Reference Values In Healthy Individuals Research Articles

The left ventricular strain-volume loop in a healthy Dutch population: age- and sex related differences

Abstract Introduction By combining left ventricular (LV) global longitudinal strain (GLS) with LV volume during the cardiac cycle, LV strain-volume loops can be generated. LV SV-loop derived parameters provide new insights into the interaction between cardiac contraction and volume in a variety of cardiac diseases (1,2) and may even have prognostic value. (3,4) Reference values for healthy individuals with attention to sex- and age-related differences have not been established yet. Therefore, the aim of this study is to provide reference ranges in a healthy adult population and investigate potential sex- and age-related differences of LV SV-loop characteristics. Methods In 125 healthy volunteers aged 18-72 years, apical 2-, 3- and 4-chamber views were acquired to measure GLS. Custom software was used to combine strain and volume data to construct SV-loops. Different parameters were derived: (i)linear slope of systolic strain-volume relation (S-Slope); (ii) early linear slope of systolic strain-volume relation (ES-Slope); (iii) early linear slope of diastolic strain-volume relation (ED-Slope); and (iv) uncoupling between systolic and diastolic strain-volume relation (UNCOUP). Results For the systolic strain-volume relation higher values were observed in females as compared with males with S-Slope values of 0.19 [0.17-0.22] %/mL m-² and 0.13 [0.11-0.15] %/mL m-² respectively. ED-Slope was higher in females as compared with males with values of 0.18 [0.09-0.28] %/mL m-² and 0.12 [0.06-0.18] %/mL m-² respectively. Relative coupling of the systolic and diastolic strain-volume relation was observed with a mean value of 0.34 ± 1.1. UNCOUP was correlated with age with a value for r of 0.4. Conclusion Higher values for the systolic and early-diastolic strain-volume relation in females can be reflective of different cardiomechanics as LV contraction is not only comprised of longitudinal but also circumferential and radial deformation. In line with current literature our custom software found relative coupling of the systolic and diastolic strain-volume relation in our cohort of healthy subjects. Towards older age relative uncoupling of the systolic and diastolic strain-volume relation was found.Figure 1.Strain-volume loop

Defining reference values of arterioles in healthy individuals for studies with adaptive optics imaging.

To investigate age-dependent wall to lumen ratio (WLR) reference values for healthy individuals in adaptive optics imaging (AO). WLR serves as an objective, dimensionless parameter for the evaluation of structural changes in vessels caused by conditions like arterial hypertension, diabetes or vascular stenosis. 50 right eyes of healthy individuals were examined by adaptive optics imaging. The central big arterioles and smaller arterial branches at least one disc diameter away from the optic disc, approximately above or below the macula were measured by the manufacturer's software. The wall-lumen-ratio (WLR), the wall cross-sectional area (WCSA) and lumen diameter (LD) were assessed. Subsequent data analysis was performed with a focus on variables including age, gender and blood pressure. Normative values for WLR, WCSA and LD in 5 different age groups could be established. However, no significant differences between the age groups were found. Intra-subject comparisons revealed significantly higher WLRs on peripheral branches when compared to central arterioles. WLR showed in this normotensive cohort no relevant correlation with the systolic, diastolic and mean blood pressure. Gender and intraocular pressure had no influence on the vascular parameters. AO is capable of examining vascular alterations in arterioles at an almost microscopic level. Age did not seem to alter WLR, normotensive blood pressure parameters showed also no significant impact. AO-based vessel analysis may provide clinically useful biomarkers for cardiovascular health and should be tested in future studies.

Using ultrasound shear wave elastography to characterize peripheral nerve mechanics: a systematic review on the normative reference values in healthy individuals.

