Spirometric Lung Function Research Articles

Childhood maltreatment and lung function: findings from the general population.

Cumulative evidence indicates that childhood maltreatment is linked to self-reported asthma and COPD. However, the relationship between childhood maltreatment and objective measures of lung function as determined by spirometry has not yet been assessed. Medical histories and spirometric lung function were taken in 1386 adults from the general population. Participants completed the Childhood Trauma Questionnaire for the assessment of emotional, physical and sexual abuse as well as emotional and physical neglect. 25.3% of the participants reported at least one type of childhood maltreatment. Among them, use of medication for obstructive airway diseases as well as typical signs and symptoms of airflow limitation were significantly more frequent than in the group without exposure to childhood maltreatment. Although participants with childhood maltreatment had numerically lower values for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow than those without, these differences were nonsignificant when accounting for relevant covariates such as age, sex, height and smoking. Likewise, there were no differences in the FEV1/FVC ratio nor in the frequency of airflow limitation regardless of its definition. No specific type of childhood maltreatment was related to spirometrically determined parameters of lung function. Our findings call into question the association of childhood maltreatment with obstructive lung diseases as indicated by prior research relying on self-reported diagnoses. We consider several explanations for these discrepancies.

Impact of Education on COPD Severity and All-Cause Mortality in Lifetime Never-Smokers and Longtime Ex-Smokers: Results of the COSYCONET Cohort.

BackgroundBeyond smoking, several risk factors for the development of chronic obstructive pulmonary disease (COPD) have been described, among which socioeconomic status including education is of particular interest. We studied the contribution of education to lung function and symptoms relative to smoking in a group of never-smokers with COPD compared to a group of long-time ex-smokers with COPD.MethodsWe used baseline data of the COSYCONET cohort, including patients of GOLD grades 1–4 who were either never-smokers (n=150, age 68.5y, 53.3% female) or ex-smokers (≥10 packyears) for at least 10 years (n=616, 68.3y, 29.9% female). Socioeconomic status was analyzed using education level and mortality was assessed over a follow-up period of 4.5 years. Analyses were performed using ANOVA and regression models.ResultsSpirometric lung function did not differ between groups, whereas CO diffusing capacity and indicators of lung hyperinflation/air-trapping showed better values in the never-smoker group. In both groups, spirometric lung function depended on the education level, with better values for higher education. Quality of life and 6-MWD were significantly different in never-smokers as well as patients with higher education. Asthma, alpha-1-antitrypsin deficiency, and bronchiectasis were more often reported in never-smokers, and asthma was more often reported in patients with higher education. Higher education was also associated with reduced mortality (hazard ratio 0.46; 95% CI 0.22–0.98).ConclusionOverall, in the COSYCONET COPD cohort, differences in functional status between never-smokers and long-time ex-smokers were not large. Compared to that, the dependence on education level was more prominent, with higher education associated with better outcomes, including mortality. These data indicate that non-smoking COPD patients’ socioeconomic factors are relevant and should be taken into account by clinicians.

The Impact of Lung Function on Extra-Pulmonary Diseases and All-Cause Mortality in US Adult Population with and without COPD.

ObjectiveSpirometric lung function is usually used to evaluate respiratory health. However, the impact of lung function on extra-pulmonary diseases and all-cause mortality has not been fully elucidated, especially in people without chronic obstructive pulmonary disease (COPD).Patients and MethodsParticipants aged ≥20 and underwent spirometry test from the US National Health and Nutrition Examination Surveys (NHANES) 2007–2012 were analyzed in this study. Multivariate logistic and Cox regressions were used to evaluate the impact of forced expiratory volume in 1 second percent of predicted (FEV1% predicted) and forced vital capacity percent of predicted (FVC% predicted) on 14 extra-pulmonary diseases and all-cause morbidity after adjusting for multiple confounders.ResultsDuring 2007–2012, 1800 COPD patients and 11,437 non-COPD subjects were included. The prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MS), congestive heart failure (CHF), coronary disease, stroke, chronic kidney disease (CKD), arthritis, cancer, underweight and osteoporosis in COPD patients was higher than that in the non-COPD population. After adjusting for confounders, the decrease of FEV1% predicted and FVC% predicted was related with higher odds of having hypertension, DM, obesity, MS, CHF, coronary disease and depression (OR > 1, P<0.05) in both the COPD and non-COPD populations. These 2 indices were also related with higher odds of dyslipidemia, CKD, arthritis and osteoporosis in the non-COPD population. The risk of stroke, anemia and cancer was not related with the decrease of lung function. In addition, the decrease of lung function was independent risk factors for the increase of all-cause mortality. These risks were gradually increased with the decrease of lung function.ConclusionThe decrease of FEV1% predicted and FVC% predicted was related with higher risk of multiple extra-pulmonary diseases and all-cause mortality in both the COPD and non-COPD population.

