Significant Differences In Lung Function Research Articles

Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study

BackgroundLung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study.MethodsDiet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates.ResultsThe study included 3,787 Black and White men and women aged 18–30 in 1985–86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment.ConclusionsIn this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.

Fetal growth rather than prematurity determines lung function in children with asthma.

Preterm birth or fetal growth has been associated with reduced lung function and asthma during childhood in the general population. We aimed to elucidate whether prematurity or fetal growth has a significant influence on lung function or symptoms in children with stable asthma. We included children with stable asthma who participated in the Korean childhood Asthma Study cohort. Asthma symptoms were determined by asthma control test (ACT). Percent predicted values of pre- and post-bronchodilator (BD) lung function including forced expiratory volume in 1 second (FEV1 ), forced vital capacity (FVC), and forced expiratory flow at 25%-75% of FVC (FEF25%-75% ) were measured. Lung function and symptoms were compared according to the history of preterm birth and birth weight (BW) for gestational age (GA). The study population consisted of 566 children (age range: 5-18 years). There were no significant differences in lung function and ACT between preterm and term subjects. We observed no significant difference in ACT but significant differences were observed in pre- and post-BD FEV1 , pre- and post-BD FVC, and post-BD FEF25%-75% according to BW for GA in total subjects. Two-way ANOVA revealed that BW for GA rather than prematurity was a significant determining factor for pre- and post-BD lung function. After regression analysis, BW for GA was still a significant determining factor of pre- and post-BD FEV1 and pre- and post-BD FEF25%-75% . Fetal growth rather than prematurity appears to have a significant effect on lung function in children with stable asthma.

Effect of Hypertonic Saline on Lung Function as Add-on Treatment in People With Cystic Fibrosis Receiving Dornase Alfa: A Cystic Fibrosis Foundation Patient Registry Analysis

Introduction of novel therapies for cystic fibrosis (CF), raises the question whether traditional treatments can be withdrawn. Nebulized hypertonic saline (HS) could potentially be discontinued in patients receiving Dornase alfa (DA). In the pre-modulator era, did people with CF who were F508del homozygous (CFF508del) and received DA and HS have better preserved lung function than those treated with DA only? Retrospective analysis of CF Foundation Patient Registry data (2006-2014). Among 13,406 CFF508del with data for at least 2 consecutive years, 1,241 CFF508del had spirometry results and were treated with DA for 1-5 years without DA or HS during the preceding (baseline) year. Absolute percent predicted FEV1 (ppFEV1) change while on DA and HS relative to DA only was the main outcome. A marginal structural model was applied to assess the effect of 1-5 years of HS while controlling for time-dependent confounding. Of 1,241 CFF508del, 619 (median baseline age 14.6 years; IQR 6-53) received DA only and 622 (14.55 years; IQR 6-48.1) were treated with DA and HS for 1-5 years. After 1 year, subjects receiving DA and HS had ppFEV1 that averaged 6.60% lower than ppFEV1 in those treated with DA only (95%CI: -8.54% to -4.66%; P<.001). Lower lung function in the former relative to the latter persisted throughout follow-up, highlighting confounding by indication. After accounting for baseline age, sex, race, DA use duration, baseline and previous year's ppFEV1 and time-varying clinical characteristics, DA and HS for 1-5 years were similar to DA only regarding ppFEV1 (year 1: mean ppFEV1 change +0.53% [95%CI: -0.66% to +1.71%; P=.38]; year 5: -1.82% [-4.01% to +0.36%; P=.10]. In the pre-modulator era, CFF508del had no significant difference in lung function when nebulized HS was added to DA for 1-5 years.

Clinical features and 1-year outcomes of chronic bronchitis in participants with normal spirometry: results from the ECOPD study in China

BackgroundEvidence regarding clinical features and outcomes of individuals with non-obstructive chronic bronchitis (NOCB) remains scarce, especially in never-smokers. We aimed to investigate the clinical features and 1-year outcomes of individuals...

Do hospital workers experience a higher risk of respiratory symptoms and loss of lung function?

