Respiratory vital capacity (as determined by VC, FVC, FEV1, FEV1/FVC, and PEF) and exercise capacity (as determined by the 6-min walk test [6 MWT]) were measured pre- and postoperatively and before discharge. The duration of hospital stay and activity of daily living (ADL) were also determined. Results Demographic and surgical characteristics, along with preoperative vital capacity and exercise capacity, were similar in the two groups. In the CG, VC (p = 0.001), FVC (p = 0.001), FEV1 (p = 0.002), PEF (p = 0.004), and 6MWT (p = 0.041) were significantly lower postoperatively than preoperatively, whereas the FEV1/FVC ratio did not differ significantly. Postoperative VC (p = 0.012), FVC (p = 0.030), FEV1 (p = 0.014), and PEF (p = 0.035) were significantly higher in the SG than in the CG, although 6MWT results did not differ. ADL on postoperative day 5 was significantly higher in the SG than in the CG (p = 0.001). Conclusion RMT and aerobic exercise can have positive effects on postoperative respiratory vital capacity and daily life activity, and would enhance recovery after surgery in MG patients.

Summary: Background: While the adverse effects of short-term ambient ozone exposure on lung function are well-documented, the impact of long-term exposure remains poorly understood, especially in adults. Methods: We aimed to investigate the association between long-term ozone exposure and lung function decline. The 3014 participants were drawn from 17 centers across eight countries, all of which were from the European Community Respiratory Health Survey (ECRHS). Spirometry was conducted to measure pre-bronchodilation forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) at approximately 35, 44, and 55 years of age. We assigned annual mean values of daily maximum running 8-h average ozone concentrations to individual residential addresses. Adjustments were made for PM2.5, NO2, and greenness. To capture the ozone-related change in spirometric parameters, our linear mixed effects regression models included an interaction term between long-term ozone exposure and age. Findings: Mean ambient ozone concentrations were approximately 65 μg/m³. A one interquartile range increase of 7 μg/m³ in ozone was associated with a faster decline in FEV1 of −2.08 mL/year (95% confidence interval: −2.79, −1.36) and in FVC of −2.86 mL/year (−3.73, −1.99) mL/year over the study period. Associations were robust after adjusting for PM2.5, NO2, and greenness. The associations were more pronounced in residents of northern Europe and individuals who were older at baseline. No consistent associations were detected with the FEV1/FVC ratio. Interpretation: Long-term exposure to elevated ambient ozone concentrations was associated with a faster decline of spirometric lung function among middle-aged European adults over a 20-year period. Funding: German Research Foundation.

Purpose: Taichi Chuan was previously shown to benefit physical health, but the results were inconsistent. The main reason is that the mechanism is not clear and may be interpreted differently. In this systematic review, we analyzed the data obtained from various randomized controlled trials to identify the effectiveness of Taichi Chuan and the mechanism by which it improves the physical health of adults. Methods: We systematically searched various databases, including PubMed, Web of Science, Scopus, Embase, EBSCO Host, Science Direct, CNKI, Wan-Fang, and VPCS, and obtained 1448 articles for review. The articles were selected following the PICO eligibility criteria. We performed a systematic review and meta-analysis to interpret the results of the different studies. Results: We included 16 studies in the systematic review. Six of them were of very high quality, ten were of acceptable quality. Overall, the results showed that Taichi Chuan is beneficial to physical fitness, but not all indices supported this statement. Specifically, the effects were significant on Balance (ES = − 0.33; P = 0.02), BMI (ES = − 0.83; P

Abstract Background Although Osteogenesis Imperfecta (OI) affects the connective tissue, pulmonary function might be compromised because of thoracic deformities. OI is known to be a restrictive lung disease, but spirometry provides global measurement without localizing the site of the restriction. Opto-electronic plethysmography (OEP), is a non-invasive method able to underline altered respiratory function as well as ventilatory thoraco-abdominal paradoxes during spontaneous breathing. We aimed to reconstruct the thoraco-abdominal surface, to perform local analyses of trunk motion and to make quantitative comparison of trunk shape and respiratory kinematics according to OI severity, particularly during maximal inspiratory and expiratory expansions. This is a cross-sectional study where we have studied the thoraco-abdominal compartmental analysis in 26 adult OI patients (14 Type III) at rest and during vital capacity manoeuvre using OEP. We have also applied a new method that created realistic and accurate 3D models to perform local analyses of trunk motion and to make quantitative comparison of trunk shape and respiratory kinematics. Results Type III patients were characterized by lower spirometric lung volume, by lower sleep quality, by a more compressed thoracic configuration aggravated by severe scoliosis, by reduced global expansion at rest and during maximal maneuvers because of the reduced expansion of the pulmonary ribcage at rest (12% vs. 65% in healthy subjects), during maximal inspiration (37% vs. 69%) and expiration (16% vs. 68%) with local paradoxical movement occurring on the side of the ribcage region. Conclusion The kinematics of the trunk changed to compensate for the severe structural deformities by shifting the expansion in the abdomen both at rest and during maximal manoeuvre because of a restricted thorax. For the first time, we have quantified and localized the site of the restriction in OI patients in the lateral part of the thorax. The 3D analysis proposed seemed a promising graphical immediate new method for pathophysiology study of chest wall restriction.

Abstract Background The forced vital capacity (FVC) of healthy individuals depends on their age, sex, ethnicity and height. Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterised by loss of FVC. We compared FVC values in the subjects with SSc-ILD in the SENSCIS trial of nintedanib versus placebo with values from hypothetical matched healthy references. Methods The SENSCIS trial enrolled subjects with SSc with first non-Raynaud symptom in the prior ≤ 7 years, extent of fibrotic ILD on HRCT ≥ 10%, and FVC ≥ 40% predicted. FVC at baseline and decline in FVC over 52 weeks were compared with FVC values in hypothetical healthy reference subjects matched 1:1 to the subjects in the trial for age, sex, ethnicity and height, determined using equations published by the European Respiratory Society Global Lung Function Initiative. Results At baseline, mean (SD) FVC was 2460 (737) mL in the nintedanib group (n = 287) compared with 3403 (787) mL in the hypothetical matched healthy references. Mean (SD) FVC was 2544 (817) mL in the placebo group (n = 286) compared with 3516 (887) mL in the hypothetical matched healthy references. Mean (SE) changes in FVC at week 52, i.e., age-related loss of lung function, in the hypothetical healthy references matched to the nintedanib and placebo groups, respectively, were − 26.3 (0.5) mL and − 25.8 (0.5) mL. The difference in the change in FVC at week 52 between the nintedanib group and the hypothetical healthy references was 26.6 mL (95% CI: 1.2, 52.0; p = 0.04). The difference in the change in FVC at week 52 between the placebo group and the hypothetical healthy references was 77.5 mL (95% CI: 51.4, 103.7; p

