Pulmonary Function Pattern Research Articles

Analyzing spirometry profile of pulmonary function pattern among gestating women with bronchial asthma: A case–control study

Asthma is a widespread respiratory illness that affects millions of people worldwide, including pregnant women. Using spirometry testing, this study examines the effects of pregnancy on the lungs of pregnant women with and without bronchial asthma. The survey included 200 asthmatic pregnant women overall and 100 pregnant healthy women. FEV1, PEFR, FVC, and FEV1/FVC ratio, among other lung function indicators, were measured during the second and third trimesters of pregnancy. The findings show that pregnant women with asthma have significantly worse lung function than healthy pregnant women, with lower FEV1, PEFR, and FEV1% values. In addition, changes in lung function and body mass index (BMI) were observed between the second and third trimesters. The FEV1/FVC ratio remained largely stable, although both FVC and FEV1% decreased significantly. These results highlight the dynamic nature of lung function and BMI during pregnancy and also highlight the importance of monitoring these changes for the health of expectant mothers and their unborn children. To ensure maternal and fetal health, it is essential to understand these physiological changes, especially in people with asthma. Future evaluation of spirometry data should consider reference equations tailored to pregnant women. This will provide important insights into the complex relationship between respiratory health and pregnancy.

Effects of physical training on body weight, pulmonary function and dietary patterns in adolescents with obesity

Physical activity offers a powerful tool to address the challenges faced by obese teenagers. By promoting social inclusion, improving physical health, and boosting mental well-being, sports can significantly enhance their overall quality of life. Our research discusses the negative effects of obesity in adolescents and the benefits of a sports program when addressing these issues. The study involved 60 participants (30 males and 30 females) aged 14-16 for a period of eight months. Results showed significant weight loss for most participants: 26 participants lost around 10% of their body weight, another group lost around 8%, and only 4 subjects did not experience significant weight change. The study also observed a 9.5% improvement in motor skills on average. The mean weight loss difference between intervention and control was 9.30%. The study emphasizes the detrimental effects of obesity in adolescents and highlights the effectiveness of physical activity programs in promoting weight loss, enhancing respiratory function and induce healthy eating habits among obese adolescents. It also underscores the positive social and lifestyle benefits associated with regular physical activity. Keywords: physical activity; obesity; exercise; inclusion; nutrition

Assessment of Pulmonary Functions in Parkinson's Disease and Unveiling the Role of Levodopa Therapy: A Cross-Sectional Study.

This investigation aimed to thoroughly characterize the range of pulmonary function abnormalities present in individuals with Parkinson's disease (PD) and to evaluate the effects of levodopa therapy on these respiratory dysfunctions. Ninety-five PD patients diagnosed via the UK Parkinson's Disease Society Brain Bank Diagnostic Criteria were recruited, excluding those with a smoking history or unable to perform pulmonary function tests (PFTs). Severity was assessed using the Hoehn and Yahr Scale. Spirometry-measured PFT parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow rate (PEFR)) were compared against matched predicted values. The changes in PFT parameters post-levodopa challenge were assessed. Most of the PD patients were aged between 51-60 years, with a mean age of 55.89 ± 8.37 years. Of these, 65.3% were male. A significant proportion of the cohort exhibited restrictive pulmonary patterns (73.7%), while a smaller fraction displayed obstructive (7.4%) or normal (18.9%) pulmonary function patterns. Notably, levodopa treatment correlated with marked improvements in all measured PFT parameters, especially evident in the enhancements from the "off" medication stage to the "on" stage for FVC and FEV1 (P=0.0001). A weak positive correlation between the severity of respiratory restriction and the duration of PD (r = 0.139, P = 0.021) was found, suggesting that PD's progression exerts an increasingly adverse effect on respiratory function over time. The findings of this study illustrate that restrictive pulmonary abnormalities are more prevalent than obstructive patterns in PD patients and that these patients respond favorably to levodopa therapy.

Real-world therapeutic performance of pirfenidone for connective tissue disease-associated interstitial lung diseases.