BackgroundHospital work environment contains various biological and chemical exposures that can affect indoor air quality and have impact on respiratory health of the staff. The objective of this study was to investigate potential effects of occupational exposures on the risk of respiratory symptoms and lung function in hospital work, and to evaluate potential interaction between smoking and occupational exposures.MethodsWe conducted a cross-sectional study of 228 staff members in a hospital and 228 employees of an office building as the reference group in Shiraz, Iran. All subjects completed a standardized ATS respiratory questionnaire and performed a spirometry test.ResultsIn Poisson regression, the adjusted prevalence ratios (aPR) among the hospital staff were elevated for cough (aPR 1.90, 95% CI 1.15, 3.16), phlegm production (aPR 3.21, 95% CI 1.63, 6.32), productive cough (aPR 2.83, 95% CI 1.48, 5.43), wheezing (aPR 3.18, 95% CI 1.04, 9.66), shortness of breath (aPR 1.40, 95% CI 0.93, 2.12), and chest tightness (aPR 1.73, 95% CI 0.73, 4.12). Particularly laboratory personnel experienced increased risks of most symptoms. In linear regression adjusting for confounding, there were no significant differences in lung function between the hospital and office workers. There was an indication of synergism between hospital exposures and current smoking on FEV1/FVC% (interaction term β = − 5.37, 95% CI − 10.27, − 0.47).ConclusionsWe present significant relations between hospital work, especially in laboratories, and increased risks of respiratory symptoms. Smoking appears to enhance these effects considerably. Our findings suggest that policymakers should implement evidence-based measures to prevent these occupational exposures.

Cluster analysis of transcriptomic datasets to identify endotypes of idiopathic pulmonary fibrosis

BackgroundConsiderable clinical heterogeneity in idiopathic pulmonary fibrosis (IPF) suggests the existence of multiple disease endotypes. Identifying these endotypes would improve our understanding of the pathogenesis of IPF and could allow...

Efficacy and safety of pulmonary rehabilitation training on lung function, quality of life, and T cell immune function in patients with stable chronic obstructive pulmonary disease: a randomized controlled trial.

Pulmonary rehabilitation training is an important means of stable chronic obstructive pulmonary disease (COPD). However, some people think that its effect is not satisfactory, and there is a lack of understanding of the effect of pulmonary rehabilitation training on T cell immune function. This study investigated the efficacy and safety of pulmonary rehabilitation training on lung function, quality of life and T cell immune function in stable COPD patients. Seventy-two stable COPD patients recruited from the Outpatient department of Affiliated Hospital of Jiangnan University and Wuxi Huishan Rehabilitation Hospital, and divided them into experimental group (39 cases) and control group (33 cases) by random number table method. Both groups were received routine drug therapy, COPD knowledge education, and smoking cessation treatment. On this basis, the experimental group received daily pulmonary rehabilitation training, including pursed-lip breathing (PLB) training, abdominal breathing training, skeletal muscle training, and coughing and expectoration training. Lung function [percentage of forced expiratory volume in 1 second (FEV1%) and the percentage of FEV1/forced vital capacity (FEV1/FVC%)], quality of life [6-minute walk test (6MWT), COPD assessment test (CAT score)], and T lymphocyte subsets (CD3+%, CD4+%, CD8+%, and CD4+%/CD8+%) levels were compared by independent sample t-test or paired t-test between the 2 groups before and after 12 weeks of treatment in a double-blind method. There were no remarkable differences in lung function indexes, 6MWT, CAT score, and T cell immune function between the 2 groups before treatment. After 12 weeks, all indexes in the experimental group (all P<0.01) and T lymphocyte subsets in the control group (CD3+%, CD4+%, CD8+% and CD4+%/CD8+% were 0.010, 0.037, 0.021 and 0.016, respectively) were significantly better than before treatment, and there were no significant differences in lung function,6MWT, and CAT scores in the control group. After 12 weeks, all indexes in the experimental group were significantly better than those in the control group except CD8+% (FEV1%, FEV1/FVC%, 6MWT, CAT score, CD3+%, CD4+% and CD4+%/CD8+% were 0.002, 0.009, <0.001, 0.007, 0.037, 0.046 and <0.001, respectively). Pulmonary rehabilitation training can improve the lung function, quality of life, and T cell immune function of stable-phase COPD patients. Perhaps the recovery of T-cell immune function is the root of the patient's improvement. Chinese Clinical Trial Registry ChiCTR2100048419.

Allergic sensitisation did not affect bronchial hyper-responsiveness in children without respiratory tract symptoms.