Changes in pulmonary restrictive parameters by intensive home hemodialysis: a case report

BackgroundPatients with End-Stage Renal Disease (ESRD) are at an increased risk for restrictive lung disease due to accumulation of uremic toxins and volume overload. Hemodialysis is the preferred treatment for improving lung function in dialysis patients. However, the effects of fluid removal and solute clearance by hemodialysis on lung function remain unclear.Case presentationWe report a case of restrictive lung disorder in a hemodialysis patient, who showed improvement in both clinical and spirometric lung function after initiation of intensive home hemodialysis (32 h per week).ConclusionIntensive hemodialysis augments fluid removal and solute clearance, which in turn may improve restrictive lung function.

Accelerated epigenetic aging as a risk factor for chronic obstructive pulmonary disease and decreased lung function in two prospective cohort studies.

Chronic obstructive pulmonary disease (COPD) is a frequent diagnosis in older individuals and contributor to global morbidity and mortality. Given the link between lung disease and aging, we need to understand how molecular indicators of aging relate to lung function and disease. Using data from the population-based KORA (Cooperative Health Research in the Region of Augsburg) surveys, we associated baseline epigenetic (DNA methylation) age acceleration with incident COPD and lung function. Models were adjusted for age, sex, smoking, height, weight, and baseline lung disease as appropriate. Associations were replicated in the Normative Aging Study. Of 770 KORA participants, 131 developed incident COPD over 7 years. Baseline accelerated epigenetic aging was significantly associated with incident COPD. The change in age acceleration (follow-up – baseline) was more strongly associated with COPD than baseline aging alone. The association between the change in age acceleration between baseline and follow-up and incident COPD replicated in the Normative Aging Study. Associations with spirometric lung function parameters were weaker than those with COPD, but a meta-analysis of both cohorts provide suggestive evidence of associations. Accelerated epigenetic aging, both baseline measures and changes over time, may be a risk factor for COPD and reduced lung function.

No obvious impact of caesarean delivery on childhood allergic outcomes: findings from Australian cohorts

Background and objectiveAs caesarean delivery and childhood allergy continue to rise, their inter-relationships may change. We examined whether caesarean delivery predicts allergic disease and impaired lung function in two contemporary...

Evaluation of Respiratory Muscle Strength and Diaphragm Ultrasound: Normative Values, Theoretical Considerations, and Practical Recommendations

Background: Reference values derived from existing diaphragm ultrasound protocols are inconsistent, and the association between sonographic measures of diaphragm function and volitional tests of respiratory muscle strength is still ambiguous. Objective: To propose a standardized and comprehensive protocol for diaphragm ultrasound in order to determine lower limits of normal (LLN) for both diaphragm excursion and thickness in healthy subjects and to explore the association between volitional tests of respiratory muscle strength and diaphragm ultrasound parameters. Methods: Seventy healthy adult subjects (25 men, 45 women; age 34 ± 13 years) underwent spirometric lung function testing, determination of maximal inspiratory and expiratory pressure along with ultrasound evaluation of diaphragm excursion and thickness during tidal breathing, deep breathing, and maximum voluntary sniff. Excursion data were collected for amplitude and velocity of diaphragm displacement. Diaphragm thickness was measured in the zone of apposition at total lung capacity (TLC) and functional residual capacity (FRC). All participants underwent invasive measurement of transdiaphragmatic pressure (Pdi) during different voluntary breathing maneuvers. Results: Ultrasound data were successfully obtained in all participants (procedure duration 12 ± 3 min). LLNs (defined as the 5th percentile) for diaphragm excursion were as follows: (a) during tidal breathing: 1.2 cm (males; M) and 1.2 cm (females; F) for amplitude, and 0.8 cm/s (M) and 0.8 cm/s (F) for velocity, (b) during maximum voluntary sniff: 2.0 cm (M) and 1.5 cm (F) for amplitude, and 6.7 (M) cm/s and 5.2 cm/s (F) for velocity, and (c) at TLC: 7.9 cm (M) and 6.4 cm (F) for amplitude. LLN for diaphragm thickness was 0.17 cm (M) and 0.15 cm (F) at FRC, and 0.46 cm (M) and 0.35 cm (F) at TLC. Values for males were consistently higher than for females, independent of age. LLN for diaphragmatic thickening ratio was 2.2 with no difference between genders. LLN for invasively measured Pdi during different breathing maneuvers are presented. Voluntary Pdi showed only weak correlation with both diaphragm excursion velocity and amplitude during forced inspiration. Conclusions: Diaphragm ultrasound is an easy-to-perform and reproducible diagnostic tool for noninvasive assessment of diaphragm excursion and thickness. It supplements but does not replace respiratory muscle strength testing.

