Excerpt: Morgan et al. (1) concluded that cystic fibrosis (CF) in children and adolescents with a high baseline forced expiratory volume (FEV1) were less likely to have a therapeutic intervention or slower rate of FEV1 decline after a single acute decline in FEV1 of 10%. This conclusion is not well supported due to the arbitrary criteria used for defining a pulmonary exacerbation, as explained below.

Målet med detta examensarbete har varit att utveckla en app med en algoritm för att mäta rotationshastigheten hos en prototyp för en spirometerlösning till en låg kostnad för smart- telefoner. En förstudie har gjorts av smarttelefoners användbarhet för att mäta hälsotillstånd och vilka alternativa lösningar och algoritmer som finns för att mäta rörelsedetektion. I detta arbete har en app med en algoritm utvecklats för att detektera rörelser och mäta rotations- hastigheten hos spirometerprototypens turbin filmad med en smarttelefonkamera. För att metoden ska fungera är det viktigt att rotationshastigheten understiger hälften av kamerans fps (bilder per sekund). Rotationshastigheten hos turbinen måste därför begränsas och det behövs en kamera som klarar minst 120 fps för att fånga rörelserna i prototypens turbin.Arbetet har resulterat i en fungerande algoritm för att bestämma turbinens rotationshastighet. Den utvecklade algoritmen detekterar topparna i en PPG (photoplethysmogram). För att minska beräkningstiden och för att öka noggrannheten analyserar algoritmen färgintensiteten i ett begränsat område, ett s.k. ROI (Region of Interest) i varje bild. Det finns stora möjligheter att använda denna algoritm för att fortsätta utvecklingen av detta alternativa sätt att utföra spirometritester. / The goal with this bachelor thesis was to develop an application with an algorithm to measure the rotation speed of a prototype, as a low-cost solution for measuring spirometry with a smartphone. In a pilot study it was investigated how a smartphone can be used to measure health and what algorithms there are to detect motion in videos. After the pilot study an app with the function to record a video by using the camera of a smartphone and then use an algorithm to detect the rotation speed in the spirometry-prototype’s turbine was developed. To make it work it is important that the rotation speed is low enough so it does not exceed half of the cameras fps. Therefore, to capture the rotation speed of the spirometry-prototype’s turbine the rotation needs to be limited and a smartphone with a camera with at least 120 fps is required.The result of this work is an algorithm that can measure the rotation speed in the spirometry prototype turbine. The algorithm is detecting the peaks in a PPG. To minimize the computation time and to increase the accuracy the algorithm analyses the colour intensity over a ROI in every frame. There is great potential to use this algorithm to further develop this alternative method of measuring spirometry.

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Introduktion  Genom dynamisk spirometri går det att beräkna kvoten mellan forcerad exspiratorisk volym under en sekund och forcerad vitalkapacitet (FEV1/FVC) där ett värde på ≤0,7 tyder på obstruktiv lungsjukdom. Mobil spirometriutrustning skulle kunna möjliggöra tidigare diagnostisering av obstruktiva lungsjukdomar men även fungera som ett kostnadseffektivt alternativ vid enklare undersökningar. Syftet med studien var att jämföra resultat erhållna vid dynamisk spirometri utförd på en stationär respektive en mobil spirometriutrustning. Material och metod  I studien deltog totalt 36 försökspersoner. Data samlades in mellan februari-mars 2023 och bestod av FVC och FEV1 erhållna från dynamisk spirometri på Vyntus™ One (stationär spirometriutrustning) och Aiocare™ Vyaire (mobil spirometriutrustning). Ett parat t-test (signifikansnivå 0,05) utfördes för att avgöra om det förelåg någon signifikant systematisk skillnad för data mellan de båda utrustningarna och förekomsten av slumpfel illustrerades med Bland-Altman-diagram. Intraklasskorrelationskoefficient (ICC) beräknades för samtliga variabler. Resultat och slutsats  En mycket god korrelation mellan utrustningarna förelåg med ett ICC>0.9 för samtliga variabler. Ingen systematisk skillnad kunde påvisas för uppmätt FVC, FEV1 eller kvoten FEV1/FVC mellan Vyntus™ One och Aiocare™ Vyaire (p >0,05) och slumpfelet bedömdes acceptabelt. / Introduction  Dynamic spirometry enables calculating the ratio of forced expiratory volume under one second and forced vital capacity (FEV1/FVC) where ≤0,7 suggests obstructive lung disease. Mobile spirometer equipment could assist in earlier detection of obstructive lung diseases, but also function as a cost-efficient alternative. The purpose of the study is to compare results obtained with dynamic spirometry performed on a stationary and a mobile spirometry equipment. Material and method  A total of 36 subjects participated in the study. Data collected between February-March 2023 consisted of FVC and FEV1 obtained from dynamic spirometry on Vyntus™ One (stationary spirometry equipment) and Aiocare™ Vyaire (mobile spirometry equipment). A paired t-test (0,05 level of significance) determined if there was any significant systematic difference between data from the two types of equipment and the magnitude of sampling error was visualized by Bland-Altman plots. Intraclass correlation coefficient (ICC) was calculated for all variables. Result and conclusion  Excellent correlation with ICC>0,9 for all variables. There was no significant difference for measured FVC, FEV1 or FEV1/FVC between Vyntus™ One and Aiocare™ Vyaire (p >0,05) and the sampling error was considered acceptable.

