Impact of COVID-19 social distancing recommendations on pulmonary function, nutritional status, and morbidity in patients with cystic fibrosis / Impacto das recomendações de distanciamento social por COVID-19 sobre a função pulmonar, estado nutricional e morbidade em pacientes com fibrose cística

ABSTRACT Objective: To evaluate the impact of COVID-19 social distancing recommendations on nutritional status, pulmonary function, and morbidity in patients with cystic fibrosis (CF). Methods: A retrospective cohort study including patients older than six years with a diagnosis of CF was performed. Demographic and clinical data, anthropometric measurements, pulmonary function, days of antibiotic use, and length of hospital stay were recorded. Variables were recorded at three time points relative to the baseline for implementation of social distancing measures: T-1 (14 months before implementation), T0 (baseline), and T1 (14 months after implementation). Delta (Δ) was calculated for each period: Δ1 (pre-pandemic T0-T-1) and Δ2 (pandemic T1-T0). Results: The study included 25 patients, with a mean age of 11.7±4.3 years. The mean forced expiratory volume in the first second (FEV1) was 85.6±23.6%, and body mass index (BMI) was 17.5±3.0 kg/m2. When comparing the two periods (Δ1 and Δ2), there was a significant increase in the FEV1/forced vital capacity (FVC) ratio (p=0.013) and in the forced expiratory flow between 25 and 75% of vital capacity (FEF25-75%) (p=0.037) in the pandemic period. There was also a significant reduction (p=0.005) in the use of antibiotics in the pandemic period compared with the pre-pandemic period. The Δ1 and Δ2 values did not differ significantly for BMI, FEV1, or length of hospital stay. Conclusions: COVID-19 social distancing recommendations had a positive impact (decrease) on morbidity (use of antibiotics) and small airway obstruction (FEF25-75%) in patients with CF.

RESUMO Objetivo: Avaliar o impacto das recomendações de medidas de distanciamento social por COVID-19 sobre estado nutricional, função pulmonar e morbidade em pacientes com fibrose cística (FC). Métodos: Estudo de coorte, retrospectivo, que incluiu pacientes com diagnóstico de FC e idade superior a seis anos. Foram registrados os dados demográficos, antropométricos, clínicos, de função pulmonar e o total de dias de uso de antibiótico e de hospitalizações. As variáveis foram registradas em três momentos relativos ao início das recomendações de distanciamento social: T-1 (14 meses antes), T0 (início das recomendações) e T1 (14 meses depois). Foram calculados deltas (Δ) para cada um dos períodos: Δ1 (pré-pandemia T0-T-1) e Δ2 (pandemia T1-T0). Resultados: Vinte e cinco pacientes, com média de idade de 11,7±4,3 anos, sendo 76% homozigotos para Δf508 e 28% colonizados por Pseudomonas aeruginosa, foram incluídos. A média do volume expiratório forçado no primeiro segundo (VEF1) foi de 85,6±23,6 (% do previsto) e o índice de massa corporal (IMC) foi de 17,5±3,0 kg/m2. Ao compararmos os períodos (Δ1 e Δ2), houve aumento significativo do VEF1/CVF (p=0,013) e do FEF25-75% (p=0,037) no período das recomendações de distanciamento. Também se observou redução significativa (p=0,005) do uso de antibióticos no período da pandemia em comparação ao período anterior a ela. Não houve diferenças significativas nos deltas para o IMC, VEF1 e dias de hospitalização. Conclusões: As recomendações de distanciamento social por COVID-19 tiveram impacto positivo (redução) sobre a morbidade (uso de antibióticos) e a obstrução de vias aéreas de menor calibre (FEF25-75%) em pacientes com FC.

Efficacy of Respiratory Muscle Training in the Immediate Postoperative Period of Cardiac Surgery: A Systematic Review and Meta-Analysis