Abstract Background Even almost 30 years after the ban on the use of asbestos in Germany, the effects of asbestos are still highly relevant in everyday clinical practice in occupational medicine. The aim of this study was to further investigate the significance of essential parameters of both pulmonary function diagnostics and imaging techniques (low-dose HR-TCT) for the prevention and early detection of asbestos-related morphological and functional lung changes. Methods Data from spirometry, body plethysmography and diffusion capacity, as well as CT images of the thorax, were retrospectively studied from 72 patients examined between 2017 and 2019 at the Institute for Occupational and Maritime Medicine (ZfAM), Hamburg, Germany. The subjects were divided into four subgroups according to the presence of comorbidities (concomitant cardiac diseases, obstructive ventilatory disorder, pulmonary function pattern consistent with emphysema, and no other pulmonary or cardiac diseases). These subgroups were analysed in addition to the overall collective. The CT images were evaluated according to the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) with radiological expertise. In addition, some asbestos-related parameters were newly quantified, and corresponding scores were defined based on ICOERD. Statistical analysis included the use of correlations and fourfold tables with calculation of Spearman's rho (ρ), Cohen’s κ, and accuracy. Results Vital capacity (VC) is slightly reduced in the total collective compared to the normal population (mean 92% of predicted value), while diffusion capacity for CO (DLCO) shows predominantly pathological values, mean 70% of the respective predicted value. The CO transfer coefficient (DLCO/VA), which refers to alveolar volume (VA), also shows slightly decreased values (mean 87% pred.). Seventy-nine percent of patients (n = 57) had signs of pulmonary fibrosis on CT scans, and pleural plaques appeared in 58 of 72 patients (81%). Of the newly quantified additional parameters, particularly frequently described findings are subpleural curvilinear lines (SC, n = 39) and parenchymal bands (PB, n = 29). VC correlates well with the expression of pleural plaques (ρ = − 0.273, P

Background and Study Aim. To assess the effects of Anulom Vilom Pranayama (AVP) or alternative nostril breathing and Rope Mallakhamb Training (RMT) on respiratory parameters among university females with athletic backgrounds. Material and Methods. A quasi experimental study was performed on thirty-six, university female students from the Department of Physical Education (T), Guru Nanak Dev University, Amritsar, Punjab, India. The subjects were divided in three groups. The groups were subjected to 4-weeks of intervention including: Group A (n1=12) subjected to AVP, Group B (n2=12) subjected to RMT, and Group C: (n3=12) no training or control. Respiratory parameters were measured twice, pre and post intervention using a wet spirometer. All measurements were performed three times and the average values were recorded for analysis. Results. 4-weeks of AVP resulted in positive increases for respiratory parameters measured including Tidal Volume (VT) 25.7%, Inspiratory Reserve Volume (IRV) 29.4%, Expiratory Reserve Volume (ERV) 27.1%, Vital Capacity (VC) 33.2%, and Inspiratory Capacity (IC) 31.6% compared to the control group. Also, 4-weeks of RMT had a positive impact on respiratory parameters including (VT) 19.8%, (IRV) 22%, (ERV) 19.4%, (VC) 32 % and (IC) 28.1% compared to the control group. Conclusions. Both AVP and RMT had a positive impact on respiratory parameters. Also, AVP training has a more positive impact on respiratory parameters than RMT and may also contribute to the enhancement of concentration-based performance and voluntary control of breathing among young females from athletic backgrounds. As a result, AVP training can be more beneficial for a competitive edge in order to improve the athletes' primary need for respiratory endurance.

The present study aimed to investigate the relationship between postural stability, external breathing, and sex, as this area of research is not yet well explored. The study included 19 healthy participants, both male and female, and compared their breathing parameters in three positions: sitting, standing, and supine. The objective was to collect data to develop a non-contact method for recording external respiration. The analysis included measurements of vital capacity and forced vital capacity pulmonary tests, as well as parameters of natural breathing. We confirmed that the lung volume component was higher in males than in females in the sitting position. Additionally, postural influence on breathing was observed only in male participants, with no significant impact on females. Men also exhibited an increased respiratory rate in both standing and supine positions, as well as increased minute ventilation when standing as compared to sitting. Furthermore, men demonstrated higher maximum inspiratory and expiratory vital capacities in all positions as compared to women. These results have important implications not only for the development of non-contact methods for recording respiration but also in the studies of vertical stance, in clinical investigations.

