Genome-wide linkage analysis of bronchodilator responsiveness and post-bronchodilator spirometric phenotypes in chronic obstructive pulmonary disease

NARCIS (Netherlands)

Palmer, LJ; Celedon, JC; Chapman, HA; Speizer, FE; Weiss, ST; Silverman, EK

2003-01-01

Chronic obstructive pulmonary disease (COPD) is a common, complex disease associated with significant and increasing morbidity and mortality. The cardinal feature of COPD is persistent airflow obstruction, measured by reductions in quantitative spirometric indices including forced expiratory volume

Improved air trapping evaluation in chest computed tomography in children with cystic fibrosis using real-time spirometric monitoring and biofeedback.

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Kongstad, Thomas; Buchvald, Frederik F; Green, Kent; Lindblad, Anders; Robinson, Terry E; Nielsen, Kim G

2013-12-01

The quality of chest Computed Tomography (CT) images in children is dependent upon a sufficient breath hold during CT scanning. This study evaluates the influence of spirometric breath hold monitoring with biofeedback software on inspiratory and expiratory chest CT lung density measures, and on trapped air (TA) scoring in children with cystic fibrosis (CF). This is important because TA is an important component of early and progressive CF lung disease. A cross sectional comparison study was completed for chest CT imaging in two cohorts of CF children with comparable disease severity, using spirometric breath hold monitoring and biofeedback software (Copenhagen (COP)) or unmonitored breath hold manoeuvres (Gothenburg (GOT)). Inspiratory-expiratory lung density differences were calculated, and TA was scored to assess the difference between the two cohorts. Eighty-four chest CTs were evaluated. Mean (95%CI) change in inspiratory-expiratory lung density differences was 436 Hounsfield Units (HU) (408 to 464) in the COP cohort with spirometric breath hold monitoring versus 229 HU (188 to 269) in the GOT cohort with unmonitored breath hold manoeuvres (pchildren with comparable CF lung disease, spirometric breath hold monitoring during examination yielded a large difference in lung volume between inhalation and exhalation, and allowed for a significantly greater measured change in lung density and TA score, compared to unmonitored breath hold maneuvers. This has implications to the clinical use of chest CT, especially in children with early CF lung disease. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Fibrose cística em adultos: aspectos clínicos e espirométricos Cystic fibrosis in adults clinical and spirometric aspects

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Antônio Carlos M. Lemos

2004-02-01

data of patients with CF diagnosed in adulthood (over 16 years of age in Bahia, Brazil. METHODS: Twenty-eight patients with cystic fibrosis diagnosed in adulthood were evaluated at the Reference Center of Cystic Fibrosis of the state of Bahia. Variables of interest were age, gender, race, body mass index (BMI, sputum culture, presence of sinusitis and bronchiectasis, spirometric tests with the best values performed for forced expiratory volume in the first second (% FEV1, forced vital capacity (FVC and response to bronchodilators. RESULTS: Mean age of diagnosis was 31.1 ± 12.4 years. Of the patients, 53.4% were black and mulattos and the mean BMI was 18.7 ± 3.0 kg/m2. P. aeruginosa was present in 12 (43% of the total patients. The mean percentages ± SD of FVC and FEV1 were 58.9 ± 21.6% and 44.1 ± 23%, respectively. In the group of patients with presence of P. aeruginosa in the sputum cultures mean of the spirometry parameters were lower than those of the P. aeruginosa-free group. However, this difference achieved a statistically significant difference (p = 0.0007 only in FVC. CONCLUSIONS: In agreement with many authors, this study strengthen the point of view that CF must be investigated in patients with recurrent infections, sinusitis and bronchiectasis even in adulthood. Values of the percentages of FVC and FEV1 in relation to those foreseen were lower in patients bearers of P.aeruginosa thereby showing a higher deterioration of the pulmonary function.

Measures of bronchodilator response of FEV1, FVC and SVC in a Swedish general population sample aged 50–64 years, the SCAPIS Pilot Study

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Torén K

2017-03-01

Full Text Available K Torén,1 B Bake,1 A-C Olin,1 G Engström,2 A Blomberg,3 J Vikgren,4 J Hedner,5 J Brandberg,4 HL Persson,6,7 CM Sköld,8 A Rosengren,9 G Bergström,9 C Janson10 1Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 2Department of Clinical Science, Lund University, Malmö, 3Division of Medicine/Respiratory Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, 4Department of Radiology, Institute of Clinical Sciences, 5Department of Internal Medicine/Lung Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 6Department of Respiratory Medicine, 7Department of Medicine and Health Sciences, Linköping University, Linköping, 8Respiratory Medicine Unit, Department of Medicine Solna, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, 9Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 10Department of Medical Sciences, Clinical Physiology and Lung, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden Background: Data are lacking from general population studies on how to define changes in lung function after bronchodilation. This study aimed to analyze different measures of bronchodilator response of forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC and slow vital capacity (SVC. Materials and methods: Data were derived from the Swedish Cardiopulmonary Bioimage Study (SCAPIS Pilot study. This analysis comprised 1,050 participants aged 50–64 years from the general population. Participants were investigated using a questionnaire, and FEV1, FVC and SVC were recorded before and 15 minutes after inhalation of 400 µg of salbutamol. A bronchodilator response was defined as the relative change from baseline value expressed as the difference in units of percent predicted normal

Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística Respiratory patterns in spirometric tests of adolescents and adults with cystic fibrosis

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Bruna Ziegler

2009-09-01

Full Text Available OBJETIVO: Avaliar os padrões dos distúrbios ventilatórios observados na espirometria em pacientes com fibrose cística (FC e suas relações com a gravidade funcional e com o comportamento dos fluxos máximos expiratórios a baixos volumes. MÉTODOS: Estudo transversal e retrospectivo, incluindo pacientes adolescentes e adultos com FC. Todos os pacientes foram submetidos à espirometria. Os pacientes foram classificados como tendo função ventilatória preservada, distúrbio ventilatório obstrutivo (DVO, DVO com CVF reduzida, sugestivo de distúrbio ventilatório restritivo (DVR ou distúrbio ventilatório combinado (DVC. Os fluxos máximos expiratórios a baixos volumes foram avaliados utilizando-se FEF25-75%, FEF75%e FEF75%/CVF. O grupo controle incluiu 65 indivíduos normais, também submetidos à espirometria. RESULTADOS: Foram incluídos 65 pacientes no grupo de estudo: 8 (12,3% com função pulmonar preservada, 18 (27,7% com DVO, 24 (36,9% com DVO com CVF reduzida, 5 (7,7% com padrão sugestivo de DVR e 10 (15,4% com DVC. O VEF1 foi significativamente menor nos grupos DVO com CVF reduzida e DVC, comparados com os outros grupos (p OBJECTIVE: To evaluate spirometric patterns of respiratory disorders and their relationship with functional severity and maximal expiratory flows at low lung volumes in patients with cystic fibrosis (CF. METHODS: A retrospective cross-sectional study including adolescents and adults with CF. All of the patients were submitted to spirometry. Patients were classified as having preserved respiratory function, obstructive lung disease (OLD, OLD with reduced FVC, presumptive restrictive lung disease (RLD or mixed obstructive and restrictive lung disease (MORLD. Maximal expiratory flows at low lung volumes were assessed using FEF25-75%, FEF75% and FEF75%/FVC. We included 65 normal subjects, also submitted to spirometry, as a control group. RESULTS: The study group included 65 patients: 8 (12.3% with preserved lung

Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

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Abdolreza Norouzy

2013-03-01

Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD

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Bernd Lamprecht

2011-01-01

Full Text Available Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD study. Those with post-bronchodilator FEV1/FVC ratio FVC ratio ≥LLN but <0.70 were defined as discordant obstructive cases. Results. Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P=.015. Conclusion. The clinical profile of discordant obstructive cases includes potentially important comorbid disease.

Clearance of technetium-99m-labeled DTPA in hyperthyroidism without clinical evidence of lung disease, and relation to pulmonary function

International Nuclear Information System (INIS)

Guldiken, S.; Tugrul, A.; Altiay, G.; Hacimahmutoglu, S.; Durmus-Altun, G.

2005-01-01

The mechanisms of dyspnea and exercise intolerance have not been fully elucidated. We aimed to investigate the clearance rate of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) from lungs in hyperthyroid patients without clinical evidence of lung disease and to explore the interactions between their Tc-99m DTPA radioaerosol lung scintigraphy, spirometric measurements, and the levels of thyroid hormones. We studied 19 hyperthyroid patients and 16 sex- and age-matched controls. Thyroid hormone levels were assessed. Spirometric lung function tests, diffusing capacity of the lung for carbon monoxide (DLCO) and the clearance rate of Tc-99m DTPA were performed in all participants. Ratio of DLCO value to the alveolar ventilation (DLCO/VA) and the means of half-time (T 1/2 ) of Tc-99m DTPA clearance rate, which were used to evaluate alveolar-capillary membrane permeability, were calculated. There were no statistical differences between spirometric parameters (vital capacity (VC), force vital capacity (FVC), one second forced expiratory volume (FEV 1 )/FVC, mean forced expiratory flow during the middle of FVC (FEF 25-75)) of the two groups (p>0.05). Although the mean FEV 1 level was significantly lower in the hyperthyroid patients than the control subjects (p 1 was only less than 80 percent of the predicted value. No significant difference in the means of DLCO, DLCO/VA or T 1/2 values of Tc-99m DTPA clearance was observed between the two groups (p>0.05). In hyperthyroid patients, there was a positive relation between DLCO/VA, DLCO/VA% and T 1/2 values of Tc-99m DTPA clearance (p 1/2 values of Tc-99m DTPA clearance in hyperthyroid group (p>0.05). We conclude that increased thyroid hormones have no effect on permeability of alveolar-capillary membrane in hyperthyroid patients. (author)

FEV1 is a better predictor of mortality than FVC: the PLATINO cohort study.

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Menezes, Ana Maria B; Pérez-Padilla, Rogelio; Wehrmeister, Fernando César; Lopez-Varela, Maria Victorina; Muiño, Adriana; Valdivia, Gonzalo; Lisboa, Carmen; Jardim, José Roberto B; de Oca, Maria Montes; Talamo, Carlos; Bielemann, Renata; Gazzotti, Mariana; Laurenti, Ruy; Celli, Bartolomé; Victora, Cesar G

2014-01-01

To determine whether the presence of chronic obstructive lung disease (COPD) and reduction of lung function parameters were predictors of mortality in a cohort. Population based cohorts were followed in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. Outcomes included all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Cox regression was used for analyses. Sensitivity, specificity, positive and negative predictive values, receiver operator characteristics curves and Youden's index were calculated. Main causes of death were cardiovascular, respiratory and cancer. Baseline COPD was associated with overall mortality (HR = 1.43 for FEV1/FVCFVC was not associated with overall mortality. For most COPD criteria sensitivity was low and specificity high. The area under the curve for FEV1 was greater than for FVC for overall and cardiovascular mortality. COPD and low FEV1 are important predictors for overall and cardiovascular mortality in Latin America.

Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

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Abdolreza Norouzy

2013-07-01

Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

FEV1 is a better predictor of mortality than FVC: the PLATINO cohort study.

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Ana Maria B Menezes

Full Text Available To determine whether the presence of chronic obstructive lung disease (COPD and reduction of lung function parameters were predictors of mortality in a cohort.Population based cohorts were followed in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. Outcomes included all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD, forced expiratory volume in one second (FEV1 and forced vital capacity (FVC. Cox regression was used for analyses. Sensitivity, specificity, positive and negative predictive values, receiver operator characteristics curves and Youden's index were calculated.Main causes of death were cardiovascular, respiratory and cancer. Baseline COPD was associated with overall mortality (HR = 1.43 for FEV1/FVCFVC was not associated with overall mortality. For most COPD criteria sensitivity was low and specificity high. The area under the curve for FEV1 was greater than for FVC for overall and cardiovascular mortality.COPD and low FEV1 are important predictors for overall and cardiovascular mortality in Latin America.

Efecto del pedaleo de brazos sobre el sistema cardiorrespiratorio de las personas con tetraplejia. (Effect of armcrank pedaling on the cardiorespiratory system of the people with tetraplegia.

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Gabriel Brizuela Costa

2010-10-01

Full Text Available Resumen Objetivos: Determinar el efecto de un programa de entrenamiento de pedaleo de brazos (PB estacionario, sobre el sistema cardiorrespiratorio de personas con tetraplejia. Método: Se estudiaron 11 participantes con tetraplejia por lesión medular (LM de origen traumático a niveles entre C4 y C6. Se midieron variables espirométricas (VC, FVC y MVV y de Variabilidad de la Frecuencia Cardíaca VFC (HR, STDHR, RMSSD, LF, HF y HRVPOWER, antes y después de 8 semanas de entrenamiento. Resultados: Todas las variables mostraron cambios significativos (p Abstract Objective: The aim of the study was to determine the effect, in subjects with tetraplejia, of a stationary armcrank pedaling (AP training program on their cardiorespiratory system. Method: 11 participants with tetraplegia, originated by traumatic spinal cord injury (SCI at levels between C4 and C6, were included in the study. Spirometric (VC, FVC and MVV and Heart Rate Variability (HRV indices (HR, STDHR, RMSSD, LF, HF, HRVPOWER were measured before and after an 8 weeks of armcrank pedaling training program. Results: Spirometric and HRV variables showed changes (p

Validation of Global Lung Function Initiative and All Ages Reference Equations for Forced Spirometry in Healthy Spanish Preschoolers.

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Martín de Vicente, Carlos; de Mir Messa, Inés; Rovira Amigo, Sandra; Torrent Vernetta, Alba; Gartner, Silvia; Iglesias Serrano, Ignacio; Carrascosa Lezcano, Antonio; Moreno Galdó, Antonio

2018-01-01

Recent publication of multi-ethnic spirometry reference equations for subjects aged from 3-95 years aim to avoid age-related discontinuities and provide a worldwide standard for interpreting spirometric test results. To assess the agreement of the Global Lung Function Initiative (GLI-2012) and All ages (FEV 0.5 ) reference equations with the Spanish preschool lung function data. To verify the appropriateness of these reference values for clinical use in Spanish preschool children. Spirometric measurements were obtained from children aged 3 to 6 years attending 10 randomly selected schools in Barcelona (Spain). Stanojevic's quality control criteria were applied. Z-scores were calculated for the spirometry outcomes based on the GLI equations. If the z-score (mean) of each parameter was close to 0, with a maximum variance of ± 0.5 from the mean and a standard deviation of 1, the GLI-2012 equations would be applicable in our population. Of 543 children recruited, 405 (74.6%) were 'healthy', and of these, 380 were Caucasians. Of these 380, 81.6% (169 females, 141 males) performed technically acceptable and reproducible maneuvers to assess FEVt, and 69.5% achieved a clear end-expiratory plateau. Z-scores for FVC, FEV 1 , FEV 1 /FVC, FEV 0.75 , FEV 0.75 /FVC, FEV 0.5 , FEF 75 and FEF 25-75 all fell within ± 0.5, except for FEV 1 /FVC (0.53 z-scores). GLI equations are appropriate for Spanish preschool children. These data provide further evidence to support widespread application of the GLI reference equations. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Improved air trapping evaluation in chest computed tomography in children with cystic fibrosis using real-time spirometric monitoring and biofeedback

DEFF Research Database (Denmark)

Kongstad, Thomas; Buchvald, Frederik F; Green, Kent

2013-01-01

CTs were evaluated. Mean (95%CI) change in inspiratory-expiratory lung density differences was 436 Hounsfield Units (HU) (408 to 464) in the COP cohort with spirometric breath hold monitoring versus 229 HU (188 to 269) in the GOT cohort with unmonitored breath hold manoeuvres (p...BACKGROUND: The quality of chest Computed Tomography (CT) images in children is dependent upon a sufficient breath hold during CT scanning. This study evaluates the influence of spirometric breath hold monitoring with biofeedback software on inspiratory and expiratory chest CT lung density measures......, and on trapped air (TA) scoring in children with cystic fibrosis (CF). This is important because TA is an important component of early and progressive CF lung disease. METHODS: A cross sectional comparison study was completed for chest CT imaging in two cohorts of CF children with comparable disease severity...

Impact of forced vital capacity loss on survival after the onset of chronic lung allograft dysfunction.

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Todd, Jamie L; Jain, Rahil; Pavlisko, Elizabeth N; Finlen Copeland, C Ashley; Reynolds, John M; Snyder, Laurie D; Palmer, Scott M

2014-01-15

Emerging evidence suggests a restrictive phenotype of chronic lung allograft dysfunction (CLAD) exists; however, the optimal approach to its diagnosis and clinical significance is uncertain. To evaluate the hypothesis that spirometric indices more suggestive of a restrictive ventilatory defect, such as loss of FVC, identify patients with distinct clinical, radiographic, and pathologic features, including worse survival. Retrospective, single-center analysis of 566 consecutive first bilateral lung recipients transplanted over a 12-year period. A total of 216 patients developed CLAD during follow-up. CLAD was categorized at its onset into discrete physiologic groups based on spirometric criteria. Imaging and histologic studies were reviewed when available. Survival after CLAD diagnosis was assessed using Kaplan-Meier and Cox proportional hazards models. Among patients with CLAD, 30% demonstrated an FVC decrement at its onset. These patients were more likely to be female, have radiographic alveolar or interstitial changes, and histologic findings of interstitial fibrosis. Patients with FVC decline at CLAD onset had significantly worse survival after CLAD when compared with those with preserved FVC (P model including baseline demographic and clinical factors (P < 0.0001; adjusted hazard ratio, 2.73; 95% confidence interval, 1.86-4.04). At CLAD onset, a subset of patients demonstrating physiology more suggestive of restriction experience worse clinical outcomes. Further study of the biologic mechanisms underlying CLAD phenotypes is critical to improving long-term survival after lung transplantation.

The Short-Term Effect of Chest Physiotherapy on Spirometric Indices in Chemical Warfare Victims Exposed to Mustard Gas

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A Abedi

2008-12-01

Full Text Available ABCTRACT Introduction & Objective: Chronic respiratory diseases are the most prevalent late sequels of sulfur mustard gas injury among Iranian chemical warfare victims. Chest physiotherapy is one of the useful methods in care, cure and infection prevention of these patients. The aim of this study was to determine the short-term effect of chest physiotherapy on spirometric indices in chemical warfare victims exposed to sulfur mustard gas. Materials & Methods: In this study, 27 of the chemical warfare victims with respiratory diseases were selected. Chest physiotherapy including postural drainage percussion and vibration were used in four positions for all patients. Pulmonary function test (PFT was obtained before (baseline, immediately and 20 minute after the chest physiotherapy. The SPSS software was used for the data analysis of the collected data. Results: Results of this study showed the significant effect (p<0.01 of chest physiotherapy upon forced expiratory volume in first second (FEV1 (baseline mean, 44.19 immediately after intervention mean 47.3 and 20 minute after intervention mean 48.3 and forced vital capacity (FVC (baseline mean, 69.37 immediately after intervention mean, 73.67 20 minute after intervention 75.74. Chest physiotherapy had significant effect (p<0.01 in asthmatic bronchitis group and also had significant effect (p<0.05 in both severe and moderate groups. Conclusion: Chest physiotherapy was able to improve pulmonary function test indices in chemical warfare victims suffering from respiratory problems. The effect on asthmatic bronchitis group, as well as both severe and moderate groups, was significant.

Reliability of FEV1/FEV6 to Diagnose Airflow Obstruction Compared with FEV1/FVC: The PLATINO Longitudinal Study

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Perez-Padilla, Rogelio; Wehrmeister, Fernando C.; Celli, Bartolome R.; Lopez-Varela, Maria Victorina; Montes de Oca, Maria; Muiño, Adriana; Talamo, Carlos; Jardim, Jose R.; Valdivia, Gonzalo; Lisboa, Carmen; Menezes, Ana Maria B.

2013-01-01

QUESTION A 6-second spirometry test is easier than full exhalations. We compared the reliability of the ratio of the Forced expiratory volume in 1 second/Forced expiratory volume in 6 seconds (FEV1/FEV6) to the ratio of the FEV1/Forced vital capacity (FEV1/FVC) for the detection of airway obstruction. METHODS The PLATINO population-based survey in individuals aged 40 years and over designed to estimate the prevalence of post-Bronchodilator airway obstruction repeated for the same study participants after 5–9 years in three Latin-American cities. RESULTS Using the FEV1/FVCFVC correlated strongly with changes in the FET of the tests (R2 0.92) unlike the prevalence based on a low FEV1/FEV6 (R2 = 0.40). CONCLUSION The FEV1/FEV6 is a more reliable index than FEV1/FVC because FVC varies with the duration of the forced exhalation. Reporting FET and FEV1/FEV6FVC-derived indices. PMID:23936297

Reliability of FEV1/FEV6 to diagnose airflow obstruction compared with FEV1/FVC: the PLATINO longitudinal study.

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Rogelio Perez-Padilla

Full Text Available QUESTION: A 6-second spirometry test is easier than full exhalations. We compared the reliability of the ratio of the Forced expiratory volume in 1 second/Forced expiratory volume in 6 seconds (FEV1/FEV6 to the ratio of the FEV1/Forced vital capacity (FEV1/FVC for the detection of airway obstruction. METHODS: The PLATINO population-based survey in individuals aged 40 years and over designed to estimate the prevalence of post-Bronchodilator airway obstruction repeated for the same study participants after 5-9 years in three Latin-American cities. RESULTS: Using the FEV1/FVCFVC correlated strongly with changes in the FET of the tests (R(2 0.92 unlike the prevalence based on a low FEV1/FEV6 (R(2 =0.40. CONCLUSION: The FEV1/FEV6 is a more reliable index than FEV1/FVC because FVC varies with the duration of the forced exhalation. Reporting FET and FEV1/FEV6FVC-derived indices.

Flow-volume loops measured with electrical impedance tomography in pediatric patients with asthma.

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Ngo, Chuong; Dippel, Falk; Tenbrock, Klaus; Leonhardt, Steffen; Lehmann, Sylvia

2018-05-01

Electrical impedance tomography (EIT) provides information on global and regional ventilation during tidal breathing and mechanical ventilation. During forced expiration maneuvers, the linearity of EIT and spirometric data has been documented in healthy persons. The present study investigates the potential diagnostic use of EIT in pediatric patients with asthma. EIT and spirometry were performed in 58 children with asthma (average age ± SD: 11.86 ± 3.13 years), and 58 healthy controls (average age ± SD: 12.12 ± 2.9 years). The correlation between EIT data and simultaneously acquired spirometric data were tested for FEV 1 , FEV 0.5 , MEF 75 , MEF 50 , and MEF 25 . Binary classification tests were performed for the EIT-derived Tiffeneau index FEV 1 /FVC and the bronchodilator test index ΔFEV 1 . Average flow-volume (FV) loops were generated for patients with pathologic spirometry to demonstrate the feasibility of EIT for graphic diagnosis of asthma. Spirometry and global EIT-based FV loops showed a strong correlation (P  0.9 in FEV 1 and FEV 0.5 ). In all criteria, the binary classification tests yielded high specificity (>93%), a high positive predictive value (≥75%) and a high negative predictive value (>80%), while sensitivity was higher in ΔFEV 1 (86.67%) and lower in FEV 1 /FVC (25% and 35.29%). A typical concave shape of the EIT-derived average FV loops was observed for asthmatic children with improvement after bronchospasmolysis. Global FV loops derived from EIT correlate well with spirometry. Positive bronchospasmolysis can be observed in EIT-derived FV loops. Flow-volume loops originated from EIT have a potential to visualize pulmonary function. © 2018 Wiley Periodicals, Inc.

Influence of the diving wetsuit on standard spirometry

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Schellart, Nico A. M.; Sterk, Wouter

2016-01-01

INTRODUCTION A well-fitting wetsuit exerts a pressure on the body that may influence spirometry. This pressure is expected to reduce the forced vital capacity (FVC) due to hampered inspiration. Since the shape of the spirometric flow curve should not be changed by the pressure effects of the

The recent multi-ethnic global lung initiative 2012 (GLI2012) reference values don't reflect contemporary adult's North African spirometry.

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Ben Saad, Helmi; El Attar, Mohamed Nour; Hadj Mabrouk, Khaoula; Ben Abdelaziz, Ahmed; Abdelghani, Ahmed; Bousarssar, Mohamed; Limam, Khélifa; Maatoug, Chiraz; Bouslah, Hmida; Charrada, Ameur; Rouatbi, Sonia

2013-12-01

The applicability of the recent multi-ethnic reference equations derived by the ERS Global Lung Initiative (ERS/GLI) in interpreting spirometry data in North African adult subjects has not been studied. To ascertain how well the recent ERS/GLI reference equations fit contemporary adult Tunisian spirometric data. Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality (LLN) were calculated using the local and the ERS/GLI reference equations. Applied definitions: large airway obstructive ventilatory defect (LAOVD): FEV1/FVC contemporary Tunisian spirometry. Using Tunisian reference equations, 71.31%, 6.71% and 19.04% of spirometry records were interpreted as normal, and as having, LAOVD and TRVD, respectively. Using the ERS/GLI reference equations, these figures were respectively, 85.82%, 4.19% and 8.39%. The mean ± SD Z-scores for the contemporary healthy North African subject's data were -0.55 ± 0.87 for FEV1, -0.62 ± 0.86 for FVC and 0.10 ± 0.73 for FEV1/FVC. The present study don't recommend the use of the recent ERS/GLI reference equations to interpret spirometry in North African adult population. Copyright © 2013 Elsevier Ltd. All rights reserved.

Association between Traffic Air Pollution and Reduced Forced Vital Capacity: A Study Using Personal Monitors for Outdoor Workers.

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Ubiratan Paula Santos

Full Text Available The effects of outdoor air pollution on lung function in adults are still controversial.Evaluate the effects of exposure to different levels of traffic-generated PM2.5 on workers' lung functions in São Paulo, Brazil.To cover a wide range of exposures, 101 non-smoking workers from three occupations (taxi drivers, traffic controllers, and forest rangers were selected for the study. After clinical evaluation, the participants were scheduled to attend four consecutive weekly visits in which they received a 24-hour personal PM2.5 sampler and had lung function tests measured on the following day. The association between the spirometric variables and the averaged PM2.5 levels was assessed using robust regression models adjusted for age, waist circumference, time at the job, daily work hours, diabetes or hypertension and former smoking habits.Relative to workers in the lowest exposed group (all measures 39.6 μg/m3 showed a reduction of predicted FVC (-12.2%; CI 95%: [-20.0% to -4.4%], a marginal reduction of predicted FEV1 (-9.1%; CI 95%: [-19.1% to 0.9%] and an increase of predicted FEF25-75%/FVC (14.9%; CI 95%: [2.9% to 26.8%] without changes of FEV1/FVC.Exposure to vehicular traffic air pollution is associated with a small but significant reduction of FVC without a reduction of FEV1/FVC.

Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance.

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Kadota, Naoki; Shinohara, Tsutomu; Machida, Hisanori; Nakanishi, Hirofumi; Suehiro, Fumie; Toda, Hiroko; Yoshino, Tadashi; Ogushi, Fumitaka

2015-06-06

Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.

High body mass index and risk of exacerbations and pneumonias in individuals with chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Çolak, Yunus; Afzal, Shoaib; Lange, Peter

2016-01-01

descent, aged 20-100 years, from the Copenhagen General Population Study, for FTO (rs9939609), MC4R (rs17782313) and TMEM18 (rs6548238), and created an allele score. A total of 10 883 individuals had spirometric COPD with forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC)

Lower lung function associates with cessation of menstruation: UK Biobank data.

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Amaral, André F S; Strachan, David P; Gómez Real, Francisco; Burney, Peter G J; Jarvis, Deborah L

2016-11-01

Little is known about the effect of cessation of menstruation on lung function. The aims of the study were to examine the association of lung function with natural and surgical cessation of menstruation, and assess whether lower lung function is associated with earlier age at cessation of menstruation.The study was performed in 141 076 women from the UK Biobank, who had provided acceptable and reproducible spirometry measurements and information on menstrual status. The associations of lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), spirometric restriction (FVC menstruation and age at cessation of menstruation were assessed using regression analysis.Women who had natural cessation of menstruation showed a lower FVC (-42 mL; 95% CI -53- -30) and FEV 1 (-34 mL; 95% CI -43- -24) and higher risk of spirometric restriction (adjusted odds ratio 1.27; 95% CI 1.18-1.37) than women still menstruating. These associations were stronger in women who had had a hysterectomy and/or oophorectomy. The earlier the natural cessation of menstruation, the lower the lung function. There was no clear association of lung function with age at hysterectomy and/or oophorectomy. Airflow obstruction was not associated with cessation of menstruation.Lower lung function associates with cessation of menstruation, especially if it occurs early in life. Copyright ©ERS 2016.

Relationships of methacholine and adenosine 5'-monophosphate (AMP) responsiveness to the postbronchodilator FEV₁/FVC ratio in children with asthma.

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Suh, Dong In; Choi, Sun Hee; Lee, Ju Kyung; Kim, Jin-Tack; Koh, Young Yull

2011-05-01

Airway remodeling has been assumed to cause bronchial hyperresponsiveness (BHR). A low postbronchodilator FEV₁/FVC ratio has been suggested to be a functional surrogate marker of airway remodeling in asthma. BHR is commonly assessed by bronchial challenges using direct or indirect stimuli. The aim of this study was to compare BHR to methacholine and adenosine 5'-monophosphate (AMP) with regard to their relationship with a marker of airway remodeling in children with asthma. Methacholine and AMP challenge tests were performed in 129 children with asthma, aged 12 years, and a provocative concentration causing a 20% fall in FEV₁ (PC₂₀) was calculated for each challenge. All subjects also underwent pre- and postbronchodilator spirometry. A postbronchodilator FEV₁/FVC ratio below the lower limits of normal was used as a marker of airway remodeling. A low postbronchodilator FEV₁/FVC ratio was found in 17 subjects (13.2%). These subjects had a significantly lower methacholine PC₂₀ (geometric mean: 0.63 mg/mL, range of 1 SD: 0.17-2.29) than those (n = 112) with a normal postbronchodilator FEV₁/FVC ratio (2.42 mg/mL, 0.57-10.32, p = .000), whereas AMP PC₂₀ was similar between the two groups (22.1 mg/mL, 3.9-125.9 vs. 27.7 mg/mL, 4.2-183.5, p = .231). In the whole group of subjects, methacholine PC₂₀, but not AMP PC₂₀, correlated significantly with the postbronchodilator FEV₁/FVC ratio (r = 0.340, p = .000, and r = 0.056, p = .526, respectively). Our results provide evidence, though indirect, that BHR to methacholine is related to airway remodeling in children with asthma and suggest that BHR to methacholine may be a better marker of airway remodeling than BHR to AMP.

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

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Joegi, Jonas; Bajc, Marika [Lund University, Skaane University Hospital, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Ekberg, Marie [Lund University, Skaane University Hospital, Department of Respiratory Medicine and Allergology, Institution of Clinical Sciences, Lund (Sweden); Jonson, Bjoern [Lund University, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Bozovic, Gracijela [Lund University, Skaane University Hospital, Department of Radiology, Institution of Clinical Sciences, Lund (Sweden)

2011-07-15

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV{sub 1}). FEV{sub 1} does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV{sub 1}, symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

International Nuclear Information System (INIS)

Joegi, Jonas; Bajc, Marika; Ekberg, Marie; Jonson, Bjoern; Bozovic, Gracijela

2011-01-01

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV 1 ). FEV 1 does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV 1 , symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be reported. V

Optimal clinical time for reliable measurement of transcutaneous CO2 with ear probes: counterbalancing overshoot and the vasodilatation effect.

Science.gov (United States)

Domingo, Christian; Canturri, Elisa; Moreno, Amalia; Espuelas, Humildad; Vigil, Laura; Luján, Manel

2010-01-01

To determine the optimal clinical reading time for the transcutaneous measurement of oxygen saturation (SpO(2)) and transcutaneous CO(2) (TcPCO(2)) in awake spontaneously breathing individuals, considering the overshoot phenomenon (transient overestimation of arterial PaCO(2)). EXPERIMENTAL SECTION: Observational study of 91 (75 men) individuals undergoing forced spirometry, measurement of SpO(2) and TcPCO(2) with the SenTec monitor every two minutes until minute 20 and arterial blood gas (ABG) analysis. Overshoot severity: (a) mild (0.1-1.9 mm Hg); (b) moderate (2-4.9 mm Hg); (c) severe: (>5 mm Hg). The mean difference was calculated for SpO(2) and TcPCO(2) and arterial values of PaCO(2) and SpO(2). The intraclass correlation coefficient (ICC) between monitor readings and blood values was calculated as a measure of agreement. The mean age was 63.1 ± 11.8 years. Spirometric values: FVC: 75.4 ± 6.2%; FEV(1): 72.9 ± 23.9%; FEV(1)/FVC: 70 ± 15.5%. ABG: PaO(2): 82.6 ± 13.2; PaCO(2): 39.9.1 ± 4.8 mmHg; SaO(2): 95.3 ± 4.4%. Overshoot analysis: overshoot was mild in 33 (36.3%) patients, moderate in 20 (22%) and severe in nine (10%); no overshoot was observed in 29 (31%) patients. The lowest mean differences between arterial blood gas and TcPCO(2) was -0.57 mmHg at minute 10, although the highest ICC was obtained at minutes 12 and 14 (>0.8). The overshoot lost its influence after minute 12. For SpO(2), measurements were reliable at minute 2. The optimal clinical reading measurement recommended for the ear lobe TcPCO(2) measurement ranges between minute 12 and 14. The SpO(2) measurement can be performed at minute 2.

Cut-off value of FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction in a Korean population

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Chung KS

2016-08-01

Full Text Available Kyung Soo Chung,1,2 Ji Ye Jung,1,2 Moo Suk Park,1,2 Young Sam Kim,1,2 Se Kyu Kim,1,2 Joon Chang,1,2 Joo Han Song1,2 1Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Forced expiratory volume in 1 second (FEV1/forced expiratory volume in 6 seconds (FEV6 has been proposed as an alternative to FEV1/forced vital capacity (FVC for detecting airway obstruction. A fixed cut-off value for FEV1/FEV6 in a Korean population is lacking. We investigated a fixed cut-off for FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction.Materials and methods: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV1/FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV1/FVC lower limit of normal.Results: Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women, 14.0% had obstructive lung function according to a fixed cut-off FEV1/FVC <70%. Optimal FEV1/FEV6 cut-off for predicting FEV1/FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987–0.990. This fixed cut-off of FEV1/FEV6 showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen’s kappa coefficient. When compared with FEV1/FVC < lower limit of normal, FEV1/FEV6 <75% tended to over-diagnose airflow limitation (just like a fixed cut

Virtual respiratory system for interactive e-learning of spirometry

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W. Tomalak

2008-04-01

Full Text Available Progress in computer simulation technology offers new possibilities for modern medicine. On one hand – virtual organs can help to create animal or human models for research, on the other hand – e-learning or distant learning through Internet is now possible. The aim of our work was to create a system for interactive learning of spirometry (SILS, enabling students or physicians to observe spirometric measurements (flow-volume modified by setting level and kind of abnormalities within the respiratory system. SILS is based on a virtual respiratory system presented previously in several papers. Its main features are: separation of the lungs and chest; anatomical division of the lungs; division of airway resistance into transmural pressure dependent (Rp and lung volume dependent (Rv parts. The one mathematical formula that represents Rp describes both flow limitation (forced expiration and dependence of Raw on lungs volume (small airflows. The output of system are spirometric parameters (as FEV1, FVC, FEV1%FVC and a flow–volume loop constructed according to results of simulation of forced expiration for the chosen abnormality kind and level. As a result – this system may be used in teaching process in medical schools and postgraduate education. We offer access to a basic version of SILS for students and physicians at: www.spirometry.ibib.waw.pl and www.zpigichp.edu.pl. As we expect feedback from users, it is possible to modify user interface or model features to comply with users' requests.

Air pollution and fuel vapour induced changes in lung functions: are fuel handlers safe?

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Chawla, Anuj; Lavania, A K

2008-01-01

Automobile exhaust derived air pollutants have become a major health hazard. Coupled with the inhalation of fuel vapour, as occurs in petrol station workers, this may lead to significant impairment of lung function. Spirometric lung functions were studied in 58 petrol station workers to examine this possibility. The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow 25%-75% (FEF25-75) and peak expiratory flow (PEF) were recorded and analysed separately for smokers and non-smokers. The workers were divided into 5 groups for analysis of data based on the number of years of work in the petrol pumps. Outdoor air analysis was also carried out. The FVC, FEV1 and PEF declined significantly with increasing years of work in petrol stations in both smokers and non-smokers. Smoking as an independent variable was found to affect the FEV1 significantly but not FVC or PEF. The FEF25-75 was found to be the most affected spirometric value with a significant reduction with increasing years of work. Smoking as such did not affect it. Oxides of nitrogen (NOx), suspended particulate matter (SPM) and particulate matter less than 10 microns (PM10) in outdoor air were higher than the national ambient air quality standards. Exposure to automobile exhaust and fuel vapour impairs lung function in a time-dependent manner. Cigarette smoking appears to accelerate the decline.

Validity and interpretation of spirometric recordings to diagnose COPD in UK primary care

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Rothnie KJ

2017-06-01

Full Text Available Kieran J Rothnie,1,2 Joht S Chandan,3,4 Harry G Goss,4,5 Hana Müllerová,6 Jennifer K Quint1,2 1Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, 2Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, 3Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, 4Medical School, Faculty of Medical Sciences, University College London, 5Jersey General Hospital, St Helier, Jersey, 6Respiratory Epidemiology, GlaxoSmithKline R&D, Uxbridge, UK Background: The diagnosis of COPD is dependent upon clinical judgment and confirmation of the presence of airflow obstruction using spirometry. Spirometry is now routinely available; however, spirometry incorrectly performed or interpreted can lead to misdiagnosis. We aimed to determine whether spirometry undertaken in primary care for patients suspected to have COPD was of sufficient quality and whether their spirometry was correctly interpreted.Methods: Two chest physicians re-read all spirometric readings for both quality of the procedure and interpretation, received as a part of COPD validation studies using data from the Clinical Practice Research Datalink (CPRD. We then used logistic regression to investigate predictors of correct interpretation.Results: Spirometry traces were obtained for 306 patients, of which 221 (72.2% were conducted in primary care. Of those conducted in primary care, 98.6% (n=218 of spirometry traces were of adequate quality. Of those traces that were of adequate quality and conducted in primary care, and in whom a general practitioner (GP diagnosis of COPD had been made, 72.5% (n=218 were consistent with obstruction. Historical records for asthma diagnosis significantly decreased odds of correct interpretation.Conclusion: The quality of the spirometry procedure undertaken in primary care is high. However, this was not reflected in the

Medidas espirométricas em pessoas eutróficas e obesas nas posições ortostática, sentada e deitada Spirometric values of obese and non-obese subjects on orthostatic, sitting and supine positions

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Nilsa Cristina Domingos-Benício

2004-04-01

Full Text Available OBJETIVO: Alguns autores demonstraram que a obesidade gera restrição pulmonar, levando a uma redução dos volumes pulmonares. Entretanto, ainda existem controvérsias acerca da existência dessa restrição e do possível mecanismo responsável por essa alteração. Frente a isso, esse estudo teve como objetivo avaliar a influência do excesso de peso corporal na espirometria, em três diferentes posições corporais, avaliado pelo Índice de Massa Corpórea (IMC, percentual de gordura e relação cintura/quadril. MÉTODOS: Quarenta e seis universitários sedentários, com idades entre 20 e 40 anos, foram avaliados e distribuídos em cinco grupos, de acordo com o IMC. Os voluntários foram submetidos ao exame físico e à mensuração das pregas cutâneas e da circunferência da cintura e do quadril. CVF, VEF1 e VEF1/CVF foram avaliados em três diferentes posições - sentado, deitado e em pé. RESULTADOS: Quando comparados os valores obtidos e previstos entre os grupos, nenhuma diferença estatisticamente significante foi detectada. Quando comparadas as posições corporais, a posição deitada apresentou valores menores que as posições sentado e em pé (pBACKGROUND: It is possible that obesity could lead to pulmonary restriction with decreasing lung volumes. However, controversies about this restriction and its etiology still exist. Thus, the purpose of this report was to evaluate the effects of body weigh excess on spirometry, on three different body positions, evaluated by Body Mass Index (BMI, percentage of fatness and the ratio of abdominal girth to hip breadth (AG/HB. METHODS: Forty-six sedentary volunteers, with ages between 20 and 40 years, were studied and distributed on five groups, based on BMI. Skin fold thickness and ratio of abdominal girth to hip breadth (AG/HB of the volunteers were measured. FVC, FEV1 and ratio of FEV1 to FVC were measured on three different body positions - sitting, supine and orthostatic positions

SPIROMETRIC RESPONSE TO OZONE (O3) IN YOUNG ADULTS AS A FUNCTION OF BODY MAASS INDEX (BMI)

Science.gov (United States)

Recent studies in murine models of obesity have shown enhanced responsiveness to ozone in obese vs. lean mice. To assess whether previous human ozone exposure data from our laboratory support an effect of BMI on the spirometric response to ozone we analyzed the post-O3 percent de...

[The diagnosis of COPD is recommendation dependent].

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Ben Saad, Helmi; Ben Amor, Leila; Ben Mdella, Samia; Ghannouchi, Ines; Ben Essghair, Mejda; Bougmiza, Iheb; Garrouche, Abdelhamid; Rouatbi, Naceur; Rouatbi, Sonia

2014-07-01

Different spirometric criteria are recommended to diagnosis chronic obstructive pulmonary disease (COPD): -American Thoracic Society/European Respiratory Society (ATS/ERS), Global initiative for chronic Obstructive Lung Disease (GOLD): a post bronchodilator (PBD) ratio between the 1st second Forced Expiratory Volume and Forced Vital Capacity (FEV1/FVC) guidelines are used for defining the disease. This forms a barrier to early diagnosis, affects public health decisions and wrong planning strategies.

Optimal Clinical Time for Reliable Measurement of Transcutaneous CO2 with Ear Probes: Counterbalancing Overshoot and the Vasodilatation Effect

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Manel Luján

2010-01-01

Full Text Available OBJECTIVES: To determine the optimal clinical reading time for the transcutaneous measurement of oxygen saturation (SpO and transcutaneous CO2 (TcPCO2 in awake spontaneously breathing individuals, considering the overshoot phenomenon (transient overestimation of arterial PaCO2. EXPERIMENTAL SECTION: Observational study of 91 (75 men individuals undergoing forced spirometry, measurement of SpO2 and TcPCO2 with the SenTec monitor every two minutes until minute 20 and arterial blood gas (ABG analysis. Overshoot severity: (a mild (0.1–1.9 mm Hg; (b moderate (2–4.9 mm Hg; (c severe: (>5 mm Hg. The mean difference was calculated for SpO2 and TcPCO2 and arterial values of PaCO2 and SpO2. The intraclass correlation coefficient (ICC between monitor readings and blood values was calculated as a measure of agreement. RESULTS: The mean age was 63.1 ± 11.8 years. Spirometric values: FVC: 75.4 ± 6.2%; FEV1: 72.9 ± 23.9%; FEV1/FVC: 70 ± 15.5%. ABG: PaO2: 82.6 ± 13.2; PaCO2: 39.9.1 ± 4.8 mmHg; SaO2: 95.3 ± 4.4%. Overshoot analysis: overshoot was mild in 33 (36.3% patients, moderate in 20 (22% and severe in nine (10%; no overshoot was observed in 29 (31% patients. The lowest mean differences between arterial blood gas and TcPCO2 was –0.57 mmHg at minute 10, although the highest ICC was obtained at minutes 12 and 14 (>0.8. The overshoot lost its influence after minute 12. For SpO2, measurements were reliable at minute 2. CONCLUSIONS: The optimal clinical reading measurement recommended for the ear lobe TcPCO2 measurement ranges between minute 12 and 14. The SpO2 measurement can be performed at minute 2.

Optimal Clinical Time for Reliable Measurement of Transcutaneous CO2 with Ear Probes: Counterbalancing Overshoot and the Vasodilatation Effect

Science.gov (United States)

Domingo, Christian; Canturri, Elisa; Moreno, Amalia; Espuelas, Humildad; Vigil, Laura; Luján, Manel

2010-01-01

OBJECTIVES: To determine the optimal clinical reading time for the transcutaneous measurement of oxygen saturation (SpO2) and transcutaneous CO2 (TcPCO2) in awake spontaneously breathing individuals, considering the overshoot phenomenon (transient overestimation of arterial PaCO2). EXPERIMENTAL SECTION: Observational study of 91 (75 men) individuals undergoing forced spirometry, measurement of SpO2 and TcPCO2 with the SenTec monitor every two minutes until minute 20 and arterial blood gas (ABG) analysis. Overshoot severity: (a) mild (0.1–1.9 mm Hg); (b) moderate (2–4.9 mm Hg); (c) severe: (>5 mm Hg). The mean difference was calculated for SpO2 and TcPCO2 and arterial values of PaCO2 and SpO2. The intraclass correlation coefficient (ICC) between monitor readings and blood values was calculated as a measure of agreement. RESULTS: The mean age was 63.1 ± 11.8 years. Spirometric values: FVC: 75.4 ± 6.2%; FEV1: 72.9 ± 23.9%; FEV1/FVC: 70 ± 15.5%. ABG: PaO2: 82.6 ± 13.2; PaCO2: 39.9.1 ± 4.8 mmHg; SaO2: 95.3 ± 4.4%. Overshoot analysis: overshoot was mild in 33 (36.3%) patients, moderate in 20 (22%) and severe in nine (10%); no overshoot was observed in 29 (31%) patients. The lowest mean differences between arterial blood gas and TcPCO2 was −0.57 mmHg at minute 10, although the highest ICC was obtained at minutes 12 and 14 (>0.8). The overshoot lost its influence after minute 12. For SpO2, measurements were reliable at minute 2. CONCLUSIONS: The optimal clinical reading measurement recommended for the ear lobe TcPCO2 measurement ranges between minute 12 and 14. The SpO2 measurement can be performed at minute 2. PMID:22315552

Comparison of the Influence of Different Rehabilitation Programmes on Clinical, Spirometric and Spiroergometric Parameters in Patients with Multiple Sclerosis

Czech Academy of Sciences Publication Activity Database

Řasová, K.; Havrdová, E.; Brandejský, P.; Zálišová, M.; Foubíková, B.; Martinková, Patrícia

2006-01-01

Roč. 12, č. 2 (2006), s. 227-234 ISSN 1352-4585 Source of funding: V - iné verejné zdroje Keywords : aerobic training * fatigue * multiple sclerosis * neurorehabilitation * spirometric and spiroergometric parameters Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.773, year: 2006

Prediction of Spirometric Forced Expiratory Volume (FEV1) Data Using Support Vector Regression

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Kavitha, A.; Sujatha, C. M.; Ramakrishnan, S.

2010-01-01

In this work, prediction of forced expiratory volume in 1 second (FEV1) in pulmonary function test is carried out using the spirometer and support vector regression analysis. Pulmonary function data are measured with flow volume spirometer from volunteers (N=175) using a standard data acquisition protocol. The acquired data are then used to predict FEV1. Support vector machines with polynomial kernel function with four different orders were employed to predict the values of FEV1. The performance is evaluated by computing the average prediction accuracy for normal and abnormal cases. Results show that support vector machines are capable of predicting FEV1 in both normal and abnormal cases and the average prediction accuracy for normal subjects was higher than that of abnormal subjects. Accuracy in prediction was found to be high for a regularization constant of C=10. Since FEV1 is the most significant parameter in the analysis of spirometric data, it appears that this method of assessment is useful in diagnosing the pulmonary abnormalities with incomplete data and data with poor recording.

Childhood asthma and spirometric indices are associated with polymorphic markers of two vitamin D 25-hydroxylase genes.

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Leung, Ting Fan; Wang, Susan Shuxin; Tang, Man Fung; Kong, Alice Pik-Shan; Sy, Hing Yee; Hon, Kam Lun; Chan, Juliana Chung-ngor; Wong, Gary Wing-kin

2015-06-01

Polymorphic markers of vitamin D pathway genes have been associated with asthma traits in different White populations. This study investigated the relationship between asthma phenotypes and single nucleotide polymorphisms (SNPs) of vitamin D receptor (VDR), vitamin D binding protein (GC), two 25-hydroxylases (CYP2R1 and CYP27A1), and 1α-hydroxylase (CYP27B1) in Hong Kong Chinese children. 23 SNPs of the five vitamin D pathway genes were successfully genotyped in 914 asthmatic children and 1231 non-allergic controls. Genotypic and haplotypic associations with asthma phenotypes (diagnosis, spirometric indices, total IgE, and eosinophil percentage) were analyzed by multivariate regression. Generalized multifactor dimensionality reduction was used to detect epistatic interactions between SNPs for asthma phenotypes. Several SNPs of CYP27A1, CYP27B1, GC, and CYP2R1 were associated with asthma or spirometric indices, although only the association between FEV1 and CYP2R1 rs7935792 passed Bonferroni correction (p = 2.73 × 10(-4) ). Patients with CC genotype of rs7935792 had higher FEV1 than those with the other two genotypes. Asthma was also associated with TT haplotype of CYP27A1 and AGGATA haplotype of CYP2R1 (p = 0.021 and 0.024, respectively). Besides, strong association was found between FEV1 and GATAG of CYP2R1 (β = 13.37, p = 4.83 × 10(-4) ). GMDR failed to identify any 2-locus to 4-locus interaction that modulated asthma or spirometric indices. Several SNPs and haplotypes of CYP2R1 are associated with asthma diagnosis and FEV1 in children. Asthma is also modestly associated with a CYP27A1 haplotype. These two 25-hydroxylase genes may be genetic determinants for asthma phenotypes in children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of active and passive smoking as risk factors for asthma and COPD in women presenting to primary care in Syria: first report by the WHO-GARD survey group.

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Mohammad, Yousser; Shaaban, Rafea; Al-Zahab, Bassam Abou; Khaltaev, Nikolai; Bousquet, Jean; Dubaybo, Basim

2013-01-01

The burden of chronic respiratory disease (CRD) is alarming. International studies suggest that women with CRD are undersurveyed and underdiagnosed by physicians worldwide. It is unclear what the prevalence of CRD is in the general population of Syria, particularly among women, since there has never been a survey on CRD in this nation. The purpose of this study was to investigate the impact of different patterns of smoking on CRD in women. We extracted data on smoking patterns and outcome in women from the Global Alliance Against Chronic Respiratory Diseases survey. Using spirometric measurements before and after the use of inhaled bronchodilators, we tracked the frequency of CRD in females active and passive narghile or cigarette smokers presenting to primary care. We administered the questionnaire to 788 randomly selected females seen during 1 week in the fiscal year 2009-2010 in 22 primary care centers in six different regions of Syria. Inclusion criteria were age >6 years, presenting for any medical complaint. In this cross-sectional study, three groups of female subjects were evaluated: active smokers of cigarettes, active smokers of narghiles, and passive smokers of either cigarettes or narghiles. These three groups were compared to a control group of female subjects not exposed to active or passive smoking. Exposure to active cigarette smoke but not narghile smoke was associated with doctor-diagnosed chronic obstructive pulmonary disease (COPD). However, neither cigarette nor narghile active smoking was associated with increased incidence of spirometrically diagnosed COPD. Paradoxically, exposure to passive smoking of either cigarettes or narghiles resulted in association with airway obstruction, defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70% according to the Global initiative for chronic Obstructive Lung Disease criteria; association with FEV1 < 80% predicted, evidencing moderate to severe GOLD spirometric grade

Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD: continuous measurement of lung density by 4-dimensional dynamic-ventilation CT

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Yamashiro T

2017-07-01

Full Text Available Tsuneo Yamashiro,1 Hiroshi Moriya,2 Shin Matsuoka,3 Yukihiro Nagatani,4 Maho Tsubakimoto,1 Nanae Tsuchiya,1 Sadayuki Murayama1 On behalf of the ACTIve Study Group 1Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan; 2Department of Radiology, Ohara General Hospital, Fukushima-City, Fukushima, Japan; 3Department of Radiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; 4Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan Purpose: Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT. Materials and methods: Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing. CT data were continuously reconstructed every 0.5 sec. Mean lung density (MLD of the five lobes (right upper [RU], right middle [RM], right lower [RL], left upper [LU], and left lower [LL] was continuously measured by commercially available software using a fixed volume of volume of interest which was placed and tracked on a single designated point in each lobe. Concordance between the MLD time curves of six pairs of lung lobes (RU-RL, RU-RM, RM-RL, LU-LL, RU-LU, and RL-LL lobes was expressed by cross-correlation coefficients. The relationship between these cross-correlation coefficients and the forced expiratory volume in one second/forced vital capacity (FEV1.0/FVC values was assessed by Spearman rank correlation analysis. Results: In all six pairs of the pulmonary lobes, the cross-correlation coefficients of the two MLD curves were significantly positively correlated with FEV1.0/FVC (ρ =0.60–0.73, P<0.001. The mean value of the six

The measurement of 99mTc-DTPA pulmonary clearance in normals, asymptomatic smokers and diabetic patients

International Nuclear Information System (INIS)

Kim, In Ju; Kim, Seong Jang; Kim, Yong Ki; Kim, Yun Seong; Lee, Min Ki; Park, Soon Kew

1998-01-01

We measured pulmonary epithelial permeability by 99m Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate 99m Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. We performed 99m Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). 99m Tc-DTPA clearance half-time (T 1/2 ) was calculated, then compared with the result of chest radiography and pulmonary function test. Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiophaty were significantly older (p 1/2 of normal subjects and asymptomatic smokers were significantly different (65.2±23.7 min vs 39.6±9.8 min, p 1/2 was 90.5±46.5 min and significantly delayed when compared with those of normals and asymptomatic smokers (p 1/2 of diabetic patients without microangiopathy, 70.0±12.7 min, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the T 1/2 and spirometric parameters including DLco, FVC, FEV 1 , FEV 1 /FVC (%) and FEF 25-75% in all subjects, and between the T 1/2 and duration of diabetes in diabetic patients. Eventhough the influence of age can't be excluded, delayed 99m Tc-DTPA clearance half-time (T 1/2 ) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy

Spirometric reference values in urban children in Madagascar: poverty is a risk factor for low lung function.

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Wolff, Peter Th; Arison, Lala; Rahajamiakatra, Abel; Raserijaona, Francis; Niggemann, Bodo

2014-01-01

Studies about children with respiratory diseases in Africa are impeded by the dearth of reliable data for the vast majority of countries on the continent. This study was conducted to establish representative reference values, therefore allowing a more accurate evaluation of lung function in Malagasy children. One thousand two hundred thirty-six students from three public and five private schools aged 8-12 years were recruited. A total of 1,093 children were healthy, had a valid lung function measurement and were thus deemed evaluable for this study. Lung function data were collected on consecutive days in Antananarivo, Madagascar's capital, using spirometry and a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The lung volumes found were substantially lower compared to Caucasian and African equations. The mean Z-score (Stanojevic) for the forced vital capacity (FVC) found was -1.45 and -0.93 for the forced expiratory volume in 1 sec (FEV1) with significant differences between private and public schools (FVC: P = 0.0023, FEV1: P = 0.0004). The equations established for school children in Madagascar's capital Antananarivo showed lung function values were lower than reference values for the same age group seen not only in European, but also in African American and African children. The unique ethnicity of the Malagasy people, which combines Southeast-Asian with substantial African influences, the heavy burden of pollution and poverty may explain these differences. © 2013 Wiley Periodicals, Inc.

Spirometric assessment of lung transplant patients: one year follow-up

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Paulo M. Pêgo-Fernandes

2009-06-01

Full Text Available OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1 and the forced vital capacity (FVC in comparison to the pre-transplant values (p <0.05. Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.

Linearity of electrical impedance tomography during maximum effort breathing and forced expiration maneuvers.

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Ngo, Chuong; Leonhardt, Steffen; Zhang, Tony; Lüken, Markus; Misgeld, Berno; Vollmer, Thomas; Tenbrock, Klaus; Lehmann, Sylvia

2017-01-01

Electrical impedance tomography (EIT) provides global and regional information about ventilation by means of relative changes in electrical impedance measured with electrodes placed around the thorax. In combination with lung function tests, e.g. spirometry and body plethysmography, regional information about lung ventilation can be achieved. Impedance changes strictly correlate with lung volume during tidal breathing and mechanical ventilation. Initial studies presumed a correlation also during forced expiration maneuvers. To quantify the validity of this correlation in extreme lung volume changes during forced breathing, a measurement system was set up and applied on seven lung-healthy volunteers. Simultaneous measurements of changes in lung volume using EIT imaging and pneumotachography were obtained with different breathing patterns. Data was divided into a synchronizing phase (spontaneous breathing) and a test phase (maximum effort breathing and forced maneuvers). The EIT impedance changes correlate strictly with spirometric data during slow breathing with increasing and maximum effort ([Formula: see text]) and during forced expiration maneuvers ([Formula: see text]). Strong correlations in spirometric volume parameters [Formula: see text] ([Formula: see text]), [Formula: see text]/FVC ([Formula: see text]), and flow parameters PEF, [Formula: see text], [Formula: see text], [Formula: see text] ([Formula: see text]) were observed. According to the linearity during forced expiration maneuvers, EIT can be used during pulmonary function testing in combination with spirometry for visualisation of regional lung ventilation.

Chronic adaptations of lung function in breath-hold diving fishermen

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Cristiane Diniz

2014-04-01

Full Text Available Objectives: The aim of this study was to verify and analyze the existence of chronic adaptations of lung function in freediving fishermen whose occupation is artisanal fishing. Material and Methods: This was a cross-sectional study involving 11 breath-hold diving fishermen and 10 non-breath-hold diving fishermen (control from the village of Bitupitá in the municipality of Barroquinha (Ceará - Brazil. Anthropometric measurements, chest and abdominal circumferences as well as spirometric and respiratory muscle strength tests were conducted according to the specifications of the American Thoracic Society/European Respiratory Society (ATS/ERS. In order to compare the measured values versus the predicted values, Student t test was used in the case of parametric test and Wilcoxon test in the case of nonparametric test. To compare the inter-group means Student t test was used for parametric test and Mann-Whitney test for the nonparametric one. The level of significance was set at α = 5%. Results: The forced vital capacity (FVC (4.9±0.6 l vs. 4.3±0.4 l and forced expiratory volume in 1 s (FEV1 (4.0±0.5 l vs. 3.6±0.3 l were, respectively, higher in the group of divers compared to the control group (p ≤ 0.05. Furthermore, in the group of free divers, the measured FVC, FEV1 and FEV1/FVC ratios were significantly greater than the predicted ones. No differences were found between the measured respiratory pressures. Conclusions: These results indicate that breath-hold diving seems to produce chronic adaptations of the respiratory system, resulting in elevated lung volumes with no airway obstruction.

Dietary Intake of Flavonoids and Ventilatory Function in European Adults: A GA2LEN Study

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Vanessa Garcia-Larsen

2018-01-01

Full Text Available Background: Flavonoids exert anti-inflammatory properties and modulate oxidative stress in vitro, suggesting a protective effect on lung function, but epidemiological studies examining this association are scarce. Methods: A stratified random sample was drawn from the GA2LEN screening survey, in which 55,000 adults aged 15 to 75 answered a questionnaire on respiratory symptoms. Post-bronchodilator spirometry was obtained from 2850 subjects. Forced vital capacity (FVC, the ratio between the forced exhaled volume in 1 second (FEV1 and FVC (FEV1/FVC, FVC below lower limit of normal (FVC < LLN, and FEV1/FVC < LLN were calculated. Intake of the six main subclasses of flavonoids was estimated using the GA2LEN Food Frequency Questionnaire. Adjusted associations between outcomes and each subclass of flavonoids were examined with multivariate regressions. Simes’ procedure was used to test for multiple comparisons. Results: A total of 2599 subjects had valid lung function and dietary data. A lower prevalence of FVC < LLN (airway restriction was observed in those with higher total flavonoid (adjusted odds ratio (aOR, higher vs. lowest quintile intake 0.58; 95% Confidence Interval (CI 0.36, 0.94, and pro-anthocyanidin intakes (aOR 0.47; 95% CI 0.27, 0.81. A higher FEV1/FVC was associated with higher intakes of total flavonoids and pro-anthocyanidins (adjusted correlation coefficient (a β-coeff 0.33; 0.10, 0.57 and a β-coeff 0.44; 95% CI 0.19, 0.69, respectively. After Simes’ procedure, the statistical significance of each of these associations was attenuated but remained below 0.05, with the exception of total flavonoids and airway restriction. Conclusions: This population-based study in European adults provides cross-sectional evidence of a positive association of total flavonoid intake and pro-anthocyanidins and ventilatory function, and a negative association with spirometric restriction in European adults.

A randomized study of contingency management and spirometric lung age for motivating smoking cessation among injection drug users.

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Drummond, Michael B; Astemborski, Jacquie; Lambert, Allison A; Goldberg, Scott; Stitzer, Maxine L; Merlo, Christian A; Rand, Cynthia S; Wise, Robert A; Kirk, Gregory D

2014-07-28

Even after quitting illicit drugs, tobacco abuse remains a major cause of morbidity and mortality in former injection drug users. An important unmet need in this population is to have effective interventions that can be used in the context of community based care. Contingency management, where a patient receives a monetary incentive for healthy behavior choices, and incorporation of individual counseling regarding spirometric "lung age" (the age of an average healthy individual with similar spirometry) have been shown to improve cessation rates in some populations. The efficacy of these interventions on improving smoking cessation rates has not been studied among current and former injection drug users. In a randomized, factorial design study, we recruited 100 active smokers from an ongoing cohort study of current and former injection drug users to assess the impact of contingency management and spirometric lung age on smoking cessation. The primary outcome was 6-month biologically-confirmed smoking cessation comparing contingency management, spirometric lung age or both to usual care. Secondary outcomes included differences in self-reported and biologically-confirmed cessation at interim visits, number of visits attended and quit attempts, smoking rates at interim visits, and changes in Fagerstrom score and self-efficacy. Six-month biologically-confirmed smoking cessations rates were 4% usual care, 0% lung age, 14% contingency management and 0% for combined lung age and contingency management (p = 0.13). There were no differences in secondary endpoints comparing the four interventions or when pooling the lung age groups. Comparing contingency management to non-contingency management, 6-month cessation rates were not different (7% vs. 2%; p = 0.36), but total number of visits with exhaled carbon monoxide-confirmed abstinence were higher for contingency management than non-contingency management participants (0.38 vs. 0.06; p = 0.03), and more contingency management

Evaluation of three scales of dyspnea in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Chhabra, S K; Gupta, A K; Khuma, M Z

2009-01-01

The Modified Medical Research Council (MMRC) scale, baseline dyspnea index (BDI) and the oxygen cost diagram (OCD) are widely used tools for evaluation of limitation of activities due to dyspnea in patients with chronic obstructive pulmonary disease (COPD). There is, however, limited information on how these relate with each other and with multiple parameters of physiological impairment. To study the interrelationships between MMRC, BDI and OCD scales of dyspnea and their correlation with multiple measures of physiological impairment. A retrospective analysis of pooled data of 88 male patients with COPD (GOLD stages 2, 3 and 4) was carried out. Dyspnea was evaluated using the MMRC, BDI and OCD scales. Physiological impairment was assessed by spirometry (FVC % predicted and FEV 1 % predicted), arterial blood gas (ABG) analysis and measurement of the 6-min walk distance (6MWD). The interrelationships between MMRC, BDI and OCD scales were moderately strong. The BDI and OCD scores had strong correlations with ABG abnormalities, weak correlations with spirometric parameters but none with 6MWD. MMRC grades were significantly associated with BDI and OCD scores but did not show clear associations with spirometric parameters, ABG abnormalities and 6MWD. The MMRC grades of dyspnea and the BDI and OCD scales are moderately interrelated. While the BDI and OCD scales have significant associations with parameters of physiological impairment, the MMRC scale does not. (author)

Spirometrically gated 133Xe ventilation imaging and phase analysis for assessment of regional lung function

International Nuclear Information System (INIS)

Inoue, Tomio

1984-01-01

The purpose of this study is to develop the technique of performing spirometrically gated 133 Xe ventilation imaging and to evaluate its clinical usefulness for the assessmentof regional ventilatory function in various lung diseases. Patients rebreathe d 133 Xe gas through the system with constant rates signaled by a metronom. The trigger signals from the patients were recorded in a minicomputer for 60 respiratory cycles simultaneously with posterior lung images. Functional images (phase analysis images) indicating phase and amplitude of regional ventilation were constructed by the first harmonic Fourier analysis. Materials included 13 normal volunteers and patients with COPD (24), lung cancer (5), pulmonary embolism (4) and others (20). In normal controls, phase analysis images before respiratory motion correction revealed gradual decrease in amplitude from base to apex with uniform phase distribution. The amplitude and phase distribution after respiratory motion correction became even more uniform. In patients with COPD, phase analysis images showed asymmetrical and irregular amplitude distribution with non-uniform phase distribution. The standard deviation (S.D.) of phase histogram correlated well with FEVsub(1.0)% (r=0.71, p<0.001) and down slope of flowvolume curve (r=0.55, p<0.001), and less prominently with %VC (r=0.42, p<0.01). Mean S.D. in patients with COPD (12.3+-6.5 degree, mean+-1 s.d.) was significantly larger than in normal controls (6.3+-1.5). Amplitude profile curve analysis revealed 83% sensitivity for the detection of abnormal spirometric respiratory function test. Data aquisition and processing of present method are rapid and easy to perform. The phase analysis of the gated ventilation images should prove useful in the clinical evaluation of patients with uneven ventilation such as COPD. (J.P.N.)

Comparison of the fixed ratio and the Z-score of FEV1/FVC in the elderly population: a long-term mortality analysis from the Third National Health and Nutritional Examination Survey.

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Oh, Dong Kyu; Baek, Seunghee; Lee, Sei Won; Lee, Jae Seung; Lee, Sang-Do; Oh, Yeon-Mok

2018-01-01

Despite the ongoing intense debate on the definition of airflow limitation by spirometry in the elderly population, there have only been few studies comparing the fixed ratio and the Z -score of forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) in terms of long-term mortalities. In this study, we aimed to identify the proper method for accurately defining the airflow limitation in terms of long-term mortality prediction in the elderly population. Data were collected from the Third National Health and Nutrition Examination Survey in the US. Non-Hispanic Caucasians aged 65-80 years were included. The receiver operating characteristic (ROC) curves of both methods were plotted and compared for 10-year all-cause, respiratory, and COPD mortalities. Of 1,331 subjects, the mean age was 71.7 years and 805 (60.5%) were males. For the 10-year all-cause mortality, the area under the curve (AUC) of the fixed ratio was significantly greater than that of the Z -score of FEV 1 /FVC, but both showed poor prediction performance (0.633 vs 0.616, p ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance with greater AUCs (0.784 vs 0.778, p =0.160, and 0.896 vs 0.896, p =0.971, respectively). Interestingly, the conventional cutoff of 0.7 in the fixed ratio was consistently higher than the optimal for the 10-year all-cause, respiratory, and COPD mortalities (0.70 vs 0.69, 0.62, and 0.61, respectively), whereas that of -1.64 in the Z -score of FEV 1 /FVC was consistently lower than the optimal cutoff (-1.64 vs -1.31, -1.47, and -1.41, respectively). In the elderly population, both the fixed ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance for the 10-year respiratory and COPD mortalities. However, the conventional cutoff of neither 0.70 in the fixed ratio nor -1.64 in the Z -score of FEV 1 /FVC was optimal for predicting the long-term mortalities.

The Concave Shape of the Forced Expiratory Flow-Volume Curve in 3 Seconds Is a Practical Surrogate of FEV1/FVC for the Diagnosis of Airway Limitation in Inadequate Spirometry.

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Li, Hao; Liu, Chunhong; Zhang, Yi; Xiao, Wei

2017-03-01

Spirometry is important for the differential diagnosis of dyspnea. However, some patients cannot exhale for ≥6 s to achieve the American Thoracic Society/European Respiratory Society criteria. The aim of this study was to demonstrate the reliability of a new parameter that quantifies the degree of concavity in the first 3 s to define airway limitation as a surrogate for the FEV 1 /FVC. Four hundred spirometry test results were selected through complete random sampling. The new parameter, termed the AUC 3 /AT 3 , was calculated as the area under the descending limb of the expiratory flow-volume curve before the end of the first 3 s (AUC 3 ) divided by the area of the triangle before the end of the first 3 s (AT 3 ). The AUC 3 /AT 3 was compared with the FEV 1 /FVC using Pearson's correlation analysis. The level of agreement between the AUC 3 /AT 3 and the FEV 1 /FVC in the detection of airway obstruction was analyzed using the kappa statistic. We also compared the diagnostic accuracy of the new index with that of the FEV 1 /forced expiratory volume in the first 3 s (FEV 3 ). There was a strong correlation (r = 0.88, P < .001) between the AUC 3 /AT 3 and the FEV 1 /FVC. There was also strong agreement between the AUC 3 /AT 3 and the FEV 1 /FVC in the detection of obstruction with kappa indices of 0.72 (Global Initiative for Chronic Obstructive Lung Disease [GOLD] criterion) and 0.67 (lower limit of normal criterion), and these values were greater than those obtained for the FEV 1 /FEV 3 . The AUC 3 /AT 3 also exhibited acceptable sensitivity, specificity, positive predictive value, and negative predictive value. The diagnostic accuracies of the AUC 3 /AT 3 were 86.3% (GOLD criterion) and 83.8% (lower limit of normal criterion), which were greater than the 76.0 and 74.0% obtained for the FEV 1 /FEV 3 , respectively. The AUC 3 /AT 3 can be utilized as a surrogate parameter for the FEV 1 /FVC when patients cannot complete a 6-s expiratory effort. Additionally, the

WE-DE-209-03: Spirometric Motion Management System

Energy Technology Data Exchange (ETDEWEB)

Hadley, S. [The University of Michigan (United States)

2016-06-15

Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

WE-DE-209-03: Spirometric Motion Management System

International Nuclear Information System (INIS)

Hadley, S.

2016-01-01

Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

Spirometrically gated /sup 133/Xe ventilation imaging and phase analysis for assessment of regional lung function

Energy Technology Data Exchange (ETDEWEB)

Inoue, Tomio (Kanto Teishin Hospital, Tokyo (Japan))

1984-10-01

The purpose of this study is to develop the technique of performing spirometrically gated /sup 133/Xe ventilation imaging and to evaluate its clinical usefulness for the assessment of regional ventilatory function in various lung diseases. Patients rebreathed /sup 133/Xe gas through the system with constant rates signaled by a metronome. The trigger signals from the patients were recorded in a minicomputer for 60 respiratory cycles simultaneously with posterior lung images. Functional images (phase analysis images) indicating phase and amplitude of regional ventilation were constructed by the first harmonic Fourier analysis. Materials included 13 normal volunteers and patients with COPD (24), lung cancer (5), pulmonary embolism (4) and others (20). In normal controls, phase analysis images before respiratory motion correction revealed gradual decrease in amplitude from base to apex with uniform phase distribution. The amplitude and phase distribution after respiratory motion correction became even more uniform. In patients with COPD, phase analysis images showed asymmetrical and irregular amplitude distribution with non-uniform phase distribution. The standard deviation (S.D.) of phase histogram correlated well with FEVsub(1.0)% (r=0.71, p < 0.001) and down slope of flow-volume curve (r=0.55, p < 0.001), and less prominently with %VC (r=0.42, p < 0.01). Mean S.D. in patients with COPD (12.3 +- 6.5 degree, mean+-1 s.d.) was significantly larger than in normal controls (6.3 +- 1.5). Amplitude profile curve analysis revealed 83% sensitivity for the detection of abnormal spirometric respiratory function test. Data aquisition and processing of present method are rapid and easy to perform. The phase analysis of the gated ventilation images should prove useful in the clinical evaluation of patients with uneven ventilation such as COPD.

Effect of Recumbent Body Positions on Dynamic Lung Function Parameters in Healthy Young Subjects.

Science.gov (United States)

Pal, Arvind Kumar; Tiwari, Sunita; Verma, Dileep Kumar

2017-05-01

The change in body position can alter pulmonary functions parameters, therefore it is important to understand the physiological basis of these alteration. Ideally, spirometry is done in sitting position until the subject is unable to do so. Hospitalized patients often assume recumbent body positions irrespective of underlying pathology. Hence, need arises to find out best recumbent body positions for the benefit of these patients to make breathing comfortable for them. The aim of this study was to find out whether the change from the supine position to crook lying and Fowler's position (45° dorsal elevation) causes change in spirometric parameters. The present work was carried out at Department of Physiology, King George's Medical University, Lucknow. A total 131 apparently healthy individuals were enrolled in this cross-sectional study. Lung function was assessed using a PC-based spirometer according to American Thoracic Society guideline in the supine, crook lying and Fowler's position (45° dorsal elevation). The study consisted of 131 subjects (male 66%, female 34%), with mean age of 20.15±2.71 years and BMI 21.20±3.28 Kg/m 2 . Repeated measures ANOVA with post hoc Bonferroni test was used to compare the mean values between each body position. Compared with the other two positions, Fowler's position showed significantly (p<0.05) higher values for FVC, FEV 1 , PEF, FEF 25-75% . Recumbent body position influences spirometric parameters in young healthy subjects. We demonstrated that spirometric values are higher in the Fowler's position than in the supine or crook lying position. The results of this study will help in the selection of the best alternative position for the spirometry in bed ridden patients.

Effects of occupational exposures and smoking on lung function in tile factory workers.

Science.gov (United States)

Jaakkola, Maritta S; Sripaiboonkij, Penpatra; Jaakkola, Jouni J K

2011-02-01

The aims of this study were to investigate the relations of occupational exposures in tile industry to lung function and to evaluate potential interaction between smoking and tile dust exposure containing silica. A cross-sectional study of 232 workers (response rate 100%) in a tile factory and 76 office workers (response rate 73%) from four factories in Thailand was conducted in 2006-2007. Participants answered a questionnaire and performed spirometry. Factory workers had lower spirometric functions than office workers, especially those with high dust exposure. There was a dose-response relation between duration of dust exposure and FEV1 and FVC, the adjusted effect of ≥ 21 years of exposure on FEV1 being -240 ml (-100 to -380) and on FVC -300 ml (-140 to -460). The adverse effect of dust on lung function was larger in current smokers suggesting synergism between smoking and tile dust exposure. This study provides evidence that long-term exposure to dust in tile industry is related to lung function reduction. There was a suggestion of synergistic effect between dust exposure and smoking. Tile factories should consider measures to reduce dust exposure and arrange spirometry surveillance for workers with such exposure. Smoking cessation should be promoted to prevent harmful effects of occupational tile dust exposure.

Air pollution and environmental risk factors for altered lung function among adult women of an urban slum area of Delhi: A prevalence study.

Science.gov (United States)

Arora, Shweta; Rasania, S K; Bachani, D; Gandhi, Asha; Chhabra, S K

2018-01-01

Household and ambient air pollution are jointly responsible for about 7 million premature deaths annually. Women living in slums, with unhealthy environment, both indoors and outdoors, particularly those living close to industrial and/or vehicular pollution zones due to multiple sources of air pollution, are at the higher risk of having impaired lung function tests. The aim of this study was to estimate the prevalence of abnormal lung functions and to identify the environmental risk factors associated with them among adult women of 18-59 years. A total of 550 women aged 18-59 years were approached in a representative urban slum. Five hundred consented to participate and 299 had prebronchodilator spirometry satisfying ATS standards. House visits to assess environmental conditions were conducted to determine their association with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Chi-square test was used to test the association of risk factors with lung functions. ANOVA was used to test the association of mean values of FEV1 and FVC with age. Out of 299 participants with acceptable spirometric curves, 5% had reduced FEV1/FVC ratio than the normal and 26.8% and 17.4% had lower values than predicted for FVC and FEV1, respectively. Altered lung function was related to age, tobacco smoking, and history of respiratory disease. Both ambient and household air pollution have a deleterious pulmonary effect on long-term women residents of a representative urban slum in Delhi.

Overweight effect on spirometric parameters in adolescents undergoing exercise.

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Costa, Rayana de Oliveira; Silva, Juliana Pereira; Lacerda, Eliana Mattos; Dias, Rodrigo; Pezolato, Vitor Alexandre; Silva, Carlos Alberto da; Krinski, Kleverton; Correia, Marco Aurélio de Valois; Cieslak, Fabrício

2016-01-01

To evaluate effects of overweight on spirometric parameters in adolescents who underwent bronchial provocation test for exercise. We included 71 male adolescents. The diagnosis of asthma was done based on participants' clinical history and on the International Study Questionnaire Asthma and Allergies in Childhood, and the diagnosis of obesity was based on body mass index above 95th percentile. The bronchospasm induced by exercise was assessed using the run-walk test on a treadmill for eight minutes. The decrease in forced expiratory volume in one second > or equal to 10% before exercise was considered positive, and to calculate the intensity in exercise-induced bronchospasm we measured the maximum percentage of forced expiratory volume in one second and above the curve area. Data analysis was carried out using the Mann-Whitney U test and Friedman test (ANOVA), followed by Wilcoxon test (padolescentes submetidos ao teste de broncoprovocação por exercício. Participaram do estudo 71 adolescentes do sexo masculino. O diagnóstico de asma foi obtido por meio de histórico clínico e do questionário International Study of Asthma and Allergies in Childhood, e o de obesidade, pelo índice de massa corporal acima do percentil 95. Para avaliar o broncoespasmo induzido pelo exercício, utilizou-se o teste correr/caminhar em esteira ergométrica, com duração de 8 minutos, considerando positivo se diminuição do volume expiratório forçado no primeiro segundo >10% do valor pré-exercício e, para a intensidade do broncoespasmo induzido pelo exercício, foram utilizados o cálculo da queda percentual máxima do volume expiratório forçado no primeiro segundo e a área acima da curva. A análise dos dados foi realizada pelo teste U Mann-Whitney e pela ANOVA de Friedman, seguido do teste de Wilcoxon (padolescentes obesos. O excesso de peso pode influenciar no aumento da frequência de broncoespasmo induzido pelo exercício em adolescentes não asmáticos, quando

Sport-specific influences on respiratory patterns in elite athletes.

