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OBJECTIVE: The purpose of this study is to determine if there are any acoustic variables that can determine compromised lung function in patients with asthma and COPD. METHODS: This study involved using mobile and wearable technology to record voice and respiratory changes during various speaking and breathing tasks before and after administration of albuterol. Collaborators at Samsung Research America, Inc. used algorithms to measure pause time, pause frequency, respiratory rate, and inhale:exhale ratio. These variables were correlated with spirometry values before and after albuterol to assess clinical significance. RESULTS: We identified several acoustic markers that significantly correlate with lung function in patients with asthma and COPD. In particular, we found that the ratio of the one-second forced expiratory volume to forced vital capacity (FEV1/FVC) after administration of albuterol significantly correlated with the inhale:exhale ratio in asthma patients during the tidal breathing task. The post-albuterol FEV1/FVC significantly correlated with the inhale:exhale ratio in COPD patients during the supine breathing task. The pre-albuterol FVC significantly correlated with the pause frequency in asthma patients during the scripted speech task. CONCLUSION: The results in this study indicate that pause frequency and inhale:exhale ratio may be important biomarkers for identifying a respiratory illness, such as asthma and COPD. More research needs to be done using digital health to monitor disease symptoms with a larger sample size.

1 Abstract Title: Effect of sitting posture on different seats on respiratory function while using a smartphone Objectives: The purpose of this thesis is to investigate respiratory function in sitting posture while using a smartphone. Another objective is to compare the values of monitored parametres and to determine which of the 3 performed experiments exhibite the greatest decreases in respiratory parametres. The last aim is to confirm the difference between female and male values and to show that men have higher values of monitored respiratory parameters and the greater decrease of respiratory function than women. Methods: 20 healthy young volunteers were recruited (10 women, 10 men). The experiment was carried out on three different types of seats - office chair, armchair and gymball. Participants spent time using a smartphone for one hour. To investigate changes in respiratory function, we measured FEV1, FVC, FEV1/FVC a PEF before and after each experiment was completed. Values were processed in MS Excel. Pair t-test and Wilcoxon test were used to evaluate the effect of sitting posture on respiratory function (p < 0,05) A two-sample t-test was used to determine a statistically significant difference in values in men and women, as well as in decrease of respiratory function in men and women. (p < 0,05)....

COPD has a profound impact on daily life, yet remains underdiagnosed and undertreated. We set out to develop a brief, reliable, self-scored questionnaire to identify individuals likely to have COPD. COPD-PS™ development began with a list of concepts identified for inclusion using expert opinion from a clinician working group comprised of pulmonologists (n = 5) and primary care clinicians (n = 5). A national survey of 697 patients was conducted at 12 practitioner sites. Logistic regression identified items discriminating between patients with and without fixed airflow obstruction (AO, postbronchodilator FEV1/FVC < 70%). ROC analyses evaluated screening accuracy, compared scoring options, and assessed concurrent validity. Convergent and discriminant validity were assessed via COPD-PS and SF-12v2 score correlations. For known-groups validation, COPD-PS differences between clinical groups were tested. Test-retest reliability was evaluated in a 20% sample. Of 697 patients surveyed, 295 patients met expert review criteria for spirometry performance; 38% of these (n = 113) had results indicating AO. Five items positively predicted AO (p < 0.0001): breathlessness, productive cough, activity limitation, smoking history, and age. COPD-PS scores accurately classified AO status (area under ROC curve = 0.81) and reliable (r = 0.91). Patients with spirometry indicative of AO scored significantly higher (6.8, SD = 1.9; p < 0.0001) than patients without AO (4.0, SD = 2.3). Higher scores were associated with more severe AO, bronchodilator use, and overnight hospitalization for breathing problems. With the prevalence of COPD in the studied cohort, a score on the COPD-PS of greater than five was associated with a positive predictive value of 56.8% and negative predictive value of 86.4%. The COPD-PS accurately classified physicianreported COPD (AUC = 0.89). The COPD-PS is a brief, accurate questionnaire that can identify individuals likely to have COPD.

