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The term \"post-COVID-19 syndrome\" describes a range of symptoms persisting beyond the acute phase of the disease. These symptoms predominantly include fatigue, muscle pain, shortness of breath, and psychological issues. Research additionally suggests the possibility of long-term neurological and psychiatric impairment associated with COVID-19. The study included patients who visited the post-COVID outpatient clinic between April 2020 and June 2022. The examination included the detailed history taking, including the COVID-19 course, posteroanterior chest X-ray and pulmonary function tests. Anxiety level was assessed using the Beck Anxiety Inventory (BAI). The relationship between anxiety, demographic data, and course of the disease, need for hospital admission during the acute phase, oxygen therapy, post-inflammatory changes on the chest X-ray and lung function parameters was investigated. This study included 1756 patients who experienced COVID-19 and visited a post-COVID outpatient clinic. The majority of individuals experienced a mild form of the infection. The results showed that younger age and female gender were associated with significantly higher anxiety scores. Inpatients had lower BAI values than those who were not hospitalized during acute phase. Patients with post-inflammatory changes on chest X-ray had surprisingly lower BAI values. Lower values of FEV1 (forced expiratory volume in 1 second), DLCO (diffusing capacity of the lungs for carbon monoxide), and KCO (carbon monoxide transfer coefficient) were associated with significantly higher BAI values. Female gender was associated with higher levels of anxiety. In contrast, higher FEV1 values reduced the risk of a pathological level of anxiety. In our study, the influence of age, gender, inpatient care during the acute phase of infection, the presence of post-inflammatory changes on the chest diagram and selected parameters of lung function (FEV1, DLCO, and KCO) were shown to be important factors in the assessment of anxiety symptoms in post-COVID patients.

A rare but important complication after lung transplantation (LTx) is postoperative phrenic nerve dysfunction (PND). Diaphragmatic plication (DP) is a well-established treatment option for PND, however, the long-term effect of PND and DP on lung function parameters and survival after LTx are currently unknown. We retrospectively reviewed 1400 LTx recipients transplanted at Medical University of Vienna between 01/2003 and 12/2022. Fluoroscopy and/or phrenic nerve conduction studies confirmed PND when chest radiographs after extubation showed a unilateral heightened diaphragm. We identified 25 patients with post-operative PND, of whom 12 underwent DP. The remaining 1,375 patients served as a control group. Median ICU-stay and hospital-stay were significantly longer in the PND groups (DP: 20 and 57 days; non-DP: 27 and 43 days; control group: 7 and 25 days; P = 0.001/ P < 0.001). PND led to consistently lower %TLC in lung function tests performed within the first three years after LTx. DP was associated with lower %FEV1.0 early after LTx but it aligned to %FEV1.0 of the other groups during follow-up. Although PND significantly affected postoperative recovery after LTx, it did not impair long-term survival outcomes.

Background In advanced chronic obstructive pulmonary disease (COPD), hypercapnia may occur due to severe bronchial obstruction with lung hyperinflation. Non-invasive ventilation (NIV) provides the standard of care intended to achieve physiological PCO 2 levels, thereby reducing overall mortality. The present study aimed to evaluate pulmonary function parameters derived from spirometry (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1]), body plethysmography (residual volume [RV], total lung capacity [TLC]), and lung diffusion capacity for carbon monoxide (single-breath method [DCO-SB], alveolar-volume corrected values [DCO-VA]) as predictors of chronic hypercapnia in patients with advanced COPD. Methods This monocentric, retrospective observational study included 423 COPD patients. Receiver operating characteristic (ROC) curve analysis and cross-validation were used to assess lung function parameters’ diagnostic accuracy for predicting chronic hypercapnia, with the resulting performance expressed as area under the ROC curve (AUROC). We performed univariable and multivariable binary logistic regression analysis to determine if these parameters were independently associated with chronic hypercapnia, with probabilities reported as odds ratios [OR] with 95% confidence intervals [95%CI]. Results FVC% (AUROC 0.77 [95%CI 0.72–0.81], P  < 0.01) and FEV1% (AURIC 0.75 [95%CI 0.70–0.79], P  < 0.01) exhibited reasonable accuracy in the prediction of chronic hypercapnia, whereas lung diffusion capacity performed poorly (AUROC 0.64 [95%CI 0.58–0.71] for DCO-SB%, P  < 0.01). FVC% (OR 0.95 [95%CI 0.93–0.97], P  < 0.01) and FEV1% (OR 0.97 [95%CI 0.94–0.99], P  = 0.029) were the only parameters associated independently with chronic hypercapnia in logistic regression analysis. FVC and FEV1 thresholds that best separated hypercapnic from normocapnic subjects reached 56% and 33% of predicted values. Conclusions Routinely collected pulmonary function parameters, particularly FVC% and FEV1%, may predict chronic hypercapnia during COPD progression.