INTRODUCTION: Blatta orientalis is an indicated remedy for asthma and other chronic obstructive pulmonary diseases in homeopathic medicine. Preclinical studies indicate that B. orientalis shows anti-asthmatic properties in animals when induced with bronchospasm using acetylcholine through nonselective anticholinergic and antihistaminic activities. However, no studies have explored the changes in the vital capacity of the lungs on administering the homeopathic remedy, B. orientalis. It is shown that isometric contraction of pectoral muscles enhances the vital capacity of lungs by increasing ventilation and decreasing alveolar partial pressure of carbon dioxide. It can act as a valuable tool for monitoring the vital capacity of the lungs before and after administration of B. orientalis. AIM: This preliminary research takes the first step toward exploring vital capacity through a randomized, placebo-controlled study elucidating the effects of ongoing isometric contraction of muscles on the vital capacity of lungs of healthy individuals on the administration of B. orientalis in different potencies. It aims to compare changes in the vital capacity of lungs in healthy participants during an acute bout of isometric contraction by handgrip dynamometer after administration of B. orientalis. MATERIALS AND METHODS: Eighteen participants who fulfilled the inclusion criteria gave voluntary consent to participate in this research study. The research team measured the Tmax (measured by handgrip dynamometer) and the vital capacity (measured by a vitalograph) of these participants at the baseline. The participants were then placed into three-medicine arms to administer medicine orally: Arm 1 – B. orientalis Q, Arm 2 – B. orientalis 30C, and Arm 3 – placebo, following allocation of six participants in each medicine arm. Lottery method was used for grouping participants randomly to each medicine arm. The participants were numbered from 1 to 18 using the lottery method, and it was made sure that each arm had one male and five females to have similar gender distribution. The research team blindfolded the participants with a cloth bandage (dupatta) before categorizing them into different medicine arms. The team measured each participant's Tmax and vital capacity, and then administered one dose of the assigned medicine. The team measured the Tmax and vital capacity of the participants after 10 min of administering the medicine. The process was repeated after every 24 h for 3 consecutive days. RESULTS: The effect of ongoing isometric contractions of the skeletal muscles on the vital capacity acted as a great tool to measure improvement in vital capacity. The vital capacity of the lungs was significantly decreased after oral administration of B. orientalis Q and B. orientalis 30C, whereas there was no significant effect found in the arm that received a placebo. CONCLUSION: This preliminary study shows that B. orientalis decreases the vital capacity of lungs in healthy subjects and calls for further exploration of its action in higher potencies and with wider experimental parameters. Following the Law of Similimum, this inference also adds to the research scope on the potential of this homeopathic medicine in patients with restrictive lung diseases where the vital lung capacity gets significantly decreased.

Background: During pregnancy, women undergo adaptive changes in different organ systems including the respiratory system by hormonal changes and mechanical pressures. Several previous studies reported the change in pulmonary functions in pregnancy and tribal populations. However, trimester-wise, pulmonary functions in tribal women residing in Jharkhand, India, are not available. Aim: This study aimed to find and compare the pulmonary function test parameters in tribal and non-tribal women in singleton first, second, and third trimesters of pregnancy. Methods: We conducted this cross-sectional observational study in a tertiary care hospital in Jharkhand, India, with 58 tribal women and 116 age-matched controls. The pulmonary function tests, namely forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR), maximal mid expiratory flow (MMEF) were measured with a computerized spirometer (Spiro Excel, Medicaid, Punjab, India) and FEV1/FVC was calculated. Results: A total of 58 tribal women with median age 22 (Q1–Q3: 21–25) years and 116 non-tribal women with median age 22 (20–25) (P=0.33) participated in the study. The tribal women showed higher respiratory rate (20 [18–24.5] vs. 16 [15–18] per minute, P

Background and Aims: Preoxygenation is supplementation of 100% oxygen prior to induction of general anaesthesia to increase the body's oxygen stores. Efficacy of preoxygenation can be increased by optimising fresh gas flow (FGF) rate and pattern of breathing. Methods: Based on pattern of breathing—Tidal Volume Breathing (TVB) or Deep Breathing (DB) and FGF-10 L/min or 15 L/min—100 subjects of the American Society of Anesthesiologists physical status I/II posted for elective surgery were recruited and randomised into four groups: T10 - TVB with 10 L/min; D10 - DB with 10 L/min; T15 - TVB with 15 L/min; and D15 - DB with 15 L/min. A tight-fitting anaesthesia mask along with continuous positive airway pressure of 5 cm of H2O with 20° head-up was used for preoxygenation. The total time taken and the total number of breaths required to achieve end tidal oxygen concentration (EtO2) of 90% were noted. Exhaled tidal volume (Vte), end tidal carbon dioxide, fraction of inspired oxygen, and EtO2 were recorded at each breath. Analysis of variance (ANOVA) was used for inferential statistics and Tukey's honestly significant difference (HSD) test was used to calculate mean difference in total time and number of breaths amongst the groups. Results: Total time taken was significantly low (P < 0.001) in DB compared to TVB (D10: 70.2 ± 19.91, D15: 68.4 ± 20.27 vs T10: 112.28 ± 47.96, T15: 113.6 ± 48.57 seconds). Number of breaths was significantly high (P < 0.001) in TVB with 22.84 ± 8.73, 23.76 ± 11.64, 10.56 ± 3.69, and 8.32 ± 1.8 in T10, T15, D10 and D15, respectively. Vte was significantly low in TVB (P < 0.001). Conclusion: Rapid preoxygenation can be achieved by DB at high FGF of a minimum of 10 L/min.

Respiratory disorders may be one of the adverse effects of sedentary lifestyle. This study investigated respiratory functions (FEV1, FVC and PEFR) and anthropometric parameters (body weight and body mass index) of healthy young males and females participating in moderate aerobic exercise. Forty young healthy untrained non-athletes, twenty males and twenty females (age, 25 ± 5.6 years; body weight, 65 ± 4.0 kg; body height, 176.9 ± 2.5 cm) volunteered to participate in this study. The exercise regimen was of moderate intensity lasting for 20 min daily on a treadmill consistently at the speed of 13 km/h for 14 days. The weight and height of participants were measured using medical scale and wall-mounted stadiometer respectively. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) were assessed using digital spirometer. The results showed a significant (p

Summary: Purpose: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. Methods: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. Results: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p

PURPOSE: The aim of this study was to achieve a control model of cardiac and respiratory function through key indicators established in a comparative analysis between the results of the initial and final pulse tests for women with normal pregnancies. METHODS: The research was done among 111 women, all Bulgarians. We used: functional tests for assessing the effects of our own original Recreational Wellness program with a specific focus on pregnant women. We measured the intensity of the tool branded under the name of the co-author Nesheva. RESULTS: During our own original Recreational Wellness program was established data by specific tests and the analysis has shown that the average values (Mean ± SD) of the measured indicators, in the six lessons are statistically different (p