ABSTRACT Introduction: This study aimed to evaluate the efficacy of respiratory muscle training during the immediate postoperative period of cardiac surgery on respiratory muscle strength, pulmonary function, functional capacity, and length of hospital stay. Methods: This is a systematic review and meta-analysis. A comprehensive search on PubMed®, Excerpta Medica Database (or Embase), Cumulative Index of Nursing and Allied Health Literature (or CINAHL), Latin American and Caribbean Health Sciences Literature (or LILACS), Scientific Electronic Library Online (or SciELO), Physiotherapy Evidence Database (or PEDro), and Cochrane Central Register of Controlled Trials databases was performed. A combination of free-text words and indexed terms referring to cardiac surgery, coronary artery bypass grafting, respiratory muscle training, and clinical trials was used. A total of 792 studies were identified; after careful selection, six studies were evaluated. Results: The studies found significant improvement after inspiratory muscle training (IMT) (n = 165, 95% confidence interval [CI] 9.68, 21.99) and expiratory muscle training (EMT) (n = 135, 95% CI 8.59, 27.07) of maximal inspiratory pressure and maximal expiratory pressure, respectively. Also, IMT increased significantly (95% CI 19.59, 349.82, n = 85) the tidal volume. However, no differences were found in the peak expiratory flow, functional capacity, and length of hospital stay after EMT and IMT. Conclusion: IMT and EMT demonstrated efficacy in improving respiratory muscle strength during the immediate postoperative period of cardiac surgery. There was no evidence indicating the efficacy of IMT for pulmonary function and length of hospital stay and the efficacy of EMT for functional capacity.

Serum interleukin-33 combined with FEF75% z-score and FeNO improves the diagnostic accuracy of asthma in children

Abstract Objective To investigate the diagnostic efficacy of serum IL-33 single indicator and combined indicators for asthma in children. Methods 132 children were initially diagnosed with asthma during acute exacerbation and 100 healthy children were included. Serum IL-33 concentration differences were compared between asthmatic and normal children. Correlations between IL-33 with pulmonary function parameters, FeNO, peripheral blood EOS counts and serum total IgE were analyzed in asthmatic children. ROC curves were used to assess IL-33 diagnostic efficacy and its combined indicators. To prevent overfitting of the predictive model, the hold-out cross-validation method was used. Results (1) Serum IL-33 concentrations were significantly higher in children with asthma than in normal children (p < 0.001). (2) IL-33 concentration was negatively correlated with FVC z-score, FEV1 z-score and FEF75% z-score in asthmatic children (p < 0.05). (3) The area under the ROC curve of IL-33 was 0.821, which was higher than those of FeNO, FVC z-score, and FEV1 z-score. (4) Cross-validation of the combined indicators showed that IL-33 significantly improved asthma diagnostic efficacy. The combination of IL-33, FEF75% z-score, and FeNO showed the highest diagnostic efficacy, with the AUC, sensitivity, and specificity of the combined indicator being 0.954, 90.1%, and 89. 0%, respectively, and good extrapolation of the predictive model. Conclusion Serum IL-33 is higher in children with asthma and increases with the severity of pulmonary ventilation obstruction. A single indicator of serum IL-33 demonstrates moderate diagnostic accuracy, and its combination with FEF75% z-score and FeNO significantly improves the diagnostic accuracy in childhood asthma.

Risk factors and determinants of pulmonary function impairments in chronic respiratory diseases in Ethiopia: A hospital-based cross-sectional study

Introduction: Chronic respiratory diseases (CRDs) are diseases of the lung airways and parenchyma. Globally, they are the leading causes of morbidity and mortality. This study aimed to characterize the common CRDs, along with their lung function and possible determinants in symptomatic patients attending Bishoftu General Hospital, Ethiopia. Methods: A cross-sessional study was conducted at the outpatient of Bishoftu Hospital, Ethiopia from June 2019 to March 2020. Consecutive adult patients aged 18 and above with CRDs (≥8 weeks) were recruited. Questionnaires were used to collect data on demographics, symptoms, diagnoses, and putative risk factors. Lung function was measured by spirometry. Result: A total of 170 participants were recruited, the majority 102(60.0%) were female. The mean age was 49 years (SD=16). The most common symptoms were wheezing in the last twelve months 156 (91.8%), cough 138 (81.2%), and severe exertional breathlessness 137 (80.6%). Thirty-nine (22.9%) were either active or passive smokers. Half of the patients (50.3%) were exposed daily to vapors, dust, gases, or fumes and 58 (34.3%) were exposed to biomass smoke. In total, 138 (81.2%) had a positive allergen skin prick test. Chronic bronchitis (49.1%) and asthma (36.1%) were the most common clinical diagnoses. Classification of lung function revealed 23 (15%) normal, 29 (19%) obstructive, 36(23.5%) restrictive and 61(39.9%) mixed patterns. Airflow obstruction was independently associated with increasing age (p<0.05), exertional breathlessness (p<0.001), previous history of asthma (p<0.05), BMI (p<0.05), and doctor-diagnosed chronic obstructive pulmonary disease (p<0.001) and asthma (p<0.05). Conclusion: This study shows a high burden of abnormal lung function in patients attending clinics because of CRDs symptoms. These findings support the critical need for spirometry services to determine lung abnormality in patients with chronic respiratory symptoms.

