Decrease In Peak Expiratory Flow Research Articles

FACTORS RELATED TO PEAK EXPIRATORY FLOW RATE IN PULMONARY TUBERCULOSIS PATIENTS

Patients with pulmonary tuberculosis can be at risk of bronchial obstruction due to secretions or secretions that collect and shallow breathing due to pain, which can cause atelectasis and decreased Peak Expiratory Flow Rate (PEFR) in pulmonary TB patients. The purpose of this study was to determine the relationship between PEFR in pulmonary TB patients at the Kramat Jati Health Center. This type of research uses correlation analytic observation using cross-sectional design and data analysis using Chi Square and Sperman rank methods. The sample in this study were 50 respondents at the TB Poly Kramat Jati Health Center and were collected using total sampling. Conclusion: The results of this study showed that gender was associated with PEFR in pulmonary TB patients with a p value=0.016 p <0.05 and work was associated with PEFR in pulmonary TB patients with a p value=0.007 p <0.05, age was unrelated to PEFR in pulmonary TB patients with a p value=0.412 and so was BMI with a p value=0.509. Suggestion: for more in-depth matters related to PEFR in pulmonary TB patients can be seen in terms of environmental factors or the physical condition of the patient.

Larger Airway Functions in Poultry and Dairy Confinement Workers: A Cross-Sectional Study.

The peak expiratory flow (PEF) test is a crucial tool for assessing larger airway functions, particularly in individuals exposed to occupational hazards. This study aims to compare PEF values between animal workers (poultry and dairy farm workers) who are regularly exposed to animal allergens and other respiratory irritants and normal workers who do not have such exposures. A cohort of animal workers from poultry and dairy farms were evaluated alongside a control group of normal workers without known respiratory hazards. PEF measurements were taken using a computerized spirometer, and results were analyzed to determine differences in respiratory function between the two groups. There was a significant difference in PEF values, with animal workers exhibiting lower PEF compared to their control group. Further, poultry farm workers had a significant decrease in PEF when compared to dairy farm workers. This study represents a pioneering effort in the comparative analysis of respiratory health among workers in poultry and dairy farms. The findings indicate that occupational exposure to allergens and irritants associated with animal environments may have deleterious effects on respiratory health. Further analysis, controlling for confounding variables such as smoking status, age, and baseline health conditions, reinforces the initial observation of compromised respiratory function in animal workers. This study underscores the importance of regular respiratory health monitoring and implementation of protective measures for individuals in occupations with high exposure to respiratory irritants. Enhanced awareness and preventive strategies could mitigate the long-term health impacts on animal workers, ensuring safer working environments and improved overall health outcomes.

Relation of changes in peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) during bronchoconstriction.

Diagnosis of asthma can be confirmed based on variability in peak expiratory flow (PEF) or changes in forced expiratory volume in 1 s(FEV1) measured with spirometry. Our aim was to use methacholine challenge as a model of induced airway obstruction to assess how well relative changes in PEF reflect airway obstruction in comparison to relative changes in FEV1. We retrospectively studied 878 patients who completed a methacholine challenge test. To assess congruency along with differences between relative changes in FEV1 and PEF during airway obstruction, a regression analysis was performed, and a Bland & Altman plot was constructed. ROC analysis, sensitivity, specificity, positive and negative predictive values and κ-coefficient were used to analyze how decrease in PEF predicts decrease of 10% or 15% in FEV1. The relative change in PEF was on average less than the relative change in FEV1. In the ROC analysis areas under the curve were 0.844 and 0.893 for PEF decrease to predict a 10% and 15% decrease in FEV1, respectively. The agreement between changes in PEF and FEV1 varied from fair to moderate. Airway obstruction detected by change in PEF was false in about 40% of cases when compared to change in FEV1. Change in PEF is not a very accurate measure of airway obstruction when compared to change in FEV1. Replacing peak flow metre with a handheld spirometer might improve diagnostic accuracy of home monitoring in asthma.