Abstract Background This study aimed to investigate the pulmonary ventilation function (PVF) according to different types of rib fractures and pain levels. Methods This was a retrospective study of patients with thoracic trauma admitted to our ward from May 1, 2015, to February 1, 2017. Vital capacity (VC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF) were measured on admission. A numerical rating scale (NRS) was used for pain assessment. Results A total of 118 (85 males and 33 females) were included. The location of rib fractures did not affect the PVF. When the number of rib fractures was ≥5, the PVF was lower than in those with ≤4 fractures (VC: 0.40 vs. 0.47, P = 0.009; FEV1: 0.37 vs. 0.44, P = 0.012; PEF: 0.17 vs. 0.20, P = 0.031). There were no difference in PVF values between rib fractures with multiple locations and those with non-multiple locations (VC: 0.41 vs. 0.43, P = 0.202; FEV1: 0.37 vs. 0.39, P = 0.692; PEF: 0.18 vs. 0.18, P = 0.684). When there were ≥ 5 breakpoints, the PVF parameters were lower than those with ≤4 breakpoints (VC: 0.40 vs. 0.50, P = 0.030; FEV1: 0.37 vs. 0.45, P = 0.022; PEF: 0.18 vs. 0.20, P = 0.013). When the NRS ≥ 7, the PVF values were lower than for those with NRS ≤ 6 (VC: 0.41 vs. 0.50, P = 0.003; FEV1: 0.37 vs. 0.47, P = 0.040; PEF: 0.18 vs. 0.20, P = 0.027). Conclusions When the total number of fractured ribs is ≥5, there are ≥5 breakpoints, or NRS is ≥7, the VC, FEV1, and PEF are more affected. Trial registration The trial was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the Ethics Committee of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, and individual consent for this retrospectively registered analysis was waived.

Background and Objectives: The current study aimed to better understand the changes in respiration that occur with aging in men and women to provide accurate recommendations for breathing exercises to improve health. Materials and Methods: A total of 610 healthy subjects, aged 20 to 59, participated in the study. They performed quiet breathing while wearing two respiration belts (Vernier, Beaverton, OR, USA) at the height of the navel and at the xiphoid process to record abdominal motion (AM) and thoracic motion (TM), respectively. Vital capacity, representing maximal inhalation movement, was measured using a spirometer (Xindonghuateng, Beijing, China). After exclusion, 565 subjects (164 men, aged 41 ± 11; 401 women, aged 42 ± 9) were included for statistical analysis using the Kruskal–Wallis U test and stepwise multiple linear regression. Results: Abdominal motion and its contribution to spontaneous breathing were significantly larger for older men, while the contribution of thoracic motion was smaller for older men. There was no significant difference in thoracic motion between the younger and older men. The differences in women’s respiratory movements among various ages were mild and negligible. The contribution of thoracic motion to spontaneous breathing in women was larger than in men for those of older ages (40–59 years), but not for those of younger ages (20–39 years). Additionally, men’s and women’s vital capacities were less in those of older ages, and the men’s were larger than the women’s. Conclusions: The findings indicate that men’s abdominal contribution to spontaneous breathing increased from 20 to 59 years of age due to increased abdominal motion. Women’s respiratory movements did not change much with aging. The maximal inhalation movement became smaller with aging for men and women. Healthcare professionals should focus on improving thoracic mobility when addressing health concerns about aging.

Introduction: Exercise pulmonary hypertension (exPH) has been defined as total pulmonary resistance (TPR) >3 mm Hg/L/min and mean pulmonary artery pressure (mPAP) >30 mm Hg, albeit with a considerable risk of false positives in elderly patients with lower cardiac output during exercise. Methods:We retrospectively analysed patients with unclear dyspnea receiving right heart catheterisation at rest and exercise (n=244) between January 2015 and January 2020. Lung function testing, blood gas analysis, and echocardiography were performed. We elaborated a combinatorial score to advance the current definition of exPH in an elderly population (mean age 67.0 years±11.9). A stepwise regression model was calculated to non-invasively predict exPH. Results: Analysis of variables across the achieved peak power allowed the creation of a model for defining exPH, where three out of four criteria needed to be fulfilled: Peak power ≤100 Watt, pulmonary capillary wedge pressure ≥18 mm Hg, pulmonary vascular resistance >3 Wood Units, and mPAP ≥35 mm Hg. The new scoring model resulted in a lower number of exPH diagnoses than the current suggestion (63.1% vs. 78.3%). We present a combinatorial model with vital capacity (VCmax) and valvular dysfunction to predict exPH (sensitivity 93.2%; specificity 44.2%, area under the curve 0.73) based on our suggested criteria. The odds of the presence of exPH were 2.1 for a 1 l loss in VCmax and 3.6 for having valvular dysfunction. Conclusion: We advance a revised definition of exPH in elderly patients in order to overcome current limitations. We establish a new non-invasive approach to predict exPH by assessing VCmax and valvular dysfunction for early risk stratification in elderly patients.

Reliable data on physical fitness and determination of the functional state of the body reflect the level of physical capabilities and the level of development of motor skills. Objective: Determination of individual physiometric indicators in students. Contingent: 130 female students of Trakia University. The average value of the vital capacity in the studied students is 3, 60, and vital indicator 61,61. With the left and right hand dynamometer, mean right hand values of 15,46 kg were found, and left - 12,76 kg. Force strength is set at 63,42kg. Conclusion: The relative share of students with low values of the vital capacity is high, the values for dynamometry force are also low; there is a disproportion between good physical development due to acceleration factors and recorded retention or deterioration of physical capacity.

Introduction: In recent times, the number of smartphone users has increased all over the world. The prolonged use of smartphone also shown increase in the musculoskeletal problems among the smartphone users. Smartphone usage become exceptionally desired by most of undergraduate students. Several studies are performed to asses the effect of smartphone usage among students. It has been suggested by many studies that the duration of smartphone usage is the better indicator of the addiction than the frequency of use. Aim: To study effect of smartphone addiction on respiratory function and position of scapula among undergraduate students. Materials and Methods: This cross-sectional study was conducted at School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, Delhi, India, from February 2020 to July 2020 on 110 undergraduate students of Delhi and National Capital Region (NCR). Smartphone usage duration along with scapula position and respiratory function was studied. Respiratory function testing was done by using Pulmonary Function Tests (PFT) Machine by RMS, Helios-401 Model. Scapula protraction was assessed by using keibers method of scapula assessment. Data was further analysed using t-test and Analysis of Variance (ANOVA) to find out variation among study population. Results: The mean age of study population was 22±3.35 years and majority of study population fall under healthy group as per Body Mass Index Body Mass Index (BMI). There was no statistically significant change in the scapular position at rest (p-value=0.334), at 45° abduction (p-value=0.840) and at 90° abduction (p-value=0.595) of addicted subjects. There was no significance (p-value=0.083) change in Forced Expiratory Flow (FEF) 25-75%, also other parameters p-value do not show any statistical significance difference between the smartphone users less than 4 years, 4-6 years, >6-8 years, more than 8 years. Conclusion: No significant changes observed in pulmonary function tests and altered scapula positioning among the smartphone addicted users.

