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Guzmán-García JM, Romero-Saldaña M, Molina-Recio G, Álvarez-Fernández C, Jiménez-Mérida MDR, Molina-Luque R. Relationship between commonly defined metabolic health phenotypes and obesity with lung function in a working population: A cross-sectional study. Heart Lung 2024; 67:62-69. [PMID: 38703640 DOI: 10.1016/j.hrtlng.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/10/2024] [Accepted: 04/20/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Four phenotypes relate metabolism and obesity: metabolically healthy (MHO) and unhealthy (MUO) people with obesity and metabolically healthy (MHNO) and unhealthy (MUNO) people without obesity. No studies have addressed the association between these categories and lung function in the working population. OBJECTIVES The aim was to determine the relationship of phenotypes to lung ageing as measured by lung age and its relationship to lung dysfunction. METHODS A descriptive cross-sectional study was conducted in a working population. The outcome variable was lung function assessed by lung age. The four phenotypes of obesity and metabolic health (MHNO, MHO, MUO and MUNO) were determined using NCEP-ATP III criteria. Lung dysfunctions were classified into restrictive, obstructive, and mixed patterns. RESULTS The mean age of the participants was 43.7 years, ranging from 18 to 67 years. Of the 1860 workers, 51.3 % were women. The prevalences found were 71.4 %, 12 %, 10.6 % and 6 % for MHNO, MUO, MHO, and MUNO, respectively. MHO (β = 0.66; p = 0.591) was not associated with increased lung ageing compared with MHNO, but MUO (β = 7.1; p < 0.001) and MUNO (β = 6.6; p < 0.001) were. Concerning pulmonary dysfunctions, MUNO (OR = 1.93; p < 0.001) and MUO (OR = 2.91; p < 0.001) were found to be related to the presence of a restrictive pattern, and MUNO (OR = 2.40; p = 0.028) to the mixed pattern. CONCLUSION The results show that metabolic abnormalities, not obesity, are responsible for premature lung ageing and, therefore, lung function decline. In our study, having obesity without metabolic abnormality was not significantly associated with the presence of dysfunctional respiratory patterns.
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Affiliation(s)
- José-Miguel Guzmán-García
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Manuel Romero-Saldaña
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain.
| | - Guillermo Molina-Recio
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Carlos Álvarez-Fernández
- Department of Occupational Health and Safety, Cordoba City Council, Huerto de San Pedro el Real, Cordoba, Spain
| | - María Del Rocío Jiménez-Mérida
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Rafael Molina-Luque
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
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van Wincoop M, Moeniralam HS, Schramel FMNH. Predictors for Long COVID and Differences in Long COVID Symptoms, Findings on Chest Imaging and Pulmonary Function between Hospitalized COVID-19 Patients with versus without Intensive Care Unit Admission. Respiration 2024; 103:233-250. [PMID: 38417420 DOI: 10.1159/000535391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/17/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Many COVID-19 survivors suffer from persisting sequelae after acute disease. This is referred to as long COVID. The objectives of this study were to assess factors associated with long COVID and to analyze differences in persistent symptoms, findings on chest imaging, and pulmonary function between intensive care unit (ICU) and non-ICU hospitalized patients. METHODS We conducted a retrospective study including patients hospitalized with COVID-19. Patients were stratified into ICU patients and non-ICU patients. We analyzed the outcomes of patients who were in clinical follow-up 6 months after discharge with persistent symptoms, radiological and/or functional abnormalities. Logistic regression was used to examine the association between long COVID and patient characteristics. RESULTS A total of 549 patients were included. Eighty-one ICU patients (66%) and 146 (34%) non-ICU patients had persistent symptoms or abnormalities on chest imaging or lung function test minimally 6 months after discharge. Significantly more ICU patients had residual fibrotic abnormalities on chest CT and functional impairment. Female gender, myocardial infarction, OSAS, low PCO2 at admission, and longer hospital stay were associated with a higher risk of developing long COVID. Diabetes and treatment with tocilizumab were associated with a lower risk of developing long COVID. CONCLUSION Of the patients hospitalized for COVID-19, 34-66% suffered from persistent symptoms, residual abnormalities on chest imaging, or reduced lung function at around 6 months after discharge. While persistent sequelae were more frequent in ICU patients, admission to the ICU was not found to be an independent risk factor for developing long COVID.
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Affiliation(s)
- Maureen van Wincoop
- Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands,
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands,
- Department of Pulmonary Diseases, St. Antonius Hospital, Nieuwegein, The Netherlands,
| | - Hazra S Moeniralam
- Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Franz M N H Schramel
- Department of Pulmonary Diseases, St. Antonius Hospital, Nieuwegein, The Netherlands
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Jiang H, Feng B, Wang Y, Ge P, Lv K, Sun X, Wu Y. Application of Anderson model to analyze the influencing factors of lung function test behavior in middle-aged and elderly people in China. Dialogues Health 2023; 2:100138. [PMID: 38515471 PMCID: PMC10953856 DOI: 10.1016/j.dialog.2023.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 03/23/2024]
Abstract
Introduction Lung function tests are valuable in assessing respiratory health and disease, and the Healthy China Initiative clearly states that people over 40 years of age should have a lung function test once a year. To explore the influence of propensity factors, ability factors, and need factors on lung function detection behaviors of middle-aged and elderly Chinese, the following studies are conducted. Method A questionnaire was designed using Anderson's model, and multi-stage sampling was used to conduct a nationwide questionnaire survey based on geographical subdivisions and population distribution. Frequency and percentages were used for descriptive statistical analysis of lung function testing among middle-aged and elderly people in China, and chi-square tests and binary logistic regression analyses were used to investigate the factors influencing lung function testing behavior among middle-aged and elderly people in China. Result A total of 404 study participants were included in this study. Education level (relative to primary school and below, middle school and high school and secondary school OR = 2.652, P = 0.018; college and above OR = 4.566, P = 0.002), mode of health care affordability (relative to those who paid for the test, non-payers OR = 2.205, P = 0.004), dimensions of the European Five Dimensional Health Scale (mobility OR = 4.571, P = 0.006; pain or discomfort OR = 0.397, P = 0.003; anxiety or depression OR = 0.511, P = 0.028), and self-efficacy (medium group 0R = 0.294, P < 0.001; low group OR = 0.162, P = 0.003) had a significant impact on lung function testing behavior in our middle-aged and older adults. Conclusion This study found that there is still room for improvement in the participation of middle-aged and elderly people in lung function testing. Among the propensity factors, the factor that affects the rate of lung function tests is the highest degree of education, which determines the degree of patients' attention to lung function tests. Among the need factors, the factors affecting the rate of lung function detection are the physical conditions of middle-aged and elderly people, and those with poor physical conditions need medical detection. Among the ability factors, the factor that affects the rate of lung function tests is the way of bearing medical expenses, and economic status is the key factor that determines whether patients can accept lung function tests.
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Affiliation(s)
- Huiwen Jiang
- School of Health Administration, Harbin Medical University, Harbin 150081, China
| | - Bojunhao Feng
- School of Medicine, Macau University of Science and Technology, Macao 999078, China
| | - Yujia Wang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin 150081, China
| | - Pu Ge
- Institute of Chinese medical sciences, University of Macau, Macau 999078, China
| | - Ke Lv
- School of Public Health, China Medical University, Shenyang 110122, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing 100191, China
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Fikayo BE, Chimezie OV, John SK, Omotola OJ, Mbon IC, Eleonu PC, Ndinne KW, Atinuke TA. Occupational Exposure to Welding Fumes and Associated Respiratory Morbidities among arc Welders in Ikenne, Nigeria. Ethiop J Health Sci 2023; 33:373-382. [PMID: 37484188 PMCID: PMC10359661 DOI: 10.4314/ejhs.v33i2.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/03/2022] [Indexed: 07/25/2023] Open
Abstract
Background Few studies have been conducted on the respiratory morbidities of welders in Nigeria, and further research is needed to determine the extent of fume exposure and the implicated metals at workplaces. This study was done to determine whether welding gases are associated with respiratory illness among welders in Ikenne Local Government Area, Ogun State, Nigeria. Methods A cross-sectional study comparing 142 welders and 142 controls was carried out. Lung function testing and clinical assessments were done. The Chi-square test & the independent T-tests were used to test for the association between socio-demographic characteristics and respiratory symptoms & the association between differences in means of lung function parameters among welders and controls respectively. Results Chromium, nickel, manganese, carbon monoxide, and nitrogen dioxide levels were higher than the recommended values. Forced expiratory volume in the first second (FEV1) was significantly lower in welders (2.62±0.7) than in controls (2.81±0.7) (t=2.148, p<0.05). FEV1/FVC was significantly lower among welders (75±13.7) compared to controls (80.7±8.0). (t=4.165, p<0.001). Conclusion The study showed that the welders presented with more respiratory morbidities than the controls, this may be a result of exposure to high levels of welding fumes beyond the recommended values for prolonged periods without using personal protective equipment, which results in significant morbidities. There should be enforcement of basic workplace safety standards by ensuring that the use of personal protective equipment (PPE) is enforced and the construction of workshops that are well-ventilated through the welders' association and relevant law enforcement agencies.