The potential for immunotherapy to prevent asthma development has become a hot topic. This prompted us to revisit data from an early study that examined allergic sensitisation on bronchial hyperresponsiveness (BHR) in children with and without respiratory symptoms. Unlike previous studies, it used both indirect and direct test methods. The study was conducted in Kuopio, Finland, in 1994 and 247 children (55.1% boys) with a mean age 10.5±1.7years were recruited using a school survey: 165 with lower respiratory symptoms and 82 healthy controls. Each child underwent a 6-min free-running test and a methacholine test with a cumulative dose of 4900µg. All participants underwent skin-prick tests: 127were sensitised and 120 were non-sensitised. There were no significant differences in lung function between the sensitised and non-sensitised children. However, sensitisation was associated with BHR which was measured by both the methacholine test (2400µg versus >4900µg, p<0.001) and the free-running test (-3.5% versus -2.6%, p=0.042). No such differences were observed among the healthy controls. Sensitisation was a predictor of allergic diseases, and only multisensitisation to a minimum of four allergens increased the incidence of asthma. Allergic sensitisation did not affect BHR in children without respiratory symptoms.

Prognosis and treatment of 46 Chinese pediatric cystic fibrosis patients

BackgroundSince public awareness of cystic fibrosis (CF) has increased, more children have been diagnosed with CF in China. This study aimed to investigate medical and other challenges faced by pediatric CF patients in China.MethodTreatments and treatment outcomes were retrospectively analyzed for 46 pediatric CF patients diagnosed from August 2009 to June 2019. Pre- and post-treatment results were compared using independent samples t-test.ResultsOf 46 pediatric CF study patients, four died and five were lost to follow-up. Thirty-seven patients were monitored for 0.03 to 9.21 years; patients exhibited fewer attacks of respiratory tract infections after diagnosis (4.49 ± 2.13 episodes/year before diagnosis vs 1.97 ± 1.87 times/year after 1-year treatment, p < 0.05), significantly reduced sputum production and experienced 1.62 ± 1.71 exacerbations/year. Patient mean body mass index was 16.87 ± 3.53 and pancreatic malfunction persisted in 15 patients. For 17 children, no significant differences in lung function were found at follow-up as compared to lung function at diagnosis (FEV1: 82.45% ± 16.56% vs 75.26% ± 22.34%, FVC: 87.18% ± 13.64% vs 86.99% ± 19.95%, FEF75%: 46.51% ± 28.78% vs 36.63% ± 24.30%, P = 0.27, 0.97, 0.20, respectively). Pseudomonas aeruginosa (17/27) and bronchiectasis (22/22) were found during follow-up evaluation. Twenty-four patients (64.8%) maintained good adherence to therapies. Overall, azithromycin and tobramycin treatments were administered for 0.5–62 months and 0.5–48 months, respectively, and triggered no obvious adverse reactions.ConclusionNo obvious declines in clinical presentation or lung function were found in Chinese pediatric CF patients after receiving standard therapeutic and active treatments, although malnutrition and low compliance were persistent challenges.

A pilot study of cystic fibrosis exacerbation response phenotypes reveals contrasting serum and sputum iron trends

The cystic fibrosis (CF) community seeks to explain heterogeneous outcomes of pulmonary exacerbation (PEX) treatment. Serum and sputum inflammatory mediators may identify people with CF (PwCF) at risk for suboptimal responses. However, lack of an established association between response phenotypes and these mediators limits clinical application. In this pilot study, we prospectively characterized treatment response phenotypes by assessing health-related quality-of-life (HRQoL) during PEX. We also measured lung function and iron-related biochemical parameters in serum and sputum. We classified subjects as sustained symptom-responders (SRs) or non-sustained symptom-responders (NSRs) based on the absence or presence, respectively, of worsened symptom scores after initial improvement. We used linear mixed models (LMMs) to determine whether trends in lung function, hematologic, serum, and sputum indices of inflammation differed between response cohorts. In 20 PwCF, we identified 10 SRs and 10 NSRs with no significant differences in lung function at PEX onset and treatment durations. SRs had better model-predicted trends in lung function than NSRs during PEX. Non-linear trends in serum and sputum iron levels significantly differed between SRs and NSRs. In adults with cystic fibrosis, PEX treatment response phenotypes may be correlated with distinctive trends in serum and sputum iron concentrations.

