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Abstract Proper functioning of the respiratory system is one of the most important determinants of human health. According to current knowledge, the diaphragmatic breathing pattern seems to be the most favourable. However, recent reports indicate that athletes often have dysfunctional breathing patterns, which may be associated with an increased risk of musculoskeletal injuries. The influence of the type of breathing pattern on the mechanical airways in athletes has not been investigated. The aim of the present study was to determine the characteristics and relationships between breathing patterns and respiratory function in athletes. This study included 69 Polish elite endurance athletes (♂40, ♀29) in different sports disciplines and 44 (♂17, ♀27) healthy nonathletes as a control group. All participants underwent pulmonary function tests (spirometry, plethysmography, diffusion capacity for carbon monoxide) with assessment of breathing patterns by the Hi–Lo test. Inspiratory and expiratory resistance (R) and reactance (X) of the respiratory system at a given frequency (5 Hz, 11 Hz, and 19 Hz) were measured by a noninvasive forced oscillation technique. In this study, almost half of the athletes (44.92%) had dysfunctional breathing patterns, although at a lower rate than that in the control group. Diaphragmatic breathing patterns were characterized by higher spirometric, plethysmographic and DLCO values compared to thoracic or abdominal breathing patterns. Similarly, lower inspiratory reactance at 5 Hz (X5%pred.) was observed in the diaphragmatic pattern compared to the thoracic pattern. A diaphragmatic breathing pattern is associated with better pulmonary function test results. However, this study revealed a dysfunctional breathing pattern in almost half of the athletes. These results suggest that the assessment of breathing patterns and the implementation of breathing exercises in athletes are essential to promote proper breathing patterns.

Abstract Background and Aims Antifibrotic therapies reduce lung function decline in patients with idiopathic pulmonary fibrosis (IPF). This single‐arm, open‐label, nonrandomized study aimed to determine the influence of antifibrotic treatment on patients' reported symptoms and expectations of the therapy. Methods Fifty‐two patients with confirmed IPF at a mean age of 65 ± 8.63 years (73% male) completed the following surveys at baseline and after 12 months of Pirfenidone treatment: Short Form Healthy Survey (SF‐36), St. George's Respiratory Questionnaire (SGRQ), Baseline Dyspnea Index (BDI), Fatigue Assessment Scale (FAS), Leicester Cough Questionnaire (LCQ), and Patient's Needs and Expectations Authors' Survey. Results The most important patients' needs were access to novel therapy, fast and easy access to health centers specializing in IPF treatment, and the improvement of the general condition or the maintenance of its level. These needs did not change with time, except for the significantly more important right of deciding on disease management after 12 months of treatment (p = 0.014). The quality of life per SF‐36, after 1 year of Pirfenidone treatment, significantly improved in the physical cumulative score (p = 0.004) and mental cumulative score (p = 0.003). Significant deteriorations were observed in bodily pain and vitality. For the remaining questionnaires (SGRQ, BDI, FAS, and LCQ), no significant changes in the course of the study were noticed. Around one in 10 patients subjected to Pirfenidone therapy had achieved general symptom improvement in all areas; that is, quality of life improvement as well as cough and dyspnea reduction. Conclusions One year of antifibrotic treatment resulted in a general improvement in the quality of life per the SF‐36 questionnaire. Patients' expectations of disease management did not change; also, access to novel therapies and easy access to health centers specializing in IPF management remained their top needs.

Abstract This study aimed to determine the use of lipid profiling to assess the effects of moderate intensity exercise training (ET) on patients with sarcoidosis. Fourteen patients with sarcoidosis (mean age, 46.0 ± 9.6 years) were examined before and after 3-week of ET programme in hospital settings. Symptoms (fatigue: FAS, dyspnoea: MRC), lung function tests and physical function tests (6 MWT, muscle force) were measured before and after ET. Proton nuclear magnetic resonance (NMR) spectroscopy combined with orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to determine lipid profile before and after ET. Twenty-five NMR signals from lipid compounds were selected for further analysis as well as serum lipid and inflammatory markers. Three weeks of ET results in improvement of symptoms (FAS: 27.5 vs. 21.0; p