Bibliographic identification BĚLOUSOVOVÁ, Anna. Monitoring of postural and respiratory changes in patients with chronic obstructive pulmonary disease Prague: Charles University, 2. Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2014. 66 p. Supervisor doc. PaedDr. Libuše Smolíková Ph.D. Abstract The thesis Monitoring of Postural and Respiratory Changes in Patients with Chronic Obstructive Pulmonary Disease summerises knowledge of etiology, etiopathogenesis and pathophysiology of the chronic obstructive pulmonary disease. It also contains chapters dealing with pathophysiology and changes of the breathing mechanics in COPD patients, changes of the spirometry results within the disease, chapters following posture and postural functions, dysfunctional breathing and alterations of the function of postural muscles and an increase of the work of breathing. In the practical part of the thesis, 18 patients was involved in kinesiological assessment, dynamic tests of the movement of the spine, an assesment of the pathological barriers of the cervical, thoracic spine and ribs according to Lewit, tests of the deep stabilizing system and tests of the quality of life - CAT and SGRQ. These data were statistically processed together with the spirometrical data of the patients. There were three groups...

Bronchial asthma incidence constitutes a compelling health and socioeconomical problem. Patients of all ages suffer from asthma, and no methods of effective prevention or healing are currently available. Poorly controlled asthma causes increase of financial expenditure as well as remarkable restriction of activities of daily living; it might even lead to death. In Czech republic, the number of patients with asthma is estimated at 500 000. The aim of this study is to evaluate effects of yoga exercise as a potential effective adjunct treatment on bronchial asthma state in adults. Theoretic part of the thesis describes pathological changes present in respiratory system, breathing pattern disorders and postural functions characteristic for patients suffering asthma disease. It also represents a brief summary of up to date findings of possible mechanisms on which are Spiral yoga and pranayama based, especially on these which can have an influence on obstructive lung disorders. Experimental part deals with the methodology and it reveals the process of making randomized clinical pilot study. Between 11 adult participants were investigated at the start and at the end of a three-month- long therapy. Investigation included pulmonary function tests, thoracic perimeter measurement, spine mobility...

Author: Bc. Pavlikhina Ekaterina Title: Influence of the posture's change on respiratory function in spinal cord injury patients. Objectives: The purpose of this thesis is to analyze change in respiratory function on change of posture in patients with spinal cord injury (SCI). Another objective is to compare the respiratory functions in a health subjects and in a SCI patients. Last but not least is an effort to find out whether SCI patients have a pattern of restrictive pulmonary dysfunction. The findings can help understanding development of respiratory complications after spinal cord injury. It may help in choosing optimal position during respiratory examination and respiratory rehabilitation. Methods: In theoretical part, there were explored the available knowledges about respiratory complications and their effects on posture. In practical part, there were 26 subjects - 16 patients with SCI and 10 healthy subjects. Subjects with SCI were divided into two groups - one with paraplegia and other one with quadriplegia. Measurements were performed with spirometer on each subject during supine, sitting and standing postures. There were collected vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) data from all subjects. All data were processed in...