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Affiliation(s)
- Bamidele Emmanuel Fikayo
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Okebalama Victor Chimezie
- Department of Anatomical Pathology and Forensic Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Sodeinde Kolawole John
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Ogunkoya John Omotola
- Department of Internal Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Ivy Chizurum Mbon
- Department of Surgery, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Peace Chioma Eleonu
- National Health Insurance Clinic, Department of Family Medicine, the University of Portsharcourt Teaching Hospital, Rivers State, Nigeria
| | | | - Taiwo Adesola Atinuke
- Benjamin S. Carson (Snr) College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
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Mu G, Wang B, Cheng M, Nie X, Ye Z, Zhou M, Zhou Y, Chen W. Long-term personal PM 2.5 exposure and lung function alternation: A longitudinal study in Wuhan urban adults. Sci Total Environ 2022; 845:157327. [PMID: 35839886 DOI: 10.1016/j.scitotenv.2022.157327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/05/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The effect of long-term PM2.5 exposure on lung function has not been well established. OBJECTIVES To investigate the effects of long-term personal PM2.5 exposure on lung function decline, obstructive, and restrictive ventilatory disorders. METHOD Personal PM2.5 concentrations were evaluated using an estimation model. Lung function parameters including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were measured in 3053 Wuhan participants from the Wuhan-Zhuhai cohort and were repeated every 3 years. Participants were classified into persistently high exposure group, persistently low exposure group and inconsistent exposure group according to the median of PM2.5 concentration of each visit. Mixed linear models with subject-specific random intercept were used to assess the association of 3-year change of lung function with personal PM2.5 exposure, and generalized linear models were used to assess the association of 6-year change of lung function with personal PM2.5 exposure. Cox regression models were applied to assess the associations of PM2.5 with obstructive and restrictive ventilatory disorders. RESULTS The medians of personal PM2.5 concentrations at baseline and two follow-ups were 153.18, 209.57 and 83.78 μg/m3, respectively. Compared with participants in the persistently low exposure group, participants in the persistently high exposure group showed a 2.99 % (95 % CI: 0.91, 5.08), a 380.15 mL/s (95 % CI: 32.82, 727.48) and a 5.98 % (95 % CI: 0.84, 11.11) additional decline in FEV1/FVC, PEF and PEFpred after 6 years, respectively. Stratified analyses showed that age, gender, body mass index, smoking status and drinking status had no significant modification effect on the associations. The associations of PM2.5 exposure with obstructive and restrictive ventilatory disorders were not significant, except for a positive association between persistently high PM2.5 exposure and restrictive ventilatory disorder among ever drinkers. CONCLUSION Long-term high PM2.5 exposure was associated with FEV1/FVC, PEF and PEFpred declines.
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Affiliation(s)
- Ge Mu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Data Center, Medical Affairs Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Man Cheng
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiuquan Nie
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zi Ye
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Mitra P, Chakraborty D, Mondal NK. Assessment of household air pollution exposure of tribal women. Sci Total Environ 2022; 817:152869. [PMID: 34995613 DOI: 10.1016/j.scitotenv.2021.152869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
There is a growing evidence that the burning of unprocessed biomass fuels is associated with adverse health impacts. This study estimated the gaseous pollutants (CO, CO2, O3, SO2, and NO2) and particulate matters (PM2.5 and PM10) during the burning of biomass and liquefied petroleum gas (LPG) fuels and their impacts on the health of tribal women. The results revealed that the tribal women mainly used six types of unprocessed biomass fuels (dry leaves, cow dung cake, dry woods, twigs, rice straw, and agricultural residues) along with five types of traditional earthen stoves. The concentration of gaseous and PM was recorded as in the order of CO2 > SO2 > CO > O3 and total suspended particulate matter (TSPM) > PM10 > PM2.5, respectively. The pollutant concentration inside the kitchen room for biomass users was significantly (p < 0.001) higher than LPG users. The biomass using tribal women might be suffering from higher cardiovascular risk than LPG users. The lung function study results also indicated that the mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were lower among biomass users than LPG users. The correlation study shows that tribal women who were exposed to biomass smoke were in a more vulnerable position than those who used LPG. Moreover, the toxicological risk among tribal biomass users was observed high (3.52) compared to LPG users (0.39). On the other hand, the Monte Carlo probabilistic simulation model for uncertainty analysis revealed that the mean value of Hazard Quotient (HQ) for PM2.5 in kitchen room was observed as 4.31E-00 and 9.40E-01 for biomass and LPG users, respectively. Modelling study also revealed that exposure of duration and cooking time are extremely important for toxicological risk assessment. However, further long-term comprehensive studies are extremely important.
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Affiliation(s)
- Pradip Mitra
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India
| | - Deep Chakraborty
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India
| | - Naba Kumar Mondal
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India.
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Landolfo F, De Rose DU, Columbo C, Valfrè L, Massolo AC, Braguglia A, Capolupo I, Bagolan P, Dotta A, Morini F. Growth and morbidity in infants with Congenital Diaphragmatic Hernia according to initial lung volume: A pilot study. J Pediatr Surg 2022; 57:643-648. [PMID: 34281708 DOI: 10.1016/j.jpedsurg.2021.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/22/2021] [Accepted: 06/26/2021] [Indexed: 11/28/2022]
Abstract
Background In congenital diaphragmatic hernia (CDH) survivors, failure to thrive is a well-known complication, ascribed to several factors. The impact of lung volume on growth of CDH survivors is poorly explored. Our aim was to evaluate if, in CDH survivors, lung volume (LV) after extubation correlates with growth at 12 and 24 months of life. Methods LV (measured as functional residual capacity-FRC) was evaluated by multibreath washout traces with an ultrasonic flowmeter and helium gas dilution technique, shortly after extubation. All CDH survivors are enrolled in a dedicated follow-up program. For the purpose of this study, we analyzed the correlation between FRC obtained shortly after extubation and anthropometric measurements at 12 and 24 months of age. We also compared growth between infants with normal lungs and those with hypoplasic lungs according to FRC values. A p < 0.05 was considered as statistically significant. Results We included in the study 22 CDH survivors who had FRC analyzed after extubation and auxological follow-up at 12 and 24 months of age. We found a significant correlation between FRC and weight Z-score at 12 months, weight Z-score at 24 months and height Z-score at 24 months. We also demonstrated that CDH infants with hypoplasic lungs had a significantly lower weight at 12 months and at 24 months and a significantly lower height at 24 months, when compared to infants with normal lungs. Conclusion We analyzed the predictive value of bedside measured lung volumes in a homogeneous cohort of CDH infants and demonstrated a significant correlation between FRC and growth at 12 and 24 months of age. An earlier identification of patients that will require an aggressive nutritional support (such as those with pulmonary hypoplasia) may help reducing the burden of failure to thrive.
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Affiliation(s)
- Francesca Landolfo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy.
| | - Claudia Columbo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Laura Valfrè
- Neonatal Surgery Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Anna Claudia Massolo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Annabella Braguglia
- Neonatal Intermediate Care Unit and Follow-up, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Irma Capolupo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Pietro Bagolan
- Neonatal Surgery Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Francesco Morini
- Neonatal Surgery Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
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Bizzotto D, Paganini S, Stucchi L, Palmisano Avallone M, Ramirez EM, Pompilio PP, Ferrucci F, Lavoie JP, Dellaca RL. A portable fan-based device for evaluating lung function in horses by the forced oscillation technique. Physiol Meas 2022; 43. [PMID: 35120344 DOI: 10.1088/1361-6579/ac522e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/04/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The assessment of lung mechanics in horses is nowadays based on invasive methods that may require sedation. The forced oscillation technique (FOT) allows the non-invasive assessment of respiratory mechanics during spontaneous breathing, but current devices are complex, cumbersome, expensive, and difficult to be applied in horses. APPROACH We developed a portable FOT device based on a novel approach in which the pressure waveforms are generated by a servo-controlled ducted fan. This new approach allows the design of devices that are more sturdy, compact, and portable compared to already existing approaches. The prototype includes 1) a small microcontroller-based electronic board for controlling the fan and measuring flow and pressure and 2) an optimized data processing algorithm. MAIN RESULTS This device provides a maximum error of 0.06 cmH2O∙s/L and 0.15 cmH2O∙s/L in measuring respiratory resistance and reactance during in-vitro validation. A pilot study was also performed on three healthy horses and three horses with severe equine asthma (SEA) and it demonstrated good tolerability and feasibility of the new device. Total respiratory system resistance (Rrs) and reactance (Xrs) significantly differed (p<0.05) between groups. At 5Hz, Rrs was 0.66±0.02 cmH2O∙s/L and 0.94±0.07 cmH2O∙s/L in healthy and in SEA, respectively. Xrs 0.38±0.02 cmH2O∙s/L and -0.27±0.05 cmH2O∙s/L. SIGNIFICANCE This novel approach for applying FOT allowed the development of a small, affordable and portable device for the non-invasive evaluation of respiratory mechanics in spontaneously breathing horses, providing a useful new tool for improving veterinary respiratory medicine. Moreover, our results provide supporting evidence of the value of this novel approach for developing portable FOT devices also for applications in humans.