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Durmic, Tijana; Lazovic, Biljana; Djelic, Marina; Lazic, Jelena Suzic; Zikic, Dejan; Zugic, Vladimir; Dekleva, Milica; Mazic, Sanja

2015-01-01

To examine differences in lung function among sports that are of a similar nature and to determine which anthropometric/demographic characteristics correlate with lung volumes and flows. This was a cross-sectional study involving elite male athletes (N = 150; mean age, 21  4 years) engaging in one of four different sports, classified according to the type and intensity of exercise involved. All athletes underwent full anthropometric assessment and pulmonary function testing (spirometry). Across all age groups and sport types, the elite athletes showed spirometric values that were significantly higher than the reference values. We found that the values for FVC, FEV1, vital capacity, and maximal voluntary ventilation were higher in water polo players than in players of the other sports evaluated (p respiratory system. That knowledge is particularly important when athletes present with respiratory symptoms such as dyspnea, cough, and wheezing. Because sports medicine physicians use predicted (reference) values for spirometric parameters, the risk that the severity of restrictive disease or airway obstruction will be underestimated might be greater for athletes.

Dependent lung opacity at thin-section CT: evaluation by spirometrically-gated CT of the influence of lung volume

International Nuclear Information System (INIS)

Lee, Ki Nam; Yoon, Seong Kuk; Sohn, Choon Hee; Choi, Pil Jo; Webb, W. Richard

2002-01-01

To evaluate the influence of lung volume on dependent lung opacity seen at thin-section CT. In thirteen healthy volunteers, thin-section CT scans were performed at three levels (upper, mid, and lower portion of the lung) and at different lung volumes (10, 30, 50, and 100% vital capacity), using spirometric gated CT. Using a three-point scale, two radiologists determined whether dependent opacity was present, and estimated its degree. Regional lung attenuation at a level 2 cm above the diaphragm was determined using semiautomatic segmentation, and the diameter of a branch of the right lower posterior basal segmental artery was measured at each different vital capacity. At all three anatomic levels, dependent opacity occurred significantly more often at lower vital capacities (10, 30%) than at 100% vital capacity (p = 0.001). Visually estimated dependent opacity was significantly related to regional lung attenuation (p < 0.0001), which in dependent areas progressively increased as vital capacity decreased (p < 0.0001). The presence of dependent opacity and regional lung attenuation of a dependent area correlated significantly with increased diameter of a segmental arterial branch (r = 0.493 and p = 0.0002; r = 0.486 and p 0.0003, respectively). Visual estimation and CT measurements of dependent opacity obtained by semiautomatic segmentation are significantly influenced by lung volume and are related to vascular diameter

[Estimation of volume of pleural fluid and its impact on spirometrical parameters].

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Karwat, Krzysztof; Przybyłowski, Tadeusz; Bielicki, Piotr; Hildebrand, Katarzyna; Nowacka-Mazurek, Magdalena; Nasiłowski, Jacek; Rubinsztajn, Renata; Chazan, Ryszarda

2014-03-01

In the course of various diseases, there is an accumulation of fluid in the pleural cavities. Pleural fluid accumulation causes thoracic volume expansion and reduction of volume lungs, leading to formation of restrictive disorders. The aim of the study was to estimate the volume of pleural fluid by ultrasonography and to search for the relationship between pleural fluid volume and spirometrical parameters. The study involved 46 patients (26 men, 20 women) aged 65.7 +/- 14 years with pleural effusions who underwent thoracentesis. Thoracentesis was preceded by ultrasonography of the pleura, spirometry test and plethysmography. The volume of the pleural fluid was calculated with the Goecke' and Schwerk' (GS) or Padykuła (P) equations. The obtained values were compared with the actual evacuated volume. The median volume of the removed pleural fluid was 950 ml. Both underestimated the evacuated volume (the median volume 539 ml for GS and 648 ml for P, respectively). Pleural fluid removal resulted in a statistically significant improvement in VC (increase 0.20 +/- 0.35 ; p Pleural fluid removal causes a significant improvement in lung function parameters. The analyzed equations for fluid volume calculation do not correlate with the actual volume.

Comparison of the fixed ratio and the Z-score of FEV1/FVC in the elderly population: a long-term mortality analysis from the Third National Health and Nutritional Examination Survey

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Oh DK

2018-03-01

Full Text Available Dong Kyu Oh,1 Seunghee Baek,2 Sei Won Lee,1 Jae Seung Lee,1 Sang-Do Lee,1 Yeon-Mok Oh1 1Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; 2Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Background and objective: Despite the ongoing intense debate on the definition of airflow limitation by spirometry in the elderly population, there have only been few studies comparing the fixed ratio and the Z-score of forced expiratory volume in 1 second (FEV1/forced vital capacity (FVC in terms of long-term mortalities. In this study, we aimed to identify the proper method for accurately defining the airflow limitation in terms of long-term mortality prediction in the elderly population. Methods: Data were collected from the Third National Health and Nutrition Examination Survey in the US. Non-Hispanic Caucasians aged 65–80 years were included. The receiver operating characteristic (ROC curves of both methods were plotted and compared for 10-year all-cause, respiratory, and COPD mortalities. Results: Of 1,331 subjects, the mean age was 71.7 years and 805 (60.5% were males. For the 10-year all-cause mortality, the area under the curve (AUC of the fixed ratio was significantly greater than that of the Z-score of FEV1/FVC, but both showed poor prediction performance (0.633 vs 0.616, p<0.001. For the 10-year respiratory and COPD mortalities, both the fixed ratio and the Z-score of FEV1/FVC showed comparable prediction performance with greater AUCs (0.784 vs 0.778, p=0.160, and 0.896 vs 0.896, p=0.971, respectively. Interestingly, the conventional cutoff of 0.7 in the fixed ratio was consistently higher than the optimal for the 10-year all-cause, respiratory, and COPD mortalities (0.70 vs 0.69, 0.62, and 0.61, respectively

Increase in prevalence and severity of asthma in young adults in Copenhagen

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Hansen, Ejvind Frausing; Rappeport, Y; Vestbo, Jørgen

2000-01-01

BACKGROUND: It is the general impression that the prevalence of asthma has increased during recent decades. A study was undertaken to investigate asthma prevalence, respiratory symptoms, and lung function in young adults in the City of Copenhagen 15 years apart. METHODS: Men and women aged 20......-35 years were sampled from the general population living in a defined area of central Copenhagen. The first examination took place in 1976-8 and comprised 1034 subjects (response rate 67.2%). A new sample comprising 1104 subjects (response rate 62.6%) from exactly the same area was examined 15 years later...... in 1991-4. All participants answered a questionnaire on respiratory symptoms and diseases and performed spirometric tests with measurement of forced expiratory volume in one second (FEV(1)) and forced vital capacity (FVC). RESULTS: The prevalence of self-reported asthma increased from 1.5% in the first...

Study of respiratory function in the elderly with different nutritional and cognitive status and functional ability assessed by plethysmographic and spirometric parameters.

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De Filippi, Francesco; Tana, Francesco; Vanzati, Simona; Balzarini, Barbara; Galetti, Giuseppe

2003-01-01

From a sample of 265 elderly subjects (age 80.2 +/- 6.8 years) admitted to a geriatric care unit, free from cardiac and respiratory diseases, with normal chest X-ray and gas analysis, 53 subjects were selected and their respiratory functions (assessed by spirometric parameters and airway resistance 'Raw') were studied to correlate them with nutritional status, cognitive impairment, independence in everyday life activities and mood disorders, assessed, respectively, by the Mini Nutritional Assessment, rapid Mini Mental State test (MMSr), activities of daily living (ADL), instrumental activities of daily living (IADL) evaluation, Barthel Index and Cornell Depression Scale. The enrolled subjects were able to perform normally a forced expiration, although most of them committed errors in this test, according to the American Thoracic Society (ATS) criteria. Thus, about 32% started at lung volume0.12 s); in 62% of the subjects expiration time was too short and in 58% the terminal plateau was nutritional status did not seem to have any influence on spirometric performance; MMSr score was related to compliance with ATS criteria for acceptability of the forced manoeuvre; mental and mood disorders, nutritional conditions and disability did not seem to have any influence on error rates. Our data show that our geriatric enrolled patients were able to perform an imperfect, often unfinished, but acceptable forced expiration; dynamic index values were related to disability, while the errors in starting the test were related to the mental conditions.

Spiroergometric and Spirometric Parameters in Patients with Multiple Sclerosis: Are there any Links between these Parameters and Fatigue, Depression, Neurological Impairment, Disability, Handicap and Quality of Life in Multiple Sclerosis?

Czech Academy of Sciences Publication Activity Database

Řasová, K.; Brandejský, P.; Havrdová, E.; Zálišová, M.; Rexová, Patrícia

2005-01-01

Roč. 11, - (2005), s. 213-221 ISSN 1352-4585 Grant - others:GA UK(CZ) 1641/2002-IV-GA UK Institutional research plan: CEZ:AV0Z10300504 Keywords : fatigue * multiple sclerosis * spirometric and spiroergometric parameters Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 2.832, year: 2005

Canadian prediction equations of spirometric lung function for Caucasian adults 20 to 90 years of age: Results from the Canadian Obstructive Lung Disease (COLD) study and the Lung Health Canadian Environment (LHCE) study

DEFF Research Database (Denmark)

Tan, Wan C; Bourbeau, J; Hernandez, P

2011-01-01

BACKGROUND: Currently, no reference or normative values for spirometry based on a randomly selected Canadian population exist. OBJECTIVE: The aim of the present analysis was to construct spirometric reference values for Canadian adults 20 to 90 years of age by combining data collected from health...

Leukotriene-B4 concentrations in exhaled breath condensate and lung function after thirty minutes of breathing technically dried compressed air.

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Neubauer, Birger; Struck, Niclas; Mutzbauer, Till S; Schotte, Ulrich; Langfeldt, Norbert; Tetzlaff, Kay

2002-01-01

In previous studies it had been shown that leukotriene-B4 [LTB4] concentrations in the exhaled breath mirror the inflammatory activity of the airways if the respiratory tract has been exposed to occupational hazards. In diving the respiratory tract is exposed to cold and dry air and the nasopharynx, as the site of breathing-gas warming and humidification, is bypassed. The aim of the present study was to obtain LTB4-concentrations in the exhaled breath and spirometric data of 17 healthy subjects before and after thirty minutes of technically dried air breathing at normobar ambient pressure. The exhaled breath was collected non-invasively, via a permanently cooled expiration tube. The condensate was measured by a standard enzyme immunoassay for LTB4. Lung function values (FVC, FEV1, MEF 25, MEF 50) were simultaneously obtained by spirometry. The measured pre- and post-exposure LTB4- concentrations as well as the lung function values were in the normal range. The present data gave no evidence for any inflammatory activity in the subjects' airways after thirty minutes breathing technically dried air.

[Factors impacting the growth and nutritional status of cystic fibrosis patients younger than 10 years of age who did not undergo neonatal screening].

Science.gov (United States)

Hortencio, Taís Daiene Russo; Nogueira, Roberto José Negrão; Marson, Fernando Augusto de Lima; Hessel, Gabriel; Ribeiro, José Dirceu; Ribeiro, Antônio Fernando

2015-01-01

The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program was implemented. Between September/2009 and March/2010, parental height of the 52 CF patients were also measured. Regarding nutritional status, four patients had Z-scores ≤ -2 for height/age (H/A) and body mass index/age (BMI/A). The following variables were associated with improved H/A ratio: fewer hospitalizations, longer time from first appointment to diagnosis, longer time from birth to diagnosis and later onset of respiratory disease. Forced vital capacity [FVC(%)], forced expiratory flow between 25-75% of FVC [FEF25-75(%)], forced expiratory volume in the first second [FEV1(%)], gestational age, birth weight and early respiratory symptoms were associated with IMC/A. Greater number of hospitalizations, diagnosis delay and early onset of respiratory disease had a negative impact on growth. Lower spirometric values, lower gestational age, lower birth weight, and early onset of respiratory symptoms had negative impact on nutritional status. Malnutrition was observed in 7.7% of cases, but 23% of children had nutritional risk. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Urinary Dialkyl Phosphate Concentrations and Lung Function Parameters in Adolescents and Adults: Results from the Canadian Health Measures Survey.

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Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

2016-04-01

Epidemiological studies have reported associations between lung function parameters and organophosphate (OP) pesticide exposures in agricultural occupations, but to our knowledge associations have not been evaluated in general populations. We examined associations between OP metabolite dialkyl phosphates (DAPs) and lung function using data from the Canadian Health Measures Survey (CHMS) Cycle 1. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1/FVC ratio, and forced expiratory flow between 25% and 75% of FVC (FEF25%-75%) were measured for 4,446 CHMS participants. Urinary concentrations of six DAP metabolites (DMP, DMTP, DMDTP, DEP, DETP, and DEDTP), smoking status, and other predictors of lung function were also measured in the CHMS-Cycle 1. Multiple linear regression analyses were used to examine the relationship between total DAP concentrations (ΣDAPs) and lung function in adolescents (12-19 years) and adults (20-79 years). In adults, estimates from multiple regression analyses suggested that a 1-unit increase on natural logarithmic scale (171% increase on the original scale) in the creatinine-corrected urinary concentration (nanomoles per gram creatinine) of ΣDAP was associated with a 32.6-mL (95% CI: -57.2, -8.1) reduction in FVC, 32.6-mL (95% CI: -59.0, -6.3) reduction in FEV1, 0.2% (95% CI: -0.6, 0.2) reduction in FEV1/FVC ratio, and 53.1-mL/sec (95% CI: -113.9, 7.7) reduction in FEF25%-75%. In adolescents, associations between ΣDAP and FEV1 were closer to the null and positive for FVC, whereas associations with FEV1/FVC and FEF25%-75% were negative, as in adults. However, none of the associations were significant in adolescents. The negative association between ΣDAP and lung function in adult participants suggests a detrimental effect of OP pesticides on lung function in the adult general population. Further studies using prospective designs are warranted to confirm the findings reported in this study. Ye M, Beach J, Martin JW

The association between anthropometric measures and lung function in a population-based study of Canadian adults.

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Rowe, A; Hernandez, P; Kuhle, S; Kirkland, S

2017-10-01

Decreased lung function has health impacts beyond diagnosable lung disease. It is therefore important to understand the factors that may influence even small changes in lung function including obesity, physical fitness and physical activity. The aim of this study was to determine the anthropometric measure most useful in examining the association with lung function and to determine how physical activity and physical fitness influence this association. The current study used cross-sectional data on 4662 adults aged 40-79 years from the Canadian Health Measures Survey Cycles 1 and 2. Linear regression models were used to examine the association between the anthropometric and lung function measures (forced expiratory volume in 1 s [FEV 1 ] and forced vital capacity [FVC]); R 2 values were compared among models. Physical fitness and physical activity terms were added to the models and potential confounding was assessed. Models using sum of 5 skinfolds and waist circumference consistently had the highest R 2 values for FEV 1 and FVC, while models using body mass index consistently had among the lowest R 2 values for FEV 1 and FVC and for men and women. Physical activity and physical fitness were confounders of the relationships between waist circumference and the lung function measures. Waist circumference remained a significant predictor of FVC but not FEV 1 after adjustment for physical activity or physical fitness. Waist circumference is an important predictor of lung function. Physical activity and physical fitness should be considered as potential confounders of the relationship between anthropometric measures and lung function. Copyright © 2017. Published by Elsevier Ltd.

Whole-lung volume and density in spirometrically-gated inspiratory and expiratory CT in systemic sclerosis: correlation with static volumes at pulmonary function tests.

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Camiciottoli, G; Diciotti, S; Bartolucci, M; Orlandi, I; Bigazzi, F; Matucci-Cerinic, M; Pistolesi, M; Mascalchi, M

2013-03-01

Spiral low-dose computed tomography (LDCT) permits to measure whole-lung volume and density in a single breath-hold. To evaluate the agreement between static lung volumes measured with LDCT and pulmonary function test (PFT) and the correlation between the LDCT volumes and lung density in restrictive lung disease. Patients with Systemic Sclerosis (SSc) with (n = 24) and without (n = 16) pulmonary involvement on sequential thin-section CT and patients with chronic obstructive pulmonary disease (COPD)(n = 29) underwent spirometrically-gated LDCT at 90% and 10% of vital capacity to measure inspiratory and expiratory lung volumes and mean lung attenuation (MLA). Total lung capacity and residual volume were measured the same day of CT. Inspiratory [95% limits of agreement (95% LoA)--43.8% and 39.2%] and expiratory (95% LoA -45.8% and 37.1%) lung volumes measured on LDCT and PFT showed poor agreement in SSc patients with pulmonary involvement, whereas they were in substantial agreement (inspiratory 95% LoA -14.1% and 16.1%; expiratory 95% LoA -13.5% and 23%) in SSc patients without pulmonary involvement and in inspiratory scans only (95% LoA -23.1% and 20.9%) of COPD patients. Inspiratory and expiratory LDCT volumes, MLA and their deltas differentiated both SSc patients with or without pulmonary involvement from COPD patients. LDCT lung volumes and density were not correlated in SSc patients with pulmonary involvement, whereas they did correlate in SSc without pulmonary involvement and in COPD patients. In restrictive lung disease due to SSc there is poor agreement between static lung volumes measured using LDCT and PFT and the relationship between volume and density values on CT is altered.

Chronic tuberculous empyema: relationships between preoperative CT findings and postoperative improvement measured by pulmonary function testing

International Nuclear Information System (INIS)

Kim, D.J.; Im, J.-G.; Goo, J.M.; Lee, H.J.; You, S.Y.; Song, J.W.

2005-01-01

AIMS: To evaluate whether preoperative computed tomography (CT) findings correlate with postoperative improvements in forced vital capacity (FVC) and forced expiratory volume during 1 s (FEV1) in persons who have undergone unilateral decortication because of unilateral chronic tuberculous empyema. METHODS: A retrospective study was carried out of 67 individuals who had undergone decortication because of chronic tuberculous empyema between January 1996 and December 2000. Of these, 13 subjects who had had preoperative chest CT and preoperative and postoperative pulmonary function tests (PFTs) were included in the investigation. On preoperative CT, the degree of volume reduction of the affected side was compared with that of the contralateral normal lung. The relative volume of empyema was calculated by dividing the volume occupied by the empyema by the sum of the total volume of the ipsilateral lung and the empyema volume. The thicknesses of pleura and extrapleural fat in the involved hemithorax were measured by CT at their thickest points, and the degree of atelectasis adjacent to the empyema in the diseased lung was assessed and classified. These five CT parameters and the ages of the patients were compared with preoperative and postoperative FVC and FEV1 changes. RESULTS: A significant negative correlation was found between FVC changes and the relative volume of the affected lung (FVC: p=0.039, RS=-0.58). FVC and FEV1 were found to be significantly and positively correlated with the relative volume of the empyema (FVC: p=0.005, RS=0.72; FEV1: p=0.014, RS=0.66) and the degree of atelectasis (FVC: p=0.007, RS=0.71; FEV1: p=0.029, RS=0.60) by Spearman's nonparametric correlation test. Other CT parameters and the ages of the patients were not found to be correlated with PFT changes. CONCLUSION: The relative volume of the affected side, the relative volume of empyema and the degree of atelectasis can predict improvements in FVC and FEV1 after decortication in patients

Diagnostic Instability and Reversals of Chronic Obstructive Pulmonary Disease Diagnosis in Individuals with Mild to Moderate Airflow Obstruction.

Science.gov (United States)

Aaron, Shawn D; Tan, Wan C; Bourbeau, Jean; Sin, Don D; Loves, Robyn H; MacNeil, Jenna; Whitmore, George A

2017-08-01

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive disease, and reversal of COPD diagnosis is thought to be uncommon. To determine whether a spirometric diagnosis of mild or moderate COPD is subject to variability and potential error. We examined two prospective cohort studies that enrolled subjects with mild to moderate post-bronchodilator airflow obstruction. The Lung Health Study (n = 5,861 subjects; study duration, 5 yr) and the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study (n = 1,551 subjects; study duration, 4 yr) were examined to determine frequencies of (1) diagnostic instability, represented by how often patients initially met criteria for a spirometric diagnosis of COPD but then crossed the diagnostic threshold to normal and then crossed back to COPD over a series of annual visits, or vice versa; and (2) diagnostic reversals, defined as how often an individual's COPD diagnosis at the study outset reversed to normal by the end of the study. Diagnostic instability was common and occurred in 19.5% of the Lung Health Study subjects and 6.4% of the CanCOLD subjects. Diagnostic reversals of COPD from the beginning to the end of the study period occurred in 12.6% and 27.2% of subjects in the Lung Health Study and CanCOLD study, respectively. The risk of diagnostic instability was greatest for subjects whose baseline FEV 1 /FVC value was closest to the diagnostic threshold, and the risk of diagnostic reversal was greatest for subjects who quit smoking during the study. A single post-bronchodilator spirometric assessment may not be reliable for diagnosing COPD in patients with mild to moderate airflow obstruction at baseline.

Effects of equipment and technique on peak flow measurements

Directory of Open Access Journals (Sweden)

O'Driscoll B Ronan

2006-06-01

Full Text Available Abstract Background Different lung function equipment and different respiratory manoeuvres may produce different Peak Expiratory Flow (PEF results. Although the PEF is the most common lung function test, there have been few studies of these effects and no previous study has evaluated both factors in a single group of patients. Methods We studied 36 subjects (PEF range 80–570 l/min. All patients recorded PEF measurements using a short rapid expiration following maximal inspiration (PEF technique or a forced maximal expiration to residual volume (FVC technique. Measurements were made using a Wright's peak flow meter, a turbine spirometer and a Fleisch pneumotachograph spirometer. Results The mean PEF was 8.7% higher when the PEF technique was used (compared with FVC technique, p Conclusion Peak flow measurements are affected by the instruction given and by the device and Peak Flow scale used. Patient management decisions should not be based on PEF measurement made on different instruments.

SHORT COMMUNICATION: Reduction of Spirometric Lung Function Tests in Habitually Smoking Healthy Young Adults: It’s Correlation with Pack Years

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Sumangala M Patil

2012-01-01

Full Text Available Background: Adolescent smoking and the subsequent health problems are a major concern today. However there are very few studies done on spirometric lung functions and its relation with pack years in young adult habitual smokers who are apparently healthy. Aims and Objectives: The present study is undertaken to assess the change in lung functions in apparently healthy young adult habitual smokers compared to their age matched controls. Materials and Methods: A random sample of apparently healthy young adult habitual smokers (n=40 and nonsmokers (n=40 between age group17-35 years with history suggesting of pack years of 2-10 years were selected from students & employee’s of B.L.D.E.U’s Sri B.M. Patil Medical College,Hospital & Research Centre Bijapur (Karnataka, India. Spirometric lung functions recorded were forced expiratory volume in one second (FEV1, FEV1%, Peak expiratory flow rate (PEFR and Maximal expiratory pressure (MEP. Results: The results suggested that inapparently healthy habitual smokers there was significant decrease in FEV1 (L (-13.34%, p<0.001, FEV1 % (-10.76%, p<0.001, PEFR (-45.26%, p<0.0001 and MEP (-35.51%, p<0.0001 compared to nonsmokers and decrease in FEV1 was negatively correlated withpack years in smokers (r2=0.063, p=0.001. Reduced lung functions and negative correlation to pack years may be attributed todecreased airway diameter & reflex broncho- constriction in response to inhaled smoke particles. Conclusions: In conclusion young adulthabitual smokers who were apparently healthy are more prone for respiratory dysfunction than their nonsmoker counterparts. FEV1 reduction in relation to pack years acts as an important determinant for detecting lung dysfunction in the early stage of the disease. As the risk of having smoking related diseases depends mainly on number of pack years, it is suggested that quitting smoking earliest helps to get greatest health benefits in apparently healthy young adult habitual smokers.

Quality of Life and Bronchial Hyper-Responsiveness in Subjects With Bronchiectasis: Validation of the Seattle Obstructive Lung Disease Questionnaire in Bronchiectasis.

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Bulcun, Emel; Arslan, Mesut; Ekici, Aydanur; Ekici, Mehmet

2015-11-01

Bronchiectasis can adversely affect quality of life. However, the tests examining quality of life in bronchiectasis are not sufficient. We examined the validity of a measure designed for COPD, the Seattle Obstructive Lung Disease Questionnaire (SOLQ), in bronchiectasis. In addition, we aimed to compare the quality of life of subjects with bronchiectasis and bronchial hyper-responsiveness with that of those without to identify the effective factors. We studied 78 subjects with clinically stable bronchiectasis and 41 healthy controls matched for age and sex. Subjects were assessed by the SOLQ. A detailed history, physical examination, the Medical Outcomes Study 36-Item Short Form questionnaire, the Hospital Anxiety and Depression Scale, and spirometric measurements were obtained. Cronbach α coefficients, which reflected internal consistency, were >0.70 for all SOLQ components except for treatment satisfaction. SOLQ component scores correlated with all of the component scores of the Medical Outcomes Study 36-Item Short Form questionnaire and the Hospital Anxiety and Depression Scale, confirming their concurrent validity. All SOLQ scores correlated positively with percent-of-predicted FEV1, whereas the physical function, treatment satisfaction, and emotional function correlated negatively with the exacerbation frequency in Pearson analysis. Emotional and physical functions were positively associated with percent-of-predicted FEV1 in linear regression analysis. Compared with subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had lower FEV1/FVC and more exacerbations/y. Compared with bronchiectasis subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had significantly lower SOLQ, physical function, and coping skills scores but not emotional function and treatment satisfaction. The SOLQ is a valid instrument for determining quality of life in subjects with bronchiectasis. Subjects with

Examination of post operative split lung function using quantitative xenon 133 (133Xe) inhalation scan

International Nuclear Information System (INIS)

Omote, Yoshiharu; Maeda, Tomio; Ikeda, Koichiro; Kubo, Yoshihiko

1992-01-01

133 Xe inhalation scan and ordinary lung function testing were performed three times in 34 patients undergoing pulmonary resection: before surgery, and one and six months postoperatively. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1.0 ) were used as spirometric parameters. From the 133 Xe inhalation scan, a split lung capacity (right to left, upper, middle and lower) and T1/2 (time required for half of the inhalation of 133 Xe gas to be expired) were calculated by computer and used as indices of split lung capacity and ventilation, respectively. The predicted postoperative lung functions were calculated using preoperative spirometric respiratory function and 133 Xe inhalation data according to the formula reported by Ali and associates. At sixth postoperative month, both predicted FVC (r=0.895, p 1.0 (r=0.897, p<0.001) correlated highly with those actually observed. These results appear to be very useful for preoperative evaluation of operative indications and the choice of surgical method. The ratios of observed to predicted lung capacity in the post operative state were examined by splitting the right and left lung and the means±S.D.(%) were 80.5±9.7% on the operated side and 119.2±11.7% on the opposite side one month after surgery. Six months after surgery, the corresponding figures were 111.0±5.6% and 96.7±16.4%. The post operative T1/2 values on the operated sides were about 2.4 times the preoperative values at one month after surgery but returned to the preoperative values by the six postoperative month. From these results, it can be said that respiratory functions after pulmonary resection are maintained primarily by compensatory lung function of opposite and operated sides at one and six months, respectively. These results also provide valuable information on postoperative respiratory care for patients who have undergone lung resection. (author)

Relationship between lung function and grip strength in older hospitalized patients: a pilot study

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Holmes SJ

2017-04-01

Full Text Available Sarah J Holmes,1 Stephen C Allen,2,3 Helen C Roberts4,5 1Medicine and Elderly Care, Hampshire Hospitals NHS Foundation Trust, Winchester, 2Medicine and Geriatrics, The Royal Bournemouth Hospital and Christchurch Hospitals NHS Foundation Trust, Bournemouth, 3Centre of Postgraduate Medical Research and Education, Bournemouth University, Poole, 4Academic Geriatric Medicine, University of Southampton, 5University Hospital Southampton NHS Foundation Trust, Southampton, UK Objective: Older people with reduced respiratory muscle strength may be misclassified as having COPD on the basis of spirometric results. We aimed to evaluate the relationship between lung function and grip strength in older hospitalized patients without known airways disease.Methods: Patients in acute medical wards were recruited who were aged ≥70 years; no history, symptoms, or signs of respiratory disease; Mini Mental State Examination ≥24; willing and able to consent to participate; and able to perform hand grip and forced spirometry. Data including lung function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, peak expiratory flow rate [PEFR], and slow vital capacity [SVC], grip strength, age, weight, and height were recorded. Data were analyzed using descriptive statistics and linear regression unadjusted and adjusted (for age, height, and weight.Results: A total of 50 patients (20 men were recruited. Stronger grip strength in men was significantly associated with greater FEV1, but this was attenuated by adjustment for age, height, and weight. Significant positive associations were found in women between grip strength and both PEFR and SVC, both of which remained robust to adjustment.Conclusion: The association between grip strength and PEFR and SVC may reflect stronger patients generating higher intrathoracic pressure at the start of spirometry and pushing harder against thoracic cage recoil at end-expiration. Conversely, patients with

Gender differences in first and secondhand smoke exposure, spirometric lung function and cardiometabolic health in the old order Amish: A novel population without female smoking.

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Reed, Robert M; Dransfield, Mark T; Eberlein, Michael; Miller, Michael; Netzer, Giora; Pavlovich, Mary; Pollin, Toni I; Scharf, Steven M; Shuldiner, Alan R; Sin, Don; Mitchell, Braxton D

2017-01-01

Due to their relatively homogeneous lifestyle and living environment, the Amish offer a novel opportunity to study the health associations of tobacco smoke exposure, particularly secondhand smoke. We hypothesized that secondhand smoke exposure is associated with worse pulmonary and cardiometabolic health. We examined cross-sectional data on 3568 Amish study participants, including tobacco use and secondhand smoke exposure from family members included in the study. Thirty-four percent of Amish men reported ever smoking. Of this proportion, 64% used cigars, 46% cigarettes, and 21% pipes. Less than 1% of women reported ever smoking. Smoking was associated with lower spirometric lung function, higher body mass index, lower HDL cholesterol, higher heart rate, lower ankle-brachial index, and larger aortic diameter in men. A greater number of sources of secondhand smoke exposure (defined from the total of spouses, parents, and siblings who smoke) was associated with higher body mass index (p = 0.03) and with higher fasting glucose in men (p = 0.01), but not in women (p = 0.007 for sex*secondhand smoke interaction). Secondhand smoke exposure was also associated with reduced HDL cholesterol only in women (p = 0.002) and a lower heart rate only in men (p = 0.006). Smoking habits among the Old Order Amish are notable for the absence of female participation and a high proportion of cigar and pipe use. Smoking is associated with decreased spirometric indices of lung function and increased cardiovascular risk in this population and secondhand smoke exposure is associated with a greater burden of risk factors for cardiovascular disease. Sex differences in correlations could reflect differences in exposure patterns, mechanisms, or susceptibilities.

[Playing of wind instruments is associated with an obstructive pattern in the spirometry of adolescents with a good aerobic resistance capacity].

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Granell, Javier; Granell, Jose; Ruiz, Diana; Tapias, Jose A

2011-03-01

There is controversy in the medical literature regarding the beneficial or detrimental effects of playing wind musical instruments on the respiratory system. The aim of this study is to analyse this relationship, taking the physical condition of the subjects into consideration. Cross-sectional observational study. Public institution with coordinated medium grade musical instruction and primary and secondary education. Young performers (between 13 and 17 years). We collected basic epidemiological parameters (gender, age, weight, size, heath status), and each subject underwent a fitness test ("course navette" cardiorespiratory fitness test) and a forced spirometry. We included 90 students, 53 females and 37 males. Thirty two were wind instrument players and 58 studied other instruments. The two groups were homogeneous with respect to gender, age and body mass index. The maximum oxygen uptake showed no significant difference (P=0.255), further demonstrating an adequate level of fitness compared to the general population. FVC was normal and similar in both groups (P=0.197). The FEV(1) percentage and the FEV(1)/FVC ratio were significantly lower (Pstudy of wind instruments was associated with an obstructive spirometric pattern in young musicians with a normal level of physical fitness. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Computed tomography measurement of rib cage morphometry in emphysema.

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Nicola Sverzellati

Full Text Available BACKGROUND: Factors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers. METHODS: Rib cage diameters and areas (calculated from the inner surface of the rib cage in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT. CTs were analyzed with software, which allows quantification of total emphysema (emphysema%. The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models. RESULTS: A model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1%, and forced vital capacity (FVC% fit best with the rib cage measurements (R(2 = 64% for the rib cage area variation at the lower anatomical level. Gender had the biggest impact on rib cage diameter and area (105.3 cm(2; 95% CI: 111.7 to 98.8 for male lower area. Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm(2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%. Lower rib cage areas decreased as FVC% decreased (5.1 cm(2; 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation. CONCLUSIONS: This study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.

Vital capacity and COPD: the Swedish CArdioPulmonary bioImage Study (SCAPIS

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Torén K

2016-05-01

Full Text Available Kjell Torén,1 Anna-Carin Olin,1 Anne Lindberg,2 Jenny Vikgren,3 Linus Schiöler,1 John Brandberg,3 Åse Johnsson,3 Gunnar Engström,4 H Lennart Persson,5 Magnus Sköld,6 Jan Hedner,7 Eva Lindberg,8 Andrei Malinovschi,8 Eeva Piitulainen,9 Per Wollmer,9 Annika Rosengren,10 Christer Janson,8 Anders Blomberg,2 Göran Bergström10 1Section of Occupational and Environmental Medicine, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 2Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, 3Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 4Department of Clinical Science, Malmö, Lund University, Lund, 5Department of Respiratory Medicine and Department of Medicine and Health Sciences, Linköping University, Linköping, 6Respiratory Medicine Unit, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, 7Department of Internal Medicine/Lung Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 8Department of Medical Sciences, Clinical Physiology and Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, 9Department of Translational Medicine, Lund University, Malmö, 10Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Background: Spirometric diagnosis of chronic obstructive pulmonary disease (COPD is based on the ratio of forced expiratory volume in 1 second (FEV1/vital capacity (VC, either as a fixed value <0.7 or below the lower limit of normal (LLN. Forced vital capacity (FVC is a proxy for VC. The first aim was to compare the use of FVC and VC, assessed as the highest value of FVC or slow vital capacity (SVC, when assessing the FEV1/VC ratio in a general population

Reference values of fractional excretion of exhaled nitric oxide among non-smokers and current smokers.

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Torén, Kjell; Murgia, Nicola; Schiöler, Linus; Bake, Björn; Olin, Anna-Carin

2017-08-25

Fractional exhaled nitric oxide (FE NO ) is used to assess of airway inflammation; diagnose asthma and monitor adherence to advised therapy. Reliable and accurate reference values for FE NO are needed for both non-smoking and current smoking adults in the clinical setting. The present study was performed to establish reference adult FE NO values among never-smokers, former smokers and current smokers. FE NO was measured in 5265 subjects aged 25-75 years in a general-population study, using a chemiluminescence (Niox ™) analyser according to the guidelines of the American Thoracic Society and the European Respiratory Society. Atopy was based on the presence of immunoglobulin E (IgE) antibodies to common inhalant allergens (measured using Phadiatop® test). Spirometry without bronchodilation was performed and forced vital capacity (FVC), forced expired volume in 1 s (FEV 1 ) and the ratio of FEV 1 to FVC values were obtained. After excluding subjects with asthma, chronic bronchitis, spirometric airway obstruction and current cold, 3378 subjects remained. Equations for predictions of FE NO values were modelled using nonparametric regression models. FE NO levels were similar in never-smokers and former smokers, and these two groups were therefore merged into a group termed "non-smokers". Reference equations, including the 5th and 95th percentiles, were generated for female and male non-smokers, based on age, height and atopy. Regression models for current smokers were unstable. Hence, the proposed reference values for current smokers are based on the univariate distribution of FE NO and fixed cut-off limits. Reference values for FE NO among respiratory healthy non-smokers should be outlined stratified for gender using individual reference values. For current smokers separate cut-off limits are proposed.

Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

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Russold, Elena; Ambrisko, Tamas D; Schramel, Johannes P; Auer, Ulrike; Van Den Hoven, Rene; Moens, Yves P

2013-01-01

To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Prospective randomized experimental study. Five experimental horses. Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis

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Adam, Martin; Schikowski, Tamara; Carsin, Anne Elie; Cai, Yutong; Jacquemin, Benedicte; Sanchez, Margaux; Vierkötter, Andrea; Marcon, Alessandro; Keidel, Dirk; Sugiri, Dorothee; Al Kanani, Zaina; Nadif, Rachel; Siroux, Valérie; Hardy, Rebecca; Kuh, Diana; Rochat, Thierry; Bridevaux, Pierre-Olivier; Eeftens, Marloes; Tsai, Ming-Yi; Villani, Simona; Phuleria, Harish Chandra; Birk, Matthias; Cyrys, Josef; Cirach, Marta; de Nazelle, Audrey; Nieuwenhuijsen, Mark J.; Forsberg, Bertil; de Hoogh, Kees; Declerq, Christophe; Bono, Roberto; Piccioni, Pavilio; Quass, Ulrich; Heinrich, Joachim; Jarvis, Deborah; Pin, Isabelle; Beelen, Rob; Hoek, Gerard; Brunekreef, Bert; Schindler, Christian; Sunyer, Jordi; Krämer, Ursula; Kauffmann, Francine; Hansell, Anna L.; Künzli, Nino; Probst-Hensch, Nicole

2015-01-01

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exposure to nitrogen oxides (NO2, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis. We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 μg·m−3 increase in NO2 exposure was associated with lower levels of FEV1 (−14.0 mL, 95% CI −25.8 to −2.1) and FVC (−14.9 mL, 95% CI −28.7 to −1.1). An increase of 10 μg·m−3 in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV1 (−44.6 mL, 95% CI −85.4 to −3.8) and FVC (−59.0 mL, 95% CI −112.3 to −5.6). The associations were particularly strong in obese persons. This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe. PMID:25193994

Respiratory symptoms, spirometry, and oxidant air pollution in nonsmoking adults

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Cohen, C.A.; Hudson, A.R.; Clauson, J.L.; Knelson, J.H.

1972-01-01

Comparison of 197 nonsmokers (Seventh Day Adventists) residing in the San Gabriel Valley (high oxidant) with 244 living in San Diego area (similar pollution but with lower oxidant) is discussed. Study was conducted in winter when differences between the two areas were negligible and thus when irreversible effects could be detected. Some unusual findings included: an unexpectedly low chronic bronchitis prevalence rate of 1.77% as compared with the general population, a greater prevalence of chronic bronchitis in women in both areas (not significant), and no effect of socio-economic status. Comparison of pulmonary function using VC, FEV, MEF, peak flow, time constant, and FVC showed no differences between the two groups. The annual mean oxidant level is about the same in both areas and may have influenced spirometric values more than oxidant peaks. Also, these tests may not have been sufficiently sensitive.

PIKO-6® vs. forced spirometry in asthmatic children.

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Gochicoa-Rangel, Laura; Larios-Castañeda, Pablo José; Miguel-Reyes, José Luis; Briseño, David Martínez; Flores-Campos, Roberto; Sáenz-López, Juan Arturo; Torre-Bouscoulet, Luis

2014-12-01

The PIKO-6® is an electronic device that measures forced expiratory volume at seconds 1 (FEV1) and 6 (FEV6) of a forced vital capacity (FVC) maneuver. This device could aid in diagnosing obstructive respiratory diseases. To determine the concordance of FEV1, FEV6, and the FEV1/FEV6 quotient achieved with PIKO-6® versus spirometric values from asthmatic patients, and compare results with measures from healthy children. A cross-sectional study with asthmatic and healthy 6-to-14-year-old children, all of whom performed a forced spirometry as well as a PIKO-6® test. The study included 82 subjects (58 asthmatics, 24 healthy children). Except for the functional parameters, the basal characteristics of the two groups were similar. The concordance correlation coefficient (CCC) for FEV1 was 0.938 (P spirometry was lower in patients with partially controlled or uncontrolled asthma compared to controlled or healthy children. The broad limits of agreement show that the FEV1, FEV6, and FEV1/FEV6 obtained with the PIKO-6® are not interchangeable with spirometry results. Longitudinal evaluations of asthma patients are necessary to assess the utility of PIKO-6®. © 2014 Wiley Periodicals, Inc.

Semiautomatic assessment of respiratory motion in dynamic MRI. Comparison with simultaneously acquired spirometry

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Tetzlaff, R.; Eichinger, M.; Puderbach, M. [Radiologie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Schoebinger, M.; Meinzer, H.P. [Medizinische und Biologische Informatik, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Kauczor, H.U. [Diagnostische Radiologie, Radiologische Universitaetsklinik, Heidelberg (Germany)

2008-11-15

Purpose: supplementing global spirometry with regional information could allow for earlier and more specific diagnosis of lung disease. Dynamic magnetic resonance imaging (dMRI) makes it possible to derive functional parameters from the visualization of the pulmonary motion of single lungs. The aim of this study was to compare high temporal resolution measurements of left and right thoracic diameters to simultaneously acquired spirometry. Materials and methods: 10 healthy volunteers underwent 2-dimensional dMRI of both lungs at 1.5 T. Spirometry was performed simultaneously with an MRI-compatible spirometer. Thoracic diameters were measured semiautomatically and compared to simultaneously measured spirometric volumes. A dMRI surrogate for the Tiffeneau Index was compared to the spirometric Tiffeneau. Results: The volume-time and flow-volume curves from dMRI were very similar to the spirometric curves. The semiautomatically measured diameters correlated well with the spirometric volumes (r > = 0.8, p < 10-15). Agreement between the methods at full temporal resolution was not as convincing (width of 95% limits of agreement interval up to 56%). Good agreement was found between the Tiffenau surrogate and spirometry (width of 95% limits of agreement interval of 14.5%). (orig.)

Semiautomatic assessment of respiratory motion in dynamic MRI. Comparison with simultaneously acquired spirometry

International Nuclear Information System (INIS)

Tetzlaff, R.; Eichinger, M.; Puderbach, M.; Schoebinger, M.; Meinzer, H.P.; Kauczor, H.U.

2008-01-01

Purpose: supplementing global spirometry with regional information could allow for earlier and more specific diagnosis of lung disease. Dynamic magnetic resonance imaging (dMRI) makes it possible to derive functional parameters from the visualization of the pulmonary motion of single lungs. The aim of this study was to compare high temporal resolution measurements of left and right thoracic diameters to simultaneously acquired spirometry. Materials and methods: 10 healthy volunteers underwent 2-dimensional dMRI of both lungs at 1.5 T. Spirometry was performed simultaneously with an MRI-compatible spirometer. Thoracic diameters were measured semiautomatically and compared to simultaneously measured spirometric volumes. A dMRI surrogate for the Tiffeneau Index was compared to the spirometric Tiffeneau. Results: The volume-time and flow-volume curves from dMRI were very similar to the spirometric curves. The semiautomatically measured diameters correlated well with the spirometric volumes (r > = 0.8, p < 10-15). Agreement between the methods at full temporal resolution was not as convincing (width of 95% limits of agreement interval up to 56%). Good agreement was found between the Tiffenau surrogate and spirometry (width of 95% limits of agreement interval of 14.5%). (orig.)

Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

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Arjomandi, Mehrdad; Zeng, Siyang; Geerts, Jeroen; Stiner, Rachel K; Bos, Bruce; van Koeverden, Ian; Keene, Jason; Elicker, Brett; Blanc, Paul D; Gold, Warren M

2018-01-01

Exposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV 1 /FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear. To investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO 2max ) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)). RV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV 1 /FVC and FEV 1 , respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r 2 =0.03; p=0.011) and lower VO 2max (n=179; r 2 =0.47; p=0.013), and %EFL was negatively associated with VO 2max (n=32; r 2 =0.40; p=0.017). In those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity.

Prognostic value of nutritional status in chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Landbo, C; Prescott, E; Lange, P

1999-01-01

The association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) is a common clinical observation. We prospectively examined whether BMI is an independent predictor of mortality in subjects with COPD from the Copenhagen City Heart...... Study. In total, 1,218 men and 914 women, aged 21 to 89 yr, with airway obstruction defined as an FEV(1)-to-FVC ratio of less than 0.7, were included in the analyses. Spirometric values, BMI, smoking habits, and respiratory symptoms were assessed at the time of study enrollment, and mortality from COPD...... with that in subjects of normal weight of 1.64 (95% confidence interval [CI]: 1.20 to 2.23) in men and 1.42 (95% CI: 1.07 to 1.89) in women. However, the association between BMI and survival differed significantly with stage of COPD. In mild and moderate COPD there was a nonsignificant U-shaped relationship...

Respiratory Abnormalities among Occupationally Exposed, Non-Smoking Brick Kiln Workers from Punjab, India.

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Tandon, Supriya; Gupta, Sharat; Singh, Sharanjeet; Kumar, Avnish

2017-07-01

Brick manufacturing industry is one of the oldest and fast-growing industries in India that employs a large section of people. Brick kiln workers are occupationally exposed to air pollutants. Nonetheless, only a few studies have so far been conducted on their respiratory health. To investigate the extent of respiratory impairment in brick kiln workers and to correlate it with the duration of exposure. A cross-sectional study was conducted. Spirometric parameters of 110 non-smoking male brick kiln workers aged 18-35 years in Patiala district, Punjab, India, were compared with an age-matched comparison group of 90 unexposed individuals. Brick kiln workers showed a significant (pworkers was associated with the duration of exposure. In workers with >8 years of exposure, the mean values of FEV 1 (1.92 L), FVC (2.01 L), FEF 25-75% (2.19 L/s) and PEFR (4.81 L/s) were significantly (pworkers with workers.

Efficiency of lung ventilation for people performing wind instruments.

Science.gov (United States)

Brzęk, Anna; Famuła, Anna; Kowalczyk, Anna; Plinta, Ryszard

Wind instruments musicians are particularly prone to excessive respiratory efforts. Prolonged wind instruments performing may lead to changes in respiratory tracts and thus to respiratory muscles overload. It may result in decreasing lung tissue pliability and, as a consequence, in emphysema. Aim of the research has been to describe basic spirometric parameters for wind players and causes of potential changes. Slow and forced spirometry with the use of Micro Lab Viasys (Micro Medical, Great Britain) was conducted on 31 wind musicians (group A). A survey concerning playing time and frequency, weight of instruments, and education on diaphragmatic breathing was conducted. The control group included 34 healthy persons at similar age (group B). The results were statistically described using Excel and Statistica programmes. The respiratory parameters were within the range of physiological norms and forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) exceeded in both groups the values of 100%. Forced vital capacity and expiratory vital capacity (EVC) values were significantly lower in the group of musicians than in the control group (p wind instrument. Spirometric parameters relative to standards may prove a good respiratory capacity. Peak expiratory flow (PEF) and FEV1 may indicate that a proper technique of respiration during performance was acquired. The length of time when performing wind instrument may influence parameters of dynamic spirometry. Med Pr 2016;67(4):427-433. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Prevalence and risk factors of COPD among never-smokers in two areas of Sweden - Occupational exposure to gas, dust or fumes is an important risk factor.

Science.gov (United States)

Hagstad, Stig; Backman, Helena; Bjerg, Anders; Ekerljung, Linda; Ye, Xiong; Hedman, Linnea; Lindberg, Anne; Torén, Kjell; Lötvall, Jan; Rönmark, Eva; Lundbäck, Bo

2015-11-01

Although active tobacco smoking is the main risk factor for COPD, COPD is not uncommon also among never-smokers. Different study locations along with different spirometric definitions of COPD have historically yielded different prevalence estimates of the disease. To study current prevalence and risk factors of COPD among never-smokers in two areas of Sweden. Data collected in 2008-2012 within the West Sweden Asthma Study and Obstructive Lung Disease in Northern Sweden Studies was pooled. The study population consisted of 1839 subjects who participated in spirometry and interviews. COPD was defined as post-bronchodilator a) FEV(1)/(F)VC never-smokers. Among the never-smoking subjects, the prevalence of COPD according to definitions a-c was 7.7%, 4.9% and 3.0%, respectively. The corresponding prevalence of GOLD grade ≥2 was 2.0%, 1.4% and 1.3%. No significant difference in prevalence between the two study areas was observed. In never-smokers, occupational exposure to gas, dust or fumes (GDF) was significantly associated with both COPD (OR 1.85, 95% CI 1.03-3.33), and GOLD ≥2 (OR 4.51, 1.72-11.9) according to definition a), after adjusting for age, educational level and exposure to passive smoking at work. Depending on definition, prevalence of COPD among never-smokers was 3.0-7.7%, whereas GOLD ≥2 was present in 1.3-2.0%. Occupational exposure to GDF remained independently and significantly associated with COPD regardless of spirometric definition of the disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

Measurement of lung volume by lung perfusion scanning using SPECT and prediction of postoperative respiratory function

International Nuclear Information System (INIS)

Andou, Akio; Shimizu, Nobuyosi; Maruyama, Shuichiro

1992-01-01

Measurement of lung volume by lung perfusion scanning using single photon emission computed tomography (SPECT) and its usefulness for the prediction of respiratory function after lung resection were investigated. The lung volumes calculated in 5 patients by SPECT (threshold level 20%) using 99m Tc-macroaggregated albumin (MAA), related very closely to the actually measured lung volumes. This results prompted us to calculate the total lung volume and the volume of the lobe to be resected in 18 patients with lung cancer by SPECT. Based on the data obtained, postoperative respiratory function was predicted. The predicted values of forced vital capacity (FVC), forced expiratory volume (FEV 1.0 ), and maximum vital volume (MVV) showed closer correlations with the actually measured postoperative values (FVC, FEV 1.0 , MVV : r=0.944, r=0.917, r=0.795 respectively), than the values predicted by the ordinary lung perfusion scanning. This method facilitates more detailed evaluation of local lung function on a lobe-by-lobe basis, and can be applied clinically to predict postoperative respiratory function. (author)

Comparative assessment of respiratory and other occupational health effects among elementary workers.

Science.gov (United States)

Hamid, Almas; Saleem, Wajeeha; Yaqub, Ghazala; Ghauri, Moin Ud Din

2017-12-14

This study was conducted to assess hazards faced by elementary workers. A questionnaire survey and a respiratory function test (spirometry) were carried out on 150 respondents. Major hazards identified related to sharp objects, heavy weight lifting, thermally harsh conditions, working at height, whole body vibration, chemicals, pathogens, increased noise levels and confined space entry. Workers suffered from upper and lower respiratory disorder symptoms, digestive problems, optical and musculoskeletal issues, etc. Spirometric measurement showed obstructive lung disorders to be highest among construction workers (CW) (48%) followed by sanitation workers (SW) (32%) and solid waste pickers (SWP) (28%). Restrictive lung pattern was dominant among SW (56%) followed by SWP (46%) and CW (42%). The observed FEV 1 /FVC in diseased SWP, SW and CW ranged from 51 to 96%, from 52 to 98% and from 31 to 99% respectively while observed mean FEV 1 was 2.15, 1.79 and 1.70 L, respectively. The study findings show that occupational exposure can significantly influence respiratory system impairment and contribute to other ailments among elementary workers. The study recommends use of appropriate protective equipment and regular medical examination for early recognition of any health risk so that timely interventions for effective management may be undertaken.

Comparison of five portable peak flow meters.

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Takara, Glaucia Nency; Ruas, Gualberto; Pessoa, Bruna Varanda; Jamami, Luciana Kawakami; Di Lorenzo, Valéria Amorim Pires; Jamami, Mauricio

2010-05-01

To compare the measurements of spirometric peak expiratory flow (PEF) from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone, Assess, Galemed, Personal Best and Vitalograph peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (pmeters were 428 (263-688 L/min), 450 (350-800 L/min), 420 (310-720 L/min), 380 (300-735 L/min), 400 (310-685 L/min) and 415 (335-610 L/min), respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone(R) (pmeters. There was no agreement between the spirometric values and the five PEF meters. The results suggest that the values recorded from Galemed meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system.

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De Palma, Angela; Sollitto, Francesco; Loizzi, Domenico; Di Gennaro, Francesco; Scarascia, Daniele; Carlucci, Annalisa; Giudice, Giuseppe; Armenio, Andrea; Ludovico, Rossana; Loizzi, Michele

2016-03-01

We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16-83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. An optimal chest wall stabilization and reconstruction was achieved with the Synthes(®) titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long

Comparação da variação de resposta ao broncodilatador através da espirometria em portadores de asma ou doença pulmonar obstrutiva crônica Comparison of spirometric changes in the response to bronchodilators of patients with asthma or chronic obstructive pulmonary disease

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Isabella Correia Silvestri

2008-09-01

Full Text Available OBJETIVO: O diagnóstico diferencial entre asma e doença pulmonar obstrutiva crônica (DPOC através da resposta aos broncodilatadores inalatórios na espirometria ainda é controverso. O objetivo deste estudo foi detectar quais variáveis espirométricas melhor diferenciam asma de DPOC. MÉTODOS: Estudo retrospectivo realizado entre abril de 2004 e janeiro de 2006, comparando-se os parâmetros espirométricos de 103 pacientes asmáticos, não fumantes, com os de 108 pacientes portadores de DPOC, fumantes de mais de 10 anos-maço. Todos os pacientes tinham mais de 40 anos e apresentavam doença estável no momento do exame. RESULTADOS: O volume expiratório forçado no primeiro segundo (VEF1 pré-broncodilatador foi igual nos dois grupos (VEF1 = 51%, mas os portadores de DPOC eram mais velhos (66 ± 9 anos vs. 59 ± 11 anos, p 10% constitui o melhor parâmetro espirométrico para diferenciar asma de DPOC.OBJECTIVE: Making the differential diagnosis between asthma and chronic obstructive pulmonary disease (COPD based on the response to inhaled bronchodilators by means of spirometry is controversial. The objective of this study was to identify the most useful spirometric variables in order to distinguish between asthma and COPD. METHODS: Retrospective study conducted from April of 2004 to January of 2006, comparing the spirometric parameters of 103 nonsmoking patients with asthma to those of 108 patients with COPD who were smokers for more than 10 pack-years. All of the patients included in the study were older than 40 and presented stable disease at the time of the test. RESULTS:Initial forced expiratory volume in one second (FEV1 was the same in the two groups (pre-bronchodilator VEF1 = 51%. However, patients with COPD were older (66 ± 9 years vs. 59 ± 11 years, p 10% is the best spirometric parameter to distinguish asthma from COPD.

The objective evaluation of obstructive pulmonary diseases with spirometry

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Özkaya S

2016-08-01

Full Text Available Sevket Ozkaya,1 Adem Dirican,2 Tibel Tuna3 1Department of Pulmonary Medicine, Faculty of Medicine, Bahçes¸ehir University, Istanbul, 2Department of Pulmonary Medicine, Samsun Medical Park Hospital, 3Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey Abstract: Airway obstruction is variable in asthma, while it is progressive and persistent in chronic bronchitis and emphysema. However, some of the patients presenting with symptoms of chronic airway diseases have clinical features of both asthma and COPD. The group with “Asthma–COPD Overlap Syndrome” (ACOS phenotype was characterized by definitely irreversible airway obstruction accompanied by symptoms and signs of reversibility. In this study, we aimed to classify obstructive airway diseases by clinical, radiological, and pulmonary function tests. Patients at Samsun Medical Park Hospital Chest Diseases outpatient clinic were evaluated between January 2013 and April 2016, and a total of 235 patients were included in this study. Mean age of the patients was 55.3±14.5 (15–88 years, and the male/female ratio was 45/190. The baseline pulmonary function test results of the patients were as follows: mean forced vital capacity (FVC values 2,825±1,108 (710–6,870 mL and 74.3±22.4 (24–155%, forced expiratory volume in 1 second (FEV1 values 1,789±774 (480–4,810 mL and 58.1±20.0 (20–130%, FEV1/FVC values 62.5±6.8 (39–70%. Reversibility criteria following bronchodilator treatment were present in 107 (45.5% patients. We specified five subgroups for patients according to their clinical, radiological, and pulmonary test findings, namely Group 1 (asthma, Group 2 (ACOS, Group 3 (chronic bronchitis, and Group 4 (emphysema. Additionally, a group of patients who had clinical and spirometric features of both asthma and chronic bronchitis in association with underlying emphysema (emphysema with chronic bronchitis and emphysema with asthma

Respiratory effects of air pollutants among nonsmoking traffic policemen of Patiala, India

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Sharat Gupta

2011-01-01

Full Text Available Background: Air pollution due to road traffic is a serious health hazard and thus the persons who are continuously exposed, may be at an increased risk. Although several studies have confirmed the ill effects of air pollutants on the lung function of traffic policemen, only a few have investigated the relationship between respiratory health and duration of exposure in this category of occupationally exposed persons. Aim: The study was carried out with the aim of evaluating the extent of impairment in lung function in traffic policemen in respect to an unexposed control group having the same age group. Materials and Methods: A cross-sectional study was conducted in which the spirometric parameters of a group of 100 nonsmoking traffic policemen, aged 20-55 years, working in and around Patiala city, were compared with those obtained in an age-matched control group, consisting of 100 healthy males, serving in the Punjab Police, who have never done traffic duty and are thus not exposed to traffic pollution. Lung function was done with MEDSPIROR. The data on the overall health status of the subjects was collected using the standard Respirator Medical Evaluation Questionnaire. The statistical analysis was carried out with SPSS PC software version 13. Results: Traffic policemen recorded a significant decline in various parameters, such as forced vital capacity (FVC, forced expiratory volume in one second (FEV 1 , and peak expiratory flow rate (PEFR when compared with controls, and is probably due to exposure to vehicular pollution. It was also observed that in traffic policemen with >8 years of exposure, the values of FVC (2.7 L, FEV 1 (1.8 L, and PEFR (7.5 L/s were significantly lower than those obtained in traffic policemen with <8 years of exposure, in whom the values were 2.9 L, 2.3 L, and 7.7 L/s for FVC, FEV 1, and PEFR, respectively. Conclusion: The effect of pollution by vehicular exhausts may be responsible for these pulmonary function

Comparison of five portable peak flow meters

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Glaucia Nency Takara

2010-01-01

Full Text Available OBJECTIVE: To compare the measurements of spirometric peak expiratory flow (PEF from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. METHODS: Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (p<0.05, Spearman's correlation test and Bland-Altman's agreement test. RESULTS: The median and interquartile ranges for the spirometric values and the Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® meters were 428 (263-688 L/min, 450 (350-800 L/min, 420 (310-720 L/min, 380 (300-735 L/min, 400 (310-685 L/min and 415 (335-610 L/min, respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone® (p<0.001 and Galemed ® (p<0.01 meters. There was no agreement between the spirometric values and the five PEF meters. CONCLUSIONS: The results suggest that the values recorded from Galemed® meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone® meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

Cardio-respiratory response of young adult Indian male subjects to stress: Effects of progressive muscle relaxation

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Arunima Chaudhuri

2014-01-01

Full Text Available Background: Stress and anxiety have become an integral part of our lives. Of late, this has resulted in the increase in incidence of hypertension and coronary heart disease. Objectives: To assess the effect of progressive muscle relaxation (PMR on young adult males and its role in the modulation of cardio-respiratory response on exposure to stress. Materials and Methods: This prospective cross-sectional study was conducted in a tertiary care referral hospital. Undergraduate male students under stress were chosen for the study. Fasting blood samples were drawn to analyze sugar and lipid profile, followed by anthropometric measurements and ECG. In the resting condition, blood pressure, pulse rate, and spirometric parameters; forced vital capacities (FVC, and forced expiratory volume in 1 sec (FEV 1 % were measured. Then, they were made to exercise with bicycle ergometer and post exercise, the vital parameters were recorded. All subjects were given a training of Jacobson′s Progressive Muscular Relaxation and asked to practice this technique for 3 months. All parameters were re-evaluated. Results: Significant decreases in resting heart rate, systolic blood pressure and diastolic blood pressure, total cholesterol, triglyceride, and low density lipoprotein (LDL cholesterol levels of subjects were seen after PMR training. Exercise-induced rise in heart rate and blood pressure were also significantly less in subjects following PMR training. Conclusion: Progressive muscle relaxation helps in modulation of heart rate, blood pressure, and lipid profile in healthy normal adult male individuals.

Can Serum Surfactant Protein D or CC-Chemokine Ligand 18 Predict Outcome of Interstitial Lung Disease in Patients with Early Systemic Sclerosis?

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Elhaj, Mona; Charles, Julio; Pedroza, Claudia; Liu, Xiaochun; Zhou, Xiaodong; Estrada-Y-Martin, Rosa M.; Gonzalez, Emilio B.; Lewis, Dorothy E.; Draeger, Hilda T.; Kim, Sarah; Arnett, Frank C.; Mayes, Maureen D.; Assassi, Shervin

2013-01-01

Objective To examine the predictive significance of 2 pneumoproteins, surfactant protein D (SP-D) and CC-chemokine ligand 18 (CCL18), for the course of systemic sclerosis (SSc)-related interstitial lung disease. Methods The pneumoproteins were determined in the baseline plasma samples of 266 patients with early SSc enrolled in the GENISOS observational cohort. They also were measured in 83 followup patient samples. Pulmonary function tests were obtained annually. The primary outcome was decline in forced vital capacity (FVC percentage predicted) over time. The predictive significance for longterm change in FVC was investigated by a joint analysis of longitudinal measurements (sequentially obtained FVC percentage predicted) and survival data. Results SP-D and CCL18 levels were both higher in patients with SSc than in matched controls (p < 0.001 and p = 0.015, respectively). Baseline SP-D levels correlated with lower concomitantly obtained FVC (r = −0.27, p < 0.001), but did not predict the short-term decline in FVC at 1 year followup visit or its longterm decline rate. CCL18 showed a significant correlation with steeper short-term decline in FVC (p = 0.049), but was not a predictor of its longterm decline rate. Similarly, a composite score of SP-D and CCL18 was a significant predictor of short-term decline in FVC but did not predict its longterm decline rate. Further, the longitudinal change in these 2 pneumoproteins did not correlate with the concomitant percentage change in FVC. Conclusion SP-D correlated with concomitantly obtained FVC, while CCL18 was a predictor of short-term decline in FVC. However, neither SP-D nor CCL18 was a longterm predictor of FVC course in patients with early SSc. PMID:23588945

Spirometric and hygienic criteria in recognition of occupational COPD in Poland - A retrospective analysis of medical records.

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Kleniewska, Aneta; Walusiak-Skorupa, Jolanta; Lipińska-Ojrzanowska, Agnieszka; Szcześniak, Kamila; Wiszniewska, Marta

2018-01-07

Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment - clinical or hygienic one - is responsible for such a low rate of occupational COPD recognitions. The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases. In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients. In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139-150. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Impact of air quality in Kuala Lumpur on human lung function

International Nuclear Information System (INIS)

Noor, H.; Mohammad, F.; Othman, Z.; Rashid, N.; Johan, R.; Awang, M.; Jaafar, Abu-Bakar

1998-01-01

In Malaysia, the 1997 haze was the worst air pollution episode ever experienced by the country. The polluted air consists of various of various gases and aerosols including nitrogen dioxide and particulate matter (PM/sub 10/). A spirometry study on lung function of traffic policemen (n=45) in KL showed a correlation between lung volumes and the concentration of NO/sub 2/ they were directly exposed to (0.014 ppm) The controls were UPM students and staff (n=23, non-smokers) of the same age group exposed to 0.005 ppm. There were significant reductions (unpaired t-test, p<0.05) in FVC compared to control (2.84++0.12 vs. e. 21+-0.16), FEV (2.54+-0.12 vs 3.04+-0.13), FEV/sub 1/ % (84.14+-2.09 vs 92.02+-1.36) and FEF/sub 25-75 %/ (3.23+-0.26 vs 4.50 +0.35), indicative of obstructions that may occur in both the large and smaller airways. In addition, higher percentage of respiratory symptoms were reported in the study subjects, the highest was continuous coughs (32% vs. 9%). Another study was done on school children in KL and Negri Sembilan, who were exposed to PM/sub 10/ of 103.27 mu g/m/sup 3/ and 47.35 mu g /m/sup 3/ respectively. Spirometric measurements show significant reductions in VC and FVC for boys compared to control (32% vs 3.25+-0.43 and 2.64+-0.48 v 2.94+-0.52, respectively) indicating signs of airways obstruction and lung restriction. Respiratory symptoms were also higher in the study subjects. The highest is chest tightness (63.18% in female, 35.19% in male) and breathing difficulties (53.05%) and 22.08% respectively) compared to controls. Conclusion made from the two studies was; exposure to 0.014 ppm of NO/sub 2/ and 103.27 mu g/m-3 of PM/sub 10/ correlates with reduced human lung function and increased respiratory symptoms due to obstruction of airways and restriction of the lung. (author)

The role of endotoxin in grain dust-induced lung disease.

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Schwartz, D A; Thorne, P S; Yagla, S J; Burmeister, L F; Olenchock, S A; Watt, J L; Quinn, T J

1995-08-01

To identify the role of endotoxin in grain dust-induced lung disease, we conducted a population-based, cross-sectional investigation among grain handlers and postal workers. The study subjects were selected by randomly sampling all grain facilities and post offices within 100 miles of Iowa City. Our study population consisted of 410 grain workers and 201 postal workers. Grain workers were found to be exposed to higher concentrations of airborne dust (p = 0.0001) and endotoxin (p = 0.0001) when compared with postal workers. Grain workers had a significantly higher prevalence of work-related (cough, phlegm, wheezing, chest tightness, and dyspnea) and chronic (usual cough or phlegm production) respiratory symptoms than postal workers. Moreover, after controlling for age, gender, and cigarette smoking status, work-related respiratory symptoms were strongly associated with the concentration of endotoxin in the bioaerosol in the work setting. The concentration of total dust in the bioaerosol was marginally related to these respiratory problems. After controlling for age, gender, and cigarette smoking status, grain workers were found to have reduced spirometric measures of airflow (FEV1, FEV1/FVC, and FEF25-75) and enhanced airway reactivity to inhaled histamine when compared with postal workers. Although the total dust concentration in the work environment appeared to have little effect on these measures of airflow obstruction, higher concentrations of endotoxin in the bioaerosol were associated with diminished measures of airflow and enhanced bronchial reactivity. Our results indicate that the concentration of endotoxin in the bioaerosol may be particularly important in the development of grain dust-induced lung disease.

Variability in childhood allergy and asthma across ethnicity, language, and residency duration in El Paso, Texas: a cross-sectional study.

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Svendsen, Erik R; Gonzales, Melissa; Ross, Mary; Neas, Lucas M

2009-12-08

We evaluated the impact of migration to the USA-Mexico border city of El Paso, Texas (USA), parental language preference, and Hispanic ethnicity on childhood asthma to differentiate between its social and environmental determinants. Allergy and asthma prevalence was surveyed among 9797 fourth and fifth grade children enrolled in the El Paso Independent School District. Parents completed a respiratory health questionnaire, in either English or Spanish, and a sub-sample of children received spirometry testing at their school. Here we report asthma and allergy outcomes across ethnicity and El Paso residency duration. Asthma and allergy prevalence increased with longer duration of El Paso residency independent of ethnicity and preferred language. Compared with immigrants who arrived in El Paso after entering first grade (18%), lifelong El Paso residents (68%) had more prevalent allergy (OR, 1.72; 95% CI, 1.32 - 2.24), prevalent asthma (OR, 1.75; 95% CI, 1.24 - 2.46), and current asthma (OR, 2.01; 95% CI, 1.37 - 2.95). Spirometric measurements (FEV1/FVC and FEF25-75) also declined with increasing duration of El Paso residency (0.16% and 0.35% annual reduction, respectively). These findings suggest that a community-wide environmental exposure in El Paso, delayed pulmonary development, or increased health of immigrants may be associated with allergy and asthma development in children raised there.

Direct assessment of lung function in COPD using CT densitometric measures

International Nuclear Information System (INIS)

Gu, Suicheng; Leader, Joseph; Gur, David; Pu, Jiantao; Zheng, Bin; Chen, Qihang; Sciurba, Frank; Kminski, Naftali

2014-01-01

To investigate whether lung function in patients with chronic obstructive pulmonary disease (COPD) can be directly predicted using CT densitometric measures and assess the underlying prediction errors as compared with the traditional spirometry-based measures. A total of 600 CT examinations were collected from a COPD study. In addition to the entire lung volume, the extent of emphysema depicted in each CT examination was quantified using density mask analysis (densitometry). The partial least square regression was used for constructing the prediction model, where a repeated random split-sample validation was employed. For each split, we randomly selected 400 CT exams for training (regression) purpose and the remaining 200 exams for assessing performance in prediction of lung function (e.g., FEV1 and FEV1/FVC) and disease severity. The absolute and percentage errors as well as their standard deviations were computed. The averaged percentage errors in prediction of FEV1, FEV1/FVC%, TLC, RV/TLC% and DLco% predicted were 33%, 17%, 9%, 18% and 23%, respectively. When classifying the exams in terms of disease severity grades using the CT measures, 37% of the subjects were correctly classified with no error and 83% of the exams were either correctly classified or classified into immediate neighboring categories. The linear weighted kappa and quadratic weighted kappa were 0.54 (moderate agreement) and 0.72 (substantial agreement), respectively. Despite the existence of certain prediction errors in quantitative assessment of lung function, the CT densitometric measures could be used to relatively reliably classify disease severity grade of COPD patients in terms of GOLD. (paper)

Lost in interpretation: should the highest VC value be used to calculate the FEV1/VC ratio?

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Fortis S

2016-09-01

Full Text Available Spyridon FortisDepartment of Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa, Iowa City, IA, USAAirflow obstruction or obstructive ventilatory defect (OVD is defined as low forced expiratory volume in 1 second (FEV1 to vital capacity (VC ratio. VC can be measured in various ways, and the definition of “low FEV1/VC” ratio varies.     VC can be measured during forced expiration before bronchodilators (forced vital capacity [FVC] and after bronchodilators (post-FVC, and during slow expiration (slow vital capacity [SVC] and during inspiration (inspiratory vital capacity [IVC]. Theoretically, in a healthy person, VC values should be the same regardless of the maneuver used. Nevertheless, SVC is usually larger than FVC except in patients with no OVD and body mass index <25 kg/m2.1 In obstructive lung diseases, FVC may be reduced, which may result in an increase of FEV1/FVC ratio and misdiagnosis.2 For that reason, American Thoracic Society–European Respiratory Society recommends using SVC or IVC to calculate the FEV1/VC ratio.2 Approximately, 10% of smokers have FEV1% predicted <80% and FEV1/FVC >70%, a pattern known as preserved ratio impaired spirometry.3 Of all the subjects with FVC below the lower limit of normal (LLN and FEV1/FVC > LLN, only 64% have restriction in lung volumes. The rest 36% have a nonspecific Pulmonary Function Test pattern.4 Approximately, 15% of patients with this nonspecific PFT pattern develop OVD in follow-up PFTs.4 It is possible that a portion of patients with obstructive lung disease remain underdiagnosed when FVC is used to compute FEV1/FVC ratio.View the original paper by Torén and colleagues.

In vitro validation of a Pitot-based flow meter for the measurement of respiratory volume and flow in large animal anaesthesia.

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Moens, Yves P S; Gootjes, Peter; Ionita, Jean-Claude; Heinonen, Erkki; Schatzmann, Urs

2009-05-01

To remodel and validate commercially available monitors and their Pitot tube-based flow sensors for use in large animals, using in vitro techniques. Prospective, in vitro experiment. Both the original and the remodelled sensor were studied with a reference flow generator. Measurements were taken of the static flow-pressure relationship and linearity of the flow signal. Sensor airway resistance was calculated. Following recalibration of the host monitor, volumes ranging from 1 to 7 L were generated by a calibration syringe, and bias and precision of spirometric volume was determined. Where manual recalibration was not available, a conversion factor for volume measurement was determined. The influence of gas composition mixture and peak flow on the conversion factor was studied. Both the original and the remodelled sensor showed similar static flow-pressure relationships and linearity of the flow signal. Mean bias (%) of displayed values compared with the reference volume of 3, 5 and 7 L varied between -0.4% and +2.4%, and this was significantly smaller than that for 1 L (4.8% to +5.0%). Conversion factors for 3, 5 and 7 L were very similar (mean 6.00 +/- 0.2, range 5.91-6.06) and were not significantly influenced by the gas mixture used. Increasing peak flow caused a small decrease in the conversion factor. Volume measurement error and conversion factors for inspiration and expiration were close to identity. The combination of the host monitor with the remodelled flow sensor allowed accurate in vitro measurement of flows and volumes in a range expected during large animal anaesthesia. This combination has potential as a reliable spirometric monitor for use during large animal anaesthesia.

Changes in pulmonary function after definitive radiotherapy for NSCLC

DEFF Research Database (Denmark)

Schytte, Tine; Bentzen, Søren M; Brink, Carsten

2015-01-01

a negative impact on FVC. Long-term FEV1 and FVC were analyzed using linear regression. Treatment year and V60 had a significant impact on loss of FEV1. V60 had a significant impact on FVC changes. CONCLUSION: In this study, early PF change reached a plateau at 6months after the start of radiotherapy......INTRODUCTION: The objective of this study was to identify factors associated with early and long-term pulmonary function (PF) changes after definitive radiotherapy for NSCLC patients. PF was measured by spirometry i.e. forced expiratory volume in 1s (FEV1), and forced vital capacity (FVC...

Efficacy of lung ventilation scintigram and exercise pulmonary hemodynamic measurement to evaluate operability for pulmonary resection

International Nuclear Information System (INIS)

Kaneda, Masanori; Hayashi, Takashi; Hiraiwa, Takane; Sakai, Takashi; Namikawa, Shoji; Kusakawa, Minoru.

1989-01-01

Preoperative evaluation of patients with lung cancer should include data concerning both resectability and operability. Operability addresses the question how much pulmonary tissue can be safely removed. The purpose of this study is to demonstrate an efficacy of the lung ventilation scintigram and measurement of exercise change in pulmonary hemodynamic parameters by detecting respiratory and circulatory reserve of pulmonary function. Predicted postoperative forced vital capacity (FVC) were calculated from the data of lung scintigram and preoperative spirometry by means of subsegmental formula. Accuracy of prediction was confirmed by spirometry 6 months after the operation. Correlation coefficient between predicted value and actually measured one was R=0.95, and simple regression formula was y=0.98x-10.4. It was recommended that the lower limit should be setted at 40% by the calculated postoperative %FVC. Exercise test were performed by means of bicycle ergometer with the measurement of pulmonary arterial pressure and cardiac output. Pulmonary arterial resistance index (PARI) were also calculated. In younger group rise of pulmonary arterial pressure during exercise was gentle, and PARI was settled between 150 to 200 in high output state. But in older group rise of pulmonary aerial pressure was steep and PARI was over 200 in some cases, just like the case of COLD. It should be recommended to set the upper limit of PARI at 400 in maximum exercise. (author)

Comparison and Validation of Long Time Serial Global GEOV1 and Regional Australian MODIS Fractional Vegetation Cover Products Over the Australian Continent

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Yanling Ding

2015-05-01

Full Text Available Fractional vegetation cover (FVC is one of the most critical parameters in monitoring vegetation status. Comprehensive assessment of the FVC products is critical for their improvement and use in land surface models. This study investigates the performances of two major long time serial FVC products: GEOV1 and Australian MODIS. The spatial and temporal consistencies of these products were compared during the 2000–2012 period over the main biome types across the Australian continent. Their accuracies were validated by 443 FVC in-situ measurements during the 2011–2012 period. Our results show that there are strong correlations between the GEOV1 and Australian MODIS FVC products over the main Australian continent while they exhibit large differences and uncertainties in the coastal regions covered by dense forests. GEOV1 and Australian MODIS describe similar seasonal variations over the main biome types with differences in magnitude, while Australian MODIS exhibit unstable temporal variations over grasslands and shifted seasonal variations over evergreen broadleaf forests. The GEOV1 and Australian MODIS products overestimate FVC values over the biome types with high vegetation density and underestimate FVC in sparsely vegetated areas and grasslands. Overall, the GEOV1 and Australian MODIS FVC products agree with in-situ FVC values with a RMSE around 0.10 over the Australian continent.

The efficacy of balneotherapy and physical modalities on the pulmonary system of patients with fibromyalgia.