This study aimed to investigate the prevalence of respiratory symptoms, the use of personal protective equipment (PPE), and lung function parameters among flour mill workers in Calabar, Nigeria. A cross-sectional study was employed to sample 222 flour mill workers. Data were collected using structured questionnaires and spirometry tests. Statistical analyses, including descriptive statistics and inferential tests, were conducted to test: (1) the association between the level of exposure to flour dust and respiratory symptoms and lung function parameters; (2) the difference in respiratory symptoms and lung function between workers who use PPE and those who do not. From this study, 39.2% of workers reported experiencing occasional cough, 9.9% reported coughing with shortness of breath, and 5.0% experienced cough and wheezing. Most respondents, 57.7% had normal FVC values, and 24.8% experienced mild reductions. 9.9% exhibited moderate reductions, and 7.7% had severe reductions. The majority of the respondents, 60.8% had normal FEV1 values, 19.8% exhibited mild reductions, 8.6% had moderate reductions, and 10.8% had severe reductions. 85.6% of respondents had a normal FEV1/FVC ratio, 7.2% exhibited mild obstruction, 3.2% experienced moderate obstruction, and 4.1% had severe obstruction. Respiratory symptoms were significantly ( χ 2  = 68.162, p  < 0.001) higher among exposed workers. There was a significant difference in lung function parameters between directly exposed subjects and those who were indirectly exposed or unexposed ( χ 2  = 20.421, p  < 0.001). The prevalence of respiratory symptoms in non-PPE users was significantly higher ( χ 2  = 12.886, p  < 0.001)) and lung function parameters also showed a significant difference ( χ 2  = 24.857), p  < 0.001). This study confirms that flour mill workers in Calabar are at increased risk of respiratory health problems due to flour dust exposure. Effective use of PPE and reducing dust exposure are essential in mitigating these risks.

The effects of blood benzene, toluene, ethylbenzene, and xylenes (BTEX) on lung function among general adults remain unknown. We enrolled 5519 adults with measured blood BTEX concentrations and lung function from the US National Health and Nutrition Examination Survey 2007–2012. Weighted linear models were fitted to assess the associations of BTEX with lung function and inflammation parameters (white blood cell five-part differential count and C-reactive protein). The mediating effect of inflammation between BTEX and lung function was also examined. Blood BTEX concentrations decreased yearly from 1999 and were extremely low from 2007 to 2012. Benzene and toluene exerted the greatest influence on lung function in terms of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), calculated FEV1:FVC ratio, peak expiratory flow rate (PEFR), and forced mid expiratory flow (FEF 25–75% ). Both ethylbenzene and all xylene isomers had no effects on FVC but reduced FEV1, FEV1:FVC ratio, PEFR, and FEF 25–75% . Weighted quantile analyses demonstrated that BTEX mixture was associated with decreases in FVC, FEV1, FEV1:FVC ratio, PEFR, and FEF 25–75% , with benzene weighted most heavily for all lung function parameters. BTEX also increased the levels of inflammation indicated by white blood cell five-part differential count and C-reactive protein, and increased levels of inflammation also reduced lung function. From multiple mediation analysis, inflammation mediated the effects of benzene on FEV1 and PEFR, the effects of toluene on FEV1, and the effects of ethylbenzene on FEV1 and PEFR. Low-dose exposure to BTEX was associated with reduced pulmonary function both in large and small airways. Inflammation could be involved in this pathogenesis.

Background To investigate the effect of simple small airway dysfunction (SAD) on large airway function parameters in old people. Methods Elderly patients aged 60–80 years with complete pulmonary function data including the measured/predicted values of ≥ 80% for each of forced expiratory capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF), and FEV1/FVC ≥ 70% were included. Patients with no known smoking history, normal chest computerized tomography, and the measured/predicted values of ≥ 70% for each of maximal flows at 50% and 25% of remaining FVC (MEF50 and MEF25) and maximum mid-expiratory flow (MMEF) were categorized into the control group, whereas patients with the measured/predicted values of < 65% for more than 2 of MEF50, MEF25, and MMEF were divided into the observation group. 104 patients with simple SAD (observation group) and 102 patients with normal pulmonary function (control group) were selected. Results The parameters of small airway function including MEF50, MEF25, and MMEF were positively correlated with slow vital capacity (SVC), FVC, FEV 1 , PEF, and MEF75 in the large airway in both groups ( r  = 0.280–0.634). Except for PEF, the other 5 parameters in the observation group were significantly different from those in the control group. There was no significant difference between total lung capacity (TLC) and functional residual capacity (FRC), but there were significant differences between residual volume (RV), RV/TLC, diffusion capacity for carbon monoxide (DLCO), and specific diffusing capacity (KCO). There were 66 cases of SVC-FVC > 0 (FVC/SVC < 1) (66/104, 63.46%) in the observation group) and 45 cases of the control group (45/102, 44.12%), and the difference between the two groups was statistically significant. The area under the curve (AUC) of SVC-FVC and FVC/SVC in the prediction of SAD was 0.631 and 0.639, respectively, with a sensitivity and specificity of 63%. Conclusions Simple SAD was associated with large airway pulmonary function, and PEF may not be a suitable parameter for large airway pulmonary function in the old adults. SVC-FVC > 0.02 L had a certain predictive value for SAD in the elderly.

