Association Between Depression, Lung Function, and Inflammatory Markers in Patients with Asthma and Occupational Asthma

Mediating role of depressive symptoms in the association between adverse childhood experiences and asthma

BACKGROUND

Adverse childhood experiences (ACEs) are associated with asthma, but the role of depressive symptoms (DS) in this is poorly studied.

OBJECTIVE

The aim of this study was to investigate the mediating effect of DS on ACEs and asthma.

PARTICIPANTS AND SETTING

This study was a retrospective cohort study of participants from the China Longitudinal Study of Health and Retirement from 2011 to 2018. A total of 12,277 participants including 5942 males and 6335 females were involved in the study.

METHODS

DS were assessed using the 10-item short form of the Center for Epidemiological Research Depression Scale. Logistic regression adjusted for confounders was used to explore the relationship between ACEs with asthma. Mediating effect analysis was used to assess the role of DS in the relationship between ACEs and asthma.

RESULTS

The results of logistic regression showed that there were an association between ACEs and asthma. Mediating effect analysis revealed that among the 15 ACEs examined, DS had partial mediating effects on the association between asthma and 5 specific ACEs (feeling alone, peer bullied, self-reported health status, health limitation, and death of parents), and fully mediated the relationship between asthma and another 5 ACEs (death of siblings, childhood neighborhood safety, childhood neighborhood quality, physical abuse, and parents' mental health) (all p < .05).

CONCLUSION

ACEs are significantly associated with an increased risk of asthma, and DS play a mediating role in the relationship between ACEs and asthma.

Association between depression and lung function in college students

Background

Depression is positively associated with lung dysfunction in middle-aged and older adults, but the correlation between depression and lung dysfunction in healthy young adults has not been well researched.

Methods

This cross-sectional study used a spirometer to evaluate the lung function of 352 college students (mean age: 24.1 years). The spirometry measurements included the peak expiratory flow (PEF), predicted percentage of the peak expiratory flow (PEF pp), forced expiratory volume in 1 s (FEV1), predicted percentage of the FEV1 (FEV1 pp), forced vital capacity (FVC), predicted percentage of the FVC (FVC pp), FEV1/FVC ratio and the predicted percentage of the FEV1/FVC ratio (FEV1/FVC pp). A validated Chinese version of the 20-item Zung Self-rating Depression Scale (SDS) was used to assess the severity of depression among young adults, with scores of ≥ 40 and ≥ 45 points indicating mild and moderate-to-severe depression, respectively. The Kruskal-Wallis tests were used to analyze the continuous variables, to estimate differences in lung function among the different levels of depression. Chi-square tests or Fisher's exact tests were used to analyze the categorical variables, to estimate differences in characteristics among the different levels of depression. Several multiple logistic regression models were used to examine the associations between participants' level of depression and each of the variables measuring lung function.

Results

Mild and moderate-to-severe depression were observed in 9.9 and 7.4% of the students, respectively. In particular, mild depression was associated with reduced FEV1 in both unadjusted (OR = 1.498, p = 0.003) and adjusted models (OR = 1.290, p = 0.018; OR = 1.199, p = 0.044). On the other hand, moderate-to-severe depression was significantly but negatively related to FEV1 in both unadjusted (OR = 3.546, p = 0.005) and adjusted models (OR = 3.137, p = 0.020; OR = 2.980, p = 0.048). Furthermore, the unadjusted model indicated that mild depression was associated with a higher risk of a lower PEF (OR = 3.546, p = 0.008).

Conclusion

Severe depression is an independent predictor of decreased FEV1 among Chinese college students.

Effects of breathing reeducation on cervical and pulmonary outcomes in patients with non specific chronic neck pain: A double blind randomized controlled trial

OBJECTIVE

The purpose of this randomized controlled trial was to study effects of breathing reeducation in the treatment of patients with non specific chronic neck pain.

METHODS

A total of sixty eight eligible patients with chronic neck pain were randomly allocated to breathing reeducation (BR) group (n = 34) and routine physical therapy (RPT) group (n = 34). Clinical outcomes were neck pain measured through visual analogue score, cervical active range of motion through CROM device, strength of neck muscles through hand held dynamometer and endurance of neck muscles measured through craniocervical flexion test. The neck disability was measured through neck disability index (NDI) and pulmonary outcomes such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio were measured through Spirolab 4. The outcomes were assessed at baseline and at 4 and at 8 weeks from baseline.

RESULTS

There were significant improvements in the BR group compared with the RPT group (P = 0.002) for cervical flexion, extension (P = 0.029), endurance (P = 0.042), strength of neck flexors (P <0.001), neck extensors (P = 0.034). Likewise there was a significant change in NDI (P = 0.011), FEV1 (P = 0.045), FVC (P <0.001), and FEV1/FVC ratio (P <0.001) in the BR group compared with the RPT group. The cervical side flexion and rotation showed no significant difference in breathing reeducation group with p > 0.05.

CONCLUSION

Breathing reeducation combined with routine physical therapy is an effective treatment in patients with non specific chronic neck pain.

TRIAL REGISTRATION

IRCT 20200226046623N1, https://www.irct.ir/trial/46240.

Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial

Background

People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain.

Methods/design

In this double blind randomised clinical trial, 30 patients with chronic neck pain (25-50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention.

Discussion

There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage.

Conclusion

Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain.

Clinical implication

Breathing re-education may be part of physiotherapy management in patients with chronic neck pain.

Trial Registration

Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.

Respiratory and voice outcomes of office-based injection laryngoplasty in patients with unilateral vocal fold paralysis

Background

Injection laryngoplasty is a surgical procedure used in management of glottal insufficiency. The objective of this study was to assess respiratory and voice outcomes of office-based injection laryngoplasty in patients with unilateral vocal fold paralysis (UVFP). Ten patients underwent office-based injection via transcutaneous approach using Radiesse or hyaluronic acid. Auditory perceptual assessment (APA), voice handicap index (VHI), size of the glottic gap, acoustic parameters (jitter, shimmer, and harmonic to noise ratio), maximum phonation time (MPT), stroboscopic evaluation, pulmonary function tests (PFTs), and videofluoroscopic evaluation of swallowing were done pre-injection, 1 week and 3 months post-injection.

Results

Subjective and objective voice outcomes, in addition to laryngostroboscopic parameters improved after injection. Non-significant difference was found between pre- and post-injection results of the PFTs.

Conclusions

Office-based injection laryngoplasty is a safe and effective method for treating UVFP. Patients with glottic gap (< 1–3 mm) are perfect candidates for such procedure. Injection laryngoplasty improves patients’ voice quality and does not impair respiration.