Pirfenidone (PFD) is commonly applied for antifibrotic treatment in patients with idiopathic pulmonary fibrosis but has rarely been studied in cases with connective tissue disease-associated interstitial lung diseases (CTD-ILDs). We aimed to examine the efficacy of PFD in patients with CTD-ILD based on real-world data. A retrospective cohort study. This study assessed the clinical features of CTD-ILD patients with or without a 6-month PFD treatment. A linear mixed effects model was employed to evaluate the effectiveness of PFD in alleviating lung function changes. Differences in response to PFD were analyzed based on CTD subtype, imaging classification, and pattern of pulmonary function at baseline. A total of 289 patients with CTD-ILD were included, with 155 (53.6%) receiving PFD treatment and the remaining constituting the control group. Patients with the usual interstitial pneumonia (UIP) pattern were more likely to receive PFD treatment, and a relatively lower proportion of cases in the PFD group received immunosuppressive therapies compared to the control group (p < 0.05). At the 6-month follow-up, patients in the PFD group demonstrated a more significant improvement in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) (ΔFVC%: 2.9% vs 0.45%, p = 0.009; ΔDLCO%: 1.9% vs -1.1%, p = 0.004). In the linear mixed model analysis, there was a statistically significant group-time interaction between FVC% and DLCO% changes over time (FVC%: β = 4.52, p < 0.001; DLCO%: β = 4.13, p = 0.003). Furthermore, subgroup analysis indicated that pirfenidone may have superior therapeutic effects in patients with systemic sclerosis (SSc)-associated ILD, non-UIP pattern, and restrictive pattern of lung function at baseline. This study provided real-world data demonstrating the effectiveness of PFD in terms of lung function improvement in patients with CTD-ILD.

Respiratory symptoms and pulmonary function impairment among textile industry workers in Alexandria, Egypt.

Occupational exposure to cotton dust is still an important cause of respiratory problems in textile workers particularly in less developed countries like Egypt. Evaluate respiratory symptoms and diseases, and pulmonary function pattern among Egyptian textile workers. Cross sectional comparative study was conducted from December 2019 to September 2020 in a textile factory in Egypt; 364 male workers (184 cotton dust exposed workers, and 180 unexposed workers) were included. Participants were subjected to an interviewing questionnaire, British Medical Research Council questionnaire, anthropometric measurements, pulmonary function tests, and byssinosis grading format. Descriptive and analytic statistics were conducted. Chronic cough, phlegm production, and shortness of breath grade I, II and III were more reported in cotton dust exposed workers than unexposed workers (P#x003C;0.01, P#x003C;0.01, and P=0.02, respectively). Prevalence of chronic bronchitis was significantly higher among cotton dust exposed workers (12%) than unexposed workers (3.9%) (P#x003C;0.01). The mean percent predicted values of lung function indices reflecting large-1irway function (VC, FVC, FEV1, FEV1%, PEFR, and FEF75) were significantly lower in cotton dust exposed workers (P#x003C;0.01). Prevalence of byssinosis was 22.8%. Workers with byssinosis had significantly higher prevalence of respiratory symptoms, chronic bronchitis, cross-shift reduction in PEFR and significant decrease in mean percent predicted values of FVC, FEV1, PEFR, FEF75, and FEF50 than workers without byssinosis. This study revealed a substantial association between cotton dust exposure at work and respiratory symptoms and morbidity. Regular measurement of cross shift change in PEFR is recommended among exposed workers for early diagnosis of byssinosis.

Association between serum creatinine levels and pulmonary function of Korean adults: the 2016-2019 Korea National Health and Nutrition Examination Survey.