Lung cancer dynamics using fractional order impedance modeling on a mimicked lung tumor setup

IntroductionAs pulmonary dysfunctions are prospective factors for developing cancer, efforts are needed to solve the limitations regarding applications in lung cancer. Fractional order respiratory impedance models can be indicative of lung cancer dynamics and tissue heterogeneity. ObjectiveThe purpose of this study is to investigate how the existence of a tumorous tissue in the lung modifies the parameters of the proposed models. The first use of a prototype forced oscillations technique (FOT) device in a mimicked lung tumor setup is investigated by comparing and interpreting the experimental findings. MethodsThe fractional order model parameters are determined for the mechanical properties of the healthy and tumorous lung. Two protocols have been performed for a mimicked lung tumor setup in a laboratory environment. A low frequency evaluation of respiratory impedance model and nonlinearity index were assessed using the forced oscillations technique. ResultsThe viscoelastic properties of the lung tissue change, results being mirrored in the respiratory impedance assessment via FOT. The results demonstrate significant differences among the mimicked healthy and tumor measurements, (p-values <0.05) for impedance values and also for heterogeneity index. However, there was no significant difference in lung function before and after immersing the mimicked lung in water or saline solution, denoting no structural changes. ConclusionSimulation tests comparing the changes in impedance support the research hypothesis. The impedance frequency response is effective in non-invasive identification of respiratory tissue abnormalities in tumorous lung, analyzed with appropriate fractional models.

Effects of sublingual-specific immunotherapy on pulmonary function and exhaled nitric oxide levels in asthmatic children with and without allergic rhinitis.

BackgroundAllergic asthma and allergic rhinitis are common chronic respiratory diseases in children. The prevalence rate of disease is increasing year by year. And avoid allergens, drug treatments and special immunotherapy (SIT) is the fundamental treatment for respiratory allergies diseases. But there are few comprehensive studies on the control level of asthma, improvement of lung function, and changes of exhaled nitric oxide (FeNO) after SLIT treatment in children with allergic asthma and rhinitis.MethodsIn all, 71 child asthma patients who received sublingual-specific immune therapy for 1 year or more were divided into an asthmatic rhinitis group (31 cases) and an asthma-alone group (40 cases). The two groups of patients were compared before and after treatment in terms of rhinitis symptom scores, daytime and nighttime asthma symptom scores, visual analog scale (VAS) score, drug score, pulmonary function, and exhaled nitric oxide level (FeNO).ResultsAfter treatment, daytime symptom scores, VAS scores, drug scores, and FeNO levels of the asthma-alone group were all lower than before treatment, and the lung function was significantly improved (P<0.05), while the difference in night symptom scores before and after treatment was not statistically significant (P>0.05). The lung function and FeNO level of children in the asthmatic rhinitis group were lower after treatment than before treatment, with statistically significant differences (P<0.05). The scores of rhinitis and VAS in the asthmatic rhinitis group were higher than those in the asthma-alone group, and the differences were statistically significant. There was no significant difference in other scores between the two groups. There was no significant difference in lung function and FeNO level between the two groups.ConclusionsSLIT for children with or without allergic asthma or with or without rhinitis has a significant effect, but its effect on children with asthma combined with rhinitis is not superior to that of children with asthma alone.

Characterization of Persistent Uncontrolled Asthma Symptoms in Community Members Exposed to World Trade Center Dust and Fumes

The destruction of the World Trade Center (WTC) towers on the 11th of September, 2001 released a vast amount of aerosolized dust and smoke resulting in acute and chronic exposures to community members as well as responders. The WTC Environmental Health Center (WTC EHC) is a surveillance and treatment program for a diverse population of community members, including local residents and local workers with WTC dust exposure. Many of these patients have reported persistent lower respiratory symptoms (LRS) despite treatment for presumed asthma. Our goal was to identify conditions associated with persistent uncontrolled LRS despite standard asthma management. We recruited 60 patients who were uncontrolled at enrollment and, after a three-month run-in period on high-dose inhaled corticosteroid and long acting bronchodilator, reassessed their status as Uncontrolled or Controlled based on a score from the Asthma Control Test (ACT). Despite this treatment, only 11 participants (18%) gained Controlled status as defined by the ACT. We compared conditions associated with Uncontrolled and Controlled status. Those with Uncontrolled symptoms had higher rates of upper airway symptoms. Many patients had persistent bronchial hyper-reactivity (BHR) and upper airway hyper-reactivity as measured by paradoxical vocal fold movement (PVFM). We found a significant increasing trend in the percentage of Controlled with respect to the presence of BHR and PVFM. We were unable to identify significant differences in lung function or inflammatory markers in this small group. Our findings suggest persistent upper and lower airway hyper-reactivity that may respond to standard asthma treatment, whereas others with persistent LRS necessitate additional diagnostic evaluation, including a focus on the upper airway.