Spirometric Abnormalities and Lung Function Decline in Current and Former Microwave Popcorn and Current Flavoring Manufacturing Workers.

The aim of this study was to compare spirometry results in microwave popcorn and flavoring manufacturing workers. We used NIOSH data on current and former microwave popcorn workers (MPWs) and surveillance data on flavoring manufacturing workers (FMWs). Former MPW had higher prevalence of mixed and high severity abnormalities, some had excessive lung function drops. Current MPW had lowest occurrence of excessive lung function drops. FMW with excessive drops and spirometric abnormalities at last test had developed a restrictive pattern. Spirometric abnormalities and excessive drops were associated with work-related factors. There was evidence of a healthy worker survivor effect in MPW. Importantly, removal from exposure did not always stabilize lung function decline indicating a need for continued monitoring. The development of a restrictive pattern should raise the level of suspicion for possible work-related disease in flavoring-exposed workers.

Bronchoalveolar Lavage Lipidomic Profiles Can Predict Short-Term Changes in Lung Function in Lung Transplant Recipients

Spirometric lung function is one of the central clinical parameters to assess allograft function after lung transplantation (LTX). Reduction in FEV1 can be the result of infections, rejections episodes and most importantly development of CLAD. Currently, there is no means to predict short-term changes in lung function after LTX. Bronchoalveolar samples of patients after standard double LTX were taken during follow-up bronchoscopy at multiple different time points. Lipidomic, metabolomic, flow cytometric and bacterial 16S rRNA gene sequencing (microbiome) data were analyzed. We then used a machine learning approach to predict future changes in FEV1 from these sample data to characterize patient lung function trajectories. We trained support vector machine (SVM) regressors on the collected lipidomic, metabolomic, microbiome and flow cytometry datasets. Changes in FEV1 within 30, 60 or 90 days after lavage sample collection were used as response variables. To train hyper-parameters and evaluate model accuracy, a nested leave-one-out cross validation scheme was used. Model accuracy was benchmarked against a model trained on clinical metadata. At a prediction timeframe of 30 days, lipidomic data were available from 34 samples of 20 patients. Lipidomics showed the highest predictive power for short-term changes 30 and 60 days after sample collection. Prediction accuracy (R2) of intra-alveolar lipid composition for a 30-day projection was 0.24, meaning that BAL lipid profiles could explain more than 20 percent of total variation in relative change in FEV1 for this time span. R² for clinical metadata alone was only 0.1, and metabolomics, microbiome and FACS analysis of BAL showed no predictive accuracy at this time point. Our results suggest that the intra-alveolar lipid composition is a powerful predictor of short-term changes in lung allograft function. This could potentially facilitate pre-emptive therapeutic interventions.

SPIROMETRIC PARAMETERS IN PATIENT WITH ALLERGIC RHINITIS

Abstract Background : the link between allergic rhinitis(AR) and asthma has been confirmed. AR is risk factor for the onset of asthma . Spirometry is noninvasive method to evaluate lower respiratory system function in AR patients. The aim of the study: to evaluate spirometric lung function and response to post- bronchodilatation test in patient with AR. Methods: This prospective cross sectional study carried out on 100 patients with persistent AR. Spirometry ,post- bronchdilatation test, serum total IgE and eosinophils in blood and sputum were performed for all patients. Results: Our results reconfirming the concept of a single air way with single disease. In our study the patients with persistent AR were have impaired spirometric parameters. Conclusion: Our study confirming the predictive value of forced expiratory flow at 25% and 75% (FEF 25-75) as marker of early bronchial involvement of small air way disease (SAD) in AR and also confirm the link between upper and lower respiratory system.