Research on the interaction between renal and lung functions has been conducted; however, studies on the general adult population are limited. This study aimed to investigate the association between serum creatinine levels and pulmonary function in Korean adults. From the 2016-2019 Korean National Health and Nutrition Examination Survey, we recruited 11,380 participants who were 40 years or older for this study. Serum creatinine levels were divided into three groups: low, normal, and high. Pulmonary function was divided into three groups: normal, restrictive, and obstructive. The odds ratios for abnormal pulmonary function patterns were calculated using weighted multinomial logistic regression analysis. The odds ratios were 0.97 for low vs. normal (0.40-2.33) and 2.00 for high vs. normal (1.18-3.38) for the restrictive pattern, and 0.12 for low vs. normal (0.02-0.49) and 1.74 for high vs. normal (0.90-3.35) for the obstructive pattern after being adjusted for age, sex, smoking status, alcohol consumption, regular exercise, body mass index, diabetes mellitus, hypertension, cardiovascular disease, total energy, and total proteins. High serum creatinine levels were associated with an increased odds ratio for restrictive and obstructive pulmonary function patterns. The odds ratio of the restrictive pattern was higher than that of the obstructive pattern. Screening for abnormal pulmonary function in individuals with high serum creatinine levels may be useful to ensure that there is no abnormal pulmonary function before the onset of potential pulmonary problems. Thus, this study highlights the relationship between renal and pulmonary function using serum creatine levels, which can be easily tested in the primary medical environment of the general population.

3D Printing Technology for Chest Wall Reconstruction With a Sternum-Ribs-Cartilage Titanium Implant: From Ideation to Creation.

We describe the use of 3-dimensional (3D) printing technology to plan and reconstruct the sternum, adjoining cartilages, and ribs with a custom-made, anatomically designed, 3D-printed titanium implant for an isolated sternal metastasis complicated with a pathological fracture. We imported submillimeter slice computed tomography scan data into Mimics Medical 20.0 software and by manual bone threshold segmentation created a 3D virtual model of the patient's chest wall and tumor. For all-around tumor-free margins, we grew the tumor by 2 cm. The replacement implant was designed in 3D using the anatomical features of the sternum, cartilages, and ribs and manufactured using TiMG 1 powder fusion technology. Physiotherapy was provided prior to and following surgery, and the impact of reconstruction on pulmonary functions was assessed. At surgery, the precise resection, clear margins, and a secure fit were achieved. At follow-up, there was no dislocation, paradoxical movement, change in performance status, or dyspnea. There was a decrease in forced expiratory volume in 1 s (FEV1) from 105% prior to surgery to 82% following surgery and in forced vital capacity (FVC) from 108% to 75%, with no difference in the FEV1/FVC ratio, suggesting a restrictive pattern of impairment. With 3D printing technology, reconstructing a large anterior chest wall defect with a custom-made, anatomical, 3D-printed titanium alloy implant is feasible and safe, and it preserves the shape, structure, and function of the chest wall, albeit with a restrictive pattern of pulmonary function, which can be addressed with physiotherapy.

Analysis of Pulmonary Function in Thymoma Subjects: A 20-Year Retrospective Cohort Study.

Thymoma is the most common tumor of the anterior mediastinum. However, the correlation between thymoma stage and pulmonary function was not assessed. Our objective in this study was to describe the pulmonary function in thymoma subjects stratified with different staging systems. A total of 143 subjects with a diagnosis of thymoma who underwent extended thymectomy for thymoma between January 2001 and December 2019 were reviewed retrospectively. All the subjects experienced pulmonary function tests (PFTs) using Master Screen PFT system and total respiratory resistance measurement. We evaluated 143 subjects with a diagnosis of thymoma; the significant differences were observed in mean values of vital capacity, inspiratory volume (IC), total lung capacity (TLC), ratio of residual volume to total lung capacity (RV/TLC), forced vital capacity, forced expiratory volume in 1 second, ratio of forced expiratory volume in 1 second to forced vital capacity, peak expiratory flow, peak inspiratory flow, maximum ventilation volume, total airway resistance, and diffusing capacity for carbon monoxide (DLCO) across upper airway obstruction classification. PFTs of subjects with varying Masaoka stages are different. RV and RV/TLC of subjects in stages III and IV were higher than those of normal level, while DLCO of subjects in stage IV was lower than the normal level, and the mean level of IC showed significant difference between stage II and stage III. The pulmonary function patterns of thymoma subjects significantly correlate with tumor location and size rather than clinical Masaoka stage.

