American Thoracic Society Recommendations Research Articles

Assessing the Consequences of Smoking Tobacco Products with Consideration of the Forced Oscillation Technique.

BACKGROUND The effects of cigarette smoking on the health of active smokers and passive smokers have long been known, in contrast to the effects of alternative forms of nicotine intake that are gaining popularity. The aim of the study was to assess the effects of smoking traditional cigarettes and alternative forms of nicotine intake on the functional state of the respiratory system of smokers and non-smokers. MATERIAL AND METHODS Study participants (n=60) were divided into 3 groups: non-smokers (control group), cigarette smokers, and nicotine alternative users. Respiratory function testing (spirometry), forced oscillation technique, and measurement of respiratory muscle strength (PImax, PEmax) were performed. All of the above respiratory function tests were performed in accordance with European Respiratory Society and American Thoracic Society recommendations. RESULTS Smokers and those using alternative forms of nicotine intake had significantly higher values, including resistance at 5 Hz% and 11 Hz%, among others. CONCLUSIONS Smokers and users of alternative forms of nicotine are characterized by reduced flow through the small bronchioles, as evidenced by a reduction in maximal expiratory flow at 25% of vital capacity. Smokers and users of alternative forms of nicotine have higher resistance values at the height of small and medium bronchioles. Assessment method of technical forced oscillation parameters is simple to perform to detect early airway changes and is an important element in the early diagnosis of changes in smokers. The correlation analysis showed a significant correlation between age of smoking initiation/use of alternative forms of nicotine and changes in mid bronchial resistance.

Bronchodilator response assessment through impulse oscillometry system and spirometry in children and adolescents with cystic fibrosis.

To investigate the effect of bronchodilator on the respiratory mechanics and pulmonary function of children and adolescents with cystic fibrosis. Cross-sectional study on clinically stable children and adolescents with cystic fibrosis aged from six to 15 years. Participants underwent impulse oscillometry and spirometry evaluations before and 15 minutes after bronchodilator inhalation. The Kolmogorov-Smirnov test was applied to verify the sample distribution, and the Student's t-test and Wilcoxon test were used to compare the data before and after bronchodilator inhalation. The study included 54 individuals with a mean age of 9.7±2.8 years. The analysis showed a statistically significant improvement in impulse oscillometry and spirometry parameters after bronchodilator inhalation. However, according to the American Thoracic Society (ATS) and European Respiratory Society (ERS) recommendations (2020 and 2021), this improvement was not sufficient to classify it as a bronchodilator response. The use of bronchodilator medication improved respiratory mechanics and pulmonary function parameters of children and adolescents with cystic fibrosis; however, most patients did not show bronchodilator response according to ATS/ERS recommendations.

Association between serum high-density lipoprotein cholesterol and lung function in adults: three cross-sectional studies from US and Korea National Health and Nutrition Examination Survey

IntroductionCholesterol is an irreplaceable nutrient in pulmonary metabolism; however, studies on high-density lipoprotein cholesterol (HDL-C) levels have shown conflicting results regarding lung function. Therefore, we investigated the association between lung...

Machine Learning Models to Predict Severity and Mortality of COVID-19 Using Neurological Symptoms (S21.002)

<h3>Objective:</h3> This study aimed to assess the correlation of neurological symptoms with the disease severity and mortality. Furthermore, different models were proposed to predict the severity and mortality using COVID-19 symptoms including neurological manifestations. <h3>Background:</h3> Coronavirus disease 2019 (COVID-19) was first described after many cases of pneumonia with unknown cause were reported in Wuhan, China in December, 2019. COVID-19 can present multiple non-respiratory symptoms and it was found to be associated with increased risk of different neurological manifestations. <h3>Design/Methods:</h3> This is a prospective cohort study conducted among hospitalized patients diagnosed with COVID-19 from April 7, 2020 to January 21, 2020. All manifestations were recorded and patients were examined by a neurologist to identify neurological symptoms. The severity was classified based on American Thoracic Society recommendations for community-acquired pneumonia. Data were analyzed and models were designed using IPython 7.22.0 in Jupyter notebook 6.3.0 from Anaconda. <h3>Results:</h3> There were 921 eligible participants (552 males and 369 females) in this study. The mean age of individuals was 61.58 ± 17.63 years. Smell and taste dysfunctions were the most common neurological symptom, reported in 619 patients (67.2%) and were associated with reduced odds of severe cases (OR: 0.63, 95%CI: 0.41 to 0.89) and death (OR: 0.61, 95%CI: 0.38 to 0.86). Myalgia (26.9%), headaches (14.8%), and dizziness (9.8%) were other common neurological symptoms. Headaches had negative correlation with severity (OR: 0.48, 95%CI: 0.34 to 0.85) and death due to COVID-19 (OR: 0.39, 95%CI: 0.77 to 0.94) but myalgia and dizziness were not correlated. The analysis of neurological and non-neurological symptoms showed that headaches and smell and taste dysfunction had the highest correlation with patients with mild severity and lower death rate. <h3>Conclusions:</h3> Neurological manifestations in hospitalized patients with COVID-19 can predict disease severity and mortality. <b>Disclosure:</b> Dr. Salehi has nothing to disclose. Dr. Garakani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters-Kluwer. Mr. Amanat has nothing to disclose.