Impact of improved air quality on lung function and blood pressure of middle-aged and older population in China

Long-term exposure to fine particulate matters (PM2.5) has been associated with respiratory and cardiovascular diseases and the burden are potentially higher in China experiencing heavy air pollution. In this study, we established the exposure-response association between long-term exposures to PM2.5 and lung function and blood pressure in Chinese middle-aged and older adults using linear mixed-effects and generalized additive mixed models based on 3 waves longitudinal health outcomes data by enrolling 19,988 participants from 121 cities across the mainland of China. We also assessed the effect of Clean Air Policy (CAP) based on a quasi-experimental difference-in-differences (DID) design. A 10 µg/m3 increase in PM2.5 concentration was associated with a 7.18 (95 % confidence interval [CI]: -8.35, -6.02) L/min decrease in PEF (peak expiratory flow) and a 0.72 (95 % [CI]: 0.53, 0.90) and a 0.30 (95 % [CI]: 0.18, 0.42) mmHg increase in systolic and diastolic blood pressure, respectively. The associations were more pronounced in males and rural areas for PEF, but similar across subgroups for blood pressure. DID results suggested that the effect of CAP on health outcomes were sensitive to magnitudes of reduction in PM2.5. A 5 µg/m3 reduction in PM2.5 or more generally led to 18.70 (95 % [CI]:0.79, 36.61) higher PEF and -2.05 (95 % [CI]: -3.87, -0.23) lower diastolic blood pressure, respectively, compared to no reduction or increase in exposure. However, the effects were significant only in rural areas. Our analysis support CAP aiming to benefit public health and provides insights to inform future control policy for efficiently decreasing air pollution exposure burden.

The relationship between changes in peak expiratory flow and asthma exacerbations in asthmatic children

BackgroundAsthma is one of the most common chronic airway diseases in children. Preventing asthma exacerbation is one of the objectives of all asthma action plans. In patients with poor perception, it is difficult to identify acute asthma exacerbations by clinical asthma score, asthma control test or asthma control questionnaire. The aim of this study is to analyze whether children with asthma have changes in peak expiratory flow(PEF)before an acute asthma exacerbation and to evaluate the relationship between PEF and asthma exacerbation.MethodsBasic information (including sex, age, atopy, etc.) and clinical information of asthmatic children who registered in the Electronic China Children’s Asthma Action Plan (e-CCAAP) from 1 September 2017 to 31 August 2021 were collected. Subjects with 14 consecutive days of PEF measurements were eligible. Subjects in this study were divided into an exacerbation group and a control group. We analyzed the relationship between changes in PEF% pred and the presence of asthma symptoms.ResultA total of 194 children with asthma who met the inclusion criteria were included, including 144 males (74.2%) and 50 females (25.8%), with a male-to-female ratio of 2.88:1. The mean age of the subjects was 9.51 ± 2.5 years. There were no significant differences in sex, age, allergy history or baseline PEF between the two groups. In children with and without a history of allergy, there was no significant difference between the variation in PEF at 14 days. Patients who only had a reduced in PEF but no symptoms of asthma exacerbation had the greatest reduction in PEF compared to the other groups. The most common cause of acute exacerbations of asthma is upper respiratory tract infection. Among the causes of acute exacerbations of asthma, the variation in PEF caused by air pollution was significantly higher than that of other causes (P < 0.05). In acute exacerbations, the decrease in PEF was significantly greater in the exacerbation group than in the control group. In children with asthma symptoms, there was a decrease in PEF approximately 1.34 days before the onset of symptoms.ConclusionChildren with asthma show a decrease in PEF 1.34 days before the onset of asthma symptoms. We recommend that asthmatic children who show a decrease in PEF should step-up asthma therapy. The most common cause of acute exacerbations of asthma was upper respiratory tract infections, and the variation in PEF caused by air pollution was significantly higher than that caused by other factors.

The Impact of Driving Pressure-Guided Positive End-Expiratory Pressure Ventilation on Cerebral Blood Flow and Pulmonary Function in Patients Undergoing Laparoscopic Radical Prostatectomy.