introduction: The theoretical part of the thesis briefly analyzes the anatomical, kinesiological and physiological aspects of breathing, pursues the issue of examinations of lung functions and also includes a chapter which applies to incentive spirometers. The experimental part of the work examines the impact of three-week training with trainer Coach2 on parameters of respiratory gas exchange at rest and during the exercise in healthy subjects. methods: Both output and control tests included spirometry and spiroergometry examination. The experimental group consisted of 10 subjects, control group consisted of 9 subjects. results: Our results show a significant influence especially on an increase in FVC, decreased respiratory rate at submaximal intensities of exercise and increased breathing rate at maximum load and also an increase in tidal volume at all load levels. Minute ventilation at maximum load increased by an average of 15.17 liters. The control group did not show any improvement. conclusion: It appears that training with trainer Coach2 might be effective in influencing certain ventilatory parameters at rest as well as during the exercise.

Formation of atelectasis, defined as reversible collapse of aerated lung, often occurs after induction of anaesthesia with mechanical ventilation. As a consequence, there is a risk for hypoxemia, altered hemodynamics and impaired respiratory system mechanics. In certain situations, the risk for atelectasis formation is increased and its consequences may also be more difficult to manage. Anesthesia for bariatric surgery in morbidly obese patients and surgery requiring one-lung ventilation (OLV) with capnothorax are examples of such situations. In Paper I (30 patients with BMI &gt; 40 kg/m2 scheduled for bariatric surgery) a recruit­ment maneuver followed by positive end-expiratory pressure (PEEP) re­duced the amount of atelectasis and improved oxygenation for a prolonged period of time. PEEP or a recruitment maneuver alone did not reduce the amount of atelectasis. In paper II we investigated whether it is possible to predict respiratory function impairment in morbidly obese patients without pulmonary disease from a preoperative lung function test. Patients with mild signs of airway obstruction (reduced end-expiratory flow) in the preoperative spirometry developed less atelectasis during anaesthesia. In paper III we developed an experimental model of sequential OLV with capnothorax using electrical impedance tomography (EIT) that in real-time detected lung separation and dynamic changes in pulmonary ventilation and perfusion distributions. OLV to the left side caused a decrease in cardiac output, arterial oxygenation and mixed venous saturation. In paper IV we used our model of OLV with capnothorax and applied a CO2-insufflation pressure of 16 cm H2O. We demonstrated that a PEEP level of 12-16 cm H2O is needed for optimal oxygenation and lowest possible driving pressure without compromising hemodynamic variables. Thus, the optimal PEEP was closely related to the level of the capnothorax insufflation pressure. With insufficient PEEP, ventilation/perfusion mismatch in the ventilated lung and redistribution of blood flow to the non-ventilated lung occurred.

Title: Physiotherapy as part of multidisciplinary care for patients following a lung transplant operation Objective: To evaluate the mobility of patients in the first days after lung transplantation. To compare the quality of life according to Karnofsky index and Jones dyspnea index. To relate spirometric values FVC and FEV1 of patients in the period prior to lung transplantation with the values in the first year after lung transplantation. Check the link between the development of quality of life and development of spirometric values. Methods: It is a pilot study, which was attended by 18 probands (13 men and 5 women), aged between 14 and 68 years. The data were collected on regular intervals using questionnaires on quality of life (Karnofsky index and Jones dyspnea index) and spirometric examinations taking place at the Motol University Hospital. The data were statistically analyzed using MS EXCEL, mostly using correlations and pair T - test. Results: Results showed substantial changes in the level of significance of p <0,01 both in the development of the quality of life, and in the development of spirometric values compared during the first year after lung transplantation with values before the transpantion. Another important result was the negative effect of a prolonged stay at intensive care...