Nontuberculous mycobacteria isolation from sputum specimens: A retrospective analysis of 1061 cases.

In recent years, with the development of laboratory methods, the frequency of nontuberculosis mycobacteria (NTM) infections has increased. The primary aim of this study was to evaluate the clinical significance of therapeutic drug monitoring (TDM) growths in respiratory samples, and the secondary aim was to evaluate the treatment regimens and treatment outcomes of treatment for TDM disease. This study was a retrospective cohort study. Persons with NTM growth in respiratory samples admitted to the reference hospital between 2009 and 2020 were included in this study. Samples detected as NTM by the immunochromatographic rapid diagnostic test, those requested by the clinicians, species were determined by the hsp65PCRREA method. The subjects were classified into 3 groups: patients with NTM infection who received treatment (135, 12.7%), those followed up without treatment (690, 65.1%), and a last group of patients with Mycobacterium tuberculosis (TB) complex strains were isolated and received TB treatment (236, 22.2%). Initiating NTM treatment was decided in accordance with the American Thoracic Society recommendations. The mean ± standard deviation age of patients was 53.8 ± 16.5 years, and 749 (70.6%) were male. In total, 278 (26.2%) out of 1061 cases had identified, and the most frequent species were MAC (81; Mycobacterium avium: 39, Mycobacterium intracellulare: 39, and MAC: 3), Mycobacterium abscessus (67), Mycobacterium kansasii (48), Mycobacterium fortuitum (23), Mycobacterium chelonae (12), Mycobacterium gordonae (11), and Mycobacterium szulgai (11). In the NTM treatment group, 116 (85.9%) of 135 patients had multiple culture positivity. Previous TB treatment history had 51 (37.8%) of 135 patients, respiratory comorbidities were evident in 37 (27.4%) of 135 patients. Thorax computed tomography imaging in 84 patients revealed nodule 38 (45.2%), consolidation 46 (54.8%), cavity 52 (61.9%), and bronchiectasis 27 (32.1%). Treatment results in the NTM treatment group were as follows: ongoing treatment 14 (10.4%), cure 64 (47.4%), default 33 (24.4%), exitus 19 (14.1%), recurrence 3 (2.2%), and refractory disease 2 (1.5%). This is a large case series evaluating the clinical significance of NTM growths and NTM treatment in Turkey. The clinical significance of NTM growth in respiratory samples is low. Treatment success rates of NTM patients who are treated are low. Treatment defaults and mortality rates are high. New drugs and new regimens are needed.

1431. Evaluation of Drug-induced Liver Injury in Patients Receiving Anti-tuberculosis Medications and Subsequent Management

