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Dyspnea as a subjective feeling of lack of air is the patients with the pathology of the respiratory system. Objectivization of this phenomenon is difficult, despite the introduction of questionnaires about the degree of dyspnoea. The results of these assessments do not always correlate with the results of spirometric tests. In patients with asthma, dyspnoea is caused by airway obstruction. In the case of patients with lung sarcoidosis, the complexity of the phenomenon causes that many mechanisms and factors are responsible for the dyspnea symptoms in these patients. Dyspnea in patients with sarcoidosis is progressive and is closely related to the extent of interstitial exchanges. The diffusion capacity for carbon monoxide (DLco) determined in these patients reflects the degree of respiratory distress. Therapeutic procedures are also dependent on this parameter., (© 2018 MEDPRESS.)

Exertional dyspnea is a common manifestation of sarcoidosis. Cardiopulmonary exercise testing (CPET) is a useful tool to evaluate exercise tolerance of sarcoid patients., Aim: The aim of the study was to evaluate of exercise capacity in patients with pulmonary sarcoidosis with regard to duration of the disease. Analysis of differences in physical tolerance between patients with cardiac sarcoidosis and without cardiac sarcoidosis., Materials and Methods: 39 patients diagnosed with pulmonary sarcoidosis were enrolled to our study. Cardiopulmonary exercise test was used to assess exercise capacity. According to time passed from diagnosis of sarcoidosis patients were grouped into 2 groups. Cardiac sarcoidosis was diagnosed in 9 subjects (23.07%). The control group consisted of 33 healthy volunteers., Results: The results of the ergospirometry test in patients with lung sarcoidosis showed statistically significant differences in comparison to the control group. The age of patients with pulmonary sarcoidosis correlated negatively with maximal heart rate, oxygen consumption at peak exercise and at anaerobic threshold, breathing frequency at peak exercise, minute ventilation at peak exercise and metabolic equivalent. There was a negative, statistically significant correlation between the oxygen pulse at the peak of exercise and the treatment of steroids in the past., Conclusions: Exercise limitation in patients with pulmonary sarcoidosis is a consequence of both ventilatory and cardiocirculatory impairment. Patients with longer disease history of sarcoidosis achieved worse results at cardiopulmonary exercise test than patients with shorter disease history. Trend towards worse exercise tolerance in patients with cardiac sarcoidosis compared to patients without cardiac sarcoidosis was observed.

Chronic thromboembolic pulmonary embolism not preceded by clinical thromboembolic event(s) in a 50 year-old male with a history of three-year dyspnea on exertion was detected. Proximal chronic pulmonary embolism, mean pulmonary artery pressure 32 mm Hg, and pulmonary vascular resistance of 444 dyn x s(-1) x cm(-5) were found. We describe a 11-year clinical course of anticoagulated patient with monitoring of functional status and echocardiography and with control of pulmonary haemodynamics at the end of follow-up.

Unlabelled: Many authors reported respiratory muscle function impairment in patients with chronic obstructive pulmonary disease (COPD). Impaired respiratory muscle function may contribute exercise intolerance which is frequently observed in this disease., Aim of the Study: was to determine the influence of respiratory muscle function on exercise capacity in patients with COPD., Methods: 23 patients with stable COPD aged 62.7 +/- 9.3 years (6F, 17M; mean post-bronchodilator FEV1 = 47.9 +/-12.4% value predicted) participated in the study. Exercise capacity was assessed by the six-minute walk test and the incremental cardiopulmonary exercise test (CPET) on a treadmill. Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after CPET., Results: The mean peak oxygen uptake (VO max) was 27.2 +/- 6.1 mlO2/min/kg and the mean distance walked during the 6MWT was 569.4 +/- 101.7 m. Both PIMax and PE max decreased significantly after maximal exercise (71.4 +/-23.0 vs 63.6 +/- 22.2 cmH2O, p = 0.001 and 124.9 +/- 46.5 vs 112.3 +/- 46.6 cm H2O, p = 0.02 respectively). No correlation between VO2max and the 6-minute walk distance and the maximal respiratory pressures was found. We observed a negative correlation between the 6-minute walk distance and the difference between the pre- and post CPET maximal inspiratory pressure., Conclusions: respiratory muscle function is impaired in patients with COPD but this does not affect exercise performance. Exercise causes a decrease of the respiratory muscle strength.