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Affiliation(s)
- Davide Bizzotto
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, 20133, ITALY
| | - Stefano Paganini
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, Milano, 20133, ITALY
| | - Luca Stucchi
- Equine Sports Medicine Lab (ESM-Lab), Università degli Studi di Milano Dipartimento di Medicina Veterinaria, Via dell'Università, 6, 26900 Lodi LO, Lodi, Lombardia, 26900, ITALY
| | - Matteo Palmisano Avallone
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, Milano, 20133, ITALY
| | - Esther Millares Ramirez
- Equine Asthma Laboratory, Université de Montréal Faculté de médecine vétérinaire, 3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada, Saint Hyacinthe, Quebec, J2S 7C6, CANADA
| | - Pasquale P Pompilio
- Restech srl, Via Melchiorre Gioia, 61, 20124 Milano MI, Milano, 20124, ITALY
| | - Francesco Ferrucci
- Equine Sports Medicine Lab (ESM-Lab), Università degli Studi di Milano Dipartimento di Medicina Veterinaria, Via dell'Università, 6, 26900 Lodi LO, Lodi, Lombardia, 26900, ITALY
| | - Jean-Pierre Lavoie
- Equine Asthma Laboratory, Université de Montréal Faculté de médecine vétérinaire, 3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada, Saint Hyacinthe, Quebec, J2S 2M2, CANADA
| | - Raffaele L Dellaca
- DEIB, Politecnico di Milano Dipartimento di Elettronica e Informazione, Via Giuseppe Colombo, 40, Milano, Milano, Lombardia, 20133, ITALY
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Yeh MH, Huang CH, Lin YC, Huang TJ, Chen MY. The health impact of an innovative summer camp for older adults: a pilot study using an interdisciplinary collaborative approach. BMC Nurs 2022; 21:4. [PMID: 34983513 PMCID: PMC8725505 DOI: 10.1186/s12912-021-00782-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Healthy aging with dignity and aging in place are important for Taiwanese individuals. Although Taiwan did not experience COVID-19 outbreaks prior to May 2021, many older adults have been encouraged to stay at home since the beginning of the global pandemic in January 2020. Such shelter-in-place recommendations have resulted in significant lifestyle changes, limiting activities associated with aging with dignity such as exercise and community engagement. Few studies have explored how to promote or maintain holistic health practices and physical fitness in older adults residing in rural communities during the COVID-19 pandemic. This pilot study aimed to establish an interdisciplinary collaboration with community care workers (CCWs) and evaluate the impact of an innovative summer camp (ISC) program for older adults residing in rural areas. Methods A quasi-experimental pre-post-test design with an interdisciplinary collaborative approach was implemented. The ISC program was based on a standardized protocol of modified Baduanjin exercise combined with three recreational breathing games. Participants were recruited from three community centers around the western coastal region of Yunlin County between June and August 2020. The ISC program was designed and executed by a nurse-led health promotion research team that collaborated with trained CCWs for 90 min per day, five days per week, for 12 weeks. Participants and CCWs wore facemasks during all activities. Paired t-test was used to measure changes in physical biomarkers, pulmonary lung function, and health-related fitness changes. Results Sixty-eight participants completed the ISC program. The ISC program significantly improved the participants’ physiological biomarkers and health-related fitness, including reduced body weight, waistline, and systolic blood pressure, and increased forced vital capacity, biceps arm flexion, and ability to sit and stand from a chair, step with a knee up in situ, and stand on one foot with eyes open. Most participants reported that they felt happy, satisfied, and hoped that this program would be continued in their community center. Conclusions This interdisciplinary, collaborative ISC program improved physical biomarkers and health-related fitness in older adults. Despite limitations, results strongly suggested that primary healthcare providers and CCWs can employ the described ISC program to promote wellness in older adults.
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Affiliation(s)
- Mei-Hua Yeh
- Department of Respiratory Therapy and Nursing, Chang Gung Memorial Hospital, 638, Yunlin, Taiwan
| | - Cheng-Hsien Huang
- Department of Family Medicine, Chang Gung Memorial Hospital, 638, Yunlin, Taiwan
| | - Yu-Chih Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, 638, Yunlin, Taiwan
| | - Tung-Jung Huang
- Department of Internal Medicine, Chang Gung Memorial Hospital, 638, Yunlin, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, 613, Chiayi, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, 613, Chiayi, Taiwan. .,School of Nursing, Chang Gung University, 333, Taoyuan, Taiwan. .,Department of Cardiology, Chang Gung Memorial Hospital, 613, Chiayi, Taiwan. .,, No. 2, Chiapu Rd. West Sec, 613, Putz City, 61363, Chiayi County, Taiwan, ROC.
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Wilson J, Carson G, Fitzgerald S, Llewelyn MJ, Jenkins D, Parker S, Boies A, Thomas J, Sutcliffe K, Sowden AJ, O'Mara-Eves A, Stansfield C, Harriss E, Reilly J. Are medical procedures that induce coughing or involve respiratory suctioning associated with increased generation of aerosols and risk of SARS-CoV-2 infection? A rapid systematic review. J Hosp Infect 2021; 116:37-46. [PMID: 34245806 PMCID: PMC8264274 DOI: 10.1016/j.jhin.2021.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The risk of transmission of SARS-CoV-2 from aerosols generated by medical procedures is a cause for concern. AIM To evaluate the evidence for aerosol production and transmission of respiratory infection associated with procedures that involve airway suctioning or induce coughing/sneezing. METHODS The review was informed by PRISMA guidelines. Searches were conducted in PubMed for studies published between January 1st, 2003 and October 6th, 2020. Included studies examined whether nasogastric tube insertion, lung function tests, nasendoscopy, dysphagia assessment, or suctioning for airway clearance result in aerosol generation or transmission of SARS-CoV-2, SARS-CoV, MERS, or influenza. Risk of bias assessment focused on robustness of measurement, control for confounding, and applicability to clinical practice. FINDINGS Eighteen primary studies and two systematic reviews were included. Three epidemiological studies found no association between nasogastric tube insertion and acquisition of respiratory infections. One simulation study found low/very low production of aerosols associated with pulmonary lung function tests. Seven simulation studies of endoscopic sinus surgery suggested significant increases in aerosols but findings were inconsistent; two clinical studies found airborne particles associated with the use of microdebriders/drills. Some simulation studies did not use robust measures to detect particles and are difficult to equate to clinical conditions. CONCLUSION There was an absence of evidence to suggest that the procedures included in the review were associated with an increased risk of transmission of respiratory infection. In order to better target precautions to mitigate risk, more research is required to determine the characteristics of medical procedures and patients that increase the risk of transmission of SARS-CoV-2.
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Affiliation(s)
- J Wilson
- Richard Wells Research Centre, University of West London, London, UK.
| | - G Carson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - S Fitzgerald
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - M J Llewelyn
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - D Jenkins
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - S Parker
- Defence Science and Technology Laboratory, Porton Down, Salisbury, UK
| | - A Boies
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - J Thomas
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - K Sutcliffe
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - A J Sowden
- Centre for Reviews and Dissemination, University of York, York, UK
| | - A O'Mara-Eves
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - C Stansfield
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - E Harriss
- Bodleian Health Care Libraries, John Radcliffe Hospital, Oxford, UK
| | - J Reilly
- Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
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Mu G, Zhou M, Wang B, Cao L, Yang S, Qiu W, Nie X, Ye Z, Zhou Y, Chen W. Personal PM 2.5 exposure and lung function: Potential mediating role of systematic inflammation and oxidative damage in urban adults from the general population. Sci Total Environ 2021; 755:142522. [PMID: 33032136 DOI: 10.1016/j.scitotenv.2020.142522] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Short-term effects of fine particulate matter (PM2.5) exposure on lung function have been reported. However, few studies have assessed PM2.5 exposure on the personal level, and the mechanism underlying the effects of PM2.5 exposure on lung function remains less clear. OBJECTIVES To evaluate the association between personal PM2.5 exposure and lung function alteration in general population and to explore the roles of systematic inflammation and oxidative damage in this association. METHODS A total of 7685 lung function tests were completed among 4697 urban adults in Wuhan, China. Plasma C-reactive protein (CRP), urinary 8-iso-prostaglandin-F2α (8-iso-PGF2α) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels were measured. Personal PM2.5 exposure levels were estimated using an estimation model from the actual measurements of individual PM2.5 levels in 191 participants. Mixed linear models were used to evaluate the association between personal PM2.5 exposure and lung function. Mediation analyses were conducted to investigate the roles of CRP, 8-iso-PGF2α and 8-OHdG in above associations. RESULTS After adjusting for confounders, each 10 μg/m3 increase in the previous-day personal PM2.5 exposure was associated with 2.94 mL, 2.02 mL and 16.14 mL/s decreases in forced vital capacity (FVC), forced expiration volume in 1 s (FEV1) and peak expiratory flow, respectively. The associations were more obvious among never smokers compared with current smokers. Cumulative 7-day exposure to PM2.5 led to the strongest adverse effects on lung function. Among never smokers with high PM2.5 exposure levels, a positive relationship was observed between personal PM2.5 level and urinary 8-iso-PGF2α, and 8-iso-PGF2α meditated 4.69% and 12.30% of the association between the 7-day moving PM2.5 concentration and FVC and FEV1, respectively. We did not observe a significant positive association between PM2.5 exposure and plasma CRP or urinary 8-OHdG. CONCLUSION Short-term personal exposure to PM2.5 is associated with reduced pulmonary ventilation function. Urinary 8-iso-PGF2α partly mediates these associations.