Traditional medicines for asthma in children and adults: A systematic review of placebo-controlled studies.

Traditional medicines (TMs) adjunctive to conventional medications are widely used for asthma in east-Asia and have gained popularity in western countries. To assess the efficacy and safety of TMs for asthma in children and adults based on placebo-controlled trials in order to inform physicians and assist them in discussions with patients. Seventeen electronic databases were searched. Participants had acute or chronic asthma. Interventions included orally administered traditional medicines used in east-Asia. Outcomes included lung function, symptoms, quality of life, exacerbations, medication use and safety. RevMan 5.3 (random effect model) was used for meta-analysis. Baseline values were assessed for balance and asthma severity. Within-group changes were calculated to assess minimal clinically important difference (MCID). Eighteen studies (2080 participants) were included. All combined TMs with conventional medicines. The single study of acute asthma (n=300) showed an improvement. For chronic asthma, severity at baseline ranged from very mild to severe. When asthma was mild, significant differences in lung function (FEV1%, PEF/R) were not detectable. When participants had moderate and/or severe asthma at baseline improvements were more evident. For measures of lung function, improvements within the TM groups tended to be greater when the asthma was more severe. Some studies showed MCIDs. No serious adverse events or interactions were reported but safety data were incomplete. The application of certain traditional herbal medicines used in east-Asia as adjuncts to conventional medications improved outcomes in acute and chronic asthma, but most evidence was based on single trials. Therefore, no single TM could be recommended. Effect sizes varied according to asthma severity at baseline. Future studies should consider baseline severity when enrolling participants.

Respiratory and allergic disorders in children with severe and partial immunoglobulin A immunodeficiency.

Immunoglobulin A deficiency (IgAD) is the most common primary immunodeficiency. Although most people with selective IgAD (sIgAD) are asymptomatic, many patients often suffer from recurrent respiratory infections and different allergic disorders. Our aim was to investigate connection between subtypes of sIgAD and incidence of respiratory and allergic disorders, as well as connection with lung function changes in children. Children with IgAD where divided into two groups; severe IgAD in patients was defined as serum IgA level <7mg/dL, while partial IgA deficiency diagnosis was made when serum IgA levels was higher than 7mg/dL but at least two standard deviations (SD) below mean normal concentrations for their age. All patients were evaluated by their clinical and laboratory investigation parameters and compared to control group of children. Group of children with IgAD, severe as well as partial, showed higher prevalence of allergic diseases and total number of infections, compared to controls. There was a statistically significant difference in lung function for peak expiratory flow (PEF), the maximal expiratory flow at 50% of the forced vital capacity (MEF50) and fraction of exhaled nitric oxide (FENO) between group of patients with severe as well as partial IgAD and control group, where children with IgAD showed reduced lung function. Children with sIgAD are at increased risk for higher number of respiratory infections and developing allergic diseases, resulting in significantly lower pulmonary function which is related with the severity of sIgAD.

Stereotactic body radiotherapy (SBRT) or surgery in early stage (I &amp; II) non small cell lung cancer (NSCLC).