Ultrasound shear wave elastography (SWE) is an emerging non-invasive imaging technique for peripheral nerve evaluation. Shear wave velocity (SWV), a surrogate measure of stiffness, holds promise as a biomarker for various peripheral nerve disorders. However, to maximize its clinical and biomechanical value, it is important to fully understand the factors that influence nerve SWV measurements. This systematic review aimed to identify the normal range of SWV for healthy sciatic and tibial nerves and to reveal the factors potentially affecting nerve SWV. An electronic search yielded 17 studies eligible for inclusion, involving 548 healthy individuals (age range, 17 to 72 years). Despite very good reliability metrics, the reported SWV values differed considerably across studies for the sciatic (1.9-9.9 m/s) and tibial (2.3-9.1 m/s) nerves. Factors such as measurement proximity to joint regions, limb postures inducing nerve axial stretching, and transducer alignment with nerve fiber orientation were associated with increased SWV. These findings suggest regional-specific nerve mechanical properties, non-linear elastic behaviour, and marked mechanical anisotropy. The impact of age and sex remains unclear and warrants further investigation. These results emphasize the importance of considering these factors when assessing and interpreting nerve SWE. While increased SWV has been linked to pathological changes affecting nerve tissue mechanics, the significant variability observed in healthy nerves highlights the need for standardized SWE assessment protocols. Developing guidelines for enhanced clinical utility and achieving a comprehensive understanding of the factors that influence nerve SWE assessments are critical in advancing the field.

The spatial distribution of interleukin-4 (IL-4) reference values in China based on a back propagation (BP) neural network.

This study aimed to investigate the geospatial distribution of normal reference values of Interleukin 4 (IL-4) in healthy Chinese adults and to provide a basis for the development of standard references. IL-4 values of 5,221 healthy adults from 64 cities in China were collected and analyzed for a potential correlation with 24 topographical, climatic and soil factors. Seven of these factors were extracted and used to build a back propagation (BP) neural network model that was used to predict IL-4 reference values in healthy individuals from 2,317 observation sites nationwide. The predicted values were tested for normality and geographic distribution by analytic Kriging interpolation to map the geographic distribution of IL-4 reference values in healthy Chinese subjects. The results showed that IL-4 values generally decreased and then increased from the South to the North. We concluded that the BP neural network model applies to this approach, where certain geographical factors determine levels of various biochemical and immunological standards in healthy adults in regions with different topography, climate and soil indices.

Establishment of Haematological Reference Values for Healthy Individuals Attending Ruhengeri Referral Hospital in Rwanda

Background: The Laboratory investigations are very important for reaching to definitive diagnosis of diseases orientation and thus enabling optimal patient management based on informed diagnoses. Decision, and these are very difficult to obtain in the absence of reference values. In many cases, laboratory diagnosis such as haematological analyses are dependent on pre-defined locally established reference values. Objective of the study: The objective of this study was to describe ranges of haematological reference values for healthy individuals attending Ruhengeri referral Hospital in Rwanda Methodology: The cross sectional study was carried out in Northern Province at Ruhengeri referral hospital from July 2018 to September 2018. Participants were 252 healthy individuals aged less than one year to 68 years. From each participant, 4mL of blood samples were collected using K3 EDTA containers, and then analysed by Sysmex XS-500i automated haematology analyser. Results: Haemoglobin levels varied with age and sex. The level decreased with the increasing age, and males had high haemoglobin level than females (15.69g/dL versus 14.46g/dL). Minimum mean values of haematological parameters for study participants were slightly on the high side with narrow confidence intervals compared to the Manufactured Sysmex values. Conclusion: The findings may be used to define normal haematological values for Rwandan population and help physicians to better define haematological abnormalities in patients.

Взаимосвязь показателей вариабельности гликемии и нарушений сердечного ритма у пациентов с сахарным диабетом 1 типа

