Gate mechanism in breathlessness caused by chest wall vibration in humans

1984 ◽  
Vol 56 (1) ◽  
pp. 8-11 ◽  
Author(s):  
I. Homma ◽  
T. Obata ◽  
M. Sibuya ◽  
M. Uchida
Keyword(s):  
Respiratory Rate ◽  
Chest Wall ◽  
Healthy Subjects ◽  
Muscle Spindles ◽  
Central Mechanism ◽  
Respiratory Cycle ◽  
Intercostal Muscles ◽  
Asthmatic Patients ◽  
Asthma Patients

The effects of bilateral alternating out-of-phase vibrations were studied in 10 normal healthy subjects and five asthmatic patients. The second or third intercostal spaces were vibrated during expiration, and the seventh to ninth intercostal spaces were vibrated during inspiration. Most subjects sensed breathlessness during such vibrations, and 100 Hz was most effective. The degree of breathlessness correlated positively with increased respiratory rate. Respiratory rate increased from 14.1 +/- 3.78 (mean +/- SD) to 22.3 +/- 7.14 breaths/min (P less than 0.05) during relatively severe breathlessness and to 20.39 +/- 5.66 breaths/min (P less than 0.05) during less uncomfortable sensation. Slight or negligible breathlessness induced no significant increase in rate (15.33 +/- 4.19 breaths/min). All asthma patients described the sensations during vibration as similar to those during asthma attacks, and their respiratory rates increased 20.7 +/- 11.03% during 100 Hz vibration (P less than 0.01). It is suggested that the uncomfortable sensation of breathlessness may be induced by muscle spindles in the intercostal muscles being activated out of phase with the respiratory cycle. The central mechanism that receives the intercostal afferents may have a certain gate that operates in relation to the sensation of breathlessness.

Expression Level of MiRNA-126 in Serum Exosomes of Allergic Asthma Patients and Lung Tissues of Asthmatic Mice

2019 ◽  
Vol 20 (10) ◽  
pp. 799-803 ◽  
Author(s):  
Meizhen Zhao ◽  
Yu-Pei Li ◽  
Xiao-Rui Geng ◽  
Miao Zhao ◽  
Shi-Bo Ma ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Real Time ◽  
Real Time Pcr ◽  
Lavage Fluid ◽  
Asthmatic Patients ◽  
Protein Levels ◽  
Sige Level ◽  
Bronchial Lumen ◽  
Asthma Patients ◽  
Serum Exosomes

Background: To investigate MiRNA-126 amounts in serum exosomes from allergic asthma patients as well as lung tissues of asthmatic mice, evaluating the expression of its target gene DNMT1 in mouse specimens. Methods: MiRNA-126 amounts in serum exosomes from asthmatic patients were detected by real-time PCR. The mouse model of allergic asthma was established by OVA-sensitization, and allergic symptoms were recorded; serum IL-4 and sIgE level evaluation (ELISA), broncho alveolar lavage fluid (BALF) cell count and H&E staining were performed to assess airway inflammation. MiRNA-126 and DNMT1 levels in the lung of asthmatic and control mice were detected by real-time PCR; DNMT1 protein levels were detected by immunoblot. Results: MiRNA-126 amounts in peripheral blood exosomes from patients with allergic asthma were significantly higher than that of healthy volunteers (P<0.05). The frequencies of scratching of both sides of the nose and sneezing were elevated within 10 min of excitation in asthmatic rats compared with controls. Meanwhile, OVA-sIgE and IL-4 levels were significantly higher in asthmatic animals than controls (P<0.05). In the asthma group, narrowed bronchial lumen and thickened wall were observed, and bronchial and peripheral vessels showed overt inflammatory cell infiltration. Eosinophil, neutrophil and mast cell amounts in the BALF of asthmatic mice were significantly higher than control values. Furthermore, lung miRNA-126 expression in asthmatic mice was significantly higher than that of controls. Finally, DNMT1 mRNA and protein levels were significantly lower in asthmatic animals compared with controls (P < 0.01). Conclusion: MiRNA-126 is highly expressed in serum exosomes from allergic asthma patients and lung tissues of asthmatic mice, suggesting that it may be involved in the pathogenesis of bronchial asthma.

scholarly journals Depression Levels Influence the Rate of Asthma Exacerbations in Females

2021 ◽  
Vol 11 (6) ◽  
pp. 586
Author(s):  
Papaporfyriou Anastasia ◽  
Tseliou Eleni ◽  
Mizi Eleftheria ◽  
Ntontsi Xenia ◽  
Papathanasiou Eygenia ◽  
...  
Keyword(s):  
Control Level ◽  
Depression Scale ◽  
Low Frequency ◽  
Anxiety And Depression ◽  
Asthmatic Patients ◽  
Asthma Exacerbations ◽  
Depression Subscale ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Global Initiative