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Kesiktas, Nur; Karagülle, Zeki; Erdogan, Nergis; Yazıcıoglu, Kamil; Yılmaz, Hurriyet; Paker, Nurdan

2011-01-01

Effects of balneotherapy on Primary Fibromyalgia Syndrome (FMS) have been studied well, except for its effect on the respiratory symptoms of FMS. In this study we allocated 56 patients with FMS into three groups who matched according to age, gender and duration of illness. All three groups received the same three physical therapy modalities (PTM): transcutaneous electrical nerve stimulation (TENS), ultrasound (US) and infrared (IR). The first group received PTM plus balneotherapy (PTM+BT), the second group received PTM alone (PTM), whilst the third group received PTM plus hydrotherapy (PTM+HT). All groups were treated for three weeks and in the same season. All patients were assessed at four time points: (a) at baseline, (b) on the 7th day of therapy, (c) at the end of therapy (after 3 weeks) and (d) at 6 months after the end of therapy. The effectiveness of treatments in all groups were evaluated in three main categories (pain, depressive and respiratory symptoms). Tender point count, total algometric measurements and pain with visual analog scale for pain; Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) for depression; dyspnea scale, and spirometric measurements for respiratory symptoms; plus quality of life with visual analog scale as a general measurement of effectiveness were taken at all four assessment time points.Both at the end of therapy and at the 6 months follow up significant improvements in dyspnea scale, and spirometric measurements, as well as in other measured parameters were observed in group PTM+BT. All groups achieved significant improvements in BDI and HDRS but scores of PTM and PTM+HT groups had overturned at 6 months follow up. Except second group which receieved PTM alone, pain evaluation assessments were improved at 6 month follow up in PTM+HT and PTM+BT groups. But PTM+BT group had more significant improvements at the end of therapy. PTM group had no significant change for dyspnea scale and spirometric

Effect of occupational silica exposure on pulmonary function.

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Hertzberg, Vicki Stover; Rosenman, Kenneth D; Reilly, Mary Jo; Rice, Carol H

2002-08-01

To assess the effect of occupational silica exposure on pulmonary function. Epidemiologic evaluation based on employee interview, plant walk-through, and information abstracted from company medical records, employment records, and industrial hygiene measurements. Drawn from 1,072 current and former hourly wage workers employed before January 1, 1986. Thirty-six individuals with radiographic evidence of parenchymal changes consistent with asbestosis or silicosis were excluded. In addition, eight individuals whose race was listed as other than white or black were excluded. Analysis of spirometry data (FVC, FEV1, FEV1/FVC) only using the test results that met American Thoracic Society criteria for reproducibility and acceptability shows decreasing percent-predicted FVC and FEV1 and decreasing FEV1/FVC in relationship to increasing silica exposure among smokers. Logistic regression analyses of abnormal FVC and abnormal FEV1 values (where abnormal is defined as OSHA)-allowable level of 0.1 mg/m3. Longitudinal analyses of FVC and FEV1 measurements show a 1.6 mL/yr and 1.1 mL/yr, respectively, decline per milligram/cubic meter mean silica exposure (p = 0.011 and p = 0.001, respectively). All analyses were adjusted for weight, height, age, ethnicity, smoking status, and other silica exposures. Systematic problems leading to measurement error were possible, but would have been nondifferential in effect and not related to silica measurements. There is a consistent association between increased pulmonary function abnormalities and estimated measures of cumulative silica exposure within the current allowable OSHA regulatory level. Despite concerns about the quality control of the pulmonary function measurements use in these analyses, our results support the need to lower allowable air levels of silica and increase efforts to encourage cessation of cigarette smoking among silica-exposed workers.

Gender differences in effects of obesity and asthma on adolescent lung function: Results from a population-based study.

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Chen, Yi-Chun; Huang, Yu-Li; Ho, Wen-Chao; Wang, Yu-Chun; Yu, Yang-Hao

2017-04-01

To investigate lung function associated with asthma and body mass index (BMI) among adolescents at 96 northern Taiwan junior high schools participating in an asthma screening program. The questionnaires and lung function test results measured for 3669 boys and 3523 girls were included in this study for data analysis. Measures of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ) and FEV 1 /FVC ratio were compared by sex, asthma status and BMI. Overall mean FVC levels were similar between students with and without asthma, 3.71 L vs. 3.71 L for boys (p = 0.991) and 2.79 vs. 2.78 for girls (p = 0.517). The overall mean FEV 1 levels were also similar between girls with and without asthma. Asthmatic boys had lower FEV 1 than non-asthmatic boys. Mean FEV 1 /FVC was significantly lower in students with asthma than those without asthma. Mean FVC and FEV 1 increased with BMI in both sexes. A lower mean FEV 1 /FVC was observed among students with asthma and high BMI, and was more pronounced in boys than in girls. Multivariable regression analysis also showed that FEV 1 /FVC ratios were negatively associated with asthma and high BMI, stronger in boys than in girls for asthma (β = -2.176 (standard errors (SE) = 0.268) vs. -1.085 (SE = 0.258) and for BMI (β = -0.309 (SE = 0.025) vs. -0.218 (SE = 0.029)). This northern Taiwan study suggests that FEV 1 /FVC is negatively associated with asthma and high BMI in adolescents, stronger for boys than for girls.

Novos valores de referência para espirometria forçada em brasileiros adultos de raça branca New reference values for forced spirometry in white adults in Brazil

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Carlos Alberto de Castro Pereira

2007-08-01

Full Text Available OBJETIVO: Descrever novas equações de referência para a espirometria em adultos brasileiros saudáveis que nunca fumaram, e comparar os valores previstos atuais com os valores derivados em 1992. MÉTODOS: Equações e limites de referência foram derivados em 270 homens e 373 mulheres, habitantes de oito cidades brasileiras, por espirômetro. A idade variou de 20 a 85 anos nas mulheres e 26 a 86 anos nos homens. Os exames seguiram as normas recomendadas pela Sociedade Brasileira de Pneumologia e Tisiologia. Os limites inferiores foram derivados pela análise do 5º percentil dos resíduos. RESULTADOS: Os valores previstos para capacidade vital forçada (CVF, volume expiratório forçado no primeiro segundo (VEF1 e para as relações VEF1/CVF e VEF1/volume expiratório forçado nos primeiros seis segundos (VEF6 se ajustaram melhor em regressões lineares. Os fluxos ajustaram-se melhor em equações logarítmicas. Em ambos os sexos, maiores estaturas resultaram em menores valores para as relações VEF1/CVF, VEF1/VEF6 e fluxos/CVF. Os valores de referência do VEF1 e da CVF, no presente estudo, foram maiores do que aqueles derivados para adultos brasileiros em 1992. CONCLUSÃO: Novos valores previstos para a espirometria forçada foram obtidos em uma amostra da população brasileira de raça branca. Os valores são maiores do que os obtidos em 1992, provavelmente em decorrência de fatores técnicos.OBJECTIVE: To describe spirometric reference equations for healthy Brazilian adults who have never smoked and to compare the predicted values with those derived in 1992. METHODS: Reference equations for spirometry were derived in 270 men and 373 women living in eight cities in Brazil. Ages ranged from 20 to 85 years in women and from 26 to 86 years in men. Spirometry examinations followed the recommendations of the Brazilian Thoracic Society. Lower limits were derived by the analysis of the fifth percentiles of the residuals. RESULTS: Forced vital

Basic pulmonary function tests in pig farmers

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Đuričić Slaviša M.

2004-01-01

absence of important alterations in the basic spirometric measures in this and the majority of the previous studies suggests that early airway injuries may not be readily apparent using spirometric measures of lung function. CONCLUSION In contrast to other world studies, our study comprised an important number of women farmers, but alterations associated to sex were not found. To asses the lung function in these pig farmers after several years may be of great importance.

Emphysema in heavy smokers with normal chest radiography

International Nuclear Information System (INIS)

Sashidhar, K.; Monga, S.; Suri, S.; Gulati, M.; Gupta, D.

2002-01-01

Purpose: To determine the severity and extent of emphysema in heavy smokers by high-resolution CT (HRCT) and to correlate the findings with spirometric tests (STs) and symptomatology. Material and Methods: Fifty adult smokers with a mean age of 53 years with a smoking history of more than 30 pack years and normal chest radiographs underwent HRCT of the chest and ST (FEV1, FEV1/FVC, PEFR). Among these, 22 had symptoms of pulmonary disease and 28 were asymptomatic. Quantification of emphysema was done using a density mask program and the visual scoring method. The results were correlated with ST and symptomatology. Results: 58% (29 out of 50) of the subjects had significant emphysema on HRCT. Eleven out of 15 with normal ST showed emphysema on HRCT while 2 with airflow obstruction on ST showed normal CT scores. 14% (4 out of 28) asymptomatic subjects had severe emphysema compared to 64% of symptomatic subjects. Emphysematous changes were predominantly seen in upper lung zones in 48% of the patients while in 52% it was distributed equally in both upper and lower zones. The number of pack years of smoking showed a positive correlation with CT scores. The correlation between HRCT scores and ST was statistically significant. Conclusion: A significant number of asymptomatic and clinically undiagnosed smokers tend to have significant emphysema. HRCT helps in early detection of disease and thus helps implementation of preventive measures

Prediction of postoperative respiratory function of lung cancer patients using quantitative lung scans

International Nuclear Information System (INIS)

Konishi, Hiroshi

1982-01-01

Quantitative sup(99m)Tc-MISA inhalation scan and sup(99m)Tc-MAA perfusion scan were performed in 35 patients with lung cancer who underwent lobectomies. Quantitative 133 Xe ventilation-perfusion scans were also performed in 34 patients with lung cancer who underwent lobectomies. To predict functional loss after lobectomy, the proportion of the No. of segments in the lobe to be resected to the No. of entire segments of that lung was provided for the study. Postoperative FVC, FEVsub(1.0) and MVV were predicted in the study, and which were compared to the respiratory function at one month after operation and more than four months after operation. The predicted postoperative respiratory function was highly correlated with the actually observed postoperative respiratory function (0.7413 lt r lt 0.9278, p lt 0.001). In this study, the postoperative respiratory function was proven to be quite accurately predicted preoperatively with combination of quantitative lung scans and spirometric respiratory function. Therefore this method is useful not only for judgement of operative indication but also for choice of operative method and for counterplan of postoperative respiratory insufficiency. (J.P.N.)

Evidence of Allergic Reactions and Cardiopulmonary Impairments among Traders Operating from Foodstuff Warehouses

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Sam Ibeneme

2016-01-01

Full Text Available Background. Foodstuff traders operating from warehouses (FTFW are potentially exposed to dangerous rodenticides/pesticides that may have adverse effects on cardiopulmonary function. Methods. Fifty consenting male foodstuff traders, comprising 15 traders (21–63 years operating outside warehouses and 35 FTFW (20–64 years, were randomly recruited at Ogbete Market, Enugu, in a cross-sectional observational study of spirometric and electrocardiographic parameters. Seventeen FTFW (21–57 years participated in focus group discussions. Qualitative and quantitative data were analysed thematically and with independent t-test and Pearson correlation coefficient at p0.05 with a significantly prolonged (p<0.05 QTc interval. Conclusion. Allergic response was evident in the FTFW. Significant decrease in FVC may negatively impact lung flow rates and explains the marginal decrease in FEF25–75, which implies a relative limitation in airflow of peripheral/distal airways and elastic recoil of the lungs. This is consistent with obstructive pulmonary disease; a significant decrease in FEF75–85/FEV1 supports this conclusion. Significant decrease in FEF200–1200 indicates abnormalities in the large airways/larynx just as significantly prolonged ventricular repolarization suggests cardiac arrhythmias.

Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome.

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Bui, Dinh S; Burgess, John A; Lowe, Adrian J; Perret, Jennifer L; Lodge, Caroline J; Bui, Minh; Morrison, Stephen; Thompson, Bruce R; Thomas, Paul S; Giles, Graham G; Garcia-Aymerich, Judith; Jarvis, Debbie; Abramson, Michael J; Walters, E Haydn; Matheson, Melanie C; Dharmage, Shyamali C

2017-07-01

The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors. To investigate the role of childhood lung function in adult COPD phenotypes. Prebronchodilator spirometry was performed for a cohort of 7-year-old Tasmanian children (n = 8,583) in 1968 who were resurveyed at 45 years, and a selected subsample (n = 1,389) underwent prebronchodilator and post-bronchodilator spirometry. For this analysis, COPD was spirometrically defined as a post-bronchodilator FEV 1 /FVC less than the lower limit of normal. Asthma-COPD overlap syndrome (ACOS) was defined as the coexistence of both COPD and current asthma. Associations between childhood lung function and asthma/COPD/ACOS were examined using multinomial regression. At 45 years, 959 participants had neither current asthma nor COPD (unaffected), 269 had current asthma alone, 59 had COPD alone, and 68 had ACOS. The reweighted prevalence of asthma alone was 13.5%, COPD alone 4.1%, and ACOS 2.9%. The lowest quartile of FEV 1 at 7 years was associated with ACOS (odds ratio, 2.93; 95% confidence interval, 1.32-6.52), but not COPD or asthma alone. The lowest quartile of FEV 1 /FVC ratio at 7 years was associated with ACOS (odds ratio, 16.3; 95% confidence interval, 4.7-55.9) and COPD (odds ratio, 5.76; 95% confidence interval, 1.9-17.4), but not asthma alone. Being in the lowest quartile for lung function at age 7 may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function in school age children may identify a high-risk group that could be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.

Investigation of the efficacy of generic and brand-name tiotropium bromide in the management of chronic obstructive pulmonary disease: A randomized comparative trial.

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Panahi, Yunes; Ghanei, Mostafa; Behzadi, Mohammad; Salehi, Maryam; Soflaei, Sara Saffar; Sahebkar, Amirhossein

2016-03-01

The beneficial effects of tiotropium bromide, a long acting anticholinergic bronchodilator, in the management of chronic obstructive pulmonary disease have been shown in previous studies. The present study aimed to compare the efficacy and safety of generic (Tiova®) and brand-name (Spiriva®) tiotropium preparations in patients with COPD. In this randomized double-blind parallel-group trial, 79 patients with documented COPD were assigned to Tiova® or Spiriva® for a period of 4 weeks. Assessment of pulmonary function (using spirometry), quality-of-life (using St. George respiratory Questionnaire [SGRQ]) and severity of respiratory symptoms (using breathlessness, cough and sputum scale [BCSS]) was performed at baseline and at the end of treatment period. There were significant increases in FEV1 and reductions in FVC by the end of study in both Tiova® and Spiriva® groups. FEV1/FVC ratio did not change significantly neither in the Tiova® nor in Spiriva® group. Overall SGRQ score as well as subscale scores of symptoms, activity and impacts were improved by both drugs. In the BCSS scale, the frequency and severity of three main symptoms (dyspnea, cough and sputum) was decreased by both drugs. Baseline as well as post-treatment values of spirometric parameters, SGRQ and BCSS scores was comparable between the groups, apart from a lower post-treatment frequency of cough and sputum in the Spiriva® versus Tiova® group. There was no report of adverse events in either of the study groups. The findings of this comparative trial showed equivalent efficacy and safety of Spiriva® and Tiova® in lessening the symptoms as well as improving the quality of life in patients with COPD. This finding has an important translational value given the significantly lower costs of generic versus brand-name products.

Reference values for spirometry in preschool children.

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Burity, Edjane F; Pereira, Carlos A C; Rizzo, José A; Brito, Murilo C A; Sarinho, Emanuel S C

2013-01-01

Reference values for lung function tests differ in samples from different countries, including values for preschoolers. The main objective of this study was to derive reference values in this population. A prospective study was conducted through a questionnaire applied to 425 preschool children aged 3 to 6 years, from schools and day-care centers in a metropolitan city in Brazil. Children were selected by simple random sampling from the aforementioned schools. Peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volumes (FEV1, FEV0.50), forced expiratory flow (FEF25-75) and FEV1/FVC, FEV0.5/FVC and FEF25-75/FVC ratios were evaluated. Of the 425 children enrolled, 321 (75.6%) underwent the tests. Of these, 135 (42.0%) showed acceptable results with full expiratory curves and thus were included in the regression analysis to define the reference values. Height and gender significantly influenced FVC values through linear and logarithmic regression analysis. In males, R(2) increased with the logarithmic model for FVC and FEV1, but the linear model was retained for its simplicity. The lower limits were calculated by measuring the fifth percentile residues. Full expiratory curves are more difficult to obtain in preschoolers. In addition to height, gender also influences the measures of FVC and FEV1. Reference values were defined for spirometry in preschool children in this population, which are applicable to similar populations. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Lung function in fragrance industry employees.

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Dix, G R

2013-07-01

Production employees in the UK fragrance industry are exposed to large numbers of chemical substances and mixtures. There is a lack of published literature describing the effects of occupational respiratory exposure in this industry. To investigate whether occupational respiratory exposure to chemicals in the UK fragrance industry is linked to a statistically significant change in lung function as measured using spirometry. A multi-site cross-sectional study in which five UK companies took part, comprising an exposed group (fragrance production and associated functions) and a control group (non-exposed industry employees, e.g. office staff). Spirometric measurements (forced expiratory volume in 1 second, forced vital capacity and peak expiratory flow) were taken pre- and post-shift. Participants provided information on potential confounding factors (smoking, history of respiratory problems and body mass index). Post-shift measurements were compared between groups, using analysis of covariance to adjust for the baseline pre-shift measurements. A total of 112 subjects participated: 60 in the exposed group and 52 in control group (response rate 33 and 24%, respectively). Adjusted mean differences in post-shift spirometric measurements between exposed and control groups were not statistically significant. No significant effects were observed on the spirometric performance of the study population. This work is the first step in a novel area of research, and the industry would benefit from further such research.

Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

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Alberto Daniel Rocha-Muñoz

2015-01-01

Full Text Available Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs versus DMARDs alone for ankylosing spondylitis (AS with reduced pulmonary function vital capacity (FVC%. Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT, Borg scale after 6MWT, and St. George’s Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P=0.04. Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5% in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55% in the DMARDs group (P=0.04. Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%.

Prevalence and determinants of airflow limitation in urban and rural children exposed to cooking fuels in South-East Nigeria.

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Oguonu, Tagbo; Obumneme-Anyim, Ijeoma N; Eze, Joy N; Ayuk, Adaeze C; Okoli, Chinyere V; Ndu, Ikenna K

2018-03-15

Background Biofuels and other cooking fuels are used in households in low- and middle-income countries. Aim To investigate the impact of cooking fuels on lung function in children in urban and rural households in South-East Nigeria. Methods The multi-stage sampling method was used to enroll children exposed to cooking fuel in the communities. Lung function values FEV1, FVC and the FEV1/FVC ratio, were measured with ndd EasyOne R spirometer. Airflow limitation was determined with FEV1/FVC Z-score values at -1.64 as the lower limit of normal (LLN5). The Global Lung Function Initiative 2012 software was used to calculate the lung function indices. Results The median age (range) of the 912 children enrolled was 10.6 years (6-18). Altogether, 468 (51.6%) children lived in rural areas. Seven hundred and thirty-seven (80.7%) were directly exposed to cooking fuels (418/737, 56.5% in rural areas). Wood and kerosene were the dominant fuels in rural and urban households. The respective mean Z-scores of the exposed children in rural and urban were zFEV1 -0.62, FVC -0.21, FEV1/FVC -0.83 and zFEV1 -0.57, zFVC -0.14, FEV1/FVC -0.75. Few (5.2%, 38/737) of the children had airflow limitation. Most of them (60.5%, 25/38) lived in the rural community; the lowest FEV1/FVC Z-scores were those of exposed to a combination of fuels. Conclusion Exposure to cooking fuels affects lung function in children with airway limitation in a small proportion, Control measures are advocated to reduce the morbidity related to cooking fuels exposure.

Association between lung function in adults and plasma DDT and DDE levels: results from the Canadian Health Measures Survey.

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Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

2015-05-01

Although DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] has been banned in many countries since the 1970s, it may still pose a risk to human respiratory health. In agriculture, DDT exposures have been associated with asthma and chronic bronchitis. However, little is known about the effect of DDT on lung function. We used data on 1,696 participants 20-79 years of age from the Canadian Health Measures Survey (CHMS) and conducted multiple regression analysis to estimate associations between plasma p,p´-DDT/DDE and lung function. Almost all participants (> 99.0%) had detectable concentrations of plasma p,p´-DDE, but only 10.0% had detectable p,p´-DDT. Participants with detectable p,p´-DDT had significantly lower mean FVC (difference = 311 mL; 95% CI: -492, -130; p = 0.003) and FEV1 (difference = 232 mL; 95% CI: -408, -55; p = 0.015) than those without. A 100-ng/g lipid increase in plasma p,p´-DDE was associated with an 18.8-mL decrease in mean FVC (95% CI: -29, -9) and an 11.8-mL decrease in mean FEV1 (95% CI: -21, -3). Neither exposure was associated with FEV1/FVC ratio or FEF25%-75%. DDT exposures, which may have occurred decades ago, were still detectable among Canadians. Plasma DDT and DDE were negatively associated with lung function parameters. Additional research on the potential effects of DDT use on lung function is warranted.

Daily Home Spirometry: An Effective Tool for Detecting Progression in Idiopathic Pulmonary Fibrosis.

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Russell, Anne-Marie; Adamali, Huzaifa; Molyneaux, Philip L; Lukey, Pauline T; Marshall, Richard P; Renzoni, Elisabetta A; Wells, Athol U; Maher, Toby M

2016-10-15

Recent clinical trial successes have created an urgent need for earlier and more sensitive endpoints of disease progression in idiopathic pulmonary fibrosis (IPF). Domiciliary spirometry permits more frequent measurement of FVC than does hospital-based assessment, which therefore affords the opportunity for a more granular insight into changes in IPF progression. To determine the feasibility and reliability of measuring daily FVC in individuals with IPF. Subjects with IPF were given handheld spirometers and instruction on how to self-administer spirometry. Subjects recorded daily FEV 1 and FVC for up to 490 days. Clinical assessment and hospital-based spirometry was undertaken at 6 and 12 months, and outcome data were collected for 3 years. Daily spirometry was recorded by 50 subjects for a median period of 279 days (range, 13-490 d). There were 18 deaths during the active study period. Home spirometry showed excellent correlation with hospital-obtained readings. The rate of decline in FVC was highly predictive of outcome and subsequent mortality when measured at 3 months (hazard ratio [HR], 1.040; 95% confidence interval [CI], 1.021-1.062; P ≤ 0.001), 6 months (HR, 1.024; 95% CI, 1.014-1.033; P spirometry in patients with IPF is highly clinically informative and is feasible to perform for most of these patients. The relationship between mortality and rate of change of FVC at 3 months suggests that daily FVC may be of value as a primary endpoint in short proof-of-concept IPF studies.

Determination of differential pulmonary function by the radioisotopic method

International Nuclear Information System (INIS)

Molinari, J.F.; Chatkin, J.M.; Barreto, S.M.

1991-01-01

A study of twenty-one patients with bronchogenic carcinoma which were submitted to lobectomy or pneumonectomy has been done, with the purpose of evaluation of regional and differential function of the lungs or parts of them. To accomplish this subject the patients underwent simple spirometry with FEV (forced expiratory volume in the first second) and FVC (forced vital capacity) measurements plus quantitative perfusional scintigraphy using 99 Tc-MAA (aggregated albumin). The relationship between these tests allowed the calculation of predictive values of FEV and FVC for the post-operative period through proposed equations. From the third month on after the operation, the patients were again submitted to spirometry with measurement of FEV and FVC to attest the hypothesis that these values were similar to those calculated. The statistical study of these results, utilizing the Student's t test, has demonstrated that the values of FEV and FVC were similar to those found in the postoperative period. These results allowed the conclusion that the radioisotopic method had predictive capacity of FEV and FVC in the lobectomized and pneumonectomized patients and it is a contribution in the evaluation of the differential pulmonary function. (author)

CAD system for quantifying emphysema severity based on multi-class classifier using CT image and spirometry information

International Nuclear Information System (INIS)

Nimura, Yukitaka; Mori, Kensaku; Kitasaka, Takayuki; Honma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi

2010-01-01

Many diagnosis methods based on CT image processing are proposed for quantifying emphysema. The most of these diagnosis methods extract lesions as Low-Attenuation Areas (LAA) by simple threshold processing and evaluate their severity by calculating the LAA (LAA%) in the lung. However, pulmonary emphysema is diagnosed by not only the LAA but also the changes of pulmonary blood vessel and the spirometric measurements. This paper proposes a novel computer-aided detection (CAD) system for quantifying emphysema by combining spirometric measurements and results of CT image processing. The experimental results revealed that the accuracy rate of the proposed method was 78.3%. It is 13.1% improvement compared with the method based on only the LAA%. (author)

Diagnosing asthma in general practice with portable exhaled nitric oxide measurement – results of a prospective diagnostic study

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Laux Gunter

2009-03-01

Full Text Available Abstract Background To evaluate the sensitivity, specificity and predictive values of fractional exhaled nitric oxide (FENO for the diagnosis of asthma in general practice. Methods Prospective diagnostic study with 160 patients attending 10 general practices for the first time with complaints suspicious of obstructive airway disease (OAD. Patients were referred to a lung function laboratory for diagnostic investigation. The index test was FENO measured with a portable FENO analyser based on electrochemical sensor. The reference standard was the Tiffeneau ratio (FEV1/VC as received by spirometric manoeuvre and/or results of bronchial provocation. Bronchial provocation with methacholine was performed to determine bronchial hyper-responsiveness (BHR in the event of inconclusive spirometric results. Results 88 (55% were female; their average age was 43.9 years. 75 (46.9% patients had asthma, 25 (15.6% had COPD, 8 (5.0% had an overlap of COPD and asthma, and 52 (32.5% had no OAD. At a cut-off level of 46 parts per billion (ppb (n = 30; 18.8%, sensitivity was 32% (95%CI 23–43%, specificity 93% (95%CI 85–97%, positive predictive value (PPV 80% (95%CI 63–91%, negative predictive value (NPV 61% (95%CI 52–69% when compared with a 20% fall in FEV1 from the baseline value (PC20 after inhaling methacholine concentration ≤ 16 mg/ml. At 76 ppb (n = 11; 6.9% specificity was 100% (95%CI 96–100% and PPV was 100% (95%CI 72–100. At a cut-off level of 12 ppb (n = 34; 21.3%, sensitivity was 90% (95%CI 79–95%, specificity 25% (95%CI 17–34%, PPV 40% (95%CI 32–50, NPV 81% (95%CI 64–91% when compared with a 20% fall of FEV1 after inhaling methacholine concentration ≤ 4 mg/ml. Three patients with unsuspicious spirometric results have to be tested with FENO to save one bronchial provocation test. Conclusion Asthma could be ruled in with FENO > 46 ppb. Mild and moderate to severe asthma could be ruled out with FENO ≤ 12 ppb. FENO measurement with

O efeito da obesidade sobre parâmetros espirométricos em adolescentes submetidos à broncoprovocação por exercício = The effect of obesity on spirometric parameters in adolescents subjected to exercise bronchoprovocation

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Fabrício Cieslak

2010-01-01

Full Text Available O objetivo deste estudo foi avaliar o efeito da obesidade sobre parâmetros espirométricos em adolescentes submetidos ao teste de broncoprovocação por exercício físico. Estudo transversal, descritivo e correlacional, composto por 15 adolescentes, de ambos os sexos. O diagnóstico de asma foi realizado por meio de histórico clínico e questionário ISAAC, e a obesidade, pelo IMC acima do percentil 95. Utilizou-se o teste de broncoprovocação com exercício físico para avaliação da asma induzida pelo exercício (AIE, considerando-se positiva a diminuição do volume expiratório forçado no primeiro segundo (VEF1 > 10% do valor pré-exercício e a intensidade da AIE foi calculada pela queda percentual máxima do VEF1 (% Quedamáx VEF1. Foram utilizados o teste t independente ou U de Mann-Whitney e a correlação de Spearman rho (p The objective of this study was to evaluate the effect of obesity on spirometric parameters in adolescents subjected to a physical exercise bronchoprovocation test. It was a cross-sectional, descriptive and correlational study composed of 15 adolescents of both genders. The diagnosis of asthma was made by clinical history and ISAAC questionnaire, and obesity by BMI above the 95th percentile. The bronchoprovocation test with physical exercise was used for assessment of exercise induced asthma (EIA, considering positive a decrease in forced expiratory volume in one second (FEV1 > 10% of pre-exercise, and the intensity was calculated by the EIA maximum percentage fall in FEV1 (% Fallmax FEV1. We used the independent t test or Mann-Whitney U test and the Spearman rho correlation (p < 0.05. Significant differences were found between asthmatics and non-asthmatics to % Fallmax FEV1 (p = 0.034. There was a negative moderate relationship to Fallmax FEV1 with leukocytes, and % Fallmax FEV1 with leukocytes. It can be concluded that the spirometric variables presented moderated correlation with the systemic inflammation of

Instrument development in the measurement of unsupported arm exercise endurance in normal adult subjects.

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Breslin, E H; Adams, E; Lutz, A; Roy, C

1993-06-01

Many daily activities, from basic grooming to employment tasks, require adequate unsupported arm endurance (UAE). We developed an electromechanical device to measure UAE endurance. The purpose of this study was to standardize the instrument for two rates of arm motion, moderate and slow, in 18 normal adult subjects (FEVI = 3.7L +/- .78, FVC = 4.2L +/- .74, FEV1/FVC = 1.1 +/- .08). Exercise endurance limits, and the following metabolic, ventilatory, and sensation responses were determined at rest prior to exercise and at end-exercise limits for both rates of UAE:minute ventilation (Ve), tidal volume (VT), respiratory rate (RR), duty cycle (Ti/Ttot), oxygen uptake (VO2), carbon dioxide production (VCO2), inspiratory flow (VT/Ti), heart rate (HR), and visual analog scale measurements (VAS) of dyspnea (D), respiratory effort (RE), and arm fatigue (AF). Significance increases from baseline rest were shown at the endurance limits for both rates of UAE in: VO2, VCO2, Ve, VT, RR, VT/Ti, HR, VAS-D, VAS-RE, and VAS-AF. There were no changes in Ti/Ttot and SaO2 with UAE. Peak VO2, RR, Ve, VT/Ti, and VAS-D with moderate exercise were significantly greater than slow UAE; and there was a trend increase in peak HR for moderate as opposed to slow rate UAE. Despite these differences, the endurance time between the two rates of UAE were similar. These data provide standards against which UAE in COPD can be evaluated.

Planimetric determination of lung volume

International Nuclear Information System (INIS)

Bieber, M.; Maurer, H.J.

1984-01-01

The total volume of the lungs was determined by digital planimetry in 102 patients with emphysema and 33 normal controls aged between 30 and 79 years. The results were compared with the findings obtained from spirometric measurements. Mean values showed a significant relationship to age, body size and body surface. Planimetrically determined lung volume did not show a linear relationship with age, but increased after 60 years. Beyong 60 years, spirometric findings were lower because of an increase in the number of patients with emphysema. The results have shown that digital planimetry is a useful addition to spirometry. (orig.) [de

Pulmonary function in women: comparative analysis of conventional versus single-port laparoscopic cholecystectomy

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MARISA DE CARVALHO BORGES

2018-05-01

Full Text Available ABSTRACT Objective: to evaluate the pulmonary function of women submitted to conventional and single-port laparoscopic cholecystectomy. Methods: forty women with symptomatic cholelithiasis, aged 18 to 70 years, participated in the study. We divided the patients into two groups: 21 patients underwent conventional laparoscopic cholecystectomy, and 19, single-port laparoscopic cholecystectomy. We assessed pulmonary function through forced vital capacity (FVC, forced expiratory volume in the first second (FEV1, and the FEV1/FVC ratio, measured before and 24 hours after the procedure. Results: in both groups, FVC and FEV1 were lower in the postoperative period than those obtained in the preoperative period, with a greater reduction in the group undergoing conventional laparoscopic cholecystectomy. Regarding the FEV1/FVC (% values, there was no statistically significant difference in any of the groups or times analyzed. Conclusion: there was a greater decline in FVC and FEV1 in the postoperative group of patients submitted to conventional laparoscopic cholecystectomy.

Genetic and Environmental Influences on Pulmonary Function and Muscle Strength: The Chinese Twin Study of Aging

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Tian, Xiaocao; Xu, Chunsheng; Wu, Yili

2017-01-01

Genetic and environmental influences on predictors of decline in daily functioning, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), handgrip, and five-times-sit-to-stand test (FTSST), have not been addressed in the aging Chinese population. We performed classical twin...... was moderate for FEV1, handgrip, and FTSST (55-60%) but insignificant for FVC. Only FVC showed moderate control, with shared environmental factors accounting for about 50% of the total variance. In contrast, all measures of pulmonary function and muscle strength showed modest influences from the unique...

Expiratory flow limitation and operating lung volumes during exercise in older and younger adults.

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Smith, Joshua R; Kurti, Stephanie P; Meskimen, Kayla; Harms, Craig A

2017-06-01

We determined the effect of aging on expiratory flow limitation (EFL) and operating lung volumes when matched for lung size. We hypothesized that older adults will exhibit greater EFL and increases in EELV during exercise compared to younger controls. Ten older (5M/5W; >60years old) and nineteen height-matched young adults (10M/9W) were recruited. Young adults were matched for%predicted forced vital capacity (FVC) (Y-matched%Pred FVC; n=10) and absolute FVC (Y-matched FVC; n=10). Tidal flow-volume loops were recorded during the incremental exercise test with maximal flow-volume loops measured pre- and post-exercise. Compared to younger controls, older adults exhibited more EFL at ventilations of 26, 35, 51, and 80L/min. The older group had higher end-inspiratory lung volume compared to Y-matched%Pred FVC group during submaximal ventilations. The older group increased EELV during exercise, while EELV stayed below resting in the Y-matched%Pred FVC group. These data suggest older adults exhibit more EFL and increase EELV earlier during exercise compared to younger adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Computational fluid dynamics in the assessment of patients' postoperative status after glottis-widening surgery.

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Marków, Magdalena; Janecki, Daniel; Orecka, Bogusława; Misiołek, Maciej; Warmuziński, Krzysztof

2017-09-01

Computational fluid dynamics (CFD), a rapidly developing instrument with a number of practical applications, allows calculation and visualization of the changing parameters of airflow in the upper respiratory tract. The aim of this study was to demonstrate the advantages of CFD as an instrument for noninvasive tests of the larynx in patients who had undergone surgical treatment due to bilateral vocal fold paralysis. Surface measurements of the glottic space were made during maximum adduction of the vocal folds. Additionally, the following spirometric parameters were determined: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF) rate. Based on the measurements, commercial mesh generation software was used to develop a geometrical model of the glottic space. The computations were carried out using a general purpose CFD code. The analysis included patients who were surgically treated for BVFP in the authors' department between 1999 and 2012. The study group consisted of 22 women (91.67%) and 2 men (8.33%). It was observed that the pressure drop calculated for free breathing depends on the area of the glottis and is independent of its shape. Importantly, for areas below approx. 40 mm2, a sudden rise occurred in the resistance to flow; for the smallest glottic areas studied, the pressure drop was almost 6 times higher than for an area of 40 mm2. Consequently, in cases of areas below 40 mm2 even minor enlargement of the glottic opening can lead to a marked improvement in breathing comfort. Computational fluid dynamics is a useful method for calculating and visualizing the changing parameters of airflow in the upper respiratory tract.

Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children.

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Shi, Yixin; Aledia, Anna S; Galant, Stanley P; George, Steven C

2013-03-01

We previously showed that impulse oscillometry (IOS) indices of peripheral airway function are associated with asthma control in children. However, little data exist on whether dysfunction in the peripheral airways can predict loss of asthma control. We sought to determine the utility of peripheral airway impairment, as measured by IOS, in predicting loss of asthma control in children. Fifty-four children (age, 7-17 years) with controlled asthma were enrolled in the study. Spirometric and IOS indices of airway function were obtained at baseline and at a follow-up visit 8 to 12 weeks later. Physicians who were blinded to the IOS measurements assessed asthma control (National Asthma Education and Prevention Program guidelines) on both visits and prescribed no medication change between visits. Thirty-eight (70%) patients maintained asthma control between 2 visits (group C-C), and 16 patients had asthma that became uncontrolled on the follow-up visit (group C-UC). There was no difference in baseline spirometric results between the C-C and C-UC groups, except for FEV1/forced vital capacity ratio (86% vs 82%, respectively; P IOS results, including resistance of the respiratory system at 5 Hz (R5; 6.4 vs 4.3 cm H2O · L(-1) · s), frequency dependence of resistance (difference of R5 and resistance of the respiratory system at 20 Hz [R5-20]; 2.0 vs 0.7 cm H2O · L(-1) · s), and reactance area (13.1 vs 4.1 cm H2O · L(-1)), of group C-UC were significantly higher than those of group C-C (P operating characteristic analysis showed baseline R5-20 and reactance area effectively predicted asthma control status at the follow-up visit (area under the curve, 0.91 and 0.90). Children with controlled asthma who have increased peripheral airway IOS indices are at risk of losing asthma control. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

International Nuclear Information System (INIS)

Lopes, Agnaldo Jose; Capone, Domenico; Mogami, Roberto; Jansen, Jose Manoel .E mail: phel.lop@uol.com.br; Cunha, Daniel Leme da; Melo, Pedro Lopes de

2007-01-01

Objective: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF). Methods: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography findings were quantified: total interstitial disease (TID), reticular abnormality/honeycombing, and ground-glass opacity (GGO). The functional variables were measured by spirometry, forced oscillation technique (FOT), helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO). Results: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations) with the measurements of forced vital capacity (FVC), total lung capacity (TLC), DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively) with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF25-75%/FVC) correlated positively with TID, reticular abnormality/honeycombing, and GGO. Conclusion: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans. (author)

Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

Energy Technology Data Exchange (ETDEWEB)

Lopes, Agnaldo Jose; Capone, Domenico; Mogami, Roberto; Jansen, Jose Manoel [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). School of Medical Sciences].E mail: phel.lop@uol.com.br; Cunha, Daniel Leme da [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Pedro Ernesto University Hospital. Dept. of Radiology and Diagnostic Imaging; Melo, Pedro Lopes de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. of Biology

2007-11-15

Objective: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF). Methods: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography findings were quantified: total interstitial disease (TID), reticular abnormality/honeycombing, and ground-glass opacity (GGO). The functional variables were measured by spirometry, forced oscillation technique (FOT), helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO). Results: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations) with the measurements of forced vital capacity (FVC), total lung capacity (TLC), DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively) with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF25-75%/FVC) correlated positively with TID, reticular abnormality/honeycombing, and GGO. Conclusion: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans. (author)

Meta-analyses of genome-wide association studies identify multiple loci associated with pulmonary function

NARCIS (Netherlands)

D.B. Hancock (Dana); M. Eijgelsheim (Mark); J.B. Wilk (Jemma); S.A. Gharib (Sina); L.R. Loehr (Laura); K. Marciante (Kristin); N. Franceschini (Nora); Y.M.T.A. van Durme; T.H. Chen; R.G. Barr (Graham); M.B. Schabath (Matthew); D.J. Couper (David); G.G. Brusselle (Guy); B.M. Psaty (Bruce); P. Tikka-Kleemola (Päivi); J.I. Rotter (Jerome); A.G. Uitterlinden (André); A. Hofman (Albert); N.M. Punjabi (Naresh); F. Rivadeneira Ramirez (Fernando); A.C. Morrison (Alanna); P.L. Enright (Paul); K.E. North (Kari); S.R. Heckbert (Susan); T. Lumley (Thomas); B.H.Ch. Stricker (Bruno); G.T. O'Connor (George); S.J. London (Stephanie)

2010-01-01

textabstractSpirometric measures of lung function are heritable traits that reflect respiratory health and predict morbidity and mortality. We meta-analyzed genome-wide association studies for two clinically important lung-function measures: forced expiratory volume in the first second (FEV1) and

Efeito da obesidade na função ventilatória Impact of obesity on ventilatory function

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Perran Boran

2007-04-01

of excess body weight, with no history of asthma or other atopic diseases were studied and compared to a control group of 50 normal weight children controlled for age and sex. The mean age of patients was 9.7±2.5 years (7 to 15 years. Anthropometric measurements and spirometry were performed in all subjects. Forced vital capacity (FVC and forced expiratory volume in 1 second (FEV1 were used as measures of ventilatory function. RESULTS: There were no significant differences in FEV1%, FVC% and FEV1%/FVC% by study group (p > 0.05. Only three patients had obstructive abnormalities documented on their pulmonary function tests (two had moderately severe and one had mild obstructive abnormalities. No correlation was observed between pulmonary function parameters and anthropometric measurements. CONCLUSION: These data demonstrate that pulmonary function test parameters of the mildly obese children were similar to those of the normal weight children. Anthropometric measurements had no significant effect on spirometric measurements in children as they did on adults.

Obstructive lung disease as a complication in post pulmonary TB

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Tarigan, A. P.; Pandia, P.; Eyanoer, P.; Tina, D.; Pratama, R.; Fresia, A.; Tamara; Silvanna

2018-03-01

The case of post TB is a problem that arises in the community. Pulmonary tuberculosis (TB) can affect lung function. Therefore, we evaluated impaired pulmonary function in subjects with diagnosed prior pulmonary TB. A Case Series study, pulmonary function test was performed in subjects with a history of pulmonary tuberculosis; aged ≥18 years were included. Exclusion criteria was a subject who had asthma, obesity, abnormal thorax and smoking history. We measured FEV1 and FVC to evaluate pulmonary function. Airflow obstruction was FEV1/FVC%pulmonary TB, 5 subjects (23%) had airflow obstruction with FEV1/FVC% value pulmonary TB.

Impact of spinal anaesthesia on peri-operative lung volumes in obese and morbidly obese female patients.

Science.gov (United States)

Regli, A; von Ungern-Sternberg, B S; Reber, A; Schneider, M C

2006-03-01

Although obesity predisposes to postoperative pulmonary complications, data on the relationship between body mass index (BMI) and peri-operative respiratory performance are limited. We prospectively studied the impact of spinal anaesthesia, obesity and vaginal surgery on lung volumes measured by spirometry in 28 patients with BMI 30-40 kg.m(-2) and in 13 patients with BMI > or = 40 kg.m(-2). Vital capacity, forced vital capacity, forced expiratory volume in 1 s, mid-expiratory and peak expiratory flows were measured during the pre-operative visit (baseline), after effective spinal anaesthesia with premedication, and after the operation at 20 min, 1 h, 2 h, and 3 h (after mobilisation). Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters. Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters; mean (SD) vital capacities were - 19% (6.4) in patients with BMI 30-40 kg.m(-2) and - 33% (9.0) in patients with BMI > 40 kg.m(-2). The decrease of lung volumes remained constant for 2 h, whereas 3 h after the operation and after mobilisation, spirometric parameters significantly improved in all patients. This study showed that both spinal anaesthesia and obesity significantly impaired peri-operative respiratory function.

Spirometry Reference Equations from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos).

Science.gov (United States)

LaVange, Lisa; Davis, Sonia M; Hankinson, John; Enright, Paul; Wilson, Rebbecca; Barr, R Graham; Aldrich, Thomas K; Kalhan, Ravi; Lemus, Hector; Ni, Ai; Smith, Lewis J; Talavera, Gregory A

2017-10-15

Accurate reference values for spirometry are important because the results are used for diagnosing common chronic lung diseases such as asthma and chronic obstructive pulmonary disease, estimating physiologic impairment, and predicting all-cause mortality. Reference equations have been established for Mexican Americans but not for others with Hispanic/Latino backgrounds. To develop spirometry reference equations for adult Hispanic/Latino background groups in the United States. The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) recruited a population-based probability sample of 16,415 Hispanics/Latinos aged 18-74 years living in the Bronx, Chicago, Miami, and San Diego. Participants self-identified as being of Puerto Rican, Cuban, Dominican, Mexican, or Central or South American background. Spirometry was performed using standardized methods with central quality control monitoring. Spirometric measures from a subset of 6,425 never-smoking participants without respiratory symptoms or disease were modeled as a function of sex, age, height, and Hispanic/Latino background to produce background-specific reference equations for the predicted value and lower limit of normal. Dominican and Puerto Rican Americans had substantially lower predicted and lower limit of normal values for FVC and FEV 1 than those in other Hispanic/Latino background groups and also than Mexican American values from NHANES III (Third National Health and Nutrition Examination Survey). For patients of Dominican and Puerto Rican background who present with pulmonary symptoms in clinical practice, use of background-specific spirometry reference equations may provide more appropriate predicted and lower limit of normal values, enabling more accurate diagnoses of abnormality and physiologic impairment.

Positive Rates and Factors Associated with Abnormal Lung Function of Greenhouse Workers in China: A Cross-Sectional Study.

Science.gov (United States)

Zhu, Xiaojun; Gao, Panjun; Gu, Yishuo; Xiao, Pei; Liu, Mengxuan; Chen, Juan; Cen, Yacai; Ma, Wenjun; Li, Tao

2017-08-24

Since the number of greenhouse workers are increasing in China, this observational cross-sectional study was designed to evaluate lung function and discuss the potential risk factors, to provide evidence in the surveillance of greenhouse workers' health. 678 greenhouse workers in Gansu Province, China were enrolled. A questionnaire which included demographic and occupational information was used. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), and FEV₁:FVC ratios (FEV₁/FVC), maximal expiratory flow after 50% of the FVC has not been exhaled (MEF 50 ), maximal expiratory flow after 25% of the FVC has not been exhaled (MEF 25 ) and maximal mid-expiratory flow curve (MMEF) were measured as lung function indicators. The mean values and standard deviations (SDs) of VC% predicted, FVC% predicted, FEV₁% predicted and FEV₁/FVC ratio were 106.07 ± 13.36, 107.60 ± 13.95, 97.19 ± 14.80 and 89.76 ± 10.78 respectively. The positive rates of above four and abnormal lung ventilation function were 2.9%, 2.8%, 11.2%, 4.6% and 6.5% respectively. Gender, age, BMI and number of greenhouses owned were influence factors of lung ventilation function ( p greenhouses owned were influence factors for small airway function ( p greenhouse might influence lung function of the workers. Small airway function indicators could be used as priority indicators for the surveillance of greenhouse workers' health.

Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

Science.gov (United States)

Calice, Ivana; Moens, Yves

2016-01-01

Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected.

A new approach to assess COPD by identifying lung function break-points

Directory of Open Access Journals (Sweden)

Eriksson G

2015-10-01

Full Text Available Göran Eriksson,1,* Linnea Jarenbäck,1,* Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson11Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden*These authors contributed equally to this workPurpose: COPD is a progressive disease, which can take different routes, leading to great heterogeneity. The aim of the post-hoc analysis reported here was to perform continuous analyses of advanced lung function measurements, using linear and nonlinear regressions.Patients and methods: Fifty-one COPD patients with mild to very severe disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Stages I–IV and 41 healthy smokers were investigated post-bronchodilation by flow-volume spirometry, body plethysmography, diffusion capacity testing, and impulse oscillometry. The relationship between COPD severity, based on forced expiratory volume in 1 second (FEV1, and different lung function parameters was analyzed by flexible nonparametric method, linear regression, and segmented linear regression with break-points.Results: Most lung function parameters were nonlinear in relation to spirometric severity. Parameters related to volume (residual volume, functional residual capacity, total lung capacity, diffusion capacity [diffusion capacity of the lung for carbon monoxide], diffusion capacity of the lung for carbon monoxide/alveolar volume and reactance (reactance area and reactance at 5Hz were segmented with break-points at 60%–70% of FEV1. FEV1/forced vital capacity (FVC and resonance frequency had break-points around 80% of FEV1, while many resistance parameters had break-points below 40%. The slopes in percent predicted differed; resistance at 5 Hz minus resistance at 20 Hz had a linear slope change of -5.3 per unit FEV1, while residual volume had no slope change above and -3.3 change per unit FEV1 below its break-point of 61

The influence of polycyclic aromatic hydrocarbons on lung function in a representative sample of the Canadian population.

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Cakmak, Sabit; Hebbern, Chris; Cakmak, Jasmine D; Dales, Robert E

2017-09-01

We investigated the associations between exposure to polycyclic aromatic hydrocarbons (PAHs) and selected respiratory physiologic measures in cycles 2 and 3 of the Canadian Health Measures Survey, a nationally representative population sample. Using generalized linear mixed models, we tested the association between selected PAH metabolites and 1-second forced expiratory volume (FEV 1 ), forced vital capacity (FVC), and the ratio between the two (FEV 1 /FVC) in 3531 people from 6 to 79 years of age. An interquartile change in urinary PAH metabolite was associated with significant decrements in FEV 1 and FVC for eight PAHs, 2-hydroxynapthalene, 1-, and 2-hydroxyphenanthrene, 2-, 3-, and 9-hydroxyfluorene and 3- and 4-hydroxyphenanthrene. Exposure to PAH may negatively affect lung function in the Canadian population. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study.

Science.gov (United States)

Sabbagh, C; Dumont, F; Fuks, D; Yzet, T; Verhaeghe, P; Regimbeau, J-M

2012-02-01

Progressive preoperative pneumoperitoneum (PPP) is used to prepare incisional hernias with loss of domain (IHLD) operations. The aim of the present study was to analyze the effect of PPP on peritoneal volume [measured using a new computed tomography (CT)-based method] and respiratory function. From July 2004 to July 2008, 19 patients were included in a prospective, observational study. The volumes of the incisional hernia (VIH), the abdominal cavity (VAC), the total peritoneal content (VP) and the VIH/VP ratio were measured before and after PPP using abdominal CT scan data. Spirometric parameters were measured before and after PPP, and postoperative clinical data were evaluated. Before and after PPP, the mean VIH was 1,420 cc and 2,110 cc (P  VIH before PPP. After PPP, the spirometric measurements revealed a restrictive syndrome. The overall postoperative morbidity rate was 37%. PPP increased the hernia and abdominal volumes. PPP induced a progressive, restrictive syndrome.

Practical surrogate marker of pulmonary dysanapsis by simple spirometry: an observational case-control study in primary care.

Science.gov (United States)

Shiota, Satomi; Ichikawa, Masako; Suzuki, Kazuhiro; Fukuchi, Yoshinosuke; Takahashi, Kazuhisa

2015-03-26

We see patients who present with spirometry airflow limitation despite their forced expiratory volume in one second (FEV1) as well as forced vital capacity (FVC) to be supernormal (FEV1/FVC spirometry conditions (results measured with spirometry) could be suitably used as a practical surrogate marker of pulmonary dysanapsis: the condition of disproportionate but physiologically normal growth between airways and lung parenchyma. We compared the conventional surrogate marker of dysanapsis, maximum mid-expiratory flow to FVC (MMF/FVC), in SUBJECTS (FEV1/FVC spirometry results with SUBJECTS) (n = 55), and in CONTROLS (age- and height- matched, normal spirometry results) (n = 25). Next we added imaging analysis to evaluate the relationship between the cross sectional airway luminal area (X-Ai) and the lung volume results among the three groups. The MMF/FVC was significantly lower in SUBJECTS and in EMPHYSEMA compared to CONTROLS. However, percent predicted peak expiratory flow (%PEFR) was significantly lower only in SUBJECTS and not in EMPHYSEMA compared to CONTROLS. The ratio of the X-Ai of the trachea and right apical bronchus to lung volume was significantly lower in SUBJECTS compared to CONTROLS. The simple spirometry conditions in SUBJECTS are highly suggestive of practical surrogate marker of pulmonary dysanapsis. Awareness of this concept would help to attenuate the risk of overdiagnosis of obstructive pulmonary disease.

Metal dust exposure and lung function deterioration among steel workers: an exposure-response relationship.

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Hamzah, Nurul Ainun; Mohd Tamrin, Shamsul Bahri; Ismail, Noor Hassim

2016-07-01

Metallic dust is a heterogeneous substance with respiratory sensitizing properties. Its long term exposure adversely affected lung function, thus may cause acute or chronic respiratory diseases. A cross-sectional study was conducted in a steel factory in Terengganu, Malaysia to assess the metal dust exposure and its relationship to lung function values among 184 workers. Metal dust concentrations values (Co, Cr, and Ni) for each worker were collected using air personal sampling. Lung function values (FEV 1 , FVC, and %FEV 1 /FVC) were determined using spirometer. Exposure to cobalt and chromium were 1-3 times higher than permissible exposure limit (PEL) while nickel was not exceeding the PEL. Cumulative of chromium was the predictor to all lung function values (FEV 1 , FVC, and %FEV 1 /FVC). Frequency of using mask was positively associated with FVC (Adj b = 0.263, P = 0.011) while past respiratory illnesses were negatively associated with %FEV 1 /FVC (Adj b = -1.452, P = 0.026). Only few workers (36.4%) were found to wear their masks all times during the working hours. There was an exposure-response relationship of cumulative metal dust exposure with the deterioration of lung function values. Improvement of control measures as well as proper and efficient use or personal protection equipment while at work could help to protect the respiratory health of workers.

Utilizing Forced Vital Capacity to Predict Low Lung Compliance and Select Intraoperative Tidal Volume During Thoracic Surgery.

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Hoftman, Nir; Eikermann, Eric; Shin, John; Buckley, Jack; Navab, Kaveh; Abtin, Fereidoun; Grogan, Tristan; Cannesson, Maxime; Mahajan, Aman

2017-12-01

Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT). We compared the correlation between TLC and PBW with the correlation between TLC and FVC to determine which was stronger. Dynamic pulmonary compliance was then calculated from intraoperative ventilator data and logistic regression models constructed to determine which clinical measure best predicted low compliance. Ratios of tidal volume/FVC plotted against peak inspiratory pressure were utilized to construct a new model for tidal volume selection. Calculated tidal volumes generated by this model were then compared with those generated by the standard lung-protective formula Vt = 7 cc/kg. The correlation between FVC and TLC (0.82 for TLCPFT and 0.76 for TLCCT) was stronger than the correlation between PBW and TLC (0.65 for TLCPFT and 0.58 for TLCCT). Patients with very low compliance had significantly smaller lung volumes (forced expiratory volume at 1 second, FVC, TLC) and lower diffusion capacity of the lungs for carbon monoxide when compared with patients with normal compliance. An FVC cutoff of 3470 cc was 100% sensitive and 51% specific for predicting low compliance. The proposed equation Vt = FVC/8 significantly reduced calculated tidal volume by a mean of 22.5% in patients with low pulmonary compliance without affecting the mean tidal volume in patients with normal compliance (mean difference 0.9%). FVC is more strongly correlated to TLC than PBW and a cutoff of about 3.5 L can be utilized to predict

Low-level exposure to organophosphate pesticides leads to restrictive lung dysfunction.

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Peiris-John, Roshini Janet; Ruberu, Dawala Kusuma; Wickremasinghe, Ananda Rajitha; van-der-Hoek, Wim

2005-10-01

Apart from symptomology, there are very few reports on lung function following exposure to low levels of organophosphate (OP) pesticides in man. Twenty-five occupationally exposed farmers and 22 environmentally exposed freshwater fishermen were evaluated between and during OP spray seasons. Forty marine fishermen living away from agricultural areas were recruited as a control group. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) were measured by spirometry. Haemoglobin corrected erythrocyte acetylcholinesterase (AChE) levels were measured during and between (baseline estimation) spray seasons using a portable WHO-approved Test-mate system (EQM Research, Ohio). FVC ratio was lower in the farmers as compared to the controls (P<0.001) between exposure seasons. In the farmers, FVC ratio decreased further during the exposure season (P=0.023). FEV(1) was lower in the farmers as compared to the controls in both periods (P<0.05). In the fishermen, the decrease in ratios of FVC and FEV(1) following exposure to pesticides was not significant. FEV(1)/FVC ratios were similar in the three groups between (P=0.988) and during (P=0.159) exposure periods. Following exposure to OPs, AChE levels dropped 12.75% in the farmers (P<0.001) and 5.62% in the freshwater fishermen (P=0.001). Occupational exposure to OP results in restrictive lung dysfunction, a phenomenon not observed following environmental exposure.

SHORT TERM EFFECT OF ACUPUNCTURE-TENS ON LUNG FUNCTIONS AND DYSPNEA FOR SUBJECTS WITH MODERATE COPD

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Vinod Babu. K

2015-10-01

Full Text Available Background: Acupuncture TENS is used to improve pain instead of invasive acupuncture. Acupuncture shown to improve dyspnoea and lung functions in COPD (Chronic Obstructive Pulmonary Disease patients. The purpose of the study is to determine Short term effectiveness of Acupuncture-TENS in reducing dyspnea and improving lung functions for subjects with moderate COPD. Method: An experimental study design, selected 30 geriatric subjects with COPD randomized 15 subjects into each Study and Control group. Study group received Acu-TENS for 45 minutes for total 5 sessions, while control group received placebo TENS. Outcome measurements such as breathlessness using Modified Borg Scale (MBS, Lung functions using Pulmonary Function Test (PFT was measured before and after intervention. Results: Analysis from pre-intervention to post-intervention within study group found that there is statistically significant change in means of MBS, FEV1, FEV1/FVC ratio and within control group there is a statistically significant change in means of MBS, but there is no statistically significant change in means of FEV1, FVC and FEV1/FVC ratio. When post-intervention means were compared between the groups there is no statistically significant difference in means of MBS and FEV1, FVC and FEV1/FVC ratio. Conclusion: It is concluded that one week of Acu-TENS on EXL1 point found no significant effect on improving dyspnea and lung functions in subjects with moderate COPD in geriatric populations.

Respiratory muscle hemodynamic and metabolic adaptations to 16 weeks of training in varsity soccer players: near-infrared spectroscopy measurements during lung function tests (Conference Presentation)

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Harris, R. Luke; Grob, Tanya; Sandhu, Komal; Schwab, Timothy

2017-02-01

The purpose of this study was to test the hypothesis that mobile, wireless near-infrared spectroscopy (NIRS) instruments can be used during standard lung function tests to measure adaptations in respiratory muscle metabolism over weeks to months. In eight varsity soccer players at 0 weeks and after 16 weeks of routine training, commercially available mobile, wireless NIRS instruments were used to measure oxygenation and hemodynamics in the sternocleidomastoid (SCM, accessory inspiration muscle). During maximal expiratory pressure (MEP) and forced vital capacity (FVC) maneuvers we determined peak or antipeak changes relative to baseline in oxygenation and hemodynamics: Δ%Sat (muscle oxygen saturation), ΔtHb (total hemoglobin), ΔO2Hb (oxygenated hemoglobin), and ΔHHb (deoxygenated hemoglobin). Subjects reported that the average training load was 13.3 h/week during the 16 study weeks, compared to 10.4 h/week during 12 prior weeks. After 16 weeks of training compared to 0 weeks we found statistically significant increases in SCM Δ%Sat (57.7%), ΔtHb (55.3%), and ΔO2Hb (56.7%) during MEP maneuvers, and in SCM Δ%Sat (64.8%), ΔtHb (29.4%), and ΔO2Hb (51.6%) during FVC maneuvers. Our data provide preliminary evidence that NIRS measurements during standard lung function tests are sufficiently sensitive to detect improvements or declines in respiratory muscle metabolism over periods of weeks to months due to training, disease, and rehabilitation exercise.

Body mass index and dynamic lung volumes in office workers

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Rasool, S.A.; Shirwany, A.K.

2012-01-01

To measure the association of body mass index (BMI) to lung volumes assessed by spirometer. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Physiology and Cell Biology, University of Health Sciences, Lahore, from February to August 2009. Methodology: Two hundred and twenty-five apparently healthy adult office workers of either gender aged > 20 years were recruited. Height and weight were measured and BMI was calculated as kg/m2. Subjects were categorized as normal (BMI=18.5 to 24.9 kg/m2); overweight (BMI=25 to 29.9 kg/m2); and obese Class 1 (BMI=30 to 34.9 kg/m2) on the basis of BMI. Lung volumes were measured by digital spirometer and were reported as percentage of predicted values for forced vital capacity (FVC%), forced expiratory volume in first second (FEV1%) and ratio of FEV1 to FVC (FEV1:FVC). Groups were compared using t-test and ANOVA, correlation was assessed by Pearson's 'r'. Results: Significant differences in lung volumes were found in different BMI categories. Obese subjects had significantly lower FVC% (p < 0.0001), as well as significantly lower FEV1% (p = 0.003) as compared to normal subjects. There were significant linear relationships between obesity and PFTs. BMI had significant negative linear association with FVC% in overweight (r = -0.197) and obese (r = - 0.488); and with FEV1% in obese subjects (r = -0.510). Gender and age had no significant effect on mean values of PFTs. Conclusion: Obese individuals in this sample had significant decline in lung volumes. (author)

Influência da adequação postural em cadeira de rodas na função respiratória de pacientes com amiotrofia espinhal tipo II Influence of wheelchair positioning aids on the respiratory function of patients with type II spinal muscular atrophy

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Luanda André Collange

2009-09-01

Full Text Available Este estudo visou determinar a influência da adequação postural em cadeira de rodas na função respiratória de pacientes com amiotrofia espinhal tipo II (AME. Doze pacientes (idades entre 7 e 24 anos com diagnóstico de AME II, confirmado por achados clínicos e análise genética, participaram do estudo. Os parâmetros respiratórios - volume minuto (VM, volume corrente (VC, capacidade vital forçada (CVF, pressões inspiratória (PImáx e expiratória (PEmáx máximas e pico de fluxo expiratório (PFE - na cadeira de rodas individual, com adaptações, e em uma cadeira de rodas padrão, isto é, sem reclinação ou inclinação. Os resultados mostram valores melhores estatisticamente significativos de todos os parâmetros respiratórios (VM, p=0,002; VC, p=0,003; CVF, p=0,017; PImáx, p=0,002; PEmáx, p=0,006; e PFE, p=0,007 nas medidas tomadas na cadeira adaptada para a postura adequada. Os resultados permitem concluir que a adequação postural em cadeira de rodas influencia positivamente a função respiratória de pacientes com AME tipo II.This study aimed at determining the influence of adequate wheelchair positioning aids on the respiratory function in spinal muscular atrophy (SMA type II patients. Twelve patients (aged 7 to 24 with SMA diagnosed by clinical findings and confirmed by genetic analysis, who owned wheelchairs with positioning aids, underwent spirometric assessment - as to minute volume (MV, tidal volume (TV, forced vital capacity (FVC, maximum inspiratory (IPmax and expiratory (EPmax pressures, and peak expiratory flow (PEF - both on their own wheelchair and on a standard wheelchair with no recline or tilt. Results show significantly better values in all assessed parameters (MV, p=0.002; TV, p=0.003; FVC, p=0.017; IPmax, p=0.002, EPmax, p=0.006; and PEF, p=0.007 of measures taken at the patient's own chair, with positioning aids. These results allow for concluding that wheelchair positioning aids may positively

Relation between respiratory function and arterial stiffness assessed using brachial-ankle pulse wave velocity in healthy workers.

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Inomoto, Atsushi; Fukuda, Rika; Deguchi, Junko; Toyonaga, Toshihiro

2017-09-01

[Purpose] Current studies report that patients with chronic obstructive pulmonary disease (COPD) may also have arteriosclerosis. This study aimed to investigate the relationship between respiratory function and arterial stiffness in healthy workers using the brachial-ankle pulse wave velocity (baPWV). [Subjects and Methods] This study included 104 male Japanese workers without COPD. We collected participant information and measured hemodynamics, body composition, and respiratory function. [Results] In the correlation analysis, baPWV showed a significant positive correlation with age, smoking index, systolic blood pressure, diastolic blood pressure, and heart rate, and a significant negative correlation with height, fat free mass, lower limb muscle mass, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1). In multiple regression analysis using factors other than baPWV and respiratory function as adjustment variables, both FVC and FEV1 showed a significant negative relationship with baPWV (p=0.009 and p=0.027, respectively). FEV1/FVC was not significantly related to baPWV (p=0.704). [Conclusion] The results of this study indicated that FEV1/FVC and the proportion of FEV1 predicted, which are indicators of airflow limitation, are not predictors of baPWV in workers without airflow limitation. However, since baPWV showed a significant negative relationship with FVC and FEV 1, the reduction in respiratory function that does not cause airflow limitation, such as FVC or FEV1 decline, may be related to an increase in the risk of arterial stiffness.

Exercise-mediated vasodilation in human obesity and metabolic syndrome: effect of acute ascorbic acid infusion.

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Limberg, Jacqueline K; Kellawan, J Mikhail; Harrell, John W; Johansson, Rebecca E; Eldridge, Marlowe W; Proctor, Lester T; Sebranek, Joshua J; Schrage, William G

2014-09-15

We tested the hypothesis that infusion of ascorbic acid (AA), a potent antioxidant, would alter vasodilator responses to exercise in human obesity and metabolic syndrome (MetSyn). Forearm blood flow (FBF, Doppler ultrasound) was measured in lean, obese, and MetSyn adults (n = 39, 32 ± 2 yr). A brachial artery catheter was inserted for blood pressure monitoring and local infusion of AA. FBF was measured during dynamic handgrip exercise (15% maximal effort) with and without AA infusion. To account for group differences in blood pressure and forearm size, and to assess vasodilation, forearm vascular conductance (FVC = FBF/mean arterial blood pressure/lean forearm mass) was calculated. We examined the time to achieve steady-state FVC (mean response time, MRT) and the rise in FVC from rest to steady-state exercise (Δ, exercise - rest) before and during acute AA infusion. The MRT (P = 0.26) and steady-state vasodilator responses to exercise (ΔFVC, P = 0.31) were not different between groups. Intra-arterial infusion of AA resulted in a significant increase in plasma total antioxidant capacity (174 ± 37%). AA infusion did not alter MRT or steady-state FVC in any group (P = 0.90 and P = 0.85, respectively). Interestingly, higher levels of C-reactive protein predicted longer MRT (r = 0.52, P exercise does not alter the time course or magnitude of exercise-mediated vasodilation in groups of young lean, obese, or MetSyn adults. However, systemic inflammation may limit the MRT to exercise, which can be improved with AA. Copyright © 2014 the American Physiological Society.

Spirometry, Static Lung Volumes, and Diffusing Capacity.

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Vaz Fragoso, Carlos A; Cain, Hilary C; Casaburi, Richard; Lee, Patty J; Iannone, Lynne; Leo-Summers, Linda S; Van Ness, Peter H

2017-09-01

Spirometric Z-scores from the Global Lung Initiative (GLI) rigorously account for age-related changes in lung function and are thus age-appropriate when establishing spirometric impairments, including a restrictive pattern and air-flow obstruction. However, GLI-defined spirometric impairments have not yet been evaluated regarding associations with static lung volumes (total lung capacity [TLC], functional residual capacity [FRC], and residual volume [RV]) and gas exchange (diffusing capacity). We performed a retrospective review of pulmonary function tests in subjects ≥40 y old (mean age 64.6 y), including pre-bronchodilator measures for: spirometry ( n = 2,586), static lung volumes by helium dilution with inspiratory capacity maneuver ( n = 2,586), and hemoglobin-adjusted single-breath diffusing capacity ( n = 2,508). Using multivariable linear regression, adjusted least-squares means (adj LS Means) were calculated for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity. The adj LS Means were expressed with and without height-cubed standardization and stratified by GLI-defined spirometry, including normal ( n = 1,251), restrictive pattern ( n = 663), and air-flow obstruction (mild, [ n = 128]; moderate, [ n = 150]; and severe, [ n = 394]). Relative to normal spirometry, restrictive-pattern had lower adj LS Means for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity ( P ≤ .001). Conversely, relative to normal spirometry, mild, moderate, and severe air-flow obstruction had higher adj LS Means for FRC and RV ( P < .001). However, only mild and moderate air-flow obstruction had higher adj LS Means for TLC ( P < .001), while only moderate and severe air-flow obstruction had higher adj LS Means for RV/TLC ( P < .001) and lower adj LS Means for hemoglobin-adjusted single-breath diffusing capacity ( P < .001). Notably, TLC (calculated as FRC + inspiratory capacity) was not increased in severe air-flow obstruction ( P ≥ .11

Respiratory impairment and the aging lung: a novel paradigm for assessing pulmonary function.

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Vaz Fragoso, Carlos A; Gill, Thomas M

2012-03-01

Older persons have an increased risk of developing respiratory impairment because the aging lung is likely to have experienced exposures to environmental toxins as well as reductions in physiological capacity. Systematic review of risk factors and measures of pulmonary function that are most often considered when defining respiratory impairment in aging populations. Across the adult life span, there are frequent exposures to environmental toxins, including tobacco smoke, respiratory infections, air pollution, and occupational dusts. Concurrently, there are reductions in physiological capacity that may adversely affect ventilatory control, respiratory muscle strength, respiratory mechanics, and gas exchange. Recent work has provided a strong rationale for defining respiratory impairment as an age-adjusted reduction in spirometric measures of pulmonary function that are independently associated with adverse health outcomes. Specifically, establishing respiratory impairment based on spirometric Z-scores has been shown to be strongly associated with respiratory symptoms, frailty, and mortality. Alternatively, respiratory impairment may be defined by the peak expiratory flow, as measured by a peak flow meter. The peak expiratory flow, when expressed as a Z-score, has been shown to be strongly associated with disability and mortality. However, because it has a reduced diagnostic accuracy, peak expiratory flow should only define respiratory impairment when spirometry is not readily available or an older person cannot adequately perform spirometry. Aging is associated with an increased risk of developing respiratory impairment, which is best defined by spirometric Z-scores. Alternatively, in selected cases, respiratory impairment may be defined by peak expiratory flow, also expressed as a Z-score.

Relationship between pulmonary function and indoor air pollution from coal combustion among adult residents in an inner-city area of southwest China

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Jie, Y.; Houjin, H.; Xun, M.; Kebin, L.; Xuesong, Y.; Jie, X.

2014-01-01

Few studies evaluate the amount of particulate matter less than 2.5 mm in diameter (PM2.5) in relation to a change in lung function among adults in a population. The aim of this study was to assess the association of coal as a domestic energy source to pulmonary function in an adult population in inner-city areas of Zunyi city in China where coal use is common. In a cross-sectional study of 104 households, pulmonary function measurements were assessed and compared in 110 coal users and 121 non-coal users (≥18 years old) who were all nonsmokers. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were compared between the 2 groups. The amount of PM2.5 was also measured in all residences. There was a significant increase in the relative concentration of PM2.5 in the indoor kitchens and living rooms of the coal-exposed group compared to the non-coal-exposed group. In multivariate analysis, current exposure to coal smoke was associated with a 31.7% decrease in FVC, a 42.0% decrease in FEV1, a 7.46% decrease in the FEV1/FVC ratio, and a 23.1% decrease in PEFR in adult residents. The slope of lung function decrease for Chinese adults is approximately a 2-L decrease in FVC, a 3-L decrease in FEV1, and an 8 L/s decrease in PEFR per count per minute of PM2.5 exposure. These results demonstrate the harmful effects of indoor air pollution from coal smoke on the lung function of adult residents and emphasize the need for public health efforts to decrease exposure to coal smoke. PMID:25296361

Usefulness of phrenic latency and forced vital capacity in patients with ALS with latent respiratory dysfunction.

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Kwon, Soonwook; Min, Ju-Hong; Cho, Hye-Jin; Joo, Byung-Euk; Cho, Eun Bin; Seok, Jin Myoung; Kim, Min-Ji; Kim, Byoung Joon

2015-07-01

The pulmonary function test (PFT) is a non-invasive and easily available technique to assess respiratory function in patients with amyotrophic lateral sclerosis (ALS); however, patients with dyspnea sometimes show normal PFT findings. Herein, we investigated whether phrenic nerve conduction study (NCS) and PFT are useful to evaluate respiratory function of patients with ALS with normal value ranges in the PFT. We prospectively enrolled 34 patients with definite or probable ALS, who showed FVC (%) ⩾80 of predicted and 78 healthy subjects. PFT and phrenic NCS were performed with the measurement of forced vital capacity (FVC, %), forced expiratory volumes in 1s (FEV1, %), FEV1/FCV ratio (%), and phrenic compound muscle action potential amplitude, and latency. Compared to healthy controls, ALS patients showed delayed phrenic nerve latency and the decrease of FVC (%) (p=0.006 and pphrenic latency (AUC=0.7655) and FVC (%) (AUC=0.8239) discriminated ALS patients from healthy subjects. We demonstrated that ALS patients had early respiratory dysfunction, despite normal PFT findings. Phrenic latency and FVC (%) can be helpful to discriminate ALS patients with latent respiratory dysfunction from healthy subjects. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Organization of metabolic pathways in vastus lateralis of patients with chronic obstructive pulmonary disease.

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Green, Howard J; Bombardier, Eric; Burnett, Margaret; Iqbal, Sobia; D'Arsigny, Christine L; O'Donnell, Dennis E; Ouyang, Jing; Webb, Katherine A

2008-09-01

The objective of this study was to determine whether patients with chronic obstructive lung disease (COPD) display differences in organization of the metabolic pathways and segments involved in energy supply compared with healthy control subjects. Metabolic pathway potential, based on the measurement of the maximal activity (V(max)) of representative enzymes, was assessed in tissue extracted from the vastus lateralis in seven patients with COPD (age 67 +/- 4 yr; FEV(1)/FVC = 44 +/- 3%, where FEV(1) is forced expiratory volume in 1 s and FVC is forced vital capacity; means +/- SE) and nine healthy age-matched controls (age 68 +/- 2 yr; FEV(1)/FVC = 75 +/- 2%). Compared with control, the COPD patients displayed lower (P chain and glycogenolysis and glycolysis relative to beta-oxidation.

A Rwandan spirometry and resting ventilation study | Gahutu ...

African Journals Online (AJOL)

To illustrate spirometric population variation and ventilatory adaptation to moderate altitude, we report the spirometric and resting ventilation values observed in a student population in Butare, Rwanda (altitude: 1 768 m; barometric pressure: 629 mm Hg). Spirometry was carried out with a Mijnhardt Volutest VT-3 ...

Cyst-based measurements for assessing lymphangioleiomyomatosis in computed tomography

Energy Technology Data Exchange (ETDEWEB)

Lo, P., E-mail: pechinlo@mednet.edu.ucla; Brown, M. S.; Kim, H.; Kim, H.; Goldin, J. G. [Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California 90024 (United States); Argula, R.; Strange, C. [Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina 29425 (United States)

2015-05-15

Purpose: To investigate the efficacy of a new family of measurements made on individual pulmonary cysts extracted from computed tomography (CT) for assessing the severity of lymphangioleiomyomatosis (LAM). Methods: CT images were analyzed using thresholding to identify a cystic region of interest from chest CT of LAM patients. Individual cysts were then extracted from the cystic region by the watershed algorithm, which separates individual cysts based on subtle edges within the cystic regions. A family of measurements were then computed, which quantify the amount, distribution, and boundary appearance of the cysts. Sequential floating feature selection was used to select a small subset of features for quantification of the severity of LAM. Adjusted R{sup 2} from multiple linear regression and R{sup 2} from linear regression against measurements from spirometry were used to compare the performance of our proposed measurements with currently used density based CT measurements in the literature, namely, the relative area measure and the D measure. Results: Volumetric CT data, performed at total lung capacity and residual volume, from a total of 49 subjects enrolled in the MILES trial were used in our study. Our proposed measures had adjusted R{sup 2} ranging from 0.42 to 0.59 when regressing against the spirometry measures, with p < 0.05. For previously used density based CT measurements in the literature, the best R{sup 2} was 0.46 (for only one instance), with the majority being lower than 0.3 or p > 0.05. Conclusions: The proposed family of CT-based cyst measurements have better correlation with spirometric measures than previously used density based CT measurements. They show potential as a sensitive tool for quantitatively assessing the severity of LAM.

Healthy eating at different risk levels for job stress: testing a moderated mediation.

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Fodor, Daniel P; Antoni, Conny H; Wiedemann, Amelie U; Burkert, Silke

2014-04-01

Health behavior, like fruit and vegetable consumption (FVC), is affected by unfavorable job conditions. However, there is little research to date that combines job stress models and health-behavior change models. This longitudinal study examined the contribution of risk factors associated with job stress to the intention-planning-FVC relationship. In the context of the Health Action Process Approach, action planning (when-where-how plans) and coping planning (plans to overcome anticipated barriers) have been shown to be successful mediators in the translation of health-related intentions into action. Risk factors for job stress are operationalized as the interaction of job demands and job resources in line with the Job Demands-Resources (JD-R) model. Two hundred seventy-two employees (mean age 41.2 years, 73.9% female) from different jobs completed measures of intention at baseline (t1), action planning and coping planning 2 weeks later (t2), and FVC another 2 weeks later (t3). Job demands and job resources were assessed at t1 and t2. A moderated mediation analysis indicated that risk factors for job stress moderate the translation of intention into action planning (B = -0.23, p < .05) and coping planning (B = -0.14, p < .05). No moderation effect of the planning-FVC relationship by risk factors for job stress was found. However, coping planning directly predicted FVC (B = 0.36, p < .001). Findings suggest that employees intending to eat healthily use action planning and coping planning when job demands exceed job resources. For increasing FVC, coping planning appears most beneficial.

Poor sleep quality has an adverse effect on childhood asthma control and lung function measures.

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Sheen, Youn Ho; Choi, Sun Hee; Jang, Sun Jung; Baek, Ji Hyeon; Jee, Hye Mi; Kim, Mi Ae; Chae, Kyu Young; Han, Man Yong

2017-08-01

It is unclear as to whether sleep respiratory breathing disorder (SRBD) is a risk factor for uncontrolled asthma in children. The aim of this study was therefore to investigate whether SRBD may have an adverse effect on childhood asthma control and lung function measures. This was a cross-sectional study of 220 children with well-controlled (n = 108), partly controlled (n = 92), and uncontrolled asthma (n = 20) according to the Global Initiative for Asthma guideline. SRBD was assessed using the Pediatric Sleep Questionnaire (PSQ). The association of SRBD with partly controlled/uncontrolled asthma was investigated on multivariate logistic regression analysis. Of 220 children with asthma, 43 (19.6%) had SRBD: well-controlled, 16.7% (18/108); partly controlled, 21.7% (20/92); and uncontrolled, 25.0% (5/20; P = 0.54). There was a significant difference in forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC; P = 0.007) and childhood asthma control test (C-ACT) score (P asthma control status, but not in PSQ score (P = 0.18). Children with obstructive sleep apnea (PSQ >0.33) had a lower C-ACT score compared with controls (PSQ ≤0.33; 19.6 ± 5.1 vs 22.0 ± 4.2, P = 0.002). PSQ score was negatively correlated with FEV 1 /FVC (r = -0.16, P = 0.02). On multivariate logistic regression analysis, high PSQ score increased the odds of having partly controlled/uncontrolled asthma by 9.12 (95% CI: 1.04-79.72, P = 0.046) after adjusting for confounding factors. SRBD is an independent risk factor for partly controlled/uncontrolled asthma and has an adverse effect on lung function measures in children. Further research is warranted to determine whether the improvement of sleep quality may also enhance level of asthma control and lung function in children. © 2017 Japan Pediatric Society.