To examine the impact of driving pressure-guided positive end-expiratory pressure ventilation on cerebral blood flow and pulmonary function in patients undergoing laparoscopic radical prostatectomy. A retrospective analysis was conducted on clinical data from patients who underwent laparoscopic radical prostatectomy at our hospital between June 2022 and June 2023. The patients were divided into two groups, namely the conventional ventilation group and the driving pressure-guided positive end-expiratory pressure ventilation group. Measurements and analyses were performed on cerebral blood flow, neurological status, and pulmonary function parameters. A total of 105 patients were included in this single-centre retrospective study, with 51 patients in the conventional ventilation group and 54 patients in the driving pressure-guided positive end-expiratory pressure ventilation group. The driving pressure-guided positive end-expiratory pressure ventilation group demonstrated significantly higher cerebral blood flow, cerebral autoregulation index, cerebrovascular resistance, and cerebral oxygen saturation compared to the conventional ventilation group (p < 0.05). Additionally, patients in the driving pressure-guided positive end-expiratory pressure ventilation group exhibited improved neurological outcomes, a higher partial pressure of oxygen/fraction of inspired oxygen ratio, increased lung compliance, decreased peak expiratory flow, elevated respiratory rate, and a lower lung injury score compared to the conventional ventilation group (p < 0.05). The findings suggest that driving pressure-guided positive end-expiratory pressure ventilation might positively influence cerebral blood flow and pulmonary function parameters in patients undergoing laparoscopic radical prostatectomy.

Relation of changes in PEF and FEV1 in exercise challenge in children.

Decrease in forced expiratory volume in one second (FEV1 ) of 10% or 15% in exercise challenge test is considered diagnostic for asthma, but a decrease of 15% in peak expiratory flow (PEF) is recommended as an alternative. Our aim was to assess the accuracy of different PEF cut-off points in comparison to FEV1 . We retrospectively studied 326 free running exercise challenge tests with spirometry in children 6-16 years old. FEV1 and PEF were measured before and 2, 5, 10 and 15 min after exercise. Receiver operating characteristics (ROC) analysis, sensitivity, specificity, positive and negative predictive values (PPV and NPV) and ϰ-coefficient were used to analyse how decrease in PEF predicts decrease of 10% or 15% in FEV1 . In the ROC analysis, areas under the curve were 0.851 (p < 0.001) and 0.921 (p < 0.001) for PEF decrease to predict a 10% and 15% decrease in FEV1 , respectively. The agreement between changes in PEF and FEV1 varied from slight to substantial (ϰ values of 0.199-0.680) depending on the cut-points. Lower cut-off for decrease in PEF had higher sensitivity and NPV, while higher cut-off values had better specificity and PPV. Decrease of 20% and 25% in PEF seemed to be the best cut-offs for detecting 10% and 15% decrease in FEV1 , respectively. Still, a fifth of the positive findings based on PEF were false. Change in PEF is not a precise predictor of change in FEV1 in exercise test. The currently recommended cut-point of 15% decrease in PEF seems to be too low and leads to high false positive rate.

THE EFFECT OF BUTEYKO BREATHING EXERCISE ON INCREASING PEAK EXPIRATIONAL FLOW IN THE ELDERLY AT THE TRESNA WERDHA BUDI MULIA III SOCIAL HOME

Background: Aging is the cause of widespread progressive changes in all aspects of biology that result in susceptibility to various diseases. The changes seen in the decrease in peak expiratory flow due to age often cause less air to enter the body. A decrease in peak expiratory flow will result in hypoxemia and hypercapnia which will lead to respiratory failure.. Buteyko Breathing Exercise is an intervention that supports increasing peak expiratory flow so that it can open the breathing path. Objective: Knowing the Effect of Buteyko Breathing Exercise on Increasing Peak Expiratory Flow in the Elderly. Method: This study uses the type of experimental research with one group pretest - posttest which is carried out at the Tresna Budi Mulia III Social Institution. In this study using 13 respondents who were selected using the Random Sampling Technique. Measurement of Peak Expiratory Flow using a Peak Flow Meter on baseline and final data after intervention for 4 weeks with a frequency of 2 times a week. Results: Changes in the increase in peak expiratory flow before and after the intervention obtained a value of p = 0.000 (p &lt; 0.05). Conclusion: There is an effect of Buteyko Breathing Exercise on Increasing Peak Expiratory Flow in the Elderly at Tresna Werdha Budi Mulia III Social Home.

