Forced Vital Capacity Score Research Articles

Parasympathetic cardiac dysfunction in Amyotrophic Lateral Sclerosis (P10-8.015)

<h3>Objective:</h3> Study the presence of cardiac dysautonomia in ALS patients. <h3>Background:</h3> Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting the upper and lower motor neurons. Diffuse neuronal affection has been observed in more frequent neurological diseases of degenerative etiology. There are isolated and sometimes contradictory studies addressing cardiac dysautonomia in ALS. Both orthostatic hypotension (sympathetic nervous system) and reduced RR interval variability (parasympathetic nervous system) are associated with a higher morbimortality. <h3>Design/Methods:</h3> Demographic variables, ALS-FRS and MRC scores and forced vital capacity (FVC) were registered in 20 ALS patients (with definite or probable diagnosis according to El Escorial Revisited criteria) attending a regular neurological control. We performed dynamometry, orthostatic testing and manually evaluated the RR interval variability in resting, deep breathing and post Valsalva maneuver electrocardiograms. All patients signed the informed consent approved by the hospital’s ethics committee. Logistic regression was used to address the relationship between cardiac parasympathetic dysautonomia and the independent relevant variables. <h3>Results:</h3> The mean age was 52 years (SD 13.79), with 75% of male patients and 85% of spinal onset. The mean ALS-FRS and FVC scores were 25.65 (SD 10.55) and 67% (SD 21). Only one patient had orthostatic hypotension while 12 (58.8%) showed reduced RR interval variability, with a strong tendency of association with age and not any other variable. <h3>Conclusions:</h3> Parasympathetic cardiac dysautonomia was very frequent in ALS patients. Larger studies are needed to confirm this finding since its diagnosis could help to tailor treatment and follow up in order to reduce other possible causes of morbimortality in ALS patients. <b>Disclosure:</b> Cecilia Quarracino has nothing to disclose. Natalia Bohorquez Morera has nothing to disclose. Dr. Capani has nothing to disclose. The institution of Santiago Perez-Lloret has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ELEA LAboratories. Gabriel Rodriguez has nothing to disclose.

Respiratory Function and Muscle Strength Vs. Past Work Type: a Cross-Sectional Study Among Retirees.

ObjectivesThe aim of this cross-sectional study was to assess the effects of past occupational activity on muscle strength and respiratory function among retirees.MethodsA total of 205 community-dwelling older adults participated in the study. Age (≥60 years) and cessation of professional activity (retirement) constituted the inclusion criteria. The International Standardized Classification of Occupations (ISCO-08) was used to stratify the participants into white- or blue-collar groups. Forced vital capacity (FVC), forced expiratory volume (FEV) in the first second, inspiratory vital capacity (IVC) parameters, and hand grip strength were tested.ResultsStatistically significant differences in IVC and FVC scores were found in white- and blue-collar workers after adjusting for sex and age (ANCOVA). White-collar men had significantly higher IVC as compared to blue-collar men.ConclusionsBlue-collar male workers may be prone to deteriorating respiratory function in older age. It is vital to promote physical activity and educate blue-collar workers about the need to use respiratory protective equipment.

Effect of ELTGOL on pulmonary function tests in patients with COPD: A quasi experimental study

Background: COPD is defined as a disease state characterized by progressive development of chronic airflow limitation that is not fully reversible and includes chronic bronchitis, emphysema and smaller airway disease. Pulmonary function testing (PFT) reveals airflow obstruction on spirometry that manifests as a reduced forced expiratory flow in one second (FEV1)/forced vital capacity (FVC) ratio (FEV1/FVC). Airway mucus hypersecretion is one of the most important features of COPD which is manifested as cough with expectoration. Chronic cough and sputum production are a few key features of chronic obstructive pulmonary disorder. These occur due to mucus hypersecretion and ciliary dysfunction. Airway clearance techniques (ACTs) involve the application of forces to enhance sputum removal from the airways. ELTGOL is known to be effective in mucus clearance in patients with COPD, chronic bronchitis, bronchiectasis etc. The goal of ELTGOL is to control the expiratory flow to prevent airway closure and facilitate mucus clearance to avoid airway compression. There are various studies that show the positive effects of airway clearance techniques on pulmonary functions. The benefits of ELTGOL on mucus clearance have also been proved. But the effects of ELTGOL on the pulmonary functions have not yet been proven to the best of our knowledge. Therefore, this study will check the effects of ELTGOL on pulmonary functions in patients with COPD. 33 Subjects were selected and explained about the intervention. Pre intervention assessment using PFT was done and intervention was given for 2 weeks once a day for 30 minutes. Post intervention PFT was done and the data was then analysed. Result: On comparison of pre and post data, change in FVC score was from 2.4±0.37 to 3.04±0.39, change in FEV1 score was from 1.43±0.27 to 2.36±0.29, change in PEFR score was from 3.38±0.66 to 4.35±0.7 and change in FEV1/FVC was from 0.58±0.04 to 0.76±0.05. This shows a statistically significant difference in the pre and post PFT scores. Conclusion: On the basis of the result, we can conclude that ELTGOL is effective in improving pulmonary functions in patients with moderate to severe COPD.