Mixed-model admixture mapping identifies smoking-dependent loci of lung function in African Americans.

Admixture mapping has led to the discovery of many genes associated with differential disease risk by ancestry, highlighting the importance of ancestry-based approaches to association studies. However, the potential of admixture mapping in deciphering the interplay between genes and environment exposures has been seldom explored. Here we performed a genome-wide screening of local ancestry-smoking interactions for five spirometric lung function phenotypes in 3300 African Americans from the COPDGene study. To account for population structure and outcome heterogeneity across exposure groups, we developed a multi-component linear mixed model for mapping gene-environment interactions and empirically showed its robustness and increased power. When applied to the COPDGene study, our approach identified two 11p15.2-3 and 2q37 loci, exhibiting local ancestry-smoking interactions at genome-wide significant level, which would have been missed by standard single-nucleotide polymorphism analyses. These two loci harbor the PARVA and RAB17 genes previously recognized to be involved in smoking behavior. Overall, our study provides the first evidence for potential synergistic effects between African ancestry and smoking on pulmonary function, and underlines the importance of ethnic diversity in genetic studies.

Associations Between Glutathione-S-Transferase Genotypes and Bronchial Hyperreactivity Patients With Di-isocyanate Induced Asthma. A Follow-Up Study.

Introduction: Di-isocyanates TDI (toluene di-isocyanate), MDI (diphenylmethane di-isocyanate), and HDI (hexamethylene di-isocyanate) are the most common chemicals causing occupational asthma. Di-isocyanate inhalation has been reported to induce oxidative stress via reactive oxygen and nitrogen species leading to tissue injury. Glutathione transferases (GSTs) and N-acetyltransferases (NATs) are detoxifying enzymes whose general function is to inactivate electrophilic substances. The most important genes regulating these enzymes, i.e., GSTM1, GSTP1, GSTT1, NAT1, and NAT2 have polymorphic variants resulting in enhanced or lowered enzyme activities. Since inability to detoxify harmful oxidants can lead to inflammatory processes involving activation of bronchoconstrictive mechanisms, we studied whether the altered GST and NAT genotypes were associated with bronchial hyperreactivity (BHR) in patients with di-isocyanate exposure related occupational asthma, irrespective of cessation of di-isocyanate exposure, and adequacy of asthma treatment.Methods: Polymerase chain reaction (PCR) based methods were used to analyze nine common polymorphisms in GSTM1, GSTM3, GSTP1, GSTT1, NAT1, and NAT2 genes in 108 patients with diagnosed occupational di-isocyanate-induced asthma. The genotype data were compared with spirometric lung function and BHR status at diagnosis and in the follow-up examination on average 11 years (range 1–22 years) after the asthma diagnosis. Serum IgE and IL13 levels were also assessed in the follow-up phase.Results: An association between BHR and GSTP1 slow activity (Val105/Val105) genotype was demonstrated in the subjects at the follow-up phase but not at the diagnosis phase. Moreover, the patients with the GSTP1 slow activity genotype exhibited characteristics of Th-2 type immune response more often compared to those with the unaltered GSTP1 gene. Interestingly, all 10 patients with the GSTP1 slow activity genotype had both the GSTM3 slow activity genotype and the unaltered GSTT1 gene.Discussion: The results suggest associations of the low activity variants of the GSTP1 gene with BHR. The fact that these associations came up only at the follow-up phase when the subjects were not any more exposed to di-isocyanates, and used asthma medication, suggest that medication and environmental factors influence the presentation of these associations. However, due to the exploratory character of the study and relatively small study size, the findings remain to be confirmed in future studies with larger sample sizes.

