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The changes in pulmonary compliance have been studied under conditions of total body hypothermia. Five groups of sheep were used; two groups were controls—one for the effects of anaesthesia and the other for normothermic biventricular bypass. The third group was cooled using a femoro-femoral arterio-venous shunt to 20°-23° C. The fourth group was cooled to 15° C. and rewarmed using the Drew technique. The excised lungs of the remaining sheep were studied at 37° and 15° C. (fifth group). The controls showed little change in compliance. The cooled animals showed a decrease in compliance. In the group subjected to hypothermia by the Drew technique, the rewarming phase initially brought a return towards normal compliance. As the temperature rose to 24°-30° C. the improvement in compliance ceased and thereafter compliance decreased for two hours after rewarming. Histologically the lungs were normal. There was no compliance change caused by cooling the excised lungs.

Respiratory pathologies alter the structure of the lung and impact its mechanics. Mice are widely used in the study of lung pathologies, but there is a lack of fundamental mechanical measurements assessing the interdependent effect of varying inflation volumes and cycling frequency. In this study, the mechanical properties of five male C57BL/6J mice (29-33weeks of age) lungs were evaluated ex vivo using our custom-designed electromechanical, continuous measure ventilation apparatus. We comprehensively quantify and analyze the effect of loading volumes (0.3, 0.5, 0.7, 0.9ml) and breathing rates (5, 10, 20 breaths per minute) on pulmonary inflation and deflation mechanical properties. We report means of static compliance between 5.4-16.1µl/cmH2O, deflation compliance of 5.3-22.2µl/cmH2O, percent relaxation of 21.7-39.1%, hysteresis of 1.11-7.6ml•cmH2O, and energy loss of 39-58%for the range of four volumes and three rates tested, along with additional measures. We conclude that inflation volume was found to significantly affect hysteresis, static compliance, starting compliance, top compliance, deflation compliance, and percent relaxation, and cycling rate was found to affect only hysteresis, energy loss, percent relaxation, static compliance and deflation compliance.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files ; We assessed associations between physical activity and lung function, and its decline, in the prospective population-based European Community Respiratory Health Survey cohort. ; FEV1 and FVC were measured in 3912 participants at 27-57 years and 39-67 years (mean time between examinations=11.1 years). Physical activity frequency and duration were assessed using questionnaires and used to identify active individuals (physical activity ≥2 times and ≥1 hour per week) at each examination. Adjusted mixed linear regression models assessed associations of regular physical activity with FEV1 and FVC. ; Physical activity frequency and duration increased over the study period. In adjusted models, active individuals at the first examination had higher FEV1 (43.6 mL (95% CI 12.0 to 75.1)) and FVC (53.9 mL (95% CI 17.8 to 89.9)) at both examinations than their non-active counterparts. These associations appeared restricted to current smokers. In the whole population, FEV1 and FVC were higher among those who changed from inactive to active during the follow-up (38.0 mL (95% CI 15.8 to 60.3) and 54.2 mL (95% CI 25.1 to 83.3), respectively) and who were consistently active, compared with those consistently non-active. No associations were found for lung function decline. ; Leisure-time vigorous physical activity was associated with higher FEV1 and FVC over a 10-year period among current smokers, but not with FEV1 and FVC decline. ; European Union

Respiratory pathologies alter the structure of the lung and impact its mechanics. Mice are widely used in the study of lung pathologies, but there is a lack of fundamental mechanical measurements assessing the interdependent effect of varying inflation volumes and cycling frequency. In this study, the mechanical properties of five male C57BL/6J mice (29–33 weeks of age) lungs were evaluated ex vivo using our custom-designed electromechanical, continuous measure ventilation apparatus. We comprehensively quantify and analyze the effect of loading volumes (0.3, 0.5, 0.7, 0.9 ml) and breathing rates (5, 10, 20 breaths per minute) on pulmonary inflation and deflation mechanical properties. We report means of static compliance between 5.4–16.1 µl/cmH(2)O, deflation compliance of 5.3–22.2 µl/cmH(2)O, percent relaxation of 21.7–39.1%, hysteresis of 1.11–7.6 ml•cmH(2)O, and energy loss of 39–58% for the range of four volumes and three rates tested, along with additional measures. We conclude that inflation volume was found to significantly affect hysteresis, static compliance, starting compliance, top compliance, deflation compliance, and percent relaxation, and cycling rate was found to affect only hysteresis, energy loss, percent relaxation, static compliance and deflation compliance.