Restrictions of VC and DLCO in relation to asbestos-related computed tomographic findings quantified by ICOERD-based parameters

BackgroundEven almost 30 years after the ban on the use of asbestos in Germany, the effects of asbestos are still highly relevant in everyday clinical practice in occupational medicine. The aim of this study was to further investigate the significance of essential parameters of both pulmonary function diagnostics and imaging techniques (low-dose HR-TCT) for the prevention and early detection of asbestos-related morphological and functional lung changes.MethodsData from spirometry, body plethysmography and diffusion capacity, as well as CT images of the thorax, were retrospectively studied from 72 patients examined between 2017 and 2019 at the Institute for Occupational and Maritime Medicine (ZfAM), Hamburg, Germany. The subjects were divided into four subgroups according to the presence of comorbidities (concomitant cardiac diseases, obstructive ventilatory disorder, pulmonary function pattern consistent with emphysema, and no other pulmonary or cardiac diseases). These subgroups were analysed in addition to the overall collective. The CT images were evaluated according to the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) with radiological expertise. In addition, some asbestos-related parameters were newly quantified, and corresponding scores were defined based on ICOERD. Statistical analysis included the use of correlations and fourfold tables with calculation of Spearman's rho (ρ), Cohen’s κ, and accuracy.ResultsVital capacity (VC) is slightly reduced in the total collective compared to the normal population (mean 92% of predicted value), while diffusion capacity for CO (DLCO) shows predominantly pathological values, mean 70% of the respective predicted value. The CO transfer coefficient (DLCO/VA), which refers to alveolar volume (VA), also shows slightly decreased values (mean 87% pred.). Seventy-nine percent of patients (n = 57) had signs of pulmonary fibrosis on CT scans, and pleural plaques appeared in 58 of 72 patients (81%). Of the newly quantified additional parameters, particularly frequently described findings are subpleural curvilinear lines (SC, n = 39) and parenchymal bands (PB, n = 29). VC correlates well with the expression of pleural plaques (ρ = − 0.273, P < 0.05), and DLCO measures show a better correlation with fibrosis score (ρ = − 0.315, P < 0.01). A third, newly developed score, which includes the extent of pleural plaques and additional subpleural parameters instead of fibrosis parameters, shows significant correlations for both VC and DLCO (ρ = − 0.283, − 0.274, resp.; both P < 0.05).DiscussionThe importance of spirometry (VC) and diffusion capacity measurement (DLCO) as essential diagnostic procedures for the early detection of asbestos-related changes ‒ also including patients with relevant concomitant cardiac or pulmonary diseases ‒ was confirmed. Significant and better correlations between lung function changes (VC and DLCO) and abnormal CT findings are seen when parenchymal bands (PB), subpleural curvilinear lines (SC), and rounded atelectasis (RA) are quantitatively included into the evaluation, in addition to assessing the extent of pleural plaques alone. Therefore, when assessing CT images according to ICOERD, these parameters should also be quantified.

Frequency of restrictive pulmonary function tests in patients with chronic Hepatitis C

Hepatis C infection is a common health problem world wide and is the major cause of chronic liver disease in Pakistan. Common complications of chronic hepatitis c infection are cirrhosis, ascities and hepatocellular carcinoma. Also HCV infection is associated with several extra hepatic manifestations including interstitial lung fibrosis. It has been found that frequency of pulmonary fibrosis is increased in patients with cirrhosis of liver as the stage of cirrhosis advances.This lung fibrosis can cause restrictive pattern of pulmonary function tests. This study was conducted to determine frequency of restrictive pulmonary function in patients with different stages of chronic hepatitis C infection, based on child pough classification.&#x0D; Study design&#x0D; This is descriptive case study&#x0D; Method&#x0D; 99 patients of age range 20 to 80 year, both males and females having chronic hepatitis C infection and interferon based treatment naïve patients were included from outpatient and inpatient department were selected. Patients were divided into three groups according to child’s criteria i.e. group A, group B, and group C. Pulmonary function tests were performed on patients in all three groups to look for FEV1/FVC ratio in all patients. FEV1/FVC ratio more than 80 was considered as restrictive pulmonary function.&#x0D; Results&#x0D; Out of 99 patients 32(35%) were found to have restrictive pattern of pulmonary functions&#x0D; Conclusion&#x0D; Chronic hepatitis C infection is associated with restrictive pattern of pulmonary function, suggestive of pulmonary fibrosis.