Awareness and influencing factors of chronic obstructive pulmonary diseases among residents in Yangpu District， Shanghai / 上海预防医学

ObjectiveTo understand the awareness of knowledge about chronic obstructive pulmonary disease （COPD） and influencing factors among residents in Yangpu District， Shanghai. MethodsWe used cluster random sampling method to conduct face-to-face questionnaire surveys on selected household residents in 12 streets of Yangpu District. The survey questions included their understanding of COPD name， lung function test， and COPD related knowledge. Multivariate logistic regression analysis was used to analyze the influencing factors of awareness rate. ResultsA total of 1 440 people were ultimately included in the analysis， and the awareness rates of COPD name， lung function test， and COPD awareness were 19.93%， 18.61%， and 14.95%， respectively. Among the people who knew the name of COPD， awareness rate of shortness of breath or dyspnea was the highest （84.12%） in the three main symptoms of COPD. Among the main risk factors of COPD， second-hand smoke（86.78%）and smoking （85.82%） were the highest. The main ways to obtain knowledge of COPD names were through television （12.60%） and the internet （11.97%）. The results of multivariate logistic regression analysis showed that men were significantly higher than women in the awareness of COPD name， lung function test， and COPD knowledge， with the OR values of （OR=1.39， 95%CI：1.08‒1.79）， （OR=1.47，95%CI：1.12‒1.92） and （OR=1.37，95%CI：1.02‒1.84）， respectively. The awareness rate of COPD names and lung function tests was the highest among people aged ≥ 65 years old， while the awareness rate of COPD knowledge was the highest among people aged 35‒50 years old. The awareness rate of COPD names was the highest among people with college education or above， civil servants， teachers， and medical staff， people with an annual household income of 100 000‒200 000 yuan. ConclusionThe overall awareness rate of COPD names， lung function tests， and COPD related knowledge among residents in Yangpu District is still at a low level. We should intensify the promotion and education of COPD among key groups such as women， young people， and those with low income， in order to improve the overall awareness rate of COPD among the population.

Impacto de un Programa de Recuperación Funcional en Músculos Ventilatorios y Apendiculares en Pacientes Post-ventilación Mecánica por COVID-19 / Impact of a Functional Recovery Program on Ventilatory and Appendicular Muscles in Patients Post-mechanical Ventilation for COVID-19

Los pacientes con COVID-19 subsidiarios de ventilación mecánica (VM), evolucionan con consecuencias funcionales en la musculatura ventilatoria y apendicular que no necesariamente se abordan de manera diferenciada. El objetivo de esta investigación fue evaluar el impacto de un programa de recuperación funcional en estos pacientes y determinar si las intervenciones afectan de manera diferenciada a las funciones ventilatorias y musculatura apendicular, utilizando pruebas de bajo costo. Se evaluaron 47 pacientes con COVID-19 que estuvieron en VM. Posterior a una espirometría basal se les realizó; presión inspiratoria máxima (PIMáx), fuerza de prensión palmar (FPP), prueba de pararse y sentarse (PPS) y Prueba de caminata en 6 minutos (PC6m), antes y después del plan de intervención. Este programa incluyó ejercicios aeróbicos y de fuerza supervisados por dos sesiones semanales de 60 minutos durante 3 meses. Después del programa, se observaron mejoras significativas en la capacidad vital forzada (CVF), el volumen espiratorio en el primer segundo (VEF1) y la PIMáx. Se encontraron relaciones significativas entre estas mediciones y la distancia recorrida de la PC6m, la FPP y la PPS. En conclusión, el programa de recuperación funcional en pacientes con COVID-19 que requirieron VM, beneficia tanto la función ventilatoria como la fuerza muscular apendicular. Las pruebas de fuerza muscular apendicular pueden ser útiles para evaluar la recuperación ya que pueden entregar información diferenciada de sus rendimientos. Por último, se necesita más investigación para comprender mejor la respuesta de estos pacientes a la rehabilitación.