Objective: To study indicators of glycemic variability (GV) and their relationship with cardiac arrhythmias in patients with type 1 diabetes mellitus according to glucocardiomonitoring data. Design: Cross-sectional study. Materials and methods. The study included 72 patients with type 1 diabetes without previously diagnosed cardiovascular pathology. Of these, 34 patients received insulin pump therapy, 38 received multiple insulin injections. The average age of patients was 39.7 ± 15.9 years, the average duration of type 1 diabetes was 15.4 ± 10.8 years. The level of glycated hemoglobin (HbA1c) was determined in patients, and according to continuous glucose monitoring (CGM), GV indices were calculated: SD (standard deviation), CONGA (continuous overall net glycemic action), LI (lability index), MAGE (mean amplitude of glycemic excursions), MAG (mean absolute glucose). Simultaneously with CGM, Holter monitoring of the electrocardiogram was carried out: heart rate (HR), the presence and time of occurrence of arrhythmias, variability of the corrected QT interval (QTc), and the presence of ischemic changes were assessed. A correlation analysis of the relationships between GV levels and heart rhythm disorders was carried out. Results. Regardless of the type of insulin therapy, GV indicators in patients with type 1 diabetes were higher than the reference values for healthy individuals. Only 19 (26%) patients reached the target HbA1c level. In 62 (86%) people, various heart rhythm disturbances were registered, in 30 (42%) of patients there was a decrease in the circadian index (CI) of heart rate, and in 14 (19%) there was a prolongation of the QTc interval. The results of the correlation analysis showed that with an increase in GV, the HR CI decreased and the frequency of supraventricular and ventricular extrasystoles increased. Conclusion. The detected changes in heart rhythm against the background of increased GV in patients with type 1 diabetes indicate a high risk of developing a cardiovascular process. Strict glycemic control and normalization of GV can better reduce the risk of cardiac arrhythmia and the development of DCAN in patients with type 1 diabetes. Keywords: type 1 diabetes mellitus, glycemic variability, cardiovascular disease, diabetic cardiovascular autonomic neuropathy

Comparative characterization of walking biomechanical parameters in hip prosthesis users with mechanical and electronic knee modules

To compare spatial and temporal parameters of walking in patients after hip replacement using prostheses with electronic and mechanical knee modules. The study included 94 patients aged between 18 and 50 with hip prostheses. The patients were divided into two groups: Group 1 included 48 patients with a hip prosthesis with a mechanical knee module; Group 2 included 46 patients with a hip prosthesis with an electronic knee module. The groups were comparable in size, gender and age distribution, and mobility grade (grade 3 according to the MOBIS classification system). All patients had no comorbidities or injuries that could limit mobility. Spatial and temporal parameters of walking on hip prostheses with different knee modules were assessed using a video analysis system (SMART DX5000, Italy). Group 2 patients (prostheses with electronic knee modules) had the following spatial and temporal biomechanical walking indices: arbitrary walking speed 1.10-1.08 m/s, walking pace 105.82 steps/minute, step cycle 1.13-1.15 s, double step length 1.27 m, rhythm index 0.89. Group 1 patients (prostheses with mechanical knee modules) had worse outcomes according to the same indices: walking speed 0.81-0.87 m/s, walking pace 90.84 steps/minute, step cycle 1.33 s, double step length 1.07 m, rhythm index 0.74. Preferred walking speed and walking pace indices in patients with electronic knee modules in hip prostheses were at the lower limits of reference values in healthy individuals; the step length was insignificantly reduced; the rhythm index was close to that of healthy individuals (0.94-0.97). The results of the study show that the use of prostheses with electronic knee modules in patients with amputation at the hip level enables patients to learn better symmetrical walking and significantly increases their mobility compared to mechanical modules.

Tongue measurements and pharyngeal residue in amyotrophic lateral sclerosis.

Aim: We aimed to analyze the relationship between tongue measurements and vallecular residue in patients with amyotrophic lateral sclerosis (ALS). Materials & methods: Twenty-one patients with ALS were assessed for posterior maximum tongue isometric pressure (PMTIP) and posterior tongue isometric endurance (PTIE) by the Iowa Oral Performance Instrument; vallecular residue after 10ml of moderately thickened consistency by Fiberoptic Endoscopic Evaluation of Swallowing; and tongue thickness (TT) by ultrasonography. Results: PMTIP, PTIEand TT were decreased compared with the reference values for healthy individuals and were not different between patients with and without vallecular residue. Conclusion: In ALS, PMTIP, PTIEand TT are not good predictors of vallecular residue in the tested volume and food consistency.

Association between core stability and physical function, functional performance in patients with systemic sclerosis.