Abstract Background For anti-tubercular medications, the risk of drug-induced liver injury (DILI) ranges from 5-33%. DILI may be asymptomatic or may present with fever, nausea, vomiting, anorexia, and lethargy. The objective of this review is to describe the incidence of hepatotoxicity occurring with anti-tuberculosis medications, management of DILI, and re-initiation of therapy. Methods Adult patients prescribed pyrazinamide during their hospital stay at Long Island Jewish Medical Center were screened for inclusion criteria of DILI (liver enzymes ≥ 3x upper limit of normal [ULN] from 7/2017 to 2/2022. IRB classified this analysis as a quality improvement project. Using the electronic medical record, retrospective data was collected for those meeting criteria for DILI which included baseline demographics, concomitant hepatotoxic medications, laboratory values (e.g., alanine aminotransferase [ALT], aspartate aminotransferase [AST], timing of drug interruption, and sequence of re-initiation. Results A total of 108 patients were screened and then 17 were included in the analysis. DILI was found in 16% of patients. The mean age was 57 years and 53% were female. None of the patients with liver injury had a history of hepatic disease, prior DILI, or alcohol consumption. Mean baseline laboratory values were total bilirubin 0.52 mg/dL, alkaline phosphatase 166 U/L, AST 54 U/L, and ALT 40 U/L. All patients were initiated on first-line treatment for drug-susceptible tuberculosis. Thirteen patients had concomitant hepatotoxic drugs (11 acetaminophen, 4 statins, 2 azole antifungals, 1 trimethoprim/sulfamethoxazole). Fourteen patients (82%) developed DILI where AST was ≥ 10 times the ULN. Drug interruption was necessary in 16 of the 17 patients (94%). Seven patients (58%) were re-initiated on treatment according to the American Thoracic Society recommendations with a mean of 8 days after drug interruption. Conclusion In conclusion, the management of DILI related to anti-tubercular medications in our institution can further be standardized to reintroduce a rifamycin analog with or without ethambutol. Education on the avoidance of concomitant hepatotoxic medications such as acetaminophen and selecting the most appropriate agents to sequentially re-initiate treatment is warranted. Disclosures All Authors: No reported disclosures.

OBSTRUCTIVE LUNG DISEASE CONCORDANCE/DISCORDANCE WHEN COMPARING TWO PREDICTIVE EQUATIONS (GLI VS CRAPO/MORRIS)

OBSTRUCTIVE LUNG DISEASE CONCORDANCE/DISCORDANCE WHEN COMPARING TWO PREDICTIVE EQUATIONS (GLI VS CRAPO/MORRIS)

Association of Skeletal Muscle Strength and Body Fat Distribution on Pulmonary Functions

Objectives: The body's muscle strength and fat distribution are essential for a normal, healthy life. This study aimed to assess a link between pulmonary function tests, upper and lower extremity muscular strength, and body fat distribution in Saudi males. Methodology: This cross-sectional study was conducted in the department of physiology at the College of Medicine, King Saud University, Riyadh, Saudi Arabia. A total of 106 participants were invited, ranging from 20-47 years old. The participants were divided into three groups, with ages ranging from 20-29 years old, 30-39 years old, and 40–47 years old. The handgrip and thigh muscle strength was assessed using isometric dynamometry. Pulmonary function tests were performed according to the American Thoracic Society's guidelines and recommendations. Results: There was no significant difference between the three age groups in upper and lower limb muscle strength. The handgrip strength was stable from 20 to 47 years, ranging from 37 to 39. The thigh muscle strength was not affected by age among the three age groups. Skinfold measurement of the upper body showed no significant differences in biceps and triceps. However, skinfold measurements of subscapular and supra iliac were different significantly. Conclusion: There was no association between the age groups in upper and lower limbs muscle strength. It’s suggested that further large studies will be conducted to explore the findings and reach better conclusions.

Association of Skeletal Muscle Strength and Body Fat Distribution on Pulmonary Functions

Objectives: The body's muscle strength and fat distribution are essential for a normal, healthy life. This study aimed to assess a link between pulmonary function tests, upper and lower extremity muscular strength, and body fat distribution in Saudi males. Methodology: This cross-sectional study was conducted in the department of physiology at the College of Medicine, King Saud University, Riyadh, Saudi Arabia. A total of 106 participants were invited, ranging from 20-47 years old. The participants were divided into three groups, with ages ranging from 20-29 years old, 30-39 years old, and 40–47 years old. The handgrip and thigh muscle strength was assessed using isometric dynamometry. Pulmonary function tests were performed according to the American Thoracic Society's guidelines and recommendations. Results: There was no significant difference between the three age groups in upper and lower limb muscle strength. The handgrip strength was stable from 20 to 47 years, ranging from 37 to 39. The thigh muscle strength was not affected by age among the three age groups. Skinfold measurement of the upper body showed no significant differences in biceps and triceps. However, skinfold measurements of subscapular and supra iliac were different significantly. Conclusion: There was no association between the age groups in upper and lower limbs muscle strength. It’s suggested that further large studies will be conducted to explore the findings and reach better conclusions.