SUMMARY: Patients with COVID-19 requiring mechanical ventilation (MV) evolve with functional consequences in the ventilatory and appendicular muscles that are not necessarily addressed in a differentiated manner. The objective of this research was to evaluate the impact of a functional recovery program in these patients and determine if the interventions differentially affect ventilatory functions and appendicular muscles, using low- cost tests. 47 patients with COVID-19 who were on MV were evaluated. After a baseline spirometry, they were performed; maximum inspiratory pressure (MIP), handgrip strength (HGS), sit to stand test (STST) and 6-minute walk test (6MWT), before and after the intervention plan. This program included supervised aerobic and strength exercises for two weekly 60-minute sessions for 3 months. After the program, significant improvements were observed in forced vital capacity (FVC), expiratory volume in the first second (FEV1) and MIP. Significant relationships were found between these measurements and the distance traveled of the 6MWT, the HGS and the STST. In conclusion, the functional recovery program in patients with COVID-19 who required MV benefits both ventilatory function and appendicular muscle strength. Appendicular muscle strength tests can be useful to evaluate recovery since they can provide differentiated information about your performances. Finally, more research is needed to better understand the response of these patients to rehabilitation.

Lung Function Tests in Infants and Children

Lung function testing is an essential modality of investigation in children as it provides objective evidence of lung disease/ health. With advances in technology, various tests are available that can aid in the diagnosis of lung disease, assess the progression and response to therapy and document the lung development and evolving lung diseases in infants. This narrative review discusses lung function tests in infants and children. Currently, lung function tests can be performed in every age group, from neonates to the elderly. Spirometry and peak expiratory flow rate (PEFR) are the most employed tests in children more than six years of age. Spirometry helps diagnose and monitoring of both obstructive and restrictive diseases. There is a need for expertise to perform and interpret spirometry correctly. The forced oscillation technique (FOT) or impulse oscillometry (IOS) is done with tidal volume breathing and is feasible even in preschool children. Their utility is mainly restricted to asthma in children at present. Lung function tests can be performed in neonates, infants and children using infant pulmonary function test (PFT) equipment, although their availability is limited. Diffusion capacity for carbon monoxide (DLCO) is a valuable tool in restrictive lung diseases. Lung volumes can be assessed by body plethysmography and multiple washout technique. The latter can also assess lung clearance index. It is essential to perform and interpret the lung function test results correctly and correlate them with the clinical condition for optimum treatment and outcome.

Pediatric Pulmonology Training in India: Current Status and Future Directions

Respiratory illnesses are common causes of morbidity and mortality in children. Postgraduates in Pediatrics spent significant time in learning to manage respiratory disorders. Improved survival of preterm neonates, improved diagnosis and survival of chronic respiratory problems, and advances in diagnosis and therapeutics have increased the need for specialists trained in managing these patients. Training programs in Pediatric Pulmonology are evolving over the past few decades. In India, super-specialty training in Pediatric Pulmonology has grown over the past few years. There is a need to modify the training structure used in industrialized countries due to differences in patient population, priorities, and limited available resources and expertise. Formal training courses have been started in a limited number of institutions. There is a large gap between the need for a trained workforce and the available specialists in the limited number of institutions. The Indian Academy of Pediatrics National Respiratory Chapter (IAPNRC) has initiated a fellowship program to bridge the gap. Comprehensive training involving academic and hands-on training may go a long way to improve the care of children with acute and chronic respiratory problems. For sustainable development of the super specialty, there is a need to work towards creating Pediatric Pulmonology service departments in various institutions that may be responsible for comprehensive training and research activities to answer common research questions.

Pulmonary function tests in compressed natural gas pump workers in Surat city

Background: Various studies have known abatements in lung function and several other health problems associated with longstanding air pollution exposure. One of the most cost-effective and environmental alternative of conventional fuels (petrol and diesel) is compressed natural gas (CNG). The increasing use of CNG as a fuel (as it is safe and cheap as compare to the conventional fuels) can add one more bug to the list of work-related disease. Aims and Objectives: This study is to evaluate the respiratory functions of CNG pump workers. Materials and Methods: The present study was held on 82 male subjects. The study group included of non-smoking healthy adult males, age group of 20–40 years working in different CNG stations in Surat city for >6 months and 8 h per day. The control group included of non-smoking healthy adult males, age group of 20–30 years working or studying in the Surat Municipal Institute of Medical Education and Research (SMIMER). Results: Out of 82 male subjects, 30 subjects were control and 52 subjects were CNG station workers. The study group comprised of 52 healthy non-smokers in the age group of 20–40 years working in different CNG station in Surat city for >6 months and 8 h/day. The control group comprised of 30 healthy non-smokers males between the age group of 20–30 years working or studying in the SMIMER. Conclusion: In this study, we have not found statistically significant deterioration in pulmonary functions of CNG pump workers when compared to controls.