Bronchoalveolar Lavage in Systemic Sclerosis Patients: A Systematic Review.

We performed a systematic review of the literature to determine the value of bronchoalveolar lavage (BAL) in evaluating the pulmonary involvement of systemic sclerosis (SSc). Articles published between 1980 and 2019 were retrieved from the databases: PubMed and Scielo. The search was restricted to clinical trials published in English, utilizing the keywords "scleroderma, systemic sclerosis, interstitial lung disease, and bronchoalveolar lavage". Twenty-two papers were analyzed. A positive correlation was observed between increased BAL cellularity (alveolitis) and worsening clinical symptoms, pulmonary function, and radiological pattern in 2, 11, and 15 studies, respectively. The majority of BAL studies that evaluated interleukin levels, including TNF-α, IL-6, IL-7, and IL-8, observed higher levels in patients with impaired pulmonary function and increased lung involvement. Alveolitis and the increase of some cytokines/chemokines in BAL were related to more severe pulmonary disease in SSc in the majority of the studies and seemed to be markers of worse prognosis, but it is unknown whether BAL adds clinical value to the use of the other non-invasive diagnostic procedures.

Prognostic value of transbronchial lung cryobiopsy for the multidisciplinary diagnosis of idiopathic pulmonary fibrosis: a retrospective validation study

Transbronchial lung cryobiopsy (TBLC) has been introduced recently in the diagnosis of interstitial lung diseases. We aimed to evaluate the prognostic significance of the distinction between idiopathic pulmonary fibrosis and other interstitial lung diseases with the use of TBLC data in multidisciplinary team (MDT) diagnosis. In this single-centre, retrospective, investigator-initiated comparative study, we evaluated consecutive patients without a definite usual interstitial pneumonia pattern on high-resolution CT, who presented to the GB Morgagni Hospital (Forlì, Italy), and who underwent TBLC (Jan 1, 2011, to Dec 31, 2014) or surgical lung biopsy (SLB; Jan 1, 2002, to Dec 31, 2016). Three pathologists reviewed the specimens, masked to clinical information. MDT evaluation was done before and after biopsy. The primary endpoint was the prognostic significance of the MDT diagnostic separation between idiopathic pulmonary fibrosis and other interstitial lung diseases in patients undergoing TBLC. Mortality was evaluated by means of Cox regression analysis. We evaluated 500 consecutive cases, 426 of which were included: 266 had TBLC and 160 had SLB. 189 patients had idiopathic pulmonary fibrosis, 143 had other fibrotic interstitial lung diseases, and 94 had non-fibrotic interstitial lung diseases. Patients undergoing TBLC had more comorbidities and better preserved lung function compared with those undergoing SLB; among patients with a final MDT diagnosis of idiopathic pulmonary fibrosis, patients undergoing TBLC were older, had more comorbidities, and had a different post-biopsy treatment profile than those who received SLB. The distinction between idiopathic pulmonary fibrosis and other interstitial lung diseases made by MDT diagnosis on the basis of TBLC biopsy had clear prognostic significance, with a 5-year transplant-free survival of 68% (95% CI 57-76) in patients with an MDT idiopathic pulmonary fibrosis diagnosis based on TBLC compared with 93% (87-96) in patients without an idiopathic pulmonary fibrosis diagnosis based on TBLC (hazard ratio 5·28, 95% CI 2·72-10·04; p<0·0001). This distinction remained statistically significant in a multivariate analysis controlling for age, sex, smoking status, comorbidities, pulmonary function, and high-resolution CT patterns (p=0·02). TBLC makes an important diagnostic contribution in interstitial lung disease, on the basis of the prognostic distinction between idiopathic pulmonary fibrosis and other interstitial lung diseases when TBLC findings are included in multidisciplinary diagnosis. None.

