BACKGROUND: Long COVID occurs when numerous symptoms begin 3 weeks after acute infection and last for 12 months or more. High-definition transcranial direct current stimulation (HD-tDCS) has been tested in patients with COVID-19; however, previous studies did not investigate the HD-tDCS use combined with inspiratory muscle training (IMT) for respiratory sequelae of long COVID.
METHODS: Six individuals (four women and two men) aged between 29 and 71 years and presenting with respiratory sequelae of long COVID were included. They were submitted to an intervention that comprised HD-tDCS combined with IMT twice a week for 5 weeks. Lung function and respiratory muscle assessments were performed at baseline and after 5 weeks of intervention.
UNASSIGNED: HD-tDCS may enhance the IMT effects by increasing respiratory muscle strength, efficiency, and lung function of individuals with long COVID.

暂无摘要。

暂无摘要。

Primary Sjögren\'s syndrome (pSS) is a systemic autoimmune disease that affects exocrine glands, mainly the salivary and lacrimal glands, leading to the development of sicca symptoms. Patients with pSS may also present with extraglandular manifestations, including lung involvement, estimated to occur in 9-24% of cases. Shrinking lung syndrome (SLS) is an uncommon respiratory complication primarily associated with systemic lupus erythematosus, with a prevalence of approximately 1% in these patients. It typically manifests as dyspnea, pleuritic chest pain, lung volume reduction, and a restrictive pattern on respiratory function tests. Cases reporting SLS with other connective tissue diseases, including pSS, are even rarer. Herein, we describe a case of a 57-year-old woman with a 10-year history of pSS who presented with dyspnea and pleuritic chest pain. After evaluation, the patient was diagnosed with SLS based on clinical, radiologic, laboratorial, and electrophysiologic characteristics. In addition, we identified and analyzed previously published cases of SLS in pSS. Treatment includes corticosteroids, immunosuppressants, and respiratory muscle training. This study highlights the importance of considering SLS in the differential diagnosis of patients with pSS and respiratory symptoms.

Diagnosis of COPD in primary care is hindered by underuse of spirometry. Case finding using validated symptom and health status questionnaires, and simple handheld devices in high-risk populations may improve diagnosis. This study aimed to determine the best combination of measures to optimise COPD diagnosis in the primary care setting.
We recruited 335 current or ex-smokers, including those with an established diagnosis of COPD from general practices. Participants\' FEV1 and FEV6 were measured using a handheld spirometry device (COPD-6®). Each completed the COPD assessment test (CAT), a modified Medical Research Council (mMRC) dyspnoea scale, St George\'s Respiratory Questionnaire (SGRQ) and smoking history questionnaire. From these data we calculated the predictive validity for spirometry-confirmed diagnosis of COPD. Area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated for each. Kappa coefficient was used to measure the agreement between the Fixed-Ratio (FR) and Lower Limit of Normal (LLN) spirometric criteria in diagnosing COPD.
FEV1/FEV6 <0.70 alone showed significant association (p<0.0001) with COPD diagnosis and good predictive accuracy (AUROC=0.725). However, no further improvement was found after combining SGRQ, CAT and mMRC with FEV1/FEV6. FEV1/FEV6 <0.70 using the COPD-6® handheld device had moderate sensitivity (65.7%) and high PPV (90.1%), high specificity (79.3%) and NPV (44.8%). There was good agreement between FR and LLN definitions (κ=0.70).
Handheld micro-spirometers can facilitate case finding of COPD in smokers and ex-smokers attending general practice. The fixed ratio criterion currently recommended by COPD-X guidelines offers the simplest method for diagnosing COPD in Australian primary care.

Idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD) is often rapidly progressive with a poor prognosis; however, no standard therapeutic regimen has been identified. This study aimed to investigate the efficacy and safety of rituximab in IIM-ILD patients. Five patients who had been administered rituximab for IIM-ILD at least once between August 2016 and November 2021 were included. Lung function decline was compared one year before and after rituximab. Disease progression, defined as a greater than 10% relative decline in forced vital capacity (FVC) compared to the baseline, was also compared before and after treatment. Adverse events were recorded for safety analysis. Five IIM-ILD patients received eight cycles. FVC-predicted values significantly decreased from 6 months before rituximab administration to those at the baseline (54.1% predicted (pre-6 months) vs. 48.5% predicted (baseline), p = 0.043); however, the FVC decline stabilized after rituximab. The rate of disease progression before rituximab showed a tendency to decrease after rituximab (75% (before) vs. 12.5% (6 months after, p = 0.059) vs. 14.3% (12 months after, p = 0.102)). Three adverse events developed, but none resulted in death. Rituximab can stabilize lung function decline with tolerable safety in Korean IIM patients with refractory ILD.