Correlation of glycemic control and BMI with pulmonary function test in Type-2 diabetes mellitus – A cross-sectional case–control study

Background: Type-2 diabetes mellitus is related to decreased lung function. Prolonged inadequate control of glucose levels may alter regulation of inflammatory pathways that are implicated in pulmonary function complications. Aim and Objectives: The objjectives of the study were to assess the relationship of pulmonary function test (PFT) with factors influencing glycemic status in type 2 diabetes mellitus. Materials and Methods: A total of 110 diabetic cases with uncontrolled blood sugar levels and similar number age- and gender-matched control subjects above 30 years of age were recruited. Sociodemographic details were collected and participants underwent laboratory ad radiological investigations. PFTs including Forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expired volume in 1 s (FEV1), forced expiratory flow (FEF 25–75%), and FEV1/FVC ratio were assessed. Results: The comparison of PFTs with levels of HbA1c (<7 and >7) showed that the levels of FVC, PEFR, FEV1, and FEF 25–75% were higher in diabetics with HbA1c <7 and FEV1/FVC ratio was high in diabetic cases with HbA1c >7. The mean difference of PFT with HbA1c and body mass index (BMI) was statistically not significant in diabetics (P > 0.05). The person’s correlation analysis showed a negative correlation between FVC, FEV1 with HbA1c, and BMI in diabetics. Conclusion: Uncontrolled glycemic status and increased BMI were associated with functional impairment of lungs. Organized glycemic control and duly checking the PFTs may reduce the risk of onset of respiratory complications and lung function.

Efectos de la menopausia temprana en la función pulmonar: revisión integrativa / Effects of early menopause on lung function: an integrative review

La menopausia provoca cambios hormonales y alteraciones sistémicas. La menopausia normal sucede entre los 45-55 años y la menopausia temprana (MT) se desarrolla antes de los 45 años. Revisar la evidencia que señala posibles asociaciones entre la MT y la función pulmonar, analizando específicamente aquellos componentes que se encuentran alterados. Se eligieron estudios transversales y revisiones sistemáticas, en inglés, portugués y español. La búsqueda se realizó de marzo a noviembre de2022, en PubMed y Scopus, aemás de búsquedas manuales. La calidad metodológica fue analizada utilizando la escala Strengthening the Reporting of Observational Studies in Epidemiology para los estudios observacionales, y el Ameasurement Tool to Assess Systematic Review para las revisiones. Se encontraron 698 estudios, 12 seleccionados para calificación metodológica, cinco excluidos. Al final del análisis metodológico, se obtuvieron seis estudios transversales y una revisión sistemática, llevados a cabo en Reino Unido, Europa y Asia. Hay una tendencia para asociación de la MT a un patrón ventilatorio restrictivo. Sin embargo la evidencia sigue siendo escasa y se sugiere la realización de nuevos estudios.

Menopause causes hormonal changes and systemic alterations. Normal menopause is when this event occurs between the ages of 45 and 55, and early menopause (EM) when it develops earlier than 45 years. To review the evidence that indicates possible associations between EM and lung function, specifically analyzing those components that are altered. Cross-sectional and systematic reviews studies, published from 2000-2022, in English, Portuguese and Spanish were selected from March to November 2022, in PubMed and Scopus and through manual searches. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology scale for observational studies, and the Measurement Tool to Assess Systematic Review for reviews. 698 studies were found, 12 were selected for methodological quality review and 5 were excluded. At the end of methodological analysis, 6 cross-sectional studies and 1 systematic review were obtained, carried out in United Kingdom, Europe and Asia. There is a tendency for EM to be associated with restrictive ventilatory pattern. However, the evidence is scarce and further studies are suggested.

Post-COVID-19 pulmonary function tests in young health care workers in South Indian population – An observational study

Background: The risk of exposure to COVID-19 pandemic was substantially higher in frontline young health care workers. Due to repeated exposure while treating patients, the viral load is exponentially higher than the other population. Lungs being the earliest organ to be affected carry more risk of long-term morbidity. Thus, pulmonary function tests (PFTs) on post-COVID young health care workers provide a better view on the impact, recovery and residual effects. Aim and Objectives: The objectives of the study are as follows: (i) To assess the PFT in study group who have recovered from COVID-19 within the past 3 months; (ii) to compare their lung function with that of health care workers who have not been infected by COVID-19; and (iii) to determine obstructive, restrictive or mixed pulmonary changes if any in health care workers after 3 months of recovery. Materials and Methods: This study involving 50 young health care workers was done in the department of pulmonary medicine for a period of 4 months between January and April 2021. The study (mild COVID-19 positive) control group involved 25 participants each. PFT and diffusing capacity of lung for carbon monoxide (DLCO) were measured using computerized spirometer and single breath method. Results were analyzed using Shapiro–Wilk test, Independent sample t test, and Chi-square test. Results: A statistically significant difference was observed among the subjects of case and control group with respect to the level of FEV1 (P < 0.05), FEV1/Forced vital capacity (FVC) (P < 0.01), and FEF. FVC, Peak expiratory flow (PEF), forced expiratory time, DLCO, and peak inspiratory flow (PIF) were not statistically different between the study and control group. (P > 0.05).The 3-month post recovery values were high in males when compared to females, except for PIF, PEF and FEV1%. Conclusion: PFT and DLCO values were normal in young health care workers after 3 months of COVID-19 infection except for a decrease in FEF 25–75%.