Mixed Airway and Pulmonary Parenchymal Disease in Patients With Primary Sjögren Syndrome: A 6-year Follow-up.

To assess pulmonary function and chronic obstructive pulmonary disease (COPD) development over time in patients with primary Sjögren syndrome (pSS), as well as the association between pulmonary function, radiographic findings, respiratory symptoms, and clinical features of pSS, taking cigarette consumption into account. Forty patients with pSS (mean age 66 yrs; range 42-81 yrs; 39 women), previously participating in a cross-sectional study on pulmonary involvement in pSS, were reassessed by pulmonary function tests after a mean follow-up time of 6 years. At follow-up, patients were also assessed by high-resolution computed tomography of the chest, as well as for pSS disease activity, respiratory symptoms, and cigarette consumption. Patients with pSS showed significantly decreased percentages of predicted total lung capacity (TLC), residual volume (RV), RV/TLC ratio, and diffusing capacity of the lungs for carbon monoxide, as well as an increase in predicted forced expiratory volume in 1 second/vital capacity (FEV1/VC) ratio from baseline to follow-up. The proportion of COPD in patients with pSS did not change significantly from baseline to follow-up (38% vs 40%, respectively). Radiographic signs of bronchial involvement and interstitial lung disease were each found in 38% of the patients. Both airway and pulmonary parenchymal disease were commonly found in patients with pSS, with a coexistence of both an obstructive and restrictive pulmonary function pattern, where the latter tended to deteriorate over time. COPD was a common finding. Airway and pulmonary involvement may be underdiagnosed in pSS, which is why special attention to clinical assessment of pulmonary involvement in patients with pSS is mandated.

Pulmonary functions of patients with isolated mandibular fractures: a preliminary report.

ObjectivesThe aim of this study was to evaluate pulmonary function in patients with mandibular fractures and to determine the pattern of pulmonary functions in these patients.Materials and MethodsThis was a cross-sectional study of pulmonary functions in Nigerian non-smoking patients with isolated mandibular fractures managed at our health institution from December 2015 to June 2017. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), and ratio of FEV1 to FVC (FEV1/FVC) were measured for all participants using a portable spirometer just before treatment. The pulmonary indices were compared with the predicted reference values for Nigerians to determine the respiratory pattern.ResultsForty participants consisting of six females (15.0%) and thirty-four males (85.0%) with a female to male ratio of 1:5.7 were included in this study. The mean patient age was 34.5±13.1 years (range, 17–63 years). The mean FVC, FEV1, FEV1/FVC, and PEFR were 3.8±1.2 L, 3.0±1.0 L, 74.3%±13.8%, and 5.2±2.2 L/s, respectively. Comparison of data with predicted values revealed that 17 subjects (42.5%) had normal pulmonary function pattern while 23 subjects (57.5%) had features suggestive of obstructive and restrictive pulmonary function patterns.ConclusionIsolated mandibular fractures presented with abnormal pulmonary function pattern.

Relationship between FVC, FEV1, FEV1/ FVC% and oxidative stress in type 2 diabetes mellitus

Background: Diabetes mellitus causes micro and macrovascular disorder with debilitating effects on many organs including lungs. There is pulmonary impairment in type 2 diabetic patients (T2DM) which is usually characterized by restrictive pattern. Increased oxidative stress is associated with type 2 diabetes which may contribute to microvascular and macrovascular complications.&#x0D; Objectives:To assess the relationship between oxidative stress and lung function in patients with type 2 diabetes mellitus.&#x0D; Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from September’2018 to August’ 2019. For this study, 35 newly diagnosed type 2 diabetic male patients aged 30-50 years and similar age and BMI 35 apparently healthy subjects were enrolled as control. Forced vital capacity (FVC), Forced expiratory volume in 1st second (FEV1) and FEV1/FVC%were assessed by portable spirometer. For evaluation of oxidative stress, plasma malondialdehyde (MDA) and catalase levels were measured by competitive ELISA technique and spectrophotometry. Statistical analysis was done by unpaired ‘t’ test, chi-square test, pearson correlation test and multiple regression analysis as applicable.&#x0D; Results: In this study, the mean percentage of predicted value of FVC and FEV1were significantly lower (p&lt;0.001) in T2DM. In addition restrictive pattern of pulmonary function was found in 65.71% and 14.28% in T2DM and healthy control respectively and the difference was statistically significant. The mean plasma catalase was significantly lower (p&lt;0.01) and plasma MDA was significantly higher (p&lt;0.001) in patients. In addition, FVC showed significant negative correlation and significant association with higher MDA level in T2DM. Moreover, FEV1 also showed significant association with MDA in T2DM.&#x0D; Conclusion: The present study reveals that restrictive pattern of pulmonary impairment is related to oxidative stress in T2DM.&#x0D; J Bangladesh Soc Physiol. 2019, December; 14(2): 69-76