Molecular characterization of nontuberculous Mycobacteria in a tuberculosis and HIV reference unit in the State of Amazonas, Brazil.

ABSTRACTBackground: In recent years, the prevalence of nontuberculous mycobacterial (NTM) infections has increased in different regions of the world. The American Thoracic Society (ATS) recommends standardized identification criteria, reinforcing the need for faster and less complicated clinical and laboratory techniques. Methods: In this retrospective study, NTM species isolated from pulmonary, extrapulmonary, and disseminated samples from patients treated at a TB/HIV reference unit in the State of Amazonas from 2011 to 2014 were identified through a combination of molecular techniques. Results: To identify the molecular technique, 50 cryopreserved NTM cultures were recovered and subcultivated in culture medium. The potentially pathogenic NTM species identified were M. avium, M. intracellulare, M. kansasii, M. chelonae, M. abscessus, M. fortuitum, and M. peregrinum. Results of GenoType® showed moderate agreement with those of genomic sequencing (kappa = 0.60), whereas the results obtained by the PRA-hsp65 technique disagreed with the results obtained by sequencing (kappa = 0.49). Conclusions: Our findings highlight that GenoType CM is a good method for the identification of NTM, as well as the need for the application of standardized criteria, such as those set forth by the ATS.

Vitamin-D Supplementation as an Adjunct to Standard Treatment of Asthma in Children: A Randomized Controlled Trial (ViDASTA Trial)

To determine the role of vitamin D supplementation as adjunct therapy in improving pediatric asthma control.Children aged 6 to 11 years with moderate persistent asthma (defined as step 3 per Global Initiative for Asthmas [GINA] guidelines) were enrolled. Individuals with coexisting pulmonary, cardiac, renal, and/or endocrine conditions that contributed to vitamin D deficiency or parathyroid disease and/or required vitamin D or calcium supplements in the previous 3 months were excluded.This 3-month randomized blinded placebo-controlled trial was conducted at a tertiary care hospital in Western India. Baseline clinical information was recorded, spirometry and fractional exhaled nitric oxide (FeNO) were performed as per American Thoracic Society and European Respiratory Society recommendations, and serum 25(OH)D level was measured. Subjects were randomly assigned to 2000 IU per day of vitamin D or placebo. Spirometry, FeNO, and a venous blood sample were repeated at 3 months post enrollment. During the study period, subjects in both groups were placed on budesonide-formoterol 100mcg/6mcg inhalation 2 puffs twice daily for maintenance, with a short-acting β agonist to use as needed. Participants recorded asthma symptoms and use of rescue inhaler daily. Asthma control using the childhood asthma control test (C-ACT) and compliance with maintenance treatment and intervention therapy (drug versus placebo) were assessed at monthly visits. Data were analyzed according to the intention-to-treat principle.A total of 60 children (intervention: 30; placebo: 30) were included in the study. Although 2 participants were lost to follow-up in each group (N = 56), all 60 children were analyzed as per the intention-to-treat protocol. Demographics, preenrollment asthma medication use, medical history, and vitamin D3 levels were similar between the 2 groups. The intervention group had significantly higher baseline C-ACT score, compared with that of the placebo group (18 vs 15.5; P = .001), although both groups had mean C-ACT scores <19, indicating similarly, poorly controlled asthma at baseline. Both groups had significant improvement in C-ACT score and forced expiratory volume in 1 second at the end of the study period, when compared with the baseline. However, no significant difference was observed between the 2 groups in terms of the C-ACT score, even after adjusting for baseline scores, forced expiratory volume in 1 second, FeNO, health care use (number of exacerbations, emergency visits, hospital admissions), and adverse effects (relating to intervention). The intervention group had improvement in serum vitamin D levels at 3-months (35.5 ng/mL vs 18.8; P < .001).Vitamin D supplementation as an add-on to standard maintenance therapy in children with moderate persistent asthma does not improve asthma control.Although vitamin D deficiency has been reportedly associated with more severe asthma exacerbations, steroid-refractory asthma, and lower pulmonary function, there continues to be conflicting literature regarding the impact of vitamin D supplementation on childhood asthma. Larger studies using different vitamin D doses in children with different asthma severities, over longer periods of time, and in different parts of the world will be needed to determine if, if any, there is utility for vitamin D supplements in asthma. In the meantime, ensuring compliance with daily inhaled corticosteroid therapy and regular follow-up with the clinicians remain the cornerstone of effective asthma management.