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Affiliation(s)
- Ge Mu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Limin Cao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Shijie Yang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Qiu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiuquan Nie
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zi Ye
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, Solis-Navarro L, Burgos F, Puppo H, Vilaró J. Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis. Pulmonology 2020; 27:328-337. [PMID: 33262076 PMCID: PMC7687368 DOI: 10.1016/j.pulmoe.2020.10.013] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID-19). The literature on previous coronavirus infections reports that patients may experience persistent impairment in respiratory function after being discharged. Our objective was to determine the prevalence of restrictive pattern, obstructive pattern and altered diffusion in patients post-COVID-19 infection and to describe the different evaluations of respiratory function used with these patients. METHODS A systematic review was conducted in five databases. Studies that used lung function testing to assess post-infection COVID-19 patients were included for review. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. RESULTS Of the 1973 reports returned by the initial search, seven articles reporting on 380 patients were included in the data synthesis. In the sensitivity analysis, we found a prevalence of 0.39 (CI 0.24-0.56, p < 0.01, I2 = 86%), 0.15 (CI 0.09-0.22, p = 0.03, I2 = 59%), and 0.07 (CI 0.04-0.11, p = 0.31, I2 = 16%) for altered diffusion capacity of the lungs for carbon monoxide (DLCO), restrictive pattern and obstructive pattern, respectively. CONCLUSION Post-infection COVID-19 patients showed impaired lung function; the most important of the pulmonary function tests affected was the diffusion capacity.
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Affiliation(s)
- R Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; International Physiotherapy Research Network (PhysioEvidence).
| | - L Vasconcello-Castillo
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; International Physiotherapy Research Network (PhysioEvidence)
| | - X Alsina-Restoy
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Solis-Navarro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - F Burgos
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Spain
| | - H Puppo
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; International Physiotherapy Research Network (PhysioEvidence)
| | - J Vilaró
- International Physiotherapy Research Network (PhysioEvidence); Blanquerna School of Health Sciences, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, Spain
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Ostojic P, Vujovic M. Prevalence and clinical correlates of small airway obstruction in patients with systemic sclerosis. Clin Rheumatol 2021; 40:1417-22. [PMID: 32827283 DOI: 10.1007/s10067-020-05353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aims to assess the prevalence and clinical correlates of small airway obstruction (SAO) in patients with systemic sclerosis (SSc). METHODS Sixty-nine consecutive patients with SSc (63 women and 6 men) were included. Lung function tests, including assessment of lung diffusing capacity, were performed in all patients. Patients were considered to have SAO when the maximal expiratory flow at 25% of the forced vital capacity (MEF25) was lower than 60% as predicted. High-resolution computed tomography (HRCT) of the lung was performed in all patients with MEF25 < 60%. We assessed the relationship of SAO in our patients with large airway obstruction, decreased lung diffusing capacity, HRCT findings, disease duration, disease subtype, scleroderma-specific antibodies, and smoking. RESULTS SAO was noticed in 46/69 (66.6%) of patients with SSc. Restrictive lung disease was found in 4/69 (5.8%), obstruction of large airways in 18/69 (26.1%), and decreased lung diffusing capacity in 47/69 (68.1%) of patients. No difference in gender, age, disease duration, disease subtype, and scleroderma-specific antibodies was found between patients with and without SAO. Eighteen out of forty-six (39.1%) patients with SAO had decreased forced expiratory volume in 1 sec (FEV1) and the Tiffeneau-Pinelli index, indicating presence of coexistent large airway obstruction. Twenty out of forty-six (43.5%) patients with SAO had associated decreased lung diffusing capacity, while 8/46 (17.4%) of patients had isolated SAO. HRCT patterns of interstitial lung disease (ILD) were found more frequently in patients with SAO and decreased lung diffusing capacity, compared with patients with SAO and normal diffusing capacity (75% vs 11.5%, p = 0.008). We have noticed that tobacco smokers among SSc patients with SAO have more common associated obstructive lung disease on spirometry (58.8% vs 15.4%, p = 0.004). On the other hand, isolated SAO and SAO associated with impaired diffusing capacity were equally frequent among smokers and non-smokers. CONCLUSION Patients with SSc have commonly SAO. It can be considered clinical feature of undiagnosed asthma or chronic obstructive pulmonary disease (COPD), if isolated or associated with large airway obstruction, especially in tobacco smokers. On the other hand, SAO associated with decreased lung diffusing capacity was found to be not related to smoking, and may indicate a possible prominent bronchiolar involvement within SSc-related interstitial lung disease Key Points • Small airway obstruction in patients with systemic sclerosis can be considered a clinical feature of undiagnosed obstructive lung disease, if isolated or associated with large airway obstruction, especially in tobacco smokers. • Obstruction of small airways, associated with decreased lung diffusing capacity, may indicate a possible prominent bronchiolar involvement within systemic sclerosis-related interstitial lung disease.
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Abstract
Although cystic fibrosis (CF) is a multiorgan disease, the extent of CF lung disease is decisive for the course and survival of patients. The optimization of symptomatic therapies has led to a significant improvement in the life expectancy of those affected in recent decades. Regular monitoring of the course of CF lung disease with microbiological, pulmonary function, and imaging examinations is essential for early detection of problems and individualized therapy. With new, causal therapy options in the form of cystic fibrosis transmembrane conductance regulator (CFTR) modulators and early diagnosis through newborn screening, a further normalization of life expectancy and quality of life of CF patients can be expected.
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Papale M, Parisi GF, Spicuzza L, Licari A, Bongiovanni A, Mulè E, Rotolo N, Manti S, Leonardi S. Lung clearance index evaluation in detecting nocturnal hypoxemia in cystic fibrosis patients: Toward a new diagnostic tool. Respir Med 2020; 164:105906. [PMID: 32217291 DOI: 10.1016/j.rmed.2020.105906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Nocturnal hypoxemia adversely affects outcomes in patients with cystic fibrosis (CF). Although an early detection of this abnormality may be desirable, still its predictability remains uncertain. The Lung Clearance Index (LCI) is a measure of lung ventilation distribution obtained from a multiple-breath washout technique (MBW), recently implemented in patients with CF. This study aimed to establish whether the LCI predicts nocturnal hypoxemia in patients with stable CF, with mild to moderate disease, and normal diurnal gas exchange. METHODS 31 stable patients (15 males, mean age 17.4 ± 5.2 years) with mild to moderate CF, normoxic when awake, were enrolled. In all patients we performed nocturnal cardio-respiratory polygraphy, lung function measurement, and MBW test to derive LCI values. RESULTS LCI was abnormal in most of the patients and inversely correlated with mean nocturnal SpO2 (r = -0.880 p < 0.01). A receiver operating characteristic (ROC) analysis, performed to assess whether LCI predicted nocturnal hypoxemia, revealed a high predictive accuracy of LCI for nocturnal desaturation (AUC = 0.96; Youden index = 0.79). Forced expiratory volume in 1 s (FEV1) was predictive only in patients with more severe airway obstruction, with a moderate degree of accuracy (AUC 0.71). CONCLUSIONS The LCI showed a high effectiveness in predicting nocturnal hypoxemia in stable patients with CF, particularly when compared with a traditional parameter of lung function such as FEV1.