Study of The Relationship between Severity of Liver Cirrhosis and Pulmonary Function Tests

Background: Cirrhosis is a condition in which the liver does not function properly due to long-term damage. This damage is characterized by the replacement of normal liver tissue by scar tissue. Objective: The aim of this work is to study the relationship between severity of liver cirrhosis according to the ChildPugh score and pulmonary function tests (namely spirometry and arterial blood gas). Patients and Methods: The study is a cross sectional one, which was carried out on 50 patients admitted in the inpatient wards, or in regular follow-up in the out-patient’s clinics of the Gastroenterology Departments, in Al-Azhar University Hospitals between November 2018 and May 2019.They were divided into 3 groups according to Child Pugh Classification (A, B and C). Result: The prevalence of hypoxia was(30%) in all studied groups (50 patients), the hypoxia was present in patients with Child C and Child B (62%) and (29.4%) respectively but none of Child A had hypoxia. It was noted that all pulmonary functions were worst in patients Child class C when compared to other groups. However, patients Child B had also significantly worse pulmonary functions when compared to patients class A. We also showed that pulmonary functions are significantly correlated with synthetic liver function, Child and MELD score. The deterioration of liver functions and rise of patients score is accompanied by worsening of all pulmonary functions. Conclusion: Patients suffering from severe liver cirrhosis and ascites, have significant reduction in (PaO2) and (SaO2) in association with restrictive pulmonary function pattern (up to 100% of patients with massive ascites).

Study of The Relationship between Severity of Liver Cirrhosis and Pulmonary Function Tests

Background: Cirrhosis is a condition in which the liver does not function properly due to long-term damage. This damage is characterized by the replacement of normal liver tissue by scar tissue. Objective: The aim of this work is to study the relationship between severity of liver cirrhosis according to the ChildPugh score and pulmonary function tests (namely spirometry and arterial blood gas). Patients and Methods: The study is a cross sectional one, which was carried out on 50 patients admitted in the inpatient wards, or in regular follow-up in the out-patient’s clinics of the Gastroenterology Departments, in Al-Azhar University Hospitals between November 2018 and May 2019.They were divided into 3 groups according to Child Pugh Classification (A, B and C). Result: The prevalence of hypoxia was(30%) in all studied groups (50 patients), the hypoxia was present in patients with Child C and Child B (62%) and (29.4%) respectively but none of Child A had hypoxia. It was noted that all pulmonary functions were worst in patients Child class C when compared to other groups. However, patients Child B had also significantly worse pulmonary functions when compared to patients class A. We also showed that pulmonary functions are significantly correlated with synthetic liver function, Child and MELD score. The deterioration of liver functions and rise of patients score is accompanied by worsening of all pulmonary functions. Conclusion: Patients suffering from severe liver cirrhosis and ascites, have significant reduction in (PaO2) and (SaO2) in association with restrictive pulmonary function pattern (up to 100% of patients with massive ascites).