The Role of Serum IL-1β in Combination with Fractional Exhaled Nitric Oxide in the Diagnosis of Adult Bronchial Asthma

Background: Asthma is a chronic airway disorder, in which cytokines are probably contributing in the inflammation and in the pathophysiology of the disease. This study aimed to determine the benefit of measurement of FENO and IL-1β in the diagnosis of asthma. Method: The study was conducted in Merjan Medical City and Spiro private clinic in Babylon province in the period from March to June 2019, 127 asthmatic patients were compared with 60 healthy subjects as control group. The age ranged from 10 to 60 years old, fractional exhaled nitric oxide (FENO) test was performed to assess asthma by using (Medisoft® company, Belgium). Body mass index (BMI) was subtracted as weight (kg)/height (m2). Waist circumference/cm (WC) was calculated between the inferior margin of thoracic ribs and midline of the iliac-crest. Hip circumference/cm (HC) was calculated from the broadest hip eminent before the waist/hip ratio (W/H) computed. The FENO measures had classified into low (&lt;25 ppb) or intermediate-high (⩾25 ppb) according to the ‘’American Thoracic Society recommendations’’. Iterleukine-1 beta (IL-1β) was measured in the sera by ELISA technique using Human IL-1β (Interleukin 1-Beta) ELISA Kit from Elabscience®. Results: there was no significant correlation between the levels of FENO and IL-1β with body weight as measured by the way of BMI and waist/hip ratio. There was no correlation between duration of asthma with the levels of FENO and IL-1β. ROC curve analysis of FENO test in BA patients showed significant (p-0.001) high sensitivity (92%) and specificity (90%). However, ROC curve analysis of IL-1β in BA patients revealed non-significant (p-0.53), lower accuracy (56.4%), sensitivity 962%) and specificity (57%) to distinguish BA patients). Conclusion: No relation between obesity and eosinophilic airways inflammation. The measurement of FENO level is more important in assessment of asthma inflammation than IL-1β.

Lung function impairment and cardiometabolic risks among rural adults: implication for an aging society

BackgroundEarly detection and prevention of cardiometabolic risk factors in an increasingly aging society are a global public health concern. Maintaining adequate lung function is important for healthy aging. Few studies exist on lung function impairment and decline in primary healthcare settings, especially among rural adults with cardiometabolic risks. This study aimed to explore the prevalence of impaired lung function and its association with cardiometabolic risks among rural adults.MethodsA community-based, cross-sectional study was conducted between March and December 2019 in western coastal Yunlin County, Taiwan. The lung function test was measured by spirometry, based on the American Thoracic Society recommendations. Three lung function parameters were obstructive lung impairment, restrictive lung impairment, and mixed lung impairment. Restrictive, obstructive, and mixed type lung function was categorized as impaired. Cardiometabolic risk factors and metabolic syndrome were based on the national standard and include five abnormal biomarkers, including abdominal obesity, blood pressure, fasting plasma glucose, triglycerides, and decreased high-density cholesterol levels.ResultsThe median age of the 1653 (92.9%) participants with complete data was 66 years (interquartile range: 55 to 75 years). The prevalence of impaired lung function was 37%, including 31.7% restrictive, 2.5% obstructive, and 2.7% mixed type. Adults with impaired lung function (86% restrictive type) engaged more in smoking and betel nut chewing, ate fewer vegetables and fruit, and drank less water compared to the normal lung function group. After adjusting for potential confounding variables, multivariate logistic regression analysis showed that cardiometabolic risk factors were independently associated with restrictive lung impairment, while cigarette smoking (OR = 2.27, 95% CI = 1.14–4.53) and betel nut chewing (OR = 2.33, 95% CI = 1.09–5.01) were significantly associated with the obstructive type of lung impairment.ConclusionsA high prevalence of restrictive lung impairment, cardiometabolic risks, and unhealthy lifestyles among rural adults were found in this study. For adults with cardiometabolic risks in rural areas, initiating lifestyle modifications with culture-tailored programs to improve lung function should be an important issue for clinicians and primary healthcare providers.