A comparative study of effects of pranayama and aerobic exercise on spirometric indices in the age group of 30–50 years

Background: Increasing awareness to lifestyle disease has led to more participation of people in taking up various forms of exercise to avail more health benefits. The ability to perform physical exercise is related to cardiovascular systems capacity to supply oxygen to muscles and pulmonary systems ability to clear carbon di oxide from blood via lungs. Spirometry is a physiological test that measures the volume and flow of air that can be inhaled and exhaled. Aim and Objectives: The purpose of this study is not only to assess the beneficial effects of pranayama and aerobic exercises but to compare the improvements in the lung functions among these two modalities of exercises. Materials and Methods: It is a non-randomized cross-sectional comparative study. Total 150 participants of both sexes aged 30–50 years were selected and divided equally into three groups: Pranayama group, aerobic exercise group, and control group who were doing pranayama and aerobic exercise and no exercise respectively from the past 3 months were included in the study. The participants were assessed by their anthropometric parameters, pulse rate, respiratory rate, blood pressure, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow rate (PEFR). Results: Among Pranayama groups, there was significantly higher level of FVC, FEV1, FEV1/FVC ratio, and PEFR as compared to aerobic exercise group and control group. Conclusion: Both pranayama and aerobic exercise play an important role in improving the pulmonary functions but effects were more pronounced with pranayama.

Relationship between Body Surface Area and Pulmonary Functions in Patients of Silicosis

Background and objective: Silicosis is one of the oldest occupational lung diseases. However, there are very few studies identifying the anthropometric variables associated with silicosis. The present study aimed at studying the association between body surface area (BSA), pulmonary function indices, and 6-minute walk distance (6MWD) in patients with silicosis. Materials and methods: The study was conducted on 102 male patients of silicosis. Height and weight were measured to calculate BSA. Spirometry and 6 minute-walk tests were performed. Data were analyzed using EPI info V 7 software. Student's t-test of significance (ANOVA) was applied to test the difference between means. Results: There are no significant changes found in the 6-minute walk distance with years of exposure and BSA. Statistically significant lower values of pulmonary function indices were observed in patients with BSA <1.6 sq m. Statistically significant higher values of forced expiratory volume in the first second and forced vital capacity were observed in patients with BSA >1.9 sq m in all categories of exposure. Conclusion: In conclusion, patients of silicosis with >1.9 sq m BSA had higher values of pulmonary function indices. Large body size may be of value in protection from developing occupational lung disease.

Morphological characteristics and pulmonary function of naval saboteurs and ground special forces of the armed forces of Montenegro / Características morfológicas y función pulmonar de saboteadores navales y fuerzas especiales terrestres de las fuerzas armadas de Montenegro

SUMMARY: The results of numerous medical and kinesiological studies indicate the existence of differences in pulmonary function in relation to age, body height, and the relationship between certain parameters of body composition. The aim of this study was to determine the state of morphological characteristics and pulmonary function of naval saboteurs and ground Special Forces of the Armed Forces of Montenegro. The sample of participants included 30 naval saboteurs aged 30.3±6 years and 30 members of the ground special forces aged 25.6±5 years. The sample of measuring instruments included 4 indicators each for the evaluation of longitudinal dimensionality, transversal dimensionality, mass and body volume, subcutaneous fat, body composition, and pulmonary function. The central and dispersion parameters of the variables were calculated. The specificities of body composition of the naval saboteurs and members of the ground Special Forces of the AF of Montenegro were determined, while the parameters of lung volume and capacity and the parameters of airway flow indicated an excellent state of their respiratory function. Furthermore, it was determined that the studied members of the armed forces had no individual health risks in the sense of the onset of obesity or obstructive ventilatory defects. The results obtained indicate the need for further studies which would predominantly focus on the impact of individual morphological measurements and parameters of body composition on pulmonary function. This would provide important data both for the armed forces in the sense of improving the training system and the realization of specific tasks, as well as for kinesiology as a science from the aspect of determining certain regularities in the functioning of the human body in specific living and working conditions in the armed forces.