Short-term effects of the chemical components of fine particulate matter on pulmonary function: A repeated panel study among adolescents

The effects of the chemical components of fine particulate matter (PM2.5) have been drawing attention. However, information regarding the impact of low PM2.5 concentrations is limited. Hence, we aimed to investigate the short-term effects of the chemical components of PM2.5 on pulmonary function and their seasonal differences in healthy adolescents living on an isolated island without major artificial sources of air pollution. A panel study was repeatedly conducted twice a year for one month every spring and fall from October 2014 to November 2016 on an isolated island in the Seto Inland Sea, which has no major artificial sources of air pollution. Daily measurements of peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) were performed in 47 healthy college students, and the concentrations of 35 chemical components of PM2.5 were analyzed every 24 h. Using a mixed-effects model, the relationship between pulmonary function values and concentrations of PM2.5 components was analyzed. Significant associations were observed between several PM2.5 components and decreased pulmonary function. Among the ionic components, sulfate was strongly related to decreases in PEF and FEV1 (−4.20 L/min [95 % confidence interval (CI): −6.40 to −2.00] and − 0.04 L [95 % CI: −0.05 to −0.02] per interquartile range increase, respectively). Among the elemental components, potassium induced the greatest reduction in PEF and FEV1. Therefore, PEF and FEV1 were significantly reduced as the concentrations of several PM2.5 components increased during fall, with minimal changes observed during spring. Several chemical components of PM2.5 were significantly associated with decreased pulmonary function among healthy adolescents. The concentrations of PM2.5 chemical components differed by season, suggesting the occurrence of distinct effects on the respiratory system depending on the type of component.

The acute effects of particulate air pollution on lung function in asthmatic children: A multicenter study with intensively repeated measurements

Evidence on the comparative effects of fine particulate matter (PM2.5) and coarse particulate matter (PM10-2.5) on the lung function of asthmatic children remained limited and inconsistent. This study aims to explore the acute effect of PM2.5 and PM10-2.5 on dynamic forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) among asthmatic children. We conducted a multicenter study and obtained intensively repeated measurements of FEV1 and PEF of clinically diagnosed asthmatic children in 89 Chinese cities from January 2017 to May 2021. Linear mixed-effects models combined with a polynomial distributed lag model were employed to evaluate the cumulative lag effect of PM2.5 and PM10-2.5 on daily FEV1 and PEF among asthmatic children. We also evaluated the effect modifications by sex, age, testing time, season, and region. A total of 590 clinically diagnosed asthmatic children with over 0.18 million dynamic lung function records were included in this study. The adverse effect of particulate matter on lung function occurred in a short term and could last for around one week. Specifically, both PM10-2.5 and PM2.5 were associated with decreases in PEF, but only PM10-2.5 could impair the measurements of FEV1. We found that an interquartile range increase in PM10-2.5 and PM2.5 were associated with 5.40 [95% confidence interval (CI): 0.88, 9.92] mL/s and 10.48 (95%CI: 5.14, 15.81) mL/s decrease in PEF, 6.46 (95%CI: 4.53, 8.40) mL and 0.25 (95%CI: −2.03, 2.54) mL decreases in FEV1, respectively. And the estimated effect of PM10-2.5 was stronger than PM2.5 on FEV1. Besides, these changes were larger in the evening and the south region of China. In conclusion, short-term exposure to both PM2.5 and PM10-2.5 could decrease the daily lung function of asthmatic children. The impact of PM10-2.5 was more hazardous than PM2.5.

Effect of Acute PM2.5 Exposure on Lung Function in Children: A Systematic Review and Meta-Analysis.