Seigo Miyoshi,1 Hitoshi Katayama,1 Minoru Matsubara,2 Takahide Kato,1 Naohiko Hamaguchi,1 Osamu Yamaguchi1 1Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan; 2Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama, Ehime 792-8543, JapanCorrespondence: Seigo MiyoshiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanTel +81-89-960-5303Fax +81-89-960-5306Email seigom@m.ehime-u.ac.jpBackground and Objective: Spirometry is sometimes difficult to perform in elderly patients and patients with cognitive impairment. Forced oscillometry (FOT) is a simple, noninvasive technique used for measuring respiratory impedance. The aim of this study was to develop regression equations to estimate vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1.0) on the basis of FOT indices and to evaluate the accuracy of these equations in patients with asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD).Materials and Methods: We retrospectively included data on 683 consecutive patients with asthma (388), COPD (128), or ILD (167) in this study. We generated regression equations for VC, FVC, and FEV1.0 by multivariate linear regression analysis and used them to estimate the corresponding values. We determined whether the estimated data reflected spirometric indices.Results: Actual and estimated VC, FVC, and FEV1.0 values showed significant correlations (all r > 0.8 and P < 0.001) in all groups. Biases between the actual data and estimated data for VC, FVC, and FEV1.0 in the asthma group were − 0.073 L, − 0.069 L, and 0.017 L, respectively. The corresponding values were − 0.064 L, 0.027 L, and 0.069 L, respectively, in the COPD group and − 0.040 L, − 0.071 L, and − 0.002 L, respectively, in the ILD group. The estimated data in the present study did not completely correspond to the actual data. In addition, sensitivity for an FEV1.0/FVC ratio of < 0.7 and the diagnostic accuracy for the classification of COPD grade using estimated data were low.Conclusion: These results suggest that our method is not highly accurate. Further studies are needed to generate more accurate regression equations for estimating spirometric indices based on FOT measurements.Keywords: forced expiratory volume in 1 second, forced oscillation technique, forced vital capacity, spirometry, vital capacity

Abstract Background Asbestos-related lung diseases are one of the leading diagnoses of the recognized occupational diseases in Germany, both in terms of their number and their socio-economic costs. The aim of this study was to determine whether pulmonary function testing (spirometry and CO diffusion measurement (DLCO)) and computed tomography of the thorax (TCT) are relevant for the early detection of asbestos-related pleural and pulmonary fibrosis and the assessment of the functional deficiency. Methods The records of 111 formerly asbestos-exposed workers who had been examined at the Institute for Occupational and Maritime Medicine, Hamburg, Germany, with data on spirometry, DLCO and TCT were reviewed. Workers with substantial comorbidities (cardiac, malignant, silicosis) and/or pulmonary emphysema (pulmonary hyperinflation and/or TCT findings), which, like asbestosis, can lead to a diffusion disorder were excluded. The remaining data of 41 male workers (mean 69.8 years ±6.9) were evaluated. The TCT changes were coded according to the International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases (ICOERD) by radiologists and ICOERD-scores for pleural and pulmonary changes were determined. Correlations (ρ), Cohens κ and accuracy were calculated. Results In all 41 males the vital capacity (VC in % of the predicted value (% pred.)) showed only minor limitations (mean 96.5 ± 18.0%). The DLCO (in % pred.) was slightly reduced (mean 76.4 ± 16.6%; median 80.1%); the alveolar volume related value (DLCO/VA) was within reference value (mean 102 ± 22%). In the TCT of 27 workers pleural asbestos-related findings were diagnosed whereof 24 were classified as pulmonary fibrosis (only one case with honey-combing). Statistical analysis provided low correlations of VC (ρ = − 0.12) and moderate correlations of DLCO (− 0.25) with pleural plaque extension. The ICOERD-score for pulmonary fibrosis correlated low with VC (0.10) and moderate with DLCO (− 0.23); DLCO had the highest accuracy with 73.2% and Cohens κ with 0.45. DLCO/VA showed no correlations to the ICOERD-score. The newly developed score, which takes into account the diffuse pleural thickening, shows a moderate correlation with the DLCO (ρ = − 0.35, p

Introduction:Systematic physical activity contributes to the development of adptive changes in the human body.Purpose of the work:The aim of the study was: To assess adaptive changes under the influence of recreational training used in men based on selected parameters.Material and method:53 men aged 45 (± 6) years were examined. The tests were performed at the beginning and end of training lasting 18 weeks. Men undertook systematic training three times a week. The training units lasted 1.5 hours, the work performed was continuous, mainly based on oxygen metabolism with elements of anaerobic effort.BMI, HR, RR, VC, TV, IRV, ERV, IC and the difference in chest circumferences between inspiration and exhalation were assessed in the subjects. Results:Average values were obtained: BMI 26 (± 2), there was no difference in measured chest circumferences before and after the training period. The measured RR values showed a significant statistical difference for diastolic pressure. Diastolic pressure decreased by 4 mmHg at significance level p = 0.000. The mean HR measured before and after the training period showed constant values of 68 (± 11) bpm. Similarly, the VC average showed no change. A significant decrease in the ERV parameter was noted for p = 0.03. The average value of ERV, IRV, TV measured before and after the training period did not show significant differences. A significant difference was observed during the IC measurement, where this parameter increased its value at the significance level p = 0.02.Conclusions:Adaptive changes and their trends depend on the type of physical training used. Not every type of systematic training used for 18 weeks will cause significant adaptive changes.