Effects of Cigarettes Smoking on Pulmonary Function among University Students

Directory of Open Access Journals (Sweden)

Hariri Azian

2017-01-01

Full Text Available Pulmonary function testing is a physiological test that measures how an individual inhales or exhales volumes of air as a function of time. Smoking is greatly associated with reduction of pulmonary function. This research is aimed to estimate the values of peak expiratory flow (PEF, forced expiratory volume in first second (FEV1, forced vital capacity (FVC and ratio between FEV1/FVC among smoking and non-smoking students in Universiti Tun Hussein Onn Malaysia. Smoking is often related to obstructive disorder with low value of FVC, FEV1 and FEV1/FVC. These pulmonary functions were analyzed based on several variables such as; the number of cigarette smoked per day, duration of smoking, age, and body mass index (BMI values. 70 healthy volunteers consist of smoking and non- smoking students was selected through several sessions. Students were interviewed to answer questionnaire on demographic, lifestyles and their smoking habit. The pulmonary function tests were conducted according to American Thoracic Society (ATS standards. The results of the pulmonary functions were analyzed by using SPSS software to compare the pulmonary functions between the smoker and the non-smoker students. The results of the studies showed that the number of cigarettes smoked by respondent and the BMI values were the significant predictors of the decrease in FEV1/FVC values among university students

Bronchodilator responsiveness and reported respiratory symptoms in an adult population.

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Wan C Tan

Full Text Available BACKGROUND: The relationship between patient-reported symptoms and objective measures of lung function is poorly understood. AIM: To determine the association between responsiveness to bronchodilator and respiratory symptoms in random population samples. METHODS: 4669 people aged 40 years and older from 8 sites in Canada completed interviewer-administered respiratory questionnaires and performed spirometry before and after administration of 200 ug of inhaled salbutamol. The effect of anthropometric variables, smoking exposure and doctor-diagnosed asthma (DDA on bronchodilator responsiveness in forced expiratory volume in 1 second (FEV1 and in forced vital capacity (FVC were evaluated. Multiple logistic regression was used to test for association between quintiles of increasing changes in FEV1 and in FVC after bronchodilator and several respiratory symptoms. RESULTS: Determinants of bronchodilator change in FEV1 and FVC included age, DDA, smoking, respiratory drug use and female gender [p<0.005 to p<0.0001 ]. In subjects without doctor-diagnosed asthma or COPD, bronchodilator response in FEV1 was associated with wheezing [p for trend<0.0001], while bronchodilator response for FVC was associated with breathlessness. [p for trend <0.0001]. CONCLUSIONS: Bronchodilator responsiveness in FEV1 or FVC are associated with different respiratory symptoms in the community. Both flow and volume bronchodilator responses are useful parameters which together can be predictive of both wheezing and breathlessness in the general population.

Effects of cigarette smoke on methacholine- and AMP-induced air trapping in asthmatics.

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Prieto, Luis; Palop, Julio; Llusar, Ruth; Herrera, Susana; Perez-Frances, Carmen; Lanuza, Amparo; Aguilar, Daniela

2015-02-01

Abstract Objective: No information is available on the effect of cigarette smoke on bronchoconstrictor-induced air trapping in asthma. The aim of this study was to evaluate the additional influence of smoking on methacholine- and adenosine 5'-monophosphate (AMP)-induced air trapping in subjects with asthma. Airway responsiveness to methacholine and AMP, bronchial (J'awNO) and alveolar (CANO) nitric oxide (NO) and exhaled breath condensate pH were measured in 68 adults (23 current smokers with asthma, 23 non-smokers with asthma and 22 current or former smokers with chronic obstructive pulmonary disease; COPD). The degree of air trapping induced by each bronchoconstrictor agent was expressed by the percent fall in forced vital capacity (FVC) at a 20% fall in forced expiratory volume in 1 s relative to FVC after saline inhalation (ΔFVC%). The ΔFVC% for AMP was higher in both smokers with asthma and patients with COPD than in non-smokers with asthma (p<0.001). By contrast, ΔFVC% for methacholine was similar in the three groups of subjects (p=0.69). In smokers with asthma, but not in the other two groups, there was a correlation between the residual volume/total lung capacity at baseline and the ΔFVC% induced by each bronchoconstrictor agent. Mean values for J'awNO were higher in non-smokers with asthma than in the other two groups (p<0.05). The results of this study suggest that factors underlying bronchoconstriction induced by indirect agonists are different in smokers and non-smokers with asthma. These observations might be clinically relevant, because triggers that frequently induce bronchial obstruction in the real world act by an indirect mechanism.

Effects of blood lead levels on airflow limitations in Korean adults: Findings from the 5th KNHNES 2011

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Chung, Hye Kyung; Chang, Yoon Soo; Ahn, Chul Woo

2015-01-01

This study aimed to examine whether blood levels of heavy metals, such as lead, mercury and cadmium, are related with pulmonary function in Korean adults. This investigation included 870 Korean adults (≥40 years) who received pulmonary function testing in the Korea National Health and Nutrition Examination Survey (KNHANES) V-2, 2011. Data of blood levels of heavy metals, pulmonary function tests and anthropometric measurements were acquired. Blood lead levels showed inverse correlations with the FEV 1 /FVC ratio before (r=−0.276, p<0.001) and after adjustment of multiple compounding factors (r=−0.115, p=0.001). A logistic multiple regression analysis revealed that blood lead levels were a significant influencing factor for the FEV 1 /FVC ratio (β=−0.017, p=0.001, adjusted R 2 =0.267). The odds ratios (ORs) for the FEV 1 /FVC ratio were significantly lower in the highest tertile group of the blood lead levels than in the lowest tertile group in Model 1 (OR=0.007, 95% CI=0.000−0.329) and Model 2 (OR=0.006, 95% CI=0.000−0.286). These findings imply that environmental exposure to lead might be an important factor that may cause airflow limitations in Korean adults. - Highlights: • Blood lead levels showed inverse correlations with the FEV 1 /FVC ratio. • Blood lead level was a significant influencing factor for the FEV 1 /FVC ratio. • ORs for FEV 1 /FVC were lower in the highest blood lead group than in the lowest group. • Environmental exposure to lead might be an important factor for airflow limitations

Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

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Heijkenskjöld Rentzhog, C; Janson, C; Berglund, L; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

2017-12-01

Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (f res ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. Lower FEV 1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF 50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV 1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV 1 /FVC and altered peripheral FOT measures (X5, f res and R5-R19) were associated with uncontrolled asthma (P-values < .05). Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV 1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements. © 2017 John Wiley & Sons Ltd.

Effects of one-hour training course and spirometry on the ability of physicians to diagnose and treat chronic obstructive pulmonary disease.

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Cai, Shan; Qin, Li; Tanoue, Lynn; Hu, Anmei; Jia, Xiujie; Luo, Hong; Chen, Yan; Chen, Ping; Peng, Hong

2015-01-01

In China, the prevalence of chronic obstructive pulmonary disease (COPD) in persons 40 years of age or older is estimated at 8.2%, but this is likely a substantial underestimate. Eight secondary hospitals which didn't have spirometries were chosen randomly in Hunan province of central south China. Physician subjects at these hospitals underwent a one-hour training course on the Chinese COPD guidelines. Physicians answered questionnaires assessing their knowledge of the guidelines before and after the training session. The mean correct scores of questionnaires were compared before and after training. Four out of the eight hospitals were given access to spirometry. Eligible patient subjects underwent spirometry testing prior to the physician visit. After seeing the patient, physicians were asked to answer a questionnaire relating to the diagnosis and severity of COPD. Physicians were then given the results of the spirometry, and asked to answer the same questionnaire. Physicians' responses before and after receiving the spirometry results were compared. 225 physicians participated in the training session. 207 questionnaires were completed. Mean scores (out of 100) before and after the training were 53.1 ± 21.7 and 93.3 ± 9.8, respectively. 18 physicians and 307 patient subjects participated in the spirometry intervention. Based on spirometric results, the prevalence of COPD was 38.8%. Physicians correctly identified the presence of COPD without spirometric data in 85 cases (76.6%); this increased to 117 cases (97.4%) once spirometric data were available. Without spirometric data, physicians incorrectly diagnosed COPD in 38 patients; this decreased to 6 patients once spirometric data were available. Spirometric data also improved the ability of physicians to correctly grade COPD severity. Simple educational training can substantially improve physicians' knowledge relating to COPD. Spirometry combined with education improves the ability of physicians to diagnose COPD

Relationship between pulmonary function and indoor air pollution from coal combustion among adult residents in an inner-city area of southwest China

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Jie, Y.; Houjin, H. [Zunyi Medical University, School of Public Health, Zunyi, Guizhou (China); Xun, M. [Affiliated Hospital of Zunyi Medical University, Department of Medicine Laboratory, Zunyi (China); Kebin, L.; Xuesong, Y.; Jie, X. [Zunyi Medical University, School of Public Health, Zunyi, Guizhou (China)

2014-09-23

Few studies evaluate the amount of particulate matter less than 2.5 mm in diameter (PM{sub 2.5}) in relation to a change in lung function among adults in a population. The aim of this study was to assess the association of coal as a domestic energy source to pulmonary function in an adult population in inner-city areas of Zunyi city in China where coal use is common. In a cross-sectional study of 104 households, pulmonary function measurements were assessed and compared in 110 coal users and 121 non-coal users (≥18 years old) who were all nonsmokers. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV{sub 1}), the FEV{sub 1}/FVC ratio, and peak expiratory flow rate (PEFR) were compared between the 2 groups. The amount of PM{sub 2.5} was also measured in all residences. There was a significant increase in the relative concentration of PM{sub 2.5} in the indoor kitchens and living rooms of the coal-exposed group compared to the non-coal-exposed group. In multivariate analysis, current exposure to coal smoke was associated with a 31.7% decrease in FVC, a 42.0% decrease in FEV{sub 1}, a 7.46% decrease in the FEV{sub 1}/FVC ratio, and a 23.1% decrease in PEFR in adult residents. The slope of lung function decrease for Chinese adults is approximately a 2-L decrease in FVC, a 3-L decrease in FEV{sub 1}, and an 8 L/s decrease in PEFR per count per minute of PM{sub 2.5} exposure. These results demonstrate the harmful effects of indoor air pollution from coal smoke on the lung function of adult residents and emphasize the need for public health efforts to decrease exposure to coal smoke.

Phenotype of asthma-chronic obstructive pulmonary disease overlap syndrome.

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Rhee, Chin Kook

2015-07-01

Many patients with asthma or chronic obstructive pulmonary disease (COPD) have overlapping characteristics of both diseases. By spirometric definition, patients with both fixed airflow obstruction (AO) and bronchodilator reversibility or fixed AO and bronchial hyperresponsiveness can be considered to have asthma-COPD overlap syndrome (ACOS). However, patients regarded to have ACOS by spirometric criteria alone are heterogeneous and can be classified by phenotype. Eosinophilic inflammation, a history of allergic disease, and smoke exposure are important components in the classification of ACOS. Each phenotype has a different underlying pathophysiology, set of characteristics, and prognosis. Medical treatment for ACOS should be tailored according to phenotype. A narrower definition of ACOS that includes both spirometric and clinical criteria is needed.

Relationship between pulmonary function and elevated glycated hemoglobin levels in health checkups: A cross-sectional observational study in Japanese participants

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Saigo Baba

2017-11-01

Full Text Available Background: Insulin resistance has been associated with cytokines, including interleukin-6 and tumor necrosis factor alpha soluble receptor, both of which are elevated in chronic obstructive pulmonary disease (COPD. Few studies have investigated the relationship between pulmonary function tests using spirometry (PFT and fasting plasma glucose (FPG or glycated hemoglobin (HbA1c levels in Japanese participants. The purpose of this study was to clarify the relationship between PFT in Japanese people who had health checkups and their FPG or HbA1c levels. In the context of preventative medicine, we intend to connect early detection of COPD to an index of blood sugar. Methods: From August 2013 through March 2014, 1019 participants underwent health checkups. PFT, FPG, and HbA1c measurements were conducted. HbA1c levels were measured according to National Glycohemoglobin Standardization Program guidelines. Results: Participants with FPG ≥100 mg/dL and HbA1c ≥5.6% showed a significantly lower forced expiratory volume in 1 s:forced vital capacity ratio (FEV1/FVC compared to participants with lower FPG and Hb1Ac levels. Prevalence of FEV1/FVC values <70% in PFT differed significantly depending on sex, age, body mass index, FPG, HbA1c, and smoking habits. Age (≥60 years, HbA1c (≥5.6%, and current or former smoking were associated with FEV1/FVC values <70%. Conclusion: In Japan, HbA1c levels were higher in participants with FEV1/FVC values <70% in PFT than in those with FEV1/FVC ≥70%. In preventive medicine, PFT by spirometry should be performed in elderly participants with elevated HbA1c levels who are current or former smokers.

Impulse oscillometry at preschool age is a strong predictor of lung function by flow-volume spirometry in adolescence.

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Lauhkonen, Eero; Riikonen, Riikka; Törmänen, Sari; Koponen, Petri; Nuolivirta, Kirsi; Helminen, Merja; Toikka, Jyri; Korppi, Matti

2018-05-01

The transition from early childhood wheezing to persistent asthma is linked to lung function impairment over time. Little is known how the methods used to study lung function at different ages correlate longitudinally. Sixty-four children with a history of hospitalization for bronchiolitis before 6 months of age were prospectively studied with impulse oscillometry (IOS) at the mean age of 6.3 years and these preschool IOS results were compared with flow-volume spirometry (FVS) measurements at mean age of 11.4 years. The baseline respiratory system resistance at 5 Hz (Rrs5) showed a modest statistically significant correlation with all baseline FVS parameters except FVC. The post-bronchodilator (post-BD) Rrs5 showed a modest statistically significant correlation with post-BD FEV 1 and FEV 1 /FVC. The bronchodilator-induced decrease in Rrs5 showed a modest statistically significant correlation with the percent increase in FEV 1 . Baseline and post-BD respiratory reactance at 5 Hz (Xrs5) showed a modest statistically significant correlation with baseline and post-BD FVS parameters except post-BD FEV 1 /FVC, respectively, and post-BD Xrs5 showed a strong correlation with post-BD FVC (ρ = 0.61) and post-BD FEV 1 (ρ = 0.59). In adjusted linear regression, preschool Xrs5 remained as a statistically significant independent predictor of FVS parameters in adolescence; the one-unit decrease in the Z-score of preschool post-BD Xrs5 predicted 9.6% lower post-BD FEV 1 , 9.3% lower post-BD FVC, and 9.7% lower post-BD MEF 50 when expressed as %-predicted parameters. Persistent post-BD small airway impairment in children with a history of bronchiolitis detected with IOS at preschool age predicted FVS results measured in early adolescence. © 2018 Wiley Periodicals, Inc.

Six minute walk test in respiratory diseases: A university hospital experience

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Al Ameri Hatem

2006-01-01

Full Text Available BACKGROUND: Six minutes walk test (6MWT, is a sub-maximal exercise test, used as a clinical indicator of the functional capacity, in patients with cardiopulmonary diseases. Its safety, validity, reliability and its correlation with several physiological instruments, are well studied. However, there are no published data on 6MWT, in the Saudi population. We are reviewing our experience with 6MWT and assessing its safety and its correlation with pulmonary function variables, in patients with pulmonary diseases, in our local population. MATERIALS AND METHODS: We consecutively studied patients with pulmonary diseases, who underwent 6MWT and pulmonary function test in King Khalid University Hospital, from June 2003 to December 2004. The 6MWTs were conducted according to the American Thoracic Society guidelines. Spirometry, lung volumes and diffusion capacity measurements were correlated with the absolute walked distance. RESULTS: One hundred and twenty nine tests were performed. All patients were of the Saudi community (59% female, with mean age of 43±15 years. Out of 129 patients, 65 patients had proven respiratory diagnosis. In all patients, the test were performed with no serious complications. The six minute walk distance (6MWD had correlation with patient′s height (r=+0.40, P < 0.001, but not with patients′ weight, BMI, borg scale, or oxygen saturation. The 6MWD correlated significantly with Dlco (r=+0.52, P < 0.01, FVC (r=+0.46, r< 0.001 and had a weaker relation with FEV1 (r=+0.31, P < 0.05. The test had no significant correlation with lung volumetric parameters (TLC, FRC and RV. CONCLUSION: 6MWT is simple and safe test in evaluating patients with chronic pulmonary diseases in the Saudi population. In our study, 6MWD showed correlation with spirometric parameters and diffusion capacity. Further studies are needed to evaluate 6MWT in a more homogenous patients′ population.

Exposure to occupational dust and changes in pulmonary function among cobblestone paving workers of Jimma, Ethiopia

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Kalkidan Abate Hassen

2014-01-01

Full Text Available The classic diseases of "dusty" occupations may be on decline, but they are not yet extinct. Studies have found associations between changes in ambient particulate air pollution and increased cardiorespiratory morbidity and mortality. A cross-sectional comparative study design was employed on 127 male nonsmoker cobblestone paving workers and 194 matched employed office workers as a reference in order to assess changes in pulmonary function related to dust exposure among cobblestone road paving workers of Jimma zone, Ethiopia. Data was collected using structured questionnaires and spirometric measurements after ethical clearance was obtained. Data was analyzed using unpaired t-tests to examine the differences between the groups. P-values equal or less than 0.05 were considered statistically significant; odds were calculated at a 95% confidence interval. Cobblestone road paving workers had significantly higher odds of respiratory symptoms, dry cough (p < 0.05, cough (p < 0.01 and sore throat (p< 0.001 compared to the reference. The FEV1 for workers exposed to cobblestone road paving workers ranged between 3.12 - 4.73 L, with a mean of 3.96 ± 0.6 L, significantly lower than the reference groups who had a range of 3.3 - 4.78 L and a mean of 4.01 ± 0.6 L (p < 0.05. The mean value of the ratio of FEV1/FVC was significantly decreased in the cobblestone road paving workers compared to the controls (87.2 (SD 4.3 v 89.5 (SD 5.4, p = 0.01. In conclusion, the study revealed clear evidence of the need for health education and for the promotion of activities directed towards mitigating respiratory hazards in order to foster a safe and healthy work environment.

FEV 1 , FVC, FEV 1 /FVVC as predictors of rhinitis among saw mill ...

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Data on sociodemographic variables, symptoms of rhinitis, etc was obtained using a modified semi structured British medical research council questionnaire while respiratory function data was measured using a spirometry. Result: A total of 400 responds comprising of 200 saw mill workers and 200 controls participated in ...

Air pollution and respiratory health among diabetic and non-diabetic subjects in Pune, India-results from the Wellcome Trust Genetic Study.

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Khafaie, Morteza Abdullatif; Salvi, Sundeep Santosh; Yajnik, Chittaranjan Sakerlal; Ojha, Ajay; Khafaie, Behzad; Gore, Sharad Damodar

2017-06-01

Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM 10 on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM 10 ) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM 10 and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM 10 and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC effect for 1 SD μg/m 3 (=98.38) increase in PM 10 concentration was 3.71% (95% CI, 0.48-4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects.

The Interpretation of Dyspnea in the Patient with Asthma

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Marc H. Lavietes

2015-01-01

Full Text Available Physicians have noted dyspnea in severely ill asthmatic patients to be associated with fright or panic; in more stable patients dyspnea may reflect characteristics including lung function, personality and behavioral traits. This study evaluates the symptom of dyspnea in 32 asthmatic patients twice: first when acutely ill and again after an initial response to therapy. Spirometry was performed, dyspnea quantified (Borg scale, and panic assessed with a specialized measure of acute panic (the acute panic inventory (API in the 32 patients before and again after treatment. After treatment, questionnaires to evaluate somatization and panic disorder were also administered. When acutely ill, both the API and all spirometric measures (PEFR; FEV1; IC correlated with dyspnea. Multiple linear regression showed that measures of the API, the peak expiratory flow rate, and female sex taken together accounted for 41% of dyspnea in acute asthma. After treatment, the API again predicted dyspnea while spirometric data did not. Those subjects who described themselves as having chronic panic disorder reported high grades of dyspnea after treatment also. We conclude that interpretations of the self-report of asthma differ between acutely ill and stable asthmatic patients.

apılan Sporun Karakteristiği Solunum Fonksiyonlarını Etkiler mi? Voleybol ve Judo Sporcularının Karşılaştırılması

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Tuğba KOCAHAN

2017-06-01

Full Text Available Sporcular yapılan spora bağlı olarak farklı fizyolojik adaptasyonlar geliştirirler. Solunum fonksiyonları da bu adaptasyonlardan etkilenir. Çalışmamızın amacı karakteristiği birbirinden oldukça farklı olan voleybol ve judo sporunun solunum fonksiyonları üzerindeki etkisini karşılaştırmaktır. Çalışmaya ortalama yaşı 15,50±1,08 yıl olan 12 erkek voleybol sporcusu ile ortalama yaşı 15,10±1.37 yıl olan 10 erkek judo sporcusu dahil edildi. Sporcuların solunum fonksiyonları spirometre ile test edildi. Sporcuların forced expiratory volume-zorlu ekspiratuar hacim (FEV, forced expiratory volume in one second-bir saniyedeki zorlu ekspiratuar hacim (FEV1, forced vital capasity- zorlu vital kapasite (FVC, forced ekspiratuary volume-zorlu ekspiraturar volüm/ forced vital capasity-zorlu vital kapasite yüzdesi (FEV1/FVC%, peak expiratory flow- tepe akım hızı (PEF, forced expiratory volume at %25- %25’deki zorlu ekspiratuar hacim (FEV25, forced expiratory volume at %50- %50’deki zorlu ekspiratuar hacim (FEV50, forced expiratory volume at %75- %75’deki zorlu ekspiratuar hacim (FEV75 değerleri kaydedildi ve SPSS istatistiksel analiz programı kullanılarak veriler karşılaştırıldı. Sporcuların yaşları arasında anlamlı bir fark bulunamamıştır (p>0,05. Boy ve kilo değerleri arasında anlamlı bir fark mevcut olsa da söz konusu bu fark BKI (Beden Kitle İndeksi için geçerli değildir (p>0,05. Spirometrik değişkenlerden FEV1/FVC% haricindeki tüm değerler voleybol sporcularında daha yüksek belirlenmiştir ve iki grup arasındaki değişkenler arasındaki farkın tamamı anlamlılık düzeyine ulaşmıştır (p<0,05. Voleybol sporunda, judo sporuna kıyasla solunum sistemi üzerine düşen yükün daha fazla olması bu sporcuların solunum fonksiyonlarının judo sporcularından yüksek çıkmasına sebep olmuştur. Bu çalışma ile yapılan sporun karakteristiğinin solunum sistemi �

Effects of Exposure to Welding Fume on Lung Function: Results from the German WELDOX Study.

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Lehnert, M; Hoffmeyer, F; Gawrych, K; Lotz, A; Heinze, E; Berresheim, H; Merget, R; Harth, V; Van Gelder, R; Hahn, J-U; Hartwig, A; Weiß, T; Pesch, B; Brüning, T

2015-01-01

The association between exposure to welding fume and chronic obstructive pulmonary disease (COPD) has been insufficiently clarified. In this study we assessed the influence of exposure to welding fume on lung function parameters. We investigated forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and expiratory flow rates in 219 welders. We measured current exposure to respirable particles and estimated a worker's lifetime exposure considering welding techniques, working conditions and protective measures at current and former workplaces. Multiple regression models were applied to estimate the influence of exposure to welding fume, age, and smoking on lung function. We additionally investigated the duration of working as a welder and the predominant welding technique. The findings were that age- and smoking-adjusted lung function parameters showed no decline with increasing duration, current exposure level, and lifetime exposure to welding fume. However, 15% of the welders had FEV1/FVC below the lower limit of normal, but we could not substantiate the presence of an association with the measures of exposure. Adverse effects of cigarette smoking were confirmed. In conclusion, the study did not support the notion of a possible detrimental effect of exposure to welding fume on lung function in welders.

Dyadic associations between cancer-related stress and fruit and vegetable consumption among colorectal cancer patients and their family caregivers.

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Shaffer, Kelly M; Kim, Youngmee; Llabre, Maria M; Carver, Charles S

2016-02-01

This study examined how stress from cancer affects fruit and vegetable consumption (FVC) in cancer patients and their family caregivers during the year following diagnosis. Colorectal cancer patients and their caregivers (92 dyads) completed questionnaires at two (T1), six (T2), and 12 months post-diagnosis (T3). Individuals reported perceived cancer-related stress (CRS) at T1 and days of adequate FVC at T1 through T3. Both patients and caregivers reported inadequate FVC during the first year post-diagnosis. Latent growth modeling with actor-partner interdependence modeling revealed that, at T1, one's own greater CRS was associated with one's partner having fewer concurrent days of adequate FVC (ps = .01). Patients' greater CRS predicted their own more pronounced rebound pattern in FVC (p = .01); both patients' and caregivers' CRS marginally predicted their partners' change in FVC (p = .09). Findings suggest that perceived stress from cancer hinders FVC around the diagnosis, but motivates positive dietary changes by the end of the first year.

Assessment of Air Pollution Effects on the Respiratory System Based on Pulmonary Function Tests Performed During Spirometry Days.

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Dąbrowiecki, Piotr; Mucha, Dominika; Gayer, Anna; Adamkiewicz, Łukasz; Badyda, Artur J

2015-01-01

The Polish Spirometry Day is an initiative aimed at increasing awareness of the causes, symptoms, course, and effects that accompany respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). In 2013, the second edition of the Spirometry Day was held. It gathered 180 medical centers and other institution. The final analysis encompassed a total of 1187 persons from 26 different locations, including rural areas, and smaller and larger city agglomerations. Of this total, 755 persons (63.6 %) completed their spirometry tests for the first time in life. Each person fulfilled a questionnaire regarding the personal information, respiratory diseases, symptoms, lifestyle, and a place of residence. In the total group, 234 (19.7 %) cases of bronchial obstruction were diagnosed. A hundred and thirty four persons with obstruction, among those tested for the first time in life (17.8 %), were unaware of their disease. The lowest values of FEV1 and FEF(1)/FVC, corresponding to the highest percentage of persons with obstruction (27.9 %) were observed in small and medium cities (100,000-500,000 inhabitants). There were differences in the prevalence of obstruction depending on the distance of the place of residence from a busy traffic road. A significant decrease of both spirometric variables was observed among people living in cities above 100,000 inhabitants within a distance lower than 50 m from roads. In general, better spirometry results were observed among inhabitants living more than 150 m from main roads.

Pulmonary function tests as outcomes for systemic sclerosis interstitial lung disease.

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Caron, Melissa; Hoa, Sabrina; Hudson, Marie; Schwartzman, Kevin; Steele, Russell

2018-06-30

Interstitial lung disease (ILD) is the leading cause of morbidity and mortality in systemic sclerosis (SSc). We performed a systematic review to characterise the use and validation of pulmonary function tests (PFTs) as surrogate markers for systemic sclerosis-associated interstitial lung disease (SSc-ILD) progression.Five electronic databases were searched to identify all relevant studies. Included studies either used at least one PFT measure as a longitudinal outcome for SSc-ILD progression ( i.e. outcome studies) and/or reported at least one classical measure of validity for the PFTs in SSc-ILD ( i.e. validation studies).This systematic review included 169 outcome studies and 50 validation studies. Diffusing capacity of the lung for carbon monoxide ( D LCO ) was cumulatively the most commonly used outcome until 2010 when it was surpassed by forced vital capacity (FVC). FVC (% predicted) was the primary endpoint in 70.4% of studies, compared to 11.3% for % predicted D LCO Only five studies specifically aimed to validate the PFTs: two concluded that D LCO was the best measure of SSc-ILD extent, while the others did not favour any PFT. These studies also showed respectable validity measures for total lung capacity (TLC).Despite the current preference for FVC, available evidence suggests that D LCO and TLC should not yet be discounted as potential surrogate markers for SSc-ILD progression. Copyright ©ERS 2018.

Comparison of four software packages for CT lung volumetry in healthy individuals

Energy Technology Data Exchange (ETDEWEB)

Nemec, Stefan F. [Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Molinari, Francesco [Centre Hospitalier Regional Universitaire de Lille, Department of Radiology, Lille (France); Dufresne, Valerie [CHU de Charleroi - Hopital Vesale, Pneumologie, Montigny-le-Tilleul (Belgium); Gosset, Natacha [CHU Tivoli, Service d' Imagerie Medicale, La Louviere (Belgium); Silva, Mario; Bankier, Alexander A. [Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

2015-06-01

To compare CT lung volumetry (CTLV) measurements provided by different software packages, and to provide normative data for lung densitometric measurements in healthy individuals. This retrospective study included 51 chest CTs of 17 volunteers (eight men and nine women; mean age, 30 ± 6 years), who underwent spirometrically monitored CT at total lung capacity (TLC), functional residual capacity (FRC), and mean inspiratory capacity (MIC). Volumetric differences assessed by four commercial software packages were compared with analysis of variance (ANOVA) for repeated measurements and benchmarked against the threshold for acceptable variability between spirometric measurements. Mean lung density (MLD) and parenchymal heterogeneity (MLD-SD) were also compared with ANOVA. Volumetric differences ranged from 12 to 213 ml (0.20 % to 6.45 %). Although 16/18 comparisons (among four software packages at TLC, MIC, and FRC) were statistically significant (P < 0.001 to P = 0.004), only 3/18 comparisons, one at MIC and two at FRC, exceeded the spirometry variability threshold. MLD and MLD-SD significantly increased with decreasing volumes, and were significantly larger in lower compared to upper lobes (P < 0.001). Lung volumetric differences provided by different software packages are small. These differences should not be interpreted based on statistical significance alone, but together with absolute volumetric differences. (orig.)

Second to fourth digit ratio: a predictor of adult lung function

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I-Nae Park

2014-02-01

Full Text Available Sex and sex hormones play a major role in lung physiology. It has been proposed that the ratio of the second to fourth digits (digit ratio is correlated with fetal sex hormones. We therefore hypothesized that digit ratio might help predict lung function. We investigated the relationship between digit ratio and pulmonary function test (PFT fi ndings. A total of 245 South Korean patients (162 male, 83 female aged from 34 to 90 years who were hospitalized for urological surgery were prospectively enrolled. Before administering the PFTs, the lengths of the second and fourth digits of the right hand were measured by a single investigator using a digital Vernier caliper. In males (n = 162, univariate and multivariate analysis using linear regression models showed that digit ratio was a signifi cant predictive factor of forced vital capacity (FVC and forced expiratory volume in 1 second (FEV1 (FVC: r = 0.156, P = 0.047; FEV1: r = 0.160, P = 0.042. In male ever-smokers (n = 69, lung functions (FVC and FEV1 were correlated with smoking exposure rather than digit ratio. In female never-smokers (n = 83, lung functions (FEV1 and FEV1/FVC ratio were positively correlated with digit ratio on univariate analysis (FEV1: r = 0.242, P = 0.027; FEV1/FVC ratio: r = 0.245, P = 0.026. Patients with lower digit ratios tend to have decreased lung function. These results suggest that digit ratio is a predictor of airway function.

Analysis of lung function and survival in RECAP: An open-label extension study of pirfenidone in patients with idiopathic pulmonary fibrosis.

Science.gov (United States)

Costabel, Ulrich; Albera, Carlo; Bradford, Williamson Z; Hormel, Phil; King, Talmadge E; Noble, Paul W; Sahn, Steven A; Valeyre, Dominique; du Bois, Roland M

2014-10-20

RECAP is an open-label extension study evaluating pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) who completed the Phase 3 CAPACITY program. We examined the effect of pirfenidone on lung function and survival in patients who were previously randomised to the placebo group in one of the two CAPACITY studies and received pirfenidone for the first time in RECAP. Eligible patients received oral pirfenidone 2403 mg/day. Forced vital capacity (FVC) was measured at baseline and at weeks 12, 36, and 60. To facilitate comparison with CAPACITY outcomes, analyses were based on patients newly treated with pirfenidone in RECAP who had baseline FVC and carbon monoxide diffusing capacity (DLCO) values that met CAPACITY entry criteria. A total of 178 patients were included in the analysis. Among these, 16.3% experienced an FVC decline ≥10% at week 60, compared with 16.8% and 24.8%, respectively, in the CAPACITY pirfenidone (n=345) and placebo (n=347) groups. The mean change from baseline to week 60 in %FVC was -5.9%, compared with -7.0% and -9.4% in the CAPACITY pirfenidone and placebo groups. Overall survival was similar to that of pirfenidone treated patients in CAPACITY. Treatment was safe and generally well tolerated; the type and frequency of adverse events were consistent with previous clinical experience. FVC and survival outcomes in IPF patients newly treated with pirfenidone in RECAP were similar to those in the CAPACITY pirfenidone group. These data provide further evidence to support the use of pirfenidone in patients with IPF.

Pulmonary Function Tests In Young Healthy Subjects Of North India

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Parag Rastogi

2004-06-01

Full Text Available Study Objectives : The diagnosis of disease done by skiagram can be substantiated by pulmonary function tests. Substantial data of Indians on PFTs is not available. The present study therefore has been planned on young healthy north Indians.Setting : 119 males and 49 female medical students of North India.Measurements : PFT's, T.V. FEV1, FVC, FER and PEFR were measured. P<0.05 was considered as significant.Results : In North Indian males, mean T. V was 437.56 ± 65.83 ml, FEV1 3.26 ±041 L, FVC 3.82 ± 0.48 L, FER 85.09 ± 2.42% and PEFR was 495.42 ± 101.82 L / min. In North Indian females, average T. V was 386.12 ± 37.90 ml, FEV1 2.39 ± 0.38 L, FVC 2.79 ± 0.43 L, FER 85.38 ± 257% and PEFR was 307.12 ± 75.74 L / min.Conclusions: Males in comparison to females had more value of PFTs. All the PFTs showed positive correlation with Height, Weight and Surface area except Tidal Volume and FER.

Evaluation of frequency of positive exercise-induced bronchospasm between swimmers and sedentary individuals

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Laricy Martins da Mata

Full Text Available Abstract Introduction: Despite the prevalence of prescribed asthma, there is uncertainty about the incidence of exercise-induced bronchospasm (EIB. Objective: Compare the frequency of EIB between swimmers and sedentary individuals, and observe heart rate variability during bronchial activity. Methods: In total, 18 swimmers (group 1 and 18 sedentary individuals (group 2 were included. The participants rested for 30 minutes for evaluation of HRV. Blood pressure (PA, respiratory rate (RR, and pulse oxygen saturation (SpO2 were measured. The volunteers remained seated for the spirometry test (maneuver of forced vital capacity - FVC. This was repeated 5, 10, 15, 20, and 30 minutes after the exercise test. The statistical analysis used the Student t, Mann Whitney, and Shapiro-Wilks tests. The significance level was p <0.05. Results: The spirometry findings showed 3 sedentary individuals and 10 swimmers with obstructive ventilatory disorder (OVD. Only 2 of the sedentary and none of the swimmer group demonstrated positive bronchial provocation. A key criterion for diagnosing OVD, the relationship between forced expiratory volume in one second and FVC (FEV1/FVC, was statistically lower in the swimmer group. The measures of the root mean square of the successive differences between adjacent normal RR intervals, in a time interval (RMSSD, and the standard deviation of all normal RR intervals recorded in a time interval (SDNN were significantly higher among the athletes. Conclusion: The bronchial provocation test identified a higher prevalence of bronchospasm among sedentary individuals. However, there was a reduction in the FEV1/FVC ratio and higher HRV in the group of swimmers.

Accuracy of spirometry for detection of asthma: a cross-sectional study.

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Meneghini, Andréa Cristina; Paulino, Ana Carolina Botto; Pereira, Luciano Penha; Vianna, Elcio Oliveira

2017-01-01

Asthma is a chronic inflammatory disease with airway hyperresponsiveness. Spirometry is the most commonly used test among asthmatic patients. Another functional test used for diagnosing asthma is the bronchial challenge test. The aim of this study was to analyze the accuracy of spirometry for detecting asthma in the general population. Cross-sectional study with data analysis to evaluate the accuracy of spirometry through calculating sensitivity, specificity and predictive values and through the kappa agreement test. Subjects who constituted a birth cohort were enrolled at the age of 23 to 25 years. Spirometric abnormality was defined as reduced forced expiratory volume in one second, i.e. lower than 80% of the predicted value. Measurement of bronchial responsiveness was performed by means of the bronchial challenge test with methacholine. The gold-standard diagnosis of asthma was defined as the presence of bronchial hyperresponsiveness in association with respiratory symptoms. Asthma was detected in 200 subjects (10.4%) out of the sample of 1922 individuals. Spirometric abnormality was detected in 208 subjects (10.9%) of the sample. The specificity of spirometric abnormality for detecting asthma was 90%, sensitivity was 23%, positive predictive value was 22%, and negative predictive value was 91%. The kappa test revealed weak agreement of 0.13 (95% confidence interval, CI: 0.07-0.19) between spirometry and the diagnosis of asthma. Spirometry, as a single test, has limitations for detecting asthma in the general population.

Clinical characteristics of the respiratory and cardiovascular systems in patients with combination of chronic obstructive pulmonary disease and heart failure

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I. I. Vyshnyvetskyy

2017-06-01

Full Text Available The aim of our work was to assess the respiratory and cardiovascular systems of patients with a combination of chronic obstructive pulmonary disease (COPD and congestive heart failure (CHF. Materials and methods. The study included 177 patients who had been diagnosed COPD by criteria GOLD. CHF was diagnosed in 77 (43.5 % cases – 29 (16.4 % with reduced systolic function and 48 (27.1 % with preserved systolic function. We analyzed some important parameters characterizing respiratory and cardiovascular systems. We tried to identify statistically significant difference of parameters between patients with COPD and those with COPD and CHF. Moreover, patients with CHF were evaluated as a whole, and separately with reduced and with preserved systolic function. Results. Thus, we observed significant deterioration in general clinical, laboratory, spirometric and echocardiographic parameters depending on the presence and severity of CHF in patients with COPD. In particular, the presence of CHF, especially with impaired systolic function significantly impair indicators such as incidence of cardiac arrhythmias and signs of ischemia on the ECG, NT-proBNP levels, prevalence of concentric, eccentric hypertrophy and concentric LV remodeling and diastolic dysfunction type "relaxation disorder", and incidence of a-wave absence during assessment of motion of the rear pulmonary artery valve wall. Listed changes as well as some of the tendencies that have not reached a certain level of significance, indicate that patients with COPD and concomitant CHF, especially with impaired systolic function, worsens general clinical parameters (breath rate, systolic blood pressure, heart rate, frequency arrhythmias and myocardial ischemia on ECG; laboratory levels of hemoglobin, hematocrit, cholesterol, glomerular filtration rate; spirometric indicators of bronchial obstruction (FEV1, FVC, instant volume expiratory flow rates; echocardiographic indicators suggest the

Spirometry of healthy adult South African men

African Journals Online (AJOL)

1996-07-07

Jul 7, 1996 ... radiographic screening process was used to identify a healthy population ... significantly lower values than the Autolink for FVC measurements despite .... t Medical Instrumentation. ATS '" American ... Quality control. Biological ...

Combining Estimation of Green Vegetation Fraction in an Arid Region from Landsat 7 ETM+ Data

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Kun Jia

2017-11-01

Full Text Available Fractional vegetation cover (FVC, or green vegetation fraction, is an important parameter for characterizing conditions of the land surface vegetation, and also a key variable of models for simulating cycles of water, carbon and energy on the land surface. There are several types of FVC estimation models using remote sensing data, and evaluating their performance over a specific region is of great significance. Therefore, this study firstly evaluated three types of FVC estimation models using Landsat 7 ETM+ data in an agriculture region of Heihe River Basin, China, and then proposed a combination strategy from different individual models to improve the FVC estimation accuracy, which employed the multiple linear regression (MLR and Bayesian model average (BMA methods. The validation results indicated that the spectral mixture analysis model with three endmembers (SMA3 achieved the best FVC estimation accuracy (determination coefficient (R2 = 0.902, root mean square error (RMSE = 0.076 among the seven individual models using Landsat 7 ETM+ data. In addition, the MLR and BMA combination methods could both improve FVC estimation accuracy (R2 = 0.913, RMSE = 0.063 and R2 = 0.904, RMSE = 0.069 for MLR and BMA, respectively. Therefore, it could be concluded that both MLR and BMA combination methods integrating FVC estimates from different models using Landsat 7 ETM+ data could effectively weaken the estimation errors of individual models and improve the final FVC estimation accuracy.

Pulmonary Function Affects Language Performance in Aging

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Lewina O Lee

2014-04-01

Full Text Available Background Good pulmonary function (PF is associated with preservation of cognitive performance, primarily of executive functions, in aging (Albert et al., 1995; Chyou et al., 1996; Emery, Finkel, & Pedersen, 2012; Yohannes & Gindo, 2013. The contribution of PF to older adults’ language abilities, however, has never been explored, to our knowledge. We addressed this gap by examining the effects of PF on older adults’ language functions, as measured by naming and sentence processing accuracy. We predicted similar effects as found for executive functions, given the positive associations between executive functions and sentence processing in aging (e.g., Goral et al., 2011. Methods Data were collected from 190 healthy adults aged 55 to 84 years (M = 71.1, SD = 8.1, with no history of neurological or psychiatric disorders. Procedure PF was measured prior to language testing. Measures included forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC. Language functions were assessed through performance on computer-administered lexical retrieval and sentence processing tasks. Sentence processing was measured using two auditory comprehension tasks: one, of embedded sentences (ES, the other, of sentences with multiple negatives (MN. Lexical retrieval was measured using the Boston Naming Test (BNT and Action Naming Test (ANT. Performance was scored for percent accuracy. Additionally, lexical retrieval was evaluated with a phonemic fluency task (FAS, which also taps executive function abilities. Statistical Analyses Multiple regression was used to examine the association between pulmonary and language functions, adjusting for age, education, gender, history of respiratory illness, current level of physical activities, and current and past smoking. Results Better PF was associated with better sentence processing and lexical retrieval on naming tasks, but not with phonemic fluency, after adjusting for covariates. Higher FVC was

A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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Carl Magnus Sköld

2016-07-01

Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

Pulmonary function studies in healthy Filipino adults residing in the United States.

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Lin, F L; Kelso, J M

1999-08-01

Differences in lung volumes among various ethnic groups are known to occur; however, this has not been studied in Filipinos. We sought to assess pulmonary function in healthy, nonsmoking Filipinos residing in the United States compared with standards for white subjects. Healthy adult Filipinos, age 18 years or greater, were recruited. All subjects were screened with health questionnaires to exclude those with cardiopulmonary disease. Pulmonary function tests were performed by using forced expiratory maneuvers. Values for FEV(1 ), forced vital capacity (FVC), FEV(1 )/FVC, forced expiratory flow from 25% to 75% of FVC, and peak expiratory flow rate were compared with predicted values for white subjects (ie, without a racial adjustment). Two hundred twenty-four healthy subjects (121 men and 103 women) completed the study. The group means (as a percentage of the predicted standard for white subjects) were as follows: FEV(1 ), 86%; FVC, 84%; FEV(1 )/FVC, 103%; forced expiratory flow from 25% to 75% of FVC, 96%; and peak expiratory flow rate, 107%. These findings are very similar to those for African Americans and other Asians. We conclude that it is appropriate to use an 85% racial adjustment for FEV(1 ) and FVC when interpreting pulmonary function test results in Filipinos.

[Pulmonary function of children with acute leukemia in maintenance phase of chemotherapy].

Science.gov (United States)

de Macêdo, Thalita Medeiros Fernandes; Campos, Tania Fernandes; Mendes, Raquel Emanuele de França; França, Danielle Corrêa; Chaves, Gabriela Suéllen da Silva; de Mendonça, Karla Morganna Pereira Pinto

2014-12-01

The aim of this study was to assess the pulmonary function of children with acute leukemia. Cross-sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys(®) in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed(®)). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively. Group A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference. Children with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

The effect of habitual waterpipe tobacco smoking on pulmonary function and exercise capacity in young healthy males: A pilot study.

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Hawari, F I; Obeidat, N A; Ghonimat, I M; Ayub, H S; Dawahreh, S S

2017-01-01

Evidence regarding the health effects of habitual waterpipe smoking is limited, particularly in young smokers. Respiratory health and cardiopulmonary exercise tests were compared in young male habitual waterpipe smokers (WPS) versus non-smokers. 69 WPS (≥3 times/week for three years) and 69 non-smokers were studied. Respiratory health was assessed through the American Thoracic Society and the Division of Lung Diseases (ATS-DLD-78) adult questionnaire. Pulmonary function and cardiopulmonary exercise tests were performed. Self-reported respiratory symptoms, forced expiratory volume in first second (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC ratio, forced expiratory flow between 25 and 75% of FVC (FEF 25-75% ), peak expiratory flow (PEF), exercise time, peak end-tidal CO 2 tension (PetCO 2 ), subject-reported leg fatigue and dyspnea; peak O 2 uptake (VO 2 max), and end-expiratory lung volume (EELV) change from baseline (at peak exercise) were measured. WPS were more likely than non-smokers to report respiratory symptoms. WPS also demonstrated: shorter exercise time; lower peak VO 2 ; higher perceived dyspnea at mid-exercise; lower values of the following: FEV 1 , FVC, PEF, and EELV change. Habitual waterpipe tobacco smoking in young seemingly healthy individuals is associated with a greater burden of respiratory symptoms and impaired exercise capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study.

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Joo, Sunghee; Shin, Doochul; Song, Changho

2015-06-22

Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients. Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing. The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study. These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population.

Age- and size-related reference ranges: a case study of spirometry through childhood and adulthood.

Science.gov (United States)

Cole, T J; Stanojevic, S; Stocks, J; Coates, A L; Hankinson, J L; Wade, A M

2009-02-28

Age-related reference ranges are useful for assessing growth in children. The LMS method is a popular technique for constructing growth charts that model the age-changing distribution of the measurement in terms of the median, coefficient of variation and skewness. Here the methodology is extended to references that depend on body size as well as age, by exploiting the flexibility of the generalised additive models for location, scale and shape (GAMLSS) technique. GAMLSS offers general linear predictors for each moment parameter and a choice of error distributions, which can handle kurtosis as well as skewness. A key question with such references is the nature of the age-size adjustment, additive or multiplicative, which is explored by comparing the identity link and log link for the median predictor.There are several measurements whose reference ranges depend on both body size and age. As an example, models are developed here for the first four moments of the lung function variables forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC) and FEV(1)/FVC in terms of height and age, in a data set of 3598 children and adults aged 4 to 80 years. The results show a strong multiplicative association between spirometry, height and age, with a large and nonlinear age effect across the age range. Variability also depends nonlinearly on age and to a lesser extent on height. FEV(1) and FVC are close to normally distributed, while FEV(1)/FVC is appreciably skew to the left. GAMLSS is a powerful technique for the construction of such references, which should be useful in clinical medicine. Copyright (c) 2008 John Wiley & Sons, Ltd.

Lung volume and expiratory flow rates from pre- to post-puberty.

Science.gov (United States)

Smith, Joshua R; Emerson, Sam R; Kurti, Stephanie P; Gandhi, Kirti; Harms, Craig A

2015-08-01

The purpose was to determine if the airways and lungs grow disproportionately from pre- to post-puberty in boys and girls. We hypothesized that the airways grow at a slower rate than lung volume (i.e. dysanapsis growth) during puberty and boys would exhibit more dysanaptic growth compared to girls. Twenty-one pre-pubescent children [11 boys (pre 10.1 ± 0.5 years, post 15.3 ± 0.5 years); 10 girls (pre 9.4 ± 1.0 years, post 14.1 ± 1.0 years)] performed pulmonary function tests (PFTs) ~5 years ago from an original cohort of 40 children. These 21 children performed PFTs, which included forced vital capacity (FVC) and forced expiratory flow at 50 % FVC (FEF50). Static pressure at 50 % of FVC [Pst(L)50 %] was estimated based on age. Dysanapsis ratio (DR) was calculated [FEF50 × FVC(-1) × Pst(L) 50 % (-1) ]. Maturation status was determined via Tanner stages. Stage of maturation was not different (p > 0.05) between boys and girls (4.2 ± 0.6 stage vs. 3.7 ± 0.7 stage, respectively). FVC and FEF50 increased (p 0.05) from pre- to post-puberty. FEF50 and FVC significantly increased and DR decreased (p puberty for both sexes. Post-puberty, boys had a significantly larger FVC, but FEF50, DR, and FEF50/FVC were not different (p > 0.05) compared to girls. These data suggest that dysanaptic growth occurs during puberty and that it is not different between boys and girls.

Functional Imaging: CT and MRI

OpenAIRE

van Beek, Edwin JR; Hoffman, Eric A

2008-01-01

Numerous imaging techniques permit evaluation of regional pulmonary function. Contrast-enhanced CT methods now allow assessment of vasculature and lung perfusion. Techniques using spirometric controlled MDCT allow for quantification of presence and distribution of parenchymal and airway pathology, Xenon gas can be employed to assess regional ventilation of the lungs and rapid bolus injections of iodinated contrast agent can provide quantitative measure of regional parenchymal perfusion. Advan...

Variability of pulmonary function test in healthy children, asthmatic and with chronicle lung disease

International Nuclear Information System (INIS)

Rodriguez Martinez, Carlos; Sossa, Monica Patricia; Cortez, Eliana; Mallol, Javier

2004-01-01

Comparison of sequential pulmonary function tests in the same individual can be used to assess progression of a disease, response to therapy, or response to bronchial provocation. These types of comparisons require an understanding of the factors influencing the variability normally in repeat measurements of lung function. To avoid misleading conclusions about changes in serial measurements, the degree of variability of each test must be considered in their interpretation. The purpose of this study was to examine the degree of intrasubject variability for pulmonary function testing in healthy, asthmatic and children with chronic lung disease (CLD). The tests examined were spirometry, and body plethysmography determination of lung volumes. We studied 21 healthy children, 19 asthmatic patients and 19 children with CLD, testing were done on nine occasions, three times within a day, on three different days, over a period of two months. Short-term variability was defined as the coefficient of variation for the s ix measurements made on days 1 and 2, and the long-term variability as the CV of the nine measurements made on days 1, 2 and 3. Based on the CV measures, children with CLD had significantly more variability in all spirometric values compared with healthy and asthmatic children, except for PEF (P< 0.05) children with CLD had a significantly lower CV for TGV and FRC compared with the other two groups (p < 0.05). Asthmatic children had a significantly higher CV for RV and RV/TLC compared with healthy and children with CLD (p < 0.05). We propose a method to consider changes in pulmonary function tests as significant. The degree of variability and an estimate of the percent change for significance of spirometric and plethysmographic tests must be considered in the interpretation of data to avoid misleading conclusions. The variability of spirometric pulmonary function data in healthy subjects was smaller than that for patients with pulmonary disease, so larger

Exhaled nitric oxide in a population-based study of asthma and allergy in schoolchildren.

Science.gov (United States)

Nordvall, S L; Janson, C; Kalm-Stephens, P; Foucard, T; Torén, K; Alving, K

2005-04-01

Exhaled nitric oxide (NO) reflects inflammation in the lower airways and is well adapted for use in children. The aims of this study were to investigate the distribution of the fraction of expired NO (FENO) in school children and to compare FENO and spirometry in relation to the International Study of Asthma and Allergies in Childhood questionnaire. The study was performed in 959 randomly selected 13-14-year-old school children in Uppsala, Sweden. Exhaled NO was measured at an inhalation rate of 0.1 l/s (FENO0.1) and a spirometric test was performed and data from these measurements were related to questionnaire data. Exhaled NO was measured according to American Thoracic Society recommendations, except the use of a mouth wash and an exhalation flow rate of 0.1 l/s. The distribution of the mean FENO0.1 values was skewed, with a preponderance of very low levels and a widespread tail of values ranging up to 102 parts per billion (ppb). Boys exhibited significantly higher mean FENO0.1 values than girls, 5.2 (4.7-5.7) vs 4.4 (4.0-4.8) ppb (geometric mean and 95% CI), P <0.01). Children who reported wheezing in the last year had higher FENO0.1 values than children that had not, 8.5 (7.1-10.2) vs 4.3 (4.0-4.6) ppb, P <0.001). The same association was found to most symptoms indicating hay fever and eczema. In contrast to this, only weak or inconsistent associations were found between asthma and spirometric indices. Exhaled NO levels were found to be independently related to male gender, wheeze and rhinoconjuctivitis but not to current eczema. In conclusion, exhaled NO was closely associated with reported asthma and allergy symptoms whereas spirometric indices such as percent predicted forced expiratory volume in 1 s were not. As most asthma cases in a population are mild, the findings suggest that exhaled NO is a sensitive marker of asthma and allergy.

Pulmonary function in advanced uncomplicated singleton and twin pregnancy.

Science.gov (United States)

Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

2014-01-01

Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes.

Science.gov (United States)

Salisbury, Margaret L; Lynch, David A; van Beek, Edwin J R; Kazerooni, Ella A; Guo, Junfeng; Xia, Meng; Murray, Susan; Anstrom, Kevin J; Yow, Eric; Martinez, Fernando J; Hoffman, Eric A; Flaherty, Kevin R

2017-04-01

Adaptive multiple features method (AMFM) lung texture analysis software recognizes high-resolution computed tomography (HRCT) patterns. To evaluate AMFM and visual quantification of HRCT patterns and their relationship with disease progression in idiopathic pulmonary fibrosis. Patients with idiopathic pulmonary fibrosis in a clinical trial of prednisone, azathioprine, and N-acetylcysteine underwent HRCT at study start and finish. Proportion of lung occupied by ground glass, ground glass-reticular (GGR), honeycombing, emphysema, and normal lung densities were measured by AMFM and three radiologists, documenting baseline disease extent and postbaseline change. Disease progression includes composite mortality, hospitalization, and 10% FVC decline. Agreement between visual and AMFM measurements was moderate for GGR (Pearson's correlation r = 0.60, P fibrosis (as measured by GGR densities) is independently associated with elevated hazard for disease progression. Postbaseline change in AMFM-measured and visually measured GGR densities are modestly correlated with change in FVC. AMFM-measured fibrosis is an automated adjunct to existing prognostic markers and may allow for study enrichment with subjects at increased disease progression risk.

Increasing the Resolution of Chronic Obstructive Pulmonary Disease Definition. Lessons from a Cohort with Remote but Extensive Exposure to Secondhand Tobacco Smoke.

Science.gov (United States)

Arjomandi, Mehrdad; Zeng, Siyang; Blanc, Paul D; Gold, Warren M

2018-04-01

The Global Initiative for Chronic Obstructive Lung Disease criteria require a ratio of forced expiratory volume in 1 second (FEV 1 ) to forced vital capacity (FVC) (FEV 1 /FVC) of less than 0.70 for the diagnosis of chronic obstructive pulmonary disease, whereas other criteria emphasize a lower limit of normal approach. However, the use of Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria may result in classification of many smokers with respiratory morbidities as not having chronic obstructive pulmonary disease. Additional accuracy in defining chronic obstructive pulmonary disease could improve its management. To determine whether in a cohort with remote but longstanding exposure to secondhand tobacco smoke, air trapping as measured by ratio of residual volume to total lung capacity (RV/TLC) can identify a subgroup at risk for respiratory morbidity among those without chronic obstructive pulmonary disease defined by Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria. We performed an observational study of symptoms and lung function in a cohort of 256 subjects with a history of extensive occupational exposure to secondhand tobacco smoke but with preserved spirometry (FEV 1 /FVC and FEV 1  ≥ lower limit of normal). We elicited symptom prevalence by structured questionnaire, and estimated the correlations between plethysmography-measured RV/TLC and spirometry-measured FEV 1 /FVC and FEV 1 . In subgroups of the cohort, we examined the association of maximum oxygen consumption ([Formula: see text]o 2 max) on exercise testing with RV/TLC (n = 179), dynamic hyperinflation (exercise-induced changes in fraction of tidal breathing that is flow-limited on expiration [percentage of expiratory flow limitation, %EFL] and end-expiratory lung volume) (n = 32), and radiographic gas trapping (percent low attenuation area in -860 to -950 Hounsfield units at end-expiration on computerized

Improved pulmonary function in working divers breathing nitrox at shallow depths

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Fitzpatrick, Daniel T.; Conkin, Johnny

2003-01-01

INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p < 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Acute respiratory effects on workers exposed to metalworking fluid aerosols in an automotive transmission plant.

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Robins, T; Seixas, N; Franzblau, A; Abrams, L; Minick, S; Burge, H; Schork, M A

1997-05-01

Exposure to metalworking fluids has been linked to modest cross-shift reductions in FEV1 and occupational asthma. To identify responsible agents, we measured personal exposures to thoracic particulate (TP), viable plus nonviable thoracic bacteria (BAC), and vapor phase nicotine (VPN) (as a surrogate for tobacco particulate) among 83 machinists exposed to soluble oils and 46 dry assemblers working in an automotive transmission machining plant using biocides infrequently. The participants completed interviews and performed pre- and postshift spirometry on Monday and Thursday of the same week in each of three rounds of data collection (June 1992, January 1993, June 1993). Generalized estimating equations were used to combine information across rounds in multiple regression models of cross-shift and cross-week changes in forced expiratory volume, I second (FEV1) and forced vital capacity (FVC). Mean seniority was 19 years among machinists. Mean personal TP levels were 0.41 mg/m3 in machinists and 0.13 mg/m3 in assemblers. Six of the 83 machinists and none of the 46 assemblers experienced a greater than 19% cross-shift decrement in FEV1 or FVC at least once (p = .07). In regression models using either TP or BAC, among subjects with lower baseline (Monday preshift) FEV1/FVC ratios, increasing exposure was significantly associated with increasing cross-shift decrements in FEV1 and FVC in linear models, and with increased likelihood of a 10% or greater cross-shift decrement in FEV1 or FVC in logistic models. Adjustment of TP for VPN did not affect models significantly. We conclude that clinically important cross-shift decrements in pulmonary function are associated with exposure to metalworking fluid aerosols within a high-seniority population.

A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study

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Ashima Sharma

Full Text Available ABSTRACT BACKGROUND: The aim here was to study acute effects of hemodialysis among end-stage renal disease (ESRD patients. DESIGN AND SETTING: Prospective study in tertiary-level care center. METHODS: Fifty ESRD patients undergoing hemodialysis were studied. Spirometric pulmonary function tests were performed before and after four-hour hemodialysis sessions. RESULTS: The patients’ average age was 45.8 ± 10.0 years; 64% were males and 64% had normal body mass index. Anemia (94% and hypoalbuminemia (72% were common. Diabetes mellitus (68%, hypertension (34% and coronary artery disease (18% were major comorbidities. Forty-five patients (90% had been on hemodialysis for six months to three years. The patients’ pre-dialysis mean forced vital capacity (FVC and forced expiratory volume in 1 second (FEV1 were below normal: 45.8 ± 24.9% and 43.5 ± 25.9% of predicted, respectively. After hemodialysis, these increased significantly, to 51.1 ± 23.4% and 49.3 ± 25.5% of predicted, respectively (P 0.05. The pre-dialysis mean forced expiratory flow 25-75% was 50.1 ± 31% and increased significantly, to 56.3 ± 31.6% of predicted (P < 0.05. The mean peak expiratory flow was below normal (43.8 ± 30.7% and increased significantly, to 49.1 ± 29.9% of predicted (P < 0.05. Males and females showed similar directions of change after hemodialysis. CONCLUSIONS: Pulmonary function abnormalities are common among ESRD patients. Comparison of pre and post-hemodialysis parameters showed significant improvements, but normal predicted values were still not achieved.

Superoxide Dismutase 3 Polymorphism Associated with Reduced Lung Function in Two Large Populations

DEFF Research Database (Denmark)

Dahl, Morten; Bowler, Russell P; Juul, Klaus

2008-01-01

. Measurements and Main Results: Genotyping the Copenhagen City Heart Study identified 35 E1/I1 homozygotes, 1,050 heterozygotes, and 8,008 noncarriers (Hardy-Weinberg equilibrium: P = 0.93). Using quadruple lung function measurements, we found that E1/I1 homozygotes had 7% lower FVC % predicted (P = 0...

Clinical Utility of Additional Measurement of Total Lung Capacity in Diagnosing Obstructive Lung Disease in Subjects With Restrictive Pattern of Spirometry.

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Lee, Hyun; Chang, Boksoon; Kim, Kyunga; Song, Won Jun; Chon, Hae Ri; Kang, Hyung Koo; Kim, Jung Soo; Jeong, Byeong-Ho; Oh, Yeon-Mok; Koh, Won-Jung; Park, Hye Yun

2016-04-01

Total lung capacity (TLC), forced expiratory flow between 25 and 75% (FEF25-75%), peak expiratory flow (PEF), or post-bronchodilator volume response is recommended to detect obstructive abnormalities in the lung. The present study was performed to evaluate the usefulness of these pulmonary function test (PFT) parameters to diagnose obstructive lung disease in subjects with a restrictive pattern of spirometry. A retrospective study was conducted in 64 subjects with a restrictive pattern of spirometry (normal FEV1/FVC and low FVC) out of 3,030 patients who underwent all pre- and post-bronchodilator spirometry and lung volume measurement between April 2008 and December 2010. After subjects were clinically classified into those with obstructive lung disease, restrictive lung disease, and mixed lung disease, the agreements between the clinical diagnosis and PFT classification according to TLC, FEF(25-75%), PEF, and post-bronchodilator response criteria were compared. Of 64 subjects, 18 (28.1%) were classified with obstructive lung disease, 39 (60.9%) had restrictive lung disease, 1 (1.6%) had mixed lung disease, and 6 (9.4%) had no clinical lung disease. Among the 58 subjects with clinical lung disease, 22 (37.9%), 37 (63.8%), 33 (56.9%), and 3 (5.2%) were classified as having obstructive pattern based on TLC, FEF25-75%, PEF, and post-bronchodilator response criteria, respectively. The kappa coefficients for the agreement between the clinical classification and PFT classification using TLC, FEF25-75%, PEF, and post-bronchodilator response criteria in 58 subjects were 0.59, 0.18, 0.17, and spirometry, when obstructive lung disease is clinically suspected. Copyright © 2016 by Daedalus Enterprises.

The effect of incentive spirometry on postoperative pulmonary function following laparotomy: a randomized clinical trial.

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Tyson, Anna F; Kendig, Claire E; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G

2015-03-01

Changes in pulmonary dynamics following laparotomy are well documented. Deep breathing exercises, with or without incentive spirometry, may help counteract postoperative decreased vital capacity; however, the evidence for the role of incentive spirometry in the prevention of postoperative atelectasis is inconclusive. Furthermore, data are scarce regarding the prevention of postoperative atelectasis in sub-Saharan Africa. To determine the effect of the use of incentive spirometry on pulmonary function following exploratory laparotomy as measured by forced vital capacity (FVC). This was a single-center, randomized clinical trial performed at Kamuzu Central Hospital, Lilongwe, Malawi. Study participants were adult patients who underwent exploratory laparotomy and were randomized into the intervention or control groups (standard of care) from February 1 to November 30, 2013. All patients received routine postoperative care, including instructions for deep breathing and early ambulation. We used bivariate analysis to compare outcomes between the intervention and control groups. Adult patients who underwent exploratory laparotomy participated in postoperative deep breathing exercises. Patients in the intervention group received incentive spirometers. We assessed pulmonary function using a peak flow meter to measure FVC in both groups of patients. Secondary outcomes, such as hospital length of stay and mortality, were obtained from the medical records. A total of 150 patients were randomized (75 in each arm). The median age in the intervention and control groups was 35 years (interquartile range, 28-53 years) and 33 years (interquartile range, 23-46 years), respectively. Men predominated in both groups, and most patients underwent emergency procedures (78.7% in the intervention group and 84.0% in the control group). Mean initial FVC did not differ significantly between the intervention and control groups (0.92 and 0.90 L, respectively; P=.82 [95% CI, 0.52-2.29]). Although

Effects of birthplace and individual genetic admixture on lung volume and exercise phenotypes of Peruvian Quechua.

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Brutsaert, Tom D; Parra, Esteban; Shriver, Mark; Gamboa, Alfredo; Palacios, Jose-Antonio; Rivera, Maria; Rodriguez, Ivette; León-Velarde, Fabiola

2004-04-01

Forced vital capacity (FVC) and maximal exercise response were measured in two populations of Peruvian males (age, 18-35 years) at 4,338 m who differed by the environment in which they were born and raised, i.e., high altitude (Cerro de Pasco, Peru, BHA, n = 39) and sea level (Lima, Peru, BSL, n = 32). BSL subjects were transported from sea level to 4,338 m, and were evaluated within 24 hr of exposure to hypobaric hypoxia. Individual admixture level (ADMIX, % Spanish ancestry) was estimated for each subject, using 22 ancestry-informative genetic markers and also by skin reflectance measurement (MEL). Birthplace accounted for the approximately 10% larger FVC (P < 0.001), approximately 15% higher maximal oxygen consumption (VO(2)max, ml.min(-1).kg(-1)) (P < 0.001), and approximately 5% higher arterial oxygen saturation during exercise (SpO(2)) (P < 0.001) of BHA subjects. ADMIX was low in both study groups, averaging 9.5 +/- 2.6% and 2.1 +/- 0.3% in BSL and BHA subjects, respectively. Mean underarm MEL was significantly higher in the BSL group (P < 0.001), despite higher ADMIX. ADMIX was not associated with any study phenotype, but study power was not sufficient to evaluate hypotheses of genetic adaptation via the ADMIX variable. MEL and FVC were positively correlated in the BHA (P = 0.035) but not BSL (P = 0.335) subjects. However, MEL and ADMIX were not correlated across the entire study sample (P = 0.282). In summary, results from this study emphasize the importance of developmental adaptation to high altitude. While the MEL-FVC correlation may reflect genetic adaptation to high altitude, study results suggest that alternate (environmental) explanations be considered. Copyright 2003 Wiley-Liss, Inc.

A comparative study of the effect of automobile pollution on pulmonary function tests of exposed cab drivers

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Amrith Pakkala

2013-01-01

Full Text Available Background: Urbanization is associated with an enormous increase in vehicular traffic emitting exhausts and polluting the atmosphere. Emissions from vehicular traffic constitute the most significant source of ultraparticle in an urban environment. Cab drivers who work near areas located in the vicinity of traffic junctions through which maximum number of vehicles passes are more prone to develop health issues pertaining to the respiratory system. The effect of this occupational hazard in this unorganised workforce is not adequately studied. This study is designed to determine the effect of air pollution on the pulmonary system in cab drivers exposed to automobile exhaust. Materials and Methods: This study was conducted by performing pulmonary function tests (PFTs on 20 cab drivers who are exposed to automobile exhaust by virtue of their work venue nearer to traffic junctions and comparing them with 20 age, gender-matched, and anthropometric profile cab drivers who work in a rural setting free from vehicular air pollution. PFT by computerized spirometer measuring forced vital capacity (FVC, forced expiratory volume (FEV 1 , FEV1/FVC, peak expiratory flow rate (PEFR, and forced expiratory flow (FEF 25%-75% were measured. Statistical analysis was done by Student′s t test (two-tailed, independent for intergroup analysis. Results: There was a statistically significant decline in dynamic pulmonary function parameters in the study group when compared. FVC, FEV in first second, PEFR, FEV 1 /FVC, and FEF 25%-75% were all found to be statistically significantly lower in cab drivers as compared to control group (P < 0.001. Conclusion: This study finds a significant decline in various PFT parameters recorded in the study group as compared with the control group. These suggests a tendency for obstructive lung disease among cab drivers exposed to a polluted urban environment.

Non-invasive biomarkers and pulmonary function in smokers

OpenAIRE

Borrill, Zo? L; Roy, Kay; Vessey, Rupert S; Woodcock, Ashley A; Singh, Dave

2008-01-01

Zoë L Borrill1, Kay Roy1, Rupert S Vessey2, Ashley A Woodcock1, Dave Singh11Medicines Evaluation Unit, University of Manchester, Wythenshawe Hospital, Southmoor Rd, Manchester, UK; 2Glaxo Smith Kline, Philadelphia, USAAbstract: Limited information exists regarding measurement, reproducibility and interrelationships of non-invasive biomarkers in smokers. We compared exhaled breath condensate (EBC) leukotriene B4 (LTB4) and 8-isoprostane, exhaled nitric oxide, induced sputum, spirometr...

Lung function after cold-water dives with a standard scuba regulator or full-face-mask during wintertime.

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Uhlig, Florian; Muth, Claus-Martin; Tetzlaff, Kay; Koch, Andreas; Leberle, Richard; Georgieff, Michael; Winkler, Bernd E

2014-06-01

Full-face-masks (FFM) prevent the diver's face from cold and can support nasal breathing underwater. The aim of the study was to evaluate the effect of the use of FFMs on lung function and wellbeing. Twenty-one, healthy, non-asthmatic divers performed two cold-water dives (4⁰C, 25 min, 10 metres' depth) - one with a FFM and the other with a standard scuba regulator (SSR). Spirometry was performed before and after each dive and well-being and cold sensation were assessed after the dives. Significant decreases in forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and midexpiratory flow at 75% of FVC (MEF₇₅) occurred after both FFM and SSR dives. Changes in FVC and FEV₁ did not differ significantly between FFM and SSR dives. However, the mid-expiratory flows measured at 50% and 25% of FVC (MEF₅₀ and MEF₂₅) were significantly lower 10 minutes after the FFM dive compared to 10 minutes after the SSR dive. The wellbeing and cold sensation of the divers were significantly improved with FFM dives compared to SSR dives. Cold-water dives during wintertime can be associated with airway narrowing. During cold-water dives, the use of a FFM appears to reduce the cold sensation and enhance the well-being of the divers. However, a FFM does not appear to prevent airway narrowing in healthy, non-asthmatic subjects.

Impact of varying physical activity levels on airway sensitivity and bronchodilation in healthy humans.

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Smith, Joshua R; Kurti, Stephanie P; Johnson, Ariel M; Kolmer, Sarah A; Harms, Craig

2015-12-01

The purpose of this study was to determine if the amount of physical activity influences airway sensitivity and bronchodilation in healthy subjects across a range of physical activity levels. Thirty healthy subjects (age, 21.9 ± 2.6 years; 13 men/17 women) with normal pulmonary function reported to the laboratory on 2 separate occasions where they were randomized to breathe either hypertonic saline (HS) (nebulized hypertonic saline (25%) for 20 min) or HS followed by 5 deep inspirations (DIs), which has been reported to bronchodilate the airways. Pulmonary function tests (PFTs) were performed prior to both conditions and following the HS breathing or 5 DIs. Moderate to vigorous physical activity (MVPA) level was measured via accelerometer worn for 7 days. Following the HS breathing, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) significantly decreased from baseline by -11.8% ± 8.4% and -9.3% ± 6.7%, respectively. A 2-segment linear model determined significant relationships between MVPA and percent change in FEV1 (r = 0.50) and FVC (r = 0.55). MVPA above ∼497 and ∼500 min/week for FEV1 and FVC, respectively, resulted in minor additional improvements (p > 0.05) in PFTs following the HS breathing. Following the DIs, FEV1 and FVC decreased (p 0.05) to MVPA. In conclusion, these data demonstrate that higher MVPA levels attenuated airway sensitivity but not bronchodilation in healthy subjects.

Geographic variation in Chinese children' forced vital capacity and its association with long-term exposure to local PM10: a national cross-sectional study.

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Wang, Hai-Jun; Li, Qin; Guo, Yuming; Song, Jie-Yun; Wang, Zhiqiang; Ma, Jun

2017-10-01

The purpose of this study was to estimate the association between Chinese children's forced vital capacity (FVC) and particulate matter with aerodynamic diameter ≤10 μm (PM 10 ). The FVC data of 71,763 children aged 7 to 18 was collected from 2010 Chinese National Survey on Students' Construction and Health (CNSSCH). The local annual average concentration of PM 10 , relative humidity, ambient temperature, and other air pollutant data of 30 cities was collected from China Meteorological Administration and Ministry of Environment Protection of China. Then, we used generalized additive model (GAM) to estimate the association between children's FVC and PM 10 . The obvious geographic variation in FVC was found in children of 30 Chinese cities ranging from 1647 ml in Xining to 2571 ml in Beijing. The annual average concentration of PM 10 was also different, ranging from 40 μg/m 3 in Haikou to 155 μg/m 3 in Lanzhou. After adjusted individual characteristics, socioeconomic conditions, ambient temperature, relative humidity, and other air pollutants (e.g., NO 2 and SO 2 ) in the generalized additive model, we found that the increase of PM 10 was associated with decrease of FVC in Chinese children. A 10-μg/m 3 increase of PM 10 was associated with 1.33-ml decrease in FVC (95% confidence interval: -2.18 to -0.47). We also found a larger effect estimate of PM 10 on FVC in boys than that in girls. Consistent associations were found in both physically inactive and active children. The increase of PM 10 was associated with decrease of children's FVC. We should develop proper public health policy to protect children's respiratory health during growth and development in polluted areas.

Evaluation of maximum voided volume in Korean children by use of a 48-h frequency volume chart.

Science.gov (United States)

Kim, Sun-Ouck; Kim, Kyung Do; Kim, Young Sig; Kim, Jun Mo; Moon, Du Geon; Park, Sungchan; Lee, Sang Don; Chung, Jae Min; Cho, Won Yeol

2012-08-01

Study Type - Diagnostic (validating cohort). Level of Evidence 2a. What's known on the subject? and What does the study add? The relationship between the maximum voided volume followed a linear curve. The formula presented, bladder capacity (mL) = 12 ×[age (years) + 11], is thought to be a reasonable one for Korean children. Korean children have a smaller bladder capacity than that reported in previous Western studies. • To develop practical guidelines for the prediction of normal bladder capacity in Korean children measured by a frequency volume chart (FVC), maximum voided volume (MVV) is an important factor in the diagnosis of children with abnormal voiding function. • In all, 298 children, aged 3-13 years, with no history of voiding disorders volunteered for the study. The MVV was determined in 219 subjects by use of a completely recorded FVC. • Linear regression analysis was used to define the exact relationship between age and bladder capacity. An approximate formula related age to bladder capacity as follows: bladder capacity (mL) = 12 ×[age (years) + 11]. • The relationship between the MVV measured by a FVC by age (3-13 years) of Korean children followed a linear curve. • When applied to normal voiding patterns, the formula presented appears to be a reasonable one for Korean children. © 2011 BJU INTERNATIONAL.

Serial automated quantitative CT analysis in idiopathic pulmonary fibrosis. Functional correlations and comparison with changes in visual CT scores

International Nuclear Information System (INIS)

Jacob, Joseph; Bartholmai, Brian J.; Rajagopalan, Srinivasan; Kokosi, Maria; Wells, Athol U.; Egashira, Ryoko; Brun, Anne Laure; Nair, Arjun; Walsh, Simon L.F.; Karwoski, Ronald

2018-01-01

To determine whether computer-based CT quantitation of change can improve on visual change quantification of parenchymal features in IPF. Sixty-six IPF patients with serial CT imaging (6-24 months apart) had CT features scored visually and with a computer software tool: ground glass opacity, reticulation and honeycombing (all three variables summed as interstitial lung disease extent [ILD]) and emphysema. Pulmonary vessel volume (PVV) was estimated by computer only. Relationships between changes in CT features and forced vital capacity (FVC) were examined using univariate and multivariate linear regression analyses. On univariate analysis, changes in computer variables demonstrated stronger linkages to FVC change than changes in visual scores (CALIPER ILD:R 2 =0.53, p<0.0001; Visual ILD:R 2 =0.16, p=0.001). PVV increase correlated most strongly with relative FVC change (R 2 =0.57). When PVV constituents (vessel size and location) were examined, an increase in middle zone vessels linked most strongly to FVC decline (R 2 =0.57) and was independent of baseline disease severity (characterised by CT fibrosis extent, FVC, or DLco). An increase in PVV, specifically an increase in middle zone lung vessels, was the strongest CT determinant of FVC decline in IPF and was independent of baseline disease severity. (orig.)