Background: Anxiety and depression are common psychological disturbances among asthmatic patients. The aim of the present study is the assessment of anxiety and depression in asthmatic patients and their correlation with symptoms control level and number of exacerbations per year. Methods: One hundred patients with asthma diagnosis, according to the Global Initiative for Asthma (GINA), aged > 18 years old, having a stable disease, were included. Emotional status was evaluated using the Hospital Anxiety Depression Scale (HADS). Patients were followed up for a year to assess the number and severity of exacerbations. Results: Most of our patients were female (58%), middle-aged (mean = 54 ± 13), and married (81%), with low frequency of smoking habits (smokers, ex-smokers and non-smokers were 26%, 30% and 37%, respectively) and low levels of both anxiety and depression [median (interquartile range (IQR)) = 4(2) and median (IQR) = 4(2), respectively]. At the low and moderate level of the depression subscale, female patients experienced asthma exacerbations more frequently compared to male patients (adjusted Incidence Rate Ratio (aIRR) = 4.30; 95% Confidence Interval (CI): 1.94–9.53 and aIRR = 1.82; 95% CI: 1.07–3.13, respectively). Conclusions. Clinicians should evaluate asthma patients for depression, as gender differentially influences outcomes among those with low and moderate levels of depression, with female asthmatics presenting more frequent exacerbations.

Neonatal chest wall afferents and regulation of respiration

1977 ◽  
Vol 42 (3) ◽  
pp. 362-367 ◽  
Author(s):  
R. Hagan ◽  
A. C. Bryan ◽  
M. H. Bryan ◽  
G. Gulston
Keyword(s):  
Chest Wall ◽  
Rem Sleep ◽  
Applied Pressure ◽  
Muscle Spindles ◽  
Face Mask ◽  
The Body ◽  
Regulation Of Respiration ◽  
Quiet Sleep ◽  
Rib Cage ◽  
Afferent Information

We have studied two groups of eight preterm infants, relating chest wall afferent information to respiratory timing. Rib cage and abdominal motion were monitored by magnetometers and flow and tidal volume via a face mask. In the first group, studies were done in REM sleep when spontaneously occurring distortion of the rib cage occurred and a significant linear relationship between the rate of distortion of the chest wall and shortening of the inspiratory time (Ti) was found in all infants. Reduction in this distortion by the use of continuous positive airway pressure (CPAP) or continuous negative pressure at the body surface (CNeg) was associated with a significant (P less than 0.01) lengthening of Ti. Absence of changes in Ti when pressure was applied in quiet sleep suggested that lung volume or chemical changes were not involved. In the second group of infants we artificially generated the afferent inflow by using vibratory stimuli applied in one intercostal interspace and produced a significant (P less than 0.05) shortening in Ti. We suggest that the distortion of the rib cage in REM sleep generates afferent information from intercostal muscle spindles that is related to the rate of distortion and this, via a supraspinal reflex, inhibits phrenic motoneuron discharge. It may then be of importance in the etiology of apneic episodes in these infants. Applied pressure may be of benefit because it reduces an inhibitory afferent inflow.

scholarly journals Comparison Of Lung Function Tests Between Healthy And Asthmatic Individuals

BioSight ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 6-10
Author(s):  
Hira Liaquat ◽  
Tabinda Najeeb ◽  
Rahima Aftab ◽  
Tayyaba Kazmi ◽  
Padma Rathore ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Case Control Study ◽  
Pulmonary Function Tests ◽  
Case Control ◽  
Asthmatic Patients ◽  
Function Tests ◽  
Lower Lung ◽  
Medical University ◽  
Control Study ◽  
Asthmatic Case

Background: Comparison of pulmonary function tests (PFTs) were achieved between asthmatic case and Controls. Materials & Methods: Case-control study conducted at Baqai Medical University (50 cases and 50 control). PFTs in both the participants were estimated by spirometry; FEC, FEV1 and their ratios were estimated. Results: According to the findings all spirometric values were lower in asthmatic patients as compared to healthy subjects. Moreover the asthamatic subjects had lower lung values when compared with healthy subjects. Conclusion: The current study evaluated spirometric values in asthmatic patients in Gadap area. This study's findings can be applied to the treatment of asthma in people of all ages.

scholarly journals Assessment of quality of life in asthma patients in 5 to 18 years of children

2020 ◽  
Vol 7 (11) ◽  
pp. 2214
Author(s):  
Nikhil Jain ◽  
Karan Joshi
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Persistent Asthma ◽  
Tertiary Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Asthmatic Patients ◽  
Asthma Patients ◽  
Severity Of The Disease