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Suh HY, Park S, Ryoo HG, Kim JY, Kim TS, Lee JM, Kim MS, Yang HC, Kim SK. Comparative Analysis of Lung Perfusion Scan and SPECT/CT for the Evaluation of Functional Lung Capacity. Nucl Med Mol Imaging 2019; 53:406-13. [PMID: 31867076 DOI: 10.1007/s13139-019-00617-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/24/2019] [Accepted: 10/11/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to compare lung perfusion scan with single photon emission computed tomography/computed tomography (SPECT/CT) for the evaluation of lung function and to elucidate the most appropriate modality for the prediction of postoperative lung function in patients with lung cancer. Methods A total of 181 patients underwent Tc-99m macroaggregated albumin lung perfusion scan and SPECT/CT to examine the ratio of diseased lung and diseased lobe. Forty-one patients with lung cancer underwent both preoperative and postoperative pulmonary function tests within 1 month to predict postoperative pulmonary function. Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) was calculated by the % radioactivity of lung perfusion scan and SPECT, and the % volume of the residual lung, assessed on CT. Results The ratios of diseased lung as seen on lung perfusion scan and SPECT showed significant correlation, but neither modality correlated with CT. The ratios of the diseased lung and diseased lobe based on CT were higher than the ratios based on either perfusion scan or SPECT, because CT overestimated the function of the diseased area. The lobar ratio of both upper lobes was lower based on the perfusion scan than on SPECT but was higher for both lower lobes. Actual postoperative FEV1 showed significant correlation with ppoFEV1 based on lung perfusion SPECT and perfusion scan. Conclusions We suggest SPECT/CT as the primary modality of choice for the assessment of the ratio of diseased lung area. Both perfusion scan and SPECT/CT can be used for the prediction of postoperative lung function.
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Koksal B, Eker I, Ozbek N, Dogan I, Y. Ozbek O. Thrombin lag time is increased in children with mild asthma. Allergol Immunopathol (Madr) 2019; 47:241-245. [PMID: 30262412 DOI: 10.1016/j.aller.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/02/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Inflammation and coagulation are closely linked events. Thrombin is the key enzyme in coagulation system and also has roles in inflammation. OBJECTIVE The aim of our study was to evaluate thrombin generation in children with mild asthma. METHODS Forty-two children with mild asthma and 49 healthy children were included in the study. All patients performed spirometry. Thrombin generation tests (TGT) were performed with a calibrated automated thrombogram (CAT) in children without asthma exacerbation during the last six months. During CAT assay thrombogram curves were obtained. The area under the curve showed endogenous thrombin potentials and indicated the total amount of endogenous thrombin generated; the peak height showed the highest thrombin value, thrombin lag time and time to thrombin peak were measured. RESULTS Thrombin lag time was significantly longer in children with asthma (3.98±1.2min) compared to those in the control group (3.29±0.6min) (p<0.01). Children with asthma also had longer thrombin tail time compared to the control group (19.5±8.9min vs. 16.7±2.9min, p=0.02). Thrombin peak was inversely correlated with FEF 25-75 (r=-0.41, p<0.01). Thrombin lag time was inversely correlated with FEF 25-75 (r=-0.39, p<0.01). CONCLUSION Inflammation in mild asthma seems to disturb coagulation but this disturbance may not be so strong as to increase thrombin levels and may only affect the initiation phase of thrombin generation.
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Wang YH, Lue KH. Association between sensitized to food allergens and childhood allergic respiratory diseases in Taiwan. J Microbiol Immunol Infect 2019; 53:812-820. [PMID: 31060817 DOI: 10.1016/j.jmii.2019.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/12/2018] [Accepted: 01/16/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Sensitization to allergen has long been known to be relate to childhood allergic diseases. Polysensitised children have more severe atopic diseases, whereas allergic rhinitis or asthma children with cosensitized to food and inhalant allergens were under-researched. OBJECTIVE To realize the association between sensitization to food allergens and pediatric allergic rhinitis and asthma in Taiwan. METHODS We included 138 participants with sensitized to allergen as assessed by serum-specific IgE. 87 of 138 participants had allergic rhinitis and 51 participants had asthma. All participants underwent a physical examination and measurement of serum total and specific IgE values. Besides, nasal peak expiratory flow rate (nPEFR) that was performed by the participants with allergic rhinitis and were requested to complete the Pediatric Rhinoconjunctivitis Quality of Life Questionnaires (PRQLQ). Lung function test and asthma control test (ACT)/child asthma control test (C-ACT) were performed by the participants with asthma. RESULTS 39 of 87 allergic rhinitis participants with sensitized to food and inhalant allergens (AR food group), 48 of 87 allergic rhinitis participants with sensitized to inhalant allergen alone (AR inhalant group). The AR food group had significantly lower nPEFR values and higher total IgE values (p < 0.05) compared with the AR inhalant group. The AR food group had higher PRQLQ scores than the AR inhalant group. 24 of 51 asthma participants with sensitized to food and inhalant allergens (Asthma food group), 27 of 51 asthma participants with sensitized to inhalant allergen alone (Asthma inhalant group). The Asthma food group had significantly higher total IgE values (p < 0.05) compared with the Asthma inhalant group. The Asthma food group had lower lung function test values and asthma control test (ACT) scores than the other group. CONCLUSIONS Children with cosensitized to food and inhalant allergens have more severe clinical symptoms and abnormal laboratory findings. Sensitization to food allergen was more related to pediatric allergic rhinitis than asthma. We may need larger, longer and extended studies to confirm these findings.
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Affiliation(s)
- Yun-Hu Wang
- Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ko-Huang Lue
- Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Larenas Linnemann DES, Del Río Navarro BE, Luna Pech JA, Romero Lombard J, Villaverde Rosas J, Cano Salas MC, Fernández Vega M, Ortega Martell JA, López Estrada EC, Mayorga Butrón JL, Salas Hernández J, Vázquez García JC, Ortiz Aldana I, Vargas Becerra MH, Bedolla Barajas M, Rodríguez Pérez N, Aguilar Aranda A, Jiménez González CA, García Bolaños C, Garrido Galindo C, Mendoza Hernández DA, Mendoza López E, López Pérez G, Wakida Kuzonoki GH, Ruiz Gutiérrez HH, León Molina H, Martínez de la Lanza H, Stone Aguilar H, Gómez Vera J, Olvera Salinas J, Oyoqui Flores JJ, Gálvez Romero JL, Lozano Saenz JS, Salgado Gama JI, Jiménez Chobillon MA, García Avilés MA, Guinto Balanzar MP, Medina Ávalos MA, Camargo Angeles R, García Torrentera R, Toral Freyre S, Montes Narvaez G, Solorio Gómez H, Rosas Peña J, Romero Tapia SJ, Reyes Herrera A, Cuevas Schacht F, Esquer Flores J, Sacre Hazouri JA, Compean Martínez L, Medina Sánchez PJ, Garza Salinas S, Baez Loyola C, Romero Alvarado I, Miguel Reyes JL, Huerta Espinosa LE, Correa Flores MÁ, Castro Martínez R. Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico. Allergol Immunopathol (Madr) 2018; 46:291-303. [PMID: 29288048 DOI: 10.1016/j.aller.2017.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/19/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.
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Affiliation(s)
| | - B E Del Río Navarro
- Department of Allergy and Clinical Immunology, Pediatric Hospital of Mexico "Federico Gómez", Mexico City, Mexico; Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - J A Luna Pech
- Department of Philosophical, Methodological and Instrumental Disciplines, University Center of Science in Health, Universidad de Guadalajara, Mexico
| | | | - J Villaverde Rosas
- A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico
| | - M C Cano Salas
- Department of Postgraduate Medicine of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - M Fernández Vega
- Dean's Office, of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico; Pregraduate Pulmonology Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - J A Ortega Martell
- Department of Pre and Postgraduate Medicine, Universidad Autónoma de Hidalgo, Pachuca, Mexico
| | - E C López Estrada
- Asthma Clinic, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - J L Mayorga Butrón
- Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico; A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico; ENT Department, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - J Salas Hernández
- General Management Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico.