Serial automated quantitative CT analysis in idiopathic pulmonary fibrosis. Functional correlations and comparison with changes in visual CT scores

Energy Technology Data Exchange (ETDEWEB)

Jacob, Joseph; Bartholmai, Brian J.; Rajagopalan, Srinivasan [Mayo Clinic Rochester, Division of Radiology, Rochester, MN (United States); Kokosi, Maria; Wells, Athol U. [Royal Brompton and Harefield NHS Foundation Trust, Interstitial Lung Disease Unit, Royal Brompton Hospital, London (United Kingdom); Egashira, Ryoko [Saga Daigaku, Department of Radiology, Saga (Japan); Brun, Anne Laure [Whittington Hospital, Department of Radiology, London (United Kingdom); Nair, Arjun [Guys and St Thomas' NHS Foundation Trust, Department of Radiology, London (United Kingdom); Walsh, Simon L.F. [Kings College Hospital NHS Foundation Trust, Department of Radiology, London (United Kingdom); Karwoski, Ronald [Mayo Clinic Rochester, Department of Physiology and Biomedical Engineering, Rochester, MN (United States)

2018-03-15

To determine whether computer-based CT quantitation of change can improve on visual change quantification of parenchymal features in IPF. Sixty-six IPF patients with serial CT imaging (6-24 months apart) had CT features scored visually and with a computer software tool: ground glass opacity, reticulation and honeycombing (all three variables summed as interstitial lung disease extent [ILD]) and emphysema. Pulmonary vessel volume (PVV) was estimated by computer only. Relationships between changes in CT features and forced vital capacity (FVC) were examined using univariate and multivariate linear regression analyses. On univariate analysis, changes in computer variables demonstrated stronger linkages to FVC change than changes in visual scores (CALIPER ILD:R{sup 2}=0.53, p<0.0001; Visual ILD:R{sup 2}=0.16, p=0.001). PVV increase correlated most strongly with relative FVC change (R{sup 2}=0.57). When PVV constituents (vessel size and location) were examined, an increase in middle zone vessels linked most strongly to FVC decline (R{sup 2}=0.57) and was independent of baseline disease severity (characterised by CT fibrosis extent, FVC, or DLco). An increase in PVV, specifically an increase in middle zone lung vessels, was the strongest CT determinant of FVC decline in IPF and was independent of baseline disease severity. (orig.)

Respiratory adaptations in different types of sport.

Science.gov (United States)

Lazovic, B; Mazic, S; Suzic-Lazic, J; Djelic, M; Djordjevic-Saranovic, S; Durmic, T; Zikic, D; Zugic, V

2015-06-01

Recent studies demonstrated that current European Respiratory Society/American Thoracic Society spirometric reference equations, used in general population, may not be applicable in population of elite athletes. Althought it is well known that physical activity may affect lung volumes, the effect of sporting activity on pulmonary function testing indices was never examined. The aim of this study was to examine the differences in functional respiratory parameters in various types of sports by measuring lung volumes and to extend the existing factors as well as sport disciplines which affect respiratory function the most. A total of 1639 elite male athletes, aged 18-35 years were divided in 4 groups according to the predominant characteristics of training: skill, power, mixed and endurance athletes. They performed basic anthropometric measurements and spirometry. Groups were compared, and Pearson's simple correlation was performed to test the relation between anthropometric and spirometric characteristics of athletes. All anthropometric characteristics significantly differed among groups and correlate with respiratory parameters. The highest correlation was found for body height and weight. Sports participation is associated with respiratory adaptation, and the extent of adaptation depends on type of activity. Endurance sports athletes have higher lung volumes in comparison with skill, mixed and power group of sport.

Evaluation of Spatiotemporal Variations of Global Fractional Vegetation Cover Based on GIMMS NDVI Data from 1982 to 2011

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Donghai Wu

2014-05-01

Full Text Available Fractional vegetation cover (FVC is an important biophysical parameter of terrestrial ecosystems. Variation of FVC is a major problem in research fields related to remote sensing applications. In this study, the global FVC from 1982 to 2011 was estimated by GIMMS NDVI data, USGS global land cover characteristics data and HWSD soil type data with a modified dimidiate pixel model, which considered vegetation and soil types and mixed pixels decomposition. The evaluation of the robustness and accuracy of the GIMMS FVC with MODIS FVC and Validation of Land European Remote sensing Instruments (VALERI FVC show high reliability. Trends of the annual FVCmax and FVCmean datasets in the last 30 years were reported by the Mann–Kendall method and Sen’s slope estimator. The results indicated that global FVC change was 0.20 and 0.60 in a year with obvious seasonal variability. All of the continents in the world experience a change in the annual FVCmax and FVCmean, which represents biomass production, except for Oceania, which exhibited a significant increase based on a significance level of p = 0.001 with the Student’s t-test. Global annual maximum and mean FVC growth rates are 0.14%/y and 0.12%/y, respectively. The trends of the annual FVCmax and FVCmean based on pixels also illustrated that the global vegetation had turned green in the last 30 years. A significant trend on the p = 0.05 level was found for 15.36% of the GIMMS FVCmax pixels on a global scale (excluding permanent snow and ice, in which 1.8% exhibited negative trends and 13.56% exhibited positive trends. The GIMMS FVCmean similarly produced a total of 16.64% significant pixels with 2.28% with a negative trend and 14.36% with a positive trend. The North Frigid Zone represented the highest annual FVCmax significant increase (p = 0.05 of 25.17%, which may be caused mainly by global warming, Arctic sea-ice loss and an advance in growing seasons. Better FVC predictions at large regional scales

Cross sectional analysis of respiratory symptoms in an injection drug user cohort: the impact of obstructive lung disease and HIV

Directory of Open Access Journals (Sweden)

Mehta Shruti H

2010-05-01

Full Text Available Abstract Background Injection drug use is associated with an increased risk of human immunodeficiency virus (HIV infection and with obstructive lung diseases (OLD. Understanding how HIV and OLD may impact respiratory symptoms among injection drug users (IDUs is important to adequately care for this high-risk population. We characterized the independent and joint effects of HIV and OLD on respiratory symptoms of a cohort of inner-city IDUs. Methods Demographics, risk behavior and spirometric measurements were collected from a cross-sectional analysis of the Acquired Immunodeficiency Syndrome Link to the IntraVenous Experience study, an observational cohort of IDUs followed in Baltimore, MD since 1988. Participants completed a modified American Thoracic Society respiratory questionnaire and the Medical Research Council (MRC dyspnea score to assess respiratory symptoms of cough, phlegm, wheezing and dyspnea. Results Of 974 participants, 835 (86% were current smokers and 288 (29.6% were HIV-infected. The prevalence of OLD (FEV1/FVC ≤ 0.70 was 15.5%, and did not differ by HIV status. OLD, but not HIV, was associated with increased frequency of reported respiratory symptoms. There was a combined effect of OLD and HIV on worsening of MRC scores. OLD and HIV were independently associated with an increased odds of reporting an MRC ≥ 2 (OR 1.83 [95%CI 1.23-2.73] and 1.50 [95%CI 1.08-2.09], respectively. COPD, but not HIV, was independently associated with reporting an MRC ≥ 3 (OR 2.25 [95%CI 1.43-3.54] and 1.29 [95%CI 0.87-1.91], respectively. Conclusions While HIV does not worsen cough, phlegm or wheezing, HIV significantly increases moderate but not severe dyspnea in individuals of similar OLD status. Incorporating the MRC score into routine evaluation of IDUs at risk for OLD and HIV provides better assessment than cough, phlegm and wheezing alone.

Effects of Body Mass Index on Lung Function Index of Chinese Population

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Guo, Qiao; Ye, Jun; Yang, Jian; Zhu, Changan; Sheng, Lei; Zhang, Yongliang

2018-01-01

To study the effect of body mass index (BMI) on lung function indexes in Chinese population. A cross-sectional study was performed on 10, 592 participants. The linear relationship between lung function and BMI was evaluated by multivariate linear regression analysis, and the correlation between BMI and lung function was assessed by Pearson correlation analysis. Correlation analysis showed that BMI was positively related with the decreasing of forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/FVC (P <0.05), the increasing of FVC% predicted value (FVC%pre) and FEV1% predicted value (FEV1%pre). These suggested that Chinese people can restrain the decline of lung function to prevent the occurrence and development of COPD by the control of BMI.

Correlation between spirometry values and pulmonary artery pressure in young healthy subjects.

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Grossman, Alon; Benderly, Michal; Prokupetz, Alex; Gordon, Barak; Kalter-Leibovici, Ofra

2014-03-01

Pulmonary hypertension is frequently associated with parenchymal lung disease. We evaluated the association between spirometry values and pulmonary artery systolic pressure (PASP) in young subjects without lung disease : We studied applicants to the Israeli Air Force, who undergo routine evaluation that includes resting spirometry and echocardiography. Applicants with overt lung disease were excluded. All echocardiographic studies performed in the years 1994 through 2010 (n = 6,598) were screened, and files that included PASP and spirometry values were analyzed for the association between PASP and FVC, FEV1, FEV1/FVC, peak expiratory flow, and forced expiratory flow during the middle half of the FVC maneuver. Of the 647 air force applicants who underwent echocardiography in which PASP was measurable and had spirometry data, 607 (94%) were male, and their average age was 18.16 ± 0.73 years. Mean PASP was 26.4 ± 5.2 mm Hg (range 10-41 mm Hg). None of the spirometry values significantly correlated with PASP. PASP in young healthy subjects is not significantly associated with spirometry values. Lung mechanics probably do not contribute significantly to PASP in this population.

Pulmonary function in advanced uncomplicated singleton and twin pregnancy

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Anwar Hasan Siddiqui

2014-06-01

Full Text Available Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups, as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

Improved pulmonary function in working divers breathing nitrox at shallow depths

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Fitzpatrick, Daniel T.; Conkin, Johnny

2003-01-01

INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Effect of gender specific anthropometric characteristics on lung function in young competitive triathletes from Malaysia.

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Johari, Hanapi M; Zainudin, Hakimi A; Knight, Victor F; Lumley, Steven A; Subramanium, Ananthan S; Caszo, Brinnell A; Gnanou, Justin V

2017-04-01

Anthropometric and lung function characteristics of triathletes are important for the implementation of individual specific training and recovery recommendations. However, limited data are available for these parameters in triathletes. Hence, the aim of this study was to characterize and examine the gender differences of lung function and anthropometry parameters in competitive triathletes from Malaysia. Body composition assessment and lung function tests were performed on sixteen competitive triathletes (nine male and seven female). The subject's body composition profile including muscle mass (kg), fat free mass (kg), and percent body fat was measured using a bio-impedance segmental body composition analyzer. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured by Quark PFT2 spirometer. The anthropometric measurements revealed that male triathletes were significantly taller than female triathletes and had significantly more protein and skeletal muscle mass. The female triathletes, however, had significantly higher percent body fat. Male triathletes had statistically significant higher FVC and FEV1 than female triathletes. Both the male and female triathletes showed a positive correlation between height, fat free mass and the lung function markers FVC and FEV1. This association was not seen with Body Mass Index (BMI) in female triathletes. The data from our study shows that anthropometric parameters are directly linked to lung function of a triathlete. We also found the relationship between BMI and lung function to be gender specific in triathletes and is dependent on the body protein and fat content. Hence, body composition characterization is essential and provides valuable information for developing individual specific training modules.

Automated Quantitative Computed Tomography Versus Visual Computed Tomography Scoring in Idiopathic Pulmonary Fibrosis: Validation Against Pulmonary Function.

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Jacob, Joseph; Bartholmai, Brian J; Rajagopalan, Srinivasan; Kokosi, Maria; Nair, Arjun; Karwoski, Ronald; Raghunath, Sushravya M; Walsh, Simon L F; Wells, Athol U; Hansell, David M

2016-09-01

The aim of the study was to determine whether a novel computed tomography (CT) postprocessing software technique (CALIPER) is superior to visual CT scoring as judged by functional correlations in idiopathic pulmonary fibrosis (IPF). A total of 283 consecutive patients with IPF had CT parenchymal patterns evaluated quantitatively with CALIPER and by visual scoring. These 2 techniques were evaluated against: forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLco), carbon monoxide transfer coefficient (Kco), and a composite physiological index (CPI), with regard to extent of interstitial lung disease (ILD), extent of emphysema, and pulmonary vascular abnormalities. CALIPER-derived estimates of ILD extent demonstrated stronger univariate correlations than visual scores for most pulmonary function tests (PFTs): (FEV1: CALIPER R=0.29, visual R=0.18; FVC: CALIPER R=0.41, visual R=0.27; DLco: CALIPER R=0.31, visual R=0.35; CPI: CALIPER R=0.48, visual R=0.44). Correlations between CT measures of emphysema extent and PFTs were weak and did not differ significantly between CALIPER and visual scoring. Intriguingly, the pulmonary vessel volume provided similar correlations to total ILD extent scored by CALIPER for FVC, DLco, and CPI (FVC: R=0.45; DLco: R=0.34; CPI: R=0.53). CALIPER was superior to visual scoring as validated by functional correlations with PFTs. The pulmonary vessel volume, a novel CALIPER CT parameter with no visual scoring equivalent, has the potential to be a CT feature in the assessment of patients with IPF and requires further exploration.

Association between high-density lipoprotein cholesterol level and pulmonary function in healthy Korean adolescents: the JS high school study.

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Park, Ji Hye; Mun, Seyeon; Choi, Dong Phil; Lee, Joo Young; Kim, Hyeon Chang

2017-12-11

Accumulating evidence suggests that high-density lipoprotein (HDL) cholesterol is associated with pulmonary function and pulmonary disorders. The aim of this study was to evaluate the association between HDL cholesterol and pulmonary function in healthy adolescents. This cross-sectional study was based on data collected for the JS High School study. The analysis included 644 adolescents (318 male and 326 female) aged 15-16 years old and free from asthma or chronic obstructive pulmonary disease. Fasting blood samples were collected for hematologic and biochemical assessment. Forced vital capacity volume (FVC) and forced expiratory volume in the 1 s (FEV1) were measured using dry-rolling-seal spirometry. The associations between HDL cholesterol and pulmonary function were analyzed using multiple linear regression models. Among male adolescents, an increase of 1.0 mg/dL in HDL cholesterol was associated with 10 mL decrease in FVC (p = 0.013) and FEV1 (p = 0.013) after adjusting for age, height, weight, alcohol drinking, smoking, physical activity, systolic blood pressure, total cholesterol, triglyceride, and monthly household income. Percent predicted values of FVC (p = 0.036) and FEV1 (p = 0.017) were also inversely associated with HDL cholesterol. However, among female adolescents, HDL cholesterol level was not significantly associated with absolute or percent predictive value of FVC and FEV1. Higher HDL cholesterol level may be associated with decreased pulmonary function among healthy male adolescents. The sex differences observed in the association between HDL cholesterol and pulmonary function need further investigation.

Measures of the inflammatory response in cryptogenic fibrosing alveolitis

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Pantin, C.F.; Valind, S.O.; Sweatman, M.; Lawrence, R.; Rhodes, C.G.; Brudin, L.; Britten, A.; Hughes, J.M.; Turner-Warwick, M.

1988-01-01

Cryptogenic fibrosing alveolitis (CFA) is characterized by interstitial fibrosis and parenchymal inflammation. Eleven patients with CFA (10 proved by lung biopsy) were followed over 2 yr using clinical symptoms, radiographic change, and pulmonary function tests to adjust their treatment. Lung lavage, positron camera (PET) measurements of regional extravascular lung density (Dev), pulmonary blood volume (Vb), and the metabolic rate for 18F-deoxyglucose (MRglc), clearance of 99mTc-diethylenetriaminepentacetate (99mTc-DTPA) aerosol, and lung uptake of 67Ga were measured initially and at the end of the first year to give a profile of the inflammatory response. Compared with normal subjects, there was an increased percentage of neutrophils and eosinophils in the lung lavage, increased Dev (p less than 0.002) with no significant difference in Vb, increased MRglc (p less than 0.02), 99mTc-DTPA clearance (p less than 0.002), and 67Ga uptake (p less than 0.02). The smallest increases in Dev were seen in the two patients with most destruction shown by lung biopsy. There were inverse correlations between Dev and both FVC and TLC, but a direct correlation between Vb and transfer factor. 99mTc-DTPA clearance changed concordantly with clinical status and radiographic and respiratory function changes during the first year. If glucose utilization (MRglc) remained in the normal range between the initial and first yearly assessment, the patient improved or remained stable during the second year as shown by clinical status and radiographic and respiratory function measurements. If it rose or remained high, the patient's condition deteriorated

Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease.

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Rodriguez-Roisin, Roberto; Tetzlaff, Kay; Watz, Henrik; Wouters, Emiel Fm; Disse, Bernd; Finnigan, Helen; Magnussen, Helgo; Calverley, Peter Ma

2016-01-01

The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland-Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of -0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis.

Is insufficient pulmonary air support the cause of dysphonia in chronic obstructive pulmonary disease?

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Hassan, Megahed M; Hussein, Mona T; Emam, Ahmed Mamdouh; Rashad, Usama M; Rezk, Ibrahim; Awad, Al Hussein

2018-08-01

Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted. Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively). Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower

Nitric oxide and carbon monoxide diffusing capacity after a 1-h oxygen dive to 9 m of sea water

NARCIS (Netherlands)

van Ooij, P. J. A. M.; van Hulst, R. A.; Houtkooper, A.; Sterk, P. J.

2014-01-01

To prevent extensive pulmonary lesions in submerged oxygen divers lung function like the forced vital capacity (FVC) or the diffusing capacity for carbon monoxide (DL,co) are used to monitor pulmonary oxygen toxicity (POT). As the diffusing capacity for nitric oxide (DL,no) measures more accurately

Waist circumference, BMI, and lung function in 8-year-old children : The PIAMA birth cohort study

NARCIS (Netherlands)

Bekkers, Marga B. M.; Wijga, Alet H.; de Jongste, Johan C.; Kerkhof, Marjan; Postma, Dirkje; Gehring, Ulrike; Smit, Henriette A.; Brunekreef, Bert

Background Body mass index (BMI) and waist circumference (WC) may be associated with lung function in children, as observed in adults. Methods Height, weight, waist circumference, and lung function (FVC and FEV1) were measured during a medical examination in 1,058 eight-year-old children

Early detection of lung function decrements in children and adolescents with cystic fibrosis using new reference values.

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Zacharasiewicz, Angela; Renner, Sabine; Haderer, Flora; Weber, Michael; Dehlink, Eleonore; Szepfalusi, Zsolt; Frischer, Thomas

2017-08-01

Interpretation of lung function values in children with cystic fibrosis (CF) depends on the applied reference values. We hypothesize that differences between the new global lung function initiative (GLI) values and the formerly used Zapletal et al. values produce significantly different clinical results. We analyzed 3719 lung function measurements of 108 children and adolescents (n = 54 male; aged 6-18 years) with CF treated between September 1991 and July 2009. Data were analyzed in milliliters (ml) and % predicted (pred.) and interpreted using Zapletal and GLI reference values. Applying GLI compared to Zapletal resulted in significantly lower mean forced expiratory volume in 1s (FEV1)% pred. Zapletal 86.6% (SD 20.6), GLI 79.9% (SD 20.3) and 32% (n = 497/1543) were misclassified as normal when using Zapletal. Despite showing no overall differences in FEV1 and forced vital capacity (FVC) between concomitant Pseudomonas detection (PA+) in n = 938 and Pseudomonas negative (PA-) (n = 2781) using either reference PA+ resulted in lower FEV1 and FVC values with increasing age; however, measurement of small airway obstruction with forced expiratory flow at 75% of FVC (FEF75) values - available for Zapletal -showed significant differences. Reassurance regarding lung function when using old reference values may occur with potential clinical significance. Discrepancies in lung function interpretation underline the importance of using uniform and best available reference values.

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

International Nuclear Information System (INIS)

Takx, Richard A.P.; Hoesein, Firdaus A.A.M.; Mali, Willem P.T.M.; Leiner, Tim; Jong, Pim A. de; Vliegenthart, Rozemarijn; Isgum, Ivana; Koning, Harry J. de; Aalst, Carlijn M. van der; Zanen, Pieter; Lammers, Jan-Willem J.; Groen, Harry J.M.; Rikxoort, Eva M. van; Ginneken, Bram van; Schmidt, Michael; Oudkerk, Matthijs

2015-01-01

The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events. In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV 1 %predicted) and FEV 1 divided by forced vital capacity (FVC; FEV 1 /FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices. 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV 1 %predicted, 1.000 (95%CI 0.986-1.015) for FEV 1 /FVC, 1.014 (95%CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95%CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index ( 3 , an increase in C-index of 0.076 and an NRI of 16.9 % (P < 0.0001). Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events. (orig.)

Brasfield and Wisconsin scoring systems have equal value as outcome assessment tools of cystic fibrosis lung disease

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Cleveland, Robert H.; Stamoulis, Catherine; Sawicki, Gregory; Kelliher, Emma; Wood, Christopher; Zurakowski, David; Lee, Edward [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States); Zucker, Evan J. [Tufts Medical School, Boston, MA (United States)

2014-05-15

Several imaging-based scoring systems have been used as outcome measures in assessing the severity of cystic fibrosis (CF) lung disease. It has been shown that chest radiography performs equally to computed tomography (CT). There is the opinion that of the two most commonly used chest radiograph (CXR) systems, the Brasfield system is less sensitive and reliable than the Wisconsin system. This report assesses the reproducibility and reliability of the two systems. Thirty patients with CXRs during a 5-year period were randomly selected. One hundred eighty-two studies had data for all CXRs and pulmonary function tests (PFTs), Forced Expiratory Volume in One Second (FEV-1) and Forced Vital Capacity (FVC). PFT values closest to the date of each CXR were recorded. Four radiologists scored each image twice by both the Brasfield and Wisconsin systems. Intra- and inter-rater reliability, correlation with PFTs and direct correlation of the two systems were calculated. Intra-rater agreement: r = 0.86-0.99 Brasfield, r = 0.78-0.96 Wisconsin. Inter-rater agreement: 0.76-0.90 Brasfield, r = 0.74-0.97 Wisconsin. Brasfield vs. FEV-1: r = 0.55, vs. FVC r = 0.61. Wisconsin vs. FEV-1: r = 0.57, vs. FVC r = 0.66. Correlation of the two systems: r = 0.86 (all P < 0.001). The Brasfield and Wisconsin systems performed very similarly providing equally reproducible, robust and reliable measures. (orig.)

Effects of side lying on lung function in older individuals.

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Manning, F; Dean, E; Ross, J; Abboud, R T

1999-05-01

Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50-74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

Indoor Environmental Factors and Occurrence of Lung Function Decline in Adult Residents in Summer in Southwest China.

Science.gov (United States)

Jie, Yu; Kebin, Li; Yin, Tang; Jie, Xu

2016-11-01

There is conflicting reports on the respiratory health effects of indoor risk factor exposure. The aim of this study was to assess the association of indoor environmental factors to pulmonary function in an adult population in Zunyi City of Southwest China. Between July and Sep 2012, we conducted a cross-sectional survey of people aged ≥18 yr in 11 inner-city areas of Zunyi. Data on asthma and asthma-related symptoms and selected home environmental factors were assessed by questionnaire. Lung function measurements, including FVC, FEV 1 , FEV 1 /FVC and PEFR, were assessed and compared. Exposure to indoor and outdoor PM 2.5 was monitored by measurement of PM 2.5 emission relative concentration. Cooking oil fumes, environmental tobacco smoke (ETS) and coal fuel use were associated with impaired lung function among adults in summer season ( P oil fumes, pest in kitchen, mosquito repellent, fluffy blanket, pets, visible mold in bedroom and ETS (active and passive smoking) tended to exhibit greater decreases in FVC, FEV 1 and PEFR values compared with their non-exposed counterparts ( P kitchen, sleeping area and outdoor were 486.0cpm, 463.0cpm and 459.0cpm, respectively. PM 2.5 relative concentration in indoor kitchen and sleeping area were significant higher than outdoor ( P kitchen, sleeping area risk factors and ETS exposure and a reduction in lung function in summer was revealed in Zunyi.

The effect of time-of-day and chest physiotherapy on multiple breath washout measures in children with clinically stable cystic fibrosis.

Science.gov (United States)

Voldby, Christian; Green, Kent; Rosthøj, Susanne; Kongstad, Thomas; Philipsen, Lue; Buchvald, Frederik; Skov, Marianne; Pressler, Tania; Gustafsson, Per; Nielsen, Kim G

2018-01-01

In this pilot study we investigated daytime variation of multiple breath nitrogen washout (N2MBW) measures in children with clinically stable cystic fibrosis. To our knowledge the effect of time-of-day on multiple breath washout measures in patients with cystic fibrosis has not previously been reported. Furthermore, we assessed the influence of chest physiotherapy on N2MBW measures. Ten school children with cystic fibrosis performed N2MBW followed by spirometry and plethysmography in the morning and afternoon at three visits that were one month apart. Chest physiotherapy was performed immediately before the afternoon measurements at visit 2 and immediately before morning and afternoon measurements at visit 3. The influence of time-of-day and chest physiotherapy on the measures was evaluated using linear mixed models. There were adequate quality data from 8 children with median age (range) 9.6 (6.0; 15.1) years. Baseline lung clearance index (LCI) (range) was 9.0 (7.1; 13.0) and baseline FEV1% predicted was 97.5 (78.5; 117.9). No N2MBW measures were significantly influenced by time-of-day or chest physiotherapy. LCI (95% confidence interval) decreased non-significantly 0.05 (-0.32; 0.22) during the day and increased non-significantly 0.08 (-0.26; 0.42) after chest physiotherapy. All spirometric measures were unaffected by time-of-day and chest physiotherapy. For plethysmographic measures FRCpleth decreased significantly (pphysiotherapy performed immediately prior to N2MBW had no consistent or significant influence on N2MBW measures. However, we emphasize that further studies of the effect of both daytime variation and the effect of chest physiotherapy on multiple breath washout measures are warranted.

O efeito da obesidade sobre parâmetros espirométricos em adolescentes submetidos à broncoprovocação por exercício - DOI: 10.4025/actascihealthsci.v32i1.6476 The effect of obesity on spirometric parameters in adolescents subjected to exercise bronchoprovocation - DOI: 10.4025/actascihealthsci.v32i1.6476

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Rosana Bento Radominski

2009-12-01

Full Text Available O objetivo deste estudo foi avaliar o efeito da obesidade sobre parâmetros espirométricos em adolescentes submetidos ao teste de broncoprovocação por exercício físico. Estudo transversal, descritivo e correlacional, composto por 15 adolescentes, de ambos os sexos. O diagnóstico de asma foi realizado por meio de histórico clínico e questionário ISAAC, e a obesidade, pelo IMC acima do percentil 95. Utilizou-se o teste de broncoprovocação com exercício físico para avaliação da asma induzida pelo exercício (AIE, considerando-se positiva a diminuição do volume expiratório forçado no primeiro segundo (VEF1 > 10% do valor pré-exercício e a intensidade da AIE foi calculada pela queda percentual máxima do VEF1 (% QuedaMax VEF1. Foram utilizados o teste t independente ou U de Mann-Whitney e a correlação de Spearman rho (p máx VEF1 (p = 0,034. Houve relação moderada negativa para a QuedaMax VEF1 com os leucócitos, e do % QuedaMax VEF1 com os leucócitos. Pode-se concluir que as variáveis espirométricas apresentam moderada correlação com as inflamações sistêmicas da obesidade. Palavras-chave: adolescente; asma induzida pelo exercício; obesidade.The objective of this study was to evaluate the effect of obesity on spirometric parameters in adolescents subjected to a physical exercise bronchoprovocation test. It was a cross-sectional, descriptive and correlational study composed of 15 adolescents of both genders. The diagnosis of asthma was made by clinical history and ISAAC questionnaire, and obesity by BMI above the 95th percentile. The bronchoprovocation test with physical exercise was used for assessment of exercise induced asthma (EIA, considering positive a decrease in forced expiratory volume in one second (FEV1 > 10% of pre-exercise, and the intensity was calculated by the EIA maximum percentage fall in FEV1 (% Fallmax FEV1. We used the independent t test or Mann-Whitney U test and the Spearman rho correlation (p 1

Asthma and Obesity in Children Are Independently Associated with Airway Dysanapsis

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Marcus H. Jones

2017-12-01

Full Text Available BackgroundAn increase in the prevalence of overweight and asthma has been observed. Both conditions affect negatively lung function in adults and children. The aim of this study was to analyze the effect of overweight and asthma on lung function in children.MethodsWe designed a case–control study of healthy and asthmatic subjects nested within an epidemiological asthma prevalence study in children between 8 and 16 years of age. The effect of asthma and overweight on lung function was assessed by impulse oscillometry and spirometry obtained at baseline and 10–15 min after salbutamol.Results188 children were recruited, 114 (61% were asthmatics and 72 (38% were overweight or obese. Children with asthma and overweight had a higher FVC (+1.16 z scores, p < 0.001 and higher FEV1 (+0.79 z scores, p = 0.004 and lower FEV1/FVC (−0.54 z scores, p = 0.008 when compared to healthy controls. Compared to normal weight asthmatics, the overweight had higher FVC (+0.78 z scores, p = 0.005 and lower FEV1/FVC (−0.50 z scores, p = 0.007. In the multivariate analysis, overweight was associated with an increase of 0.71 and 0.44 z scores in FVC and FEV1, respectively, and a reduction in FEV1/FVC by 0.40 z scores (p < 0.01 for all. Overweight had no effect on maximal flows and airway resistance at baseline, and this was not modified by inhalation of a bronchodilator. Asthma was also associated with higher post-BD FVC (0.45 z scores, p = 0.012 and FEV1 (0.35 z scores, p = 0.034 but not with FEV1/FVC and FEF25–75%. Two-way analysis of variance did not detect any interaction between asthma and overweight on lung function variables before or after bronchodilator.ConclusionOur results suggest that asthma and overweight are independently associated with airway dysanaptic growth in children which can be further scrutinized using impulse oscillometry. Overweight contributed more to the reduction in FEV1/FVC than asthma in children

Efecto del tabaquismo, los síntomas respiratorios y el asma sobre la espirometría de adultos de la Ciudad de México Effect of tobacco smoking, respiratory symptoms and asthma on spirometry among adults attending a check-up clinic in Mexico City

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Justino Regalado-Pineda

2005-10-01

Full Text Available OBJETIVO: Evaluar el efecto del tabaquismo, los síntomas respiratorios y el asma sobre la función pulmonar espirométrica en población adulta mexicana. MATERIAL Y MÉTODOS: Se generaron ecuaciones de predicción basadas en modelos de regresión lineal múltiple para la capacidad vital forzada (FVC, el vollumen espiratorio forzado al primer segundo (FEV1 y FEV1/FVC de espirometrías obtenidas de adultos que acuden a evaluación de salud y se determinó el efecto del tabaquismo, los síntomas respiratorios y el asma sobre los modelos de estos parámetros. RESULTADOS: Se estudiaron 919 sujetos de entre 14 y 86 años de edad. El asma disminuye la FVC y el FEV1 en hombres con un cambio en la R² OBJECTIVE: To evaluate the effect of tobacco smoking, respiratory symptoms, and asthma on lung function among Mexican adults who were evaluated during a medical exam in a private health clinic. MATERIAL AND METHODS: Reference prediction equations were generated for spirometry parameters [forced vital capacity (FVC, forced expired volume in one second (FEV1 and FEV1/FVC] based on multiple linear regression models. The effect of tobacco smoking, respiratory symptoms and asthma on these equations were explored. RESULTS: Spirometry tests were performed on 919 subjects from 14 to 86 years of age. Asthma decreased FVC and FEV1 in men with a R² change <1%. Respiratory symptoms decreased the FEV1/FVC ratio in both sexes. Tobacco smoking was associated with a significant reduction in FEV1 in women. CONCLUSIONS: Asthma lightly reduced lung function in males while tobacco smoking decreased FEV1, particularly in females.

[Value of forced expiratory volume in 6 seconds (FEV(6)) in the evaluation of pulmonary function in Chinese elderly males].

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Pan, M M; Zhang, H S; Sun, T Y

2017-05-30

Objective: To evaluate the value of forced expiratory volume in 6 seconds (FEV(6)) in the evaluation of pulmonary function in Chinese elderly males. Methods: Pulmonary function tests of elderly who had received regular physical examination in Beijing Hospital from July 2003 to April 2015 were analyzed on subjects with the following characteristics: aged 60 years or older, completion of bronchial dilation test and able to exhale for at least six seconds. The included subjects were divided into 2 groups: 60-function in the study population was evaluated. Results: A total of 475 elderly men aged 60 years or older were enrolled, with a mean age of (77.13±9.53) years. Totally there were 269 subjects in 60-accounted for 56.6%; 206 subjects were in ≥80 years group, which accounted for 43.4%. There were 292 subjects with irreversible airflow obstruction, accounting for 61.5%. In all the included subjects, FEV(6) was significantly correlated with FVC and post-bronchodilator FEV(1)/FEV(6) was significantly correlated with post-bronchodilator FEV(1)/FVC( r =0.971, 0.978; both P function middle group, a total of 73 cases, which included 20 cases ≥80 years old. The proportion of middle group among ≥80 years group was significantly less than that of the 60-function middle group, FEV(1)/FEV(6) or FEV(1)/FVC had no correlation with inspiratory capacity or residual volume/total lung capacity (all P >0.05). Conclusions: FEV(6) and FEV(1)/FEV(6) are strongly correlated with FVC and FEV(1)/FVC, and there is excellent agreement between FEV(1)/FEV(6) and FEV(1)/FVC. FEV(6) is simple, easy to operate and with less influencing factors, which can be used as a valid alternative for FVC in diagnosing airflow obstruction in elderly males.

Evaluation of the Global Lung Initiative 2012 Reference Values for Spirometry in African Children.

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Arigliani, Michele; Canciani, Mario C; Mottini, Giovanni; Altomare, Michele; Magnolato, Andrea; Loa Clemente, Sofia Vanda; Tshilolo, Leon; Cogo, Paola; Quanjer, Philip H

2017-01-15

Despite the high burden of respiratory disease, no spirometry reference values for African children are available. Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function. Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey. Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n = 306), Democratic Republic of the Congo (n = 377), and Madagascar (n = 399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEV 1 , -0.08 (0.86) for FVC, and -0.07 (0.83) for FEV 1 /FVC. Because of low scatter, the fifth centile corresponded to -1.3 z-scores in boys and -1.5 z-scores in girls. Malnourished African children had a normal FEV 1 /FVC ratio but significant reductions of ∼0.5 z-scores (∼5%) in FEV 1 and FVC compared with African American peers from the third National Health and Nutrition Survey. Children in Angola had the lowest, and those in Madagascar had the highest, zFEV 1 and zFVC. The results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV 1 and FVC without respiratory impairment, as shown by the normal FEV 1 /FVC ratio.

High-Resolution Time-Frequency Spectrum-Based Lung Function Test from a Smartphone Microphone

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Tharoeun Thap

2016-08-01

Full Text Available In this paper, a smartphone-based lung function test, developed to estimate lung function parameters using a high-resolution time-frequency spectrum from a smartphone built-in microphone is presented. A method of estimation of the forced expiratory volume in 1 s divided by forced vital capacity (FEV1/FVC based on the variable frequency complex demodulation method (VFCDM is first proposed. We evaluated our proposed method on 26 subjects, including 13 healthy subjects and 13 chronic obstructive pulmonary disease (COPD patients, by comparing with the parameters clinically obtained from pulmonary function tests (PFTs. For the healthy subjects, we found that an absolute error (AE and a root mean squared error (RMSE of the FEV1/FVC ratio were 4.49% ± 3.38% and 5.54%, respectively. For the COPD patients, we found that AE and RMSE from COPD patients were 10.30% ± 10.59% and 14.48%, respectively. For both groups, we compared the results using the continuous wavelet transform (CWT and short-time Fourier transform (STFT, and found that VFCDM was superior to CWT and STFT. Further, to estimate other parameters, including forced vital capacity (FVC, forced expiratory volume in 1 s (FEV1, and peak expiratory flow (PEF, regression analysis was conducted to establish a linear transformation. However, the parameters FVC, FEV1, and PEF had correlation factor r values of 0.323, 0.275, and −0.257, respectively, while FEV1/FVC had an r value of 0.814. The results obtained suggest that only the FEV1/FVC ratio can be accurately estimated from a smartphone built-in microphone. The other parameters, including FVC, FEV1, and PEF, were subjective and dependent on the subject’s familiarization with the test and performance of forced exhalation toward the microphone.

Intrathecal morphine plus general anesthesia in cardiac surgery: effects on pulmonary function, postoperative analgesia, and plasma morphine concentration

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Luciana Moraes dos Santos

2009-04-01

Full Text Available OBJECTIVES: To evaluate the effects of intrathecal morphine on pulmonary function, analgesia, and morphine plasma concentrations after cardiac surgery. INTRODUCTION: Lung dysfunction increases morbidity and mortality after cardiac surgery. Regional analgesia may improve pulmonary outcomes by reducing pain, but the occurrence of this benefit remains controversial. METHODS: Forty-two patients were randomized for general anesthesia (control group n=22 or 400 µg of intrathecal morphine followed by general anesthesia (morphine group n=20. Postoperative analgesia was accomplished with an intravenous, patient-controlled morphine pump. Blood gas measurements, forced vital capacity (FVC, forced expiratory volume (FEV, and FVC/FEV ratio were obtained preoperatively, as well as on the first and second postoperative days. Pain at rest, profound inspiration, amount of coughing, morphine solicitation, consumption, and plasma morphine concentration were evaluated for 36 hours postoperatively. Statistical analyses were performed using the repeated measures ANOVA or Mann-Whiney tests (*p<0.05. RESULTS: Both groups experienced reduced FVC postoperatively (3.24 L to 1.38 L in control group; 2.72 L to 1.18 L in morphine group, with no significant decreases observed between groups. The two groups also exhibited similar results for FEV1 (p=0.085, FEV1/FVC (p=0.68 and PaO2/FiO2 ratio (p=0.08. The morphine group reported less pain intensity (evaluated using a visual numeric scale, especially when coughing (18 hours postoperatively: control group= 4.73 and morphine group= 1.80, p=0.001. Cumulative morphine consumption was reduced after 18 hours in the morphine group (control group= 20.14 and morphine group= 14.20 mg, p=0.037. The plasma morphine concentration was also reduced in the morphine group 24 hours after surgery (control group= 15.87 ng.mL-1 and morphine group= 4.08 ng.mL-1, p=0.029. CONCLUSIONS: Intrathecal morphine administration did not significantly alter

Defining obstructive ventilatory defect in 2015 | Affes | Libyan ...

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% vs. 78+17%) and FVC (71+15% vs. 93+19%). Conclusion: The frequency of OVD much depends on the criteria used for its definition. Keywords: obstructive ventilatory defect; FEV1/FVC; fixed threshold; lower limit of normal; spirometry; ...

Cytotoxic potential of lung CD8(+) T cells increases with chronic obstructive pulmonary disease severity and with in vitro stimulation by IL-18 or IL-15.

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Freeman, Christine M; Han, MeiLan K; Martinez, Fernando J; Murray, Susan; Liu, Lyrica X; Chensue, Stephen W; Polak, Timothy J; Sonstein, Joanne; Todt, Jill C; Ames, Theresa M; Arenberg, Douglas A; Meldrum, Catherine A; Getty, Christi; McCloskey, Lisa; Curtis, Jeffrey L

2010-06-01

Lung CD8(+) T cells might contribute to progression of chronic obstructive pulmonary disease (COPD) indirectly via IFN-gamma production or directly via cytolysis, but evidence for either mechanism is largely circumstantial. To gain insights into these potential mechanisms, we analyzed clinically indicated lung resections from three human cohorts, correlating findings with spirometrically defined disease severity. Expression by lung CD8(+) T cells of IL-18R and CD69 correlated with severity, as did mRNA transcripts for perforin and granzyme B, but not Fas ligand. These correlations persisted after correction for age, smoking history, presence of lung cancer, recent respiratory infection, or inhaled corticosteroid use. Analysis of transcripts for killer cell lectin-like receptor G1, IL-7R, and CD57 implied that lung CD8(+) T cells in COPD do not belong to the terminally differentiated effector populations associated with chronic infections or extreme age. In vitro stimulation of lung CD8(+) T cells with IL-18 plus IL-12 markedly increased production of IFN-gamma and TNF-alpha, whereas IL-15 stimulation induced increased intracellular perforin expression. Both IL-15 and IL-18 protein expression could be measured in whole lung tissue homogenates, but neither correlated in concentration with spirometric severity. Although lung CD8(+) T cell expression of mRNA for both T-box transcription factor expressed in T cells and GATA-binding protein 3 (but not retinoic acid receptor-related orphan receptor gamma or alpha) increased with spirometric severity, stimulation of lung CD8(+) T cells via CD3epsilon-induced secretion of IFN-gamma, TNF-alpha, and GM-CSF, but not IL-5, IL-13, and IL-17A. These findings suggest that the production of proinflammatory cytokines and cytotoxic molecules by lung-resident CD8(+) T cells contributes to COPD pathogenesis.

Pulmonary Function and Incidence of Selected Respiratory Diseases Depending on the Exposure to Ambient PM10

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Artur Badyda

2016-11-01

Full Text Available It is essential in pulmonary disease research to take into account traffic-related air pollutant exposure among urban inhabitants. In our study, 4985 people were examined for spirometric parameters in the presented research which was conducted in the years 2008–2012. The research group was divided into urban and rural residents. Traffic density, traffic structure and velocity, as well as concentrations of selected air pollutants (CO, NO2 and PM10 were measured at selected areas. Among people who live in the city, lower percentages of predicted values of spirometric parameters were noticed in comparison to residents of rural areas. Taking into account that the difference in the five-year mean concentration of PM10 in the considered city and rural areas was over 17 μg/m3, each increase of PM10 by 10 μg/m3 is associated with the decline in FEV1 (forced expiratory volume during the first second of expiration by 1.68%. These findings demonstrate that traffic-related air pollutants may have a significant influence on the decline of pulmonary function and the growing rate of respiratory diseases.

Ultrasound assessment of diaphragmatic function in patients with amyotrophic lateral sclerosis.

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Fantini, Riccardo; Mandrioli, Jessica; Zona, Stefano; Antenora, Federico; Iattoni, Andrea; Monelli, Marco; Fini, Nicola; Tonelli, Roberto; Clini, Enrico; Marchioni, Alessandro

2016-07-01

Evaluation of diaphragm function in Amyotrophic Lateral Sclerosis (ALS) is critical in determining when to commence non-invasive mechanical ventilation (NIV). Currently, forced vital capacity (FVC) and sniff nasal inspiratory pressure (SNIP) are volitional measures for this evaluation, but require collaboration and are poorly specific. The primary aim of this study was to assess whether diaphragmatic thickness measured by ultrasound (US) correlates with lung function impairment in ALS patients. The secondary aim was then to compare US diaphragm thickness index (ΔTdi) with a new parameter (ΔTmax index). 41 patients with ALS and 30 healthy subjects were enrolled in the study. All subjects underwent spirometry, SNIP and diaphragm US evaluation, while arterial blood gases were measured in some patients only. US assessed diaphragm thickness (Tdi) at tidal volume (Vt) or total lung capacity (TLC), and their ratio (ΔTmax) were recorded. Changes (Δ) in Tdi indices during tidal volume (ΔTdiVt) and maximal inspiration (ΔTdiTLC) were also assessed. ΔTdiTLC (p <0.001) and ΔTmax (p = 0.007), but not ΔTdiVt, differed between patients and controls. Significant correlation (p < 0.05) was found between ΔTdiTLC, ΔTmax and FVC. The ROC curve analysis for comparison of individual testing showed better accuracy with Δtmax than with ΔtdiTLC for FVC (AUC 0.76 and 0.27) and SNIP (AUC 0.71 and 0.25). Diaphragm thickness assessed by ultrasound significantly correlates with global respiratory alterations in patients with ALS. ΔTmax represents a new US index of early diaphragmatic dysfunction, better related with the routinely performed lung function tests. © 2016 Asian Pacific Society of Respirology.

Investigation of Acute Pulmonary Deficits Associated with Biomass Fuel Cookstove Emissions in Rural Bangladesh

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Danielle N. Medgyesi

2017-06-01

Full Text Available The use of solid biomass fuels in cookstoves has been associated with chronic health impacts that disproportionately affect women worldwide. Solid fuel stoves that use wood, plant matter, and cow dung are commonly used for household cooking in rural Bangladesh. This study investigates the immediate effects of acute elevated cookstove emission exposures on pulmonary function. Pulmonary function was measured with spirometry before and during cooking to assess changes in respiratory function during exposure to cookstove emissions for 15 females ages 18–65. Cookstove emissions were characterized using continuous measurements of particulate matter (PM2.5—aerodynamic diameter <2.5 μm concentrations at a 1 s time resolution for each household. Several case studies were observed where women ≥40 years who had been cooking for ≥25 years suffered from severe pulmonary impairment. Forced expiratory volume in one second over forced vital capacity (FEV1/FVC was found to moderately decline (p = 0.06 during cooking versus non-cooking in the study cohort. The study found a significant (α < 0.05 negative association between 3- and 10-min maximum PM2.5 emissions during cooking and lung function measurements of forced vital capacity (FVC, forced expiratory volume in one second (FEV1, and FEV1/FVC obtained during cooking intervals. This study found that exposure to biomass burning emissions from solid fuel stoves- associated with acute elevated PM2.5 concentrations- leads to a decrease in pulmonary function, although further research is needed to ascertain the prolonged (e.g., daily, for multiple years impacts of acute PM2.5 exposure on immediate and sustained respiratory impairment.

Effect of Emphysema Extent on Serial Lung Function in Patients with Idiopathic Pulmonary Fibrosis.

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Cottin, Vincent; Hansell, David M; Sverzellati, Nicola; Weycker, Derek; Antoniou, Katerina M; Atwood, Mark; Oster, Gerry; Kirchgaessler, Klaus-Uwe; Collard, Harold R; Wells, Athol U

2017-11-01

Patients with idiopathic pulmonary fibrosis and emphysema may have artificially preserved lung volumes. In this post hoc analysis, we investigated the relationship between baseline emphysema and fibrosis extents, as well as pulmonary function changes, over 48 weeks. Data were pooled from two phase III, randomized, double-blind, placebo-controlled trials of IFN-γ-1b in idiopathic pulmonary fibrosis (GIPF-001 [NCT00047645] and GIPF-007 [NCT00075998]). Patients with Week 48 data, baseline high-resolution computed tomographic images, and FEV 1 /FVC ratios less than 0.8 or greater than 0.9 (0.9 in GIPF-007), as well as randomly selected patients with ratios of 0.8-0.9 and 0.7-0.8, were included. Changes from baseline in pulmonary function at Week 48 were analyzed by emphysema extent. The relationship between emphysema and fibrosis extents and change in pulmonary function was assessed using multivariate linear regression. Emphysema was identified in 38% of patients. A negative correlation was observed between fibrosis and emphysema extents (r = -0.232; P emphysema extent (28 to 65%) showed the smallest FVC decline, with a difference of 3.32% at Week 48 versus patients with no emphysema (P = 0.047). In multivariate analyses, emphysema extent greater than or equal to 15% was associated with significantly reduced FVC decline over 48 weeks versus no emphysema or emphysema less than 15%. No such association was observed for diffusing capacity of the lung for carbon monoxide or composite physiologic index. FVC measurements may not be appropriate for monitoring disease progression in patients with idiopathic pulmonary fibrosis and emphysema extent greater than or equal to 15%.

Lung volumes and airway resistance in patients with a possible restrictive pattern on spirometry.

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Schultz, Kenia; D'Aquino, Luiz Carlos; Soares, Maria Raquel; Gimenez, Andrea; Pereira, Carlos Alberto de Castro

2016-01-01

Many patients with proportional reductions in FVC and FEV1 on spirometry show no reduction in TLC. The aim of this study was to evaluate the role that measuring lung volumes and airway resistance plays in the correct classification of patients with a possible restrictive pattern on spirometry. This was a prospective study involving adults with reduced FVC and FEV1, as well as an FEV1/FV(C) ratio within the predicted range. Restrictive lung disease (RLD) was characterized by TLC below the 5th percentile, as determined by plethysmography. Obstructive lung disease (OLD) was characterized by high specific airway resistance, significant changes in post-bronchodilator FEV1, or an FEF25-75% espirometria não têm CPT reduzida. O objetivo deste estudo foi avaliar o papel da medida dos volumes pulmonares e da resistência das vias aéreas para a classificação correta de pacientes com possível restrição à espirometria. Estudo prospectivo de adultos com CVF e VEF1 reduzidos e relação VEF1/CV(F) na faixa prevista. Distúrbio ventilatório restritivo (DVR) foi definido por CPT espirometria. A obstrução ao fluxo aéreo é comum nesses casos.

The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study.

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Townend, John; Minelli, Cosetta; Mortimer, Kevin; Obaseki, Daniel O; Al Ghobain, Mohammed; Cherkaski, Hamid; Denguezli, Myriam; Gunesekera, Kirthi; Hafizi, Hasan; Koul, Parvaiz A; Loh, Li C; Nejjari, Chakib; Patel, Jaymini; Sooronbayev, Talant; Buist, Sonia A; Burney, Peter G J

2017-06-01

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0-10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV 1 /FVCwealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV 1 /FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; pwealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (pwealth scores explained 38% of the variation in mean FEV 1 /FVC between sites (r 2 =0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries. Copyright ©ERS 2017.

Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

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Coton, Sonia; Vollmer, William M; Bateman, Eric; Marks, Guy B; Tan, Wan; Mejza, Filip; Juvekar, Sanjay; Janson, Christer; Mortimer, Kevin; P A, Mahesh; Buist, A Sonia; Burney, Peter G J

2017-10-01

Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV 1 /FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV 1 . We measured the agreement between classifications and the validity of the FEV 1 -based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV 1 -based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV 1 /FVC ratio is only in moderate agreement with the severity assessed using FEV 1 but is equally strongly associated with other outcomes. Severity assessed using the FEV 1 /FVC ratio is likely to be independent of ethnicity.

Impulse oscillometry in acute and stable asthmatic children: a comparison with spirometry.

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Batmaz, Sehra Birgul; Kuyucu, Semanur; Arıkoglu, Tugba; Tezol, Ozlem; Aydogdu, Ayse

2016-01-01

Lung function tests have attracted interest for the diagnosis and follow-up of childhood asthma in recent years. For patients who cannot perform forced expiratory maneuvers, impulse oscillometry (IOS), performed during spontaneous breathing, may be an alternative tool. Thirty-five acute, 107 stable asthmatic and 103 healthy children who presented to our clinic performed IOS followed by spirometry before and after salbutamol inhalation. The mean baseline and reversibility of IOS and spirometry parameters were compared between the groups. Correlation analyses were undertaken within the asthmatics, and the healthy controls separately. To distinguish the three groups, the sensitivity and specificity of baseline and reversibility values of IOS and spirometry were computed. When spirometry was taken as the gold standard, the discriminating performance of IOS to detect the airway obstruction and reversibility was investigated. The mean absolute values of Zrs, R5, R5-R20, X5, X10, X15, Fres, AX, and all spirometric parameters, and the mean reversibility values of R5, R10, Fres, AX and forced expiratory volume in one second were different between the groups and the highest area under curve values to discriminate the groups was obtained from area of reactance (AX) and ΔAX. Zrs, all resistance (including R5-R20) and reactance parameters, Fres and AX were correlated with at least one spirometric parameter. Spirometric reversibility was detected by ≤-22.34 and ≤-39.05 cut-off values of ΔR5 and ΔAX, respectively. IOS has shown a highly significant association with spirometric indices and reversibility testing. It may be a substitute for spirometry in children who fail to perform forced expiratory maneuvers.

Risk of bacterial cross infection associated with inspiration through flow-based spirometers.

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Bracci, Massimo; Strafella, Elisabetta; Croce, Nicola; Staffolani, Sara; Carducci, Annalaura; Verani, Marco; Valentino, Matteo; Santarelli, Lory

2011-02-01

Bacterial contamination of spirometers has been documented in water-sealed devices, mouthpieces, and connection tubes. Little information is available about bacterial contamination of flow-based apparatuses such as turbine-type spirometers and pneumotachographs. Inspiration through contaminated equipment is a potential source of cross infection. To investigate bacteria mobilization (ie, bacteria detachment and aerosolization from the instrument) during routine spirometric testing, 2 types of flow-based spirometers were used. Bacteria mobilization during artificial inspiration through in-line filters or cardboard mouthpieces was evaluated. Nine hundred workers undergoing periodic spirometric testing were enrolled at the occupational physician office in 30 sessions of 30 subjects each. The participants were asked to perform a forced vital capacity test in a turbine-type spirometer and in an unheated pneumotachograph fitted with disposable in-line filters or cardboard mouthpieces. To evaluate bacterial mobilization, an artificial inspiration was performed and bacterial growth determined. The bacterial growth analysis was assessed after the first and the thirtieth spirometric tests of each session without disinfecting the instruments between tests. In addition, instrument bacterial contamination was evaluated. No significant bacterial mobilization and instrument contamination were found in spirometric tests executed with in-line filters. Conversely, a significant bacterial mobilization and instrument contamination were observed in tests performed with cardboard mouthpieces. Differences between the 2 spirometers were not significant. In-line filters may effectively reduce the risk of bacterial cross infection. Inspiration through flow-based spirometers fitted with disposable cardboard mouthpieces is completely safe when combined with spirometer disinfection/sterilization between subjects. Copyright © 2011 Association for Professionals in Infection Control and

Generalized Multiparameters Fractional Variational Calculus

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Om Prakash Agrawal

2012-01-01

Full Text Available This paper builds upon our recent paper on generalized fractional variational calculus (FVC. Here, we briefly review some of the fractional derivatives (FDs that we considered in the past to develop FVC. We first introduce new one parameter generalized fractional derivatives (GFDs which depend on two functions, and show that many of the one-parameter FDs considered in the past are special cases of the proposed GFDs. We develop several parts of FVC in terms of one parameter GFDs. We point out how many other parts could be developed using the properties of the one-parameter GFDs. Subsequently, we introduce two new two- and three-parameter GFDs. We introduce some of their properties, and discuss how they can be used to develop FVC. In addition, we indicate how these formulations could be used in various fields, and how the generalizations presented here can be further extended.

About PF

Science.gov (United States)

... make scar tissue. Fibrosis : Scar tissue. Forced expiratory volume (FEV1): The amount of air you can blow out oin one second after filling up your lungs with as much air as possible. Measured by a test called spirometry. Forced vital capacity (FVC): The amount of air you can blow ...

Comparação entre exercícios de respiração profunda e espirometria de incentivo no pós-operatório de cirurgia de revascularização do miocárdio Comparison between deep breathing exercises and incentive spirometry after CABG surgery

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Julia Alencar Renault

2009-06-01

- FVC, forced expiratory volume in 1 second - FEV1, maximal respiratory pressures and oxygen saturation. METHODS: Thirty six patients in CABG postoperative period underwent thirty minutes of non-invasive ventilation during the first 24 hours after extubation and were randomly shared into two groups as following: DBE (n=18 and IS (n=18. The spirometric variables were assessed on the preoperative period and seventh postoperative day (POD. The respiratory muscle strength and oxygen saturation were assessed on the preoperative period, first, second and seventh POD. RESULTS: The groups were considered homogeneous in relation to the demographic and surgical variables. It has been noted fall in the values of FVC and FEV1 between the preoperative period and the seventh POD, but without significant differences between groups. The maximal respiratory pressures showed drop in the first POD but with and partial recovery until the seventh POD, also without significant differences between groups. The oxygen saturation was the only variable that was completely recovered on the seventh POD, also without significant differences between groups. CONCLUSION: There were not observed significant differences in maximal respiratory pressures, spirometric variables and oxygen saturation in patients undergone deep breathing exercises and flow-oriented incentive spirometry after coronary artery bypass grafting.

Imunofenotipagem e remodelamento da matriz extracelular na sarcoidose pulmonar e extrapulmonar Immunophenotyping and extracellular matrix remodeling in pulmonary and extrapulmonary sarcoidosis

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Pedro Henrique Ramos Quintino da Silva

2012-06-01

correlated with FVC (p < 0.05, whereas the amount of CD3+, CD4+, and CD8+ lymphocytes correlated with the FEV1/FVC ratio and VC. There were inverse correlations between TLC and the CD1a+ cell count (p < 0.05, as well as between DLCO and collagen/elastic fiber density (r = -0.90; p = 0.04. CONCLUSIONS: Immunophenotyping and remodeling both showed differences between pulmonary and extrapulmonary sarcoidosis in terms of the characteristics of the biopsy samples. These differences correlated with the clinical and spirometric data obtained for the patients, suggesting that two different pathways are involved in the mechanism of antigen clearance, which was more effective in the lungs and lymph nodes.

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

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Emel Torun

2014-09-01

Full Text Available Background: Childhood obesity has become a global epidemic. It is related to several chronic diseases such as essential hypertension, type 2 diabetes mellitus, and renal disease. The relationship between the degree of obesity and lung functions is well defined in adults, but limited information is available about the childhood period. Aims: This study aims to determine the impact of the degree of obesity on the pulmonary functions of school children and adolescents. Study Design: Cross sectional study. Methods: Included in the study were a total of 170 school children and adolescents (9-17 years old referred to our paediatric outpatient clinic. Of these subjects, 42 were lean and non-obese (BMI % <85, 30 subjects were overweight (BMI % ˃85, <95, 34 subjects were obese (BMI % ˃95, <97, and 64 subjects were morbidly obese (BMI % ˃97. Anthropometric measurements were taken and spirometry was performed on all subjects. Forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, forced vital capacity 25-75 (FEV25-75 and peak expiratory flow (PEF were used to measure the ventilatory functions for all the subjects. Results: The groups showed no significant differences in age or gender. Despite no statistically significant differences in FEV1, FVC, or FEV1/FVC, there were significant reductions in PEF (p<0.001 and FEV25-75 (p<0.001 in the overweight, obese and morbidly obese subjects, when compared with those who were non-obese. Conclusion: Overweight, obese and morbidly obese children have no obstructive abnormalities compared with healthy lean subjects.

Relationship between spontaneous expiratory flow-volume curve pattern and air-flow obstruction in elderly COPD patients.

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Nozoe, Masafumi; Mase, Kyoshi; Murakami, Shigefumi; Okada, Makoto; Ogino, Tomoyuki; Matsushita, Kazuhiro; Takashima, Sachie; Yamamoto, Noriyasu; Fukuda, Yoshihiro; Domen, Kazuhisa

2013-10-01

Assessment of the degree of air-flow obstruction is important for determining the treatment strategy in COPD patients. However, in some elderly COPD patients, measuring FVC is impossible because of cognitive dysfunction or severe dyspnea. In such patients a simple test of airways obstruction requiring only a short run of tidal breathing would be useful. We studied whether the spontaneous expiratory flow-volume (SEFV) curve pattern reflects the degree of air-flow obstruction in elderly COPD patients. In 34 elderly subjects (mean ± SD age 80 ± 7 y) with stable COPD (percent-of-predicted FEV(1) 39.0 ± 18.5%), and 12 age-matched healthy subjects, we measured FVC and recorded flow-volume curves during quiet breathing. We studied the SEFV curve patterns (concavity/convexity), spirometry results, breathing patterns, and demographics. The SEFV curve concavity/convexity prediction accuracy was examined by calculating the receiver operating characteristic curves, cutoff values, area under the curve, sensitivity, and specificity. Fourteen subjects with COPD had a concave SEFV curve. All the healthy subjects had convex SEFV curves. The COPD subjects who had concave SEFV curves often had very severe airway obstruction. The percent-of-predicted FEV(1)% (32.4%) was the most powerful SEFV curve concavity predictor (area under the curve 0.92, 95% CI 0.83-1.00), and had the highest sensitivity (0.93) and specificity (0.88). Concavity of the SEFV curve obtained during tidal breathing may be a useful test for determining the presence of very severe obstruction in elderly patients unable to perform a satisfactory FVC maneuver.

Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis

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Manners, David [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); Wong, Patrick; Murray, Conor; Teh, Joelin [Royal Perth Hospital, Department of Diagnostic Imaging, Perth (Australia); Kwok, Yi Jin [Sir Charles Gairdner Hospital, Department of Diagnostic Imaging, Nedlands, WA (Australia); De Klerk, Nick; Franklin, Peter [University of Western Australia, School of Population Health, Perth, WA (Australia); Alfonso, Helman; Reid, Alison [Curtin University, School of Public Health, Perth, WA (Australia); Musk, A.W.B. [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); University of Western Australia, School of Population Health, Perth, WA (Australia); University of Western Australia, School of Medicine and Pharmacology, Perth, WA (Australia); Brims, Fraser J.H. [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); University of Western Australia, School of Population Health, Perth, WA (Australia); Curtin University, Curtin Medical School, Perth (Australia)

2017-08-15

The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV{sub 1}) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. (orig.)

Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis

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Manners, David; Wong, Patrick; Murray, Conor; Teh, Joelin; Kwok, Yi Jin; De Klerk, Nick; Franklin, Peter; Alfonso, Helman; Reid, Alison; Musk, A.W.B.; Brims, Fraser J.H.

2017-01-01

The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. (orig.)

Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study

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Martínez-González Silvia

2011-06-01

Full Text Available Abstract Background Undiagnosed airflow limitation is common in the general population and is associated with impaired health and functional status. Smoking is the most important risk factor for this condition. Although primary care practitioners see most adult smokers, few currently have spirometers or regularly order spirometry tests in these patients. Brief medical advice has shown to be effective in modifying smoking habits in a large number of smokers but only a small proportion remain abstinent after one year. The aim of this study is to evaluate the effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers. Methods/design Intervention study with a randomized two arms in 5 primary care centres. A total of 485 smokers over the age of 18 years consulting their primary care physician will be recruited. On the selection visit all participants will undergo a spirometry, peak expiratory flow rate, test of smoking dependence, test of motivation for giving up smoking and a questionnaire on socio-demographic data. Thereafter an appointment will be made to give the participants brief structured advice to give up smoking combined with a detailed discussion on the results of the spirometry. After this, the patients will be randomised and given appointment for follow up visits at 3, 6, 12 and 24 months. Both arms will receive brief structured advice and a detailed discussion of the spirometry results at visit 0. The control group will only be given brief structured advice about giving up smoking on the follow up. Cessation of smoking will be tested with the carbon monoxide test. Discussion Early identification of functional pulmonary abnormalities in asymptomatic patients or in those with little respiratory symptomatology may provide "ideal educational opportunities". These opportunities may increase the success of efforts to give up smoking and

Predictors of need for noninvasive ventilation during respiratory tract infections in medically stable, non-ventilated subjects with amyotrophic lateral sclerosis.

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Sancho, Jesus; Servera, Emilio; Bañuls, Pilar; Marin, Julio

2015-04-01

Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The aim of this study was to determine whether a clinical or functional parameter can predict the need for noninvasive ventilation (NIV) during an acute respiratory infection for medically stable, non-ventilated patients with ALS. This was a prospective study involving all non-ventilated subjects with ALS admitted due to an acute respiratory infection to a respiratory care unit from a tertiary hospital. Thirty-two non-ventilated subjects with ALS were admitted to our respiratory care unit due to an acute respiratory infection: 60.72 ± 10.54 y, 13 males, 23 with spinal onset, FVC of 1.58 ± 0.83 L, FVC of 56.21 ± 23.15% of predicted, peak cough flow of 3.41 ± 1.77 L/s, maximum insufflation capacity of 1.87 ± 0.94 L, revised Amyotrophic Lateral Sclerosis Functional Rating Scale score of 22.80 ± 8.83, and Norris bulbar score of 23.48 ± 12.14. Fifteen subjects required NIV during the episode. Logistic regression analysis showed that the only predictors of need for NIV were percent-of-predicted FVC (odds ratio of 1.06, 95% CI 1.01-1.11, P = .02) and peak cough flow (odds ratio of 2.57, 95% CI 1.18-5.59, P = .02). In medically stable, non-ventilated patients with ALS, measurement of percent-of-predicted FVC and peak cough flow can predict the need for NIV during an acute lower respiratory tract infection. Copyright © 2015 by Daedalus Enterprises.

Effect of inhaled N-acetylcysteine monotherapy on lung function and redox balance in idiopathic pulmonary fibrosis.

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Muramatsu, Yoko; Sugino, Keishi; Ishida, Fumiaki; Tatebe, Junko; Morita, Toshisuke; Homma, Sakae

2016-05-01

An oxidant-antioxidant imbalance is considered to be involved in the pathogenesis of idiopathic pulmonary fibrosis (IPF). Therefore, administration of antioxidants, such as N-acetylcysteine (NAC), may represent a potential treatment option for IPF patients. The aim of this study was to evaluate the effect of inhaled NAC monotherapy on lung function and redox balance in patients with IPF. A retrospective observational study was done, involving 22 patients with untreated early IPF (19 men; mean [±S.D.] age, 71.8 [±6.3]y). At baseline and at 6 and 12 months after initiating inhaled NAC monotherapy, we assessed forced vital capacity (FVC) and measured the levels of total glutathione, oxidized glutathione (GSSG), and the ratio of reduced to oxidized glutathione in whole blood (hereafter referred to as the ratio), and of 8-hydroxy-2'-deoxyguanosine in urine. To evaluate response to treatment, we defined disease progression as a decrease in FVC of ≥5% from baseline and stable disease as a decrease in FVC of <5%, over a period of 6 months. Change in FVC in the stable group at 6 and 12 months were 95±170mL and -70±120mL, while those in the progressive group at 6 and 12 months were -210±80mL, -320±350mL, respectively. The serial mean change in GSSG from baseline decreased as the ratio of reduced to oxidized glutathione increased in patients with stable disease, while it increased as this ratio decreased in patients with progressive disease. Receiver operating characteristic curve analysis revealed that a baseline GSSG level of ≥1.579μM was optimal for identifying treatment responders. Inhaled NAC monotherapy was associated with improved redox imbalance in patients with early IPF. Copyright © 2015 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Study On Harmful Effects Of Opium On Liver And Lungs In Chronic Opium Addicts Of Western Rajasthan

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M Kamla

2011-12-01

Full Text Available Background: Today opium dependence is widely prevalent in certain states of India, especially Rajasthan, Punjab, Haryana, Madhya Pradesh (MP etc. In rural areas of western Rajasthan crude opium is consumed with a social acceptance by a notable proportion (8.0% of adult male population. Later on they become addicted to it.Objective: to observe the changes in some liver and lung function parameters in opium addicted subjects of Barmer city of Western Rajasthan.Methods: The present study was conducted in district hospital of Barmer, Rajasthan. Total fifty (50 adult male subjects with age ranged from 30 to 50 years were participated in this study. Among them 25 were opium addicted and were considered as study group (Group B and another 25 apparently healthy adult male of same age group were designated as control group (Group A. Opium addicts were consuming about 5–11 gm/day opium for >2 years. Then liver function tests were evaluated by estimating serum aspartate amino transferase (AST, alanine amino transferase (ALT, alkaline phosphatase and lung function tests by measuring FVC, FEV1 , FEV1/FVC% , PEF, FEF 25-75% of both the groups.Results: In this study AST, ALT and alkaline phosphatase levels were found significantly (p<.05 higher in group B as compared to those of group A. Again, FVC, FEV1, FEV1/ FVC were significantly (p<.05 lower in group B as compared to those of group A. PEF (L/sec and FEF 25-75% were also significantly (p<0.001 lower in group B as compared to those of group A.Conclusion: it is concluded that chronic long term use of opium, increases the risk of hepatic and pulmonary damage.

Spatial-temporal Evolution of Vegetation Coverage and Analysis of it’s Future Trends in Wujiang River Basin

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Xiao, Jianyong; Bai, Xiaoyong; Zhou, Dequan; Qian, Qinghuan; Zeng, Cheng; Chen, Fei

2018-01-01

Vegetation coverage dynamics is affected by climatic, topography and human activities, which is an important indicator reflecting the regional ecological environment. Revealing the spatial-temporal characteristics of vegetation coverage is of great significance to the protection and management of ecological environment. Based on MODIS NDVI data and the Maximum Value Composites (MVC), we excluded soil spectrum interference to calculate Fractional Vegetation Coverage (FVC). Then the long-term FVC was used to calculate the spatial pattern and temporal variation of vegetation in Wujiang River Basin from 2000 to 2016 by using Trend analysis and Hurst index. The relationship between topography and spatial distribution of FVC was analyzed. The main conclusions are as follows: (1) The multi-annual mean vegetation coverage reveals a spatial distribution variation characteristic of low value in midstream and high level in other parts of the basin, owing a mean value of 0.6567. (2) From 2000 to 2016, the FVC of the Wujiang River Basin fluctuated between 0.6110 and 0.7380, and the overall growth rate of FVC was 0.0074/a. (3) The area of vegetation coverage tending to improve is more than that going to degrade in the future. Grass land, Arable land and Others improved significantly; karst rocky desertification comprehensive management project lead to persistent vegetation coverage improvement of Grass land, Arable land and Others. Residential land is covered with obviously degraded vegetation, resulting of urban sprawl; (4) The spatial distribution of FVC is positively correlated with TNI. Researches of spatial-temporal evolution of vegetation coverage have significant meaning for the ecological environment protection and management of the Wujiang River Basin.

[The importance of lung volumes in the investigation of heavy smokers].

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Ben Saad, H; Ben Amor, L; Ben Mdalla, S; Ghannouchi, I; Ben Essghair, M; Sfaxi, R; Garrouche, A; Rouatbi, N; Rouatbi, S

2014-01-01

Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVCvolume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

The association of systemic microvascular changes with lung function and lung density: a cross-sectional study.

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Bianca Harris

Full Text Available Smoking causes endothelial dysfunction and systemic microvascular disease with resultant end-organ damage in the kidneys, eyes and heart. Little is known about microvascular changes in smoking-related lung disease. We tested if microvascular changes in the retina, kidneys and heart were associated with obstructive spirometry and low lung density on computed tomography. The Multi-Ethnic Study of Atherosclerosis recruited participants age 45-84 years without clinical cardiovascular disease. Measures of microvascular function included retinal arteriolar and venular caliber, urine albumin-to-creatinine ratio and, in a subset, myocardial blood flow on magnetic resonance imaging. Spirometry was measured following ATS/ERS guidelines. Low attenuation areas (LAA were measured on lung fields of cardiac computed tomograms. Regression models adjusted for pulmonary and cardiac risk factors, medications and body size. Among 3,397 participants, retinal venular caliber was inversely associated with forced expiratory volume in one second (FEV(1 (P<0.001 and FEV(1/forced vital capacity (FVC ratio (P = 0.04. Albumin-to-creatinine ratio was inversely associated with FEV(1 (P = 0.002 but not FEV(1/FVC. Myocardial blood flow (n = 126 was associated with lower FEV(1 (P = 0.02, lower FEV(1/FVC (P = 0.001 and greater percentage LAA (P = 0.04. Associations were of greater magnitude among smokers. Low lung function was associated with microvascular changes in the retina, kidneys and heart, and low lung density was associated with impaired myocardial microvascular perfusion. These cross-sectional results suggest that microvascular damage with end-organ dysfunction in all circulations may pertain to the lung, that lung dysfunction may contribute to systemic microvascular disease, or that there may be a shared predisposition.

Adopting Clean Fuels and Technologies on School Buses. Pollution and Health Impacts in Children

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D’Souza, Jennifer; Sheppard, Lianne; Kaufman, Joel D.; Hallstrand, Teal S.; Davey, Mark E.; Sullivan, James R.; Jahnke, Jordan; Koenig, Jane; Larson, Timothy V.; Liu, L. J. Sally

2015-01-01

Rationale: More than 25 million American children breathe polluted air on diesel school buses. Emission reduction policies exist, but the health impacts to individual children have not been evaluated. Methods: Using a natural experiment, we characterized the exposures and health of 275 school bus riders before, during, and after the adoption of clean technologies and fuels between 2005 and 2009. Air pollution was measured during 597 trips on 188 school buses. Repeated measures of exhaled nitric oxide (FeNO), lung function (FEV1, FVC), and absenteeism were also collected monthly (1,768 visits). Mixed-effects models longitudinally related the adoption of diesel oxidation catalysts (DOCs), closed crankcase ventilation systems (CCVs), ultralow-sulfur diesel (ULSD), or biodiesel with exposures and health. Measurements and Main Results: Fine and ultrafine particle concentrations were 10–50% lower on buses using ULSD, DOCs, and/or CCVs. ULSD adoption was also associated with reduced FeNO (−16% [95% confidence interval (CI), −21 to −10%]), greater changes in FVC and FEV1 (0.02 [95% CI, 0.003 to 0.05] and 0.01 [95% CI, −0.006 to 0.03] L/yr, respectively), and lower absenteeism (−8% [95% CI, −16.0 to −0.7%]), with stronger associations among patients with asthma. DOCs, and to a lesser extent CCVs, also were associated with improved FeNO, FVC growth, and absenteeism, but these findings were primarily restricted to patients with persistent asthma and were often sensitive to control for ULSD. No health benefits were noted for biodiesel. Extrapolating to the U.S. population, changed fuel/technologies likely reduced absenteeism by more than 14 million/yr. Conclusions: National and local diesel policies appear to have reduced children’s exposures and improved health. PMID:25867003

Analysis of spirometry results in hospitalized patients aged over 65 years

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Wróblewska I

2015-06-01

Full Text Available Izabela Wróblewska,1 Piotr Oleśniewicz,2 Donata Kurpas,3 Mariusz Sołtysik,2 Jerzy Błaszczuk41Faculty of Health Science, Wroclaw Medical University, 2Institute of Tourism and Recreation, University School of Physical Education in Wroclaw, 3Department of Family Medicine, 4Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Lower Silesia, PolandIntroduction and objective: The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged ≥65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders.Material and methods: In the research, 217 (100% patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro–Wilk test, the ANOVA test, and the Scheffé’s test were applied.Results: The majority of the patients (59.4% were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%. The study showed a statistically significant dependence between the forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive

The Effect of Swimming Activity on Lung Function Parameters Among Smoking and Non-Smoking Youth – Research Extended

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Michalak Katarzyna

2015-12-01

Full Text Available Purpose. The purpose of this study was to evaluate the effect of regular swimming activity on the respiratory system of smokers and non-smokers. Methods. The study included 196 students, aged 19 to 24 years, attending weekly swimming classes. All students underwent pulmonary function testing before and after participating in a swimming program for 10 months. Measurements included forced vital capacity (FVC, forced expiratory volume in one second (FEV1, and peak expiratory flow (PEF. Maximal inspiratory and expiratory pressure at the mouth (PImax, PEmax and the percentage carboxyhemoglobin level in blood (%CoHb were also measured. Results. After 10 months of regular swimming activity the values of FVC, PEF, MIP and MEP increased in the non-smoking as well as in the smoking group, while the FEV1 increased only among smokers. The percentage of CoHB level in the blood decreased in both groups. Conclusions. The study confirmed the positive effect of swimming on respiratory system function and the importance of promoting physical activity such as swimming among cigarette smokers as well as non-smokers.

Impact of diagnostic criteria on the prevalence of COPD

DEFF Research Database (Denmark)

Çolak, Yunus; Løkke, Anders; Marott, Jacob Louis

2013-01-01

INTRODUCTION: The reduction in the ratio between forced expiratory volume in 1 s (FEV(1) ) and forced vital capacity (FVC) is used for the diagnosis of chronic obstructive pulmonary disease (COPD). The choice between a simple fixed cut-off ratio (FEV(1) /FVC LLN had well-preserved FEV(1) . CONCLU...

Lung-dominant connective tissue disease among patients with interstitial lung disease: prevalence, functional stability, and common extrathoracic features

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Daniel Antunes Silva Pereira

2015-04-01

Full Text Available OBJECTIVE: To describe the characteristics of a cohort of patients with lung-dominant connective tissue disease (LD-CTD. METHODS: This was a retrospective study of patients with interstitial lung disease (ILD, positive antinuclear antibody (ANA results (≥ 1/320, with or without specific autoantibodies, and at least one clinical feature suggestive of connective tissue disease (CTD. RESULTS: Of the 1,998 patients screened, 52 initially met the criteria for a diagnosis of LD-CTD: 37% were male; the mean age at diagnosis was 56 years; and the median follow-up period was 48 months. During follow-up, 8 patients met the criteria for a definitive diagnosis of a CTD. The remaining 44 patients comprised the LD-CTD group, in which the most prevalent extrathoracic features were arthralgia, gastroesophageal reflux disease, and Raynaud's phenomenon. The most prevalent autoantibodies in this group were ANA (89% and anti-SSA (anti-Ro, 27%. The mean baseline and final FVC was 69.5% and 74.0% of the predicted values, respectively (p > 0.05. Nonspecific interstitial pneumonia and usual interstitial pneumonia patterns were found in 45% and 9% of HRCT scans, respectively; 36% of the scans were unclassifiable. A similar prevalence was noted in histological samples. Diffuse esophageal dilatation was identified in 52% of HRCT scans. Nailfold capillaroscopy was performed in 22 patients; 17 showed a scleroderma pattern. CONCLUSIONS: In our LD-CTD group, there was predominance of females and the patients showed mild spirometric abnormalities at diagnosis, with differing underlying ILD patterns that were mostly unclassifiable on HRCT and by histology. We found functional stability on follow-up. Esophageal dilatation on HRCT and scleroderma pattern on nailfold capillaroscopy were frequent findings and might come to serve as diagnostic criteria.

Delayed diagnosis of sarcoidosis is common in Brazil

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Mauri Monteiro Rodrigues

2013-09-01

Full Text Available OBJECTIVE: To determine the frequency of and the factors related to delayed diagnosis of sarcoidosis in Brazil. METHODS: We evaluated patients with a biopsy-proven diagnosis of sarcoidosis, using a questionnaire that addressed the following: time since symptom onset and since the first medical visit; and the number and specialty of the physicians visited. We divided the patients by the timeliness of the diagnosis-timely (< 6 months and delayed (≥ 6 months-comparing the two groups in terms of systemic and pulmonary symptoms; extrathoracic involvement; spirometric data; radiological staging; level of education; income; and tuberculosis (diagnosis and treatment. RESULTS: We evaluated 100 patients. The median number of physicians consulted was 3 (range, 1-14. In 11 cases, sarcoidosis was diagnosed at the first visit. In 54, the first physician seen was a general practitioner. The diagnosis of sarcoidosis was timely in 41 patients and delayed in 59. The groups did not differ in terms of gender; race; type of health insurance; level of education; income; respiratory/systemic symptoms; extrathoracic involvement; and radiological staging. In the delayed diagnosis group, FVC was lower (80.3 ± 20.4% vs. 90.5 ± 17.1%; p = 0.010, as was FEV1 (77.3 ± 19.9% vs. 86.4 ± 19.5%; p = 0.024, misdiagnosis with and treatment for tuberculosis (≥ 3 months also being more common (24% vs. 7%, p = 0.032, and 20% vs. 0%; p = 0.002, respectively. CONCLUSIONS: The diagnosis of sarcoidosis is often delayed, even when the imaging is suggestive of sarcoidosis. Delayed diagnosis is associated with impaired lung function at the time of diagnosis. Many sarcoidosis patients are misdiagnosed with and treated for tuberculosis.