Title: Effect of physiotherapy in respiratory diseases during healing stays Objective: The main objective of this work is to analyze the importance of physiotherapy as one of the treatments used in the care of pediatric patients with bronchial asthma. Method: In the theoretic part of the dissertation anatomy and physiology of the respiratory tract, respiratory biomechanics, problems of asthma bronchiale, possibilities of asthma treatment, prevention and improvement of quality of life in children with respiratory difficulties under physiotherapy are discussed. The practical part is made as a pilot experimental study of influence of various physiotherapy unit length on patiens respiratory parameters. For monitoring of changes in respiratory displays standardized spirometry measurement was provided supplemented by electronic stethoscope examination. Results: The positive effect of respiratory and movement physiotherapy in children with asthma bronchiale was demonstrated. Further the optimal length of one therapeutic unit in the interval between 10 and 30 minutes was defined. Key words: Asthma bronchiale, spirometry, respiratory physiotherapy, school age

The present work aims to answer questions regarding lung function among students of two types of grammar schools and describe selected indicators of differences between different groups of students within a reference population. The starting point for this work was speculation that the obligations defined by seconadary education in the ordinary type of school may significantly affect the students of the same age group and same Framework educational program for intensive regime of movement, breathing function. Is it possible that the secondary school educational program could affect the degree of respiratory function of students, for example by having less time and not having time for regular exercise? Are students of common type of grammar school physically less active than their peers from sports-oriented type of school? What are lung volumes of today's teens and how much do they differ from the current standards? The selection of respondents was elected from the students of sport-oriented grammar school and the common type of secondary school students. A total of 196 students participated in the study. Students were measured by spirometry lung capacity and function through painstaking cast in relation to strenuous breath. I have found that ordinary secondary school students have a positive...