Abstract Background Standard spirometry cannot identify the predominant mechanism underlying airflow obstruction in COPD, namely emphysema or airway disease. We aimed at validating a previously developed methodology to detect emphysema by mathematical analysis of the maximal expiratory flow-volume (MEFV) curve in standard spirometry. Methods From the COPDGene population we selected those 5930 subjects with MEFV curve and inspiratory-expiratory CT obtained on the same day. The MEFV curve descending limb was fit real-time using forced vital capacity (FVC), peak expiratory flow, and forced expiratory flows at 25, 50 and 75% of FVC to derive an emphysema severity index (ESI), expressed as a continuous positive numeric parameter ranging from 0 to 10. According to inspiratory CT percent lung attenuation area below − 950 HU we defined three emphysema severity subgroups (%LAA-950insp

Background and Aim: Exercises to reduce respiratory symptoms of asthma and Vitamin D by regulating the immune system can play a significant role in the health of asthmatic patients. The purpose of the present study was to investigate the effect of short-term consumption of vitamin D supplements following a session of increasing activity on respiratory parameters and tolerance to activity of women with mild asthma. Materials and Methods: This study was quasi-experimental based on the pre-test and post-test pattern that following the announcement of the call, 30 asthmatic women volunteered in Ahwaz was performed. Ballk test for cardiopulmonary patients was used for increasing aerobic exercise. Supplementation with vitamin D tablets at a dose of 1000 units daily was performed for six weeks. For evaluation of pulmonary Vital Capacity (VC) and Maximum Voluntary Ventilation (MVV) indices, the Spirometer device was used. To determine normality of the data was used Shapiro-Wilk's test and data analysis by using paired t-test. Results: The results showed that after the intervention, there was a significant difference in VC and MVV levels and tolerance to activity in the pre-test, supplementation and exercise stages (P≤0.05.( Conclusion: Taking vitamin D supplementation with aerobic exercise can improve respiratory function in asthmatic patients and increase tolerance to activity.

Abstract Background The two 52-week INPULSIS trials investigated nintedanib versus placebo in patients with IPF, FVC ≥50% predicted and DLco 30–79% predicted. The 24-week INSTAGE trial investigated nintedanib plus sildenafil versus nintedanib alone in patients with IPF and DLco ≤35% predicted. We used data from INPULSIS and INSTAGE to compare the effects of nintedanib in patients with IPF with less versus more severe impairment in gas exchange at baseline. Methods Analyses were conducted in patients treated with nintedanib alone in the INPULSIS and INSTAGE trials and in patients treated with placebo in the INPULSIS trials. Outcomes included the rate of decline in FVC over 24 weeks, the proportions of patients who had a confirmed or suspected idiopathic acute exacerbation over 24 weeks, deaths over 24 weeks, and adverse events. Analyses were descriptive. Results In total, 638 and 136 patients received nintedanib alone in the INPULSIS and INSTAGE trials, respectively, and 423 patients received placebo in the INPULSIS trials. Rates of FVC decline were − 52.3 and − 66.7 mL/24 weeks in patients treated with nintedanib alone in INPULSIS and INSTAGE, respectively, and − 102.8 mL/24 weeks in patients treated with placebo in INPULSIS. Confirmed or suspected idiopathic acute exacerbations were reported in 0.6 and 3.7% of patients treated with nintedanib alone in INPULSIS and INSTAGE, respectively, and 2.1% of patients treated with placebo in INPULSIS. Deaths occurred in 2.0, 11.0 and 1.9% of patients in these groups, respectively. Diarrhoea adverse events were reported in 52.5 and 48.5% of patients treated with nintedanib alone in INPULSIS and INSTAGE, respectively, and 16.1% of patients treated with placebo in INPULSIS. Conclusions Based on data from the INSTAGE and INPULSIS trials, nintedanib had a similar effect on FVC decline over 24 weeks, and a similar safety and tolerability profile, in patients with IPF and more versus less severe impairment in gas exchange. These data support the use of nintedanib in patients with IPF who have advanced disease. Trial registration INPULSIS (NCT01335464 and NCT01335477); INSTAGE (NCT02802345).

Background and Aims: Modern anesthetic practice utilizes low-flow anesthesia with evolving evidence on its pulmonary effects. Studies comparing measurement of vital capacity and inspiratory reserve volume using respirometer in both low-flow and high-flow anesthesia are sparse. We evaluated the effects of low-flow and high-flow anesthesia on postoperative pulmonary functions using respirometer. Material and Methods: This was a prospective randomized double blind study wherein One hundred and ten patients undergoing peripheral surgeries under general anesthesia were allocated into two groups Group I- Low-flow anesthesia with O2 + N2O + Sevoflurane (0.5L + 0.5L + 3.5%) and Group II- High-flow anesthesia with O2 + N2O + Sevoflurane (2L + 2L + 2%). The difference in vital capacity (VC), inspiratory reserve volume (IRV), and peak expiratory flow rates (PEFR) from the preoperative period were compared in both the groups postoperatively. Results: The difference in VC, IRV, and PEFR measured in both the groups between the preoperative and postoperative period were found to be similar and statistically insignificant (P - 0.173, 1.00 and 0.213 respectively). The difference in single breath count (SBC), breath holding time (BHT), and respiratory rates (RR) were also similar in both the groups (P – 0.101, 0.698, and 0.467) respectively. Conclusions: The pulmonary effects of low-flow anesthesia are comparable with the high-flow ones in patients undergoing elective surgeries under general anesthesia.

Background A lot of indices can be used as predictors of weaning off mechanical ventilation, such as rapid shallow breathing index (RSBI), integrative weaning index (IWI), vital capacity (VC), maximal inspiratory pressure (MIP), and respiratory rate (RR). MIP and IWI were considered the most sensitive parameters for prediction of weaning. Objective To compare between the efficacies of some predictors of successful weaning in ventilated patients with chronic obstructive pulmonary disease with acute respiratory failure. Design A total of 30 patients with chronic obstructive pulmonary disease with acute respiratory failure were mechanically ventilated and classified into two groups, with 15 patients each. Clinical and demographic data assessment and routine investigations were done for all patients, and then RSBI and IWI were measured in group I, and also VC and MIP were measured in group II, whereas RR was measured in the two groups. Results Successful cases had significantly short duration of ventilation and high IWI, MIP, and VC, but RSBI was significantly lower in successful cases, whereas RR was significantly high in failed cases. Conclusion MIP and IWI were considered the most sensitive parameters in predicting the outcome of weaning, and prolonged duration on mechanical ventilation was associated with weaning failure.