The objective of this study was to conduct a systematic review and meta-analysis to identify the adverse effects of acute PM2.5 exposure on lung function in children. Systematic review and meta-analysis. Setting, participants and measures: Eligible studies analyzing PM2.5 level and lung function in children were screened out. Effect estimates of PM2.5 measurements were quantified using random effect models. Heterogeneity was investigated with Q-test and I2 statistics. We also conducted meta-regression and sensitivity analysis to explore the sources of heterogeneity, such as different countries and asthmatic status. Subgroup analyses were conducted to determine the effects of acute PM2.5 exposure on children of different asthmatic status and in different countries. A total of 11 studies with 4314 participants from Brazil, China and Japan were included finally. A 10 μg/m3 increase of PM2.5 was associated with a 1.74L/min (95% CI: -2.68, -0.90) decrease in peak expiratory flow (PEF). Since the asthmatic status and country could partly explain the heterogeneity, we conducted the subgroup analysis. Children with severe asthma were more susceptible to PM2.5 exposure (-3.11 L/min per 10 μg/m3 increase, 95% CI -4.54, -1.67) than healthy children (-1.61 L/min per 10 μg/m3 increase, 95% CI -2.34, -0.91). In the children of China, PEF decreased by 1.54 L/min (95% CI -2.33, -0.75) with a 10 μg/m3 increase in PM2.5 exposure. In the children of Japan, PEF decreased by 2.65 L/min (95% CI -3.82, -1.48) with a 10 μg/m3 increase of PM2.5 exposure. In contrast, no statistic association was found between every 10 μg/m3 increase of PM2.5 and lung function in children of Brazil (-0.38 L/min, 95% CI -0.91, 0.15). Our results demonstrated that the acute PM2.5 exposure exerted adverse impacts on children's lung function, and children with severe asthma were more susceptible to the increase of PM2.5 exposure. The impacts of acute PM2.5 exposure varied across different countries.

Reduced peak expiratory flow predicts increased risk of cardiovascular disease: A 10-year prospective cohort study in Eastern China

BackgroundThe correlation between impaired lung function and cardiovascular diseases (CVD) has attracted more and more attention. We aimed to assess the longitudinal association between decreased peak expiratory flow (PEF) and cardiovascular risk among Eastern Chinese general population. MethodsIn total, 6295 participants aged>30 years and free of CVD at baseline were followed for up to 10 years in Eastern China. The adjusted hazard ratios (HRs) for CVD and mortality associated with decreased PEF were analyzed. ResultsAmong all participants, 421 CVD incident events were reported during 10-year follow-up, and a total of 272 participants died during the follow-up period, 94 of them from CVD. The HRs in the lowest group of PEF (PEF ≤218.33 L/min) were 1.31 (95% confidence interval [CI]:1.01 to 1.68) for high CVD incidence (172 vs 116), 2.43 (95% CI:1.72 to 3.42) for all-cause mortality (156 vs 48), and 3.94 (95% CI:1.96 to 7.92) for CVD mortality (59 vs 10) when compared with the highest group (PEF ≥321.68 L/min). ConclusionThe decreased PEF was associated with increased CVD incidence, CVD and all-cause mortality in Eastern Chinese general population.

The Correlation of Peak Expiratory Flow Rate and Hand Dynamometry in Chronic Obstructive Pulmonary Disease Patients A Case Control study

Objectives: To determine the correlation of peak expiratory flow rate and hand dynamometry in patients with chronic obstructive pulmonary disease and to find out the differences between hand grip in cases and control group Methodology: This study was carried out in the Department of Physiology and Department of Chest Medicine, Liaquat National Hospital and Medical College between July 1st 2019 and June 30th 2020 after the approval of the research and ethical committee of the same hospital. We used purposive sampling technique. Total 100 consenting individuals were recruited that were equally divided into control group and chronic obstructive pulmonary disease group. Anthropometric measurements alongwith peak expiratory flow rate and hand dynamometry values were measured. Results: We found significant difference in hand grip strength and peak expiratory flow rate between the case and control groups, chronic obstructive pulmonary disease patients have decreased peak expiratory flow rate and handgrip strength. Weak correlation exists between peak expiratory flow rate and hand grip strength with significant p value. No relationship was found between waist hip ratio and hand grip. Also, body mass index showed a weak negative but statistically significant correlation with hand grip strength. Conclusion: In chronic obstructive pulmonary disease patients, hand grip strength is decreased and determining hand grip strength may ensures quick assessment of quality of life.

