The Main Clinical Indicators of Sarcopenia in Patients with Chronic Respiratory Disease: Skeletal Muscle Dysfunction Approach

Patients with chronic respiratory diseases (CRDs) have a disorder in muscle structure and function, but their function increases with physical progress and decreases the risk of general, and muscular weakness are more likely to develop sarcopenia. We randomly selected patients (N = 38) with mean age of 72 ± 1.0 years old men and women elderly with chronic respiratory diseases such as asthma, COPD, bronchiectasis and obesity with dyspnea score ≥ 2 in MRC index. All patients after receiving research information and signing informed consent have gone through performing clinical assessments. They performed femur bone mineral density (FBMD) and ultrasound on the rectus femoris muscle mid-tight cross-sectional area (RFMTCSA) in the quadriceps muscle. The significant changes in BMI were seen in all patients, pre-rehabilitation, BMI = 30 ± 1.06 kg/m2 and post-rehabilitation, BMI = 29 ± 1.00 kg/m2. In Pearson’s correlation of r = 0.607 between T-score and Z-score in FBMD and RFMTCSA in pre-rehabilitation, there is a little bit significant correlation between the variables than in the Pearson’s correlation of r = 0.910 in post-rehabilitation, P < 0.00. Comparing femur bone and rectus femoris muscle parameters as indicators for diagnosis of sarcopenia in chronic respiratory patients, we observed that in rectus femoris muscle, ultrasound is the most effective foot muscle detector.

Historical Aspects of Hyperbaric Physiology and Medicine

The history of hyperbaric oxygen therapy (HBOT) makes for fascinating reading. From pneumatic chambers and compressed air baths to empirical therapeutic applications during the nineteenth century, the impetus to scientific application of HBOT began in seeking solution for decompression sickness during various construction ventures. French physiologist Paul Bert’s research was pathbreaking and provided a scientific explanation on the etiology of the “bends.” In 1908, JS Haldane’s experiments recommended staged decompression and made diving safe. In 1921, OJ Cunningham employed HBOT to treat hypoxia secondary to lung infections successfully. It was cardiac surgeon Ite Boerema who put HBOT on a solid footing with his open-heart surgery results in various pediatric cardiac conditions and rightly deserved the title of father of modern-day hyperbaric medicine. From 1937 onwards, HBOT research snowballed into treating a wide variety of diseases. In 1999, the Undersea and Hyperbaric Medical Society and Food and Drug Administration recognized the value of HBOT, and this led to its becoming a major tool in the armamentarium of clinicians, either as a primary or adjunctive therapy for a spectrum of diseases.

Environmental Media and Associated Respiratory Defects

Environmental media majorly connotes abiotic components of the natural environment, namely, air, water and soil. Pollution to these media has resulted to a great deal of respiratory defects. Epidemiologic studies conducted in the U.S. and abroad provide evidence of associations between short and long-term exposure to fine particles in the air and both decrements in lung function growth in children and increased respiratory symptoms. Particles deposited in the respiratory tract in sufficient amounts induce lung inflammation, which has been demonstrated in both animal and controlled human exposure studies. More recently, the International Agency for Research on Cancer (IARC) also conducted an evaluation on the carcinogenicity of outdoor air pollution in the respiratory tract, including particle pollution, and concluded that both are Group I agents (carcinogenic to humans). Air pollution has been given great priority as a causal factor for respiratory defects; meanwhile dust particles from contaminated soil could also cause a great havoc. Moreover polluted water is also a major causal pathway. According to world health organization (WHO) 80% diseases are waterborne. Though water is an important natural resource used for drinking and other developmental purposes in our lives but health risk associated with polluted water includes different diseases in which respiratory diseases are the major ones. Bacterial, viral and parasitic diseases are spreading through polluted water and affecting human health. Poliomyelitis virus is responsible for poliomyelitis, sore throat, fever, nausea, which are all due to polluted water.

The Respiratory System during Intermittent-Sprint Work: Respiratory Muscle Work and the Critical Distribution of Oxygen

In healthy individuals at rest and while performing moderate-intensity exercise, systemic blood flow is distributed to tissues relative to their metabolic oxygen demands. During sustained high-intensity exercise, competition for oxygen delivery arises between locomotor and respiratory muscles, and the heightened metabolic work of breathing, therefore, contributes to limited skeletal muscle oxygenation and contractility. Intriguingly, this does not appear to be the case for intermittent-sprint work. This chapter presents new evidence, based on inspiratory muscle mechanical loading and hypoxic gas breathing, to support that the respiratory system of healthy men is capable of accommodating the oxygen needs of both locomotor and respiratory muscles when work is interspersed with short recovery periods. Only when moderate hypoxemia is induced, substantial oxygen competition arises in favour of the respiratory muscles. These findings extend our understanding of the relationship between mechanical and metabolic limits of varied exercise modes.