Effects of Occupational Exposure on Lung Function Tests in Old Process Plant Units workers, North Oil Company, Iraq

Occupational exposure to petroleum vapors has been shown to affect functioning of different systems of the body. The present study was taken up to assess the Pulmonary Function Tests. Method: A total of 356 male old process plant units' workers in north oil company, Kirkuk, Iraq, were assessed for lung function status. Respiratory function test was according to the American Thoracic Society (ATS) recommendations, Questionnaire performed and respiratory functions viz. (FVC, FEV1, FEV1/FVC% and PEF) were recorded by a portable electronic spirometer. Results: There was a statistically significant decrease in FEV1, FVC, and PEF in this study of exposured state compared to the normal state which was normal. FEV1/FVC% ratio was within normal limit. Conclusion: Most findings point towards adverse effects of petroleum vapors on lung function, mainly on lower airways with restrictive pattern of disease.

Target Workload For Exercise Challenge Tests Exceeds Achievable Workload In Children With Mild Asthma

PURPOSE: Exercise challenge tests are bronchoprovocation tests used to diagnose exercise induced bronchoconstriction. The American Thoracic Society (ATS) recommends calculating the target workload for exercise challenge tests using predicted forced expiratory volume in 1s (FEV1). The goal is for patients to achieve a minute ventilation between 40 to 60% of predicted maximum voluntary ventilation (PMVV) during the exercise challenge test. The purpose of this study was to compare predicted workload with actual workload achieved during an exercise challenge test in 8 to 12-year-old children with mild asthma. METHODS: Eleven children (3 girls, 10.3 ± 0.9 yr, 142.6 ± 8.1 cm, 40.7 ± 9.6 kg) completed pulmonary function testing and also completed maximal exercise tests and exercise challenge tests on a stationary bike. PMVV was calculated as 35 x measured FEV1. The test was completed at a target workload calculated using measured FEV1 (53.76 x measured FEV1 - 11.07). Our goal was to increase workload every minute as follows: 60%, 75%, 90%, and 100% target. However, if the child was unable to maintain cadence or expressed inability to complete 6 minutes of cycling, the workload was maintained or reduced to an achievable workload. RESULTS: 27% of children were below 40% PMVV, 36% were between 40 - 60% of PMVV, and 36% exceeded 60% of PMVV during the fifth minute of the exercise challenge test. After excluding the 3 children who did not achieve minute ventilation of at least 40% of PMVV, measured workload during the exercise challenge test (64 ± 18W; 66 ± 9%, Range: 49 - 78% of predicted target workload) was significantly lower than predicted target workload (96 ± 18W; P<0.001). Workload during the exercise challenge test was 67 ± 8% (Range: 60 - 80%) of maximum workload from the maximal exercise test. In the current project, we used measured FEV1 to calculate target workload for exercise challenge tests. However, even when predicted FEV1 was used to calculate target workload, measured workload during the exercise challenge test was below target and ranged from 43 - 112% (66 ± 22%) of target workload. CONCLUSIONS: The predicted workload for exercise challenge tests based on ATS guidelines may be difficult to achieve for children with mild asthma. However, target ventilation can be achieved at a workload that is between 60 - 80% of maximum workload.

The Practice Of Physical Activity Protects The Lung Function And Mechanics In Hypertensive Elderly

PURPOSE: Hypertension is still a growing problem in public health, presenting higher rates among elderlies. Recent studies have pointed out that hypertension may be an independent factor impairing the lung function. In addition, several studies have demonstrated that physical activity promotes beneficial effects in hypertensive individuals, but never before the impact of physical activity on lung function and mechanics in hypertensive and non-hypertensive elderlies have been evaluated. METHODS: 110 physically active hypertensive elderlies (ActH; 69.39 ± 5.49 years old) and 187 sedentary hypertensive elderlies (SedH; 70.09 ± 7.51). The inclusion criteria: no respiratory diseases, unable to perform spirometry test, no respiratory infections in the last 30 days. Lung function (spirometry) and lung mechanics (by impulse oscillometry) was evaluated according to American Thoracic Society recommendations by using IOS Masterscreen Jaeger (Germany). Graph Pad Prism 5.0 was used to perform statistical analysis and p<0.05 were considered significant. RESULTS: The analysis of lung function revealed that physical activity preserved the lung function (forced vital capacity - FVC) as demonstrated by comparisong between ActH versus SedH group (3.65 ± 0.05 x 2.79 ± 0.07; p<0.01). Simillary, the forced expiratory volume in the first second (FEV1) was higher in ActH when compared with SedH elderlies (2.96 ± 0.04 x 2.12 ± 0.05; p=0.02) as well as the FEV1/FVC relation (84.06 ± 0.77 x 75.99 ± 0.57; p=0.03). Concerning the lung mechanics, the results revealed that physical activity was able to preserve the impairment of distal lung elastance (X5), when compared ActH with SedH elderlies (-1.60 ± 0.19 x -1.47 ± 0.10; p<0.02) and also the impairment of proximal airways resistance (R20Hz), (2.58 ± 0.06 x 3.12 ± 0.09; p < 0.0001). CONCLUSIONS: Physical activity preserves the lung function and mechanics in elderlies in hypertensive elderlies.