Pulmonary function evaluation during the Skylab and Apollo-Soyuz missions

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Sawin, C. F.; Nicogossian, A. E.; Rummel, J. A.; Michel, E. L.

1976-01-01

Previous experience during Apollo postflight exercise testing indicated no major changes in pulmonary function. Pulmonary function has been studied in detail following exposure to hypoxic and hyperoxic normal gravity environments, but no previous study has reported on men exposed to an environment that was both normoxic at 258 torr total pressure and at null gravity as encountered in Skylab. Forced vital capacity (FVC) was measured during the preflight and postflight periods of the Skylab 2 mission. Inflight measurements of vital capacity (VC) were obtained during the last 2 weeks of the second manned mission (Skylab 3). More detailed pulmonary function screening was accomplished during the Skylab 4 mission. The primary measurements made during Skylab 4 testing included residual volume determination (RV), closing volume (CV), VC, FVC and its derivatives. In addition, VC was measured in flight at regular intervals during the Skylab 4 mission. Vital capacity was decreased slightly (-10%) in flight in all Skylab 4 crewmen. No major preflight-to-postflight changes were observed. The Apollo-Soyuz Test Project (ASTP) crewmen were studied using equipment and procedures similar to those employed during Skylab 4. Postflight evaluation of the ASTP crewmen was complicated by their inadvertent exposure to nitrogen tetroxide gas fumes upon reentry.

Preschool Children's Self-Reports of Fruit and Vegetable Knowledge, Preference, and Messages Encouraging Consumption

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Hansen, Andrew R.; Alfonso, Moya L.; Hackney, Amy A.; Luque, John S.

2015-01-01

Background: Fruit and vegetable consumption (FVC) is associated with a reduced risk of diabetes, obesity, cancer, and cardiovascular disease. Only one third of children aged 4-8?years consume the recommended 5 servings a day. Studies involving school-aged children (6-11?years) demonstrate that positive outcome expectancies can mediate FVC. There…

Assessment of minute volume of lung in NPP workers for Korean reference man

International Nuclear Information System (INIS)

Lee, Y. J.; Song, S. H.; Lee, J.; Jin, Y. W.; Yim, Y. K.; Kim, J. S.

2001-01-01

To formulation of the reference Korean for radiation protection purpose, we measured the forced vital capacity(FVC), forced expiratory volume in second(FEVI), minute ventilation(MV) of Nuclear Power Plant workers using SP-1 Spirometry Unit(Schiller AG. 1998) and eatimated the liters of breathed for working and resting, also compared these data with ICRP 23

Assessment of minute volume of lung in NPP workers for Korean reference man

Energy Technology Data Exchange (ETDEWEB)

Lee, Y. J.; Song, S. H.; Lee, J.; Jin, Y. W.; Yim, Y. K.; Kim, J. S. [KNETEC, Seoul (Korea, Republic of)

2001-05-01

To formulation of the reference Korean for radiation protection purpose, we measured the forced vital capacity(FVC), forced expiratory volume in second(FEVI), minute ventilation(MV) of Nuclear Power Plant workers using SP-1 Spirometry Unit(Schiller AG. 1998) and eatimated the liters of breathed for working and resting, also compared these data with ICRP 23.

Short term exposure to cooking fumes and pulmonary function

Directory of Open Access Journals (Sweden)

Qvenild Torgunn

2009-05-01

Full Text Available Abstract Background Exposure to cooking fumes may have different deleterious effects on the respiratory system. The aim of this study was to look at possible effects from inhalation of cooking fumes on pulmonary function. Methods Two groups of 12 healthy volunteers (A and B stayed in a model kitchen for two and four hours respectively, and were monitored with spirometry four times during twenty four hours, on one occasion without any exposure, and on another with exposure to controlled levels of cooking fumes. Results The change in spirometric values during the day with exposure to cooking fumes, were not statistically significantly different from the changes during the day without exposure, with the exception of forced expiratory time (FET. The change in FET from entering the kitchen until six hours later, was significantly prolonged between the exposed and the unexposed day with a 15.7% increase on the exposed day, compared to a 3.2% decrease during the unexposed day (p-value = 0.03. The same tendency could be seen for FET measurements done immediately after the exposure and on the next morning, but this was not statistically significant. Conclusion In our experimental setting, there seems to be minor short term spirometric effects, mainly affecting FET, from short term exposure to cooking fumes.

Feasibility of Lung Volume Recruitment in Early Neuromuscular Weakness: A Comparison Between Amyotrophic Lateral Sclerosis, Myotonic Dystrophy, and Postpolio Syndrome.

Science.gov (United States)

Kaminska, Marta; Browman, Franceen; Trojan, Daria A; Genge, Angela; Benedetti, Andrea; Petrof, Basil J

2015-07-01

Lung volume recruitment (LVR) is a cough assistance technique used in persons with neuromuscular disorders (NMDs), most typically in those requiring noninvasive ventilation (NIV). Whether it may be useful in persons with NMDs who have milder respiratory impairment is unknown. To assess the feasibility, impact on quality of life (QOL), and preliminary physiological effects of daily LVR in different categories of persons with NMDs who have an early stage of respiratory impairment. Feasibility study. Academic tertiary care center. Outpatients diagnosed with amyotrophic lateral sclerosis (n = 8), postpolio syndrome (n = 10), and myotonic dystrophy (n = 6) who had restrictive respiratory defects but were not yet using NIV. Participants were asked to perform LVR up to 4 times daily and log their LVR use in a diary. Physiological measurements and questionnaires were completed at baseline and after 3 months. Compliance with LVR use was assessed, along with QOL and willingness to continue the treatment. Physiological measurements included forced vital capacity (FVC), lung insufflation capacity (LIC), and the LIC minus FVC difference. Of the 24 recruited subjects, 7 with amyotrophic lateral sclerosis, 7 with postpolio syndrome, and 5 with myotonic dystrophy completed the study (n = 19). At baseline, mean values for FVC and spontaneous peak cough flow were 59.9% predicted and 373.1 L/min, respectively. For subjects completing the study, 74% were willing to continue long-term LVR use, and QOL scores were not adversely affected by LVR in any NMD subgroup. The LIC-FVC difference increased from baseline to follow-up by a mean of 0.243 L (P = .006) in all subjects (n = 19), suggesting a possible improvement in respiratory system mechanics. In patients with NMDs who have early restrictive respiratory defects but do not yet require NIV, regular use of LVR is feasible with no negative impact on QOL over a 3-month period and may have physiological benefits. Further work is needed to

Childhood-onset asthma in smokers. association between CT measures of airway size, lung function, and chronic airflow obstruction.

Science.gov (United States)

Diaz, Alejandro A; Hardin, Megan E; Come, Carolyn E; San José Estépar, Raúl; Ross, James C; Kurugol, Sila; Okajima, Yuka; Han, MeiLan K; Kim, Victor; Ramsdell, Joe; Silverman, Edwin K; Crapo, James D; Lynch, David A; Make, Barry; Barr, R Graham; Hersh, Craig P; Washko, George R

2014-11-01

Asthma is associated with chronic airflow obstruction. Our goal was to assess the association of computed tomographic measures of airway wall volume and lumen volume with the FEV1 and chronic airflow obstruction in smokers with childhood-onset asthma. We analyzed clinical, lung function, and volumetric computed tomographic airway volume data from 7,266 smokers, including 590 with childhood-onset asthma. Small wall volume and small lumen volume of segmental airways were defined as measures 1 SD below the mean. We assessed the association between small wall volume, small lumen volume, FEV1, and chronic airflow obstruction (post-bronchodilator FEV1/FVC ratio childhood-onset asthma, those with childhood-onset asthma had smaller wall volume and lumen volume (P childhood-onset asthma, those with the smallest wall volume and lumen volume had the lowest FEV1 and greatest odds of chronic airflow obstruction. A similar tendency was seen in those without childhood-onset asthma. When comparing these two groups, both small wall volume and small lumen volume were more strongly associated with FEV1 and chronic airflow obstruction among subjects with childhood-asthma in multivariate models. In smokers with childhood-onset asthma, smaller airways are associated with reduced lung function and chronic airflow obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010*

Science.gov (United States)

FORD, Earl S.; CUNNINGHAM, Timothy J.; MERCADO, Carla I.

2015-01-01

Background Considerable uncertainty remains about obstructive lung function (OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. Methods We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007–2010. Subjects’ MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. Results After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9% (1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Conclusions Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. PMID:26677470

Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010.

Science.gov (United States)

Ford, Earl S; Cunningham, Timothy J; Mercado, Carla I

2014-11-01

Considerable uncertainty remains about obstructive lung function( OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007-2010. Subjects'MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9%(1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Impact of diagnostic criteria on the prevalence of COPD

DEFF Research Database (Denmark)

Çolak, Yunus; Løkke, Anders; Marott, Jacob Louis

2012-01-01

INTRODUCTION: The reduction in the ratio between forced expiratory volume in 1¿s (FEV(1) ) and forced vital capacity (FVC) is used for the diagnosis of chronic obstructive pulmonary disease (COPD). The choice between a simple fixed cut-off ratio (FEV(1) /FVC <0.70) and the use of lower limit of n...

Prognostic Role of Exhaled Breath Condensate pH and Fraction Exhaled Nitric Oxide in Systemic Sclerosis Related Interstitial Lung Disease.

Science.gov (United States)

Guillen-Del Castillo, Alfredo; Sánchez-Vidaurre, Sara; Simeón-Aznar, Carmen P; Cruz, María J; Fonollosa-Pla, Vicente; Muñoz, Xavier

2017-03-01

Interstitial lung disease (ILD) is one of the major causes of death in systemic sclerosis (SSc). This study investigated exhaled breath (EB) and exhaled breath condensate (EBC) biomarkers in patients with SSc and analyzed their role as a prognostic tool in SSc-related ILD. Fraction exhaled nitric oxide (FeNO) and exhaled carbon monoxide (eCO) measured in EB, together with pH, nitrite, nitrate and interleukin-6 levels measured in EBC were prospectively analyzed in 35 patients with SSc. Twelve patients had established ILD by chest high-resolution computed tomography (HRCT), and 23 patients showed no evidence of ILD. EB and EBC biomarkers were determined at inclusion, and pulmonary function tests were annually performed during 4 years of follow-up. No differences at baseline biomarkers levels were found between groups. In all patients studied, low EBC pH levels were associated with a decreased diffusing capacity for carbon monoxide (DLCO) during follow-up. Low FeNO levels were correlated with lower forced vital capacity (FVC) at baseline, 4years of follow-up and with a decrease in FVC and DLCO during monitoring. Among ILD patients, high eCO levels were correlated with lower baseline FVC. In the global cohort, a worse progression-free survival was identified in patients with EBC pH values lower than 7.88 and FeNO levels lower than 10.75ppb (Log Rank P=.03 and P<.01, respectively). EB and EBC could help to detect patients likely to present a deterioration on lung function during follow up. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Energy Technology Data Exchange (ETDEWEB)

Takx, Richard A.P.; Hoesein, Firdaus A.A.M.; Mali, Willem P.T.M.; Leiner, Tim; Jong, Pim A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); Isgum, Ivana [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Koning, Harry J. de; Aalst, Carlijn M. van der [Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam (Netherlands); Zanen, Pieter; Lammers, Jan-Willem J. [University Medical Center Utrecht, Department of Pulmonology, Utrecht (Netherlands); Groen, Harry J.M. [University Medical Center Groningen, Department of Pulmonology, Groningen (Netherlands); Rikxoort, Eva M. van; Ginneken, Bram van [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Institute for Medical Image Computing, Fraunhofer MEVIS, Bremen (Germany); Schmidt, Michael [Institute for Medical Image Computing, Fraunhofer MEVIS, Bremen (Germany); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands)

2015-01-15

The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events. In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV{sub 1}%predicted) and FEV{sub 1} divided by forced vital capacity (FVC; FEV{sub 1}/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices. 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV{sub 1}%predicted, 1.000 (95%CI 0.986-1.015) for FEV{sub 1}/FVC, 1.014 (95%CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95%CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (<0.015) and NRI (<2.8 %) were minimal. Coronary artery calcium volume had a hazard ratio of 1.046 (95%CI 1.034-1.058) per 100 mm{sup 3}, an increase in C-index of 0.076 and an NRI of 16.9 % (P < 0.0001). Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events. (orig.)

Adopting Clean Fuels and Technologies on School Buses. Pollution and Health Impacts in Children.

Science.gov (United States)

Adar, Sara D; D'Souza, Jennifer; Sheppard, Lianne; Kaufman, Joel D; Hallstrand, Teal S; Davey, Mark E; Sullivan, James R; Jahnke, Jordan; Koenig, Jane; Larson, Timothy V; Liu, L J Sally

2015-06-15

More than 25 million American children breathe polluted air on diesel school buses. Emission reduction policies exist, but the health impacts to individual children have not been evaluated. Using a natural experiment, we characterized the exposures and health of 275 school bus riders before, during, and after the adoption of clean technologies and fuels between 2005 and 2009. Air pollution was measured during 597 trips on 188 school buses. Repeated measures of exhaled nitric oxide (FeNO), lung function (FEV1, FVC), and absenteeism were also collected monthly (1,768 visits). Mixed-effects models longitudinally related the adoption of diesel oxidation catalysts (DOCs), closed crankcase ventilation systems (CCVs), ultralow-sulfur diesel (ULSD), or biodiesel with exposures and health. Fine and ultrafine particle concentrations were 10-50% lower on buses using ULSD, DOCs, and/or CCVs. ULSD adoption was also associated with reduced FeNO (-16% [95% confidence interval (CI), -21 to -10%]), greater changes in FVC and FEV1 (0.02 [95% CI, 0.003 to 0.05] and 0.01 [95% CI, -0.006 to 0.03] L/yr, respectively), and lower absenteeism (-8% [95% CI, -16.0 to -0.7%]), with stronger associations among patients with asthma. DOCs, and to a lesser extent CCVs, also were associated with improved FeNO, FVC growth, and absenteeism, but these findings were primarily restricted to patients with persistent asthma and were often sensitive to control for ULSD. No health benefits were noted for biodiesel. Extrapolating to the U.S. population, changed fuel/technologies likely reduced absenteeism by more than 14 million/yr. National and local diesel policies appear to have reduced children's exposures and improved health.

Chronic obstructive pulmonary disease in patients with end-stage kidney disease on hemodialysis

DEFF Research Database (Denmark)

Plesner, Louis L; Warming, Peder E; Nielsen, Ture L

2016-01-01

The objectives of this study were to assess the prevalence of chronic obstructive pulmonary disease (COPD) in hemodialysis patients with spirometry and to examine the effects of fluid removal by hemodialysis on lung volumes. Patients ≥18 years at two Danish hemodialysis centers were included....... Forced expiratory volume in one second (FEV1 ), forced vital capacity (FVC), and FEV1 /FVC ratio were measured with spirometry before and after hemodialysis. The diagnosis of COPD was based on both the GOLD criteria and the lower limit of normal criteria. There were 372 patients in treatment at the two...... centers, 255 patients (69%) completed spirometry before dialysis and 242 of these (65%) repeated the test after. In the initial test, 117 subjects (46%) had airflow limitation indicative of COPD with GOLD criteria and 103 subjects (40.4%) with lower limit of normal criteria; COPD was previously diagnosed...

A comparison of the effects of sodium cromoglycate and beclomethasone dipropionate on pulmonary function and bronchial hyperreactivity in subjects with asthma

DEFF Research Database (Denmark)

Svendsen, U G; Frølund, L; Madsen, F

1987-01-01

on logarithm-natural (Ln) (PC20), i.e., the mean effects of the two periods, was also significant (p less than 0.01). SCG, however, was most effective when it was used as the first drug, indicated by a significant increase in FVC in the first period (p less than 0.05). Neither in the first nor in the second...... period did SCG treatment influence the Ln (PC20) value positively, and the SCG treatment administered in the second period could not maintain the improvement in the pulmonary function (i.e., FEV1, FVC, and PEF) obtained initially with the BDP treatment. When the effect of BDP on FEV1, FVC, PEF, and Ln...

Radiotherapy of lung cancer: the inspiration breath hold with a spirometric monitoring

International Nuclear Information System (INIS)

Garcia, R.; Oozeer, R.; Le Thanh, H.; Chastel, D.; Doyen, J.C.; Chauvet, B.; Reboul, F.

2002-01-01

A CT acquisition during a free breathing examination generates images of poor quality. It creates an uncertainty on the reconstructed gross tumour volume and dose distribution. The aim of this study is to test the feasibility of a breath hold method applied in all preparation and treatment days. Five patients received a thoracic radiotherapy with the benefit of this procedure. The breathing of the patient was measured with a spirometer. The patient was coached to reproduce a constant level of breath-hold in a deep inspiration. Video glasses helped the patients to fix the breath-hold at the reference level. The patients followed the coaching during preparation and treatment, without any difficulty. The better quality of the CT reconstructed images resulted in an easier contouring. No movements of the gross tumour volume lead to a better coverage. The deep breath hold decreased the volume of irradiated lung. This method improves the reproducibility of the thoracic irradiation. The decrease of irradiated lung volume offers prospects in dose escalation and intensity modulation radiotherapy. (authors)

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial

Science.gov (United States)

Kumar, Amaravadi Sampath; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Introduction Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group

performance evaluation of feature sets of minutiae quadruplets

African Journals Online (AJOL)

databases. This shows that the evaluation of algorithms on just one or two databases is not sufficient to confirm the performance of tech- niques as they may be database-dependent. Much work was done to find a feature-set that would have a good performance across three. FVC databases of the FVC 2000, 2002 and. 2004 ...

Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India.

Science.gov (United States)

Murhekar, Manoj V; Kamaraj, P; Kanagasabai, K; Elavarasu, G; Rajasekar, T Daniel; Boopathi, K; Mehendale, Sanjay

2017-03-01

District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers' recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing

Analysis of cardiovascular system responses to forced vital capacity in COPD Análise das respostas do sistema cardiovascular ao teste de capacidade vital forçada na DPOC

Directory of Open Access Journals (Sweden)

Felipe A. R. Mendes

2011-04-01

Full Text Available BACKGROUND: The forced vital capacity (FVC test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD. However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR, blood pressure (BP and heart rate variability (HRV during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD and frequency domains (LF, HF and LF/HF at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (pCONTEXTUALIZAÇÃO: O teste de capacidade vital forçada (CVF é rotineiramente realizado na avaliação da função pulmonar de pacientes com doença pulmonar obstrutiva crônica (DPOC. Entretanto, permanece pouco compreendida a influência do teste de CVF sobre o sistema cardiovascular de pacientes com DPOC. OBJETIVOS: Analisar o comportamento da frequência cardíaca (FC, pressão arterial (PA e variabilidade da frequência cardíaca (VFC no teste de CVF na DPOC. MÉTODOS: Dezenove homens com DPOC (72 ± 7 anos, no estágio de gravidade GOLD I=3, II=5, III=7 e IV=4 pacientes realizaram a manobra de CVF e tiveram sua FC monitorada durante todo o exame, e a VFC analisada nos domínios do tempo (rMSSD e da frequência (BF, AF e BF/AF durante o repouso, antes e após a melhor manobra de CVF. A PA foi analisada no repouso, imediatamente ao final da manobra de CVF e 10 minutos após o término de todos os testes. RESULTADOS: Ao início da manobra de CVF, a FC reduziu (p<0,001 e, em seguida, aumentou progressivamente até o final do teste (p<0,001. Após término da manobra, a FC continuou

Airway resistance at maximum inhalation as a marker of asthma and airway hyperresponsiveness

Directory of Open Access Journals (Sweden)

O'Connor George T

2011-07-01

Full Text Available Abstract Background Asthmatics exhibit reduced airway dilation at maximal inspiration, likely due to structural differences in airway walls and/or functional differences in airway smooth muscle, factors that may also increase airway responsiveness to bronchoconstricting stimuli. The goal of this study was to test the hypothesis that the minimal airway resistance achievable during a maximal inspiration (Rmin is abnormally elevated in subjects with airway hyperresponsiveness. Methods The Rmin was measured in 34 nonasthmatic and 35 asthmatic subjects using forced oscillations at 8 Hz. Rmin and spirometric indices were measured before and after bronchodilation (albuterol and bronchoconstriction (methacholine. A preliminary study of 84 healthy subjects first established height dependence of baseline Rmin values. Results Asthmatics had a higher baseline Rmin % predicted than nonasthmatic subjects (134 ± 33 vs. 109 ± 19 % predicted, p = 0.0004. Sensitivity-specificity analysis using receiver operating characteristic curves indicated that baseline Rmin was able to identify subjects with airway hyperresponsiveness (PC20 min % predicted, FEV1 % predicted, and FEF25-75 % predicted, respectively. Also, 80% of the subjects with baseline Rmin min > 145% predicted had hyperresponsive airways, regardless of clinical classification as asthmatic or nonasthmatic. Conclusions These findings suggest that baseline Rmin, a measurement that is easier to perform than spirometry, performs as well as or better than standard spirometric indices in distinguishing subjects with airway hyperresponsiveness from those without hyperresponsive airways. The relationship of baseline Rmin to asthma and airway hyperresponsiveness likely reflects a causal relation between conditions that stiffen airway walls and hyperresponsiveness. In conjunction with symptom history, Rmin could provide a clinically useful tool for assessing asthma and monitoring response to treatment.

Occupational chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

2014-01-01

Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

Fractional vector calculus and fractional Maxwell's equations

International Nuclear Information System (INIS)

Tarasov, Vasily E.

2008-01-01

The theory of derivatives and integrals of non-integer order goes back to Leibniz, Liouville, Grunwald, Letnikov and Riemann. The history of fractional vector calculus (FVC) has only 10 years. The main approaches to formulate a FVC, which are used in the physics during the past few years, will be briefly described in this paper. We solve some problems of consistent formulations of FVC by using a fractional generalization of the Fundamental Theorem of Calculus. We define the differential and integral vector operations. The fractional Green's, Stokes' and Gauss's theorems are formulated. The proofs of these theorems are realized for simplest regions. A fractional generalization of exterior differential calculus of differential forms is discussed. Fractional nonlocal Maxwell's equations and the corresponding fractional wave equations are considered

Long-Term Exposure to Ambient Air Pollution in Childhood-Adolescence and Lung Function in Adulthood.

Science.gov (United States)

Dubrowski, A; Kliś, K; Żurawiecka, M; Dereń, K; Barszcz, M; Nowakowski, D; Wronka, I

2018-02-15

The aim of the study was to evaluate the effect of air pollution in the dwelling place during childhood-adolescence on respiratory function in early adulthood. The study was conducted in 220 female and 160 male university undergraduates in the cities of Cracow and Wroclaw in Poland and consisted of spirometry to assess lung function. The subjects' exposure to pollution during childhood-adolescence was assessed from the data acquired by the Polish Chief Inspectorate for Environmental Protection. We found differences in all spirometry variables depending on benz[a]piren exposure, in FVC% and FEV 1 /%FVC depending on PM 2.5 content, and in FVC% depending on NO 2 content . Statistically significant differences in spirometry variables were also found in relation to the degree of urbanization of the place of living during the early life period in question. The higher the urbanization, the higher is FEV 1 % and FCV%, and the lower FEV 1 /%FVC. Additionally, undergraduates of Cracow University had worse lung function compared to those of Wroclaw University. In conclusion, air pollution in the dwelling place during childhood-adolescence has an impact on lung function in early adulthood, independently of the current exposure to pollutants.

The prognostic importance of lung function in patients admitted with heart failure.

Science.gov (United States)

Iversen, Kasper Karmark; Kjaergaard, Jesper; Akkan, Dilek; Kober, Lars; Torp-Pedersen, Christian; Hassager, Christian; Vestbo, Jorgen; Kjoller, Erik

2010-07-01

The purpose of the present study was to determine the prognostic importance for all-cause mortality of lung function variables obtained by spirometry in an unselected group of patients admitted with heart failure (HF). This was a prospective prognostic study performed as part of the EchoCardiography and Heart Outcome Study (ECHOS). This analysis included 532 patients admitted with a clinical diagnosis of HF. All patients underwent spirometry and echocardiography and the diagnosis of HF was made according to established criteria. Mean forced expiratory volume in 1 s (FEV(1)) was 65% of the predicted value [95% confidence interval (CI) 63-67%], mean forced vital capacity (FVC) was 71% of predicted (95% CI 69-72%), and FEV(1)/FVC was 0.72 (95% CI 0.71-0.73). FEV(1), FVC, and FEV(1)/FVC were all significant prognostic factors for all-cause mortality in univariate analyses. In a multivariate analysis, FEV(1) had independent prognostic value (hazard ratio 0.86 per 10% change, P information for all-cause mortality in patients admitted with HF. Spirometry therefore seems to be worth considering for all patients admitted with HF in order to identify patients at high risk.

Social disparities in dietary habits among women: Geographic Research on Wellbeing (GROW) Study.

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Wang, May; Heck, Katherine; Winkleby, Marilyn; Cubbin, Catherine

2016-06-01

Relationships among race/ethnicity, individual socio-economic status (SES), neighbourhood SES and acculturation are complex. We sought to answer whether: (i) race/ethnicity, individual SES and neighbourhood SES have independent effects on women's fruit and vegetable consumption (FVC); (ii) SES modifies the effects of race/ethnicity on FVC; and (iii) nativity modifies the effect of Latina ethnicity on FVC. Cross-sectional surveys from the population-based Geographic Research on Wellbeing (GROW) Study were linked with census-tract level data. FVC was indicated by (i) consuming fruits and vegetables less often than daily (LOWFV) and (ii) not having fruits and vegetables in the home very often. Other variables included age, marital status, race/ethnicity, country of birth, educational attainment, family income and longitudinal neighbourhood poverty (based on latent class growth models). Weighted logistic regression models accounting for the complex sample design were constructed. California, USA, 2012-2013. Women (n 2669). In adjusted models, race/ethnicity, education and income were independently associated with FVC, but not neighbourhood poverty. Women of colour, high-school graduates and women with incomes at 301-400 % of the federal poverty level were at higher odds of LOWFV compared with non-Hispanic Whites, college graduates and those with incomes >400 % of the federal poverty level. Little evidence for interactions between race/ethnicity and individual or neighbourhood SES was found; similar patterns were observed for immigrant and US-born Latinas. Addressing the dietary needs of lower-SES communities requires multilevel interventions that simultaneously provide culturally tailored nutrition education and address the physical and economic accessibility of culturally acceptable fruits and vegetables.

Using principal component analysis and annual seasonal trend analysis to assess karst rocky desertification in southwestern China.

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Zhang, Zhiming; Ouyang, Zhiyun; Xiao, Yi; Xiao, Yang; Xu, Weihua

2017-06-01

Increasing exploitation of karst resources is causing severe environmental degradation because of the fragility and vulnerability of karst areas. By integrating principal component analysis (PCA) with annual seasonal trend analysis (ASTA), this study assessed karst rocky desertification (KRD) within a spatial context. We first produced fractional vegetation cover (FVC) data from a moderate-resolution imaging spectroradiometer normalized difference vegetation index using a dimidiate pixel model. Then, we generated three main components of the annual FVC data using PCA. Subsequently, we generated the slope image of the annual seasonal trends of FVC using median trend analysis. Finally, we combined the three PCA components and annual seasonal trends of FVC with the incidence of KRD for each type of carbonate rock to classify KRD into one of four categories based on K-means cluster analysis: high, moderate, low, and none. The results of accuracy assessments indicated that this combination approach produced greater accuracy and more reasonable KRD mapping than the average FVC based on the vegetation coverage standard. The KRD map for 2010 indicated that the total area of KRD was 78.76 × 10 3  km 2 , which constitutes about 4.06% of the eight southwest provinces of China. The largest KRD areas were found in Yunnan province. The combined PCA and ASTA approach was demonstrated to be an easily implemented, robust, and flexible method for the mapping and assessment of KRD, which can be used to enhance regional KRD management schemes or to address assessment of other environmental issues.

Pulmonary functions of children with asthma improve following massage therapy.

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Fattah, Mohammed Abdel; Hamdy, Basant

2011-11-01

This study aimed at evaluating the effect of massage therapy on the pulmonary functions of stable Egyptian children with asthma. This study was an open, randomized, controlled trial. The study was conducted in pediatric allergy and chest unit of the New Children's Hospital of Cairo University, Egypt. Sixty (60) children with asthma were divided randomly into two equal groups: massage therapy group and control group. Subjects in the massage therapy group received a 20-minute massage therapy by their parents at home before bedtime every night for 5 weeks in addition to the standard asthma treatment. The control group received the standard asthma treatment alone for 5 weeks. Spirometry was performed for all children on the first and last days of the study. Forced expiratory flow in first second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) were recorded. At the end of the study, mean FEV1 of the massage therapy group was significantly higher than controls (2.3-0.8 L versus 1.9-0.9 L, p=0.04). There was no significant difference in FVC (2.5-0.8 L versus 2.7-0.7 L, p=0.43). However, FEV1/FVC ratio showed a significant improvement in the massage therapy group (92.3-21.5 versus 69.5-17, pmassage therapy in pediatric asthma is suggested. It improved the key pulmonary functions of the children, namely, FEV1 and FEV1/FVC ratio. However, further research on a larger scale is warranted. © Mary Ann Liebert, Inc.

Improvement in pulmonary functions and clinical parameters due to addition of breathing exercises in asthma patients receiving optimal treatment

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Dipti Agarwal

2017-01-01

Conclusions: Breathing exercises provided significant improvements in spirometric parameters and significant reduction in breathlessness, wheezing, and nocturnal symptoms as well as requirements of rescue medicines in asthma patients who were receiving optimal asthma treatment.

Validity of physician-diagnosed COPD in relation to spirometric definitions of COPD in a general population aged 50–64 years – the SCAPIS pilot study

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Torén K

2017-08-01

Full Text Available Kjell Torén,1,2 Nicola Murgia,1,2 Anna-Carin Olin,1 Jan Hedner,3 John Brandberg,4 Annika Rosengren,5 Göran Bergström51Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; 2Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Italy; 3Department of Medicine/Lung Medicine, Sahlgrenska Academy, University of Gothenburg, 4Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 5Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden Background: In epidemiological studies, items about physician-diagnosed COPD are often used. There is a lack of validation and standardization of these items.Materials and methods: In a general population-based study, 1,050 subjects completed a questionnaire and performed spirometry, including forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC after inhalation of 400 µg of salbutamol. COPD was defined as the ratio of FEV1/FVC <0.7 after bronchodilation. Physician-diagnosed COPD was defined as an affirmative answer to the single item: “Have you ever had COPD diagnosed by a physician?”, physician-diagnosed COPD/emphysema as an affirmative answer to any of the two single items; “Have you ever had COPD diagnosed by a physician?” or “Have you ever been told by a physician that you have emphysema?”, physician-diagnosed chronic bronchitis as an affirmative answer to; “Have you ever been told by a physician that you have chronic bronchitis?” and physician-diagnosed COPD, emphysema or chronic bronchitis was defined as an affirmative answer to either of the three items above.Results: For the single item about physician-diagnosed COPD, the sensitivity was around 0.11 and the specificity was almost 0.99 in relation to COPD. The sensitivity of the combined items about COPD

Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

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Roberto de Cleva

2014-07-01

Full Text Available OBJECTIVE:Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior.METHODS:We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique.RESULTS:The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3% had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior. The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L and FVC (2.0±0.7 L with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p= 0.59 for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed.CONCLUSIONS:Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery.

Science.gov (United States)

Cleva, Roberto de; Assumpção, Marianna Siqueira de; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C; Jacob Filho, Wilson

2014-07-01

Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. The mean age of the patients was 56 ± 13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6 ± 0.6 L) and FVC (2.0 ± 0.7 L) with maintenance of FEV1/FVC of 0.8 ± 0.2 in both groups. The maximum intra-abdominal pressure values were similar (p=0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis.

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Jacob, Joseph; Bartholmai, Brian J; Brun, Anne Laure; Egashira, Ryoko; Rajagopalan, Srinivasan; Karwoski, Ronald; Kouranos, Vasileios; Kokosi, Maria; Hansell, David M; Wells, Athol U

2017-11-01

To determine whether computer-based quantification (CALIPER software) is superior to visual computed tomography (CT) scoring in the identification of CT patterns indicative of restrictive and obstructive functional indices in hypersensitivity pneumonitis (HP). A total of 135 consecutive HP patients had CT parenchymal patterns evaluated quantitatively by both visual scoring and CALIPER. Results were evaluated against: forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DL CO ) and a composite physiological index (CPI) to identify which CT scoring method better correlated with functional indices. CALIPER-derived scores of total interstitial lung disease extent correlated more strongly than visual scores: FVC (CALIPER R = 0.73, visual R = 0.51); DL CO (CALIPER R = 0.61, visual R = 0.48); and CPI (CALIPER R = 0·70, visual R = 0·55). The CT variable that correlated most strongly with restrictive functional indices was CALIPER pulmonary vessel volume (PVV): FVC R = 0.75, DL CO R = 0.68 and CPI R = 0.76. Ground-glass opacity quantified by CALIPER alone demonstrated strong associations with restrictive functional indices: CALIPER FVC R = 0.65; DL CO R = 0.59; CPI R = 0.64; and visual = not significant. Decreased attenuation lung quantified by CALIPER was a better morphological measure of obstructive lung disease than equivalent visual scores as judged by relationships with TLC (CALIPER R = 0.63 and visual R = 0.12). All results were maintained on multivariate analysis. CALIPER improved on visual scoring in HP as judged by restrictive and obstructive functional correlations. Decreased attenuation regions of the lung quantified by CALIPER demonstrated better linkages to obstructive lung physiology than visually quantified CT scores. A novel CALIPER variable, the PVV, demonstrated the strongest linkages with restrictive functional indices and could represent a new

Pulmonary function tests in type 2 diabetes mellitus and their association with glycemic control and duration of the disease

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Swati H Shah

2013-01-01

Full Text Available Background: Pulmonary complications of diabetes mellitus (DM have been poorly characterized. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. Some studies have shown abnormal respiratory parameters in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions. Aims and Objectives: The study was undertaken to analyze the pulmonary function parameters in diabetic patients and compare them with age and gender matched healthy subjects. We correlated forced vital capacity (FVC and forced expiratory volume in 1 second (FEV 1 in diabetic patients with duration of the disease and glycosylated hemoglobin (HbA1c. Materials and Methods: Pulmonary function tests (PFTs were recorded in 60 type 2 diabetic male patients and 60 normal healthy male controls aged 40-60 years by using Helios 702 spirometer. The PFTs recorded were - FVC, FEV 1 , FEV 1 /FVC, FEF 25 , FEF 50 , FEF 75 , FEF 25-75 , FEF 0.2-1.2 , and peak expiratory flow rate (PEFR. HbA1c of all the patients was estimated by ion exchange resin method, which is a very standard method of estimation. PFTs of diabetic patients and controls were compared by applying Student′s unpaired t test. Associations between FVC and FEV 1 and HbA1c and duration of illness in diabetic patients were analyzed by applying Pearson′s coefficient. Results: The PFTs were significantly decreased in diabetic patients compared with the healthy controls except FEV 1 /FVC. There was no correlation found between FVC and FEV 1 and duration of illness as well as HbA1c. Conclusion: DM being a systemic disease, which also affects lungs causing restrictive type of ventilatory changes probably because of glycosylation of connective tissues, reduced pulmonary elastic recoil and inflammatory changes in lungs. We found glycemic levels and duration of disease are probably not the major determinants of

Oscillometric and spirometric bronchodilator response in preschool children with and without asthma

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Shin, Youn Ho; Jang, Sun Jung; Yoon, Jung Won; Jee, Hye Mi; Choi, Sun Hee; Yum, Hye Yung; Warburton, David; Han, Man Yong

2012-01-01

BACKGROUND: Bronchodilator responses (BDR) are routinely used in the diagnosis and management of asthma; however, their acceptability and repeatability have not been evaluated using quality control criteria for preschool children. OBJECTIVES: To compare conventional spirometry with an impulse oscillometry system (IOS) in healthy and asthmatic preschool children. METHODS: Data from 30 asthmatic children and 29 controls (two to six years of age) who underwent IOS and spirometry before and after salbutamol administration were analyzed. RESULTS: Stable asthmatic subjects significantly differed versus controls in their spirometry-assessed BDR (forced expiratory volume in 1 s [FEV1], forced vital capacity and forced expiratory flow at 25% to 75% of forced vital capacity) as well as their IOS-assessed BDR (respiratory resistance at 5 Hz [Rrs5], respiratory reactance at 5 Hz and area under the reactance curve). However, comparisons based on the area under the ROC curve for ΔFEV1 % initial versus ΔRrs5 % initial were 0.82 (95% CI 0.71 to 0.93) and 0.75 (95% CI 0.62 to 0.87), respectively. Moreover, the sensitivity and specificity for ΔFEV1 ≥9% were 0.53 and 0.93, respectively. Importantly, sensitivity increased to 0.63 when either ΔFEV1 ≥9% or ΔRrs5 ≥29% was considered as an additional criterion for the diagnosis of asthma. CONCLUSION: The accuracy of asthma diagnosis in preschool children may be increased by combining spirometry with IOS when measuring BDR. PMID:22891189

Lung function parameters of healthy Sri Lankan Tamil young adults.

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Balasubramaniam, M; Sivapalan, K; Thuvarathipan, R

2014-06-01

To establish reference norms of lung function parameters for healthy Sri Lankan Tamil young adults. Cross sectional study of Tamil students at the Faculty of Medicine, Jaffna. Healthy non smoking students of Sri Lankan Tamil ethnic group were enrolled. Age, height, weight, BMI and spirometric measurements (Micro Quark) were recorded in 267 participants (137 females and 130 males). Height was significantly correlated with (pTamils. When mean values were compared, these parameters were significantly higher in Tamil males (pTamil females (pTamils. However, our study sample was confined to medical students of 20-28 years which may explain the differences with Sinhalese.

Impulse oscillometry, spirometry, and passive smoking in healthy children and adolescents

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C.I.S. Schivinski

2017-11-01

Conclusion: Children and adolescents exposed to PS had lower values for the spirometric variables and higher values for the oscillometric variables, indicating changes in forced and quiet parameters of lung function compared to the NPSG.

Astma w badaniach spirometrycznych

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Iwona Grzelewska-Rzymowska

2010-06-01

Full Text Available Astma i POChP to choroby charakteryzujące się zmiennym zwężeniem dróg oddechowych określanym jako „obturacja oskrzeli". Obturacja wywołana jest przez zapalenie błony śluzowej i przebudowę, które wynikają z napływu komórek zapalnych oraz działania różnorodnych mediatorów i cytokin. W procesie zapalnym zaangażowane są różne struktury i procesy określane jako „jednostka nabłonkowo-mezenchymalna". Rozpoznanie astmy opiera się na wywiadzie, badaniu alergologicznym i ocenie wskaźników spirometrycznych. Do podstawowych wskaźników stosowanych do właściwej interpretacji czynności płuc należą: FVC, FEV! i stosunek FEN^ do FVC. Stopień ciężkości zaburzeń wentylacji opiera się na ocenie wartości odsetka FEV! w stosunku do wartości należnej. Charakterystyczną cechą astmy jest zmienność objawów klinicznych i wskaźników spirometrycznych. Najważniejszym wskaźnikiem charakteryzującym obturację jest FEV1/FVC. Typowe wskaźniki spirometryczne to: prawidłowa FVC, obniżone FEV! i FEV1/FVC. Czasami FVC i FEV! są jednocześnie obniżone, a FEV1/FVC pozostaje w normie lub prawie w normie. Częścią badań funkcji płuc jest test odwracalności obturacji. Wzrost FEV! i/lub FVC >12% w stosunku do wartości wyjściowej i >200 ml stanowi dodatnią odpowiedź bronchodylatacyjną. Celem tego testu jest określenie, czy czynność płuc może poprawić się po wziewaniu 400 ^g salbutamolu lub po 2-8-tygodniowym leczeniu wziewnymi glikokortykosteroidami. Wskaźniki spirometryczne pozwalają ocenić ciężkość choroby i możliwość interwencji terapeutycznej. W celu diagnozowania astmy i oceny leczenia należy również dokonywać pomiaru nadreaktywności oskrzeli dróg oddechowych. Nadreaktywność oskrzeli jest bardzo czułym, lecz nieswoistym narzędziem dla celów diagnostycznych. Ujemny wynik testu wziewnego z metacholiną pozwala wykluczyć astmę, dodatni wynik testu potwierdza rozpoznanie astmy w w

Magnetic resonance imaging biomarkers of chronic obstructive pulmonary disease prior to radiation therapy for non-small cell lung cancer

International Nuclear Information System (INIS)

Sheikh, Khadija; Capaldi, Dante P.I.; Hoover, Douglas A.; Palma, David A.; Yaremko, Brian P.; Parraga, Grace

2015-01-01

•Three imaging phenotypes of COPD and ventilation heterogeneity.•We examine relationships for non-tumour lobe ventilation voids and clinical tests.•Smoking history and airflow obstruction were diagnostics for imaging phenotypes. Three imaging phenotypes of COPD and ventilation heterogeneity. We examine relationships for non-tumour lobe ventilation voids and clinical tests. Smoking history and airflow obstruction were diagnostics for imaging phenotypes. In this prospectively planned interim-analysis, the prevalence of chronic obstructive lung disease (COPD) phenotypes was determined using magnetic resonance imaging (MRI) and X-ray computed tomography (CT) in non-small-cell-lung-cancer (NSCLC) patients. Stage-III-NSCLC patients provided written informed consent for pulmonary function tests, imaging and the 6-min-walk-test. Ventilation defect percent (VDP) and CT lung density (relative-of-CT-density-histogram <−950, RA 950 ) were measured. Patients were classified into three subgroups based on qualitative and quantitative COPD and tumour-specific imaging phenotypes: (1) tumour-specific ventilation defects (TSD), (2) tumour-specific and other ventilation defects without emphysema (TSD V ), and, (3) tumour-specific and other ventilation defects with emphysema (TSD VE ). Seventeen stage-III NSCLC patients were evaluated (68 ± 7 years, 7 M/10 F, mean FEV 1 = 77% pred ) including seven current and 10 ex-smokers and eight patients with a prior lung disease diagnosis. There was a significant difference for smoking history (p = .02) and FEV 1 /FVC (p = .04) for subgroups classified using quantitative imaging. Patient subgroups classified using qualitative imaging findings were significantly different for emphysema (RA 950 , p < .001). There were significant relationships for whole-lung VDP (p < .05), but not RECIST or tumour-lobe VDP measurements with pulmonary function and exercise measurements. Preliminary analysis for non-tumour burden ventilation abnormalities

Comparison of forced expiratory spirometric flow changes following ...

African Journals Online (AJOL)

Group B received intrathecal anaesthesia 15 mgs of bupivacaine with 0.5 ml of normal saline and Group BF received 15 mgs of bupivacaine with 0.5 ml of fentanyl (25 μg) intrathecally. The patients were instructed about the performance of the spirometry on the previous evening of the surgery. Forced vital capacity, forced ...

Assessment of hydrogen peroxide in breath condensate as an ...

African Journals Online (AJOL)

2 concentration compared to values in normal subjects( p<0.0001). Bad housing showed significant correlation to asthma severity and to number of acute asthmatic attacks. Basal spirometric pulmonary function tests, mean values showed no ...

Arthroscopic shoulder surgery under general anesthesia with brachial plexus block: postoperative respiratory dysfunction of combined obstructive and restrictive pathology.

Science.gov (United States)

Gwak, M S; Kim, W H; Choi, S J; Lee, J J; Ko, J S; Kim, G S; Kim, Y I; Kim, M H

2013-02-01

Changes in respiratory parameters and pulmonary function tests were evaluated after shoulder arthroscopic surgery with brachial plexus block (BPB). The purpose of this study was to identify the mechanism of respiratory dysfunction after this type of surgery. Patients undergoing arthroscopic rotator cuff repair under general anesthesia (GA) with BPB were enrolled in the arthroscopy group (n = 30) while those undergoing open reduction of a clavicle or humerus fracture under GA were enrolled in the control group (n = 30). Forced vital capacity (FVC) and forced expiratory volume 1 s (FEV(1)) were measured at the outpatient clinic stage (#1) before (#2) and 20 min after BPB (#3) and 1 h after extubation (#4). Respiratory variable measurements along with the cuff leak test were performed 5 min after surgical positioning (T1) and at the start of skin closure (T2). Respiratory discomfort was evaluated after extubation. The upper airway diameters and soft tissue depth of chest wall were also measured by ultrasonography at stages #3 and #4. Static compliance decreased significantly at T2 in the arthroscopy group (50 ± 11 at T1 vs. 44 ± 9 ml/cm H(2)O at T2, p =0.035) but not in the control group. The incidence of positive cuff leak tests at T2 was significantly higher in the arthroscopy group than in the control group (47% in the arthroscopy group vs. 17% in controls, p =0.010). While FEV(1) and FVC remained stable at stages #1 and #2, FVC and FEV(1) decreased at stages #3 and #4 only in the arthroscopy group (FVC in arthroscopy group, #2: 3.26 ± 0.77 l; #3: 2.55 ± 0.63 l, p =0.015 vs. #2; #4: 2.66 ± 0.41 l, p =0.040 vs. #2). The subglottic diameter decreased at #4 in the arthroscopy group, while no changes occurred in the control group (0.70 ± 0.21 cm vs. 0.85 ± 0.23 cm in the arthroscopy and control groups, respectively, p =0.011). Depth of skin to pleura increased at both intercostal spaces 1-2 and 3-4 in the

Occupational exposure to dusts, gases, and fumes and incidence of chronic obstructive pulmonary disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults

NARCIS (Netherlands)

Mehta, A.J.; Miedinger, D.; Keidel, D.; Bettschart, R.; Bircher, A.; Bridevaux, P.O.; Curjuric, I; Kromhout, H.; Rochat, T.; Rothe, T.; Russi, E.W.; Schikowski, T.; Schindler, C.; Schwartz, J.; Turk, A.; Vermeulen, R.; Probst-Hensch, N.; Künzli, N.

2012-01-01

RATIONALE There is limited evidence from population-based studies demonstrating incidence of spirometric-defined chronic obstructive pulmonary disease (COPD) in association with occupational exposures. OBJECTIVES We evaluated the association between occupational exposures and incidence of COPD in

Preserved microvascular endothelial function in young, obese adults with functional loss of nitric oxide signaling

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John eHarrell

2015-12-01

Full Text Available Data indicate endothelium-dependent dilation (EDD may be preserved in the skeletal muscle microcirculation of young, obese adults. Preserved EDD might be mediated by compensatory mechanisms, impeding insight into preclinical vascular dysfunction. We aimed to determine the functional roles of nitric oxide synthase (NOS and cyclooxygenase (COX toward EDD in younger obese adults. We first hypothesized EDD would be preserved in young, obese adults. Further, we hypothesized a reduced contribution of NOS in young, obese adults would be replaced by increased COX signaling. Microvascular EDD was assessed with Doppler ultrasound and brachial artery infusion of acetylcholine (ACh in younger (27±1 yr obese (n=29 and lean (n=46 humans. Individual and combined contributions of NOS and COX were examined with intra-arterial infusions of L-NMMA and ketorolac, respectively. Vasodilation was quantified as an increase in forearm vascular conductance (ΔFVC. Arterial endothelial cell biopsies were analyzed for protein expression of endothelial nitric oxide synthase (eNOS. ΔFVC to ACh was similar between groups. After L-NMMA, ΔFVC to ACh was greater in obese adults (p<0.05. There were no group differences in ΔFVC to ACh with ketorolac. With combined NOS-COX inhibition, ΔFVC was greater in obese adults at the intermediate dose of ACh. Surprisingly, arterial endothelial cell eNOS and phosphorylated eNOS were similar between groups. Younger obese adults exhibit preserved EDD and eNOS expression despite functional dissociation of NOS-mediated vasodilation and similar COX signaling. Compensatory NOS- and COX-independent vasodilatory mechanisms conceal reduced NOS contributions in otherwise healthy obese adults early in life, which may contribute to vascular dysfunction.

Treatment with a nitric oxide-donating NSAID alleviates functional muscle ischemia in the mouse model of Duchenne muscular dystrophy.

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Thomas, Gail D; Ye, Jianfeng; De Nardi, Claudio; Monopoli, Angela; Ongini, Ennio; Victor, Ronald G

2012-01-01

In patients with Duchenne muscular dystrophy (DMD) and the standard mdx mouse model of DMD, dystrophin deficiency causes loss of neuronal nitric oxide synthase (nNOSμ) from the sarcolemma, producing functional ischemia when the muscles are exercised. We asked if functional muscle ischemia would be eliminated and normal blood flow regulation restored by treatment with an exogenous nitric oxide (NO)-donating drug. Beginning at 8 weeks of age, mdx mice were fed a standard diet supplemented with 1% soybean oil alone or in combination with a low (15 mg/kg) or high (45 mg/kg) dose of HCT 1026, a NO-donating nonsteroidal anti-inflammatory agent which has previously been shown to slow disease progression in the mdx model. After 1 month of treatment, vasoconstrictor responses to intra-arterial norepinephrine (NE) were compared in resting and contracting hindlimbs. In untreated mdx mice, the usual effect of muscle contraction to attenuate NE-mediated vasoconstriction was impaired, resulting in functional ischemia: NE evoked similar decreases in femoral blood flow velocity and femoral vascular conductance (FVC) in the contracting compared to resting hindlimbs (ΔFVC contraction/ΔFVC rest=0.88 ± 0.03). NE-induced functional ischemia was unaffected by low dose HCT 1026 (ΔFVC ratio=0.92 ± 0.04; P>0.05 vs untreated), but was alleviated by the high dose of the drug (ΔFVC ratio=0.22 ± 0.03; Ptreatment up to 3 months. The effect of the NO-donating drug HCT 1026 to normalize blood flow regulation in contracting mdx mouse hindlimb muscles suggests a putative novel treatment for DMD. Further translational research is warranted.

Impact of dynamic rate coding aspects of mobile phone networks on forensic voice comparison.

Science.gov (United States)

Alzqhoul, Esam A S; Nair, Balamurali B T; Guillemin, Bernard J

2015-09-01

Previous studies have shown that landline and mobile phone networks are different in their ways of handling the speech signal, and therefore in their impact on it. But the same is also true of the different networks within the mobile phone arena. There are two major mobile phone technologies currently in use today, namely the global system for mobile communications (GSM) and code division multiple access (CDMA) and these are fundamentally different in their design. For example, the quality of the coded speech in the GSM network is a function of channel quality, whereas in the CDMA network it is determined by channel capacity (i.e., the number of users sharing a cell site). This paper examines the impact on the speech signal of a key feature of these networks, namely dynamic rate coding, and its subsequent impact on the task of likelihood-ratio-based forensic voice comparison (FVC). Surprisingly, both FVC accuracy and precision are found to be better for both GSM- and CDMA-coded speech than for uncoded. Intuitively one expects FVC accuracy to increase with increasing coded speech quality. This trend is shown to occur for the CDMA network, but, surprisingly, not for the GSM network. Further, in respect to comparisons between these two networks, FVC accuracy for CDMA-coded speech is shown to be slightly better than for GSM-coded speech, particularly when the coded-speech quality is high, but in terms of FVC precision the two networks are shown to be very similar. Copyright © 2015 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

Association between nailfold capillaroscopy findings and pulmonary function tests in patients with systemic sclerosis.

Science.gov (United States)

Castellví, Ivan; Simeón-Aznar, Carmen Pilar; Sarmiento, Mónica; Fortuna, Ana; Mayos, Mercedes; Geli, Carme; Diaz-Torné, César; Moya, Patricia; De Llobet, Josep Maria; Casademont, Jordi

2015-02-01

To determine whether there is an association between different capillaroscopic findings and pulmonary function tests in systemic sclerosis (SSc). We did a retrospective observational study in a cohort of patients with SSc and early SSc. Patients with at least 1 nailfold videocapillaroscopy (NVC) magnified 120× were included. Pathological findings were giant capillaries, angiogenesis, and density loss. Findings were compared with lung function values: percent expected value of forced vital capacity (FVC), DLCO, and FVC/DLCO ratio. Other variables collected were sex and SSc type, and the presence of digital ulcers (DU), interstitial lung disease (ILD), scleroderma renal crisis, and/or pulmonary hypertension (PH). Of 136 patients with SSc, 85 had undergone an NVC. The frequency of ILD, DU, and PH was 24.1%, 28.7%, and 17.2%, respectively. Data analysis showed that patients with density loss had worse FVC% (86.91 ± 19.42 vs 101.13 ± 16.06, p < 0.01) and DLCO% (71.43 ± 21.19 vs 85.9 ± 19.81, p < 0.01) compared to those without. Patients with loss of density present worse FVC and DLCO values. Prospective studies are warranted to determine whether NVC is useful for studying pulmonary function in SSc.

Evaluation of the lung function in cancer patients undergoing to chemotherapy

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Caroline Heemann Vione

2016-10-01

Full Text Available Background and Objective: Some neoplastic agents used in cancer treatment cause pulmonary toxicity and other important adverse effects, therefore, the present study aimed to evaluate the presence of obstructive lung disease (OLD, restrictive lung disease (RLD or mixed in patients 2 with cancer undergoing chemotherapy. Method: This is a cross-sectional and descriptive study that evaluated patients diagnosed with cancer and undergoing chemotherapy using Doxorubicin, Bleomycin, Vinblastine, Dacarbazine, Cyclophosphamide, Fluorouracil and Vincristine, being excluded those diagnosed with lung cancer. Realized pulmonary function test byspirometric analysis (EasyOne®, Switzerland in patients who started chemotherapy for over 30 days, it was evaluated the Forced Vital Capacity (FVC, forced expiratory volume in one second FVC (FEV1, forced expiratory flow between 25-75% of FVC (FEF25-75 % and the FEV1 / FVC Relation before the chemotherapy session. Results: Sample (n = 18 composed of cancer patients with average age of 49.28±9.90 years and 26.49±5.67 kg/m2 on which 44.4% had normal spirometry standard, 27.8% had OLD, 16.7% presented RLD and 11.1% presented mixed respiratory disorder. Conclusion: Thechemotherapy resulted in obstructive pulmonary disease, restrictive and mixedin patients with leukemia, breast cancer and Hodgkin's lymphoma not specific evaluated.

Genome-wide study of percent emphysema on computed tomography in the general population. The Multi-Ethnic Study of Atherosclerosis Lung/SNP Health Association Resource Study

NARCIS (Netherlands)

Manichaikul, Ani; Hoffman, Eric A.; Smolonska, Joanna; Gao, Wei; Cho, Michael H.; Baumhauer, Heather; Budoff, Matthew; Austin, John H. M.; Washko, George R.; Carr, J. Jeffrey; Kaufman, Joel D.; Pottinger, Tess; Powell, Charles A.; Wijmenga, Cisca; Zanen, Pieter; Groen, Harry J.M.; Postma, Dirkje S.; Wanner, Adam; Rouhani, Farshid N.; Brantly, Mark L.; Powell, Rhea; Smith, Benjamin M.; Rabinowitz, Dan; Raffel, Leslie J.; Stukovsky, Karen D. Hinckley; Crapo, James D.; Beaty, Terri H.; Hokanson, John E.; Silverman, Edwin K.; Dupuis, Josee; O'Connor, George T.; Boezen, Hendrika; Rich, Stephen S.; Barr, R. Graham

2014-01-01

Rationale: Pulmonary emphysema overlaps partially with spirometrically defined chronic obstructive pulmonary disease and is heritable, with moderately high familial clustering. Objectives: To complete a genome-wide association study (GWAS) for the percentage of emphysema-like lung on computed

[Iatrogenic bronchial obstruction: study of 4 atopic children with bronchial obstruction induced by acetyl salicylic acid].

Science.gov (United States)

De Luca, L; Vuillemier, P L; Principe, A M; Petrillo, T

1986-01-01

The authors have studied the modification of the spirometric parameters in four atopic children, during nonallergic diet, after administration of ASA (400 mg). The examination of the respiratory functionality has showed a fall of parameters starting four hours after the challenge and with an increase of respiratory resistance. This bronchospastic reaction persisted for about eighteen hours to diminish 24 h. after administration of 400 mg of ASA. The study of spirometric values has showed a remarkable fall of MMEF, sign of small airways obstruction, but also of FEV1-CV for the involvement of the higher airways. The authors attribute the reaction to the metabolites of arachidonic acid (Leukotrienes) and to their different receptor site on the bronchial mucous membrane target cells. The authors conclude showing the gravity of injury that will induce imprudent administration of ASA in hypersensitive subject.

The Mid-Term Changes of Pulmonary Function Tests After Phrenic Nerve Transfer.

Science.gov (United States)

Yavari, Masoud; Hassanpour, Seyed Esmail; Khodayari, Mohammad

2016-03-01

In the restoration of elbow flexion, the phrenic nerve has proven to be a good donor, but considering the role of the phrenic nerve in respiratory function, we cannot disregard the potential dangers of this method. In the current study, we reviewed the results of pulmonary function tests (PFT) in four patients who underwent phrenic nerve transfer. We reviewed the results of serial spirometry tests, which were performed before and after phrenic nerve transfer surgery. All patients regained Biceps power to M3 strength or above. None of our patients experienced pulmonary problems or respiratory complaints, but a significant reduction of spirometric parameters occurred after surgery. This study highlights the close link between the role of the phrenic nerve and pulmonary function, such that the use of this nerve as a transfer donor leads to spirometric impairments.

Spirometry in an unselected group of 6-year-old children

DEFF Research Database (Denmark)

Kjaer, Henrik Fomsgaard; Eller, Esben; Bindslev-Jensen, Carsten

2008-01-01

birth cohort study. Children with known asthma, possible asthma and a control group also performed bronchodilator measurements. At least two acceptable flow-volume curves at baseline were obtained by 368/404 children (91%). The two best values for FEV1 and FVC were within 5% of each other in 88% and 83...... in Delta FEV1(mean) between healthy children and children with asthma (3.1% vs. 6.1%, P

Analisis Faktor Risiko Paparan Debu Kayu Terhadap Gangguan Fungsi Paru Pada Pekerja Industri Pengolahan Kayu PT. Surya Sindoro Sumbing Wood Industry Wonosobo

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Meta Suryani

2015-12-01

Full Text Available ABSTRAK Background: One of the negative impacts of wood processing industry is air pollution caused by wood ash that occurred during the process or as the output of the industry. The wood ash will contaminate the industry area as well as the environment so not only the workers, but also the people living around the factory will be exposed to ash from raw material, added material, and the output, thus causing lung function disturbance.  The aim of this research is to measure the risk of factors that causes lung function disturbance to the workers in wood processing industry at PT Surya Sindoro Sumbing Wood Industry Wonosobo. Method : This is an observational research using cross-sectional design. The samples are workers that fulfill the criteria inclusively and exclusively as many as 70 persons. This research was done in February 2005 and the data collection was done using wood ash content measurement in Furniture Component (FC and Wood Working Area (WWA sections, lung function capacity measurement, body height and body weight measurements, as well as interview with the respondents. Result : This research showed that the amount of the wood ash in WWA and FC of 6.1452mg/m3 and 4.0101mg/m3 respectively; and the average of lung function capacity on the workers is 92.04% FEV1/FVC with standard deviation of 6.68 with the lowest and the highest rate of 66% FEV1/FVC and 100% FEV1/FVC respectively. The data analysis in this research used chi-square test, Independent   t Test,while the multivariat analysis used logistic regression test with enter method. The statistics test showed that there was a relationship between the working period and the smoking habit with lung function capacity (p0.05. Conclusions : The working period and the smoking habit at the same time can become the risk factor of the lung function disturbance. As such, smoking prohibition during working hours in the wood processing industry should be applied in order to avoid lung

Forced vital capacity predicts morbidity and mortality in adults with repaired tetralogy of Fallot.

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Cohen, Katie E; Buelow, Matthew W; Dixon, Jennifer; Brazauskas, Ruta; Cohen, Scott B; Earing, Michael G; Ginde, Salil

2017-07-01

Abnormal lung function characterized by a reduced forced vital capacity (FVC) is common in adults with repaired tetralogy of Fallot (TOF) and is associated with previous thoracotomies and sternotomies. The impact of abnormal lung function on clinical outcomes in adult patients with repaired TOF is unclear. The aim of this study was to determine the impact of abnormal lung function on the outcome of hospitalization and death in adults with repaired TOF when analyzed with other traditional cardiac risk factors. Retrospective study of adults with repaired TOF, who underwent spirometry between 2000 and 2014. FVC < 60% of predicted was categorized as moderate-to-severely reduced lung function. Primary outcome measure was the combined clinical endpoint of death, cardiac transplantation, or nonelective hospitalization for primary cardiac or respiratory indication. A total of 122 patients were included. Average age at spirometry testing was 31 ± 10.1 years. FVC was < 60% predicted in 23 (19%) patients. During a mean follow-up period of 3.97 ± 2.65 years, 23 (19%) patients reached the combined clinical outcome of nonelective hospitalization and/or death. FVC < 60% predicted was independently associated with the risk for the combined clinical outcome (RR 6.68 (95% CI 2.49-17.94), P < .001). Abnormal pulmonary function characterized by reduced FVC is common in adults with repaired TOF. Patients with FVC < 60% predicted had a 6 times higher rate of hospitalization and/or death compared to those with FVC ≥ 60%. © 2017 Wiley Periodicals, Inc.

Immediate effect of suryanadi pranayama on pulmonary function (ventilatory volumes and capacities in healthy volunteers

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Shravya Keerthi G, Hari Krishna Bandi, Suresh M, Mallikarjuna Reddy N

2013-10-01

Full Text Available Objectives: we found only effects of at least a short term practice extended over a period of a few days to weeks of pranayama (alternate nostril breathing rather than acute effects of unilateral right nostril breathing (suryanadi pranayama. Keeping this in mind the present study was designed to test the hypothesis that 10 min. of right nostril breathing have any immediate effect on ventilatory volumes and capacities in healthy volunteers. Methodology: Forced vital capacity (FVC, Forced expiratory volume in the first second (FEV1, Forced expiratory volume percent (FEV1/FVC%, Peak expiratory flow rate (PEFR, Forced expiratory flow25-75% (FEF25-75%, Maximum voluntary ventilation (MVV, Slow vital capacity (SVC, Expiratory reserve volume (ERV, Inspiratory reserve volume (IRV and Tidal volume (TV were recorded before and after Surya Nadi Pranayama. Results & Conclusion: There was a significant increase in FVC (p<0.0001, FEV1 (p<0.0007, PEFR (p<0.0001, FEF25-75% (p<0.0001, MVV (p<0.0001, SVC (p<0.0001, ERV (0.0006, IRV (p<0.0001 and TV (0.0055 after suryanadi pranayama. The immediate effect of suryanadi pranayama practice showed alleviation of ventilatory capacities and volumes. Any practice that increases PEFR and FEF25–75% is expected to retard the development of COPD’s. The increase in PEFR, vital capacities and flow rates by suryanadi pranayama practice obviously offers an increment in respiratory efficiency and it can be advocated to the patients of early bronchitis and as a preventive measure for COPD.

Genome-wide joint meta-analysis of SNP and SNP-by-smoking interaction identifies novel loci for pulmonary function.

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Dana B Hancock

Full Text Available Genome-wide association studies have identified numerous genetic loci for spirometic measures of pulmonary function, forced expiratory volume in one second (FEV(1, and its ratio to forced vital capacity (FEV(1/FVC. Given that cigarette smoking adversely affects pulmonary function, we conducted genome-wide joint meta-analyses (JMA of single nucleotide polymorphism (SNP and SNP-by-smoking (ever-smoking or pack-years associations on FEV(1 and FEV(1/FVC across 19 studies (total N = 50,047. We identified three novel loci not previously associated with pulmonary function. SNPs in or near DNER (smallest P(JMA = 5.00×10(-11, HLA-DQB1 and HLA-DQA2 (smallest P(JMA = 4.35×10(-9, and KCNJ2 and SOX9 (smallest P(JMA = 1.28×10(-8 were associated with FEV(1/FVC or FEV(1 in meta-analysis models including SNP main effects, smoking main effects, and SNP-by-smoking (ever-smoking or pack-years interaction. The HLA region has been widely implicated for autoimmune and lung phenotypes, unlike the other novel loci, which have not been widely implicated. We evaluated DNER, KCNJ2, and SOX9 and found them to be expressed in human lung tissue. DNER and SOX9 further showed evidence of differential expression in human airway epithelium in smokers compared to non-smokers. Our findings demonstrated that joint testing of SNP and SNP-by-environment interaction identified novel loci associated with complex traits that are missed when considering only the genetic main effects.

Health Effects of Operators in the Production of Wood Pellets

Energy Technology Data Exchange (ETDEWEB)

Hagstroem, K.; Arvidsson, H.; Bryngelsson, I.L.; Fedeli, C. [Oerebro Univ. (Sweden). Dept. of Occupational and Environmental Medicine; Eriksson, K. [Univ. Hospital of Umeaa (Sweden). Dept. of Occupational and Environmental Medicine; Andersson, E. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Occupational and Environmental Medicine

2006-07-15

The environmental and energy policy in Sweden is aiming to replace fossil energy with renewable sources such as biofuels, e.g., wood Pellets produced from shavings and sawdust of pine and spruce. Reported health effects in the wood processing industries are airway, eye and skin irritation, reduced lung function as well as eczema. The aim of our study was to investigate the prevalence of airway and skin symptoms and measure lung function in a population of pellet operators in the Swedish wood industry. Additional reported acute effects from the airways, eyes, nose and skin were recorded. From May 2004 until April 2005 50 blue-collar workers from four Swedish pellet-producing industries were investigated. The study included a questionnaire about skin and airway symptoms (n=50), acute effect questionnaire (n=67; 44 individuals) as well as a test of the lung function (spirometry) before and after work shift (n=118; 39 individuals). Acute effects questionnaire and spirometry were done one to three times per participants and for the acute effects the worker had to assess their symptoms in the airways, eyes, nose and skin between 6 and 8 times during a day. The results from the symptom questionnaires were compared with reference data from other Swedish studies and the lung function data with a European reference material. Statistical tests used were chi-2-test for the questionnaire, t-test for lung function before shift compared expected values, and for difference in lung function between before and after work shift mixed models with subjects as a random factor. No statistical significant difference was seen for the skin and airway symptoms in the questionnaire. Reported acute effects were seen especially for eye and nose symptoms (table 1). Spirometry showed significantly higher forced vital capacity (FVC; p=0.0003) and no difference in forced expiratory volume in 1 second (FEV1; p=0.08) before work shift compared to expected values. FVC was 108,1 % and FEV1 was 104

General practitioners' needs for ongoing support for the interpretation of spirometry tests.

NARCIS (Netherlands)

Poels, P.J.P.; Schermer, T.R.J.; Akkermans, R.P.; Jacobs, A.; Bogart-Jansen, M.; Bottema, B.J.A.M.; Weel, C. van

2007-01-01

BACKGROUND: Although one out of three general practitioners (GPs) carries out spirometry, the diagnostic interpretation of spirometric test results appears to be a common barrier for GPs towards its routine application. METHODS: Multivariate cross-sectional analysis of a questionnaire survey among

Evaluation of pulmonary function in beta-thalassemia major patients

International Nuclear Information System (INIS)

Eidani, I.; Keikhaei, B.; Rahim, F.; Bagheri, A.

2010-01-01

Objective: To describe and quantify the functional change of the lung in patients with beta-thalassemia major (TM) and determine the correlation between pulmonary function test (PFT) results with hemoglobin, ferritin and age changes. Methodology: Pulmonary function tests were performed on 60 transfusion-dependent patients with TM, ranging in age from 10 to 45 years. Percent-predicted values for forced expiratory volume in one second (FEV1), and forced expiratory flows (FEF) 25-75% were significantly reduced, whereas forced expiratory vital capacity (FVC) and FEV1/FVC were closed to normal limits, indicating a restrictive disease. All factors including; FVC, FEV1, and FEV1/FVC, FEF 25-75% were negatively correlated with age and ferritin levels. In contrast, all factors including; FVC, FEV1, and FEV1/FVC, FEF 25-75% were positively correlated with hemoglobin (Hb). We performed linear regression analysis to study the simultaneous influence of the presence of age, ferritin, and Hb on obstructive PFT indexes. Results: Pulmonary function test results were normal in only 32 (53.3%) of 60 patients and the rest 28 cases (46.7%) showed abnormal pulmonary function. FEV1 and FEF 25% - 75% have significant negative correlation with age (r = - 0.64 p(r) = 0.003 and r = - 0.58 p(r) = 0.02 respectively), also have significant positive correlation with Hb (r = 0.31 p(r) = 0.015 and r = 0.33 p(r) = 0.01 respectively), and only FEF 25% - 75% has significant negative correlation with ferritin (r -0.26 p(r) = 0.04). Conclusion: The present study has shown that restrictive disease and reduced lung diffusing capacity are the predominant abnormalities of pulmonary function patients with TM. The low hemoglobin concentration and a fall in the diffusing capacity of the alveola - capillary membrane, together with the dependence of the reduced pulmonary diffusing capacity on age and serum ferritin levels, as well as of the entity of restrictive disease on age, suggests that pulmonary

Association of Forced Vital Capacity with the Developmental Gene NCOR2.

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Cosetta Minelli

Full Text Available Forced Vital Capacity (FVC is an important predictor of all-cause mortality in the absence of chronic respiratory conditions. Epidemiological evidence highlights the role of early life factors on adult FVC, pointing to environmental exposures and genes affecting lung development as risk factors for low FVC later in life. Although highly heritable, a small number of genes have been found associated with FVC, and we aimed at identifying further genetic variants by focusing on lung development genes.Per-allele effects of 24,728 SNPs in 403 genes involved in lung development were tested in 7,749 adults from three studies (NFBC1966, ECRHS, EGEA. The most significant SNP for the top 25 genes was followed-up in 46,103 adults (CHARGE and SpiroMeta consortia and 5,062 children (ALSPAC. Associations were considered replicated if the replication p-value survived Bonferroni correction (p<0.002; 0.05/25, with a nominal p-value considered as suggestive evidence. For SNPs with evidence of replication, effects on the expression levels of nearby genes in lung tissue were tested in 1,111 lung samples (Lung eQTL consortium, with further functional investigation performed using public epigenomic profiling data (ENCODE.NCOR2-rs12708369 showed strong replication in children (p = 0.0002, with replication unavailable in adults due to low imputation quality. This intronic variant is in a strong transcriptional enhancer element in lung fibroblasts, but its eQTL effects could not be tested due to low imputation quality in the eQTL dataset. SERPINE2-rs6754561 replicated at nominal level in both adults (p = 0.036 and children (p = 0.045, while WNT16-rs2707469 replicated at nominal level only in adults (p = 0.026. The eQTL analyses showed association of WNT16-rs2707469 with expression levels of the nearby gene CPED1. We found no statistically significant eQTL effects for SERPINE2-rs6754561.We have identified a new gene, NCOR2, in the retinoic acid signalling pathway pointing

Ambient air pollution, lung function, and airway responsiveness in asthmatic children.

Science.gov (United States)

Ierodiakonou, Despo; Zanobetti, Antonella; Coull, Brent A; Melly, Steve; Postma, Dirkje S; Boezen, H Marike; Vonk, Judith M; Williams, Paul V; Shapiro, Gail G; McKone, Edward F; Hallstrand, Teal S; Koenig, Jane Q; Schildcrout, Jonathan S; Lumley, Thomas; Fuhlbrigge, Anne N; Koutrakis, Petros; Schwartz, Joel; Weiss, Scott T; Gold, Diane R

2016-02-01

Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthmatic patients are lacking. We sought to investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide, and sulfur dioxide concentrations in 1003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to ZIP/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and forced vital capacity (FVC) percent predicted, FEV1/FVC ratio, and PC20, adjusting for seasonality and confounders. Same-day and 1-week average CO concentrations were negatively associated with postbronchodilator percent predicted FEV1 (change per interquartile range, -0.33 [95% CI, -0.49 to -0.16] and -0.41 [95% CI, -0.62 to -0.21], respectively) and FVC (-0.19 [95% CI, -0.25 to -0.07] and -0.25 [95% CI, -0.43 to -0.07], respectively). Longer-term 4-month CO averages were negatively associated with prebronchodilator percent predicted FEV1 and FVC (-0.36 [95% CI, -0.62 to -0.10] and -0.21 [95% CI, -0.42 to -0.01], respectively). Four-month averaged CO and ozone concentrations were negatively associated with FEV1/FVC ratio (P pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications might not protect but rather worsens the effects of CO on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Ambient air pollution, lung function and airway responsiveness in children with asthma

Science.gov (United States)

Ierodiakonou, Despo; Zanobetti, Antonella; Coull, Brent A.; Melly, Steve; Postma, Dirkje S.; Boezen, H. Marike; Vonk, Judith M.; Williams, Paul V.; Shapiro, Gail G.; McKone, Edward F.; Hallstrand, Teal S.; Koenig, Jane Q.; Schildcrout, Jonathan S.; Lumley, Thomas; Fuhlbrigge, Anne N.; Koutrakis, Petros; Schwartz, Joel; Weiss, Scott T.; Gold, Diane R

2016-01-01

Background Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthma are lacking. Objective To investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. Methods We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide (NO2) and sulfur dioxide (SO2) levels in 1,003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to zip/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and FVC %predicted, FEV1/FVC and PC20, adjusting for seasonality and confounders. Results Same-day and 1-week average CO levels were negatively associated with post-bronchodilator %predicted FEV1 (change(95%CI) per IQR: −0.33(−0.49, −0.16), −0.41(−0.62, −0.21), respectively) and FVC (−0.19(−0.25, −0.07), −0.25(−0.43, −0.07)). Longer-term four-month averages of CO were negatively associated with prebronchodilator %predicted FEV1 and FVC (−0.36(−0.62, −0.10), −0.21(−0.42, −0.01)). Four-month averaged CO and ozone levels were negatively associated with FEV1/FVC (ppollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications may not protect but worsens the CO effects on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication. PMID:26187234

Lifetime Exposure to Ambient Pollution and Lung Function in Children.

Science.gov (United States)

Rice, Mary B; Rifas-Shiman, Sheryl L; Litonjua, Augusto A; Oken, Emily; Gillman, Matthew W; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A; Schwartz, Joel; Koutrakis, Petros; Mittleman, Murray A; Gold, Diane R

2016-04-15

Few studies have examined associations between exposure to air pollution and childhood lung function after implementation of strict air quality regulations in the 1990s. To assess traffic-related pollution exposure and childhood lung function. We geocoded addresses for 614 mother-child pairs enrolled during pregnancy in the Boston area 1999-2002 and followed them until a mid-childhood visit (median age, 7.7). We calculated the proximity of the home to the nearest major roadway. We estimated first year of life, lifetime, and prior-year exposure to particulate matter with a diameter smaller than 2.5 μm (PM2.5) by a hybrid model using satellite-derived aerosol optical depth, and to black carbon (BC) by a land-use regression model. Residential proximity to roadway and prior-year and lifetime PM2.5 and BC exposure were all associated with lower FVC. Associations with FEV1 were also negative and proportionally similar. Pollution exposures were not associated with the FEV1/FVC ratio or bronchodilator response. Compared with distances greater than or equal to 400 m, living less than 100 m from a major roadway was associated with lower FVC (-98.6 ml; -176.3 to -21.0). Each 2 μg/m(3) increment in prior-year PM2.5 was associated with lower FVC (-21.8 ml; -43.9 to 0.2) and higher odds of FEV1 less than 80% predicted (1.41; 1.03-1.93). Each 0.2 μg/m(3) increment in prior-year BC was associated with a 38.9 ml (-70.4 to -7.3) lower FVC. Estimates of long-term exposure to ambient pollution, including proximity to major roadway, PM2.5, and BC (a traffic-related PM2.5 constituent), were associated with lower lung function in this Boston-area cohort of children with relatively low pollution exposures.

Maximal oxygen consumption, respiratory volume and some related factors in fire-fighting personnel

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Touraj Khazraee

2017-01-01

Full Text Available Background: Firefighters for difficult activities and rescue of damaged people must be in appropriate physical ability. Maximal oxygen capacity is an indicator for diagnosis of physical ability of workers. This study aimed to assess the cardiorespiratory system and its related factors in firefighters. Methods: This study was conducted on 110 firefighters from various stations. An self-administered questionnaire (respiratory disorders questionnaire, Tuxworth-Shahnavaz step test, and pulmonary function test was used to collection of required data. Average of humidity and temperature was 52% and 17°C, respectively. Background average noise levels were between 55 and 65 dB. Data were analyzed using SPSS software (version 19. Results: The mean age of the study participants was 32 ± 6.2 years. The means of forced vital capacity (FVC, forced expiratory volume in 1 s (FEV1, and FEV1/FVC were 92% ±9.4%, 87% ±9.2%, and 80% ±6.1%, respectively. The participants' mean VO2-max was 2.79 ± 0.29 L/min or 37.34 ± 4.27 ml/kg body weight per minute. The results revealed that weight has a direct association with vital capacity (VC, FVC, and peak expiratory flow. In addition, height was directly associated with VC, FVC, and VO2-max (P < 0.05. However, there was an inverse and significant association between height and FEV1/FVC (r = −0.23,P< 0.05. Height, weight, body mass index, and waist circumference were directly associated with VO2-max. Conclusions: The findings of this study showed that the amount of maximum oxygen consumption is close with the proposed range of this parameter among firefighters in other studies. Furthermore, the results of the study revealed that individuals had normal amounts of lung volume index. This issue can be attributed to the appropriate usage of respiratory masks.