Treatment of acute respiratory distress syndrome (ARDS) is challenging due to its multifactorial aetiology. The benefit of antioxidant therapy was not consistently demonstrated by previous studies. We evaluated the effect of two different doses of intravenous (i.v.) N-acetylcysteine (NAC) on oxidative stress, inflammation and lung functions in the animal model of severe LPS-induced lung injury requiring mechanical ventilation. Adult Wistar rats with LPS (500 μg/kg; 2.2 mL/kg) were treated with i.v. NAC 10 mg/kg (NAC10) or 20 mg/kg (NAC20). Controls received saline. Lung functions, lung oedema, total white blood cell (WBC) count and neutrophils count in blood and bronchoalveolar lavage fluid, and tissue damage in homogenized lung were evaluated. NAC significantly improved ventilatory parameters and oxygenation, reduced lung oedema, WBC migration and alleviated oxidative stress and inflammation. NAC20 in comparison to NAC10 was more effective in reduction of oxidative damage of lipids and proteins, and inflammation almost to the baseline. In conclusion, LPS-instilled and mechanically ventilated rats may be a suitable model of ARDS to test the treatment effects at organ, systemic, cellular and molecular levels. The results together with literary data support the potential of NAC in ARDS.

Background The Nuss procedure was introduced at our center in 1999. The operation was mainly performed for cosmesis. Little information is available regarding the influence of this operation on lung function. Methods The aim of this study, a prospective analysis, was to analyze the effect of the Nuss procedure on lung function variables. Between 1999 and 2007 a total of 203 patients with pectus excavatum were treated with the Nuss procedure, of whom 145 (104 male, 41 female) were located at Emma Children’s Hospital. In the latter subset of consecutive patients, static lung function variables [total lung capacity (TLC), functional residual capacity (FRC), vital capacity (VC)] and dynamic lung function variables [forced expired volume in 1 s (FEV1), maximum expiratory flow (MEF50)] were performed using spirometry and body box measurements at four time points: prior to operation (T0), 6 months after the Nuss procedure (T1, n = 111), prior to removal of the Nuss bar (T2, n = 74), and 6 months after removal (T3, n = 53). All values were expressed as a percent of normal values for sex, age, and height. Results were compared with a paired‐samples t‐test, with the level of significance at p = 0.05. Results At 6 months after bar insertion the TLC, FRC, VC, FEV1, and MEF50 showed a significant increase; and prior to bar removal the FRC and MEF50 showed significantly increased values. At 6 months after Nuss bar removal, none of the lung function variables showed any significant change compared to the preoperative values. Conclusion After the Nuss procedure for pectus excavatum, there was no improvement of pulmonary function, but neither was the patient’s pulmonary function harmed by resolving a largely cosmetic problem.

Background: In patients with severe chronic obstructive pulmonary disease (COPD), pursed-lips breathing (PLB) improves the pulmonary gas exchange and hyperinflation measured by electro-optic coupling. The response to PLB in inspiratory lung function tests is not known. Objectives: The purpose of this study was to measure the effect of PLB on inspiratory parameters. Methods: Thirty-five subjects with stable COPD and a forced expiratory volume in first second (FEV 1 ) <50% of the predicted value were tested for the following primary parameters before and immediately after PLB, and 5 min later: forced inspiratory vital capacity, inspiratory capacity (IC), forced inspiratory volume in first second, maximal inspiratory flow at 50% of vital capacity, and peak inspiratory flow. Patients were also tested for the following secondary parameters: vital capacity, FEV 1 , breathing frequency, end-tidal CO 2 tension, and oxygen saturation. Results: Of all the primary parameters only IC (p = 0.006) improved significantly; with regard to the secondary parameters, the mean oxygen saturation was improved by 1% (p = 0.005) and the mean end-tidal CO 2 tension and breathing frequency decreased significantly (p < 0.0001 for both) to 3.2 mm Hg and 3.1 breaths/min, respectively. After 5 min the effects diminished. Conclusion: Improved IC after PLB indicates less hyperinflation in patients with severe COPD; there was no effect on parameters of flow.

The purpose of the study was to evaluate serum concentrations of selected growth factors and the diffusing capacity of the lung for carbon monoxide (DLCO) in 21 females treated for systemic lupus erythematosus. The control group consisted of 24 healthy women. Based on the high-resolution computed tomography (HRCT), patients were allocated to a subgroup of 11 subjects (HRCT-negative) and a subgroup of 10 with pulmonary abnormalities (HRCT-positive). In HRCT-negative patients a significantly higher level of TNF-α as compared with the control was observed and positive correlation between TNF-α and bFGF was revealed in this subgroup and in the total group of patients. DLCO was below the predicted value in 13 patients. No correlations between DLCO and growth factors concentrations were observed. DLCO reduction in asymptomatic, with respect to the respiratory system, SLE patients suggests a need for long-term monitoring of this parameter. The role of TNF-α in these patients requires further investigations.