Los resultados de numerosos estudios médicos y kinesiológicos indican la existencia de diferencias en la función pulmonar en relación con la edad, la altura corporal y la relación entre determinados parámetros de la composición corporal. El objetivo de este estudio fue determinar el estado de las características morfológicas y la función pulmonar de los saboteadores navales y de las Fuerzas Especiales terrestres de las Fuerzas Armadas de Montenegro. La muestra de participantes incluyó a 30 saboteadores navales de 30,3±6 años de edad y 30 miembros de las fuerzas especiales terrestres de 25,6±5 años. La muestra de instrumentos de medición incluyó 4 indicadores cada uno para la evaluación de dimensionalidad longitudinal, dimensionalidad transversal, masa y volumen corporal, grasa subcutánea, composición corporal y función pulmonar. Se calcularon los parámetros centrales y de dispersión de las variables. Se determinaron las especificidades de la composición corporal de los saboteadores navales y miembros de las Fuerzas Especiales terrestres de la FA de Montenegro, mientras que los parámetros de volumen y capacidad pulmonar y los parámetros de flujo de las vías respiratorias indicaron un excelente estado de su función respiratoria. Además, se determinó que los miembros de las fuerzas armadas estudiados no tenían riesgos individuales de salud en el sentido de la obesidad o defectos ventilatorios obstructivos. Los resultados obtenidos indican la necesidad de más estudios que se centren predominantemente en el impacto de las medidas morfológicas individuales y los parámetros de composición corporal en la función pulmonar. Esto proporcionaría datos importantes tanto para las fuerzas armadas en el sentido de mejorar el sistema de entrenamiento y la realización de tareas específicas, como para la kinesiología como ciencia desde el aspecto de determinar ciertas regularidades en el funcionamiento del cuerpo humano en situaciones específicas de vida. y condiciones de trabajo en las fuerzas armadas.

Study of lung function tests in tea garden factory workers in relation to duration of exposure to tea dust

Background: Occupational hazard is a common health problem in the world today. The tea industry is also no exception. Tea dust inhalation leads to development of many respiratory symptoms: Acute as well as chronic. Workers in the tea factory often are not aware of the ill effects of inhalation of tea dust. There is therefore a need to make them aware of their working environment and take necessary precautions to keep themselves healthy to earn their livelihood. Aims and Objectives: The aim of the study was to assess the pulmonary function tests (PFT) in tea garden factory workers and assess the outcome of exposure duration to tea dust in them. Materials and Methods: The study had been carried out on 210 male tea garden factory workers (cases) and 70 male field workers (control) employed in various tea gardens of Dibrugarh, in Assam. Computerized spirometer was used to evaluate PFTs. The cases were categorized into three categories (70 numbers in every category) according to their exposure duration, namely – Category 1: Exposure duration <1 year; Category 2: Exposure duration of 1–2 years; and Category 3: Exposure duration of >2 years up to 5 years. Statistical analysis was done using ANOVA. Results: On comparing with control group values, statistically significant decline of forced vital capacity and forced expiratory volume (FEV)1 values were seen in Category 1 while highly significant decline were seen for Categories 2 and 3. Decline of FEV1% in Category 3 was highly significant. Decline of peaked expiratory flow rate values in Category 2 and Category 3 was significant. Conclusion: Increase in exposure duration to tea dust causes a significant decline in lung functions.

Pulmonary function and exercise capacity six months after hospital discharge of patients with severe COVID-19

ABSTRACT Introduction: The long-term consequences of COVID-19, especially pulmonary impairment, are frequent but not well understood. The knowledge about sequels or long COVID-19 are necessary, considering the high prevalence and need for specific public strategies. Method: The study was conducted to evaluate symptoms (standardized questionnaire), pulmonary function (spirometry), and exercise capacity (6-minute-walk-test) at 30 (D30), 90 (D90), and 180 (D180) days after hospital discharge of patients surviving to severe COVID-19. We excluded in this follow up patients with comorbidities before COVID infection. Results: 44 patients were included and 31 (26 men) completed the 6-month follow-up (age mean 53.6 ± 9.6 years). At D180, 28% presented still at least one symptom. The most common was dyspnea (17.2%), followed by cough (13.8%), and myalgia (10.3%). All spirometric parameters showed progressive improvement from D30 to D180. However, 16% maintained a restrictive pattern on spirometry test, 44% presented desaturation on the 6-minute walk-test, and 25% walked < 75% of the predicted value. Conclusion: 6-months after hospital discharge, reduced pulmonary function and reduced exercise capacity was founded frequently and more than a quarter remained symptomatic. The persistent symptoms and functional impairment suggest that sequels and development of Long COVID-19 are very common. The identification of these patients to provide the necessary health care is a challenging task, considering the large number of patients infected and surviving to COVID-19 disease.