Predictors of asthma-chronic obstructive pulmonary disease overlap syndrome in patients with chronic obstructive pulmonary disease from a tertiary care center in India

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Irfan Ismail Ayub

2018-01-01

Full Text Available Background: There is dearth of literature on asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS in India. The aim was to compare clinical characteristics between patients with ACOS and non-ACOS COPD and to identify clinical predictors of ACOS in patients with COPD. Methods: We conducted a retrospective study by reviewing data collected from patients performing spirometry at our hospital. Those with postbronchodilator FEV1/FVC <70% were included in the study. Among them, those with significant reversibility (change in FEV1or FVC by 12% and 200 ml postbronchodilator were diagnosed with ACOS and the rest were considered to have non-ACOS COPD. Data on the 2 groups were compared and statistical analysis was performed. Results: Out of a total of 324 patients, 100 of them had postbronchodilator FEV1/FVC <70%. Of them, 45 and 55 were diagnosed with ACOS and non-ACOS COPD, respectively. Patients with ACOS had significantly higher postbronchodilator FVC volumes and FVC % predicted values (P < 0.05, had higher reported wheeze (P = 0.02 and ankle edema (P < 0.05, were more likely to be smokers (P = 0.01 with lower smoking index (P = 0.03, and had frequent (≥2 ER visits (P = 0.04. However, very frequent (≥3 per year hospital admissions (P < 0.01 with higher rates of invasive mechanical ventilation (P = 0.02, and pulmonary hypertension diagnosed by two-dimensional echocardiography (P < 0.01 were significantly higher in the non-ACOS group. The two groups did not differ with respect to history of atopy, family history of wheeze, compliance to inhaler therapy, or blood absolute eosinophil counts. Conclusion: Our study highlights how the ACOS phenotype may clinically differ from their counterparts elsewhere, making it a clinical challenge to identify them in India.

Air Pollution from Livestock Farms Is Associated with Airway Obstruction in Neighboring Residents.

Science.gov (United States)

Borlée, Floor; Yzermans, C Joris; Aalders, Bernadette; Rooijackers, Jos; Krop, Esmeralda; Maassen, Catharina B M; Schellevis, François; Brunekreef, Bert; Heederik, Dick; Smit, Lidwien A M

2017-11-01

Livestock farm emissions may not only affect respiratory health of farmers but also of neighboring residents. To explore associations between spatial and temporal variation in pollutant emissions from livestock farms and lung function in a general, nonfarming, rural population in the Netherlands. We conducted a cross-sectional study in 2,308 adults (age, 20-72 yr). A pulmonary function test was performed measuring prebronchodilator and post-bronchodilator FEV 1 , FVC, FEV 1 /FVC, and maximum mid-expiratory flow (MMEF). Spatial exposure was assessed as (1) number of farms within 500 m and 1,000 m of the home, (2) distance to the nearest farm, and (3) modeled annual average fine dust emissions from farms within 500 m and 1,000 m of the home address. Temporal exposure was assessed as week-average ambient particulate matter livestock farms within a 1,000-m buffer from the home address and MMEF, which was more pronounced in participants without atopy. No associations were found with other spatial exposure variables. Week-average particulate matter livestock air pollution emissions are associated with lung function deficits in nonfarming residents.

Emerging potential treatments: new hope for idiopathic pulmonary fibrosis patients?

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U. Costabel

2011-09-01

Full Text Available Currently, there are no approved pharmacological treatments for the management of patients with idiopathic pulmonary fibrosis (IPF in the USA or Europe. Pirfenidone is an orally bio-available small molecule that exhibits antifibrotic and anti-inflammatory properties in a variety of in vitro and animal models. Pirfenidone has been evaluated in four randomised, double-blind, placebo-controlled clinical trials conducted in Japan, North America and Europe. The totality of the data from these trials indicates that pirfenidone is able to reduce the rate of decline in lung function, measured as change in per cent predicted forced vital capacity (FVC or vital capacity. There was also an effect on secondary end-points of progression free survival, categorical change in per cent predicted FVC, and the 6-min walk test. A recent meta-analysis of the three phase III studies in IPF demonstrated that pirfenidone significantly reduced the risk of disease progression by 30%. The efficacy of pirfenidone is associated with an acceptable tolerability and safety profile.

The Glittre-ADL test reflects functional performance measured by physical activities of daily living in patients with chronic obstructive pulmonary disease

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Manuela Karloh

2016-01-01

Full Text Available ABSTRACT Background The Glittre-ADL test (TGlittre is a valid and reliable test for the evaluation of functional capacity and involves multiple physical activities of daily living (PADL, which are known to be troublesome to patients with Chronic Obstructive Pulmonary Disease (COPD. However, it is still unknown if this test is also able to reflect the functional performance of patients with COPD. Objective To investigate whether the TGlittre reflects the functional performance of COPD patients and whether the necessary time to complete the TGlittre and the PADL varies according to disease severity. Method Thirty-eight patients with COPD (age 65, SD=7 years; forced expiratory volume in the first second 41.3, SD=15.2% predicted underwent anthropometric and lung function assessments and were submitted to the TGlittre and PADL measurement. Results TGlittre performance correlated significantly (p<0.05 with PADL variables, such as time sitting (r=0.50, walking (r=-0.46, number of steps taken (r=–0.53, walking movement intensity (r=–0.66, walking energy expenditure (r=-0.50, and total energy expenditure (r=–0.33. TGlittre performance was not significantly different in patients among the Global Initiative for COPD (GOLD spirometric stages, but walking and sitting time were significantly lower and greater, respectively, in severe and very severe patients compared to those with moderate disease (p<0.05. Conclusion The performance on the TGlittre correlates with walking and sitting time and other real life PADL measurements. The severity of the disease is associated with the differences in the level of physical activity in daily life more than in functional capacity.

The Effect of 8 Weeks Yoga Training on Respiratory Function and Heart Rate of Non-Athlete Females

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KH

2015-07-01

Conclusions: Results of this study showed that 8 weeks of practicing yoga and pranayama to increase vital capacity and forced expiratory volume in the first second and decreased heart rate and respiratory rate at rest is. Keywords: Yoga, Pranayama, spirometric indices, heart rate

Body Burden of Dichlorodiphenyl Dichloroethene (DDE and Childhood Pulmonary Function

Directory of Open Access Journals (Sweden)

Pallavi P. Balte

2017-11-01

Full Text Available Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1 were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE and FEV1 (n = 328; −0.17 L per μg/L of DDE, mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.

Diaphragm pacing improves sleep in patients with amyotrophic lateral sclerosis.

Science.gov (United States)

Gonzalez-Bermejo, Jesus; Morélot-Panzini, Capucine; Salachas, François; Redolfi, Stefania; Straus, Christian; Becquemin, Marie-Hélène; Arnulf, Isabelle; Pradat, Pierre-François; Bruneteau, Gaëlle; Ignagni, Anthony R; Diop, Moustapha; Onders, Raymond; Nelson, Teresa; Menegaux, Fabrice; Meininger, Vincent; Similowski, Thomas

2012-01-01

In amyotrophic lateral sclerosis (ALS) patients, respiratory insufficiency is a major burden. Diaphragm conditioning by electrical stimulation could interfere with lung function decline by promoting the development of type 1 muscle fibres. We describe an ancillary study to a prospective, non-randomized trial (NCT00420719) assessing the effects of diaphragm pacing on forced vital capacity (FVC). Sleep-related disturbances being early clues to diaphragmatic dysfunction, we postulated that they would provide a sensitive marker. Stimulators were implanted laparoscopically in the diaphragm close to the phrenic motor point in 18 ALS patients for daily conditioning. ALS functioning score (ALSFRS), FVC, sniff nasal inspiratory pressure (SNIP), and polysomnographic recordings (PSG, performed with the stimulator turned off) were assessed before implantation and after four months of conditioning (n = 14). Sleep efficiency improved (69 ± 15% to 75 ± 11%, p = 0.0394) with fewer arousals and micro-arousals. This occurred against a background of deterioration as ALSFRS-R, FVC, and SNIP declined. There was, however, no change in NIV status or the ALSFRS respiratory subscore, and the FVC decline was mostly due to impaired expiration. Supporting a better diaphragm function, apnoeas and hypopnoeas during REM sleep decreased. In conclusion, in these severe patients not expected to experience spontaneous improvements, diaphragm conditioning improved sleep and there were hints at diaphragm function changes.

Volumetric capnography for the evaluation of pulmonary disease in adult patients with cystic fibrosis and noncystic fibrosis bronchiectasis.

Science.gov (United States)

Veronez, L; Moreira, M M; Soares, S T P; Pereira, M C; Ribeiro, M A G O; Ribeiro, J D; Terzi, R G G; Martins, L C; Paschoal, I A

2010-06-01

This study was designed to use volumetric capnography to evaluate the breathing pattern and ventilation inhomogeneities in patients with chronic sputum production and bronchiectasis and to correlate the phase 3 slope of the capnographic curve to spirometric measurements. Twenty-four patients with cystic fibrosis (CF) and 21 patients with noncystic fibrosis idiopathic bronchiectasis (BC) were serially enrolled. The diagnosis of cystic fibrosis was based on the finding of at least two abnormal sweat chloride concentrations (iontophoresis sweat test). The diagnosis of bronchiectasis was made when the patient had a complaint of chronic sputum production and compatible findings at high-resolution computed tomography (HRCT) scan of the thorax. Spirometric tests and volumetric capnography were performed. The 114 subjects of the control group for capnographic variables were nonsmoker volunteers, who had no respiratory symptoms whatsoever and no past or present history of lung disease. Compared with controls, patients in CF group had lower SpO(2) (P volumes normalized for weight (V(E)/kg) (P volume (P3Slp/V(E)) (P capacities and both groups had very similar abnormalities. The capnographic variables in the patient group suggest a restrictive respiratory pattern (greater respiratory rates, smaller expiratory times and expiratory volumes, normal peak expiratory flows). Both groups of patients showed increased phase III slopes compared with controls, which probably indicates the presence of diffuse disease of small airways in both conditions leading to inhomogeneities of ventilation.

Non-malignant consequences of decreasing asbestos exposure in the Brazil chrysotile mines and mills.

Science.gov (United States)

Bagatin, E; Neder, J A; Nery, L E; Terra-Filho, M; Kavakama, J; Castelo, A; Capelozzi, V; Sette, A; Kitamura, S; Favero, M; Moreira-Filho, D C; Tavares, R; Peres, C; Becklake, M R

2005-06-01

To investigate the consequences of improvement in the workplace environment over six decades (1940-96) in asbestos miners and millers from a developing country (Brazil). A total of 3634 Brazilian workers with at least one year of exposure completed a respiratory symptoms questionnaire, chest radiography, and a spirometric evaluation. The study population was separated into three groups whose working conditions improved over time: group I (1940-66, n = 180), group II (1967-76, n = 1317), and group III (1977-96, n = 2137). Respiratory symptoms were significantly related to spirometric abnormalities, smoking, and latency time. Breathlessness, in particular, was also associated with age, pleural abnormality and increased cumulative exposure to asbestos fibres. The odds ratios (OR) for parenchymal and/or non-malignant pleural disease were significantly lower in groups II and III compared to group I subjects (0.29 (0.12-0.69) and 0.19 (0.08-0.45), respectively), independent of age and smoking status. Similar results were found when groups were compared at equivalent latency times (groups I v II: 30-45 years; groups II v III: 20-25 years). Ageing, dyspnoea, past and current smoking, and radiographic abnormalities were associated with ventilatory impairment. Lower spirometric values were found in groups I and II compared to group III: lung function values were also lower in higher quartiles of latency and of cumulative exposure in these subjects. Progressive improvement in occupational hygiene in a developing country is likely to reduce the risk of non-malignant consequences of dust inhalation in asbestos miners and millers.

Praktiserende laegers anvendelse af heliumspirometriske lungefunktionsundersøgelser i et hospitalsambulatorium

DEFF Research Database (Denmark)

Knudsen, Torben; Hansen, J M

1989-01-01

The case records of 94 helium spirometric pulmonary function investigations on patients referred by their general practitioners to the clinical-physiological department, Svendborg Hospital during 1985 and 1986 are reviewed. In 35% of the cases, the diagnosis on referral was "dyspnoea of unknown o...

Author Details

African Journals Online (AJOL)

Imad, H. Vol 21, No 1 (2015) - Articles Epidemiological and clinical characteristics, spirometric parameters and response to budesonide/formoterol in patients attending an asthma clinic: an experience in a developing country. Abstract PDF. ISSN: 1937-8688. AJOL African Journals Online. HOW TO USE AJOL.

Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes

DEFF Research Database (Denmark)

Holst, G; Høst, A; Doekes, G

2016-01-01

was identified based on technical inspection and bedroom dampness on parents' self-report. Classroom and bedroom dust was analysed for seven microbial components. Skin-prick-testing determined atopic sensitisation. Lung function was expressed as z-scores for forced expiratory volume in one second (zFEV1...... ), forced vital capacity (zFVC) and the ratio zFEV1 /zFVC using GLI-2012-prediction-equations. The parents reported children's allergies, airway symptoms and doctor-diagnosed asthma. High classroom dampness, but not bedroom dampness, was negatively associated with zFEV1 (β-coef. -0.71; 95%CI -1.17 - -0...... (ETS) decreased zFEV1 (β-coef. -0.22; 95%CI -0.42- -0.02) and zFEV1 /zFVC-ratio (β-coef. -0.26; 95%CI -0.44 - -0.07) and increased upper airway symptoms (OR1.66; 95%CI 1.03-2.66). In conclusion, dampness in classrooms may have adverse respiratory health effects in pupils, but microbial agents...

Pulmonary function levels as predictors of mortality in a national sample of US adults.

Science.gov (United States)

Neas, L M; Schwartz, J

1998-06-01

Single breath pulmonary diffusing capacity for carbon monoxide (DL(CO)) was examined as a predictor of all-cause mortality among 4,333 subjects who were aged 25-74 years at baseline in the First National Health and Nutrition Examination Survey (NHANES I) conducted from 1971 to 1975. The relation of the percentage of predicted DL(CO) to all-cause mortality was examined in a Cox proportional hazard model that included age, sex, race, current smoking status, systolic blood pressure, serum cholesterol, alcohol consumption, body mass index, percentage of predicted forced vital capacity (FVC), and the ratio of forced expiratory volume at 1 second (FEV1) to FVC. Mortality had a linear association with the percentage of predicted FVC (rate ratio (RR) = 1.12, 95% confidence interval (CI) 1.08-1.17, for a 10% decrement) and a significantly nonlinear association with the percentage of predicted DL(CO) with an adverse effect that was clearly evident for levels below 85% of those predicted (RR = 1.24, 95% CI 1.12-1.37 for a 10% decrement). The relative hazard for the percentage of predicted DL(CO) below 85% was not modified by sex, smoking status, or exclusion of subjects with clinical respiratory disease on the initial examination. This association with the percentage of predicted DL(CO) was present among 3,005 subjects with FEV1 levels above 90% of those predicted. Thus, pulmonary diffusing capacity below 85% of predicted levels is a significant predictor of the all-cause mortality rate within the general US population independent of standard spirometry measures and even in the absence of apparent clinical respiratory disease.

Breathing pattern and chest wall volumes during exercise in patients with cystic fibrosis, pulmonary fibrosis and COPD before and after lung transplantation.

Science.gov (United States)

Wilkens, H; Weingard, B; Lo Mauro, A; Schena, E; Pedotti, A; Sybrecht, G W; Aliverti, A

2010-09-01

Pulmonary fibrosis (PF), cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) often cause chronic respiratory failure (CRF). In order to investigate if there are different patterns of adaptation of the ventilatory pump in CRF, in three groups of lung transplant candidates with PF (n=9, forced expiratory volume in 1 s (FEV(1))=37+/-3% predicted, forced vital capacity (FVC)=32+/-2% predicted), CF (n=9, FEV(1)=22+/-3% predicted, FVC=30+/-3% predicted) and COPD (n=21, FEV(1)=21+/-1% predicted, FVC=46+/-2% predicted), 10 healthy controls and 16 transplanted patients, total and compartmental chest wall volumes were measured by opto-electronic plethysmography during rest and exercise. Three different breathing patterns were found during CRF in PF, CF and COPD. Patients with COPD were characterised by a reduced duty cycle at rest and maximal exercise (34+/-1%, pvolume (0.75+/-0.10 and 0.79+/-0.07 litres) (pvolumes increased significantly in patients with COPD and CF but not in those with PF. End-inspiratory volumes did not increase in CF and PF. The breathing pattern of transplanted patients was similar to that of healthy controls. There are three distinct patterns of CRF in patients with PF, CF and COPD adopted by the ventilatory pump to cope with the underlying lung disease that may explain why patients with PF and CF are prone to respiratory failure earlier than patients with COPD. After lung transplantation the chronic adaptations of the ventilatory pattern to advanced lung diseases are reversible and indicate that the main contributing factor is the lung itself rather than systemic effects of the disease.

Mensuration of cardioangiopulmonary indices by radiocardiogram before and after the verapamil oral administration in subjects with chronic obstructive pulmonary disease. Mensuracao de indices cardiangiopulmonares, atraves do radiocardiograma antes e apos o emprego de verapamil por via oral em portadores de molestia pulmonar obstrutiva cronica

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Lara, P F [Sao Paulo Univ., SP (Brazil). Inst. de Ciencias Biomedicas; Hueb, W A [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina

1982-11-01

Twenty subjects with chronic obstructive pulmonary disease were studied. The diagnosis was obtained from the history, clinical evaluation, pulmonary radiography, pulmonary and hepatic scintigraphies and spirometry. About 360 mg of verapamil was administered daily, every eight hours for ten days. Before and after drug administration, the arterial pressures, the spirometric measurements and nine cardiac roentgenographic indexes were measured. Vital capacity increased in all cases, but did not reach the normal levels. These data suggest that the effect of verapamil on the pulmonary circulation brought benefits to the subjects. This occurred either by direct pulmonary vasodilation, or by bronchodilation, reducing hypoxia. In all cases, the pulmonary resistance was diminished. Finally, verapamil seems to be a drug with real benefits in subjects with chronic obstructive pulmonary disease and we advise a continuation of the studies. (author).

Mensuration of cardioangiopulmonary indices by radiocardiogram before and after the verapamil oral administration in subjects with chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Lara, P.F.; Hueb, W.A.

1982-01-01

Twenty subjects with chronic obstructive pulmonary disease were studied. The diagnosis was obtained from the history, clinical evaluation, pulmonary radiography, pulmonary and hepatic scintigraphies and spirometry. About 360 mg of verapamil was administered daily, every eight hours for ten days. Before and after drug administration, the arterial pressures, the spirometric measurements and nine cardiac roentgenographic indexes were measured. Vital capacity increased in all cases, but did not reach the normal levels. These data suggest that the effect of verapamil on the pulmonary circulation brought benefits to the subjects. This occurred either by direct pulmonary vasodilation, or by bronchodilation, reducing hypoxia. In all cases, the pulmonary resistance was diminished. Finally, verapamil seems to be a drug with real benefits in subjects with chronic obstructive pulmonary disease and we advise a continuation of the studies. (author)

Prediction equations for spirometry in adults from northern India.

Science.gov (United States)

Chhabra, S K; Kumar, R; Gupta, U; Rahman, M; Dash, D J

2014-01-01

Most of the Indian studies on prediction equations for spirometry in adults are several decades old and may have lost their utility as these were carried out with equipment and standardisation protocols that have since changed. Their validity is further questionable as the lung health of the population is likely to have changed over time. To develop prediction equations for spirometry in adults of north Indian origin using the 2005 American Thoracic Society/European Respiratory Society (ATS/ERS) recommendations on standardisation. Normal healthy non-smoker subjects, both males and females, aged 18 years and above underwent spirometry using a non-heated Fleisch Pneumotach spirometer calibrated daily. The dataset was randomly divided into training (70%) and test (30%) sets and the former was used to develop the equations. These were validated on the test data set. Prediction equations were developed separately for males and females for forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, and instantaneous expiratory flow rates using multiple linear regression procedure with different transformations of dependent and/or independent variables to achieve the best-fitting models for the data. The equations were compared with the previous ones developed in the same population in the 1960s. In all, 685 (489 males, 196 females) subjects performed spirometry that was technically acceptable and repeatable. All the spirometry parameters were significantly higher among males except the FEV1/FVC ratio that was significantly higher in females. Overall, age had a negative relationship with the spirometry parameters while height was positively correlated with each, except for the FEV1/FVC ratio that was related only to age. Weight was included in the models for FVC, forced expiratory flow (FEF75) and FEV1/FVC ratio in males, but its contribution was very small. Standard errors of estimate were provided to enable calculation of the lower

Gray matter perfusion correlates with disease severity in ALS.

Science.gov (United States)

Rule, Randall R; Schuff, Norbert; Miller, Robert G; Weiner, Michael W

2010-03-09

The goal of this study is to determine if regional brain perfusion, as measured by arterial spin labeling (ASL) MRI, is correlated with clinical measures of amyotrophic lateral sclerosis (ALS) disease severity. The presence of such a relationship would indicate a possible role for ASL perfusion as a marker of disease severity and upper motor neuron involvement in ALS. Disease severity was assessed in 16 subjects with ALS (age 54 +/- 11) using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) and the pulmonary function measure, forced vital capacity (FVC). Upper motor neuron involvement was assessed by testing rapid tapping of the fingers and feet. Magnetic resonance perfusion images were coregistered with structural T1-weighted MRI, corrected for partial volume effects using the structural images and normalized to a study-specific atlas. Correlations between perfusion and ALS disease severity were analyzed, using statistical parametric mapping, and including age as a factor. Analyses were adjusted for multiple clusters. ALS severity, as measured by the ALSFRS and FVC, was correlated with gray matter perfusion. This correlation was predominantly observed in the hemisphere contralateral to the more affected limbs. ALSFRS scores correlated with perfusion in the contralateral frontal and parietal lobe (p frontal lobe (p frontal lobe (p Upper motor neuron involvement, as measured by rapid finger tapping, correlated bilaterally with perfusion in the middle cingulate gyrus (p < 0.001). Amyotrophic lateral sclerosis (ALS) severity is correlated with brain perfusion as measured by arterial spin labeling (ASL) perfusion. This correlation appears to be independent of brain atrophy. ASL perfusion may be a useful tool for monitoring disease progression and assessing treatment effects in ALS.

A comparison of maximal inspiratory pressure and forced vital capacity as potential criteria for initiating non-invasive ventilation in amyotrophic lateral sclerosis.

Science.gov (United States)

Mendoza, Michelle; Gelinas, Deborah F; Moore, Dan H; Miller, Robert G

2007-04-01

Using a retrospective analysis of 161 patients with amyotrophic lateral sclerosis (ALS) from the Western ALS study group (WALS) database, the sensitivity of maximal inspiratory pressure (MIP)NIV) were compared. Sixty-five per cent of patients at enrollment met the MIP criterion, compared with only 8% of patients who met the FVC criterion. There were no cases in which FVCNIV, a MIP< -60 cm H(2)O allows US clinicians to obtain non-invasive ventilatory support for patients earlier than if using the FVC criterion alone.

Predictive equations for spirometric reference values in a healthy ...

African Journals Online (AJOL)

men and 98 women were selected to the reference value group. ... adult population in Dar es Salaam, Tanzania, and compare these equations to already ... which has proven to be suitable in field work as it operates on batteries and requires no ..... thought to be partly due to difference in body build and that Blacks have ...

Use of tracheal auscultation for the assessment of bronchial responsiveness in asthmatic children

NARCIS (Netherlands)

Sprikkelman, A. B.; Grol, M. H.; Lourens, M. S.; Gerritsen, J.; Heymans, H. S.; van Aalderen, W. M.

1996-01-01

BACKGROUND: It can be difficult to assess bronchial responsiveness in children because of their inability to perform spirometric tests reliably. In bronchial challenges lung sounds could be used to detect the required 20% fall in the forced expiratory volume in one second (FEV1). A study was

Use of tracheal auscultation for the assessment of bronchial responsiveness in asthmatic children

NARCIS (Netherlands)

Sprikkelman, AB; Grol, MH; Lourens, MS; Gerritsen, J; Heymans, HSA; vanAalderen, WMC

Background - It can be difficult to assess bronchial responsiveness in children because of their inability to perform spirometric tests reliably. In bronchial challenges lung sounds could be used to detect the required 20% fall in the forced expiratory volume in one second (FEV(1)). A study was

Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations

NARCIS (Netherlands)

P.H. Quanjer (Philip); S. Stanojevic (Sanja); T.J. Cole (Tim); X. Baur (Xaver); G.L. Hall (G. L.); B.H. Culver (Bruce); P.L. Enright (Paul); J.L. Hankinson; M.S.M. Ip; J. Zheng (Jinping); J. Stocks (Janet); C. Schindler (C.)

2012-01-01

textabstractThe aim of the Task Force was to derive continuous prediction equations and their lower limits of normal for spirometric indices, which are applicable globally. Over 160,000 data points from 72 centres in 33 countries were shared with the European Respiratory Society Global Lung Function

A guide to spirometry as applied to occupational health | White ...

African Journals Online (AJOL)

In the context of occupational health, spirometric testing of respiratory function has a number of important applications. These applications can be expected to become more widespread in view of extensive changes to occupational health and compensation legislation in South Africa. Spirometry is an essential component of ...

Influence of treatment with inhalable heroin on pulmonary function

NARCIS (Netherlands)

Buster, M. C. A.; van den Brink, W.; van Brussel, G. H. A.; van Ree, J. M.

2011-01-01

This study aims to asses the influence of inhalable heroin on pulmonary function in chronic heroin-dependent patients treated with inhalable heroin. Among 32 patients (all cigarette smokers), a spirometric test was conducted at baseline and after an average period of 10 months of treatment with

Pulmonary function in adolescents with ataxia telangiectasia.

Science.gov (United States)

McGrath-Morrow, Sharon; Lefton-Greif, Maureen; Rosquist, Karen; Crawford, Thomas; Kelly, Amber; Zeitlin, Pamela; Carson, Kathryn A; Lederman, Howard M

2008-01-01

Pulmonary complications are common in adolescents with ataxia telangiectasia (A-T), however objective measurements of lung function may be difficult to obtain because of underlying bulbar weakness, tremors, and difficulty coordinating voluntary respiratory maneuvers. To increase the reliability of pulmonary testing, minor adjustments were made to stabilize the head and to minimize leaks in the system. Fifteen A-T adolescents completed lung volume measurements by helium dilution. To assess for reproducibility of spirometry testing, 10 A-T adolescents performed spirometry on three separate occasions. Total lung capacity (TLC) was normal or just mildly decreased in 12/15 adolescents tested. TLC correlated positively with functional residual capacity (FRC), a measurement independent of patient effort (R2=0.71). The majority of individuals had residual volumes (RV) greater than 120% predicted (10/15) and slow vital capacities (VC) less than 70% predicted (9/15). By spirometry, force vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) values were reproducible in the 10 individuals who underwent testing on three separate occasions (R=0.97 and 0.96 respectively). Seven of the 10 adolescents had FEV1/FVC ratios>90%. Lung volume measurements from A-T adolescents revealed near normal TLC values with increased RV and decreased VC values. These findings indicate a decreased ability to expire to residual volume rather then a restrictive defect. Spirometry was also found to be reproducible in A-T adolescents suggesting that spirometry testing may be useful for tracking changes in pulmonary function over time in this population. Copyright (c) 2007 Wiley-Liss, Inc.

Correlation analysis between pulmonary function test parameters and CT image parameters of emphysema

Science.gov (United States)

Liu, Cheng-Pei; Li, Chia-Chen; Yu, Chong-Jen; Chang, Yeun-Chung; Wang, Cheng-Yi; Yu, Wen-Kuang; Chen, Chung-Ming

2016-03-01

Conventionally, diagnosis and severity classification of Chronic Obstructive Pulmonary Disease (COPD) are usually based on the pulmonary function tests (PFTs). To reduce the need of PFT for the diagnosis of COPD, this paper proposes a correlation model between the lung CT images and the crucial index of the PFT, FEV1/FVC, a severity index of COPD distinguishing a normal subject from a COPD patient. A new lung CT image index, Mirage Index (MI), has been developed to describe the severity of COPD primarily with emphysema disease. Unlike conventional Pixel Index (PI) which takes into account all voxels with HU values less than -950, the proposed approach modeled these voxels by different sizes of bullae balls and defines MI as a weighted sum of the percentages of the bullae balls of different size classes and locations in a lung. For evaluation of the efficacy of the proposed model, 45 emphysema subjects of different severity were involved in this study. In comparison with the conventional index, PI, the correlation between MI and FEV1/FVC is -0.75+/-0.08, which substantially outperforms the correlation between PI and FEV1/FVC, i.e., -0.63+/-0.11. Moreover, we have shown that the emphysematous lesion areas constituted by small bullae balls are basically irrelevant to FEV1/FVC. The statistical analysis and special case study results show that MI can offer better assessment in different analyses.

EMPIRICAL MODELS FOR PERFORMANCE OF DRIPPERS APPLYING CASHEW NUT PROCESSING WASTEWATER

Directory of Open Access Journals (Sweden)

KETSON BRUNO DA SILVA

2016-01-01

Full Text Available The objective of this work was to develop empirical models for hydraulic performance of drippers operating with cashew nut processing wastewater depending on operating time, operating pressure and effluent quality. The experiment consisted of two factors, types of drippers (D1=1.65 L h-1, D2=2.00 L h-1 and D3=4.00 L h-1, and operating pressures (70, 140, 210 and 280 kPa, with three replications. The flow variation coefficient (FVC, distribution uniformity coefficient (DUC and the physicochemical and biological characteristics of the effluent were evaluated every 20 hours until complete 160 hours of operation. Data were interpreted through simple and multiple linear stepwise regression models. The regression models that fitted to the FVC and DUC as a function of operating time were square root, linear and quadratic, with 17%, 17% and 8%, and 17%, 17% and 0%, respectively. The regression models that fitted to the FVC and DUC as a function of operating pressures were square root, linear and quadratic, with 11%, 22% and 0% and the 0%, 22% and 11%, respectively. Multiple linear regressions showed that the dissolved solids content is the main wastewater characteristic that interfere in the FVC and DUC values of the drip units D1 (1.65 L h-1 and D3 (4.00 L h-1, operating at work pressure of 70 kPa (P1.

Interstitial lung disease associated with collagen vascular disorders: disease quantification using a computer-aided diagnosis tool

Energy Technology Data Exchange (ETDEWEB)

Marten, K.; Engelke, C. [University Hospital of Goettingen, Department of Radiology, Goettingen (Germany); Dicken, V. [MeVis Research GmbH, Bremen (Germany); Kneitz, C. [University Hospital of Wuerzburg, Dept. of Rheumatology and Clinical Immunology, Medizinische Klinik and Poliklinik, Wuerzburg (Germany); Hoehmann, M.; Kenn, W.; Hahn, D. [University Hospital of Wuerzburg, Department of Radiology, Wuerzburg (Germany)

2009-02-15

The purpose of this study was to evaluate a computer-aided diagnosis (CAD) tool compared to human observers in quantification of interstitial lung disease (ILD) in patients with collagen-vascular disorders. A total of 52 patients with rheumatoid arthritis (n=24), scleroderma (n=14) and systemic lupus erythematosus (n=14) underwent thin-section CT. Two independent observers assessed the extent of ILD (EoILD), reticulation (EoRet) and ground-glass opacity (EoGGO). CAD assessed EoILD twice. Pulmonary function tests were obtained. Statistical evaluation used 95% limits of agreement and linear regression analysis. CAD correlated well with diffusing capacity (DL{sub CO}) (R=-0.531, P<0.0001) and moderately with forced vital capacity (FVC) (R=-0.483, P=0.0008). There was close correlation between CAD and the readers (EoILD vs. CAD: R=0.716, P<0.0001; EoRet vs. CAD: R=0.69, P<0.0001). Subgroup analysis including patients with minimal EoGGO (<15%) strengthened the correlations between CAD and the readers, readers and PFT, and CAD and PFT. EoILD by readers correlated strongly with DL{sub CO} (R=-0.705, P<0.0001) and moderately with FVC (R=-0.559, P=0.0002). EoRet correlated closely with DL{sub CO} and moderately with FVC (DL{sub CO}: R=-0.663; FVC: R=-0.436; P{<=}0.005). The CAD system is a promising tool for ILD quantification, showing close correlation with human observers and physiologic impairment. (orig.)

Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water

OpenAIRE

Rizzetti, Danize Aparecida; Quadros, Janayna Rodembuch Borba; Ribeiro, Bruna Esmerio; Callegaro, Letícia; Veppo, Aline Arebalo; Wiggers, Giulia Alessandra; Peçanha, Franck Maciel

2017-01-01

ABSTRACT Objective: To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. Methods: This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expirato...

New Danish reference values for spirometry

DEFF Research Database (Denmark)

Løkke, Anders; Marott, Jacob Louis; Mortensen, Jann

2013-01-01

years of age or older with adequate lung function. Results:  We used sex-stratified multiple linear regression analysis to find prediction formulas for forced expiratory volume in 1 s (FEV(1) ), forced vital capacity (FVC) and FEV(1) /FVC adjusted for age and height. The cutoff value of normal lung......Introduction:  International recommendations state that reference values for lung function should derive from cross-sectional studies of healthy nonsmokers and be renewed from time to time because of cohort effect and newer, more accurate, technical equipment. In 1986, the Danish Lung Society...

Airflow limitation in people living with HIV and matched uninfected controls

DEFF Research Database (Denmark)

Ronit, Andreas; Lundgren, Jens; Afzal, Shoaib

2018-01-01

-matched controls from the Copenhagen General Population Study were included. Lung function was assessed using FEV1 and FVC, while airflow limitation was defined by the lower limit of normal (LLN) of FEV1/FVC and by FEV1/FVClinear regression models were used......INTRODUCTION: Whether HIV influences pulmonary function remains controversial. We assessed dynamic pulmonary function in people living with HIV (PLWHIV) and uninfected controls. METHODS: A total of 1098 PLWHIV from the Copenhagen Co-morbidity in HIV infection study and 12 161 age-matched and sex...

Silicosis and lung function decrements among female ceramic workers in Italy.

Science.gov (United States)

Forastiere, Francesco; Goldsmith, David F; Sperati, Alessandra; Rapiti, Elisabetta; Miceli, Maria; Cavariani, Fulvio; Perucci, Carlo A

2002-11-01

It is well known that male ceramic workers have elevated risks of chronic silicosis. The objective of this study was to assess whether female ceramic workers also have an increased risk of silicosis and whether these women have decreased lung function related to silica exposure. Ceramic workers from Civitacastellana, Italy, were enrolled in health surveillance during the 1970s. A total of 642 women were under surveillance; a respiratory monitoring program was conducted from 1974 to 1987, with follow-up through 1991 that included annual chest radiography and measurement of lung function. Radiography findings were defined as silicosis if the chest films were > or =1/0 with small, rounded opacities. Multiple linear regression models for repeated measures (generalized estimating equations) were run to evaluate associations of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)) with years of exposure and radiograph opacities. Nine cases of silicosis were identified on the basis of radiographic evidence. Silicosis risk was not associated with smoking but was related to employment before 1970 and demonstrated a dose-response gradient for years of exposure. FVC and FEV(1) both showed significant (p associations with duration of exposure and with positive radiography findings. The results for female ceramic workers are consistent with those for male employees regarding exposure to fibrogenic dusts.

Exposure to air pollution and pulmonary function in university students.

Science.gov (United States)

Hong, Yun-Chul; Leem, Jong-Han; Lee, Kwan-Hee; Park, Dong-Hyun; Jang, Jae-Yeon; Kim, Sun-Tae; Ha, Eun-Hee

2005-03-01

Exposure to air pollution has been reported to be associated with increase in pulmonary disease. The aims of the present study were to examine the use of personal nitrogen dioxide (NO(2)) samplers as a means of measuring exposure to air pollution and to investigate the relationship between personal exposure to air pollution and pulmonary function. We measured individual exposures to NO(2) using passive personal NO(2) samplers for 298 healthy university students. Questionnaire interview was conducted for traffic-related factors, and spirometry was performed when the samplers were returned after 1 day. Personal NO(2) concentrations varied, depending on the distance between residence and a main road (P=0.029). Students who used transportation for more than 1 h were exposed to higher levels of NO(2) than those using transportation for less than 1 h (P=0.032). In terms of transportation, riding in a bus or subway caused significantly higher exposure than not using them (P=0.046). NO(2) exposure was not significantly associated with forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV(1)) but was associated with the ratio of FEV(1)/FVC and mid-expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75)) (Ppollution and are associated with decreased pulmonary function.

Quantitative assessment of lung volumes using multi-detector row computed tomography (MDCT) in patients with chronic obstructive pulmonary disease (COPD)

International Nuclear Information System (INIS)

Lee, Sang Min; Hur, Jin; Kim, Tae Hoon; Kim, Sang Jin; Kim, Hyung Jung

2008-01-01

To evaluate the clinical value of the multi-detector row computed tomography (MDCT) in the quantitative assessment of lung volumes and to assess the relationship between the MDCT results and disease severity as determined by a pulmonary function test (PFT) in Chronic Obstructive Pulmonary Disease (COPD) patients. We performed a PFT and MDCT on 39 COPD patients. Using the GOLD classifications, we divided the patients into three groups according to disease severity; stage I (mild, n = 10), stage II (moderate, n = 15), and stage III (severe, n = 14). Using the pulmo-CT software program, we measured the proportion of lung volumes with attenuation values below -910 and -950 HU. The mean FEV1 (% of predicted) and FEV1/FVC was 82.2 ± 2% and 66.2 ± 3% in stage I, 53.5 ± 11% and 52 ± 6% in stage II, and 32.3 ± 7% and 44.2% ± 13% in stage III, respectively. Differences in lung volume percentage at each of the thresholds (-910 and -950 HU) among the 3 stages were statistically significant (ρ < 0.01, ρ < 0.01) and correlated well with the FEV1 and FEV1/FVC (r = -0.803, r -0.766, r = -0.817, and r = -0.795, respectively). The volumetric measurement obtained by MDCT provides an accurate means of quantifying pulmonary emphysema

Browse Title Index

African Journals Online (AJOL)

Items 851 - 900 of 3286 ... Vol 21, No 1 (2015), Epidemiological and clinical characteristics, spirometric parameters and response to budesonide/formoterol in patients attending an asthma clinic: an experience in a developing country, Abstract PDF. H Imad, G Yasir. Vol 23, No 1 (2016), Epidemiological and histopathological ...

Interpretation of Spirometry: Selection of Predicted Values and Defining Abnormality.

Science.gov (United States)

Chhabra, S K

2015-01-01

Spirometry is the most frequently performed investigation to evaluate pulmonary function. It provides clinically useful information on the mechanical properties of the lung and the thoracic cage and aids in taking management-related decisions in a wide spectrum of diseases and disorders. Few measurements in medicine are so dependent on factors related to equipment, operator and the patient. Good spirometry requires quality assured measurements and a systematic approach to interpretation. Standard guidelines on the technical aspects of equipment and their calibration as well as the test procedure have been developed and revised from time-to-time. Strict compliance with standardisation guidelines ensures quality control. Interpretation of spirometry data is based only on two basic measurements--the forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV1) and their ratio, FEV1/FVC. A meaningful and clinically useful interpretation of the measured data requires a systematic approach and consideration of several important issues. Central to interpretation is the understanding of the development and application of prediction equations. Selection of prediction equations that are appropriate for the ethnic origin of the patient is vital to avoid erroneous interpretation. Defining abnormal values is a debatable but critical aspect of spirometry. A statistically valid definition of the lower limits of normal has been advocated as the better method over the more commonly used approach of defining abnormality as a fixed percentage of the predicted value. Spirometry rarely provides a specific diagnosis. Examination of the flow-volume curve and the measured data provides information to define patterns of ventilatory impairment. Spirometry must be interpreted in conjunction with clinical information including results of other investigations.

PAI-1 gain-of-function genotype, factors increasing PAI-1 levels, and airway obstruction: The GALA II Cohort.

Science.gov (United States)

Sherenian, M G; Cho, S H; Levin, A; Min, J-Y; Oh, S S; Hu, D; Galanter, J; Sen, S; Huntsman, S; Eng, C; Rodriguez-Santana, J R; Serebrisky, D; Avila, P C; Kalhan, R; Smith, L J; Borrell, L N; Seibold, M A; Keoki Williams, L; Burchard, E G; Kumar, R

2017-09-01

PAI-1 gain-of-function variants promote airway fibrosis and are associated with asthma and with worse lung function in subjects with asthma. We sought to determine whether the association of a gain-of-function polymorphism in plasminogen activator inhibitor-1 (PAI-1) with airway obstruction is modified by asthma status, and whether any genotype effect persists after accounting for common exposures that increase PAI-1 level. We studied 2070 Latino children (8-21y) with genotypic and pulmonary function data from the GALA II cohort. We estimated the relationship of the PAI-1 risk allele with FEV1/FVC by multivariate linear regression, stratified by asthma status. We examined the association of the polymorphism with asthma and airway obstruction within asthmatics via multivariate logistic regression. We replicated associations in the SAPPHIRE cohort of African Americans (n=1056). Secondary analysis included the effect of the at-risk polymorphism on postbronchodilator lung function. There was an interaction between asthma status and the PAI-1 polymorphism on FEV 1 /FVC (P=.03). The gain-of-function variants, genotypes (AA/AG), were associated with lower FEV 1 /FVC in subjects with asthma (β=-1.25, CI: -2.14,-0.35, P=.006), but not in controls. Subjects with asthma and the AA/AG genotypes had a 5% decrease in FEV 1 /FVC (P<.001). In asthmatics, the risk genotype (AA/AG) was associated with a 39% increase in risk of clinically relevant airway obstruction (OR=1.39, CI: 1.01, 1.92, P=.04). These associations persisted after exclusion of factors that increase PAI-1 including tobacco exposure and obesity. The decrease in the FEV 1 /FVC ratio associated with the risk genotype was modified by asthma status. The genotype increased the odds of airway obstruction by 75% within asthmatics only. As exposures known to increase PAI-1 levels did not mitigate this association, PAI-1 may contribute to airway obstruction in the context of chronic asthmatic airway inflammation. © 2017

Lung volume recruitment in multiple sclerosis.

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Nadim Srour

Full Text Available INTRODUCTION: Pulmonary function abnormalities have been described in multiple sclerosis including reductions in forced vital capacity (FVC and cough but the time course of this impairment is unknown. Peak cough flow (PCF is an important parameter for patients with respiratory muscle weakness and a reduced PCF has a direct impact on airway clearance and may therefore increase the risk of respiratory tract infections. Lung volume recruitment is a technique that improves PCF by inflating the lungs to their maximal insufflation capacity. OBJECTIVES: Our goals were to describe the rate of decline of pulmonary function and PCF in patients with multiple sclerosis and describe the use of lung volume recruitment in this population. METHODS: We reviewed all patients with multiple sclerosis referred to a respiratory neuromuscular rehabilitation clinic from February 1999 until December 2010. Lung volume recruitment was attempted in patients with FVC <80% predicted. Regular twice daily lung volume recruitment was prescribed if it resulted in a significant improvement in the laboratory. RESULTS: There were 79 patients included, 35 of whom were seen more than once. A baseline FVC <80% predicted was present in 82% of patients and 80% of patients had a PCF insufficient for airway clearance. There was a significant decline in FVC (122.6 mL/y, 95% CI 54.9-190.3 and PCF (192 mL/s/y, 95% 72-311 over a median follow-up time of 13.4 months. Lung volume recruitment was associated with a slower decline in FVC (p<0.0001 and PCF (p = 0.042. CONCLUSION: Pulmonary function and cough decline significantly over time in selected patients with multiple sclerosis and lung volume recruitment is associated with a slower rate of decline in lung function and peak cough flow. Given design limitations, additional studies are needed to assess the role of lung volume recruitment in patients with multiple sclerosis.

Clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease experiencing frequent acute exacerbations

Directory of Open Access Journals (Sweden)

Prem Parkash Gupta

2018-01-01

Full Text Available Purpose: The present study aimed at clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease (COPD to anticipate future exacerbations. Methods: The study included 80 COPD patients; 40 patients had ≥2 acute exacerbations during preceding 1 year (frequent exacerbation [FECOPD] group and 40 patients had <2 acute exacerbations during preceding 1 year (infrequent exacerbation [I-FECOPD] group. Clinical profile, sputum microbiology, blood gas analysis, spirometric indices, and diffusion capacity (transfer test variables were assessed. Groups' comparison was performed using an independent t-test for numeric scale parameters and Chi-square test for nominal parameters. Pearson's and Spearman's correlation coefficients were derived for numeric scale parameters and numeric nominal parameters, respectively. Multinomial logistic regression analysis was done using SPSS software. Results: FECOPD group contained younger patients than in I-FECOPD group although the difference was not statistically significant. There was no significant difference between two groups regarding smoking pack-years and duration of illness. FECOPD group had significantly more expectoration score and Modified Medical Research Council dyspnea scores. Cough score and wheeze score did not differ significantly between two groups. More patients in FECOPD group (12/40 vs. 4/40 had lower airway bacterial colonization. Arterial blood gas parameters were more deranged in FECOPD group. Spirometric indices (forced expiratory volume during 1st s as well as transfer test (both diffusing capacity for carbon monoxide and transfer coefficient of the lung values were significantly reduced in FECOPD group. Conclusions: The patients in FECOPD group had clinical, spirometric, and transfer test profiling suggestive of a severe COPD phenotype, the recognition will help in predicting future exacerbations and a better management.

Prevalence of chronic obstructive pulmonary disease according to BTS, ERS, GOLD and ATS criteria in relation to doctor's diagnosis, symptoms, age, gender, and smoking habits.

Science.gov (United States)

Lindberg, Anne; Jonsson, Ann-Christin; Rönmark, Eva; Lundgren, Rune; Larsson, Lars-Gunnar; Lundbäck, Bo

2005-01-01

Guidelines and standards for diagnosis and management of chronic obstructive pulmonary disease (COPD) have been presented by different national and international societies, but the spirometric criteria for COPD differ between guidelines. To estimate prevalence of COPD using the guidelines of the British Thoracic Society (BTS), the European Respiratory Society (ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and the American Thoracic Society (ATS). Further, to evaluate reported airway symptoms, contacts with health care providers, and physician diagnosis of COPD in relation to the respective criteria, and gender differences. In 1992 a postal questionnaire was sent to a random sample of adults aged 20-69 years, 4,851 (85%) out of 5,681 subjects responded. In 1994-1995 a random sample of the responders, 970 subjects, were invited to a structured interview and a lung function test; 666 (69%) participated. The prevalence of COPD was 7.6, 14.0, 14.1, 12.2 and 34.1% according to BTS, ERS, GOLD, clinical ATS (with symptoms or physician diagnosis), and spirometric ATS criteria, respectively. Prevalent COPD was related to age, smoking habits and family history of obstructive airway disease but not to gender. Physician diagnosis of chronic bronchitis or emphysema was only reported by 16.3, 12.2, 11.0, 23.4 and 8.2% of subjects fulfilling the respective criteria, though a majority reported airway symptoms. The main determinants for prevalent COPD were age, smoking habits and spirometric criteria of COPD. Though a majority reported airway symptoms and contact with health care providers due to respiratory complaints, only a minority was diagnosed as having COPD, indicating a large underdiagnosis. Copyright (c) 2005 S. Karger AG, Basel.

Spirometric abnormalities associated with chronic bronchitis, asthma, and airway hyperresponsiveness among boilermaker construction workers

Energy Technology Data Exchange (ETDEWEB)

Hauser, R.; Eisen, E,A,; Pothier, L,; Lewis, D,; Bledsoe, T,; Christiani, D.C. [Harvard University, Boston, MA (United States). School of Public Health

2002-06-01

In a 2-year longitudinal study of boilermaker construction workers, authors found a significant association between working at oil-fired, coal-fired, and gas-fired industries during the past year and reduced lung function. In the present study, authors investigated whether chronic bronchitis, asthma, or baseline methacholine airway responsiveness can explain the heterogeneity in lung function response to boilermaker work. Exposure was assessed with a work history questionnaire. Spirometry was performed annually to assess lung function. A generalized estimating equation approach was used to account for the repeated-measures design. One hundred eighteen boilermakers participated in the study. Self-reported history of chronic bronchitis and asthma were associated with a larger FEV1 reduction in response to workplace exposure at coal-fired and gas-fired industries. Although a high prevalence (39%) of airway hyperresponsiveness (provocative concentration of methacholine causing a 20% fall in FEVI of {lt} 8 mg/mL) among boilermakers was found, there was no consistent pattern of effect modification by airway responsiveness. Conclusions: Although chronic bronchitis and asthma were associated with a greater loss in lung function in response to hours worked as a boilermaker, and therefore they acted as effect modifiers of the exposure-lung function relationship, airway hyperresponsiveness did not. However, the high prevalence of airway hyperresponsiveness found in the cohort may be a primary consequence of long-term workplace exposure among boilermakers.

Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Jeong; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

2011-09-15

We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV{sub 1}/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV{sub 1}/FVC and the dyspnea score.

Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

International Nuclear Information System (INIS)

Park, Hyun Jeong; Hwang, Jung Hwa

2011-01-01

We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV 1 /FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV 1 /FVC and the dyspnea score.

Quantitative prediction of respiratory tidal volume based on the external torso volume change: a potential volumetric surrogate

International Nuclear Information System (INIS)

Li Guang; Arora, Naveen C; Xie Huchen; Ning, Holly; Citrin, Deborah; Kaushal, Aradhana; Zach, Leor; Camphausen, Kevin; Miller, Robert W; Lu Wei; Low, Daniel

2009-01-01

An external respiratory surrogate that not only highly correlates with but also quantitatively predicts internal tidal volume should be useful in guiding four-dimensional computed tomography (4DCT), as well as 4D radiation therapy (4DRT). A volumetric surrogate should have advantages over external fiducial point(s) for monitoring respiration-induced motion of the torso, which deforms in synchronization with a patient-specific breathing pattern. This study establishes a linear relationship between the external torso volume change (TVC) and lung air volume change (AVC) by validating a proposed volume conservation hypothesis (TVC = AVC) throughout the respiratory cycle using 4DCT and spirometry. Fourteen patients' torso 4DCT images and corresponding spirometric tidal volumes were acquired to examine this hypothesis. The 4DCT images were acquired using dual surrogates in cine mode and amplitude-based binning in 12 respiratory stages, minimizing residual motion artifacts. Torso and lung volumes were calculated using threshold-based segmentation algorithms and volume changes were calculated relative to the full-exhalation stage. The TVC and AVC, as functions of respiratory stages, were compared, showing a high correlation (r = 0.992 ± 0.005, p 2 = 0.980) without phase shift. The AVC was also compared to the spirometric tidal volumes, showing a similar linearity (slope = 1.030 ± 0.092, R 2 = 0.947). In contrast, the thoracic and abdominal heights measured from 4DCT showed relatively low correlation (0.28 ± 0.44 and 0.82 ± 0.30, respectively) and location-dependent phase shifts. This novel approach establishes the foundation for developing an external volumetric respiratory surrogate.

Prospective evaluation of pulmonary function in Parkinson's disease patients with motor fluctuations.

Science.gov (United States)

Hampson, Neil B; Kieburtz, Karl D; LeWitt, Peter A; Leinonen, Mika; Freed, Martin I

2017-03-01

Spirometry patterns suggesting restrictive and obstructive pulmonary dysfunction have been reported in Parkinson's disease (PD). However, the patterns' precise relation to PD pathophysiology remains unclear. Purpose/Aim. To assess ON- versus OFF-state pulmonary function, the quality of its spirometric evaluation, and the quality of longitudinal spirometric findings in a large sample of PD patients with motor fluctuations. During a placebo-controlled trial of an inhaled levodopa formulation, CVT-301, in PD patients with ≥2 h/d of OFF time, spirometry was performed by American Thoracic Society (ATS) guidelines at screening and throughout the 4-week treatment period. Among 86 patients, mean motor impairment during an OFF state at screening was moderately severe. However, mean spirometry results at screening were within normal ranges, and in a mixed model for repeated measures (MMRM), the results at screening were not dependent on motor state (ON vs. OFF). In the placebo group (n = 43), 76% of ON-state and 81% of OFF-state examinations throughout the study met ATS quality metrics, and in an MMRM analysis, mean findings at these patients' arrivals for treatment-period visits showed no significant 4-week change. Across all 86 patients, flow-volume curves prior to any study-drug administration showed only a 3% incidence of "sawtooth" morphology. In PD patients with motor fluctuations, longitudinal spirometry of acceptable quality was generally obtained. Although mean findings were normal, about a quarter of spirograms did not meet ATS quality criteria. Spirogram morphology may be less indicative of various forms of respiratory dysfunction than has previously been reported in PD.

Marital Relationship and Its Associated Factors in Veterans Exposed to High Dose Chemical Warfare Agents

Directory of Open Access Journals (Sweden)

Shervin Assari

2008-06-01

Full Text Available Objective: The aim of this study was to determine the associates of marital relationship in mustard exposed veterans.Materials and Methods: Two hundred ninety two married Iranian mustard exposed veterans, who had been exposed to single high dose mustard gas in Iraq-Iran war, were assessed for marital adjustment with Revised Dyadic Adjustment Scale (RDAS. Census sampling was done. The patients' quality of life (SF-36, spirometric measures and war related data were also extracted.Results: A total of 189 subjects (65% completed our study. The mean (±SD of the RDAS Total score, RDAS Dyadic Consensus , RDAS Affectional Expression, RDAS Dyadic Satisfaction , and RDAS Dyadic Cohesion were 50.61 (8.16, 16.67 (2.77, 7.62 (1.84, 14.76 (3.39, and 11.54 (3.79, respectively. RDAS Dyadic satisfaction was correlated with SF-36 and all its sub-scores (p<0.05. RDAS total score showed significant correlation with SF-36 total score and most of its sub-scores (p<0.05. RDAS affective expression was significantly correlated with role limitation, social function, general mental health, vitality, General health perceptions, physical composite score (PCS and mental composite score (MCS (p<0.05. RDAS dyadic consensus was not correlated with any SF-36 sub-scores.Conclusion: Veterans health team including physicians, psychologists and/or psychiatrists should know that poorer marital satisfaction is linked with lower quality of life scores, late after mustard exposure, although marital relationship is independent of spirometric findings, age, duration from exposure and comorbidity score.

Airflow Obstruction and Use of Solid Fuels for Cooking or Heating: BOLD Results.

Science.gov (United States)

Amaral, André F S; Patel, Jaymini; Kato, Bernet S; Obaseki, Daniel O; Lawin, Hervé; Tan, Wan C; Juvekar, Sanjay K; Harrabi, Imed; Studnicka, Michael; Wouters, Emiel F M; Loh, Li-Cher; Bateman, Eric D; Mortimer, Kevin; Buist, A Sonia; Burney, Peter G J

2017-09-12

Evidence supporting the association of COPD or airflow obstruction with use of solid fuels is conflicting and inconsistent. To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. We analysed 18,554 adults from the BOLD study, who had provided acceptable post-bronchodilator spirometry measurements and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analysed. We carried out similar analyses for spirometric restriction, chronic cough and chronic phlegm. We found no association between airflow obstruction and use of solid fuels for cooking or heating (ORmen=1.20, 95%CI 0.94-1.53; ORwomen=0.88, 95%CI 0.67-1.15). This was true for low/middle and high income sites. Among never smokers there was also no evidence of an association of airflow obstruction with use of solid fuels (ORmen=1.00, 95%CI 0.57-1.76; ORwomen=1.00, 95%CI 0.76-1.32). Overall, we found no association of spirometric restriction, chronic cough or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never smokers and those who had been exposed for ≥20 years. Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.

Long-term mortality among adults with asthma

DEFF Research Database (Denmark)

Ali, Zarqa; Dirks, Christina Glattre; Ulrik, Charlotte Suppli

2013-01-01

from an out-patient clinic in 1974 to 1990, and followed up until the end of 2011. Subjects were classified as having allergic or non-allergic asthma on the basis of detailed history, spirometric tests, tests for IgE-mediated allergy (skin prick tests and RAST), and bronchial challenge tests...

Spirometry and volumetric capnography in lung function assessment of obese and normal-weight individuals without asthma.

Science.gov (United States)

Ferreira, Mariana S; Mendes, Roberto T; Marson, Fernando A L; Zambon, Mariana P; Antonio, Maria A R G M; Paschoal, Ilma A; Toro, Adyléia A D C; Severino, Silvana D; Ribeiro, Maria A G O; Ribeiro, José D

To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV 1 /FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p11 years (p<0.05). Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV 1 /FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The effect of flexible body armour on pulmonary function.

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Armstrong, Nicola C; Gay, Louise A

2016-05-01

The additional mass and fit of current military in-service body armour (ISBA) can reduce pulmonary function in a way that is characteristic of a restrictive respiratory impairment. This could ultimately impair exercise capacity and military performance. This study compared pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]) in UK ISBA (15.3 kg) and three flexible body armours (BAs) (FA1: 10 kg; FA2: 7.8 kg; FA3: 10 kg) in eight male soldiers. The design of the ballistic plates differed between the BAs to improve the flexibility. FVC and FEV1 were reduced by 4-6%, without reduction in FEV1/FVC for ISBA, FA2 and FA3, when compared to NoBA (p armour caused a mild restrictive ventilatory impairment. However, the design of the armour can be modified to reduce the degree of this impairment. This may lead to improvements in soldier performance during tasks that require body armour.

Prediction of therapeutic response in steroid-treated pulmonary sarcoidosis. Evaluation of clinical parameters, bronchoalveolar lavage, gallium-67 lung scanning, and serum angiotensin-converting enzyme levels

International Nuclear Information System (INIS)

Hollinger, W.M.; Staton, G.W. Jr.; Fajman, W.A.; Gilman, M.J.; Pine, J.R.; Check, I.J.

1985-01-01

To find a pretreatment predictor of steroid responsiveness in pulmonary sarcoidosis the authors studied 21 patients before and after steroid treatment by clinical evaluation, pulmonary function tests, bronchoalveolar lavage (BAL), gallium-67 lung scan, and serum angiotensin-converting enzyme (SACE) level. Although clinical score, forced vital capacity (FVC), BAL percent lymphocytes (% lymphs), quantitated gallium-67 lung uptake, and SACE levels all improved with therapy, only the pretreatment BAL % lymphs correlated with the improvement in FVC (r = 0.47, p less than 0.05). Pretreatment BAL % lymphs of greater than or equal to 35% predicted improvement in FVC of 10/11 patients, whereas among 10 patients with BAL % lymphs less than 35%, 5 patients improved and 5 deteriorated. Clinical score, pulmonary function parameters, quantitated gallium-67 lung uptake, and SACE level used alone, in combination with BAL % lymphs or in combination with each other, did not improve this predictive value. The authors conclude that steroid therapy improves a number of clinical and laboratory parameters in sarcoidosis, but only the pretreatment BAL % lymphs are useful in predicting therapeutic responsiveness

alpha-adrenergic Blockade Unmasks a Greater Compensatory Vasodilation in Hypoperfused Contracting Muscle

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Darren P. Casey

2012-07-01

Full Text Available We previously demonstrated that acute hypoperfusion in exercising human muscle causes an immediate increase in vascular resistance that is followed by a partial restoration (less than 100% recovery of flow. In the current study we examined the contribution of alpha-adrenergic vasoconstriction in the initial changes in vascular resistance at the onset of hypoperfusion as well as in the recovery of flow over time. Nine healthy male subjects (29 ± 2 performed rhythmic forearm exercise (20% of maximum during hypoperfusion evoked by intra-arterial balloon inflation. Each trial included; baseline, exercise prior to inflation, exercise with inflation, and exercise after deflation (3 min each. Forearm blood flow (FBF; ultrasound, local (brachial artery, and systemic arterial pressure (MAP; Finometer were measured. The trial was repeated during phentolamine infusion (alpha-adrenergic receptor blockade. Forearm vascular conductance (FVC; ml min-1 100 mmHg-1 and resistance (mmHg ml min-1 was calculated from BF (ml min-1 and local MAP (mmHg. Recovery of FBF and FVC (steady state inflation plus exercise value – nadir/ [steady state exercise (control value-nadir] with phentolamine was enhanced compared with the respective control (no drug trial (FBF = 97 ± 5% vs. 81 ± 6%, P < 0.05; FVC = 126 ± 9% vs. 91 ± 5%, P < 0.01. However, the absolute (0.05 ± 0.01 vs. 0.06 ± 0.01 mmHg ml min-1; P = 0.17 and relative (35 ± 5% vs. 31 ± 2%; P = 0.41 increase in vascular resistance at the onset of balloon inflation was not different between the alpha-adrenergic receptor inhibition and control (no drug trials. Therefore, our data indicate that alpha-adrenergic mediated vasoconstriction restricts compensatory vasodilation during forearm exercise with hypoperfusion, but is not responsible for the initial increase in vascular resistance at the onset of hypoperfusion.

Correlação dos achados tomográficos com parâmetros de função pulmonar na fibrose pulmonar idiopática em não fumantes Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

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Agnaldo José Lopes

2007-12-01

functional variables were measured by spirometry, forced oscillation technique (FOT, helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO. RESULTS: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations with the measurements of forced vital capacity (FVC, total lung capacity (TLC, DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF25-75%/FVC correlated positively with TID, reticular abnormality/honeycombing, and GGO. CONCLUSION: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans.

Effects of permafrost degradation on alpine grassland in a semi-arid basin on the Qinghai–Tibetan Plateau

International Nuclear Information System (INIS)

Yi Shuhua; Zhou Zhaoye; Ren Shilong; Xu Ming; Qin Yu; Chen Shengyun; Ye Baisheng

2011-01-01

Permafrost on the Qinghai–Tibetan Plateau (QTP) has degraded over the last few decades. Its ecological effects have attracted great concern. Previous studies focused mostly at plot scale, and hypothesized that degradation of permafrost would cause lowering of the water table and drying of shallow soil and then degradation of alpine grassland. However, none has been done to test the hypothesis at basin scale. In this study, for the first time, we investigated the relationships between land surface temperature (LST) and fractional vegetation cover (FVC) in different types of permafrost zone to infer the limiting condition (water or energy) of grassland growth on the source region of Shule River Basin, which is located in the north-eastern edge of the QTP. LST was obtained from MODIS Aqua products at 1 km resolution, while FVC was upscaled from quadrat (50 cm) to the same resolution as LST, using 30 m resolution NDVI data of the Chinese HJ satellite. FVC at quadrat scale was estimated by analyzing pictures taken with a multi-spectral camera. Results showed that (1) retrieval of FVC at quadrat scale using a multi-spectral camera was both more accurate and more efficient than conventional methods and (2) the limiting factor of vegetation growth transitioned from energy in the extreme stable permafrost zone to water in the seasonal frost zone. Our study suggested that alpine grassland would respond differently to permafrost degradation in different types of permafrost zone. Future studies should consider overall effects of permafrost degradation, and avoid the shortcomings of existing studies, which focus too much on the adverse effects.

[Effect of obesity on pulmonary function in asthmatic children of different age groups].

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Xu, Xiao-Wen; Huang, Ying; Wang, Jian; Zhang, Xue-Li; Liang, Fan-Mei; Luo, Rong

2017-05-01

To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests [forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests [maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (Page group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (Page group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (Page in children with asthma, and the effect is more obvious in those of preschool age.

Respiratory parameters in elite athletes – does sport have an influence?

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S. Mazic

2015-07-01

Full Text Available Introduction: Unlike large population studies about cardiovascular components and how they adapt to intensive physical activity, there is less research into the causes of enlargement of the respiratory system in athletes (e.g. vital capacity, maximum flow rates and pulmonary diffusion capacity. The purpose of this research was to study and compare pulmonary function in different types of sports and compare them with controls in order to find out which sports improve lung function the most. Materials and method: Pulmonary functional capacities, vital capacity (VC, forced vital capacity (FVC, forced expiratory volume in one second (FEV1 and maximum voluntary ventilation (MVV of 493 top athletes belonging to 15 different sports disciplines and of 16 sedentary individuals were studied. Pulmonary function test was performed according to ATS/ERS guidelines. Results: Basketball, water polo players and rowers had statistically higher vital capacity (VC, forced vital capacity (FVC, forced expiratory volume in one second (FEV1 than the healthy sedentary control individuals. Football and volleyball players had lower VC while FVC was higher in the football group compared to controls. Peak expiratory flow was lower in boxing, kayak, rugby, handball, taekwondo and tennis. The maximum voluntary ventilation (MVV was significantly higher in water polo players and rowers. Boxers had statistically lower MVV than the controls. Players of other sports did not differ from the control group. Conclusion: The study suggests that specific type of training used in basketball, water polo or rowing could have potential for improving pulmonary function and rehabilitation. Keywords: Lung volumes, Male athlete, VC, FEV1, FVC

Tamsulosin reduces nighttime urine production in benign prostatic hyperplasia patients with nocturnal polyuria: a prospective open-label long-term study using frequency-volume chart.

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Kojima, Yoshiyuki; Sasaki, Shoichi; Imura, Makoto; Kubota, Yasue; Hayashi, Yutaro; Kohri, Kenjiro

2012-01-01

The effects of tamsulosin treatment on changes in frequency-volume chart (FVC) data, especially nighttime urine production, over time were assessed, and the mechanisms underlying the improvement of nocturia in benign prostatic hyperplasia (BPH) patients with nocturnal polyuria (NP) are discussed. A total of 104 patients with lower urinary tract symptoms secondary to BPH were enrolled. After enrollment in the study, the patients were treated with tamsulosin (0.2 mg) once daily. Visits were scheduled every 4 weeks until week 12 (month 3) after study entry, and then every 12 weeks subsequently. All patients completed the International Prostate Symptom Score (IPSS), quality of life (QOL) index, and 3-day FVC, and underwent uroflowmetry at enrollment and on each visit. Eighty-two patients (mean age: 70.9 ± 7.1 years) were analyzed for 24 months after treatment. Patients were divided into two groups, NP and nonNP, based on FVC outcome. The IPSS, QOL index, and maximum flow rate improved during the 24-month period after treatment in both groups. Mean daytime urine volume significantly increased in the NP group, but no changes were detected in the nonNP group. Mean nighttime urine frequency significantly decreased in the NP group over a 24-month period, and was associated with a significant decrease in nighttime urine volume that was not found in the nonNP group. Maximum voided volume increased most months after treatment in both groups. The present long-term prospective study using FVC demonstrated that tamsulosin reduced nighttime urine production in BPH patients with NP. Copyright © 2011 Wiley Periodicals, Inc.

Identifying decreased diaphragmatic mobility and diaphragm thickening in interstitial lung disease: the utility of ultrasound imaging

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Santana, Pauliane Vieira; Prina, Elena; Albuquerque, André Luis Pereira; Carvalho, Carlos Roberto Ribeiro; Caruso, Pedro

2016-01-01

Objective: To investigate the applicability of ultrasound imaging of the diaphragm in interstitial lung disease (ILD). Methods: Using ultrasound, we compared ILD patients and healthy volunteers (controls) in terms of diaphragmatic mobility during quiet and deep breathing; diaphragm thickness at functional residual capacity (FRC) and at total lung capacity (TLC); and the thickening fraction (TF, proportional diaphragm thickening from FRC to TLC). We also evaluated correlations between diaphragmatic dysfunction and lung function variables. Results: Between the ILD patients (n = 40) and the controls (n = 16), mean diaphragmatic mobility was comparable during quiet breathing, although it was significantly lower in the patients during deep breathing (4.5 ± 1.7 cm vs. 7.6 ± 1.4 cm; p < 0.01). The patients showed greater diaphragm thickness at FRC (p = 0.05), although, due to lower diaphragm thickness at TLC, they also showed a lower TF (p < 0.01). The FVC as a percentage of the predicted value (FVC%) correlated with diaphragmatic mobility (r = 0.73; p < 0.01), and an FVC% cut-off value of < 60% presented high sensitivity (92%) and specificity (81%) for indentifying decreased diaphragmatic mobility. Conclusions: Using ultrasound, we were able to show that diaphragmatic mobility and the TF were lower in ILD patients than in healthy controls, despite the greater diaphragm thickness at FRC in the former. Diaphragmatic mobility correlated with ILD functional severity, and an FVC% cut-off value of < 60% was found to be highly accurate for indentifying diaphragmatic dysfunction on ultrasound. PMID:27167428

Beverage specific alcohol intake in a population-based study: Evidence for a positive association between pulmonary function and wine intake

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McCann Susan E

2002-05-01

Full Text Available Abstract Background Lung function is a strong predictor of cardiovascular and all-cause mortality. Previous studies suggest that alcohol exposure may be linked to impaired pulmonary function through oxidant-antioxidant mechanisms. Alcohol may be an important source of oxidants; however, wine contains several antioxidants. In this study we analyzed the relation of beverage specific alcohol intake with forced expiratory volume in one second (FEV1 and forced vital capacity (FVC in a random sample of 1555 residents of Western New York, USA. Methods We expressed pulmonary function as percent of predicted normal FEV1 (FEV1% and FVC (FVC% after adjustment for height, age, gender and race. To obtain information on alcohol intake we used a questionnaire that reliably queries total alcohol and beverage specific recent (past 30 days and lifetime alcohol consumption. Results: Using multiple linear regression analysis after adjustment for covariates (pack-years of smoking, weight, smoking status, education, nutritional factors and for FEV1%, in addition, eosinophil count, we observed no significant correlation between total alcohol intake and lung function. However, we found positive associations of recent and lifetime wine intake with FEV1% and FVC%. When we analyzed white and red wine intake separately, the association of lung function with red wine was weaker than for white wine. Conclusion While total alcohol intake was not related to lung function, wine intake showed a positive association with lung function. Although we cannot exclude residual confounding by healthier lifestyle in wine drinkers, differential effects of alcoholic beverages on lung health may exist.

Occupation and three-year incidence of respiratory symptoms and lung function decline: the ARIC Study

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Mirabelli Maria C

2012-03-01

Full Text Available Abstract Background Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. Methods We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1 and forced vital capacity (FVC measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. Results During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 1/FVC 1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57 and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08. Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the

Spirometry quality in adults with very severe lung function impairment.

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Torre-Bouscoulet, Luis; Velázquez-Uncal, Mónica; García-Torrentera, Rogelio; Gochicoa-Rangel, Laura; Fernández-Plata, Rosario; Enright, Paul; Pérez-Padilla, Rogelio

2015-05-01

Some technologists worry that patients with very severe lung disease are unable to complete several spirometry maneuvers, which require considerable effort. We retrospectively selected all spirometry tests with an FEV1 30,000 subjects tested during the 3-y period) had adequate quality spirometry. Subjects with airway obstruction were less likely to meet FVC repeatability goals. A poor spirometry quality grade was associated with a very low FVC and a low body mass index, but not older age. Severe lung disease should not be used as an excuse for not meeting spirometry quality goals. Copyright © 2015 by Daedalus Enterprises.

[Impairment of muscle vasodilation during mental stress in women with subclinical hypothyroidism].

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Ghetti, Fabiana de Faria; Lacerda, Rafaela Pinheiro; Wernek, Francisco Zacaron; Coelho, Emerson Filipino; Vaisman, Mário; Lima, Jorge Roberto Perrout de; Martinez, Daniel Godoy; Laterza, Mateus Camaroti

2014-10-01

To test the hypothesis that women with subclinical hypothyroidism (SH) have forearm vascular conductance (FVC) impaired during mental stress. We evaluated 20 women with SH and 21 euthyroid (Control group), matched for age (p = 0.699) and body mass index (p = 0.462). Muscle blood flow (MBF) was assessed by venous occlusion plethysmography and blood pressure by Dixtal2023. Both variables were recorded simultaneously for 3 minutes of baseline followed by 3 minutes of mental stress. The FVC was calculated by dividing MBF by mean arterial pressure. Significant differences were assumed at p muscle vasodilatatory response during mental stress.

The effect of cisatracurium and rocuronium on lung function in anesthetized children.

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Yang, Charles I; Fine, Gavin F; Jooste, Edmund H; Mutich, Rebecca; Walczak, Stephen A; Motoyama, Etsuro K

2013-12-01

Neuromuscular blocking drugs have been implicated in intraoperative bronchoconstrictive episodes. We examined the effects of clinically relevant doses of cisatracurium and rocuronium on the lung mechanics of pediatric subjects. We hypothesized that cisatracurium and rocuronium would have bronchoconstrictive effects. We studied ASA physical status I and II pediatric subjects having elective dental or urological procedures, requiring general anesthesia with endotracheal intubations with either cisatracurium or rocuronium. Pulmonary function tests were performed before and after neuromuscular blocking drug dosing and again after albuterol administration. Using forced deflation and passive deflation techniques, forced vital capacity (FVC) and maximum expiratory flow rate at 10% (MEF10) of FVC were obtained. Fractional changes from the baseline were used to compare subjects. Changes in MEF10 of >30% were considered clinically significant. A Shapiro-Wilk test, paired t test, and Wilcoxon rank sum test were used to analyze the data. Twenty-five subjects (median age = 5.25 years; range = 9 months-9.9 years) were studied; 12 subjects received cisatracurium and 13 subjects received rocuronium. Data are shown as mean proportional change ± SD or, in the case of not normally distributed, median proportional change (first, third quartile) with P values. In the cisatracurium group, there were no differences between baseline and postneuromuscular blocker administration in the fractional change from the baselines of FVC (1.00 ± 0.04, P = 0.5), but there was a significant decrease in MEF10 (0.80 ± 0.18, P = 0.002). In the rocuronium group, there were small yet significant decreases of FVC (0.99 [first quartile 0.97, third quartile 1], P = 0.02) and significant decreases in MEF10 (0.78 ± 0.26, P = 0.008). After administration of albuterol in the cisatracurium group, FVC increased slightly but significantly from baseline values (1.02 ± 0.02, P = 0.005). MEF10 increased

Analisis Faktor Risiko kadar debu Organik di udara terhadap Gangguan fungsi Paru pada Pekerja Industri Penggilingan Padi di Demak

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F. S. Nugraheni S.

2015-12-01

Full Text Available ABSTRACT Background: Industry will not only increase the prosperity of society, but also could bring on an effect of pollution, included rice mill industry at Demak Regency. The effect is air pollution, in which it would take along a disturbance on lung’s function of, especially, workers of the industry. The aim of this research is to find out risk factor of dust’s amount on air at working area to lung’s function of the workers inside, and also to measure the prevalence ratio of dust exposure’s effect to the disturbance of lung’s function on workers. Disturbance of lung’s function, on this research, is limited on lung function parameter, which are FVC, FEV1 and FEV1/FVC ratio and all are classified as dichotomy. Methods: This research is classified as survey analitic research with cross sectional approach. The population is workers on industry at Demak Regency. Research is carried on by measuring lung’s function parameter using Spirometer. The samples are 45 peoples of 3 (three rice mill industry. They are taken by Simple Random Sampling method of 85 existing workers. Results: The result shows that 34 of 45 respondents are working indoor with the amount of dust is bigger than Limiting Value. From the Statistical Test, we get that the incidence of disturbance of lung’s function on workers is influenced by the amount of dust on air at working area (p value = 0,002, and also strengthened by working duration (p value = 0,000, smoking habit (p value = 0,001, and the existence of history of lung disease (p value = 0,001. The prevalence ratios of each independent variables to the incidence of disturbance of lung’s function are : the amoung of organic dust on air (PR = 3,018, p value = 0.039, and also strengthened by the existence of history of lung disease (PR = 3.535, p value = 0.021, working duration (PR = 4.130, p value = 0.024. Meanwhile, the utilization of masker is proven not influencing in decreasing the incidence of

Spirometry as a motivational tool to improve smoking cessation rates: a systematic review of the literature.