Background Inhomogeneous lung ventilation and pulmonary air leaks are common adverse effects of mechanical ventilation in preterm infants suffering from respiratory distress syndrome. We hypothesized that shortening of inspiratory times can improve the homogeneity of lung aeration. We assumed that ultrashort inspiratory times lead to a full build‐up of pressure in regions with low compliance while maintaining incomplete filling of regions with high compliance. Methods We connected a two‐compartment model of the lung with different compliances of the two compartments to a neonatal ventilator. Pressures and flow rates were measured separately for each compartment at inspiratory times ranging from 0.1 to 0.8 s and various combinations of tidal volumes. Results An inspiratory time of 0.8 s resulted in near total pressure equalization between the airway pressure and the two compartments, as 97% of the maximum applied peak pressure was reached in the low compliance compartment and 95% in the high compliance compartment. The distribution of the tidal volume was proportional to the compartment compliance. Ultrashort inspiratory times lowered the peak pressure and tidal volume in the high compliance compartment but maintained higher pressure and volume in the low compliance compartment. An inspiratory time of 0.2 s resulted in a peak pressure of 80% of peak airway pressure in the low compliance compartment and in 61% of peak airway pressure in the high compliance compartment (p < .001). Conclusion Ventilation with ultrashort inspiratory times may improve homogeneity of air distribution in inhomogeneous lungs of ventilated preterm or term infants.

AbstractGiven the recent increase in dust‐induced lung disease among U.S. coal miners and the respiratory hazards encountered across the U.S. mining industry, it is important to enhance an understanding of lung disease trends and the organizational contexts that precede these events. In addition to exploring overall trends reported to the Mine Safety and Health Administration (MSHA), the current study uses MSHA's enforcement database to examine whether or not compliance with health regulations resulted in fewer mine‐level counts of these diseases over time. The findings suggest that interstitial lung diseases were more prevalent in coal mines compared to other mining commodities, in Appalachian coal mines compared to the rest of the United States, and in underground compared to surface coal mines. Mines that followed a relevant subset of MSHA's health regulations were less likely to report a lung disease over time. The findings are discussed from a lung disease prevention strategy perspective.

Local policy networks can aid federal agencies, but they can also coopt federal resources for unintended purposes. Our empirical study finds that effective local networks increase both enforcement and compliance rates for the Clean Water Act. We discuss the circumstances under which effective networks can transform political culture, enhancing enforcement and compliance even in conservative areas generally opposed to regulation. The modified detection‐controlled estimation procedure enables us to utilize official enforcement records from 1994 to 2000 to study both enforcement and compliance.

BACKGROUND. Ultrasound study significantly expanded the possibilities of bedside diagnosis in patients with respiratory failure. Using ultrasound, it is possible to determine the volume of lung damage in the form of collapsed alveoli and infiltration areas with preserved airness of the lung tissue. AIM OF STuDY To study the possibility of assessing the recruitment maneuver of the alveoli based on changes in the ultrasound signs of lung tissue damage.MATERIAL AND METHODS. A prospective study was performed in the Clinic of Anesthesiology and Resuscitation of S.M. Kirov Military Medical Academy. The study included 36 patients who were treated in the period from 2010 to 2017 with a duration of respiratory support of at least 48 hours and oxygenation index less than 300 mmHg. For 36 patients, 48 alveoli recruitment maneuvers were performed according to a step-by-step method under the control of dynamic compliance and average tidal volume. Ultrasound determined the type and extent of destruction of lung tissue by signs of infiltration and consolidation.RESULTS. In the studied patients, after carrying out a maneuver of recruitment of the alveoli, arterial blood oxygenation indices increased statistically significantly, PaCO2 level decreased, pulmonary tissue compliance improved, respiratory volume grew. All this confirmed the mobilization of the alveoli and improved lung ventilation. Ultrasonographic evaluation of lung tissue showed a significant decrease in the severity of the ultrasound sign of infiltration after recruitment maneuver from 46.5 (38; 57.5) to 37.5 (30.5; 49.5). However, recruitment had practically no effect on the volume of the consolidated area of lung tissue: the general consolidation index before (4 (3; 5)) and after (4 (3; 5)) the maneuver had no statistically significant differences.CONCLUSIONS. The pneumonia-affected consolidated lung tissue has a low recruitment potential and the volume of consolidation does not change with the growth of PEEP. After the recruitment maneuver, the number of B-lines decreases, indicating a decrease in infiltration and an increase in lung airness.Authors declare lack of the conflicts of interests. ; АКТУАЛЬНОСТЬ. Ультразвуковое исследование существенно расширило возможности прикроватной диагностики у пациентов с дыхательной недостаточностью. С помощью ультразвука имеется возможность определения объема поражения легких в виде коллабированных альвеол и зон инфильтрации с сохранением воздушности легочной ткани.ЦЕЛЬ ИССЛЕДОВАНИЯ. Изучить возможность оценки маневра рекрутирования альвеол на основании изменения ультразвуковых признаков поражения легочной ткани.МАТЕРИАЛ И МЕТОДЫ. Проспективное исследование выполнено в клинике анестезиологии и реаниматологии Военномедицинской академии им. С.М. Кирова. В исследование были включены 36 пациентов, которые находились на лечении в период с 2010 по 2017 г. с длительностью аппаратной респираторной поддержки не менее 48 часов; индексом оксигенации менее 300 мм рт.ст. Тридцати шести пациентам было выполнено 48 маневров рекрутирования альвеол по пошаговой методике под контролем динамической податливости и среднего значения дыхательного объема. При ультразвуковом сканировании определяли характер и объем поражения легочной ткани по признакам инфильтрации и консолидации.РЕЗУЛЬТАТЫ. У обследуемых пациентов после проведения маневра рекрутирования альвеол статистически значимо выросли показатели оксигенации артериальной крови, индекс оксигенации, снизился уровень PaСO2 , улучшилась податливость легочной ткани, увеличился дыхательный объем. Все это свидетельствовало о мобилизации альвеол и улучшении вентиляции легких. Сонографическая оценка легочной ткани показала существенное уменьшение выраженности ультразвукового признака инфильтрации после проведения маневра рекрутирования с 46,5 (38; 57,5) до 37,5 (30,5; 49,5). Однако рекрутирование практически не оказало влияния на объем консолидированной зоны легочной ткани: общий индекс консолидации до (4 (3; 5)) и после (4 (3; 5)) маневра не имел статистически достоверных различий.ВЫВОДЫ. 1) Пораженная пневмонией консолидированная легочная ткань имеет низкий рекрутабельный потенциал и при увеличении положительного давления в конце выдоха объем консолидации не меняется. 2) После маневра рекрутирования уменьшается количество В-линий, свидетельствующих о снижении инфильтрации и увеличении воздушности легких.Авторы заявляют об отсутствии конфликта интересов.