Background: Asthma is a common cause of morbidity and mortality with prevalence of 300 million in world. The QOL of asthmatic patients cannot be determined only on the basis the severity of the disease, but requires a measurement of personal perception. This study was conducted with the aim to assess and compare the QOL using PedsQl scale in asthma patients between 5 to 18 years of age with different demographic and clinical variables.Methods: This was a cross-sectional observational study conducted at respiratory clinic in tertiary hospital, Rewa from October 2017 to June 2019. A total number of 150 asthmatic patients and their parents participated. Asthmatic patients (N=150) and their parents, presenting to asthma clinic of Gandhi Memorial Hospital, Rewa (after applying inclusion-exclusion criteria) were assessed for QOL using PedsQl scale 3.0. Statistical analysis was performed by SPSS version 20. Test of significance by student T-test and one way ANOVA.Results: The QOL is severely hampered by asthma with mean of 59 in intermittent asthma, 51 in mild, 44.74 in moderate and 40 in severe persistent asthma, significant p value of <0.05. Younger age, level of asthma control and severity were significantly related to QOL with p value of <0.05. Sex, socioeconomic status, were insignificantly related.Conclusions: QOL is impaired as the grading of asthma increases. Impairment of Quality of life are mostly associated with low level of asthma control, poly-therapy and frequent night attacks.

scholarly journals Periodontal clinical features of bronchial asthma patient using inhalation drugs

2021 ◽  
Vol 33 (3) ◽  
pp. 217
Author(s):  
Maria Efrinta Ginting ◽  
Rosiliwati Wihardja ◽  
Dyah Nindita Carolina
Keyword(s):  
Periodontal Disease ◽  
Clinical Features ◽  
Bronchial Asthma ◽  
Periodontal Pocket ◽  
Periodontal Status ◽  
Asthmatic Patients ◽  
Gingival Bleeding ◽  
Periodontal Index ◽  
Asthma Patients ◽  
One Year

Introduction: Bronchial asthma patients use inhalation drugs as therapy to achieve a controlled asthma state. Inhaled corticosteroids and β2 agonists are the medication that is being used in this case. Prolonged use of inhalation drugs will affect the health of periodontal tissue. The effect of these drugs can reduce the periodontal defense mechanism and increase the risk of periodontal disease. This study aims to determine the periodontal clinical features of bronchial asthma patients using inhalation drugs. Method: This research was a descriptive study. The sample of the study were 22 females and 8 males bronchial asthma patients at the Community Lung Health Center of Bandung (Balai Besar Kesehatan Paru Masyarakat Bandung/BBKPM Bandung) who had been using inhalation drugs for at least one year. The periodontal clinical feature was assessed by employing a Community Periodontal Index (CPI) modified with probing the gingival sulcus to assess the presence of gingival bleeding, periodontal pocket, and loss of clinical attachment where then a periodontal status was obtained. The periodontal status data were then processed using the periodontitis case definitions from the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) to determine periodontal disease in asthmatics patients. Results: Clinical features of gingival bleeding were found in 26 asthmatic patients (86.7%), periodontal pockets in 18 asthmatic patients (60%), and loss of clinical attachment in 27 asthmatic patients (90%). Based on the CDC/AAP case definition, 23 asthmatic patients (76.7%) had periodontitis. Bronchial asthma patients who used inhalation drugs had a risk of periodontitis.Conclusion: Bronchial asthma patients who used inhalation drugs for at least one year had gingival bleeding and loss of clinical attachment and periodontal pocket.

The Utility of Serum IL-1β and CRP Together with Fractional Exhaled Nitric Oxide in the Diagnosis of Asthma in Adults

2021 ◽  
Vol 19 (8) ◽  
pp. 119-124
Author(s):  
Hayder Abdul-Amir Makki Al-Hindy ◽  
Ali Jihad Hemid Al-Athari ◽  
Mazin J. Mousa ◽  
Safa Jihad Hameed ◽  
Suhad Hafidh Obeed
Keyword(s):  
Nitric Oxide ◽  
Sensitivity And Specificity ◽  
Bronchial Asthma ◽  
High Sensitivity ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
Asthma Patients ◽  
Hs Crp