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Wilt, Timothy J; Niewoehner, Dennis; Kane, Robert L; MacDonald, Roderick; Joseph, Anne M

2007-01-01

Obtaining spirometric testing and providing those results to individuals who smoke has been advocated as a motivational tool to improve smoking cessation. However, its effectiveness is not known. We conducted a systematic review to determine if this approach improves rates of smoking cessation. Data sources included MEDLINE (1966 to October 2005), the Cochrane Library, and experts in the field. Eligible randomized controlled trials (RCTs) enrolled at least 25 smokers per arm, evaluated spirometry with associated counseling or in combination with other treatments, followed subjects at least 6 months, and provided smoking abstinence rates. Results from nonrandomized studies also were summarized. The primary outcome was patient-reported long-term (at least 6 months) sustained abstinence with biological validation. Additional outcomes included self-reported abstinence and point-prevalence abstinence. Seven RCTs (N = 6,052 subjects) met eligibility criteria. Follow-up duration ranged from 9 to 36 months. In six trials, the intervention group received concomitant treatments previously demonstrated to increase cessation independently. The range of abstinence was 3%-14% for control subjects and 7%-39% among intervention groups, statistically significantly in favor of intervention in four studies. The only RCT that assessed the independent contribution of spirometry in combination with counseling demonstrated a nonsignificant 1% improvement in patient-reported point-prevalence abstinence at 12 months in the group that received spirometry plus counseling versus counseling alone (6.5% versus 5.5%). Findings from observational studies were mixed, and the lack of controls makes interpretation problematic. Available evidence is insufficient to determine whether obtaining spirometric values and providing that information to patients improves smoking cessation compared with other smoking cessation methods. Spirometric values are of limited benefit as a predictor of smoking

Developing a new ultrasonic method to assess diaphragm movement and comparing the accuracy with existing methods

DEFF Research Database (Denmark)

Helbo Skaarup, Søren; Løkke, Anders; Laursen, Christian

2017-01-01

Introduction: Diaphragm is the most important respiratory muscle. Movement can be evaluated with ultrasound. Currently two different methods are used, M-mode and B-mode. However, diaphragm movement is complex.Aim: We hypothesized that the two existing methods are imprecise as they only measure...... film clips independently to assess inter-rater variability.Results: We found a linear correlation between FVC and diaphragmatic movement. M-mode had Pearson r=0.84 (95%CI 0.76-0.89), B-mode had r=0.68 (95%CI 0.55-0.79) and Area-measurement had r=0.84 (95%CI 0.77-0.90). Inter-rater agreement was r=0...

AIR POLLUTION AND LUNG CAPACITY OF PEOPLE LIVING AROUND THE CEMENT INDUSTRY, INDONESIA

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Erwin Azizi Jayadipraja

2016-05-01

Full Text Available Backgrounds: A cement industry is one of anthropogenic sources of air pollution. In polluting the air, the industry creates some dust particles, nitrogen oxide (NO2, sulfur oxide (SO2, and carbon monoxide (CO. Research Purpose: The research aimed at finding out the ambient air quality around a cement industry and relating it with the lung capacity of people living around the area. Methodology: This was a cross sectional studies by measuring the ambient air quality in the morning, noon, and evening in four different settlements within 3 km from the cement industry. The measurement is then correlated with the FEV1 and FVC of lung capacity of people living around the area. Result: Of all four locations, three have ambient air quality (PM2.5 = 109.47 µg/Nm3, TSP = 454.7 µg/Nm3 that surpass the quality standard (PM2.5 = 65 µg/Nm3, TSP = 230 µg/Nm3. Of 241 respondents, the average level of FVC and FEV1 is respectively 1.9352 liter (SD: 0.45578 and 1.7486 liter (SD: 0.43874. Furthermore, the level of PM2.5 in the morning and at noon is respectively p=0.009 and p=0.003; the level of TSP in the morning and at noon is respectively p=0.003 and p=0.01; the level of NO2 in the morning is p=0.006; the level of SO2 in the morning, at noon and in the evening is respectively p=0.000, p=0.022, and p=0.000; and the level of CO in the morning, at noon and in the evening is respectively p=0.003, p=0.015, and p=0.024. Those levels are associated with the level of respondents’ FEV1. Moreover, the level of TSP in the morning is p=0.024; the level of SO2 in the morning and in the evening is p=0.007. These levels relate to the level of respondents’ FVC. Conclusion: The ambient air quality around a cement industry is affected by dispersion of industrial emission and of other sources which can cause some impairment to lung capacity.

Ozone exposure increases respiratory epithelial permeability in humans

International Nuclear Information System (INIS)

Kehrl, H.R.; Vincent, L.M.; Kowalsky, R.J.; Horstman, D.H.; O'Neil, J.J.; McCartney, W.H.; Bromberg, P.A.

1987-01-01

Ozone is a respiratory irritant that has been shown to cause an increase in the permeability of the respiratory epithelium in animals. We used inhaled aerosolized /sup 99m/Tc-labeled diethylene triamine pentacetic acid (/sup 99m/Tc-DTPA) to investigate whether human respiratory epithelial permeability is similarly affected by exposure to ozone. In a randomized, crossover double-blinded study, 8 healthy, nonsmoking young men were exposed for 2 h to purified air and 0.4 ppm ozone while performing intermittent high intensity treadmill exercise (minute ventilation = 66.8 L/min). SRaw and FVC were measured before and at the end of exposures. Seventy-five minutes after the exposures, the pulmonary clearance of /sup 99m/Tc-DTPA was measured by sequential posterior lung imaging with a computer-assisted gamma camera. Ozone exposure caused respiratory symptoms in all 8 subjects and was associated with a 14 +/- 2.8% (mean +/- SEM) decrement in FVC (p less than 0.001) and a 71 +/- 22% increase in SRaw (p = 0.04). Compared with the air exposure day, 7 of the 8 subjects showed increased /sup 99m/Tc-DTPA clearance after the ozone exposure, with the mean value increasing from 0.59 +/- 0.08 to 1.75 +/- 0.43%/min (p = 0.03). These data show that ozone exposure sufficient to produce decrements in the pulmonary function of human subjects also causes an increase in /sup 99m/Tc-DTPA clearance

Time course of lung function changes in atypical pneumonia.

Science.gov (United States)

Benusiglio, L N; Stalder, H; Junod, A F

1980-01-01

We measured pulmonary function in each of 21 patients suffering from "atypical", non-bacterial pneumonia during the acute illness and during convalescence (two to 18 months) to study the course and the nature of functional impairment at different stages of the disease. In six patients, no aetiological agent was found. An aetiological agent was identified in 15 of the patients: Mycoplasma pneumoniae (seven patients), influenza A (three patients), parainfluenza 3 (one patient), varicella (two patients), Q fever (one patient), coxsackie B3 (one patient). At the time of admission we observed a restrictive pattern in 52%, an obstructive pattern (decreased FEV1/FVC ratio) in 52% abnormalities in distribution of ventilation (abnormal slope of phase 3) in 63%, and abnormalities in gas exchange (increased AaDO2) in 75% of the patients. The frequency of abnormalities in these pulmonary function tests decreased dramatically after two to four weeks and nearly disappeared in most patients during convalescence. The only major residual abnormality was a decreased FEV1/FVC ratio in five subjects, four of whom were smokers. However, when MMEF and V75 were measured at this stage, their average value for all the groups of patients with the exclusion of the Mycoplasma pneumoniae group, was markedly reduced. These data suggest that small airways involvement can be demonstrated during the convalescence of patients recovering from various types of atypical pneumonia other than those caused by Mycoplasma pneumoniae. PMID:7444825

Prevalence and Determinants of Chronic Obstructive Pulmonary Disease (COPD) in Bangladesh.

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Alam, Dewan S; Chowdhury, Muhammad Ah; Siddiquee, Ali T; Ahmed, Shyfuddin; Clemens, John D

2015-01-01

There is a paucity of population-based data on COPD prevalence and its determinants in Bangladesh. To measure COPD prevalence and socioeconomic and lifestyle determinants among ≥40 years Bangladeshi adults. In a cross-sectional study, we measured lung function of 3744 randomly selected adults ≥40 years from rural and urban areas in Bangladesh, using a handheld spirometer. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as post-bronchodilator ratio of Forced Expiratory Volume in 1st second (FEV1) to Forced Vital Capacity (FVC) COPD was also assessed by the lower limit of normal (LLN) threshold defined as lower fifth percentile for the predicted FEV1/FVC. The prevalence of COPD was 13.5% by GOLD criteria and 10.3% by LLN criteria. Prevalence of COPD was higher among rural than urban residents and in males than females. More than half of the COPD cases were stage II COPD by both criteria. Milder cases (Stages I and II) were over estimated by the GOLD fixed criteria, but more severe cases (Stages III and IV) were similarly classified. In multiple logistic regression analysis, older age, male sex, illiteracy, underweight, history of smoking (both current and former), history of asthma and solid fuel use were significant predictors of COPD. COPD is a highly prevalent and grossly underdiagnosed public health problem in Bangladeshi adults aged 40 years or older. Illiteracy, smoking and biomass fuel burning are modifiable determinants of COPD.

Variable versus conventional lung protective mechanical ventilation during open abdominal surgery (PROVAR): a randomised controlled trial.

Science.gov (United States)

Spieth, P M; Güldner, A; Uhlig, C; Bluth, T; Kiss, T; Conrad, C; Bischlager, K; Braune, A; Huhle, R; Insorsi, A; Tarantino, F; Ball, L; Schultz, M J; Abolmaali, N; Koch, T; Pelosi, P; Gama de Abreu, M

2018-03-01

Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively. In CVV, tidal volumes varied randomly, following a normal distribution, on a breath-by-breath basis. The primary endpoint was the forced vital capacity (FVC) on postoperative Day 1. Secondary endpoints were oxygenation, non-aerated lung volume, distribution of ventilation, and pulmonary and extrapulmonary complications until postoperative Day 5. FVC did not differ significantly between CVV and CNV on postoperative Day 1, 61.5 (standard deviation 22.1) % vs 61.9 (23.6) %, respectively; mean [95% confidence interval (CI)] difference, -0.4 (-13.2-14.0), P=0.95. Intraoperatively, CVV did not result in improved respiratory function, haemodynamics, or redistribution of ventilation compared to CNV. Postoperatively, FVC, forced expiratory volume at the first second (FEV 1 ), and FEV 1 /FVC deteriorated, while atelectasis volume and plasma levels of interleukin-6 and interleukin-8 increased, but values did not differ between groups. The incidence of postoperative pulmonary and extrapulmonary complications was comparable in CVV and CNV. In patients undergoing open abdominal surgery, CVV did not improve intraoperative and postoperative respiratory function compared with CNV. NCT 01683578. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Pulmonary impairment after tuberculosis in a South African population

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Gibwa Cole

2016-06-01

Full Text Available Background: In South Africa, pulmonary tuberculosis (PTB remains a problem of epidemic proportions. Despite evidence demonstrating persistent lung impairment after PTB cure, few population-based South African studies have investigated this finding. Pulmonary rehabilitation post-cure is not routinely received. Objectives: To determine the effects of PTB on lung function in adults with current or past PTB. To determine any association between PTB and chronic obstructive pulmonary disease (COPD. Methods: This study was observational and cross-sectional in design. Participants (n = 55 were included if they were HIV positive on treatment, had current PTB and were on treatment, and/or had previous PTB and completed treatment or if they were healthy adult subjects with no history of PTB. A sample of convenience was used with participants coming from a similar socio-economic background and undergoing spirometry testing. Multiple regression analyses were conducted on each lung function variable. Results: Compared to normal percentage-predicted values, forced expiratory volume in 1 second (FEV1 , forced vital capacity (FVC and FEV1 :FVC were significantly reduced in those with current PTB by 23.39%, 15.99% and 6.4%, respectively. Both FEV1 and FVC were significantly reduced in those with past PTB by 11.76% and 10.79%, respectively. There was no association between PTB and COPD – those with previous PTB having a reduced FEV1 :FVC (4.88% less than the norm, which was just short of significance (p = 0.059. Conclusions: Lung function is reduced both during and after treatment for PTB and these deficits may persist. This has implications regarding the need for pulmonary rehabilitation even after medical cure. Keywords: Lung function, pulmonary, tuberculosis

Pulmonary function changes in long-term survivors of bone marrow transplantation

International Nuclear Information System (INIS)

Gore, Elizabeth M.; Lawton, Colleen A.; Ash, Robert C.; Lipchik, Randolph J.

1996-01-01

Purpose: This study was undertaken to evaluate long-term pulmonary function changes in patients undergoing bone marrow transplantation (BMT), to assess their clinical significance, and to identify factors influencing these changes. Methods and Materials: Pulmonary function tests (PFT) were evaluated before and after BMT in 111 adult patients undergoing BMT between 1985 and 1991. Forced expiratory volume at 1 s (FEV 1 ), forced vital capacity (FVC), diffusing capacity (DLCO), and total lung capacity (TLC) were evaluated. One hundred and three patients (92.8%) received total body irradiation (TBI) to a total dose of 14 Gy in nine equal fractions. The lung dose was restricted to 1 , FVC, and TLC were lower than pre transplant values (p 1 did not fall significantly in patients without acute or chronic GVHD and recovered earlier than in patients without post transplant pulmonary infection. Recovery of FVC, TLC, and DLCO was also delayed in patients with acute and chronic GVHD and post transplant pulmonary infection. Multiple regression analysis revealed an association between a higher radiation dose to the lungs, and decreased FVC at 2 years (p = 0.01). Progressive obstructive pulmonary disease was not observed. Conclusions: An initial decline in PFTs with subsequent recovery was observed. Factors associated with delayed recovery and incomplete recovery of PFTs were GVHD, post transplant pulmonary infection, and higher radiation dose to the lungs. The conditioning regimen used at Medical College of Wisconsin, including relatively high TBI doses with partial transmission pulmonary shielding, appears to be well tolerated by the lungs in long-term survivors. No progressive decline in PFTs or symptomatic decline in pulmonary function was observed during the time interval studied

Airway wall thickness of allergic asthma caused by weed pollen or house dust mite assessed by computed tomography.

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Liu, Liping; Li, Guangrun; Sun, Yuemei; Li, Jian; Tang, Ningbo; Dong, Liang

2015-03-01

Little was known about Airway wall thickness of asthma patients with different allergen allergy. So we explored the possible difference of Airway wall thickness of asthma patients mono-sensitized to weed pollen or HDM using high-resolution computed tomography. 85 severe asthma patients were divided into weed pollen group and HDM group according to relevant allergen. 20 healthy donors served as controls. Airway wall area, percentage wall area and luminal area at the trunk of the apical bronchus of the right upper lobe were quantified using HRCT and compared. The values of pulmonary function were assessed as well. There were differences between HDM group and weed pollen group in WA/BSA,WA% and FEF25-75% pred, and no significant difference in FEV1%pred, FEV1/FVC and LA/BSA. In weed pollen group, WA/BSA was observed to correlate with the duration of rhinitis, whereas in HDM group, WA/BSA and LA/BSA was observed to correlate with the duration of asthma. In weed pollen group, FEV1/FVC showed a weak but significant negative correlation with WA%, but in HDM group FEV1/FVC showed a significant positive correlation with WA% and a statistical negative correlation with LA/BSA. FEV1/FVC and FEF25-75% pred were higher and WA/BSA and LA/BSA were lower in healthy control group than asthma group. FEV1%pred and WA% was no significant difference between asthma patients and healthy subjects. There are differences between HDM mono-sensitized subjects and weed pollen mono-sensitized subjects, not only in airway wall thickness, but also small airway obstruction. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of the Use of Capnography during the Transport of Critically Ill Mechanically Ventilated Patients.

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1992-12-15

DISCUSSION: Gervais et a13 demonstrated that respiratory alkalosis developed when ICU patients were manually ventilated, without 7 spirometric...developed a respiratory acidosis. Use of the non-invasive monitor, the capnograph prevented this adverse effect and resulted in inIproved patient safety...ventilation, all patients developed respiratory acidoses. Capnography uniformly prevented the development of respiratory acidosis during transport. We

Pulmonary dysfunctions, oxidative stress and DNA damage in brick kiln workers.

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Kaushik, R; Khaliq, F; Subramaneyaan, M; Ahmed, R S

2012-11-01

Brick kilns in the suburban areas in developing countries pose a big threat to the environment and hence the health of their workers and people residing around them. The present study was planned to assess the lung functions, oxidative stress parameters and DNA damage in brick kiln workers. A total of 31 male subjects working in brick kiln, and 32 age, sex and socioeconomic status matched controls were included in the study. The lung volumes, capacities and flow rates, namely, forced expiratory volume in first second (FEV(1)), forced vital capacity (FVC), FEV(1)/FVC, expiratory reserve volume, inspiratory capacity (IC), maximal expiratory flow when 50% of FVC is remaining to be expired, maximum voluntary ventilation, peak expiratory flow rate and vital capacity were significantly decreased in the brick kiln workers. Increased oxidative stress as evidenced by increased malonedialdehyde levels and reduced glutathione content, glutathione S-transferase activity and ferric reducing ability of plasma were observed in the study group when compared with controls. Our results indicate a significant correlation between oxidative stress parameters and pulmonary dysfunction, which may be due to silica-induced oxidative stress and resulting lung damage.

Forced vital capacity and not central chemoreflex predicts maximal hyperoxic breath-hold duration in elite apneists.

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Bain, Anthony R; Barak, Otto F; Hoiland, Ryan L; Drvis, Ivan; Bailey, Damian M; Dujic, Zeljko; Mijacika, Tanja; Santoro, Antoinette; DeMasi, Daniel K; MacLeod, David B; Ainslie, Philip N

2017-08-01

The determining mechanisms of a maximal hyperoxic apnea duration in elite apneists have remained unexplored. We tested the hypothesis that maximal hyperoxic apnea duration in elite apneists is related to forced vital capacity (FVC) but not the central chemoreflex (for CO 2 ). Eleven elite apneists performed a maximal dry static-apnea with prior hyperoxic (100% oxygen) pre-breathing, and a central chemoreflex test via a hyperoxic re-breathing technique (hyperoxic-hypercapnic ventilatory response: HCVR); expressed as the increase in ventilation (pneumotachometry) per increase in arterial CO 2 tension (PaCO 2 ; radial artery). FVC was assessed using standard spirometry. Maximal apnea duration ranged from 807 to 1262s (mean=1034s). Average HCVR was 2.0±1.2Lmin -1 mmHg -1 PaCO 2 . The hyperoxic apnea duration was related to the FVC (r 2 =0.45, p0.05). These findings were interpreted to suggest that during a hyperoxic apnea, a larger initial lung volume prolongs the time before reaching intolerable discomfort associated with pending lung squeeze, while CO 2 sensitivity has little impact. Copyright © 2017 Elsevier B.V. All rights reserved.

Work-related symptoms and dose-response relationships for personal exposures and pulmonary function among woodworkers.

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Mandryk, J; Alwis, K U; Hocking, A D

1999-05-01

Four sawmills, a wood chipping mill, and five joineries in New South Wales, Australia, were studied for the effects of personal exposure to wood dust, endotoxins. (1-->3)-beta-D-glucans, Gram-negative bacteria, and fungi on lung function among woodworkers. Personal inhalable and respirable dust sampling was carried out. The lung function tests of workers were conducted before and after a workshift. The mean percentage cross-shift decrease in lung function was markedly high for woodworkers compared with the controls. Dose-response relationships among personal exposures and percentage cross-shift decrease in lung function and percentage predicted lung function were more pronounced among joinery workers compared with sawmill and chip mill workers. Woodworkers had markedly high prevalence of regular cough, phlegm, and chronic bronchitis compared with controls. Significant associations were found between percentage cross-shift decrease in FVC and regular phlegm and blocked nose among sawmill and chip mill workers. Both joinery workers and sawmill and chip mill workers showed significant relationships between percentage predicted lung function (FVC, FEV1, FEV1/FVC, FEF25-75%) and respiratory symptoms. Wood dust and biohazards associated with wood dust are potential health hazards and should be controlled.

The association between circulating adiponectin levels, lung function and adiposity in subjects from the general population; data from the Akershus Sleep Apnea Project

DEFF Research Database (Denmark)

Caspersen, Nina F; Røsjø, Helge; Flyvbjerg, Allan

2018-01-01

results. Accordingly, we hypothesized that ADPN would be associated with lung function in a population-based sample and tested how abdominal adiposity, metabolic syndrome, and systemic inflammation influenced this association. METHODS: We measured total ADPN in serum, forced vital capacity (FVC...... for smoking (beta 1.4, p = 0.042)), but this association was attenuated and no longer significant in multivariate analysis (standardized beta -0.06, p = 0.254)). CONCLUSION: In this population-based sample no association between ADPN and lung function was evident after adjustment for covariates related...

Quantitative prediction of respiratory tidal volume based on the external torso volume change: a potential volumetric surrogate

Energy Technology Data Exchange (ETDEWEB)

Li Guang; Arora, Naveen C; Xie Huchen; Ning, Holly; Citrin, Deborah; Kaushal, Aradhana; Zach, Leor; Camphausen, Kevin; Miller, Robert W [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (United States); Lu Wei; Low, Daniel [Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO 63110 (United States)], E-mail: ligeorge@mail.nih.gov

2009-04-07

An external respiratory surrogate that not only highly correlates with but also quantitatively predicts internal tidal volume should be useful in guiding four-dimensional computed tomography (4DCT), as well as 4D radiation therapy (4DRT). A volumetric surrogate should have advantages over external fiducial point(s) for monitoring respiration-induced motion of the torso, which deforms in synchronization with a patient-specific breathing pattern. This study establishes a linear relationship between the external torso volume change (TVC) and lung air volume change (AVC) by validating a proposed volume conservation hypothesis (TVC = AVC) throughout the respiratory cycle using 4DCT and spirometry. Fourteen patients' torso 4DCT images and corresponding spirometric tidal volumes were acquired to examine this hypothesis. The 4DCT images were acquired using dual surrogates in cine mode and amplitude-based binning in 12 respiratory stages, minimizing residual motion artifacts. Torso and lung volumes were calculated using threshold-based segmentation algorithms and volume changes were calculated relative to the full-exhalation stage. The TVC and AVC, as functions of respiratory stages, were compared, showing a high correlation (r = 0.992 {+-} 0.005, p < 0.0001) as well as a linear relationship (slope = 1.027 {+-} 0.061, R{sup 2} = 0.980) without phase shift. The AVC was also compared to the spirometric tidal volumes, showing a similar linearity (slope = 1.030 {+-} 0.092, R{sup 2} = 0.947). In contrast, the thoracic and abdominal heights measured from 4DCT showed relatively low correlation (0.28 {+-} 0.44 and 0.82 {+-} 0.30, respectively) and location-dependent phase shifts. This novel approach establishes the foundation for developing an external volumetric respiratory surrogate.

Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants

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Díaz-Sánchez David

2009-12-01

Full Text Available Abstract Introduction Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants. Methods A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI and a Mediterranean diet index (MDI were constructed. The impact of these indices on lung function and interleukin-8 (IL-8 and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope. Results FVI was inversely related to IL-8 levels in nasal lavage (p 1 (test for trend p 1 and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children. Conclusion Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.

Air stacking: effects on pulmonary function in patients with spinal muscular atrophy and in patients with congenital muscular dystrophy,

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Tanyse Bahia Carvalho Marques

2014-10-01

Full Text Available OBJECTIVE: Respiratory complications are the main causes of morbidity and mortality in patients with neuromuscular disease (NMD. The objectives of this study were to determine the effects that routine daily home air-stacking maneuvers have on pulmonary function in patients with spinal muscular atrophy (SMA and in patients with congenital muscular dystrophy (CMD, as well as to identify associations between spinal deformities and the effects of the maneuvers. METHODS: Eighteen NMD patients (ten with CMD and eight with SMA were submitted to routine daily air-stacking maneuvers at home with manual resuscitators for four to six months, undergoing pulmonary function tests before and after that period. The pulmonary function tests included measurements of FVC; PEF; maximum insufflation capacity (MIC; and assisted and unassisted peak cough flow (APCF and UPCF, respectively with insufflations. RESULTS: After the use of home air-stacking maneuvers, there were improvements in the APCF and UPCF. In the patients without scoliosis, there was also a significant increase in FVC. When comparing patients with and without scoliosis, the increases in APCF and UPCF were more pronounced in those without scoliosis. CONCLUSIONS: Routine daily air-stacking maneuvers with a manual resuscitator appear to increase UPCF and APCF in patients with NMD, especially in those without scoliosis.

Diffusing capacity for lung carbon monoxide (dlco) in chemical lung injuries due to the use of mustard gas in the poisoned soldiers of Iran-Iraq war 2006

International Nuclear Information System (INIS)

Rouhi, H.; Ganji, F.

2010-01-01

To assess the Mustard gas exposure effects on pulmonary system, particularly on diffusing capacity for lung carbon monoxide (DLCO) and simple spirometry. Sixty-five sulfur mustard- poisoned soldiers from Mostazafan and Janbazan organization were referred to our center in 2005. Complete history, physical examination, chest X ray, Echocardiography, Arterial blood gas, high - resolution computerized tomography, diffusion capacity for lung carbon monoxide and spirometry of these were performed and compared this result with normal value. The mean value of indices in studied injured subjects was: Spirometry: forced expiratory volume in one second (FEV1) = 70.4, Forced vital capacity (FVC) = 66.5, EFE 25-75=81.1, FEV1/FVC=101.9, Flow 25% = 28.7, Flow 50%= 72.9, Flow 75%= 100.1, Sample volume: Functional residual capacity of lungs (FRC) = 131.5, residual volume (RV) = 157.3, RV/TLC= 169.1, Total lung capacity (TLC) = 91.3, KCO= 131.6, TLCO= 116.3. No significant correlation was observed between TLCO values with HRCT, echocardiography, ABG and spirometry values (P>0.05). We recommend TLCO and RV/TLV tests to assess severity of Injuries as there is no a suitable criterion to measure the real consequences of mustard gas on affected combatants. and Biological markers are also needed to determine cause effect relations. (author)

Indoor Air Quality and Respiratory Health among Malay Preschool Children in Selangor

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Nur Azwani Mohd Nor Rawi

2015-01-01

Full Text Available Indoor air quality (IAQ has been the object of several studies due to its adverse health effects on children. Methods. A cross-sectional comparative study was carried out among Malay children in Balakong (2 studied preschools and Bangi (2 comparative preschools, Selangor, with the aims of determining IAQ and its association with respiratory health. 61 and 50 children aged 5-6 years were selected as studied and comparative groups. A questionnaire was used to obtain an exposure history and respiratory symptoms. Lung function test was carried out. IAQ parameters obtained include indoor concentration of particulate matter (PM, volatile organic compounds (VOCs, carbon monoxide (CO, carbon dioxide (CO2, temperature, air velocity (AV, and relative humidity. Results. There was a significant difference between IAQ in studied and comparative preschools for all parameters measured (P<0.001 except for CO2 and AV. Studied preschools had higher PM and CO concentration. FVC, FEV1, FVC% and FEV1% predicted values were significantly lower among studied group. Exposures to PM, VOCs, and CO were associated with wheezing. Conclusion. The finding concluded that exposures to poor IAQ might increase the risk of getting lung function abnormality and respiratory problems among study respondents.

Multicenter study of quantitative computed tomography analysis using a computer-aided three-dimensional system in patients with idiopathic pulmonary fibrosis.

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Iwasawa, Tae; Kanauchi, Tetsu; Hoshi, Toshiko; Ogura, Takashi; Baba, Tomohisa; Gotoh, Toshiyuki; Oba, Mari S

2016-01-01

To evaluate the feasibility of automated quantitative analysis with a three-dimensional (3D) computer-aided system (i.e., Gaussian histogram normalized correlation, GHNC) of computed tomography (CT) images from different scanners. Each institution's review board approved the research protocol. Informed patient consent was not required. The participants in this multicenter prospective study were 80 patients (65 men, 15 women) with idiopathic pulmonary fibrosis. Their mean age was 70.6 years. Computed tomography (CT) images were obtained by four different scanners set at different exposures. We measured the extent of fibrosis using GHNC, and used Pearson's correlation analysis, Bland-Altman plots, and kappa analysis to directly compare the GHNC results with manual scoring by radiologists. Multiple linear regression analysis was performed to determine the association between the CT data and forced vital capacity (FVC). For each scanner, the extent of fibrosis as determined by GHNC was significantly correlated with the radiologists' score. In multivariate analysis, the extent of fibrosis as determined by GHNC was significantly correlated with FVC (p < 0.001). There was no significant difference between the results obtained using different CT scanners. Gaussian histogram normalized correlation was feasible, irrespective of the type of CT scanner used.

Type 2 diabetes affects sleep quality by disrupting the respiratory function.

Science.gov (United States)

Colbay, Gulcan; Cetin, Mustafa; Colbay, Mehmet; Berker, Dilek; Guler, Serdar

2015-09-01

The effects of diabetes on the respiratory system were investigated with arterial blood gas, sleep quality index and respiratory functions tests. Fifty-three patients with type II diabetes and 41 healthy cases were included. Their biochemical data, demographic characteristics, anthropometric measurements and echocardiographic findings were collected from polyclinic records. Respiratory function tests were performed for all subjects and Pittsburgh Sleep Quality Index questionnaire was conducted. Aforementioned data were compared between these two groups. The age, body weight and body mass index were similar but oxygen pressure, oxygen saturation, forced vital capacity (FVC; %), and sleep quality were decreased in patients with diabetes. Sleep quality was correlated with the presence of diabetes and hypertension, duration of diabetes, fasting and postprandial blood glucose levels, homeostasis model of assessment-insulin resistance, Glycosylated hemoglobin levels, and FVC. Half of the diabetic patients exhibited respiratory failure during sleep. Especially diabetic patients with autonomic neuropathy, experienced a more severe and prolonged decrease in oxygen saturation. Blood gas, respiratory functions and sleep quality, which need to be evaluated as a whole, were affected in patients with diabetes. Assessment of sleep and its quality requires special attention in patients with diabetes. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Correlation of Lipopolysaccharide Endotoxin Level in Cotton Dust with the Increase of TNFα Level and the Decline of Lung Function in Cotton Spinning Factory Workers

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Fadilatus Sukma Ika Noviarmi

2014-08-01

Full Text Available Lipopolysaccharide (LPS endotoxin contained in cotton dust may cause airway inflammation and decline of lung function when inhaled, which eventually leads to respiratory symptoms. The objective of this research is to analyze the correlation of the exposure of LPS endotoxin in cotton dust with the increase of TNFα level and the decline of lung function after one day’s work. This study applies analytical observation method and prospective cohort approach. Main participants of this study were the workers of a cotton spinning factory located in Tulangan District, Sidoarjo Regency, East Java Province. Sixteen samples from cotton factory were taken as study group, and twenty three samples from village administrators were taken as control group. Data collection involves several techniques: spirometry, laboratory test, and interview. Results showed that concentration of personal dust has a significant relationship with the decline of FVC, %FVC, FEV1, and %FEV1, with Pearson correlation test showing p0.05. The research concludes that the level of LPS endotoxin was strongly related to the increase of blood serum TNFα and the decline of lung function. Development of more effective preventive measures such as stronger enforcement of worker’s health maintenance regulations and use of personal protective equipment is needed to ensure the best protection of cotton workers’ health.

Function of external respiration in patients after kidney transplantation under conditions of immunosuppressive therapy.

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O. V. Kuryata

2018-04-01

Full Text Available The aim of our study was to evaluate the changes in the parameters of the function of external respiration in patients after kidney transplantation due to chronic kidney disease and to assess the relationship between the level of cyclosporin A and tacrolimus in the blood with FVD indices. The study included 37 patients after kidney transplantation. The first group included 27 patients who received cyclosporine at an average dose of 225 [175-350] mg/day under the immunosuppressive therapy regimen, the second group included 10 patients who received tacrolimus at an average dose of 8.25 [5.0-9.0] mg/day. A significant difference (p˂0.05 between the indicators of the VCmax (78 [71-90]% and 76.5 [72-78]%, FVC (93 [85-99]% and 95 [91-98]%, PEF (82 [64-94]% and 80 [69-84]%, MEF25-75 (75 [66-112]% and 82.5 [67-90]% was found in patients of the first and second groups relative to the FVD of the comparison group: VCmax (102.5 [98-113]%, FVC (107.5 [105.5-124]%, PEF (99.5 [95-102.5]%, MEF25-75 (98.5 [97.5-101.5]%. In both groups, a statistically significant negative correlation between the indicators of the VCmax, FVC and the level of cyclosporin A (R=-0.69, p<0.0001 and R=-0.4, p<0.037 in the blood in the first group and FVC and tacrolimus (R=-0.72, p<0.018 in the second group was found. A moderate decrease in the VCmax values in patients after kidney transplantation requires monitoring of the function of external respiration and managing such patients by nephrologists together with specialists in the pulmonological profile.

Reference values of spirometry for Finnish adults.

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Kainu, A; Timonen, K L; Toikka, J; Qaiser, B; Pitkäniemi, J; Kotaniemi, J T; Lindqvist, A; Vanninen, E; Länsimies, E; Sovijärvi, A R A

2016-09-01

Diagnostic assessment of lung function necessitates up-to-date reference values. The aim of this study was to estimate reference values for spirometry for the Finnish population between 18 and 80 years and to compare them with the existing Finnish, European and the recently published global GLI2012 reference values. Spirometry was performed for 1380 adults in the population-based FinEsS studies and for 662 healthy non-smoking volunteer adults. Detailed predefined questionnaire screening of diseases and symptoms, and quality control of spirometry yielded a sample of 1000 native Finns (387 men) healthy non-smokers aged 18-83 years. Sex-specific reference values, which are estimated using the GAMLSS method and adjusted for age and height, are provided. The predicted values for lung volumes are larger than those obtained by GLI2012 prediction for the Caucasian subgroup for forced vital capacity (FVC) by an average 6·2% and 5·1% and forced expiratory volume in 1 s (FEV1) by an average 4·2% and 3·0% in men and women, respectively. GLI2012 slightly overestimated the ratio FEV1/FVC with an age-dependent trend. Most reference equations from other European countries, with the exception of the Swiss SAPALDIA study, showed an underestimation of FVC and FEV1 to varying degrees, and a slight overestimation of FEV1/FVC. This study offers up-to-date reference values of spirometry for native Finns with a wide age range. The GLI2012 predictions seem not to be suitable for clinical use for native Finns due to underestimation of lung volumes. © 2015 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Developmental and genetic components explain enhanced pulmonary volumes of female Peruvian Quechua.

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Kiyamu, Melisa; Bigham, Abigail; Parra, Esteban; León-Velarde, Fabiola; Rivera-Chira, María; Brutsaert, Tom D

2012-08-01

High altitude natives have enlarged vital capacities and residual volumes (RV). Because pulmonary volumes are an indication of functionally relevant traits, such as diffusion capacity, the understanding of the factors (genetic/developmental) that influence lung volumes provides insight into the adaptive responses of highlanders. In order to test for the effect of growth and development at high altitude on lung volumes, we obtained forced vital capacities (FVC), RV, and total lung capacities (TLC) for a sample of 65 Peruvian females of mostly Quechua origins (18-34 years) who were sub-divided into two well-matched groups: 1) sea-level born and raised females (BSL, n = 34) from Lima, Peru (150 m), and 2) high-altitude born and raised females (BHA, n = 31) from Cerro de Pasco, Peru (4,338 m). To determine Quechua origins, Native American ancestry proportion (NAAP) for each individual was assessed using a panel of 70 ancestry informative markers. NAAP was similar between groups (BSL = 91.71%; BHA = 89.93%; P = 0.240), and the analysis confirmed predominantly Quechua origins. After adjusting for body size and NAAP, BHA females had significantly higher FVC (3.79 ± 0.06 l; P < 0.001), RV (0.98 ± 0.03 l; P < 0.001) and TLC (4.80 ± 0.07 l; P < 0.001) compared to BSL females (FVC = 3.33 ± 0.05 l; RV = 0.69 ± 0.03 l; TLC = 4.02 ± 0.06 l). NAAP was not associated with FVC (P = 0.352) or TLC (P = 0.506). However, NAAP was positively associated with RV (P = 0.004). In summary, results indicate that developmental exposure to high altitude in females constitutes an important factor for all lung volumes, whereas both genetic and developmental factors seem to be important for RV. Copyright © 2012 Wiley Periodicals, Inc.

Pulmonary dysfunction in obese early adolescents

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Bambang Supriyatno

2010-08-01

Full Text Available Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree.Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT to assess FEV1/FVC, FEV1, FVC, V50, and V25.Results 110 subjects fulfilled study criteria, 83 (75.5% were male and 27 (24.5% were female with median BMI 26.7 (22.6-54.7 kg/m2; 92 subjects (83.6% were superobese. History of asthma and allergic rhinitis were found in 32 (29.1% and 46 (41.8% subjects, respectively. 64 (58.2% subjects had abnormal PFT results consisting of restrictive type in 28 (25.5% subjects, obstructive in 3 (2.7%, and combined type in 33 (30%. Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction.Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%, followed by restrictive (25.5%, and obstructive type (2.7%. There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84Key words: early adolescents, obesity, pulmonary function test

Respiratory muscle weakness and respiratory muscle training in severely disabled multiple sclerosis patients.

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Gosselink, R; Kovacs, L; Ketelaer, P; Carton, H; Decramer, M

2000-06-01

To evaluate the contribution of respiratory muscle weakness (part 1) and respiratory muscle training (part 2) to pulmonary function, cough efficacy, and functional status in patients with advanced multiple sclerosis (MS). Survey (part 1) and randomized controlled trial (part 2). Rehabilitation center for MS. Twenty-eight bedridden or wheelchair-bound MS patients (part 1); 18 patients were randomly assigned to a training group (n = 9) or a control group (n = 9) (part 2). The training group (part 2) performed three series of 15 contractions against an expiratory resistance (60% maximum expiratory pressure [PEmax]) two times a day, whereas the control group performed breathing exercises to enhance maximal inspirations. Forced vital capacity (FVC), inspiratory, and expiratory muscle strength (PImax and PEmax), neck flexion force (NFF), cough efficacy by means of the Pulmonary Index (PI), and functional status by means of the Extended Disability Status Scale (EDSS). Part 1 revealed a significantly reduced FVC (43% +/- 26% predicted), PEmax (18% +/- 8% predicted), and PImax (27% +/- 11% predicted), whereas NFF was only mildly reduced (93% +/- 26% predicted). The PI (median score, 10) and EDSS (median score, 8.5) were severely reduced. PEmax was significantly correlated to FVC, EDSS, and PI (r = .77, -.79, and -.47, respectively). In stepwise multiple regression analysis. PEmax was the only factor contributing to the explained variance in FVC (R2 = .60), whereas body weight (R2 = .41) was the only factor for the PI. In part 2, changes in PImax and PEmax tended to be higher in the training group (p = .06 and p = .07, respectively). The PI was significantly improved after 3 months of training compared with the control group (p functional status. Expiratory muscle training tended to enhance inspiratory and expiratory muscle strength. In addition, subjectively and objectively rated cough efficacy improved significantly and lasted for 3 months after training cessation.

Influence of stapling the intersegmental planes on lung volume and function after segmentectomy.

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Tao, Hiroyuki; Tanaka, Toshiki; Hayashi, Tatsuro; Yoshida, Kumiko; Furukawa, Masashi; Yoshiyama, Koichi; Okabe, Kazunori

2016-10-01

Dividing the intersegmental planes with a stapler during pulmonary segmentectomy leads to volume loss in the remnant segment. The aim of this study was to assess the influence of segment division methods on preserved lung volume and pulmonary function after segmentectomy. Using image analysis software on computed tomography (CT) images of 41 patients, the ratio of remnant segment and ipsilateral lung volume to their preoperative values (R-seg and R-ips) was calculated. The ratio of postoperative actual forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) per those predicted values based on three-dimensional volumetry (R-FEV1 and R-FVC) was also calculated. Differences in actual/predicted ratios of lung volume and pulmonary function for each of the division methods were analysed. We also investigated the correlations of the actual/predicted ratio of remnant lung volume with that of postoperative pulmonary function. The intersegmental planes were divided by either electrocautery or with a stapler in 22 patients and with a stapler alone in 19 patients. Mean values of R-seg and R-ips were 82.7 (37.9-140.2) and 104.9 (77.5-129.2)%, respectively. The mean values of R-FEV1 and R-FVC were 103.9 (83.7-135.1) and 103.4 (82.2-125.1)%, respectively. There were no correlations between the actual/predicted ratio of remnant lung volume and pulmonary function based on the division method. Both R-FEV1 and R-FVC were correlated not with R-seg, but with R-ips. Stapling does not lead to less preserved volume or function than electrocautery in the division of the intersegmental planes. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Estimating fractional vegetation cover and the vegetation index of bare soil and highly dense vegetation with a physically based method

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Song, Wanjuan; Mu, Xihan; Ruan, Gaiyan; Gao, Zhan; Li, Linyuan; Yan, Guangjian

2017-06-01

Normalized difference vegetation index (NDVI) of highly dense vegetation (NDVIv) and bare soil (NDVIs), identified as the key parameters for Fractional Vegetation Cover (FVC) estimation, are usually obtained with empirical statistical methods However, it is often difficult to obtain reasonable values of NDVIv and NDVIs at a coarse resolution (e.g., 1 km), or in arid, semiarid, and evergreen areas. The uncertainty of estimated NDVIs and NDVIv can cause substantial errors in FVC estimations when a simple linear mixture model is used. To address this problem, this paper proposes a physically based method. The leaf area index (LAI) and directional NDVI are introduced in a gap fraction model and a linear mixture model for FVC estimation to calculate NDVIv and NDVIs. The model incorporates the Moderate Resolution Imaging Spectroradiometer (MODIS) Bidirectional Reflectance Distribution Function (BRDF) model parameters product (MCD43B1) and LAI product, which are convenient to acquire. Two types of evaluation experiments are designed 1) with data simulated by a canopy radiative transfer model and 2) with satellite observations. The root-mean-square deviation (RMSD) for simulated data is less than 0.117, depending on the type of noise added on the data. In the real data experiment, the RMSD for cropland is 0.127, for grassland is 0.075, and for forest is 0.107. The experimental areas respectively lack fully vegetated and non-vegetated pixels at 1 km resolution. Consequently, a relatively large uncertainty is found while using the statistical methods and the RMSD ranges from 0.110 to 0.363 based on the real data. The proposed method is convenient to produce NDVIv and NDVIs maps for FVC estimation on regional and global scales.

Recent Marijuana Use and Associations With Exhaled Nitric Oxide and Pulmonary Function in Adults in the United States.

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Papatheodorou, Stefania I; Buettner, Hannah; Rice, Mary B; Mittleman, Murray A

2016-06-01

The medical and recreational use of marijuana is now legal in some parts of the United States; the health effects are unknown. We aimed to evaluate associations between recent marijuana use and exhaled nitric oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey in the years 2007 to 2012. We examined associations between marijuana use and eNO, FEV1, FVC, the FEV1/FVC ratio, and forced expiratory flow (midexpiratory phase) (FEF25%-75%) by weighted linear regression. In the study population, there were 4,797 never users, 4,084 past marijuana users, 555 participants who used marijuana 5 to 30 days before the examination, and 891 participants who used marijuana 0 to 4 days before the examination. Current marijuana use in the past 4 days was associated with 13% lower eNO (95% CI, -18% to 8%). FVC was higher in past users (75 mL; 95% CI, 38-112) and current users in the past 5 to 30 days (159 mL; 95% CI, 80-237) and in users within 0 to 4 days of the examination (204 mL; 95% CI, 139-270) compared with never users. All associations remained unchanged and statistically significant in sensitivity analyses excluding current and past tobacco users. Current marijuana use was associated with lower levels of eNO and higher FVC. The lower eNO in marijuana smokers suggests that short-term exposure to marijuana may, like tobacco, acutely affect the pulmonary vascular endothelium and impair airflow through the small airways. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Valor de la espirometría para el diagnostico de restricción pulmonar Accuracy of spirometry in the diagnosis of pulmonary restriction

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Silvia Quadrelli

2007-12-01

.0011 and RV/ TLC ratio (56.89 ± 12.82 vs. 38.43 ± 13.07%, p = <0.0001 were significantly higher. We conclude that a decreased FVC or VC cannot be considered evidence of ventilatory restriction in the presence of airflow obstruction on spirometry. Diagnosis of "mixed defects" by spirometry is inaccurate and should be avoided without the measurement of lung volumes.

Responsividade do teste do degrau de seis minutos a um programa de treinamento físico em pacientes com DPOC Responsiveness of the six-minute step test to a physical training program in patients with COPD

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Kamilla Tays Marrara

2012-10-01

Full Text Available OBJETIVO: Avaliar a responsividade do teste do degrau de seis minutos (TD6 a um programa de treinamento físico (PTF aeróbio e verificar a eficácia do PTF quanto às variáveis ergoespirométricas no TD6, assim como ao desempenho físico, sensação de dispneia e SpO2 no TD6 e no teste de caminhada de seis minutos (TC6 em pacientes com DPOC. MÉTODOS: Estudo controlado, prospectivo e randomizado com pacientes com diagnóstico clínico de DPOC que apresentassem relação VEF1/CVF OBJECTIVE: To evaluate the responsiveness of the six-minute step test (6MST to an aerobic physical training program (PTP and to determine the efficacy of the PTP regarding spirometric variables during the 6MST, as well as physical performance, sensation of dyspnea, and SpO2 during the 6MST and the six-minute walk test (6MWT, in patients with COPD. METHODS: This was a controlled, prospective randomized study involving patients clinically diagnosed with COPD, with an FEV1/FVC ratio < 70%, and having been clinically stable in the last two months. The patients were randomized to undergo a PTP on a treadmill, three times a week, for six weeks (PTP group or not (control group. Histories were taken from all of the patients, who received regular respiratory therapy during the study period, undergoing physical examination and spirometry before and after bronchodilator use; incremental symptom-limited cardiopulmonary exercise testing; the 6MST; and the 6MWT. RESULTS: Of the 36 patients that completed the study, 21 and 15 were in the PTP and control groups, respectively. In the PTP group, there was a significant increase in the number of steps climbed during the 6MST and in the six-minute walk distance (in m and % of predicted, as well as a significant decrease in the sensation of dyspnea during the 6MWT. CONCLUSIONS: The 6MST showed responsiveness to the PTP. However, the 6MWT appears to be more responsive to the PTP proposed.

Long acting β2 agonists for stable chronic obstructive pulmonary disease with poor reversibility: a systematic review of randomised controlled trials

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Mensinkai Shaila

2004-08-01

Full Text Available Abstract Background The long acting β2-agonists, salmeterol and formoterol, have been recommended, by some, as first line treatment of stable chronic obstructive pulmonary disease (COPD. We reviewed evidence of efficacy and safety when compared with placebo or anticholinergic agents in patients with poorly reversible COPD. Methods After searching MEDLINE, EMBASE, HealthSTAR, BIOSIS Previews, PASCAL, ToxFile, SciSearch, the Cochrane Library, and PubMed, as well as Web sites, selected journals, reference lists, and contacting drug manufacturers, two reviewers independently screened reports of randomised controlled trials of parallel or crossover design lasting four weeks or longer and including patients with a forced expiratory volume in one second (FEV1 ≤ 75% of predicted, a ratio of FEV1 to forced vital capacity (FVC ≤ 88% of predicted, and Results Twelve trials satisfied our inclusion criteria; eight were high quality (Jadad score >2 and four were low quality (≤ 2. The adequacy of allocation concealment was unclear in all of them. We did not perform a meta-analysis due to differences in trial design and how outcomes were reported. Two trials comparing salmeterol with ipratropium did not detect differences; one trial comparing formoterol and ipratropium described greater improvement with formoterol in morning PEFR (15.3 versus 7.1 l/min, p = 0.040. Of twelve trials comparing long acting β2 agonists with placebo, six reported no improvement in exercise capacity, eleven reported improvements in FEV1 lung function (one reported no improvement, six reported less rescue inhaler usage (one reported no difference and five reported improved dyspnea scores (two reported no improvement. Differences in quality of life were detected in one salmeterol trial ; however, two salmeterol, and one formoterol trial reported no differences. Adverse effects of interest were not reported. Conclusion In terms of clinical outcomes and safety, we could not find

Forced deflation pulmonary function test: a novel method to evaluate lung function in infants and young children.

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Goyal, Rakesh K; Ibrahimova, Azada; Escolar, Maria L; Szabolcs, Paul; Vander Lugt, Mark T.; Windreich, Randy M; Weiner, Daniel J

2017-04-01

We describe the safety and feasibility of a forced deflation pulmonary function test (dPFT) in infants and young children. Fifty-two dPFT studies were performed in 26 patients (median age, 1.4 years). Forced vital capacity (FVC) and forced expiratory flow (FEF 75 ) were normal in all except one case, but respiratory system compliance (Crs) was reduced in 24% patients. There were no significant differences in pre-blood and marrow transplantation FVC, FEF 75 , and Crs between those patients who did and those who did not have posttransplant pulmonary complications. A larger study is needed to determine the prevalence and significance of PFT abnormalities in this age group. © 2016 Wiley Periodicals, Inc.

The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease

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Lee Todd A

2011-02-01

Full Text Available Abstract Background Administrative data is often used to identify patients with chronic obstructive pulmonary disease (COPD, yet the validity of this approach is unclear. We sought to develop a predictive model utilizing administrative data to accurately identify patients with COPD. Methods Sequential logistic regression models were constructed using 9573 patients with postbronchodilator spirometry at two Veterans Affairs medical centers (2003-2007. COPD was defined as: 1 FEV1/FVC Results 4564 of 9573 patients (47.7% had an FEV1/FVC Conclusion Commonly used definitions of COPD in observational studies misclassify the majority of patients as having COPD. Using multiple diagnostic codes in combination with pharmacy data improves the ability to accurately identify patients with COPD.

Patterns of respiratory illness in Sheffield infant school children

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Lunn, J E; Knowelden, J; Handyside, A J

1967-01-01

Children were selected for exposure to air pollution within the divergent city of Sheffield. Mean age of children was approx. 5 yr, 4.5 months with range of about 1 yr. Examination included respiratory history, mucopurulent discharge, tonsils, eardrums, FEV/sub 0/ /sub 75/, and FVC. Nasal discharge, history of 3 or more per year, history of colds going to chest, and history of lower respiratory tract illness showed significant variations between lightly and heavily polluted areas. History of frequent cough showed social class correlation. Steadily decreasing FEV with increasing pollution was observed. FVC was lowest in area with highest pollution, but similarly high in other areas. Both parameters were influenced by previous history of respiratory tract disease.

The Effectiveness of Practicing Pranayama Yoga on Some Respiratory Indicators in Patients Suffering from Bronchial Disease

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Khue Ai Thi HOANG

2015-06-01

Full Text Available Bronchial asthma is considered as a large burden of disease cross the world wasting billions of dollars each year. Using drug for treatment is not only expensive but also causes many adverse health affect. The study aim s to assess the effects of pranayama yoga practice on lung functions in patients with bronchial diseases. This is a controlled trial study. After three months of yoga practice, breath indicators such as FVC, FEV 1, FEV1/FVC, PEFR of intervention group sign ificantly improved with p value < .01 to .001 in comparison wi th the previous three months of the control group. Practicing pranayama yoga is beneficial to patients with bronchial asthma.

Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study

DEFF Research Database (Denmark)

Garcia-Aymerich, J; Lange, Peter; Benet, M

2007-01-01

RATIONALE: We have previously reported that regular physical activity reduces risk of chronic obstructive pulmonary disease (COPD) exacerbation. We hypothesized that higher levels of regular physical activity could reduce the risk of COPD by modifying smoking-related lung function decline....... OBJECTIVE: To estimate the longitudinal association between regular physical activity and FEV(1) and FVC decline and COPD risk. METHODS: A population-based sample (n = 6,790) was recruited and assessed with respect to physical activity, smoking, lung function, and other covariates, in Copenhagen in 1981....../yr of FEV(1), P-for-trend = 0.006, and +2.6 and +7.7 ml/yr of FVC, P-for-trend function decline. Active smokers with moderate to high physical activity had...

Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

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Rodriguez-Roisin R

2016-08-01

Full Text Available Roberto Rodriguez-Roisin,1 Kay Tetzlaff,2,3 Henrik Watz,4 Emiel FM Wouters,5 Bernd Disse,2 Helen Finnigan,6 Helgo Magnussen,4 Peter MA Calverley7 1Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Barcelona, Spain; 2Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 3Department of Sports Medicine, University of Tübingen, Tübingen, Germany; 4Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; 5Department of Respiratory Medicine, University Hospital Maastricht, Maastricht University, Maastricht, the Netherlands; 6Department of Biostatistics and Data Sciences, Boehringer Ingelheim, Bracknell, UK; 7Institute of Ageing and Chronic Disease, Aintree University Hospital, Liverpool, UK Abstract: The WISDOM study (NCT00975195 reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume

Bronchodilator response of advanced lung function parameters depending on COPD severity

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Jarenbäck L

2016-11-01

Full Text Available Linnea Jarenbäck,1 Göran Eriksson,1 Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson1 1Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1 percent predicted (%p in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p <65 and >65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC, forced vital capacity (FVC, FEV1/FVC and expiratory resistance (Rex, which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p <65 and >65, response of FEV1%p did not correlate to response of volume parameters. Conclusion: Response of several advanced lung function parameters differs depending on patients’ baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p <65. Volume and resistance responses do not follow the flow response measured with FEV1 and may thus be used as a

Assessment of pulmonary function using pixel indexes of multiple-slice spiral CT low-dose two-phase scanning in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Zhang Lihua; Wang Yunhua; Jiang Zhongbiao; Zhang Lejun; Sun Wanli; Zhang Chunming

2012-01-01

Objective: To explore the values of pixel indexes (PI) with multiple-slice spiral CT low-dose two-phase scanning for assessing the pulmonary function in chronic obstructive pulmonary disease (COPD). Methods: Thirty-six patients with COPD (COPD group)and 30 healthy people (control group)underwent pulmonary function test (PFT). Chest 64-MSCT low-dose (50 mAs) scanning at full inspiration and expiration, routine scanning (100 mAs) at inspiration were performed. The effective dose (ED) was calculated. The lung was divided into three regions (upper, middle, lower). PI of lung were divided into five groups: -960--1024, -910--960, -800--910, -700--800, -400--700. The PI -910 (sum of the PI under -910 HU) of low-dose scanning at each region were measured and calculated using pulmo software. All PI included PIin -910 , PIiex -910 , PIin -910 -PIiex -910 , PIiex -910 /PIin -910 and (PIin -910 -PIiex -910 )/PIin -910 . All patients underwent PFT within 3 days after 64-MSCT canning, FEV1% and FEV1/FVC were selected for comparison. Results: The PIin in three regions (-960 - -1024, -910 - -960, -800 - -910) were statistically significant between normal and COPD groups (U=0.00, 57.00, 20.50, P<0.01). The PIex in all regions were statistically significant (U=0.00, 0.00, 71.52, 191.00, 6.00, P<0.01). PI -910--1024 at expiration and inspiration were correlated with FEV1% and FEV1/FVC (r=-0.548, -0.664, -0.752, -0.781, P<0.01). PIin -910 , PIex -910 ,PIiex -910 /PIin -910 , (PIin -910 -PIex -910 )/PIin -910 had a good correlation with FEV1% and FEV1/FVC (r=-0.548, -0.664, -0.752, -0.781, -0.674, -0.642, 0.674, 0.642, P<0.01). Conclusion: Pixel indexes of 64-MSCT low-dose two-phase scanning can be used to evaluate pulmonary function in COPD patients. (authors)

IL6R Variation Asp358Ala Is a Potential Modifier of Lung Function in Asthma

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Hawkins, Gregory A; Robinson, Mac B; Hastie, Annette T; Li, Xingnan; Li, Huashi; Moore, Wendy C; Howard, Timothy D; Busse, William W.; Erzurum, Serpil C.; Wenzel, Sally E.; Peters, Stephen P; Meyers, Deborah A; Bleecker, Eugene R

2012-01-01

Background The IL6R SNP rs4129267 has recently been identified as an asthma susceptibility locus in subjects of European ancestry but has not been characterized with respect to asthma severity. The SNP rs4129267 is in linkage disequilibrium (r2=1) with the IL6R coding SNP rs2228145 (Asp358Ala). This IL6R coding change increases IL6 receptor shedding and promotes IL6 transsignaling. Objectives To evaluate the IL6R SNP rs2228145 with respect to asthma severity phenotypes. Methods The IL6R SNP rs2228145 was evaluated in subjects of European ancestry with asthma from the Severe Asthma Research Program (SARP). Lung function associations were replicated in the Collaborative Study on the Genetics of Asthma (CSGA) cohort. Serum soluble IL6 receptor (sIL6R) levels were measured in subjects from SARP. Immunohistochemistry was used to qualitatively evaluate IL6R protein expression in BAL cells and endobronchial biopsies. Results The minor C allele of IL6R SNP rs2228145 was associated with lower ppFEV1 in the SARP cohort (p=0.005), the CSGA cohort (0.008), and in combined cohort analysis (p=0.003). Additional associations with ppFVC, FEV1/FVC, and PC20 were observed. The rs2228145 C allele (Ala358) was more frequent in severe asthma phenotypic clusters. Elevated serum sIL6R was associated with lower ppFEV1 (p=0.02) and lower ppFVC (p=0.008) (N=146). IL6R protein expression was observed in BAL macrophages, airway epithelium, vascular endothelium, and airway smooth muscle. Conclusions The IL6R coding SNP rs2228145 (Asp358Ala) is a potential modifier of lung function in asthma and may identify subjects at risk for more severe asthma. IL6 transsignaling may have a pathogenic role in the lung. PMID:22554704

Reduced lung function is independently associated with increased risk of type 2 diabetes in Korean men

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Kwon Chang-Hee

2012-04-01

Full Text Available Abstract Background Reduced lung function is associated with incident insulin resistance and diabetes. The aim of this study was to assess the relationship between lung function and incident type 2 diabetes in Korean men. Methods This study included 9,220 men (mean age: 41.4 years without type 2 diabetes at baseline who were followed for five years. Subjects were divided into four groups according to baseline forced vital capacity (FVC (% predicted and forced expiratory volume in one second (FEV1 (% predicted quartiles. The incidence of type 2 diabetes at follow-up was compared according to FVC and FEV1 quartiles. Results The overall incidence of type 2 diabetes was 2.2%. Reduced lung function was significantly associated with the incidence of type 2 diabetes after adjusting for age, BMI, education, smoking, exercise, alcohol, and HOMA-IR. Both FVC and FEV1 were negatively associated with type 2 diabetes (P 1 had a significantly higher odds ratio for type 2 diabetes compared with the highest quartile after adjusting for age and BMI (2.15 [95% CI 1.02-4.57] and 2.19 [95% CI 1.09-4.42]. Conclusions Reduced lung function is independently associated with the incidence of type 2 diabetes in Korean men.

Aerobic capacity and its correlates in patients with ankylosing spondylitis.

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Hsieh, Lin-Fen; Wei, James Cheng-Chung; Lee, Hsin-Yi; Chuang, Chih-Cheng; Jiang, Jiunn-Song; Chang, Kae-Chwen

2016-05-01

To evaluate aerobic capacity in patients with ankylosing spondylitis (AS) and determine possible relationships between aerobic capacity, pulmonary function, and disease-related variables. Forty-two patients with AS and 42 healthy controls were recruited in the study. Descriptive data, disease-related variables (grip strength, lumbosacral mobility, occiput-to-wall distance, chest expansion, finger-to-floor distance, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hemoglobin), and chest and thoracic spine x-rays were collected in each patient with AS. All subjects took standard pulmonary function and exercise tolerance tests, and forced vital capacity (FVC) and aerobic capacity were recorded. Both aerobic capacity and FVC in patients with AS were significantly lower than those in normal subjects (P aerobic capacity. There was significant correlation between aerobic capacity, vital capacity, chest expansion, Schober's test, cervical range of motion, and BASFI in patients with AS. Neither aerobic capacity nor vital capacity correlated with disease duration, ESR, CRP, and hemoglobin. Significantly reduced aerobic capacity and FVC were observed in patients with AS, and there was significant correlation between aerobic capacity, vital capacity, chest expansion, and BASFI. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers' pneumoconiosis

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Yildiz, O.A.; Gulbay, B.E.; Saryal, S.; Karabiylkoglu, G. [Ankara University, Ankara (Turkey). School of Medicine

2007-05-15

The aim of this study was to investigate the effect of the radiological evidence of emphysema, and the extent of interstitial involvement, on lung function and pulmonary arterial pressure (PAP) in patients with coal workers' pneumoconiosis (CWP). All patients showed a mild decrease in FEV1/FVC and a mild increase in FRC. Forty-four per cent of patients developed mild to moderate pulmonary hypertension. Emphysema scores correlated significantly with airflow rates, including FEV1%, FEV1/FVC and FEF25-75%, and with carbon monoxide diffusing capacity (DLCO)% predicted as well as FRC% predicted and the ratio RV/TLC, which are indices of air trapping. Additionally, profusion and global profusion scores showed significant correlation with FEV1/FVC, DLCO% predicted, specific airway conductance and smoking. Mean PAP showed a significant negative correlation with FEF50% predicted, DLCO% predicted and profusion score. The impairment of pulmonary function (mainly disturbance in airflow rates and air trapping) and pulmonary hypertension may be present, even in a simple form of CWP. The pulmonary function impairment in patients with CWP is likely to be attributable to the occurrence of emphysema. However, pulmonary hypertension was directly related to the profusion of pneumoconiotic nodules, which may result in obliteration of the vascular bed.

Relating small airways to asthma control by using impulse oscillometry in children.

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Shi, Yixin; Aledia, Anna S; Tatavoosian, Ahramahzd V; Vijayalakshmi, Shruthi; Galant, Stanley P; George, Steven C

2012-03-01

Previous reports suggest that the peripheral airways are associated with asthma control. Patient history, although subjective, is used largely to assess asthma control in children because spirometric results are many times normal values. Impulse oscillometry (IOS) is an objective and noninvasive measurement of lung function that has the potential to examine independently both small- and large-airway obstruction. We sought to determine the utility of IOS in assessing asthma control in children. Asthmatic and healthy children (6-17 years) were enrolled in the study. Spirometric and IOS (resistance of the respiratory system at 5 Hz [R5] and 20 Hz [R20], reactance of the respiratory system at 5 Hz [X5], resonant frequency of reactance [Fres], and area under the reactance curve between 5 Hz and Fres [reactance area {AX}]) values were collected in triplicate before and after a bronchodilator was administered. The physicians were blinded to the IOS measurements and assessed asthma control using American Thoracic Society guidelines. Small-airway IOS measurements, including the difference of R5 and R20 [R5-20], X5, Fres, and AX, of children with uncontrolled asthma (n = 44) were significantly different from those of children with controlled asthma (n = 57) and healthy children (n = 14), especially before the administration of a bronchodilator. However, there was no difference in large-airway IOS values (R20). No differences were found between children with controlled asthma and healthy children in any of the end points. Receiver operating characteristic analysis showed cut points for baseline R5-20 (1.5 cm H(2)O · L(-1) · s) and AX (9.5 cm H(2)O · L(-1)) that effectively discriminated controlled versus uncontrolled asthma (area under the curve, 0.86 and 0.84) and correctly classified more than 80% of the population. Uncontrolled asthma is associated with small-airways dysfunction, and IOS might be a reliable and noninvasive method to assess asthma control in children

Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community.

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Armour, Carol; Bosnic-Anticevich, Sinthia; Brillant, Martha; Burton, Debbie; Emmerton, Lynne; Krass, Ines; Saini, Bandana; Smith, Lorraine; Stewart, Kay

2007-06-01

Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design. Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status. 186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from "severe" to "not severe" than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference -149.11 microg, 95% CI -283.87 to -14.36; p=0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long-acting beta agonist (OR 3.80, 95% CI 1.40 to 10.32; p=0.01) and improved scores on risk of non-adherence (difference -0.44, 95% CI -0.69 to -0.18; p=0.04), quality of life (difference -0.23, 95% CI -0.46 to 0.00; p=0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference -1.39, 95% CI -2.44 to -0.35; p<0.01). No significant change in spirometric measures occurred in either group. A pharmacist

Pentoxifylline does not alter the response to inhaled grain dust.

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Jagielo, P J; Watt, J L; Quinn, T J; Knapp, H R; Schwartz, D A

1997-05-01

Pentoxifylline (PTX) has been shown to reduce sepsis-induced neutrophil sequestration in the lung and inhibit endotoxin-mediated release of tumor necrosis factor-alpha (TNF-alpha). Previously, we have shown that endotoxin appears to be the principal agent in grain dust causing airway inflammation and airflow obstruction following grain dust inhalation. To determine whether PTX affects the physiologic and inflammatory events following acute grain dust inhalation, 10 healthy, nonsmoking subjects with normal airway reactivity were treated with PTX or placebo (PL) followed by corn dust extract (CDE) inhalation (0.08 mL/kg), using a single-blinded, crossover design. Subjects received PTX (1,200 mg/d) or PL for 4 days prior to CDE inhalation and 400 mg PTX or PL on the exposure day. Both respiratory symptoms and declines in FEV1 and FVC occurred following CDE exposure in both groups, but there were no significant differences in the frequency of symptoms or percent declines from baseline in the FEV1 and FVC at any of the time points measured in the study. Elevations in peripheral blood leukocyte and neutrophil concentrations and BAL total cell, neutrophil, TNF-alpha, and interleukin-8 concentrations were measured 4 h following exposure to CDE in both the PTX- and PL-treated subjects, but no significant differences were found between treatment groups. These results suggest that pretreatment with PTX prior to inhalation of CDE, in the doses used in this study, does not alter the acute physiologic or inflammatory events following exposure to inhaled CDE.

Improved correlation between CT emphysema quantification and pulmonary function test by density correction of volumetric CT data based on air and aortic density

International Nuclear Information System (INIS)

Kim, Song Soo; Seo, Joon Beom; Kim, Namkug; Chae, Eun Jin; Lee, Young Kyung; Oh, Yeon Mok; Lee, Sang Do

2014-01-01

Objectives: To determine the improvement of emphysema quantification with density correction and to determine the optimal site to use for air density correction on volumetric computed tomography (CT). Methods: Seventy-eight CT scans of COPD patients (GOLD II–IV, smoking history 39.2 ± 25.3 pack-years) were obtained from several single-vendor 16-MDCT scanners. After density measurement of aorta, tracheal- and external air, volumetric CT density correction was conducted (two reference values: air, −1000 HU/blood, +50 HU). Using in-house software, emphysema index (EI) and mean lung density (MLD) were calculated. Differences in air densities, MLD and EI prior to and after density correction were evaluated (paired t-test). Correlation between those parameters and FEV 1 and FEV 1 /FVC were compared (age- and sex adjusted partial correlation analysis). Results: Measured densities (HU) of tracheal- and external air differed significantly (−990 ± 14, −1016 ± 9, P < 0.001). MLD and EI on original CT data, after density correction using tracheal- and external air also differed significantly (MLD: −874.9 ± 27.6 vs. −882.3 ± 24.9 vs. −860.5 ± 26.6; EI: 16.8 ± 13.4 vs. 21.1 ± 14.5 vs. 9.7 ± 10.5, respectively, P < 0.001). The correlation coefficients between CT quantification indices and FEV 1 , and FEV 1 /FVC increased after density correction. The tracheal air correction showed better results than the external air correction. Conclusion: Density correction of volumetric CT data can improve correlations of emphysema quantification and PFT

Improved health of hospitality workers after a Swiss cantonal smoking ban.

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Durham, André-Dante; Bergier, Samuel; Morisod, Xavier; Locatelli, Isabella; Zellweger, Jean-Pierre; Huynh, Cong Khanh; Cornuz, Jacques

2011-12-22

Hospitality workers are a population particularly at risk from the noxious effects of environmental tobacco smoke (ETS). The Canton of Vaud, Switzerland banned smoking in public places in September 2009. This prospective study addresses the impact of the ban on the health of hospitality workers. ETS exposure was evaluated using a passive sampling device that measures airborne nicotine; lung function was assessed by spirometry; health-related quality of life, ETS exposure symptoms and satisfaction were measured by questionnaire. 105 participants (smokers and non-smokers) were recruited initially and 66 were followed up after one year. ETS exposure was significantly lower after the ban. Hospitality workers had lower pre-ban forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values than expected. FEV1 remained stable after the ban, with a near-significant increase in the subgroup of asthmatics only. FVC increased at one year follow-up from 90.42% to 93.05% (p = 0.02) in the entire cohort; women, non-smokers and older participants gained the greatest benefit. The health survey showed an increase in physical wellbeing after the ban, the greatest benefit being observed in non-smokers. ETS exposure symptoms were less frequent after the ban, especially red and irritated eyes and sneezing. The new law was judged useful and satisfactory by the vast majority of employees, including smokers. The recent cantonal ban on smoking in public places brought about an improvement in lung function, physical well-being and ETS symptoms of hospitality workers, including smokers.

Assessment of spirometry and impulse oscillometry in relation to asthma control.

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Manoharan, Arvind; Anderson, William J; Lipworth, Joseph; Lipworth, Brian J

2015-02-01

Guidelines advocate the use of spirometry to assess pulmonary function in asthmatic patients. Commonly used measures include forced expiratory volume in 1 s (FEV1), forced expiratory ratio (FEV1/FVC), and forced mid-expiratory flow between 25 and 75 % of forced vital capacity (FEF25-75). Impulse oscillometry (IOS) is an effort-independent test performed during tidal breathing. IOS may be used to assess the total and central airway resistance at 5 Hz (R5) and 20 Hz (R20), respectively, and hence derive the peripheral airway resistance from the difference (R5-R20). We compared spirometry and IOS as tests of global airway function (i.e., FEV1, FEV1/FVC, R5) and putative measures of small airways function (i.e., FEF25-75, R5-R20) and their relationship to oral steroid and short-acting beta-agonist (SABA) use as surrogates for long-term asthma control. Spirometry and IOS measurements from physician-diagnosed asthmatics were linked to a health informatics database for oral steroid and SABA use 1 year prior to the index measurements. Four hundred forty-two patients had both spirometry and IOS, mean FEV1 = 86 % predicted, 94 % on ICS, median dose 800 µg/day. IOS and spirometry measures were equally predictive of impaired asthma control for both oral steroid and SABA use. For oral steroid use, the adjusted odds ratio, OR (95 % CI) is as follows: FEV1 150 %: 1.91(1.25-2.95), p = 0.003; and R5-R20 > 0.1 kPa L(-1) s 1.73(1.12-2.66), p = 0.013. For SABA use, the adjusted OR (95 % CI) is as follows: FEV1 150 %: 1.76(1.18-2.63), p = 0.006; and R5-R20 > 0.1 kPa L(-1) s: 2.94(1.94-4.46), p Spirometry or IOS measurements were equally useful as potential markers of asthma control in persistent asthmatic patients.

BMI, waist circumference at 8 and 12 years of age and FVC and FEV

NARCIS (Netherlands)

M.B.M. Bekkers (Marga); A.H. Wijga (Alet); U. Gehring (Ulrike); G.H. Koppelman (Gerard); J.C. de Jongste (Johan); H.A. Smit (Henriëtte); B. Brunekreef (Bert)

2015-01-01

textabstractBackground: In adults, overweight is associated with reduced lung function, in children evidence on this association is conflicting. We examined the association of body mass index (BMI) and waist circumference (WC) at age 12, and of persistently (at ages 8 and 12 years) high BMI and

BMI, waist circumference at 8 and 12 years of age and FVC and FEV

NARCIS (Netherlands)

Bekkers, Marga B.; Wijga, Alet H.; Gehring, Ulrike; Koppelman, Gerard H.; de Jongste, Johan C.; Smit, Henriette A.; Brunekreef, Bert

2015-01-01

Background: In adults, overweight is associated with reduced lung function, in children evidence on this association is conflicting. We examined the association of body mass index (BMI) and waist circumference (WC) at age 12, and of persistently (at ages 8 and 12 years) high BMI and large WC, with

Multispecies breath analysis faster than a single respiratory cycle by optical-feedback cavity-enhanced absorption spectroscopy

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Ventrillard-Courtillot, Irene; Gonthiez, Thierry; Clerici, Christine; Romanini, Daniel

2009-11-01

We demonstrate a first application, of optical-feedback cavity-enhanced absorption spectroscopy (OF-CEAS) to breath analysis in a medical environment. Noninvasive monitoring of trace species in exhaled air was performed simultaneous to spirometric measurements on patients at Bichat Hospital (Paris). The high selectivity of the OF-CEAS spectrometer and a time response of 0.3 s (limited by sample flow rate) allowed following the evolution of carbon monoxide and methane concentrations during individual respiratory cycles, and resolving variations among different ventilatory patterns. The minimum detectable absorption on this time scale is about 3×10-10 cm-1. At the working wavelength of the instrument (2.326 μm), this translates to concentration detection limits of ~1 ppbv (45 picomolar, or ~1.25 μg/m3) for CO and 25 ppbv for CH4, well below concentration values found in exhaled air. This same instrument is also able to provide measurement of NH3 concentrations with a detection limit of ~10 ppbv however, at present, memory effects do not allow its measurement on fast time scales.

Clinical Characteristics of Fungal Sensitization in Children with Allergic Respiratory Diseases

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Pınar Uysal

2016-08-01

Full Text Available Objective: The aim of the study was to evaluate the prevelance of fungal sensitization among school-aged children with allergic respiratory diseases who attended our outpatient clinic and to evaluate its clinical impact on disease severity. Materials and Methods: Children with allergic symptoms during mould season, who attended our outpatient clinic between January 2014 and August 2015, were evaluated for allergic respiratory diseases. Skin prick testing with fungal and other commercial standardized solutions of aeroallergens was performed in all children. Spirometry was performed in children with asthma. Serum total immunoglobulin E (IgE and aeroallergen specific IgE (sIgE levels were measured. Results: A total of 112 children were included in the study. The prevelance of fungal sensitization was 6.4%. Alternaria alterna was the most common fungal allergen in both mono and polysensitized groups (p=0.002, p=0.004, respectively. Alternaria alterna sensitization was significantly higher in patients with persistent allergic rhinitis compared to those with intermittant allergic rhinitis (p=0.002. The patients with mild asthma were mostly monosensitized (p=0.003, but cases with severe asthma (SA were polysensitized (p=0.007. In polysensitized cases, Alternaria alterna and Cladosporium spp. coexistance was the most common combination compared to other fungal combinations (p<0.001. The sensitivity rate of sIgE was found to be 88%. In spirometric analysis, forced expiratory volume in 1 second (FEV1 and FEV1/forced vital capacity values were lower in polysensitized children with asthma and in children with asthma coexisting allergic rhinitis compared to children with allergic rhinitis only (p=0.004, p=0.001, respectively. Conclusion: The most common fungal allergen was Alternaria alterna in children with mono or polysensitization. Polysensitization with fungal allergens was closely associated with SA and lower spirometric parameters.

Short- and long-term effectiveness of a supervised training program in spirometry use for primary care professionals.

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Represas-Represas, Cristina; Botana-Rial, Maribel; Leiro-Fernández, Virginia; González-Silva, Ana Isabel; García-Martínez, Ana; Fernández-Villar, Alberto

2013-09-01

Despite the importance of spirometry, its use and quality are limited in the Primary Care setting. There are few accredited training programs that have demonstrated improvement in the quality of spirometric studies. In this paper, we analyze the short- and long-term effectiveness of a supervised training program for performing and interpreting spirometries. Ours is an intervention study with before and after measurements. The target population included teams of physicians and nursing staff at 26 health-care centers in the area of Vigo (Galicia, Spain). The structured training program involved 2 theoretical and practical training sessions (that were 2months apart), an intermediate period of 30 supervised spirometries performed in the respective centers and weekly e-mail exercises. Effectiveness was evaluated using exercises at the beginning (test 1) and the end (test 2) of the 1st day, 2nd day (test 3) and one year later (test 4), as well as the analysis of spirometries done in month1, month2 and one year later. Participants also completed a survey about their satisfaction. 74 participants initiated the program; 72 completed the program, but only 45 participated in the one-year evaluation. Mean test scores were: 4.1±1.9 on test 1; 7.5±1.6 on test 2; 8.9±1.3 on test 3, and 8.8±1.4 on test 4. During month1, the percentage of correctly done/interpreted tests was 71%, in month two it was 91% and after one year it was 83% (Ptraining program based on theoretical and practical workshops and a supervised follow-up of spirometries significantly improved the ability of Primary Care professionals to carry out and interpret spirometric testing, although the quality of the tests diminished over time. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

Phrenic nerve block caused by interscalene brachial plexus block: breathing effects of different sites of injection.

Science.gov (United States)

Bergmann, Lars; Martini, Stefan; Kesselmeier, Miriam; Armbruster, Wolf; Notheisen, Thomas; Adamzik, Michael; Eichholz, Rϋdiger

2016-07-29

Interscalene brachial plexus (ISB) block is often associated with phrenic nerve block and diaphragmatic paresis. The goal of our study was to test if the anterior or the posterior ultrasound guided approach of the ISB is associated with a lower incidence of phrenic nerve blocks and impaired lung function. This was a prospective, randomized and single-blinded study of 84 patients scheduled for elective shoulder surgery who fullfilled the inclusion and exclusion critereria. Patients were randomized in two groups to receive either the anterior (n = 42) or the posterior (n = 42) approach for ISB. Clinical data were recorded. In both groups patients received ISB with a total injection volume of 15 ml of ropivacaine 1 %. Spirometry was conducted at baseline (T0) and 30 min (T30) after accomplishing the block. Changes in spirometrical variables between T0 and T30 were investigated by Wilcoxon signed-rank test for each puncture approach. The temporal difference between the posterior and the anterior puncture approach groups were again analyzed by the Wilcoxon-Mann-Whitney test. The spirometric results showed a significant decrease in vital capacity, forced expiratory volume per second, and maximum nasal inspiratory breathing after the Interscalene brachial plexus block; indicating a phrenic nerve block (p Wilcoxon signed-rank). A significant difference in the development of the spirometric parameters between the anterior and the posterior group could not be identified (Wilcoxon-Mann-Whitney test). Despite the changes in spirometry, no cases of dyspnea were reported. A different site of injection (anterior or posterior) did not show an effect in reducing the cervical block spread of the local anesthetic and the incidence of phrenic nerve blocks during during ultrasound guided Interscalene brachial plexus block. Clinical breathing effects of phrenic nerve blocks are, however, usually well compensated, and subjective dyspnea did not occur in our patients. German