To investigate the association of core stability with physical function and functional performance in patients with systemic sclerosis (SSc). Forty patients who met the American College of Rheumatology / European League Against Rheumatism 2013 classification criteria for SSc were included in the cross-sectional study. For evaluation of core stability, trunk muscle endurance and trunk muscle strength were assessed. Trunk extensor and trunk flexor endurance tests were used for assessment of trunk muscle endurance. Trunk muscle strength was measured with a hand-held dynamometer and modified sit-up test. To measure physical function the Health Assessment Questionnaire Disability Index (HAQ-DI) and to measure functional performance 6-minute walking test (6MWT) and sit-to-stand test (STS) were used. Patients with SSc had lower mean trunk extensor and flexor endurance test times (49.87±30.81 and 32.17±15.42seconds, respectively), modified sit-up test repetition (17.42±7.81) and trunk extensor and flexor muscle strength (7.48±2.29kg and 6.20±1.68kg, respectively) when compared to the reference values in healthy individuals. All measurements were used to evaluate core stability associated with HAQ-DI score, 6DMWT walking distance and STS test duration (all P<.05). Patients with SSc have markedly reduced core stability and this negatively affects the physical function and functional performance. Therefore, this study highlights the importance of trunk muscle in patients with SSc. We suggest that not only upper-lower extremity muscles, but also trunk muscle strength and endurance should be measured and core stability exercises can be added to the training programs to maintain and/or improve physical functions and functional performance in SSc patients.

Türkiye'de Sağlıklı Erişkinlerde Optik Sinir Kılıfı Çapının Değerlendirilmesi

Introduction: In this study, we aimed to investigate how the normal values of optic nerve sheath diameter are distributed in normal healthy volunteers in Turkish population. Materials and Methods: This prospective study was planned between November 15, 2019 and April 15, 2020. The study included 160 healthy volunteers who were over 18 years of age and didn’t have acute and chronic systemic disorders. The optic nerve sheath diameters (ONSD) of the subjects were measured from both eyes ultrasonographically. Results: ONSD means (median, IQR) of right and left eyes of the subjects were measured as 4.87 (0.41) mm and 4.86 (0.32) mm, respectively. Right and left eye ONSD measurements were detected lower in female gender than men, and this difference was statistically significant. (p = 0.017 and p = 0.031, respectively). Conclusion: Determination of ONSD optimal reference values in healthy individuals would benefit in predicting increase in intracranial pressure in clinical practice.

Lateral and Frontal Cephalometric Measurements in a Cohort With Saethre-Chotzen Syndrome.

Descriptions of the craniofacial morphology in Saethre-Chotzen syndrome (SCS) are primarily based on case reports or visual assessments of affected families. The aim of this study was to compare cephalometric measurements of the craniofacial skeleton in a cohort of individuals with SCS and age- and sex-matched individuals without craniofacial anomalies. Retrospective case series. Eight girls and 4 boys with SCS (age range, 7.0-19.2 years). Cephalometric measurements were performed using lateral and frontal cephalograms. Most of the individuals with Saethre-Chotzen syndrome exhibited lower values for SNA, SNB, s-n and s-ar, while their NSL/NL, NSL/ML, NL/ML, and n-s-ba values were higher than the respective mean reference values for healthy individuals. In comparison with age- and sex-matched individuals without craniofacial anomalies, the individuals with SCS showed higher values for the maxillary and mandibular angular measurements, as well as for the menton midline angle. This sample of 12 unrelated individuals with SCS is the largest collected to date for cephalometric measurements. We found that the syndrome is associated with bimaxillary retrognathism, posterior maxillary and mandibular inclination, neutral sagittal relation as well as a tendency toward an open vertical skeletal relation, a short and flattened skull base, and facial asymmetry, as compared to individuals without the syndrome.

Reference Values of the QOLIBRI from General Population Samples in the United Kingdom and The Netherlands.