Introdução: A ressecção pulmonar pode ser seguramente realizada em pacientes com função pulmonar comprometida se eles forem selecionados apropriadamente, sendo importante determinar o impacto do procedimento cirúrgico no estado funcional e nas atividades de vida diária do paciente. Objetivo: Avaliar as repercussões da ressecção pulmonar sobre a espirometria e sobre a qualidade de vida de pacientes com câncer de pulmão. Métodos: Estudo de coorte transversal que incluiu todos pacientes que realizaram cirurgia com ressecção pulmonar entre Setembro de 2006 e março de 2007, após assinar o termo de consentimento livre e esclarecido. Os pacientes foram avaliados no pré-operatório e após seis meses do procedimento cirúrgico através de espirometria e responderam a dois questionários de qualidade de vida: um geral -The Medical Outcomes Study 36-item Short-Form Health Survey e um específico para sintomas respiratórios - Hospital Saint George. Resultados: Concluíram o estudo 33 pacientes, 14 homens e 19 mulheres com faixa etária entre 39 e 79 anos. Todos os pacientes independentemente de fumantes ou não, apresentaram piora significante da função pulmonar. Na análise de qualidade de vida, observamos valores próximos à população normal, e no questionário específico para doenças respiratórias foi observada redução de 50 a 60% nos vários domínios, em relação a uma população de DPOC. Conclusão: Existe impacto direto da ressecção pulmonar na deterioração da espirometria e na qualidade de vida com ênfase nos aspectos diretamente ligados à função pulmonar. Cabe ressaltar a importância da avaliação da função pulmonar destes pacientes no pré-operatório para se estimar sua evolução pós-cirúrgica / Introduction: Lung resection can be performed safely in patients with compromised lung function if properly selected. It is important to determine the impact of surgical procedure in the functional status and daily life activities, aiming at improving quality of life. Objective: Evaluate the effects of pulmonary resection on spirometry and the impact of surgery for lung cancer on patients quality of life. Methods: Prospective study, conducted between September 2006 and March 2007; all patients who performed pulmonary resection surgery were included after signing a free informed consent term. Patients were evaluated in the pre-operative and after six months of the surgical procedure by spirometry and answered two quality of life questionnaires (The medical Outcomes Study 36-item Short-form Health Survey and Saint George Hospital). Results: 33 patients concluded this study; 14 men and 19 women, age between 39 and 79 years. All patients smokers or not, showed worsening of lung function with statistical significance. General QOL scales showed near normal values, nevertheless, respiratory QOL was 50 to 60% worse than COPD. Conclusions: We observed a direct impact of lung resection on spirometry and QOL. It is important to adequately estimate lung and QOL function before assuming lung resection in cancer patients

Introdução: Os mecanismos fisiopatológicos da asma grave resistente ao tratamento (STRA) em crianças não está totalmente elucidado e parece diferir do observado em adultos, justificando investigações específicas neste grupo de pacientes. O escarro induzido é método útil para identificar fenótipos e endotipos de asma grave através de marcadores inflamatórios. O objetivo deste estudo foi investigar os padrões inflamatórios de crianças com STRA através escarro induzido e comparar com um grupo de crianças com asma grave que atingiram o controle. Métodos: Crianças (6-18 anos) com diagnóstico de asma grave (critério GINA) em tratamento a pelo menos 6 meses em um centro de referência foram avaliadas em um coorte prospectivo por 3 meses (3 visitas consecutivas). Foi averiguada técnica inalatória, adesão ao tratamento e investigado as principais comorbidades. Realizado coleta de escarro induzido para análise citológica e avaliação quantitativa de citocinas do sobrenadante, espirometria, pletismografia e medidas da FeNO. Após período de seguimento, os pacientes foram classificados em dois grupos: asma grave controlada e asma grave resistente ao tratamento conforme critérios da ATS/ERS. Resultados: Foram incluídos 40 pacientes (idade média 12,8 anos; 62,5% sexo masculino), sendo 13 (32,5%) classificados como STRA após o período de seguimento. A mediana do número de exacerbações foi maior e do escore de ACT menor nos pacientes STRA e esta diferença foi significativa. Não foram encontradas diferenças significativas: nos dados demográficos, nos parâmetros funcionais espirométricos e de pletismografia (CVF, VEF1, VEF/CV, FEF 25-75%, LTC, RV, RV/LTC, resistência e