Chronic model of sulfur mustard‐induced lung injury in Fischer 344 rats

Recent chemical attacks in Syria demonstrate the nondiscriminatory threat that chemical agents pose to both military personnel and civilians alike. Sulfur mustard (SM)is a highly reactive and toxic chemical agent that poses such a threat and is considered a potential weapon that could be employed in acts of terror. SM reacts with epithelial tissue of the respiratory tract, causing a progressive, debilitating injury that currently has no FDA‐approved medical therapeutic countermeasure. This study aimed to develop a chronic model of SM‐induced pulmonary morbidities in inbred Fischer 344 rats with the overall goal of evaluating mesenchymal stem cell therapy as a proof‐of‐concept study. Fifty‐one (n=15 per SM group, n=6vehicle group) male rats were anesthetized, underwent tracheal intubation and were exposed to one of three concentrations of sulfur mustard vapor (0.7, 1.0, and1.4 mg/kg) or vehicle (ethanol) via inhalation for 50 min. At euthanasia (21–28days PE), respiratory mechanics and lung pathology, on the left and accessory lobes, were assessed. Forced oscillation parameters of SM‐exposed animals showed similar significant reductions, despite the SM dose, in inspiratory capacity (IC), compliance of the entire respiratory system (Crs), and significant increases in the respiratory system elastance(Ers) and resistance (Rrs) in comparison to control (ethanol) animals. Pressure‐volume (PV) loop parameters showed that all three SM doses caused similar significant reductions in static compliance (Cst), forced vital capacity FVC, inspiratory capacity (A), K, forced expiratory volume at 200ms (FEV200) and peak inspiratory flow (PEF) in comparison to control animals. However, SM‐induced reductions in these parameters were non‐distinguishable between doses. Animals that received SM had pathology findings of proteinaceous edema fluid in the bronchial, bronchiolar, and alveolar regions of the lungs with mild to severe perivascular edema, hemorrhage and inflammation. Multifocal bronchiolar mucous cell hyperplasia was prominent after SM exposure with partial to extensive fibrosis of the bronchial wall and variable epithelial loss occurring. Although variable in severity and not widespread, alveolar fibrosis also occurred multifocally. In conclusion, a reduction in Crs and an increase in Ers of the forced oscillation measures, in animals that received SM, indicate an increased lung stiffness and elasticrecoil of the lung. PV‐loop analysis presented with a restrictive and obstructive pulmonary function pattern with an increase in Rrs and decreases in inspiratory capacity, FEV200 and PEF along with flattening (reduction) of the downward curvature of the deflating limb of the PV loop. Pathology results are consistent with the respiratory mechanics findings.Support or Funding InformationThe research described was supported by an interagency agreement (AOD18014‐001‐00000) between the NIH office of the Directory and the USAMRICD under the oversight of the Chemical Countermeasures Research Program within the Office of Biodefense Research at the National Institute of Allergy and Infectious Diseases. The views expressed are solely those of the authors and do not necessarily represent the official views of the CCRP, NIAID, NIH, HHS, USAMRICD or DOD.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Pulmonary function patterns and their association with genotype and phenotype in adult cystic fibrosis patients

ABSTRACTBackground: While cystic fibrosis (CF) lung disease is generally considered to be an obstructive disorder, other pulmonary function patterns (PFP) may occur. Furthermore, little is known about possible associations between PFP and genotype or phenotypical characteristics.Methods: Cross-sectional study including CF patients aged 16 years or more, identifying different PFP and exploring associations between PFP and genotype or phenotypical characteristics.Results: Obstructive PFP was most prevalent in our population (n = 80), comprising obstructive lung disease (62.5%), small airway (obstructive) disease (11.2%), and mixed obstructive-restrictive disorder (1.3%). However, one in four adult CF patients did not show any obstruction at all: normal (13.7%) or restrictive (8.8%) lung disease and isolated diffusion disorder (2.5%). Obstructive PFP was associated with a greater proportion of CF-related diabetes mellitus (CFRD) (P = 0.04), Pseudomonas aeruginosa colonization (P = 0.02) and frequent exacerbators (P = 0.04). We observed no association between PFP and genotype.Conclusions: Obstructive PFP remains the most common pulmonary function pattern in adult CF and is associated with CFRD, Pseudomonas aeruginosa colonization and frequent exacerbators.

P268 Pulmonary function patterns and their association with genotype and phenotype in adult cystic fibrosis patients

P268 Pulmonary function patterns and their association with genotype and phenotype in adult cystic fibrosis patients