| | - J C Vázquez García
- Dean's Office, of the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - I Ortiz Aldana
- Secretary of Health of the State of Guanajuato, Guanajuato (Gto), Mexico
| | - M H Vargas Becerra
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico; Unit of Medical Investigations in Respiratory Medicine, of the Instituto Mexicano del Seguro Social, Mexico
| | - M Bedolla Barajas
- Civil Hospital of Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Mexico
| | - N Rodríguez Pérez
- Institute of Science and Superior Studies of Tamaulipas, Universidad Autónoma de Tamaulipas, Matamoros, Mexico
| | - A Aguilar Aranda
- Medical Unit of High-Level Specialization, of Hospital de Pediatría Centro Médico de Occidente, Mexico
| | | | - C García Bolaños
- General Hospital "Doctor Gaudencio González Garza" of the Centro Médico Nacional La Raza, Mexico City, Mexico
| | - C Garrido Galindo
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | | | - E Mendoza López
- Sistema Tec Salud, Hospital San José, Monterrey (NL), Mexico
| | - G López Pérez
- Allergy Department, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - H H Ruiz Gutiérrez
- Servicio de Neumología Pediátrica, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, Mexico
| | | | | | | | - J Gómez Vera
- Allergy Department, Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Mexico City, Mexico
| | | | | | - J L Gálvez Romero
- Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE), Regional, Puebla, Puebla, Mexico
| | | | - J I Salgado Gama
- Clínica del Niño y del Adolescente de Coatzacoalcos (Veracruz), Mexico
| | | | - M A García Avilés
- Secretary of Health, National Center for Preventive Programs for Disease Control (CENAPRECE), Mexico City, Mexico
| | | | - M A Medina Ávalos
- Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE) of Veracruz, Mexico
| | - R Camargo Angeles
- Secretary of Health, National Center for Preventive Programs for Disease Control (CENAPRECE), Mexico City, Mexico
| | - R García Torrentera
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - S Toral Freyre
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | | | | | - J Rosas Peña
- Private Practice, Guadalajara, Guadalajara, Mexico
| | - S J Romero Tapia
- Unit of Education and Investigation, Hospital de Alta Especialidad del Niño "Dr. Rodolfo Nieto Padrón", Villahermosa, Tabasco, Mexico; Profesor Investigador de la División Académica de la Universidad Juárez Autónoma de Tabasco, Mexico
| | | | - F Cuevas Schacht
- Department of Pulmonology and Thoracic Surgery, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - J Esquer Flores
- Hospital del ISSSSTE, 'Fray Junipero Serra', Tijuana, BC, Mexico
| | | | - L Compean Martínez
- Servicio de Otorrinolaringología del Centenario Hospital Hidalgo de Aguascalientes, Mexico
| | | | | | | | - I Romero Alvarado
- Emergency Department, Hospital Infantil de México "Federico Gómez", Mexico City, Mexico
| | - J L Miguel Reyes
- Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico
| | - L E Huerta Espinosa
- Pediatric Hospital of Legaria of the Secretary of Health, Mexico City, Mexico
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Kuti BP, Oladimeji OI, Kuti DK, Adeniyi AT, Adeniji EO, Osundare YJ. Rural-urban disparity in lung function parameters of Nigerian children: effects of socio-economic, nutritional and housing factors. Pan Afr Med J 2017; 28:230. [PMID: 29629016 PMCID: PMC5882213 DOI: 10.11604/pamj.2017.28.230.13836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 10/20/2017] [Indexed: 01/07/2023] Open
Abstract
Introduction The effect of socio-demographic and nutritional factors on lung functions of African children is poorly studied. This study set out to determine the effects of these factors on lung functions of Nigerian school children. Methods Rural and urban secondary schools students in Ilesa, Nigeria were selected by multistage sampling. The socio-demographic, nutritional status as well as lung function parameters measured using incentive Spirometry (MIR Spirolab III srl, Italy) of the children were obtained and compared among the rural and urban children. Results A total of 250 children (128 rural and 122 urban) aged 9 to 17 years participated in the study over a 12 month period. Mean (SD) age was 12.6 (1.9) years and Male: Female 1:1.1. The urban children were heavier, taller and have larger lung volumes than their age and sex matched rural counterpart. Stunted rural males [Mean (SD) FVC 1.8 (0.3) L vs. 2.2 (0.6) L t-test = 2.360; p = 0.022], underweight females [Mean (SD) FVC 1.8 (0.4) L vs. 2.2 (0.6) L; t-test = 2.855; p = 0.006] and those exposed to unclean fuel [Mean (SD) FVC 2.1 (0.6) L vs. 2.4 (0.5) L; t-test = 2.079; p = 0.041] had significantly lower lung volumes compared to their counterparts without these conditions. Conclusion Undernutrition, low socio-economic class and use of unclean fuels adversely affect the lung functions of Nigerian children. Improved standard of living, use of clean fuel and adequate nutrition may ensure better lung health among these children.
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Affiliation(s)
- Bankole Peter Kuti
- Department of Paediatrics and Child Health Obafemi Awolowo University, Ile-Ife, Nigeria.,Department of Paediatrics Wesley Guild Hospital, Ilesa, Nigeria
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Phan PA, Zhang C, Geer D, Formenti F, Hahn CEW, Farmery AD. The Inspired Sinewave Technique: A Comparison Study With Body Plethysmography in Healthy Volunteers. IEEE J Transl Eng Health Med 2017; 5:2700209. [PMID: 29282434 PMCID: PMC5737179 DOI: 10.1109/jtehm.2017.2732946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/15/2017] [Accepted: 06/11/2017] [Indexed: 11/28/2022]
Abstract
The inspired sinewave technique is a noninvasive method to measure airway dead space, functional residual capacity, pulmonary blood flow, and lung inhomogeneity simultaneously. The purpose of this paper was to assess the repeatability and accuracy of the current device prototype in measuring functional residual capacity, and also participant comfort when using such a device. To assess within-session repeatability, six sinewave measurements were taken over two-hour period in 17 healthy volunteers. To assess day-to-day repeatability, measurements were taken over 16 days in 3 volunteers. To assess accuracy, sinewave measurements were compared to body plethysmography in 44 healthy volunteers. Finally, 18 volunteers who experienced the inspired sinewave device, body plethysmography and spirometry were asked to rate the comfort of each technique on a scale of 1–10. The repeatability coefficients for dead space, functional residual capacity, and blood flow were 48.7 ml, 0.48L, and 2.4L/min respectively. Bland-Altman analyses showed a mean BIAS(SD) of −0.68(0.42)L for functional residual capacity when compared with body plethysmography. 14 out of 18 volunteers rated the inspired sinewave device as their preferred technique. The repeatability and accuracy of functional residual capacity measurements were found to be as good as other techniques in the literature. The high level of comfort and the non-requirement of patient effort meant that, if further refined, the inspired sinewave technique could be an attractive solution for difficult patient groups such as very young children, elderly, and ventilated patients.
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Affiliation(s)
- Phi Anh Phan
- Nuffield Department of Clinical NeurosciencesNuffield Division of AnaestheticsUniversity of Oxford
| | | | | | - Federico Formenti
- Centre of Human & Aerospace Physiological SciencesKing's College London
| | - Clive E W Hahn
- Nuffield Department of Clinical NeurosciencesNuffield Division of AnaestheticsUniversity of Oxford
| | - Andrew D Farmery
- Nuffield Department of Clinical NeurosciencesNuffield Division of AnaestheticsUniversity of Oxford
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Kamada T, Kaneko M, Tomioka H. The relationship between respiratory system impedance and lung function in asthmatics: A prospective observational study. Respir Physiol Neurobiol 2017; 239:41-5. [PMID: 28189708 DOI: 10.1016/j.resp.2017.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim was to elucidate the relationship between the annual changes in respiratory system impedance, measured by FOT, and lung function tests in patients with asthma. METHODS Between March 2011 and March 2012, asthma outpatients who attended Kobe City Medical Center West Hospital were recruited. Lung function tests, FOT were conducted every 6 months until March 2016. The relationships between annual parameter changes were evaluated. RESULTS AND CONCLUSION Sixty-four patients were completed this study. The median follow-up period was 55 months. At enrollment, although resistance showed no relationship with forced expiratory volume in one second (%FEV1), the reactance was moderately correlated with X5 (r=0.524, r2=0.275, <0.001), Fres (r=-0.498, r2=0.248, <0.001) and ALX (r=-0.416, r2=0.173, p=<0.001). By contrast, the annual resistance change at 5Hz (R5) was highly and significantly associated with%FEV1 change (r=-0.564, r2=0.318, p<0.001). Longitudinal changes in airway resistance and reactance measured by FOT might be useful for the assessment of lung function in patients with asthma.
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Simaga B, Forton K, Motoji Y, Naeije R, Faoro V. Lung diffusing capacity in sub-Saharan Africans versus European Caucasians. Respir Physiol Neurobiol 2017; 241:23-7. [PMID: 28087341 DOI: 10.1016/j.resp.2017.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/20/2016] [Accepted: 01/04/2017] [Indexed: 11/20/2022]
Abstract
Single breath measurements of lung diffusing capacity (DL) for carbon monoxide (CO) and nitric oxide (NO) were performed in age-, sex-, weight- and height-matched 32 sub-Saharan Africans (13 women) and 32 Caucasian Europeans, and repeated in 14 of each group at 80% of maximum exercise capacity. In Africans versus Caucasians respectively, DLNO was 153±31 vs 176±38ml/mmHg/min at rest (P<0.001) and 210±48 vs 241±52ml/mmHg/min at exercise (P<0.01) while hemoglobin-adjusted DLCO was 29±6 vs 34±6ml/mmHg/min at rest (P<0.001), and 46±11 vs 51±13ml/mmHg/min at exercise (P<0.01). However there were no differences in DLCO/alveolar volume(VA) (KCO) and DLNO/VA(KNO). The sitting-to-standing height ratio was lower in the Africans. Differences in lung volume with respect to body height explain lower DLNO and DLCO in sub-Saharan Africans as compared to Caucasian Europeans.