The Quality of Life after Traumatic Brain Injury (QOLIBRI) instrument is an internationally validated patient-reported outcome measure for assessing disease-specific health-related quality of life (HRQoL) in individuals after traumatic brain injury (TBI). However, no reference values for general populations are available yet for use in clinical practice and research in the field of TBI. The aim of the present study was, therefore, to establish these reference values for the United Kingdom (UK) and the Netherlands (NL). For this purpose, an online survey with a reworded version of the QOLIBRI for general populations was used to collect data on 4403 individuals in the UK and 3399 in the NL. This QOLIBRI version was validated by inspecting descriptive statistics, psychometric criteria, and comparability of the translations to the original version. In particular, measurement invariance (MI) was tested to examine whether the items of the instrument were understood in the same way by different individuals in the general population samples and in the TBI sample across the two countries, which is necessary in order to establish reference values. In the general population samples, the reworded QOLIBRI displayed good psychometric properties, including MI across countries and in the non-TBI and TBI samples. Therefore, differences in the QOLIBRI scores can be attributed to real differences in HRQoL. Individuals with and without a chronic health condition did differ significantly, with the latter reporting lower HRQoL. In conclusion, we provided reference values for healthy individuals and individuals with at least one chronic condition from general population samples in the UK and the NL. These can be used in the interpretation of disease-specific HRQoL assessments after TBI applying the QOLIBRI on the individual level in clinical as well as research contexts.

Relationship Between Nostril, Nasal Valve and Minimal Cross-Sectional Area in Functional Upper Airway.

To propose a three-dimensional cephalometric analysis of upper airway (UA) related to its functionality, defining normal reference values in healthy individuals and the relationship between nostril, nasal valve, and minimal cross-sectional area (MCS) in functional upper airway. The UAs of 20 Class I patients were analyzed with CBCT using Nemoceph 3D-OS and HOROS software, determining linear distances, volumes and cross-sectional areas, including MCS. MCS was mostly located in the middle-upper oropharynx and high hypopharynx. MCS showed moderate correlation with the area of both nares (BNA) (r = 0.60, P = 0.004) and high correlation with the area of both internal nasal valves (BNV) (r = 0.66, P = 0.0016). BNA and BNV showed a moderate correlation (r = 0.445, P = 0.049). A total upper airway (TUA) and functional upper airway (FUA) volumes were established. TUA and FUA showed the strongest statistical correlation (r = 0.82, P = 0.00). A paired samples t test compared the measurement as absolute values of MCS with BNA (t = 0.781, P = 0.44), with BNV (t = -0.12, P = 0.90); and BNA with BNV (t = -0.76, P = 0.45), showed no significant differences. A functional cephalometric analysis of the UA with stable parameters in cervical spine and normal reference values has been proposed. BNA and BNV could be used as reference to establish the MCS compatible with respiratory health.

Handgrip Strength in Preoperative Elective Cardiac Surgery Patients and Association With Body Composition and Surgical Risk.

Handgrip strength (HGS) is a potential method to approximate perioperative risk in cardiothoracic surgery patients and correlates well with European System for Cardiac Operative Risk Evaluation (EuroSCORE) values. This study aimed to characterize the functional capacity in preoperative cardiac surgery patients through HGS. This cross-sectional study investigated patients aged 18 years or older. The collected data included surgical risk (EuroSCORE), body mass index (BMI), body composition (electrical bioimpedance), and HGS. The mean age of the 278 participants was 62.1 ± 11.2 years, of whom 61.5% were male, 43.2% were overweight, and 26.3% were obese. The main types of surgery were myocardial revascularization (50%) and valve replacement (40.6%). HGS values differed between genders in all age groups (P < 0.05) and were approximately 40% lower than reference values for healthy individuals. The values differed with respect to operative risk (P = 0.003) and had a moderate positive correlation with fat-free mass (rs = 0.435, P < 0.001), a moderate negative correlation with fat mass (rs = -0.447, P < 0.001), and weak negative correlations with age (rs = -0.270, P < 0.01) and EuroSCORE (rs = -0.316, P < 0.01). The HGS values of preoperative elective cardiac surgery patients were below reference values for healthy individuals, were lower in male patients, were positively correlated with fat-free mass, and were negatively correlated with fat mass, age, and operative risk. Its preoperative use in these patients is an attractive complementary method of risk assessment in clinical practice.

Reference equation for spirometry interpretation for Eastern India.