Personal PM2.5-bound PAH exposure and lung function in healthy office workers: A pilot study in Beijing and Baoding, China

The effect of short-term exposure to polycyclic aromatic hydrocarbons (PAHs) on the respiratory system among healthy residents is unclear. Beijing and Baoding are typical polluted cities in China, and there is little research on PAH exposure and its health effects at the individual level. Fourteen healthy female office workers were recruited in urban Beijing and Baoding, China, in 2019. The personal exposure to fine particulate matter (PM2.5)-bound PAHs and lung function were seasonally monitored. The relationships between PAH exposure and lung function were determined by a generalized mixed linear model. Subjects were exposed to high levels of PAH, in which the benzo[a]pyrene (BaP) level (1.26 ng/m3) was over than Chinese national indoor standard (1 ng/m3). All PAHs concentration was higher in winter than that in summer and autumn. Only benz[a]anthracene (BaA) and chrysene (Chr) exposure showed weak relations with decreased lung function, i.e., a 0.58% and 0.73% decrease in peak expiratory flow at lag 2 day, respectively (p < 0.05). PAHs may not be suitable exposure indicators for short-term change in lung function. Our findings highlight the importance of reducing PAH pollution for public respiratory health protection in heavy-polluted cities of China. This pilot study also provides experience on personal PAH assessment such as estimation of the number of repeated measurements required, which is helpful to determine the relationship between PAH exposure and health effect.

Changes in Cough Airflow and Acoustics After Injection Laryngoplasty.

We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology. Prospective interventional study. Subjects with glottic insufficiency secondary to unilateral vocal fold paresis, paralysis, or atrophy, and scheduled for injection laryngoplasty completed an instrumental assessment of voluntary cough airflow using a pneumotachometer and a protocolized voluntary cough sound recording. A Wilcoxon signed-rank test was used to compare the differences between pre- and post-injection laryngoplasty in airflow and acoustic measures. A Spearman rank-order correlation was used to evaluate the association between airflow and acoustic cough measures. Twenty-five patients (13F:12M, mean age 68.8) completed voluntary cough airflow measurements and 22 completed cough sound recordings. Following injection laryngoplasty, patients had a statistically significant decreased peak expiratory flow rise time (PEFRT) (mean change: -0.03 s, SD: 0.06, p=0.04) and increased cough volume acceleration (mean change: 13.1 L/s2 , SD: 33.9, p=0.03), suggesting improved cough effectiveness. Correlation of cough acoustic measures with airflow measures showed a weak relationship between PEFRT and acoustic energy (coefficient: -0.31, p=0.04) and peak power density (coefficient: -0.35, p=0.02). Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds. 3 Laryngoscope, 133:S1-S14, 2023.

Adiposity: Determinant of Peak Expiratory Flow Rate in Young Indian Adults Male

Although several factors such as respiratory muscle strength, lung compliance, resistance to airflow, and even obesity affect the lung functions, the nature of relationship with markers of adiposity is not clear. We hypothesised that central pattern of fat distribution is a significant predictor of decreased peak expiratory flow rate (PEFR). The present study was designed with the aim to examine the effects of adiposity on PEFR in males. One hundred young healthy male volunteers were analysed in the study. They were classified into non-obese, and obese groups based on body mass index (BMI) (obese > or = 30 Kg/m2 and non-obese < 30 Kg/m2). The PEFR was measured by using Wright's peak flow meter. Data was analysed using unpaired 't' test for statistical significance of differences between the non-obese and the obese, stratified into age groups of 20 to 30 years and 30 to 40 years. A partial correlation adjusted to age, height and BMI followed by regression analysis was conducted using adiposity markers as a predictor of PEFR. The model adjusted to age, height, weight and BMI revealed waist hip ratio (WHR) as the only parameter which shows significant variance in PEFR with a Pearson's r=-0.59, F (1, 100)=12.23, p=0.04. The resulting linear regression equation is y=-388.72xWHR+850.68. Our findings suggest that obesity itself and especially the pattern of body fat distribution have independent effects on PEFR. These results suggest that abdominal adiposity, measured as WHR, is a better predictor of expiratory flow than weight or BMI.

The impact of obstructive sleep apnea on quality of life in children with asthma

Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA.&#x0D; Objective To evaluate the influence of OSA on quality of life in children with asthma.&#x0D; Methods This cross-sectional study in asthmatic children aged 7?15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).&#x0D; Results Using the ISAAC questionnaire distributed through teachers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects’ mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA.&#x0D; Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life.