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Barikbin P, Sallmon H, Wilitzki S, Photiadis J, Bührer C, Koehne P, Schmalisch G. Lung function in very low birth weight infants after pharmacological and surgical treatment of patent ductus arteriosus - a retrospective analysis. BMC Pediatr 2017; 17:5. [PMID: 28056907 PMCID: PMC5217232 DOI: 10.1186/s12887-016-0762-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 12/15/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The indications and strategies for treatment of patent ductus arteriosus (PDA) are controversial, and the safety and long-term benefits of surgical PDA closure remain uncertain. The aim of this study was to compare the lung function of very low birth weight (VLBW) infants after successful PDA treatment with a cyclooxygenase inhibitor or secondary surgical ligation. METHODS A total of 114 VLBW infants (birth weight < 1500 g), including 94 infants (82%) with a birth weight < 1000 g, who received treatment for hemodynamically significant PDA (hsPDA), were examined at a median postmenstrual age of 48 weeks. All infants were initially given pharmacological treatment, and 40 infants (35%) required PDA ligation. Lung function testing (LFT) included tidal breathing measurements, measurement of respiratory mechanics assessed by the occlusion test, whole-body plethysmography, SF6 multiple breath washout, forced expiratory flow (V'maxFRC) by the rapid thoracoabdominal compression technique, exhaled NO (FeNO), and arterialized capillary blood gas analysis. RESULTS On the day of the LFT, the 2 groups had similar postconceptional age and body weight. However, the PDA ligation group was more immature at birth (p < 0.001) and had reduced respiratory compliance (p < 0.001), lower V'maxFRC (p = 0.006), increased airway resistance (Raw) (p < 0.001), and impaired blood gases (p < 0.001). Multivariate analysis showed that PDA surgery was an independent risk factor for increased Raw. CONCLUSION PDA ligation after failed pharmacological treatment is associated with impaired lung function as compared to successful pharmacological closure in infants at a postmenstrual age of 48 weeks. However, only Raw was independently affected by PDA ligation, while all other differences were merely explained by patient characteristics.
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Affiliation(s)
- Payman Barikbin
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany.
| | - Hannes Sallmon
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany
| | - Silke Wilitzki
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany
| | - Joachim Photiadis
- Department of Congenital Heart Surgery, German Heart Institute, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christoph Bührer
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany
| | - Petra Koehne
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany
| | - Gerd Schmalisch
- Department of Neonatology, Charité University Medical Centre, Charitéplatz 1, 10117, Berlin, Germany
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Linhares SGD, Pereira JCDN, Fernades PMP, de Campos JRM. Functional exercise capacity and lung function in patients undergoing an early rehabilitation program after the Nuss procedure: a randomized controlled trial. Pediatr Surg Int 2017; 33:69-74. [PMID: 27738823 DOI: 10.1007/s00383-016-3992-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this study was to compare the functional exercise capacity and the lung function among patients undergoing early rehabilitation with those submitted to the conventional care after pectus excavatum repair using the Nuss procedure. METHOD Patients were randomly allocated to the early rehabilitation group (ERG) who started rehabilitation after surgery and the group of the conventional care (CG) received routine care of the institution. They were evaluated before surgery (preoperative) and in hospital discharge day (postoperative). RESULTS Forty patients were evaluated, twenty in each group. All patients presented a significant reduction in FVC, FEV1, and PEF in the postoperative period, there was no statistically significant difference between groups. There was significant different in postoperative functional exercise capacity between the ERG and CG (506.26 ± 66.54 vs 431.11 ± 75.61, p = 0.02) and the difference between distance walked in the preoperative and postoperative period was lower in the ERC than in the CG (76.57 ± 49.41 vs 166.82 ± 70.13, p < 0.001). CONCLUSION Patients undergoing the early rehabilitation after the Nuss procedure presented a better postoperative functional exercise capacity in hospital discharge day compared with patients in the conventional group, with no difference in lung function between groups.
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Maloča Vuljanko I, Turkalj M, Nogalo B, Bulat Lokas S, Plavec D. Diagnostic value of a pattern of exhaled breath condensate biomarkers in asthmatic children. Allergol Immunopathol (Madr) 2017; 45:2-10. [PMID: 27592280 DOI: 10.1016/j.aller.2016.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/28/2016] [Accepted: 05/04/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diagnosing asthma in children is a challenge and using a single biomarker from exhaled breath condensate (EBC) showed the lack of improvement in it. OBJECTIVE The aim of this study was to assess the diagnostic potential of a pattern of simple chemical biomarkers from EBC in diagnosing asthma in children in a real-life setting, its association with lung function and gastroesophageal reflux disease (GERD). METHODS In 75 consecutive children aged 5-7 years with asthma-like symptoms the following tests were performed: skin prick tests, spirometry, impulse oscillometry (IOS), exhaled NO (FENO), 24-hour oesophageal pH monitoring and EBC collection with subsequent analysis of pH, carbon dioxide tension, oxygen tension, and concentrations of magnesium, calcium, iron and urates. RESULTS No significant differences were found for individual EBC biomarkers between asthmatics and non-asthmatics (p>0.05 for all). A pattern of six EBC biomarkers showed a statistically significant (p=0.046) predictive model for asthma (AUC=0.698, PPV=84.2%, NPV=38.9%). None to moderate association (R2 up to 0.43) between EBC biomarkers and lung function measures and FENO was found, with IOS parameters showing the best association with EBC biomarkers. A significantly higher EBC Fe was found in children with asthma and GERD compared to asthmatics without GERD (p=0.049). CONCLUSIONS An approach that involves a pattern of EBC biomarkers had a better diagnostic accuracy for asthma in children in real-life settings compared to a single one. Poor to moderate association of EBC biomarkers with lung function suggests a complementary value of EBC analysis for asthma diagnosis in children.
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Sorlí-Aguilar M, Martín-Luján F, Flores-Mateo G, Jardí-Piñana C, Aparicio-Llopis E, Basora-Gallisà J, Solà-Alberich R; ESPITAP Study Group investigators. Adiposity markers and lung function in smokers: a cross-sectional study in a Mediterranean population. BMC Pulm Med 2016; 16:178. [PMID: 27938399 DOI: 10.1186/s12890-016-0341-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 12/02/2016] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this study was to assess the association of key adiposity markers with lung function in smokers without respiratory disease in a Mediterranean population. Methods We performed a cross-sectional study with baseline data from a representative sample of the ESPITAP study in Spain. Participants were 738 smokers (52.3% men) without respiratory disease, aged 35 to 70, selected from 12 primary health care centres. We assessed weight, height, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). The pulmonary functional parameters were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio. Results In this cohort of smokers, 22.2% of individuals had central obesity. FVC% was inversely associated with all anthropometric measures (BMI, WC and WHtR) in the overall population and in men; in women, only BMI was associated with FVC%. FEV1% was inversely associated to BMI and WC in the overall population, and to all anthropometric measures in men. Furthermore, both BMI and obesity were positively associated with FEV1/FVC ratio overall and when stratified by sex; this suggests a restrictive pattern explained by the altered ventilator mechanics experienced by people with obesity. Conclusion In a Mediterranean population of smokers without respiratory symptoms, abdominal obesity, evaluated not only by BMI and WC but also WHtR, is inversely associated with lung function. Fat distribution appears more strongly related to pulmonary function parameters in men than in women. In smokers with high values for WC, WHtR and BMI, assessment of lung function is recommended. Trial registration Current Controlled Trials NCT01194596. Registered 2 September 2010.
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Sorli-Aguilar M, Martin-Lujan F, Flores-Mateo G, Arija-Val V, Basora-Gallisa J, Sola-Alberich R. Dietary patterns are associated with lung function among Spanish smokers without respiratory disease. BMC Pulm Med 2016; 16:162. [PMID: 27884188 PMCID: PMC5123418 DOI: 10.1186/s12890-016-0326-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 11/17/2016] [Indexed: 01/22/2023] Open
Abstract
Background Diet can help preserve lung function in smokers, in addition to avoidance of smoking. The study aimed to evaluate associations between dietary patterns and lung function in smokers without respiratory disease. Methods This cross-sectional study analysed baseline data from randomised representative smokers without respiratory disease (n = 207, aged 35–70 years), selected from 20 primary health-care centres. Participants completed a validated semi-quantitative food-frequency questionnaire. Dietary patterns were identified by Principal Component Analysis (PCA). Impaired lung function was defined as FVC <80% and/or FEV1 < 80% of predicted value and/or FEV1/FVC <0.7. Associations were determined by logistic regression. Results Three major dietary patterns were identified. In multivariate-adjusted model, impaired lung function was associated with the Alcohol-consumption pattern (OR 4.56, 95% CI 1.58–13.18), especially in women (OR 11.47, 95% CI 2.25–58.47), and with the Westernised pattern in women (OR 5.62, 95% CI 1.17–27.02), whereas it not was associated with the Mediterranean-like pattern (OR 0.71, 95% CI 0.28–1.79). Conclusion In smokers without respiratory disease, the Alcohol-consumption pattern and the Westernised pattern are associated with impaired lung function, especially in women. The Mediterranean-like pattern appears to be associated with preserved lung function because no statistical association is observed with impaired lung function. In addition to smoking cessation, modifying dietary patterns has possible clinical application to preserve lung function. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0326-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mar Sorli-Aguilar
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Spain.,Study Group on Respiratory Tract Diseases (GEPAR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Francisco Martin-Lujan
- Study Group on Respiratory Tract Diseases (GEPAR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain. .,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Tarragona, Spain. .,CAP Sant Pere-Institut Català de la Salut, C/Cami de Riudoms, 53-55, 43203, Reus, Tarragona, Spain.