Study on the correlation between ceramic and chronic obstructive pulmonary disease in Foshan City / 中华劳动卫生职业病杂志

Objective: To study the correlation between ceramic and chronic obstructive pulmonary disease (COPD), and explore its related risk factors. Methods: In January 2021, five representative ceramic enterprises were selected from Chancheng District, Nanhai District, Gaoming District and Sanshui District of Foshan City. The ceramic workers who came to Chancheng Hospital of Foshan First People's Hospital for physical examination from January to October 2021 were selected as the research objects, and 525 people were included. Conduct questionnaire survey and pulmonary function test. Logistic regresion was performed to analyze the influencing facters of COPD among ceramic workers. Results: The subjects were (38.51±1.25) years old, 328 males and 197 females, and the detection rate of COPD was 9.52% (50/525). The incidence of respiratory symptoms such as dyspnea, chronic cough, wheezing and chest tightness, the detection rates of abnormal lung age, abnormal lung function and COPD in males were higher than those in females (P<0.05). The logistic regression analysis showed that male, age, working years, smoking status and family history of COPD were the risk factors for COPD among ceramic workers (P<0.05) . Conclusion: The ceramic workers are the high risk population of COPD. We should do a good job in health education, and do a regular physical examination to find the changes of lung function in time, and prevent the occurrence of COPD as soon as possible.

Study on risk factors of abnormal pulmonary function among dust-exposed workers and prediction model / 中华劳动卫生职业病杂志

Objective: To explore the influencing factors of abnormal pulmonary function in dust-exposed workers and establish the risk prediction model of abnormal pulmonary function. Methods: In April 2021, a total of 4255 dust exposed workers from 47 enterprises in 2020 were included in the study. logistic regression was used to analyze the influencing factors of abnormal pulmonary function in dust-exposed workers, and the corresponding nomogram prediction model was established. The model was evaluated by ROC curve, Calibrationpolt and decision analysis curve. Results: logistic regression analysis showed that age (OR=1.03, 95%CI=1.02~1.05, P<0.001) , physical examination type (OR=4.52, 95%CI=1.69~12.10, P=0.003) , dust type (Comparison with coal dust, Cement dust, OR=3.45, 95%CI=1.45~8.18, P=0.005, Silica dust (OR=2.25, 95%CI=1.01~5.03, P=0.049) , blood pressure (OR=1.63, 95%CI=1.22~2.18, P=0.001) , creatinine (OR=0.08, 95%CI=0.05~0.12, P<0.001) , daily exposure time (OR=1.06, 95%CI=1.10~1.12, P=0.034) and total dust concentration (OR=1.29, 95%CI=1.08~1.54, P=0.005) were the influencing factors of abnormal pulmonary function. The area under the ROC curve of risk prediction nomogram model was 0.764. The results of decision analysis curve showed that the nomogram model had reference value in the prevention and intervention of abnormal pulmonary function when the threshold probability exceeded 0.05. Conclusion: The accuracy ofthe nomogram model constructed by logistic regression werewell in predicting the risk of abnormal lung function of dust-exposed workers.

Clinical characteristics and follow-up analysis of 12 patients of acute phosphine poisoning / 中华劳动卫生职业病杂志

Objective: To investigate the clinical characteristics of patients with acute phosphine poisoning, and to follow up and evaluate the prognosis of patients. Methods: In May 2022, 12 patients with phosphine poisoning by respiratory inhalation in Beijing Chao-Yang Hospital of Capital Medical University were analyzed. The patients were treated with symptomatic support therapy. Three months later, patients were re-evaluated the symptoms of poisoning, pulmonary function and magnetic resonance imaging (MRI) of the brain to understand the prognosis of the phosphine poisoning. Results: The main symptoms of 12 patients were respiratory and central nervous system symptoms with hypoxia. The symptoms of poisoning improved after treatment. Follow-up found that the patients had different degrees of residual symptoms. Pulmonary function showed increased airway resistance. Airway challenge test was positive in some patients. MRI of the head of some patients showed small ischemic focus in bilateral frontal lobes. Conclusion: Acute phosphine poisoning may cause persistent damage to the respiratory system and central system, and residual symptoms after 3 months.