Purpose: Surgical treatment of oral cavity neoplasms consists of the resection of tumor surrounded by a healthy tissue margin. The removal of tissues leads to breathing disturbances. Apnea episodes cause a drop in the arterial blood saturation with oxygen. This study was designed to qualitatively and quantitatively evaluate breathing disturbances and dyspnoea after resection of oral cavity structures, throat structures and muscles of the neck., Material and Methods: For this purpose, spirometry and pulsoximetry were done. Breathing disorders in sleeping patients were also examined. We enrolled 50 persons after surgery and divided them into three groups according to the type of resected structures: lateral part of the mandible; mental part of the mandible; part of the tongue., Conclusions: The following conclusions were drawn: 1) Operations in the oral cavity in spite of reconstructions result in breathing disturbances. 2) Spirometry and pulsoximetry are useful for the study of breathing disturbances. 3) Static and dynamic values of key spirometric parameters were reduced in the patients; 4) Deterioration of blood saturation during sleep in patients after operations confirms breathing disorders.

The authors presented symptoms of botulism, diagnostics and treatment. In this case there was a necessity of urgent tracheotomy. The authors had good results because of early treatment with serum antibotulism A+B+C and symptomatic treatment. Decannulation was only after 45 days because the paralytic symptoms declined very slowly.

The sensation of dyspnea on exertion is usually the first clinical symptom in patients with IPF. The aim of the study was to assess breathlessness in patients with IPF at the time of diagnosis. The study group included 9 patients (5 women and 4 men), aged 61.4 +/- 10.5 (mean +/- SD) yrs, (range 38-71 yrs). FVC was 65.8 +/- 8.3% pred., FEVI 70.0 +/- 9.0% pred., TLC 65.1 +/- 10.5% pred. 6 min walking test was performed, during which pts reported their breathlessness according to Borg scale. All patients but one reported breathlessness during exercise. Patients were divided into two groups according to the level of dyspnea at the end of the walking test. Patients with dyspnea equal or less than moderate (= < level 3 Borg scale) had significantly higher lung volumes FVC (2.57 +/- 0.44 vs 1.79 +/- 0.5 l, p < 0.05), FEVI (2.23 +/- 0.29 vs 1.56 +/- 0.36 l, p < 0.02), TLC (4.26 +/- 0.26 vs 3.13 +/- 0.69 l, p < 0.02), DLCO (4.49 +/- 0.52 vs 3.43 +/- 0.23 mmol/min/kPa, p < 0.02), and smaller alveolar-arterial oxygen tension difference at rest (31.8 +/- 5.6 vs 43.8 +/- 2.8 mmHg, p < 0.01) as compared to the patients with more severe dyspnea (> level 3 Borg scale). All patients desaturated during the test, but there was no correlation between the degree of desaturation and dyspnea level at the end of the test. 4 patients from the first group (dyspnea level = < 3 Borg scale) desaturated from 6.3% to 19.4% from baseline value. So patients with IPF may experience severe desaturation during normal daily activity not being aware of it. Dyspnea on exertion in these patients seems to depend on both disturbed lung mechanics and gas exchange. Simple 6-minutes walking test proved to be useful in assessing severity of the disease in patients with IPF.

Thirty two patients with severe COPD were studied. We evaluated relationships between their psychological status, lung function parameters, exercises tolerance (6 MWD test) and dyspnea at rest and exercise (visual analogue scale). Patients demonstrated increased level of anxiety and psychological tension. In nearly half of the patients depression, low self-esteem and disbelief in the efficiency of therapy were observed. The correlations between the psychological status and the exercise tolerance hasn't been found. The correlation between the high level of depression and impairment of the lung function was found. The high increase in dyspnea score during exercises was connected with low self-esteem, although at rest the dyspnea level in those patients was low.