| | - Gemma Flores-Mateo
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Spain
| | - Victoria Arija-Val
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Tarragona, Spain
| | - Josep Basora-Gallisa
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Tarragona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Rosa Sola-Alberich
- NFOC group School of Medicine and Health Sciences, Universitat Rovira i Virgili, Tarragona, Spain
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Saranz R, Lozano A, Valero A, Lozano N, Bovina Martijena M, Agresta F, Ianiero L, Ponzio M. Impact of rhinitis on lung function in children and adolescents without asthma. Allergol Immunopathol (Madr) 2016; 44:556-562. [PMID: 27496783 DOI: 10.1016/j.aller.2016.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/10/2016] [Accepted: 04/01/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Subclinical spirometric abnormalities may be detected in patients with rhinitis without asthma, proportional to the severity established by ARIA (Allergic Rhinitis and Its Impact on Asthma) guidelines. New criteria of rhinitis classification were recently validated according to the ARIA modified (m-ARIA), which allow the discrimination between moderate to severe grades. The impact of rhinitis on lung function according to frequency and severity is unknown. OBJECTIVES To investigate subclinical spirometric impairment in children and adolescents with allergic and non-allergic rhinitis without overt symptoms of asthma, according to the frequency and severity criteria of rhinitis classified by m-ARIA. METHODS An observational cross-sectional study, including children and adolescents aged 5-18 years with allergic and non-allergic rhinitis without asthma. We analysed the functional abnormalities and bronchodilator response with spirometry in relation to the grade of rhinitis established by m-ARIA using an adjusted logistic model. A value of p<0.05 was considered statistically significant. RESULTS We studied 189 patients; 22.2% showed spirometric abnormalities. Patients with persistent rhinitis had greater impairment of lung function compared to intermittent grade (p=0.026). Lung functional impairment was more frequent in severe and moderate rhinitis than mild grade (p=0.005) and was independent of the atopic status to both frequency (p=0.157) and severity (p=0.538). There was no difference in bronchodilator reversibility between groups (p>0.05). CONCLUSIONS Impaired lung function was associated with persistence and severity of rhinitis and there was no significant difference between patients with moderate and severe rhinitis. The spirometric abnormality was demonstrated in patients with allergic and non-allergic rhinitis.
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Sánchez-García S, Olaguibel JM, Quirce S, Ibáñez MD. Measurement of Lung Function and Bronchial Inflammation in Children Is Underused by Spanish Allergists. J Investig Allergol Clin Immunol 2016; 26:126-8. [PMID: 27164634 DOI: 10.18176/jiaci.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Sánchez-García
- Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - J M Olaguibel
- Allergy Department, Complejo Hospitalario Universitario de Navarra, Pamplona, Spain
| | - S Quirce
- Allergy Department, Hospital Universitario La Paz, Madrid, Spain
| | - M D Ibáñez
- Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Kumar AS, Alaparthi GK, Augustine AJ, Pazhyaottayil ZC, Ramakrishna A, Krishnakumar SK. Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial. J Clin Diagn Res 2016; 10:KC01-6. [PMID: 26894090 DOI: 10.7860/jcdr/2016/16164.7064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 12/07/2015] [Indexed: 11/24/2022]
Abstract
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 1(st), 2(nd) and 3(rd) postoperative day when compared with preoperative day. On 4(th) and 5(th) 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. CONCLUSION Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.
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Affiliation(s)
- Amaravadi Sampath Kumar
- Lecturer, Department of Physiotherapy, Father Muller Medical College Hospital , RGUHS, India
| | - Gopala Krishna Alaparthi
- Associate Professor, Department of Physiotherapy, Kasturba Medical College, Manipal University , India
| | | | | | - Anand Ramakrishna
- Associate Dean and Professor, Department of Pulmonary Medicine, Kasturba Medical College, Manipal University , India
| | - Shyam Krishnan Krishnakumar
- Assistant Professor, Senior Scale, Department of Physiotherapy, Kasturba Medical College, Manipal University , India
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Löwhagen O, Bergqvist P. Physiotherapy in asthma using the new Lotorp method. Complement Ther Clin Pract 2014; 20:276-9. [PMID: 25130138 DOI: 10.1016/j.ctcp.2014.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/31/2014] [Accepted: 07/18/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physiotherapy in bronchial asthma has given various results. AIM To test a new method focusing on breathing exercise and massage of the thoracic muscles. PATIENTS AND METHODS Twenty-eight adult patients with a physician-diagnosed asthma were studied during 6 weeks. All patients were prescribed asthma medication. The new method [active group, n = 17) was compared with physical training (control group, n = 12). RESULTS PEF was significantly improved (p = 0.001) in the active group, however, FEV1 showed no significant change. The symptoms "tightness of the chest", "difficult breathing in", "air hunger", and the individually dominating symptom (p = 0.001) were significantly reduced in the active group. Exercise-induced breathing troubles and chest expansion were also significantly reduced. CONCLUSION Physiotherapy including breathing exercise and massage of the thoracic muscles (the Lotorp method) in patients with physician-diagnosed asthma resulted in significantly reduced respiratory symptoms during rest and exercise and increased chest expansion. The improvements may be due to an increased mobility of the chest and diaphragm.
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Affiliation(s)
- O Löwhagen
- Department of Internal Medicine, Sahlgenska Academy, University of Göteborg, Sweden.
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Shim JY. Association of wheezing phenotypes with fractional exhaled nitric oxide in children. Korean J Pediatr 2014; 57:211-6. [PMID: 25045362 PMCID: PMC4102682 DOI: 10.3345/kjp.2014.57.5.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 03/19/2014] [Indexed: 02/01/2023]
Abstract
Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma.
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Affiliation(s)
- Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
BACKGROUND The ISAAC (the International Study of Asthma and Allergies in Childhood) questionnaire has been used to standardize research on the prevalence of asthma in children since 1991. AIM In this Phase I study, the prevalence of asthma, other allergic diseases and atopy was evaluated in North Cyprus. METHODS The ISAAC questionnaire was distributed to grades I-V schoolchildren. Data were obtained from parents of 580 schoolchildren aged between 7 and 12 years attending a primary school in Nicosia, the capital of North Cyprus. Of those, a sub-group of 97 (16.7%) randomly selected children were evaluated by skin prick test (SPT) and lung function test (LFT). RESULTS The prevalence rates of asthma ever, current wheezing and SPT-positivity were 20.8%, 10% and 68%, respectively. The prevalence of atopy was significantly higher in the randomly selected subgroup of 97 (68%) patients subjected to SPT and LFT, and the house dust mite (HDM) was the allergen to which children were most frequently sensitized. CONCLUSIONS In northern Cyprus, the prevalence rates of asthma, allergic diseases and atopic sensitization in 7-12-year-old children are extremely high. Sensitization to HDM is a risk factor for the development of asthma.
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Rothe T, Gharbo R, Däppen M. Baron Munchhausen's lung function expertise. Respir Med Case Rep 2012; 8:1-2. [PMID: 26029603 PMCID: PMC3920413 DOI: 10.1016/j.rmcr.2012.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 10/31/2012] [Indexed: 11/30/2022] Open
Abstract
A young anorectic woman suffering from asthma since her early childhood exacerbated without obvious cause and did not respond to treatment. Body plethysmography showed an isolated huge increase of the expiratory resistance. During inspiration, resistance was not elevated. However, in 1 out of 3 successive manoeuvres, expiratory resistance was completely normal. We believe this to be a Munchhausen's case coupled with a proven asthma. The pattern in lung function can be explained by putting the tongue forward into the spirometer's mouthpiece. In the assessment of asthma refractory to treatment, especially in workers in paramedical professions, Munchhausen's syndrome should be considered.
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Affiliation(s)
- Thomas Rothe
- Zürcher Höhenklinik Davos, Dept. of Internal Medicine & Pneumology, CH - 7272 Davos Clavadel, Switzerland
- Corresponding author. Tel.: +41 81 4174444.
| | - Raschid Gharbo
- Zürcher Höhenklinik Davos, Dept. of Internal Medicine & Pneumology, CH - 7272 Davos Clavadel, Switzerland
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