A asma é uma doença crônica das vias aéreas, cuja fisiopatologia compreende inflamação, hiper-responsividade e remodelação. As características clínicas e a espirometria são usadas para avaliar o controle da doença. Alguns asmáticos não conseguem controlar tomando altas doses de medicações de controle (asma de difícil controle). A tomografia computadorizada quantitativa de tórax (TCQ) é pouco usada na asma, mas pode fornecer biomarcadores da doença. Objetivos: Comparar os achados de TCQ de indivíduos sem doenças respiratórias (grupo controle - GC), com asma controlada (ABC) e com asma de difícil controle (ADC), visando prioritariamente parâmetros substitutivos do remodelamento das vias aéreas. Investigar se há correlações entre os parâmetros QCT e espirometria. Materiais e Métodos: Recrutamos sujeitos com ADC e ABC em um hospital terciário. Usamos registros médicos e convite pessoal para obter dados de CG. Todos os indivíduos foram submetidos a tomografia computadorizada de alta resolução e espirometria. Um software (Yacta) foi usado para obter dados de TCQ. O teste t de Student, o one-way ANOVA e o teste exato de Fisher foram realizados para comparar os dados dos grupos. Os coeficientes de correlação de Pearson foram calculados para avaliar as correlações entre os parâmetros espirométricos e TCQ. Resultados: O GC foi composto por 21 sujeitos; ABC, de 28 e ADC, de 27. Estes últimos eram mais idosos que GC e ABC (50,85 (10,11); 41,27 (11,57); 42,04 (10,11) anos; p = 0,002). A espessura relativa das vias aéreas (ERP3-8) foi significativamente diferente entre GC e ADC (45,31% (3,71); 49,38% (3,38); p = 0,001) e entre GC e ABC (45,31%, 71); 48,25 (4,51); p = 0,001). A espessura normalizada das vias aéreas (Pi10) foi significativamente diferente entre ADC e ABC (0,51 (0,10); 0,44 (0,10); p = 0,0001) e entre ADC e CG (0,51 (0,10), 0,39 (0,08), p = 0,0001). A área da parede das vias aéreas (AP/ASC-mm2) da terceira geração brônquica foi significativamente diferente entre o ADC e o GC (37,14 (9,70); 30,18 (5,06); p = 0,005) e entre ABC e GC (35, 54 (6,37); 30,18 (5,06); p = 0,005). A área da luz da via aérea da terceira geração brônquica (LA/ASC-mm2) foi significativamente diferente entre ADC e ABC (28,81 (10,08); 35,88 (7,12); p = 0,002) e entre ADC e GC (28 81 (10,08); 36,14 (7,29); p = 0,002). A atenuação máxima média (MMA-Hounsfield Units) da terceira geração brônquica foi significativamente diferente entre ADC e GC (-128,68 (67,15); -232,01 (75,20); p = 0,0001) e entre ABC e CG (-147,81 (75,31); -232,01 (75,20); p = 0,0001). Encontramos correlações negativas entre o volume expiratório forçado no primeiro segundo (VEF1) e a ERP na terceira, quarta e quinta gerações brônquicas; entre o índice Tiffeneau e a ERP nessas gerações; entre fluxo expiratório forçado (FEF25-75%) e ERP nas mesmas gerações. Encontramos correlações negativas entre VEF1 e AMMna terceira e quarta gerações e entre o índice de Tiffeneau e AMM nessas gerações. Encontramos correlações negativas entre o FEF(25-75%) e o AMM nessas gerações. Conclusões: Mesmo os asmáticos com doença controlada apresentaram evidências radiológicas de comprometimento da parede das vias aéreas; as evidências foram maiores em asma de difícil controle. Características tomográficas podem ser devido a inflamação ou remodelação. Encontramos correlações entre os parâmetros espirométricos e TCQ. Nossos achados reforçam a utilidade potencial dos parâmetros do TCQ como biomarcadores do controle da asma e da resposta ao tratamento, em pesquisa e em bases clínicas / Asthma is a chronic airway disease whose pathophysiology comprises inflammation, hyperresponsivenes and remodelling. Clinical characteristics and spirometry are used to assess disease control. Some asthmatics do not achieve control taking high doses of controller therapy (difficult to control asthma). Quantitative lung computed tomography (QCT) is seldom used in asthma but may provide asthma biomarkers. Objectives: To compare QCT findings of subjects without respiratory diseases (control group - CG), with controlled asthma (CA) and with difficult to control asthma (DCA), aiming primarily at surrogate parameters of airway remodelling. To investigate whether there are correlations between QCT and spirometry parameters. Materials and Methods: We recruited subjects with DCA and CA from a tertiary hospital. We used medical records and personal invitation to obtain CG data. All subjects underwent high resolution computed tomography and spirometry. A software (Yacta) was used to obtain QCT data. Student\'s t-test, one-way ANOVA and Fisher\'s exact test were performed to compare data from the groups. Pearson correlation coefficients were calculated to assess correlations between spirometric and QTC parameters. Results: The CG was comprised of 21 subjects; CA, of 28 and DCA, of 27. The latter had older subjects than CG and CA (50,85 (10,11); 41,27 (11,57); 42,04 (10,11) years; p=0,002). Relative airway thickness (RT) was significantly different between CG and DCA (45,31% (3,71); 49,38% (3,38); p=0,001) and between CG and CA (45,31% (3,71); 48,25 (4,51); p=0,001). Normalised airway thickness (Pi10) were significantly different between DCA and CA (0,51 (0,10); 0,44 (0,10); p=0,0001) and between DCA and CG (0,51 (0,10); 0,39 (0,08); p=0,0001). Airway wall area (AWAmm2) of the third bronchial generation was significantly different between DCA and CG (37,14 (9,70); 30,18 (5,06); p=0,005) and between CA and CG (35,54 (6,37); 30,18 (5,06); p=0,005). Airway lumen area of the third bronchial generation (ALA-mm2) was significantly different between DCA and CA (28,81 (10,08); 35,88 (7,12); p=0,002) and between DCA and CG (28,81 (10,08); 36,14 (7,29); p=0,002). Mean maximum attenuation (MMA-Hounsfield Units) of the third bronchial generation was significantly different between DCA and CG (-128,68 (67,15); -232,01 (75,20); p=0,0001) and between CA and CG (-147,81 (75,31); -232,01 (75,20); p=0,0001). We found negative correlations between forced expiratory volume on the first second (FEV1) and RT on the third, fourth and fifth bronchial generations ; between the Tiffeneau index and RT on those generations; between forced expiratory flow (FEF25-75) and RT on the same generations. We found negative correlations between FEV1 and MMA on the third and fourth generations and between the Tiffeneau index and MMA on those geneations. We found negative correlations between FEF25-75 and MMA on those generations.Conclusions: Even asthmatics with controlled disease had radiological evidence of airway wall involvement; the evidences were greater in difficult to control asthma. Tomographic features can be due to inflammation or remodelling. We found correlations between spirometric and QTC parameters. Our findings reinforce the potential usefulness of QTC parameters as biomarkers of asthma control and of response to treatment, on research and clinical grounds