condutância das vias aéreas) e nos valores de FeNO quando comparado o grupo de pacientes controlados com o de STRA. O padrão inflamatório eosinofílico foi predominante nos dois grupos de pacientes, entretanto, o grupo STRA apresentou porcentagem proporcionalmente maior de neutrófilos no escarro comparados com o grupo de asma grave controlada, na visita 3 e também na visita 1 quando analisados retrospectivamente (p < 0,05). As medianas nos níveis das citocinas IL10, GM-CSF, INFy e TNFalfa no escarro foram significativamente maiores no grupo STRA quando comparado ao grupo controlado (p < 0,05) e o GM-CSF e TNF-alfa apresentaram correlação inversa com escore de ACT. Conclusão: Nesta coorte prospectiva, os parâmetros funcionais e a FeNO não discriminaram crianças com STRA dos que atingiram o controle. A presença de neutrófilos no escarro e das citocinas IL10, INFy e, particularmente, GM-CSF e TNFalfa podem ter para um papel na resistência ao tratamento da asma grave em crianças e adolescentes. Antagonistas específicos dessas citocinas podem no futuro representar uma estratégia na terapêutica / Background: The pathophysiological mechanisms of severe therapyresistant asthma (STRA) in children are not fully elucidated and seem to differ from findings in adults, thus justifying specific research on children. Induced sputum is useful for detecting phenotypes and endotypes of severe asthma via inflammatory markers. The aim of the present study was to investigate the inflammatory patterns of children with STRA by the induced sputum method and to compare them with a group of children who achieved control of severe asthma. Methods: A prospective cohort of children (6-18 years old) diagnosed with severe asthma (Global Initiative for Asthma - GINA criteria) and in treatment for at least 6 months at a reference center was assessed for 3 months (3 consecutive visits). Inhalation technique, adherence to treatment and main comorbidities were assessed. Induced sputum samples were collected for cytology analysis and quantitative assessment of cytokines in the supernatant; the participants were also subjected to spirometry, plethysmography and fractional exhaled nitric oxide (FeNO) measurements. At the end of follow-up, the patients were classified into two groups: controlled severe asthma and STRA according to the European Respiratory Society and American Thoracic Society (ERS/ATS) criteria. Results: Forty patients were included (average age 12.8 years old; 62.5% male); 13 (32.5%) were classified as STRA at the end of follow up. The median number of exacerbations was higher and the Asthma Control Test (ACT) score was lower in the STRA group; these differences were significant. Significant differences were not found relative to demographic data, spirometry and plethysmography function parameters [forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), ratio of FEV1 to slow vital capacity (FEV1/SCV), forced expiratory flow at 25-75% of FVC (FEF 25-75%), total lung capacity (TLC), residual volume (RV), RV/TLC, airway resistance and conductance] and FeNO after comparison of the STRA and controlled asthma groups. The eosinophilic inflammatory pattern predominated in both groups; however, the STRA group showed a proportionally higher percentage of sputum neutrophils compared with the controlled asthma group at visit 3 and visit 1 upon retrospective analysis (p<0.05). The median sputum levels of the cytokines IL-10, GM-CSF, IFN-y and TNF-alpha were significantly higher in the STRA group compared with the controlled asthma group (p < 0.05); GM-CSF and TNF-? showed inverse correlations with ACT scores. Conclusion: In the analyzed prospective cohort, functional parameters and FeNO did not discriminate between children with STRA and children with controlled asthma. The presence of neutrophils and the cytokines IL-10, IFN-y and, more particularly, TNF-alpha and GM-CSF in the sputum might have a role in resistance to treatment for severe asthma among children and adolescents. Antagonists specific for these cytokines might represent a therapeutic strategy in the future