Identifying the threshold of outdoor PM2.5 reversing the beneficial association between physical activity and lung function: A national longitudinal study in China

BackgroundDespite cumulative evidence reports the interaction effects of physical activity (PA) and air pollution on lung function, the findings have been inconsistent. We aimed to identify the threshold values that reverse the beneficial effects of PA on lung function. MethodsThis multistage probability sampling study examined 13,032 individuals aged ≥45 years across China from 2011 to 2015. City-level particulate matter 2.5 μm or less in diameter (PM2.5) were estimated based on a two-stage machine learning model, with a spatial resolution of 0.1° × 0.1°. We assessed PA and a range of covariates using standardized self-reported questionnaires. The peak expiratory flow (PEF) was measured using a peak flow meter. We used mixed-effects linear regression models to examine the associations between PA and PM2.5, and their interactions with PEF. ResultsParticipants were 60.4 ± 9.4 years old [mean ± standard deviation (SD)]. The mean ± SD of PM2.5 and PEF was 54.4 ± 23.0 μg/m3 and 273 ± 116 L/min, respectively. Each 10 μg/m3 increase in PM2.5 was associated with a 1.27 L/min decrease in PEF. The PEF increased by 2.48 (95% confidence interval, CI: 0.40, 4.55) L/min, 0.74 (95% CI: −1.17, 2.66) L/min, and 1.99 (95% CI: 0.001, 3.99) L/min following a 10 h/week increment of walking, moderate intensity PA, and vigorous intensity PA, respectively. Detrimental associations between PM2.5 and PEF outweighed PA benefits for approximate PM2.5 concentrations >81 μg/m3 (95% CI: 58.9, 111) and >77 μg/m3 (95% CI: 39.7, 102) for walking and vigorous intensity PA, respectively. ConclusionsWe identified the threshold of ambient PM2.5 above which the beneficial association of PA with lung function may be reversed to an adverse one. Although the threshold may vary across populations and places, the findings suggested that reducing air pollution could enhance the benefits of PA on lung function.

Gambaran Arus Puncak Ekspirasi Pada Penderita Asma Di Wilayah Kerja Puskesmas Mujur

Asthma is one of lung diseases caused by inflammation, it causes the asthma sufferers to experience breath difficulty which results in the decrease of PEF (Peak Expiratory Flow) scores. The purpose of this research was to obtain knowledge about PEF on asthma sufferers in Puskesmas Mujur. The method of this research was descriptive with design cross sectional. There were 38 respondents as samples of this research for two weeks. An instrument applied in this research was peak flow meter to measure PEF scores of patients. The result of this research showed that twenty-five respondents PEF scores (65.6%) are in red zone (&lt;50%) and thirteen people (34.4%) are in yellow zone (50%). The conclusion of this research is that peak expiratory flow decreases in patients suffering asthma.

Decreased peak expiratory flow rate associated with mortality in idiopathic pulmonary fibrosis: A preliminary report.

ObjectivesThe peak expiratory flow rate (PEFR) is known to decrease in patients with sarcopenia. However, little is known about the clinical impact of the PEFR in idiopathic pulmonary fibrosis (IPF). This study aimed to confirm whether a decrease in PEFR over 6 months was associated with survival in IPF patients.MethodsConsecutive IPF patients who had been assessed at a single center were retrospectively analyzed. The relative decline in PEFR over 6 months was assessed. Survival analyses were performed by univariate and multivariate Cox proportional hazard models.ResultsA total of 61 eligible cases (average age 70 years) were examined, and 21 patients (34.4%) died. The univariate Cox regression analysis showed that the body mass index, baseline % predicted forced vital capacity (FVC), baseline % predicted PEFR, % predicted diffusion capacity for carbon monoxide (DLCO), relative decline in FVC, and relative decline in PEFR were prognostic factors. On multivariate analyses, relative decline in PEFR (hazard ratio [HR] 1.037, p < .05) and baseline % predicted FVC (HR 0.932, p < .001) were independent prognostic factors, whereas relative decline in FVC was not.ConclusionA decrease in PEFR after 6 months may predict worse survival in patients with IPF.