Background: Bronchial asthma (BrA), recognized lately as an umbrella, covers various subtypes rather than only one disease. Asthma is a chronic inflammation of the airways, in which cytokines could play a crucial role in its pathogenesis. Hence, labors to progress noninvasive markers for asthma had centered through this era. Presently, the fractional exhaled nitric oxide (FeNO), serum C-reactive protein (CRP), and interleukin levels are emerging analytical biomarkers in this field. FeNO is a noninvasive and practical tool even in mild asthma. This study aimed to evaluate the utility of serum IL-1β and CRP together with fractional exhaled nitric oxide in the diagnosis of adult bronchial asthma. Method: The study was a case control, including 150-patients and 100-healthy controls. FeNO tests, measurements of plasma levels IL-1β and HS-CRP had undertaken for all the participants. The statistical data had examined by SPSS (V/27) for Windows. Descriptive data of the variables had compatibly used. A significance lower than or identical to 0.05 had intended. ROC curve examination of FeNO tests, IL-1β, and HS-CRP, to predict asthma from healthy control had applied. Results: there was a significant difference in the FeNo test, HS-CRP levels, and BMI, while no significant difference in all other variables between the groups. The FeNo results correlate positively, though not significantly, with the levels of IL-1β in asthmatic patients (> 0.05). There was a nonsignificant negative correlation between the FeNo results with the level of HSCRP. The accuracy, sensitivity, and specificity of the IL-1β to distinguish asthma were 68.6% and 58% at 95% CI [0.41-0.745], respectively, which was not significant (p>0.05). However, ROC analysis of HS-CRP revealed predictability for asthma patients (p-0.000), with higher accuracy, sensitivity, and specificity: 89.9%, and 68.1% at 95% CI [0.820-0.979], respectively. The FeNo tests revealed highly significant (0.000), high sensitivity, and specific (91% for both) with high 95% CI [0.938-1.000] predictability for asthma. Conclusion: The utility of circulating HS-CRP is more valuable than IL-1β when combined with fractional exhaled nitric oxide in the diagnosis of asthma. Novel biomarkers could improve the precision of this field.

Steady-state response of quadriplegic subjects to inspiratory resistive load

1986 ◽  
Vol 60 (5) ◽  
pp. 1482-1492 ◽  
Author(s):  
V. Im Hof ◽  
H. Dubo ◽  
V. Daniels ◽  
M. Younes
Keyword(s):  
Steady State ◽  
Chest Wall ◽  
Muscle Spindles ◽  
Normal Subjects ◽  
Afferent Feedback ◽  
Resistive Load ◽  
State Response ◽  
The Face ◽  
Inspiratory Resistance

Normal subjects preserve tidal volume (VT) in the face of added inspiratory resistance by increasing maximal amplitude and duration of the rising phase of respiratory driving pressure (DP) and by changing the shape of this phase to one that is more concave to the time axis. To explore the possible role of chest wall afferents in mediating these responses, we determined averaged DP in eight quadriplegic subjects during steady-state unloaded breathing and while breathing through an inspiratory resistance (8.5 cmH2O X 1(-1) X s). As with normal subjects, quadriplegics preserved VT (loaded VT = 106% control) by utilizing all three mechanisms. However, prolongation of the inspiratory duration derived from the DP waveform (+22% vs. +42%) and shape response were significantly less in the quadriplegic subjects. Shape response was completely absent in subjects with C4 lesions. The results provide strong evidence that respiratory muscle spindles are responsible for shape response and that changes in afferent feedback from the chest wall play an important role in mediating inspiratory prolongation.

scholarly journals PHOTOGRAMMETRY: A PROPOSAL OF OBJECTIVE ASSESSMENT OF CHEST WALL IN ADOLESCENT IDIOPATHIC SCOLIOSIS

2019 ◽  
Vol 37 (2) ◽  
pp. 225-233
Author(s):  
Anderson Sales Alexandre ◽  
Evandro Fornias Sperandio ◽  
Liu Chiao Yi ◽  
Josy Davidson ◽  
Patrícia Rios Poletto ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Lung Function ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Chest Wall ◽  
Healthy Subjects ◽  
Objective Assessment ◽  
Spine Deformity ◽  
Xiphoid Process ◽  
Cross Sectional

ABSTRACT Objective: To evaluate the chest wall shape in patients with adolescent idiopathic scoliosis (AIS) in comparison to healthy subjects and the association between the chest wall shape with the spine deformity and lung function in patients with AIS. Methods: This cross-sectional study enrolled 30 AIS patients and 20 healthy subjects aged 11-18 years old. The Cobb angle evaluation was performed in AIS patients. The chest wall shape was assessed by the photogrammetry method, using the Postural Assessment Software (PAS). We created thoracic markers shaped as angles (A) and distances (D), as follows: A2 (right acromion/xiphoid/left acromion), A4L (angle formed between the outer point of the smallest waist circumference and its upper and lower edges on the left side), A7 (angle formed by the intersection of the tangent segments of the upper and lower scapulae angles), D1R/D1L [distance between the xiphoid process and the last false rib on the right (R) and left (L) sides], and D3 (distance between xiphoid process and anterior superior iliac spine). Results: The thoracic markers A2 and A7 were significantly higher, while the A4L and D1R/D1L were significantly reduced in the AIS group compared to the control. Moderate correlations were found between: A2 and the main and proximal thoracic Cobb angles (r=0.50, r=0.47, respectively); D1R/D1L and the main thoracic Cobb angle (r=- 0.40); and the forced expiratory volume in the first second (FEV1) and D3R (r=0.47). Conclusions: The photogrammetry method was able to detect chest wall changes in AIS patients, besides presenting correlation between Cobb angles and lung function.

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