Tobacco is the single greatest cause of death globally. As many as half of people who use tobacco die from the results of this use. The World Health Organization (WHO) estimates that each year tobacco causes about 6 million deaths (about 10% of all deaths) with 0.6 million of these occurring in non-smokers due to second-hand smoke. In the 20th century, tobacco is estimated to have caused 100 million deaths. The government of India implemented Cigarettes and other Tobacco Products Act of 2003, which prohibits smoking in public places, advertisement and regulation of trade and commerce, production, supply and distribution, direct or indirect advertisement, sponsorship and promotion of tobacco products and sale to and by minors and prohibition of sale around educational institutions. In order to find the compliance of COTPA in Mysore district, the study was conducted with the help of State Institute of Health & Family Welfare, Karnataka, and the International Union against Tuberculosis and Lung Disease. The objective of the study was to assess the current level of compliance to various sections of COTPA in Mysore district. For compliance monitoring, an observation checklist was used to assess the compliance to different sections of the Act which has been developed by the "International Union against Tuberculosis and Lung Disease." A total of 410 public places, 400 points of sale, and 400 educational institutions were observed to assess the compliance to the COTPA Act (2003). It was found that there is clear violation of the Act in majority of the places.

Musaddique Hussain,1 Shahzada Khurram Syed,2 Mobeen Fatima,1 Saira Shaukat,1 Malik Saadullah,3 Ali M Alqahtani,4 Taha Alqahtani,4 Talha Bin Emran,5 Ali H Alamri,6 Muhammad Qasim Barkat,7 Ximei Wu7 1Department of Pharmacology, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan; 2Department of Basic Medical Sciences, School of Health Sciences, University of Management and Technology Lahore, Lahore, 54000, Pakistan; 3Department of Pharmaceutical Chemistry, Government College University, Faisalabad, 38000, Pakistan; 4Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, 62529, Saudi Arabia; 5Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh; 6Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha, 62529, Saudi Arabia; 7Department of Pharmacology, School of Medicine, Zhejiang University, Hangzhou City, 310000, People's Republic of ChinaCorrespondence: Musaddique HussainDepartment of Pharmacology, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, 63100, PakistanEmail musaddique.hussain@iub.edu.pkXimei WuDepartment of Pharmacology, School of Medicine, Zhejiang University, Hangzhou City, People's Republic of ChinaEmail xiwu@zju.edu.cnAbstract: Acute respiratory distress syndrome (ARDS) is an overwhelming inflammatory disorder of the lung due to direct and indirect insults to the lungs. ARDS is characterized by increased vascular permeability, protein-rich edema, diffuse alveolar infiltrate, and loss of aerated lung tissue, leading to decreased lung compliance, tachypnea, and severe hypoxemia. COVID-19 is generally associated with ARDS, and it has gained prime importance since it started. The mortality rate is alarmingly high in COVID-19-related ARDS patients regardless of advances in mechanical ventilation. Several pharmacological agents, including corticosteroids, nitric oxide, neuromuscular blocker, anti-TNF, statins, and exogenous surfactant, have been studied and some are under investigation, like ketoconazole, lisofylline, N-acetylcysteine, prostaglandins, prostacyclin, and fish oil. The purpose of this review is to appraise the understanding of the pathophysiology of ARDS, biomarkers, and clinical trials of pharmacological therapies of ARDS and COVID-19-related ARDS.Keywords: acute respiratory distress syndrome, acute lung injury, COVID-19, COVID-19-related ARDS

