FIGURE 2. (A) Subtracted image of the diaphragm excursions in the most caudal (inspiratory) and cranial (expiratory) diaphragm positions during tidal breathing in a healthy control. (B) A subtracted image of the diaphragm excursions in the most caudal (inspiratory) and cranial (expiratory) diaphragm positions during tidal breathing in a patient with chronic low back pain. (C) Schematic description of 3 diaphragmatic points (B, C, and D) used for diaphragm excursion calculations. The following 6 distances (in mm) were obtained by measuring the distance between the horizontal baseline in both expiratory and inspiratory diaphragm positions. Diaphragm excursion points: B1 to D1 were derived from the inspiratory diaphragm positions obtained from MRI images; B2 to D2 were derived from expiratory diaphragm positions obtained from respective MRI images. The inspiratory diaphragm position is designated by points B1, C1, and D1. The expiratory diaphragm position is designated by points B2, C2, and D2. Total diaphragm excursion is designated by the distance from the lower to the upper curve along points B1 to B2, C1 to C2, and D1 to D2. Adapted from Kolar et al.

The aim was to describe diaphragmatic behavior during postural limb activities and examine the ventilatory and stabilizing functions of the diaphragm. Thirty healthy subjects were examined in the supine position using a dynamic MRI system assessed simultaneously with specialized spirometric readings. The diaphragmatic excursions (DEs) were measured at three diaphragmatic points in the sagittal plane; the diaphragm positions (DPs) as related to a reference horizontal baseline were determined. Measurements were taken during tidal breathing (TB) and isometric flexion of upper or lower extremities against external resistance together with TB. Mean DE in both upper and lower postural limb activities was greater compared with the TB condition (P < 0.05), with the effect greater for lower limb activities. Inspiratory DPs in the upper and lower extremity activities were lower compared with TB alone (P < 0.01). Expiratory DP was lower only for lower extremity activities (P < 0.01). DP was most affected at the apex of the crescent and crural (posterior) portion of the diaphragm. DEs correlated strongly with tidal volume (Vt) in all conditions. Changes in DEs relative to the initial value were minimal for upper and lower extremities but were related to lower values of Vt (P < 0.03). Significant involvement of the diaphragm in the limb postural activities was found. Resulting DEs and DPs differed from the TB conditions, especially in lower extremity activities. The differences between the percent changes of DEs vs. Vt found for lower extremity activities were confirmed by both ventilatory and postural diaphragm recruitment in response to postural demands.

The boy-to-girl ratio at birth (secondary sex ratio) is around 0.51 in most populations. The sex ratio varies between societies and may be influenced by many factors, such as stress and immunosuppression, age, primiparity, the sex of the preceding siblings and the socioeconomic status of the parents. As parasite infection affects many immunological and physiological parameters of the host, we analyzed the effect of latent toxoplasmosis on sex ratios in humans. Clinical records of 1,803 infants born from 1996 to 2004 contained information regarding the mother's age, concentration of anti-Toxoplasma antibodies, previous deliveries and abortions and the sex of the newborn. The results of our retrospective cohort study suggest that the presence of one of the most common parasites (with a worldwide prevalence from 20 to 80%), Toxoplasma gondii, can influence the secondary sex ratio in humans. Depending on the antibody concentration, the probability of the birth of a boy can increase up to a value of 0.72, C.I.95 = (0.636, 0.805), which means that for every 260 boys born, 100 girls are born to women with the highest concentration of anti-Toxoplasma antibodies. The toxoplasmosis associated with immunosuppression or immunomodulation might be responsible for the enhanced survival of male embryos. In light of the high prevalence of latent toxoplasmosis in most countries, the impact of toxoplasmosis on the human population might be considerable.

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We investigated 30 patients with idiopathic pulmonary fibrosis (IPF) and 103 healthy volunteers for the cytokines polymorphisms of the IL-1alpha, IL-1beta, IL-1R, IL-1RA, IL-2, IL-4, IL-6, IL-10, IL-12, tumor necrosis factor-alpha, interferon-gamma, transforming growth factor-beta, IL-1beta, IL-2, IL-4, and IL-4RA genes. The strongest correlation of a genotype with the disease was found for gene polymorphisms at the promotor region of IL-4, where the CT genotypes at the positions (-590) and (-33) were more frequent in the IPF group (P < 0.0001, P(corr) < 0.0022; vs P < 0.0001, P(corr) < 0.0022). Our results support the idea of the pathogenic role of cytokine gene polymorphisms in the etiology and pathogenesis of IPF, with emphasize on the IL-4 promotor gene polymorphisms.

Idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP) and sarcoidosis belong to interstitial lung diseases (ILD) where an imbalance of regulatory, profibrotic and antifibrotic cytokines is hypothesized. The relationship of bronchoalveolar lavage (BAL) fluid (BALF) cytokines, BALF cell profile and ILD course is supposed. The aim of our study was to correlate BALF cytokine and chemokine levels with BALF cellular characteristics and lung function parameters in different ILD. Twenty‐two sarcoidosis, seven IPF and 11 HP patients underwent lung function tests and BAL. The BALF differential cell counts and superficial cell markers were characterized, and MCP‐1, MIP‐1α, MIP‐1β, RANTES, epithelial neutrophil‐activating protein (ENA)‐78, FGF, G‐CSF, GM‐CSF, IFN‐γ, interleukin (IL)‐1α, IL‐1RA, IL‐1β, ‐2β, ‐4β, ‐5β, ‐6β, ‐8β, ‐10β, ‐17β, tumour necrosis factor (TNF)‐α, thromobopoietin (Tpo) and vascular endothelial growth factor (VEGF) values measured. The BALF VEGF values were highest in sarcoidosis (P = 0.0526). IL‐1RA values were higher in IPF and HP compared with sarcoidosis (P = 0.0334). IL‐8/ENA‐78 ratio positively correlated with BALF neutrophil counts in IPF (r = 0.89, P = 0.04). Vital capacity and TLCO values positively correlated with VEGF and negatively with IL‐8 BALF levels in all ILDs but the correlations were most significant in sarcoidosis group. We suppose that VEGF plays a role in ILDs’ early phases and has rather angiogenic than profibrotic effect. On the contrary, IL‐8 is probably upregulated in advanced ILDs with prominent fibrosis and marked lung functions decline. We state that BALF VEGF, IL‐8 and ENA‐78 levels and IL‐8/ENA‐78 ratio could become useful markers of ILDs’ phase, activity and prognosis. They might also be helpful in treatment modality choice.

The most parsimonious explanation for the observed data is that the RhD-positive phenotype might protect infected subjects against a broad spectrum of detrimental effects of latent toxoplasmosis, including excessive gestational weight gain.

No abstract