Melatonin may slow disease progression in amyotrophic lateral sclerosis: Findings from the Pooled Resource Open-Access ALS Clinic Trials database.

We utilized the Pooled Resource Open-Access Clinical Trials (PRO-ACT) database to investigate whether melatonin use among patients with amyotrophic lateral sclerosis (ALS) was associated with slower disease progression and prolonged survival. This retrospective analysis of the PRO-ACT database addresses the impact of melatonin on progression and overall survival of ALS. A Cox proportional hazards ratio model was performed to investigate the effect that melatonin had on time to death. For secondary outcome measures, linear mixed effects regression models were used to ascertain the effect of melatonin on change in standardized ALS Functional Rating Scale (sALSFRS) and percentage predicted forced vital capacity (FVC) scores. Melatonin users had a significantly decreased annualized hazard death rate compared with the non-melatonin users (hazard ratio, 0.241; 95% confidence interval, 0.088-0.659; P = .0056). The melatonin users also had a slower rate of decline in sALSFRS score (t = 2.71; P = .0069) and change in percent predicted FVC score (t = 2.94; P = .0035) compared with the non-melatonin users. Our findings suggest that melatonin may be beneficial for patients with ALS. Due to the nature of this database, our results are solely intended to be hypothesis-generating and no strong associations can be made. Given the low cost and favorable safety profile of melatonin, the hypotheses generated warrant further investigation.

Study protocol for a randomised, double-blind, placebo-controlled study evaluating the Efficacy of cannabis-based Medicine Extract in slowing the disease pRogression of Amyotrophic Lateral sclerosis or motor neurone Disease: the EMERALD trial

IntroductionAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no known cure and with an average life expectancy of 3–5 years post diagnosis. The use of complementary medicine such as...

Correlation of sCD40L Level with Force Vital Capacity Value in Restrictive Lung Disease of Systemic Sclerosis Patients

Background: Interstitial Lung Disease (ILD) is one of the major cause of morbidity and mortality in Systemic Sclerosis (SSc). The gold standard to diagnose ILD is using High Resolution Computed Tomography (HRCT) scan. HRCT scan need a lot of cost and not always available, so another diagnosing test is needed as an alternative modality to diagnose ILD. ILD is a restrictive lung disease caused by lung fibrosis which is proved by the decrease of Forced Vital Capacity (FVC) in spirometry, and followed by the increase of soluble CD40L (sCD40L) level in plasma. This sCD40L may become a potential biomarker to evaluate lung fibrosis in SSc patients. The aim of this study is to analyze the correlation of sCD40L levels with FVC score in SSc patients with restrictive lung disease.Method:This cross sectional study was enrolled by the SSc patient who has restrictive lung disease based on spirometry test, at Rheumatology outpatient clinic dr. Hasan Sadikin Hospital from May 2015 to May 2016. All subject took underwent history, physical examination, spirometry and blood test for sCD40L. Data were analyzed using Pearson correlation.Result:There were 38 subjects involved in this study, dominated bywoman (92.1%) with mean age 41(±11) years. Subjects consist of 22(57,9%) with limited SSc, 16(42,1%) with diffuse SSc patients and 33 subjects treated with DMARD. Mean sCD40L serum in this study was 6.690,3(±2.377,3) pg/mL, with no statistical difference between limited and diffuse type (p=0.154). Mean FVC score in this study was 58.2(±10,8). There was no significant correlation between sCD40L serum with FVC (r=0.058; p=0.366). There was weak correlation on DMARD naïve subject between sCD40L serum and FVC (r=0.058; p=0.366) but statistically insignificant. There was no significant correlation between sCD40L serum with mRSS (r=0,066; p=0,346).Conclusion: This study founds no correlation between sCD40L with FVC in SSc at dr. Hasan Sadikin Hospital. Keyword : sCD40L, Forced Vital Capacity, Restrictive Lung Disease, Systemic Sclerosis

