Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

Background: Music intervention can reduce anxiety. This study analyzed the physiological changes from using music intervention after cardiothoracic surgery. Methods: Subjects were randomly assigned to the music group or the control group. The maximal inspiratory pressure/maximal expiratory pressure (MIP/MEP), pulse oximeter oxygen saturation (SpO2), visual analogue scale (VAS) for pain, and State-Trait Anxiety Inventory (STAI) were compared. Results: Compared to the control group (n = 9), the music group (n = 9) had higher MIP and MEP during the overall test (p < 0.05), with significant differences in the changes and time (p < 0.001). However, only MEP was significant in terms of the interaction between music intervention and time (p < 0.001). In terms of the groups, SpO2 and VAS were significant (p < 0.05). SBP, SpO2, and VAS over time showed significant differences between the two groups (p < 0.05). In terms of the interaction between music intervention and time, only SpO2 was significant (p < 0.05). The STAI-S scale decreased by −5.7 ± 5.8 in the music group vs. −0.47 ± 9.37 in control group and the STAI-T scale increased by 4.17 ± 12.31 in the music group vs. 1.9 ± 9.29 in the control group, but showed no significance. Conclusions: Music intervention with nature sounds has a positive physiological impact and can reduce postoperative pain and anxiety in cardiothoracic surgery patients.

There are currently no good indicators that can be used to predict the medical expenses of chronic obstructive pulmonary disease (COPD). This was a retrospective study that focused on the correlation between the age, dyspnoea, and airflow obstruction (ADO) index and the Charlson comorbidity index (CCI) on the medical burden in COPD patients, specifically, those of patients with complete ADO index and CCI data in our hospital from January 2015 to December 2016. Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilisation was positively correlated with the ADO index. A significant association was found between the ADO index and CCI of COPD patients (p < 0.001). In-hospitalization expenses were positively correlated with the CCI (p < 0.001). Under the same CCI, the higher the ADO score, the higher the hospitalisation expenses. The ADO quartiles were positively correlated with the number of hospitalisations (p < 0.001), hospitalisation days (p < 0.001), hospitalisation expenses (p = 0.03), and total medical expenses (p = 0.037). Findings from this study show that the ADO index can predict the medical burden of COPD.

IL13 polymorphism is associated with chronic obstructive pulmonary disease (COPD). Patients with COPD have smaller numbers of mitochondria deoxyribonucleic acid copies (mtDNA-CN) than people without COPD do. However, whether IL13 polymorphism affects the mutation and recombination of mitochondria remains unclear. Data for patients with COPD and non-COPD were collected from Kaohsiung Chang Gung Memorial Hospital to enable a comparison of their leukocyte mtDNA-CN and the association of this information with IL-13 promoter (−1055) polymorphism. This study included 99 patients with COPD and 117 individuals without COPD. The non-COPD individuals included 77 healthy individuals that never smoked and 40 healthy smokers. The patients with COPD exhibited significantly lower mtDNA-CN than non-COPD did (250.34 vs. 440.03; p < 0.001); mtDNA-CN was particularly pronounced in individuals with the IL13 CC and CT genotypes compared with individuals with the TT genotype. When only individuals without COPD were considered and when all participants were considered, the differences in the mtDNA-CNs in individuals with the CC and CT genotypes were more significant than those in individuals with the TT genotype (448.4 and 533.6 vs. 282.8; p < 0.05 in non-COPD group); (368.8 and 362.6 vs. 249.6, p < 0.05 in all participants). The increase mtDNA-CN in the CC and CT genotypes was also more than that in the TT genotype in COPD patients, but showed no significance (260.1 and 230.5 vs. 149.9; p = 0.343). The finding shows that COPD is a mitochondria regulatory disorder and IL-13 promoter (−1055) polymorphism is associated with leukocyte mtDNA-CN. Developing COPD control methods based on mitochondrial regulation will be possible.

Background and Objectives:The ADO (age, dyspnea, and airflow obstruction) and BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) indices are often used to evaluate the prognoses for chronic obstructive pulmonary disease(COPD); however, an index suitable for predicting medical costs has yet to be developed. Materials and Methods: We investigated the BODE and ADO indices to predict medical costs and compare their predictive power. A total of 396 patients with COPD were retrospectively enrolled. Results: For hospitalization frequencies, BODE was R² = 0.093 (p < 0.001), and ADO was R² = 0.065 (p < 0.001); for hospitalization days, BODE was R² = 0.128 (p < 0.001), and ADO was R² = 0.071 (p < 0.001); for hospitalization expenses, BODE was R² = 0.020 (p = 0.047), and ADO was R² = 0.012 (p = 0.179). BODE and ADO did not differ significantly in the numbers of outpatient visits (BODE, R² = 0.012, p = 0.179; ADO, R² = 0.017, p = 0.082); outpatient medical expenses (BODE, R² = 0.012, p = 0.208; ADO, R² = 0.008, p = 0.364); and total medical costs (BODE, R² = 0.018, p = 0.072; ADO, R² = 0.016, p = 0.098). In conclusion, BODE and ADO indices were correlated with hospitalization frequency and hospitalization days. However, the BODE index exhibits slightly better predictive accuracy than the ADO index in these items.

This retrospective study included COPD patients who attended our medical center between January and October 2018, and analyzed the outcomes of their influenza vaccination, including medical visits, hospitalization, medical expenses, and the incidence of respiratory failure. Airflow limitation was stratified according to GOLD guidelines. Overall, 543 COPD patients were enrolled, including 197, 113, 126, and 107 mild, moderate, severe, and very severe patients, respectively. Of all the participants, 238 received an influenza vaccination (43.8%), which significantly reduced hospital utilization for moderate (odds ratio [OR] 0.22, 95%CI 0.09–0.51), severe (OR 0.19, 95%CI 0.08–0.44), and very severe patients (OR 0.15, 95%CI 0.05–0.5) compared to mild patients (OR 0.51, 95%CI 0.2–1.26); reduced emergency department utilization for moderate (OR 0.33, 95%CI 0.14–0.77), severe (OR 0.22, 95%CI 0.10–0.52), and very severe patients (OR 0.30, 95%CI 0.10–0.88) compared to mild patients (OR 0.64, 95%CI 0.30–1.37); and reduced the occurrence of respiratory failure for moderate (OR 0.20, 95%CI 0.06–0.68), severe (OR 0.40, 95%CI 0.16–0.98), and very severe patients (OR 0.36, 95%CI 0.15–0.82) compared to mild patients (OR 0% CI 0.14–3.20). Influenza vaccination is more effective in COPD patients with moderate, severe, and very severe airflow obstruction than in those with mild obstruction with respect to hospital utilization, emergency department utilization, and respiratory failure.