Abdominal surgeries are the most common operative procedures including a wide range of both emergency and elective surgical interventions. Postoperative Pulmonary Complications (PPCs) following upper abdominal surgery are the most common surgical complications. The combined effect of surgical trauma and anaesthesia results in reduced lung volumes and respiratory muscle dysfunction. Chest physical therapy is widely recommended to prevent and treat PPCs, using a wide variety of techniques and devices, including incentive spirometry, continuous positive airway pressure, positive expiratory pressure, intrapulmonary percussive ventilation and Inspiratory Muscle Training (IMT) using a pressure threshold device that targets the muscles of inspiration. The present narrative review aimed to determine the available literature to evaluate whether preoperative respiratory muscle training is effective on pulmonary function test, Respiratory Muscle Strength (RMS) and preventing PPCs after abdominal surgery. A computer-based literature search was done using the PubMed, PubMed Central, Science Direct and Google Scholar. Relevant articles with full text published in English from 1995 to 2021 were screened and included. Studies were included which had preoperative physiotherapy techniques on patients undergoing abdominal surgery. Editorials, commentaries, discussion papers, conference abstracts, reviews and duplicates were excluded. After screening, only studies with full text articles were included that comprised of nine relevant articles. It is imperative to discover the probable outcome of preoperative respiratory exercises training. Hence, a review could be helpful in delivering a perception about which exercises program could cause improved and enhanced postoperative outcome.

Depth-based plethysmography (DPG) for the measurement of respiratory parameters is a mobile and cost-effective alternative to spirometry and body plethysmography. In addition, natural breathing can be measured without a mouthpiece, and breathing mechanics can be visualized. This paper aims at showing further improvements for DPG by analyzing recent developments regarding the individual components of a DPG measurement. Starting from the advantages and application scenarios, measurement scenarios and recording devices, selection algorithms and location of a region of interest (ROI) on the upper body, signal processing steps, models for error minimization with a reference measurement device, and final evaluation procedures are presented and discussed. It is shown that ROI selection has an impact on signal quality. Adaptive methods and dynamic referencing of body points to select the ROI can allow more accurate placement and thus lead to better signal quality. Multiple different ROIs can be used to assess breathing mechanics and distinguish patient groups. Signal acquisition can be performed quickly using arithmetic calculations and is not inferior to complex 3D reconstruction algorithms. It is shown that linear models provide a good approximation of the signal. However, further dependencies, such as personal characteristics, may lead to non-linear models in the future. Finally, it is pointed out to focus developments with respect to single-camera systems and to focus on independence from an individual calibration in the evaluation.

Objectives. This study aimed to characterize the sexual differences in chest dimensions and shape in Bulgarian schoolchildren and the relation of chest measurements with vital capacity and some anthropometric parameters. Material and methods. A total of 107 (60 boys and 47 girls) schoolchildren aged 9-10 years from Sofia, Bulgaria were studied. Chest’s diameters and circumference, waist circumference and vital capacity of each subject were measured. Thoracic index and BMI were calculated. Results. In 9-10 years old children the sexual differences of some variables are well expressed as the boys had greater values than girls. Conclusions. Significant positive association of all chest dimensions with anthropometric features in both sexes was observed. A significant and positive relation between some torso parameters and vital capacity also was found. In boys it was low and in girls - moderate.

PURPOSE: The aim of this study was to achieve a control model of basic functional indicators established by comparative analysis between the results of initial and final anthropometric and functional tests in women with normal pregnancy. METHODS: The research was done among 112 individuals, all Bulgarians, in the period 2015-2018, ages 21 to 31 years old. In order to fulfil the aim of the research we used: functional tests for assessing the effects of our original program build for the specific needs of pregnant women. The program content was branded under our family name: “Gym program for pregnant women Nesheva” and was validated in our doctoral thesis and then published in a book (under patent). RESULTS: During our original gymnastics program was registered data by specific tests and the analysis has shown that the average values (Mean ± SD) of the measured parameters, in the three periods of time (during the pregnancy) are statistically different (p

Abstract A proportion of patients with certain types of interstitial lung disease (ILD), including chronic hypersensitivity pneumonitis and ILDs associated with autoimmune diseases, develop a progressive fibrosing phenotype that shows similarities in clinical course to idiopathic pulmonary fibrosis. Irrespective of the clinical diagnosis, these progressive fibrosing ILDs show commonalities in the underlying pathogenetic mechanisms that drive a self-sustaining process of pulmonary fibrosis. The natural history of progressive fibrosing ILDs is characterized by decline in lung function, worsening of symptoms and health-related quality of life, and early mortality. Greater impairment in forced vital capacity or diffusion capacity of the lungs for carbon monoxide, and a greater extent of fibrotic changes on a computed tomography scan, are predictors of mortality in patients with fibrosing ILDs. However, the course of these diseases is heterogenous and cannot accurately be predicted for an individual patient. Data from ongoing clinical trials and patient registries will provide a better understanding of the clinical course and impact of progressive fibrosing ILDs.

ABSTRACT Purpose: to evaluate the reliability of the maximum phonation time (MPT) and Vital Capacity intra and inter-examiner, by means of the single-breath counting test (CT) and the sustained /a/ phoneme, and the slow vital capacity (SVC). Methods: a reliability study carried out in three groups of healthy individuals, each group with 30 volunteers, allocated according to age. SVC was measured using a spirometer, while the MPT was assessed by the phoneme /a/ and CT. The data were analyzed using SPSS version 20.0. Initially, descriptive statistics were used and for data reliability, the intraclass correlation coefficient (ICC). Results: the Intraclass Correlation Coefficients (ICC) were considered excellent, with significant results above 0.92 for SVC and greater than 0.79 for CT and phoneme /a/. Regarding the inter-examiner evaluation, the ICCs were also significant for both SVC with values greater than 0.96, and for CT and the phoneme /a/ with values greater than 0.85. The error inherent in the technique was assessed using the standard error of the measurement for intra and inter-examiner analyses with values ranging from 1.79 to 3.29 for phoneme /a/, 3.20 to 6.58 for CT and 65, 05 to 206.73 for SVCml. Conclusion: phonation techniques with the phoneme /a/ and CT, as well as SVC, have an excellent reliability, due to intra and inter-examiner agreement measures.