Correlation of sCD40L Level with Force Vital Capacity Value in Restrictive Lung Disease of Systemic Sclerosis Patients

Background: Interstitial Lung Disease (ILD) is one of the major cause of morbidity and mortality in Systemic Sclerosis (SSc). The gold standard to diagnose ILD is using High Resolution Computed Tomography (HRCT) scan. HRCT scan need a lot of cost and not always available, so another diagnosing test is needed as an alternative modality to diagnose ILD. ILD is a restrictive lung disease caused by lung fibrosis which is proved by the decrease of Forced Vital Capacity (FVC) in spirometry, and followed by the increase of soluble CD40L (sCD40L) level in plasma. This sCD40L may become a potential biomarker to evaluate lung fibrosis in SSc patients. The aim of this study is to analyze the correlation of sCD40L levels with FVC score in SSc patients with restrictive lung disease.Method:This cross sectional study was enrolled by the SSc patient who has restrictive lung disease based on spirometry test, at Rheumatology outpatient clinic dr. Hasan Sadikin Hospital from May 2015 to May 2016. All subject took underwent history, physical examination, spirometry and blood test for sCD40L. Data were analyzed using Pearson correlation.Result:There were 38 subjects involved in this study, dominated bywoman (92.1%) with mean age 41(±11) years. Subjects consist of 22(57,9%) with limited SSc, 16(42,1%) with diffuse SSc patients and 33 subjects treated with DMARD. Mean sCD40L serum in this study was 6.690,3(±2.377,3) pg/mL, with no statistical difference between limited and diffuse type (p=0.154). Mean FVC score in this study was 58.2(±10,8). There was no significant correlation between sCD40L serum with FVC (r=0.058; p=0.366). There was weak correlation on DMARD naïve subject between sCD40L serum and FVC (r=0.058; p=0.366) but statistically insignificant. There was no significant correlation between sCD40L serum with mRSS (r=0,066; p=0,346).Conclusion: This study founds no correlation between sCD40L with FVC in SSc at dr. Hasan Sadikin Hospital. Keyword : sCD40L, Forced Vital Capacity, Restrictive Lung Disease, Systemic Sclerosis

The multi-ethnic global lung initiative 2012 and Third National Health and Nutrition Examination Survey reference values do not reflect spirometric measurements in Black boys and men from Tanzania.

The interpretation of spirometric results of Black Africans according to reference standards based on data from outside their native environment may lead to the wrong conclusions. This article aims to characterize the ventilatory capacity of boys and men from Tanzania according to forced expiratory volume in one second (FEV1 ), forced vital capacity (FVC), peak expiratory flow (PEF) and FEV1 /FVC based on the collected anthropological material and to compare them to NHANES III, Third National Health and Nutrition Examination Survey (NHANES III) African American predicted values and GLI2012 equations. The analysis included spirometric measurements of n=295 participants from Tanzania. Pearson's correlation analysis and the backward stepwise multiple regression analysis were performed. FEV1 , FVC, PEF and FEV1 /FVC results were compared to the NHANES III African American predicted values as well as to the GLI2012 equations. FEV1 measurements are lower than the reference values according to NHANES III and GLI2012 equations by 22·1% and 25·8%. FVC results fell short of the NHANES III predicted by 29·5% and of GLI2012 by 32·5%. The average %FEV1 /FVC scores for the boys and men exceeded the recommended GLI2012 predicted by 10·5-15·2%. All the spirometric measurements included in the analysis were statistically significantly correlated with age, body height, sitting height, trunk length and body weight. The application of prediction formulae developed for non-African populations overestimates the values for Black Africans. The results of spirometric measurements are ecosensitive and dependent on various external (environmental) factors.