99 Background: For patients with NSCLC clinical stages I and II disease with no medical contraindications, surgery is treatment of choice showing 5-year survival rates of about 60–80% for stage I and 40–50% for stage II, respectively. However, for patients who are medically or technically unfit for surgery and for patients refusing surgery, SBRT is an alternative with local control rates &gt; 90% at 3 years. Methods: Medical journals in all patients with stage I or II NSCLC who were underwent surgery and treated with SBRT at the Department of oncology or thoracic surgery, Karolinska University Hospital, Sweden from 2003 to 2010 were retrospectively reviewed. Results: In all, 267 (74.8%) underwent surgery and 90 (25.2%) were treated with SBRT. Mean, median and range of age among the surgery group was 69.2, 70.0 and 41-85 years, while in the SBRT group, these figures were 77.6, 79.0 and 52-90 years. The difference in age between the groups was significant (p &lt; 0.001).There were significantly more comorbidites in the SBRT group. Among the surgery group, 90.2% were smokers or former smokers. The figures for SBRT group was 91.1%. The difference in smoking habits between the groups was not significant (p &lt; 0.713). There was a significant difference in performance status (PS) between the groups (p &lt; 0.001) with with PS 0-1 in 99.3% in the surgery group compared with 66.7% in the SBRT group. There was a significant difference in lung function with median FEV1 2.11 liter in surgery group compared to 1.3 in the SBRT group. The figures for median FEV1% was 85.0% respectively 57.0%. The median overall survival was 7.7 years for the surgery group and 3.72 years for the SBRT group (p &lt; 0.001). Five years survival was 65.5% in the surgery group and 31.6% in the SBRT group (p &lt; 0.001). Conclusions: The much worse median overall survival in the SBRT group can be explained by the selection of patients, but still, a median survival for nearly 4 years in an elderly group with so many comorbidities and a poor PS indicates that SBRT has been of value.

Comparison of lung function between breath-holding diving and non-breath-holding diving fishermen in Ambon city

Breath-hold diving is a traditional method used by fishermen to catch fish or other marine organisms. When humans hold their breath during diving, generally their body will develop physiological changes, and with regular exercise, this can improve the lung function. Based on many studies reported, there is an increase in lung function in breath-hold diving fishermen. The objective of this study was to analyze the comparison of pulmonary function between breath-hold diving fishermen and non-divers fishermen in Ambon. This study uses analytical methods with a cross-sectional approach using primary data of 15 breath-hold divers and 15 non-divers fishermen sample with same background of healthy behavior. The pulmonary function differences between breath-hold diving fishermen and non-diving fishermen were analyzed using t-student test. Pulmonary function parameters i.e. VC, FVC, and FEV1% was measured using spirometer. The results of this study showed that mean value of lung function comparison between breath-hold diving fishermen and non-breath lung function fishermen in vital capacity (VC) ratio was 3.48 ± 0.5 vs. 3.01 ± 0.63 (tα(2)0.05:P = 0‘03), forced vital capacity (FVC) was 2.19 ± 0.45 vs. 1.84 ± 0.46 (tα(2)0.05:P = 0.045), and forced expiratory volume in one second (FEV1%) was 91.46 ± 9.12 vs. 83.44 ± 10.3 (tα(2)0.05:P = 0.03). The lung function comparison in breath-hold diving fishermen and non-diver fishermen showed that there is a significant difference in lung function between breath-hold fishermen and non-diver fishermen. The conclusion of the research is, with the same background of life behavior, the lung function of breath-hold diving fishermen is better than non-diver fishermen.

Granulocyte-Macrophage Colony-Stimulating Factor Inhalation Therapy for Severe Pulmonary Alveolar Proteinosis.

Some patients with pulmonary alveolar proteinosis (PAP) still present with high recurrence rate after large-volume whole lung lavage (WLL). Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been proved to be effective for PAP, but clinical research on GM-CSF inhalation therapy combined with WLL for severe PAP is rare in Asia. This study aimed to investigate the clinical efficacy of GM-CSF inhalation combined with WLL in Chinese patients with PAP. We performed regression analysis on 33 patients with severe PAP who underwent WLL alone or WLL combined with GM-CSF inhalation. The patients were put into 2 groups, WLL group and GM-CSF/WLL group. Physiologic, serologic, and radiologic features of the 2 groups at different time points after treatment and the recurrence rates at 1-year follow-up were compared. There were no significant differences in lung function, blood gas analysis indices, and lung CT between the 2 groups after 1-week treatment (P > 0.05). After 3-month treatment, the GM-CSF/WLL group showed significantly faster improvement in FEV1%Pred (P = 0.028), FVC%Pred (P = 0.014), PaO2 (P = 0.022), PA-aO2 (P = 0.009), PaO2/FiO2 (P = 0.025), 6-minute walking test (P = 0.002), and lung CT parameters (P < 0.05) compared with the WLL group. The recurrence rate at the 1-year follow-up in the GM-CSF/WLL group (5.5%) was significantly higher than that in the WLL group (46.67%; P < 0.05). GM-CSF inhalation therapy combined with WLL is an effective treatment for patients with severe PAP, with further improvement in lung function at the base of WILL as well as reduction on re-WLL incidence.