暂无摘要。

BACKGROUND: Crop residue burning (CRB) is one of the top contributors to ambient air pollution (particulate matter 2·5 [PM2·5]) in north-western India. Despite the magnitude of the problems associated with high particulate amounts, there are few epidemiological data in India on the associated health effects of CRB, focusing on rural populations. The present study was conducted to quantify the effect of PM2·5 from CRB on the respiratory health of agricultural community in the Nabha block in Patiala, India.
METHODS: Participants aged 10-60 years who were residents of six villages in the Nabha block in Patiala, India, who had resided in the area for at least 10 years and had self-reported as being in good health and non-pregnant women were enrolled in this cross-sectional study using purposive sampling. The participants were recruited from their residence, and all volunteered to participate in the study. The study population was surveyed for self-reported health symptoms and other exposure confounders. Lung function tests (LFTs) were done to examine forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), both during CRB and non-CRB periods. 24-h continuous PM2·5 monitoring was done using the modified low-volume Combo Dust Samplers and particles were collected in glass fiber filters. The PM2·5 mass concentrations were analysed using the standard gravimetric method. Multiple regression models were used to quantify the association of PM2·5 from CRB on respiratory health after controlling for other exposure variables; namely, cooking fuel, ventilation, and distance from the road.
RESULTS: A total of 3644 participants were enrolled from Oct 16 to 26, 2018, and March 7 to April 3, 2019 (the non-CRB periods), and from Oct 27 to Nov 20, 2018 and from Nov 3 to 13, 2019 (CRB periods). The present study showed significant associations between PM2·5 exposure and poor respiratory health with an increased prevalence of respiratory symptoms and lung function decrement among the study population. The older group (>40-60 years) reported more respiratory complaints during CRB than the younger groups (10-18 and >18-40 years), including coughs (OR 1·57; 95% CI 1·14-2·16), phlegm (1·69; 1·19-2·16), and itchiness of the eyes (3·44; 2·54-4·66). The study found a decrease in the results of LFTs with increasing PM2·5 across all age groups during CRB compared with the non-CRB period. The youngest group (10-18 years) had the highest reduction in lung capacity based on LFT variables. In men, FEV1 declined 16% in those aged 10-18 years, 9% in those aged older than 18 to 40 years, and 10% in those older than 40 to 60 years; and in women, it declined 26% in those aged 10-18 years, 12% in those older than 18 to 40 years, and 7% in those older than 40 to 60 years, during CRB (with a mean PM2·5 increase of 167 μg/m3). Similar declines were noted for the other (FVC and PEF) lung function variables.
CONCLUSIONS: This study, which shows the adverse effects on health from CRB (increases in respiratory symptoms and poor lung function), highlights to need to accelerate policy interventions and engage farmers in discussions on CRB elimination.
BACKGROUND: Central Pollution Control Board of India (B-33014/40/2018/AQM-EPC 9836).

The purpose of the study was to investigate pulmonary functions of patients with chronic neck pain and compare them with those of asymptomatic controls.
This case-control study was conducted with 25 patients with chronic neck pain (age, 26.84 ± 7.89 years) and 27 age-matched asymptomatic controls (age, 25.96 ± 7.13 years). Pulmonary function tests were performed using spirometry (Quark PFT, COSMED, Rome, Italy). Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% to 75% vital capacity, peak expiratory flow, maximum voluntary ventilation, and the FEV1/FVC ratio were measured and are expressed as (%) predicted value for patients with chronic neck pain and asymptomatic controls.
The chronic neck pain group had lower FEV1 (P = .015), FVC (P = .029), forced expiratory flow at 25% to 75% vital capacity (P = .040), and maximum voluntary ventilation (P = .042) compared with asymptomatic controls; however, FEV1/FVC (P = .470) and peak expiratory flow (P = .183) were similar in both groups.
These results demonstrated that dynamic lung volumes were lower in patients with chronic neck pain compared with asymptomatic controls.

Attempts to analyze respiratory function of the laryngectomized patient with tests such as spirometry and plethysmography have been described in the literature, highlighting however substantial difficulties. Oscillometry, through the forced oscillation technique (FOT), measures the mechanical properties of the respiratory system minimizing the problems related to the patient\'s lack of compliance. This methodology has never been applied to these patients and therefore represents a new perspective in the analysis of respiratory function.