Double-Blind Placebo-Controlled Trial on the Use of Acetyl-L-Carnitine for the Treatment of Amyotrophic Lateral Sclerosis (P04.151)

Objective: To assess superiority of acetyl-L-carnitine/riluzole (ALC) combination over riluzole alone on functional disability in patients with amyotrophic lateral sclerosis (ALS). Background ALS is a fatal motorneuron disease. Unlike riluzole, no disease-modifier drugs are available. ALC counteracts motor neuron death induced by toxic agents or deprivation of trophic factors and reduces disease progression in animal models. Design/Methods: Patients 40-70 years with definite or probable ALS, disease duration 6-24 months, self-supporting (ie, able to swallow, cut foods/handling utensils, and walk), and with forced vital capacity (FVC)>80% were enrolled in a pilot double-blind, placebo-controlled, parallel group trial and followed for 48 weeks. ALC 3g/day and placebo were added to riluzole 100mg/day. Primary end-point: no. patients becoming non self-supporting. Secondary end-points: changes in the ALS-FRS-R scale, MRC scale, FVC and McGill quality-of-life scale. Analysis was performed in the intention-to-treat (ITT) population, completers and completers/ compliers (ie, taking >75% of study drug). Results: 42 patients received ALC and 40 patients placebo. In the ITT population, 34 patients receiving ALC (80.9%) and 39 receiving placebo (97.5%) became non self-supporting (p=0.030). Percentages in study completers were 71.4 vs. 94.7% (p=0.064) and in “completers/compliers”, 71.4% vs. 94.4% (p=0.069). In the per-protocol analysis, percentages were 84.4 vs. 100.0% (p=0.054) and 76.2 vs. 100.0% (p=0.132)(completers & completers/compliers). At 48 weeks, ALC was associated with higher mean ALR-FRS-R scores (p=0.039) and FVC scores (p=0.016), while MRC and quality of life were no different. Adverse events were similar. Conclusions: ALC appears superior to placebo and is well-tolerated and safe. A confirmatory phase III trial is needed. (*) Italian ALS Study Group: Virginio Bonito, Paolo Buzzi, Claudia Caponnetto, Adriano Chio, Massimo Corbo, Fabio Giannini, Maurizio Inghilleri, Vincenzo La Bella, Lorenzo Lorusso, Christian Lunetta, Letizia Mazzini, Paolo Messina, Gabriele Mora, Michele Perini, Elisabetta Pupillo, Maria Lidia Quadrelli, Vincenzo Silani, Isabella Simone, Lucio Tremolizzo. Supported by: Agenzia Italiana per il Farmaco (AIFA). Sigma-Tau pharma company provided active treatment and placebo. Disclosure: Dr. Beghi has received personal compensation for activities with UCB Pharma as a speaker. Dr. Beghi has received personal compensation in an editorial capacity for Epilepsia. The Italian ALS Study Group has nothing to disclose.

Gray matter perfusion correlates with disease severity in ALS

The goal of this study is to determine if regional brain perfusion, as measured by arterial spin labeling (ASL) MRI, is correlated with clinical measures of amyotrophic lateral sclerosis (ALS) disease severity. The presence of such a relationship would indicate a possible role for ASL perfusion as a marker of disease severity and upper motor neuron involvement in ALS. Disease severity was assessed in 16 subjects with ALS (age 54 +/- 11) using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) and the pulmonary function measure, forced vital capacity (FVC). Upper motor neuron involvement was assessed by testing rapid tapping of the fingers and feet. Magnetic resonance perfusion images were coregistered with structural T1-weighted MRI, corrected for partial volume effects using the structural images and normalized to a study-specific atlas. Correlations between perfusion and ALS disease severity were analyzed, using statistical parametric mapping, and including age as a factor. Analyses were adjusted for multiple clusters. ALS severity, as measured by the ALSFRS and FVC, was correlated with gray matter perfusion. This correlation was predominantly observed in the hemisphere contralateral to the more affected limbs. ALSFRS scores correlated with perfusion in the contralateral frontal and parietal lobe (p < 0.001) and ipsilateral frontal lobe (p < 0.02). FVC scores correlated with gray matter perfusion in contralateral frontal lobe (p < 0.001). Upper motor neuron involvement, as measured by rapid finger tapping, correlated bilaterally with perfusion in the middle cingulate gyrus (p < 0.001). Amyotrophic lateral sclerosis (ALS) severity is correlated with brain perfusion as measured by arterial spin labeling (ASL) perfusion. This correlation appears to be independent of brain atrophy. ASL perfusion may be a useful tool for monitoring disease progression and assessing treatment effects in ALS.