Introdução: O interesse científico sobre os efeitos da qualidade do ar na função respiratória e na saúde humana tem aumentado, principalmente nos grandes centros urbanos e nos centros industriais. Os poluentes atmosféricos têm sido associados a uma grande variedade de sintomas, disfunções e doenças agudas e crônicas, em especial no aparelho respiratório. Em regiões industriais como Cubatão espera-se uma maior ocorrência de efeitos adversos quando comparadas com as cidades de melhor qualidade do ar. Objetivo: O objetivo deste estudo foi verificar a associação entre poluição atmosférica e alterações da função pulmonar em indivíduos fumantes e não fumantes decorrentes da exposição crônica à poluição, na faixa etária de 29 a 50 anos, nos municípios de Cubatão e Bertioga. Método: Trata-se de estudo ecológico transversal em duas cidades geograficamente próximas e de condições climáticas semelhantes. O trabalho foi subdividido em três fases. Inicialmente foi realizada a mensuração da qualidade do ar na região central da cidade de Bertioga, tendo como parâmetros as Partículas Totais em Suspensão (PTS), as Partículas Inaláveis (MP10) e o Ozônio (O3). Os dados de qualidade do ar de Cubatão foram os da rede de monitoramento da CETESB, estação Cubatão/Centro. Na seqüência foram aplicados questionários de sintomas respiratórios em ambos os municípios, sendo a amostra constituída de funcionários públicos municipais. Por último, foram realizados os testes espirométricos para verificar a função respiratória dos participantes. Resultados: Os resultados das medidas de concentração de poluentes em Bertioga indicam uma boa qualidade do ar; as médias obtidas foram de 26,5 µg/m3 para PTS, 15,2µg/m3 para MP10 e 23,4 µg/m3 para o O3. As concentrações em Cubatão, no mesmo período, mostraram-se mais elevadas. Os resultados do questionário sócio clínico e de sintomas respiratórios mostraram que, em Cubatão é mais freqüente e significativa (p<0,05) a ocorrência de doença respiratória, de tosse sem resfriado, de manifestação de coceira no nariz, bem como de resfriados, quando comparada a Bertioga. A presença de não fumantes com doença pulmonar foi maior em Cubatão e significativa estatisticamente (p<0,05). O teste espirométrico constatou que o número de distúrbios ventilatórios foi maior em Cubatão e com significância estatística (p<0,05), com predomínio de distúrbio ventilatório restritivo leve (DVR) e distúrbio ventilatório obstrutivo moderado (DVO). Em Bertioga distúrbios graves foram mais freqüentes, porém foram associados a doenças respiratórias crônicas pré-existentes. Não houve influência do tabagismo nas duas populações estudadas, ou seja, fumar foi igualmente prejudicial à saúde dos indivíduos em ambas as cidades. A presença de DVR sem evidência de doença pré-existente indica provável associação do decréscimo da função respiratória em decorrência da exposição à poluição atmosférica. Conclusão: Concluiu-se que Cubatão apresenta maior risco de desenvolver alterações da função respiratória dos indivíduos, comparada a Bertioga, que deve estar relacionada à maior exposição aos poluentes atmosféricos, considerando que as condições climáticas são semelhantes / Introduction: The scientifical interest in studying about the air quality effects on pulmonary function and health has been often developed, mainly in big cities and industrial areas. Many pulmonary sympthoms, dysfunctions, acute and chronicle diseases have been related to pollution. It is estimated to see a higher number of side effects cases occurred in industrial areas like Cubatão than other cities where the air quality is better. Objective: The aim of this study was to assess the association between air pollution and lung function changes in smokers and non smokers from exposure to chronic pollution, aged 29 to 50 years in the cities of Cubatão and Bertioga. Method: It is based on a transversal ecological study developed in two cities, which are next to each other and have similar weather conditions. This work has been divided in three parts. At first, the air quality in Bertioga city was based on Total suspended solids (PTS), particulate matter (PM10) and Ozone (O3), in downtown area. The air quality statistics were from CETESB (Cubatão station). A respiratory symptoms survey was given to a group of public workers from both cities. At the end, the participants used a spirometer to evaluate their breathing capacity. Results: The of pollutants in Bertioga city resulted in a good air quality with average of 26.5 mg/m3 for PTS, 15.18 mg/m3 for PM10 and O3 showed 23.4 mg/m3. In Cubatão, the number of pollutants was higher. The respiratory symptoms were more evident (p<0,05) if compared to Bertioga as well as the pointed out that the number of breathing alterations is statistically higher in Cubatão. However, serious alterations can be found in Bertioga due to preexistent chronicle pulmonary illnesses. The tobacco did not offer any difference on these two groups of people. The restrictive pulmonary alteration in people who have no previous disease is possibly present because of their contact with the air pollution. Conclusion: It is concluded that Cubatão city brings more of pulmonary function alterations than Bertioga because the people who live there are constantly exposed to the pollutants.