Effect of secondhand smoke exposure on lung function among non-smoking population

Background: Secondhand Smoke (SHS) exposure is known to be associated with various cardiovascular and respiratory problems but its effect on pulmonary function remains unexplored. This study was done to evaluate the effect of Secondhand Smoke (SHS) exposure on lung function among non-smoking population.Methods: This cross-sectional study was conducted in Bahour, Pondicherry from 2017-2018. 350 participants, age 40 year and older, with no respiratory symptoms or prior lung diseases were included in this study. Both self-reported history and measurement of urinary cotinine level were used to evaluate the smoking status. Spirometry data, including FVC and FEV1 were used to assess lung function. Diverse variables between groups were compared using T- test and Chi-square test. Analysis of covariance (ANCOVA) adjusted for age, height, alcohol consumption, and level of exercise was used to see any statistical differences in lung function parameters between non-SHS exposed and SHS-exposed groups.Results: Among 350 non-smokers, 120 were SHS-exposed. The urinary cotinine levels clearly distinguished SHS exposure, and the mean urinary cotinine levels were 7±0.3 and 11±0.4 in non-SHS exposed group vs SHS-exposed group, respectively. However, both groups had no significant difference in lung function and was found normal.Conclusions: SHS exposure urinary cotinine is a valuable marker.

A field follow-up study of six years′ outcome of children with asthma

Objective To investigate six years′ outcome of children with asthma. Methods Children with asthma diagnosed in the epidemiological survey of childhood asthma in urban area of Beijing in 2010 were selected in this study.The field follow-up was conducted in 2016 (6 years later) to obtain information about asthma attack, di-sease control, medication usage, and comorbidities of allergic diseases.The skin prick test, lung function and exhaled nitric oxide were performed during field follow-up stage. Results Sixty-four children, aged 7-19 years old[(13.59±3.48) years old], completed the field follow-up survey.Among 35.9% (23/64 cases) children, the asthma symptoms still persisted within 2 years (without remission), while 64.1% (41/64 cases) children had no symptoms within 2 years and above (remission). The course of children without remission (9.0 years) was significantly longer than that of children with remission (5.5 years), and there was statistical significance (z=-3.775, P<0.001). Among the children without remission, the number of uncontrolled children in the last month accounted for 13.0% (3/23 cases), partially controlled for 17.4% (4/23 cases), and under controlled for 69.6% (16/23 cases). The majority of unrelieved children were treated with intermittent control drug [43.5% (10/23 cases) vs.12.2% (5/41 cases), χ2=8.036, P<0.01]. A total of 47.8% (11/23 cases) of children without remission were completely unaffected by physical activity, while 92.7% (38/41 cases) of children with clinical remission were completely unaffected by physical activity (χ2=14.117, P<0.001). The proportion of children without remission with eczema and atopic dermatitis lasting longer than 6 years old was 56.5% (13/23 cases), which was significantly higher than that of children with remission [29.3%(12/41 cases), χ2=4.598, P<0.05]. In 2010 and 2016, there were 46 children with allergen results.Compared with 2010, the proportion of animal fur and pollen allergy increased in 2016 [19.6% (9/46 cases) vs.52.2% (24/46 cases), 36.9% (17/46 cases) vs.67.4% (31/46 cases)], and there were statistical significances(χ2=10.632, 8.538, all P<0.01). In 2016, the number and degree of total allergens in the clinical unrelieved children were higher than that in the relieved children.Further analysis showed that the unrelieved children had higher cigarette allergy positivity (21.7% vs. 2.5%, χ2=4.239, P<0.05). There was no significant difference in lung function and exhaling nitric oxide between the clinical unrelieved children and the relieved children. Conclusions Six years later, the proportion of animal fur and pollen allergy increased in children with asthma.Compared with children with remission, the children without remission had more treatment with intermittent control drug, with higher proportion of eczema and atopic dermatitis over six years old, and higher percentage of cigarette allergy positivity. Key words: Child; Asthma; Follow-up study