Objectives: Adverse health effects due to air pollution have recently been recognized as a serious social problem in China. In this study, we investigated inter-city relationships between air pollution and physical fitness levels among Mongolian elementary school boys in five cities of the Inner Mongolia Autonomous Region (IMAR), China. Study design: Retrospective cross-sectional cohort study. Methods: Physical fitness measurements of 1443 male Mongolian sixth-grade children were obtained from an existing dataset from the year 2013–2016, and correlations were calculated between these measurements and the percentage of good air quality days for five different cities: Hohhot, Baotou, Chifeng, Bayannur, and Xilinhot. Results: Significant differences in the percentage of good air quality days from 2013 to 2016 were observed among the five cities studied. Statistical analysis showed a significantly positive correlation between good days and students’ vital capacity, and a significantly negative correlation between good days and 50 ​m ​× ​8 shuttle run time for the students included in this study. Differences in the extent of air pollution among the study cities might account for differences in lung function and cardiovascular endurance levels in these Mongolian children. Conclusions: There is an urgent need for policy intervention to reduce air pollution levels in the IMAR. It is necessary to improve school physical education classes and physical training considering the current air pollution situation. Future research needs to replicate school year survey results from other cities, include longitudinal studies, and clarify the relationship between air pollution, physical exercise, and overall health.

ABSTRACT Objective: To evaluate the relationship that the difference between slow vital capacity (SVC) and FVC (ΔSVC-FVC) has with demographic, clinical, and pulmonary function data. Methods: This was an analytical cross-sectional study in which participants completed a respiratory health questionnaire, as well as undergoing spirometry and plethysmography. The sample was divided into two groups: ΔSVC-FVC ≥ 200 mL and ΔSVC-FVC < 200 mL. The intergroup correlations were analyzed, and binomial logistic regression analysis was performed. Results: The sample comprised 187 individuals. In the sample as a whole, the mean ΔSVC-FVC was 0.17 ± 0.14 L, and 61 individuals (32.62%) had a ΔSVC-FVC ≥ 200 mL. The use of an SVC maneuver reduced the prevalence of nonspecific lung disease and of normal spirometry results by revealing obstructive lung disease (OLD). In the final logistic regression model (adjusted for weight and body mass index > 30 kg/m2), OLD and findings of air trapping (high functional residual capacity and a low inspiratory capacity/TLC ratio) were predictors of a ΔSVC-FVC ≥ 200 mL. The chance of a bronchodilator response was found to be greater in the ΔSVC-FVC ≥ 200 mL group: for FEV1 (OR = 4.38; 95% CI: 1.45-13.26); and for FVC (OR = 3.83; 95% CI: 1.26-11.71). Conclusions: The use of an SVC maneuver appears to decrease the prevalence of nonspecific lung disease and of normal spirometry results. Individuals with a ΔSVC-FVC ≥ 200 mL, which is probably the result of OLD and air trapping, are apparently more likely to respond to bronchodilator administration.

Shoichiro Yamamoto,1 Seigo Miyoshi,1 Hitoshi Katayama,1 Mikio Okazaki,2 Hisayuki Shigematsu,2 Yoshifumi Sano,2 Minoru Matsubara,3 Naohiko Hamaguchi,1 Takafumi Okura,1 Jitsuo Higaki1 1Department of Cardiology, Pulmonology, Hypertension, and Nephrology, 2Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, Toon, 3Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama, Japan Purpose: Spirometry is sometimes difficult to perform in elderly patients and in those with severe respiratory distress. The forced-oscillation technique (FOT) is a simple and noninvasive method of measuring respiratory impedance. The aim of this study was to determine if FOT data reflect spirometric indices.Patients and methods: Patients underwent both FOT and spirometry procedures prior to inclusion in development (n=1,089) and validation (n=552) studies. Multivariate linear regression analysis was performed to identify FOT parameters predictive of vital capacity (VC), forced VC (FVC), and forced expiratory volume in 1 second (FEV1). A regression equation was used to calculate estimated VC, FVC, and FEV1. We then determined whether the estimated data reflected spirometric indices. Agreement between actual and estimated spirometry data was assessed by Bland–Altman analysis.Results: Significant correlations were observed between actual and estimated VC, FVC, and FEV1 values (all r>0.8 and P0.8 and P

Our study evaluated relationships between two surrogates measured vital capacity and aerobic capacity to predict the Cardiorespiratory Fitness among Soccer Players. Based on the background, which confirms that the vital capacity is a limiting factor of aerobic capacity. For this proposed, a total of 163 male soccer players under 17 years from Algerian football championship participated in the present study. There VO2max were estimated based on the formula Cooper Test (VO2max = 22.351 d (km) – 11.288 (ml/min/kg)). As well as their vital capacity was calculating based on formula [vital capacity (ml) = (27.63 - 0.112 × age) × height (cm)]. Based on the statistical applied. Our results confirm: 1) There was a significant relation between soccer players' maximal aerobic Capacity and vital capacity. 2) Soccer players' maximal aerobic Capacity and vital capacity; are the features affecting each other.

Our study evaluated relationships between two surrogates measured vital capacity and aerobic capacity to predict the Cardiorespiratory Fitness among Soccer Players. Based on the background, which confirms that the vital capacity is a limiting factor of aerobic capacity. For this proposed, a total of 163 male soccer players under 17 years from Algerian football championship participated in the present study. There VO2max were estimated based on the formula Cooper Test (VO2max = 22.351 d (km) – 11.288 (ml/min/kg)). As well as their vital capacity was calculating based on formula [vital capacity (ml) = (27.63 - 0.112 × age) × height (cm)]. Based on the statistical applied. Our results confirm: 1) There was a significant relation between soccer players' maximal aerobic Capacity and vital capacity. 2) Soccer players' maximal aerobic Capacity and vital capacity; are the features affecting each other.