Introduction:Spirometry measurements are interpreted by comparing with reference values for healthy individuals that have been derived from multiple regression equations from earlier studies. There are only two such studies from Eastern India, both by Chatterjee et al., one each for males and females. These are however single center and approximately two decades old studies.Aims:(1) to formulate a new regression equation for predicting FEV1 and FVC for eastern India and (2) to compare the results to the previous two studies by Chatterjee et al.Materials and Methods:Healthy nonsmokers were recruited through health camps under the initiative of four large hospitals of Kolkata. Predicted equations were derived for FEV1, FVC and FEV1/FVC in males and females separately using multiple linear regression, which were then compared with the older equations using Bland-Altman method.Results:The Bland-Altman analyses show that the mean bias for females for FVC was 0.39 L (95% limits of agreement 1.32 to −0.54 L) and for FEV1 was 0.334 L (95% limits of agreement of 1.08 to –0.41 L). For males the mean bias for FEV1 was –0.141 L, (95% limits of agreement 0.88 to –1.16 L) while that for FVC was –0.112 L (95% limits of agreement 0.80 to –1.08 L).Conclusion:New updated regression equations are needed for predicting reference values for spirometry interpretation. The regression equations proposed in this study may be considered appropriate for use in current practice for eastern India until further studies are available.

New red blood cell and reticulocyte parameters and reference values for healthy individuals and in chronic kidney disease

Introduction: The importance of local references values has been well described in the literature; this is because the characteristics of the population may influence the laboratory tests. Objective: To establish the reference range for traditional and extended red blood cell parameters and reticulocyte indices in order to investigate its application in patients with chronic kidney disease (CKD). Materials and methods: 249 blood donors (125 males and 124 females) were selected to establish the reference values. The hemodialysis sample consisted of 62 patients with terminal CKD (48 male and 14 female). All analyzes were performed using the Sysmex XE-5000 automated hematology analyzer. Results: Differences between reference values was observed in relation to gender: red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular hemoglobin concentration (MCHC), percentage of hyperchromic red blood cells (%HYPER), percentage of microcytosis (%MICRO), percentage of macrocytosis (%MACRO), absolute reticulocyte count (RET), reticulocyte hemoglobin content (RET-He), immature reticulocyte fraction (IFR), low fluorescence reticulocytes (LFR), medium fluorescence reticulocytes (MFR), and high fluorescence reticulocytes (HFR). Individuals with CKD presented RBC, HGB, HCT, MCHC, red cell distribution width expressed as coefficient of variation (RDW-CV), percentage of hypochromic red blood cells (%HYPO), percentage of reticulocytes (RET%), RET (female group), IFR, LFR, MFR, and HFR results compatible with the anemic state, which can be observed in 91.8% of patients. All studied parameters were in the area under the curve (AUC) > 0.4. In male group, %HYPO (AUC: 0.806) and IFR (AUC: 0.762) presented higher AUC values, while female group presented %HYPO (AUC: 0.806), %HYPER (AUC: 0.815), and IFR (AUC: 0.660). Conclusion: The medical advancement, the development of new techniques and hematological parameters have revealed important information about functional integrity of bone marrow, diagnosis of anemia and recombinant human erythropoietin monitoring therapy used in hemodialysis patients.

Assessment of left and right ventricular parameters in healthy Korean volunteers using cardiac magnetic resonance imaging: change in ventricular volume and function based on age, gender and body surface area

The clinical utility of cardiac magnetic resonance imaging (CMR) is growing and is being used predominantly as a means of measuring ventricular function. The normal reference range of ventricular function may vary based on age, sex and ethnicity. At present, most CMR reference values for healthy individuals have been reported from Western countries. The intent of this study was to investigate the normal CMR reference range for left ventricular (LV) and right ventricular (RV) parameters in healthy Koreans. Healthy volunteers between the ages of 20-70years without any history of cardiovascular disease or associated risk factors were prospectively recruited to be a part of this study. A total of 124 patients were recruited for this study. Steady-state free precession pulse sequences were used to obtain the cine images for LV and RV volume analysis. All parameters were analyzed based on age and gender, and normalized to body surface area (BSA). LV volume, mass and cardiac output were significantly greater in males than in females. However, all of these parameters which are associated with BSA and gender differences disappeared when corrected for BSA. RV volume was less in females even after the data was normalized for BSA. LV and RV volumes normalized for BSA gradually decreased with greater age, whereas the ejection fraction increased with age, thus maintaining the stroke volume index and cardiac index. LV and RV volumes, mass and function values for a healthy population largely depend on BSA and should be evaluated after normalization by BSA. LV parameters show no difference based on gender, but RV volume is less in the female. Greater age is associated with less ventricular volume, suggesting the possibility of volume sensitivity in the elderly.