ABSTRAK Tuberkulosis merupakan penyakit menular bahkan bisa menyebabkan kematian, penyakit ini menyebar melalui droplet orang yang telah terinfeksi basil tuberkulosis. Tuberkulosis masih menjadi salah satu pembunuh utama bagi manusia, jika tidak diobati dengan baik maka penyakit ini dapat menyebabkan kematian pada hampir setengah kasus selama 5 tahun setelah menderita penyakit ini. Kepatuhan rata-rata pasien pada pengobatan jangka panjang terhadap penyakit kronis di negara maju hanya sebesar 50% sedangkan di negara berkembang jumlah tersebut bahkan lebih rendah. Ketidakpatuhan pasien dalam pengobatan merupakan masalah kesehatan yang serius dan sering terjadi pada pasien dengan penyakit kronis, seperti pada penyakit Tuberkulosis Paru. Penelitian ini bertujuan untuk mengetahui kepatuhan pasien Tuberkulosis Paru di Puskesmas Padasuka Kecamatan Cibeunying Kidul Kota Bandung. Desain dalam penelitian ini adalah deskriptif kuantitatif. Pengambilan data dilakukan dengan menggunakan kuesioner dan teknik accidental sampling dengan jumlah sampel 21 orang. Hasil penelitian menunjukkan bahwa mayoritas pasien Tuberkulosis Paru memiliki kepatuhan terhadap regimen terapeutik yaitu diperoleh 16 orang (76%), yang tidak patuh diperoleh 5 orang (24%). Alasan yang paling banyak diungkapkan oleh responden yang patuh adalah karena ingin cepat sembuh dari penyakitnya, bisa beraktivitas kembali seperti biasa sebelum sakit, dukungan dari keluarga responden dan informasi yang didapatkan dari petugas puskesmas sangat baik sehingga termotivasi untuk patuh meminum obat. Diharapkan semua pihak diantaranya keluarga pasien, pemerintah dan tenaga kesehatan untuk lebih memotivasi pasien Tuberkulosis Paru untuk kepatuhan berobat dan melakukan pendidikan kesehatan terhadap pasien Tuberkulosis Paru untuk meningkatkan keberhasilan terapi pengobatan. Kata kunci : Kepatuhan, Regimen Terapeutik dan Tuberkulosis Paru. ABSTRACTTuberculosis is an infectious disease that can cause death, disease is spread through droplet of people who have been infected with the tuberculosis bacillus. Tuberculosis is one of the major killer of humans at this time, the disease can cause death in almost half of cases for 5 years after the disease. The average patient compliance in long-term treatment of chronic diseases in developed countries is only 50%, while in developing countries the number is lower. Noncompliance of patients in the treatment of a serious health problem and often occurs in patients with chronic diseases, such as Tuberculosis disease. This study aims to determine the compliance of pulmonary Tuberculosis patients in sub-district Puskesmas Padasuka Cibeunying Bandung Kidul. Design of this research is quantitative descriptive. Data were collected using questionnaires and accidental sampling with a sample of 21 people. The results showed that the majority of patients with pulmonary tuberculosis have adherence to therapeutic regimens is obtained by 16 people (76%), which do not comply obtained 5 people (24%). The most reason expressed by respondents who are obedient because they want toget well from his illness, can do aktivity before ill, the support of family respondents and the information obtained from health center personnel very good so motivated to obey taking drugs. It is hoped all parties including the patient's family, the government and health professionals to better motivate patients for pulmonary Tuberculosis treatment compliance and conduct health education for patients with pulmonary Tuberculosis to increase the therapeutic efficacy of treatment.

An short introduction or overview in Dutch Tobacco Control legislation, including a smoking ban in bars and restaurants and regulation of Tobacco Sale.

The Environmental Protection Agency (EPA) is considering regulating radon, a naturally occurring soil gas dissolved in drinking water, because it poses a lung cancer risk. Benefits and costs of compliance are estimated for 29 water systems with radon above the proposed maximum contaminant level. The estimated cancer risk is three times higher than assumed by EPA, making it likely that a national regulatory standard of 300 picocuries per liter of water would pass a cost-benefit test. Site specific estimates of compliance costs are also substantially greater than EPA estimates. Nevertheless, the estimated cost per avoided death is only about $1 million.