Effects of Guarding on the Outcomes of the 6-Minute Walk Test

Introduction: The American Thoracic Society recommends not walking with the client during the 6-minute walk test (6MWT). This recommendation raises safety concerns for individuals at increased risk of falls. To date, the effects of guarding during the 6MWT have not been investigated. Purpose: The purpose of this study was to determine whether guarding during the 6MWT affected gait velocity and distance walked. Methods: This multicenter study collected data from healthy younger (n = 103, 24.2 ± 3.4 yr) and older adults (n = 102, 71.1 ± 11.3 yr) who performed 2 consecutive 6MWT trials. Participants were randomized into a “guarded first” versus “guarded second” condition. Data were analyzed using a one-sample t test, intraclass correlation coefficients (ICCs), and Bland–Altman plots. Results: Guarding significantly decreased (P &lt; .001) the distance walked (mean difference = 13.5 ± 40.3 m, 95% limits of agreement [LOA] = 65.5 and −92.4 m) and gait velocity (mean difference = 0.04 ± 0.11 m/sec, 95% LOA = 0.26 and −0.18 m/sec). Guarding decreased distance walked and velocity when divided into an older and younger group as well but had a more significant impact in the younger grouping. Conclusions: Guarding during the 6MWT influenced walking distance. Findings suggest that the measurements under the 2 walking conditions are not interchangeable.

Serum folate metabolites, asthma, and lung function in a nationwide US study

In a U.S. nationwide study, a high serum 5-MTHF to UMFA ratio is associated with decreased odds of asthma, increased FEV1 in children and adults, and increased FVC in adults.

M201 SHOULD FENO BE USED AS A BIOMARKER TO MEASURE RESPONSE TO BENRALIZUMAB?

Fractional exhaled nitric oxide (FENO) is commonly used in clinical practice for assessing and monitoring patients with asthma. The American Thoracic Society recommends using FENO in diagnosing and monitoring eosinophilic airway inflammation and identifying those likely responsive or noncompliant to corticosteroids. We observed 2 patients with severe uncontrolled eosinophilic asthma, compliant with inhaled corticosteroids and treated with benralizumab, an IL5 receptor inhibitor, in which FENO did not correlate with either clinical response or the presence of eosinophilic inflammation.

High Prevalence of Respiratory Symptoms among Particleboard Workers in Ethiopia: A Cross-Sectional Study.

Work in the wood industry might be associated with respiratory health problems. The production of particleboard used for furniture making and construction is increasing in many countries, and cause dust, endotoxin and formaldehyde exposure of the workers. The aim of the study was to assess the prevalence of respiratory symptoms and to measure lung function among Ethiopian particleboard workers using Eucalyptus trees as the raw material. In total 147 workers, 74 from particleboard production and 73 controls, participated in the study. Mean wood dust in the particleboard factories was measured to be above recommended limit values. Particleboard workers had a mean age of 28 years and the controls were 25 years. They had been working for 4 and 2 years, respectively. Lung function test was done using spirometry following American Thoracic Society (ATS) recommendations. Respiratory symptoms were collected using a standard questionnaire of ATS. Particleboard workers had higher prevalence of wheezing, cough, cough with sputum production, phlegm, and shortness of breath compared to controls. Lung function status was similar in the two groups. The symptoms might be related to the work in the factories. Longitudinal studies are recommended to explore the chronic impact of work in particleboard factories on respiratory health.