Background: Thoracic surgery is a recommended treatment option for non-small cell lung cancer patients. An important part of a patient’s therapy, which helps to prevent postoperative complications and improve quality of life, is pulmonary rehabilitation (PR). The aim of this study was to assess whether the implementation of physical activity has an influence on forced oscillation technique (FOT) values in patients after thoracic surgery due to lung cancer. Methods: In this observational study, we enrolled 54 patients after thoracic surgery due to lung cancer, 49 patients with idiopathic interstitial fibrosis (IPF), and 54 patients with chronic obstructive pulmonary disease/asthma–COPD overlap (COPD/ACO). All patients were subjected to three weeks of in-hospital PR and assessed at the baseline as well as after completing PR by FOT, spirometry, grip strength measurement, and the 6-min walk test (6MWT). Results: We observed differences between FOT values under the influence of physical activity in studied groups, mostly between patients after thoracic surgery and COPD/ACO patients; however, no significant improvement after completing PR among FOT parameters was noticed in any group of patients. Improvements in the 6MWT distance, left hand strength, and right hand strength after PR were noticed (p < 0.001, 0.002, and 0.012, respectively). Conclusions: Three weeks of pulmonary rehabilitation had no impact on FOT values in patients after thoracic surgery due to lung cancer. Instead, we observed improvements in the 6MWT distance and the strength of both hands. Similarly, no FOT changes were observed in IPF and COPD/ACO patients after completing PR.

Given the previous evidence that breath-hold diving is a cause of physiological stress, this study aimed to determine whether a combination static and dynamic apnea would affect total oxidant status, nitric oxide, heat shock proteins and cardiovascular parameters in elite freedivers. Thirteen finalists of the World and European championships in swimming pool breath-hold diving participated in the study. Whole-body plethysmography and electrocardiography was performed to determine the cardiorespiratory variables at baseline and during the simulation static apnea. An assessment of the heart rate, blood oxygen saturation and biochemical variables was performed before and in response to a combination of a static followed by a dynamic apnea. Static and dynamic breath-holding had a significant effect on oxidative stress, as evidenced by an increase in the total oxidant status/capacity (p < 0.001). The post apnea concentrations of heat shock proteins 27 (HSP27) were significantly elevated (p < 0.03, but total antioxidant status (TAS), HSP90, HSP70, and nitric oxide (NO) changes were not significant. levels under the influence of the static and dynamic breath-hold protocol. A significant positive correlation between HSPs and TAS (r = 0.63; p < 0.05) as well as NO levels was associated with beneficial cardiovascular adaptation. An increase in serum HSP27 levels mediated in nitric oxide levels could explain its important role in improving cardiovascular functions in elite freedivers. Further studies are necessary to explain the exact mechanisms of breath holds training of cardiovascular adaptation responsible for maintaining adequate oxygen supply in elite divers.

INTRODUCTION: This report introduces two cases presenting absorption of considerable radiological changes in the course of the coronavirus pneumonia in patients treated with prolonged oral steroids.CASES: The first case concerns a male receiving steroids only during hospitalisation in the Infectious Disease Hospital. After discharge, the patient experienced increasing dyspnoea resulting in hospitalisation in our Department of Lung Diseases. HRCT revealed progression of a bilateral, middle, and basal ground-glass opacity when compared to the examination performed at the early stage of the disease. The supplementary oxygen therapy and steroids were administered, followed by extended prednisone consumption up to 2 months after discharge. Follow-up HRCT revealed an almost complete absorption of the ground-glass opacity. The second case concerns a male treated with steroids only during hospitalisation in the Infectious Disease Hospital. Chest CT revealed widespread bilateral ground-glass opacities with consolidations. After discharge with no treatment, he suffered from severe dyspnoea and exercise intolerance, resulting in hospitalisation on the 7th day of home stay. Since then, a continued steroid treatment was administered resulting in a clinical, spirometric, and radiological improvement.CONCLUSIONS: Based on these observations, patients after the COVID-pneumonia may derive benefits from a prolonged steroid treatment. Therefore, this class of medications should be considered in SARS-CoV-2 patients, especially in patients with persistent radiological changes and dyspnoea requiring the supplementary oxygen therapy. However, randomised controlled trials are required to establish guidelines for the steroid treatment in this group of patients.