Bronchoalveolar Lavage Results Are Independent of Season, Age, Gender and Collection Site

BackgroundClinical interpretation of bronchoalveolar lavage fluid results is dependent on the availability of reference values for healthy individuals. Only a few studies have published such reference values and the applicability of results is restricted by small sample sizes and the limited representativeness of the study population. We aim to investigate the influence of age, gender, collection site and season on bronchoalveolar lavage fluid results and to establish reference values for use in clinical practice.Methodology/Principal FindingsBronchoalveolar lavage fluid data from 295 healthy never-smoking volunteers, investigated during 1990–2009, were analyzed retrospectively. 47 volunteers had 2–5 repeat lavages during the course of several years. Fluid recovery, total number of cells, cell concentration, and differential cell counts on cytospin prepared slides were recorded. Reference values, as represented by the 5th to the 95th percentile, were 72–96% for macrophages, 2–26% for lymphocytes, 0–4% for neutrophils and 0–1% for eosinophils. Basophils and mast cells were rare. When repeat lavages were performed, there was a relatively large intra-individual variability, mainly for macrophages and lymphocytes. An age dependent decrease of lavage fluid return was present, but there was no age dependent correlation with any of the other BALF parameters. The BALF cell parameters were independent of gender, season and site (lingula vs. middle lobe).Conclusions/SignificanceOur data show that bronchoalveolar lavage fluid cell differential count is independent of age, gender, season and collection site (RML or lingua). It therefore seems acceptable to use the same reference values for all never-smoking individuals.

Patients with polymyositis or dermatomyositis have reduced grip force and health-related quality of life in comparison with reference values: an observational study

The aims of this study were to investigate hand function in PM and DM patients and compare this with reference values in healthy individuals and also to investigate if hand function correlated with activity performance and health-related quality of life. An observational cross-sectional study was performed in 18 women and 13 men with PM or DM with established disease. Grip force and hand mobility were assessed by Grippit and Escola Paulista de Medicina-Range of Motion scale. Activity performance was measured with myositis activities profile and health-related quality of life by short form-36 (SF-36). Women and men with PM and DM with mean disease duration of 6.8 (5.5) years had a significantly lower grip force than gender- and age-matched healthy individuals (women 71% and men 60%). They also had significantly lower mean values in all dimensions of the health-related quality of life instrument SF-36 compared with the Swedish population. In patients with PM and DM, the grip force correlated significantly with the ability to perform domestic activities. In women with PM and DM, the grip force correlated significantly with the health-related quality of life dimensions vitality and mental health. There were no significant differences between patients with PM and DM regarding grip force, hand mobility, activity performance or health-related quality of life. Patients with PM or DM have reduced grip force that could influence activity performance and health-related quality of life.

The Impact of Fiber Supplementation on ADMA Levels

Asymmetric dimethylarginine (ADMA) is an emerging biomarker that has been associated with oxidative metabolism and increased cardiovascular risk. Little information is available regarding the effect of diet on ADMA. The authors studied 86 overweight/obese adults as part of a clinical trial of psyllium supplementation to determine whether 3 months of such supplementation would affect ADMA levels. Forty-one people in the intervention group received 14 g/day of psyllium in addition to their usual diet compared with 45 controls who followed their usual diet alone. The 2 groups were comparable at baseline in demographic characteristics and body mass index. Baseline ADMA levels were elevated in this overweight/obese population compared with published reference values in healthy individuals (0.75 vs 0.50 micromol/L). The change in ADMA levels over 3 months was not different in the psyllium group compared with the control group (-.03 vs -.01 micromol/L, P=.73). These findings do not support a significant effect of psyllium fiber supplementation on ADMA.