P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies

Abstract Background Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance Methods 14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients. Results Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p&lt;0.05). Diaphragm excursion amplitude was significantly reduced in HF patients (4.29±1.35 cm vs. 7.34±2.10 cm, p&lt;0.05). Diaphragm contractility was impaired too, as reflected by the diaphragm thickening ratio (DTR; 2.01±0.46 vs. 2.53±0.74, p&lt;0.05). Diaphragm CMAP following COMS and CEMS of the phrenic nerves revealed normal latencies in HF patients compared to controls (COMS Latency; 19.05±2.37 msec vs. 18.97±3.59 msec, p= n. s.). Conclusions Diaphragm involvement in systolic HF is reflected by reduced FVC and impaired ultrasound parameters of diaphragm function. Diaphragmatic pathology is likely to be myopathic because magnetic phrenic nerve conduction studies show no abnormalities. Diaphragm ultrasound may be useful as a diagnostic tool for assessment of diaphragm function in systolic HF. Acknowledgement/Funding This study was supported by Sanofi-Genzyme, Neu-Isenburg, Germany. The funders had no role in study design, data collection and analysis, preparation.

BMI but not central obesity predisposes to airway closure during bronchoconstriction.

Obesity produces restrictive effects on lung function. We previously reported that obese patients with asthma exhibit a propensity towards small airway closure during methacholine challenge which improved with weight loss. We hypothesized that increased abdominal adiposity, a key contributor to the restrictive effects of obesity on the lung, mediates this response. This study investigates the effect of body mass index (BMI) versus waist circumference (WC) on spirometric lung function, sensitivity to airway narrowing and closure, and airway closure during bronchoconstriction in patients with asthma. Participants underwent spirometry and methacholine challenge. Sensitivity to airway closure and narrowing was assessed from the dose-response slopes of the forced vital capacity (FVC) and the ratio of forced expiratory volume in 1 s (FEV1 ) to FVC, respectively. Airway closure during bronchoconstriction (closing index) was computed as the percent reduction in FVC divided by the percent reduction in FEV1 at maximal bronchoconstriction. A total of 116 asthmatic patients (56 obese) underwent methacholine challenge. Spirometric lung function was inversely related to WC (P < 0.05), rather than BMI. Closing index increased significantly during bronchoconstriction in obese patients and was related to increasing BMI (P = 0.01), but not to WC. Sensitivity to airway closure and narrowing was not associated with BMI or WC. Although WC is associated with restrictive effects on baseline lung function, increased BMI, rather than WC, predisposes to airway closure during bronchoconstriction. These findings suggest that obesity predisposes to airway closure during bronchoconstriction through mechanisms other than simple mass loading.

Role of spirometric lung functions and body mass index in patients with bronchial asthma

Background: Bronchial asthma is an inflammatory disease also characterized by airflow limitation with a reduced peak expiratory flow (PEF), FEV1, and a low FEV1/forced vital capacity (FVC). In contrast with chronic obstructive pulmonary disease, the airflow limitation is highly reversible either spontaneously or with therapy. Repeated lung function measurements using portable peak flow meters have resulted in improved outcomes. In developing countries, there is a rising prevalence associated with increasing urbanization. The consistent finding of asthmatic airways correlates broadly with the severity of the disease, bronchial hyperreactivity, and reduced lung function. The purpose of our research was to perform spirometric lung function tests and grade the severity of airway obstruction. Aims and Objectives: This study aimed: (1) To perform spirometric lung function tests and grade the severity of airway obstruction in bronchial asthma and (2) distribution of asthma patients according to body mass index (BMI). Materials and Methods: The study comprises a total number of 50 bronchial asthma patients of both sexes between the age groups of 13 and 65 years. BMI was calculated in all patients, and spirometric lung function tests were recorded by means of a Helios computerized spirometer. The study variables include FVC, forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, PEF rate, and forced expiratory flow (25–75%) were analyzed in all patients. Based on severity predicted by FEV1%, asthma patients were classified into mild, moderate, and severe asthmatics. Results: The mild group has FEV1% predicted test value of 101.43 ± 12.43 (mean ± standard deviation) compared with the severe group having 45.3 ± 12.6 while the moderate group has 70.5 ± 5.14. Majority of the cases (74%) were in normal BMI category. Conclusion: FEV1% is important indicator of bronchial asthma severity. The symptoms of asthma have, at their core, obstructive lung impairment, which is detected by lung function tests using spirometry.

Bacterial load and defective monocyte-derived macrophage bacterial phagocytosis in biomass smoke-related COPD.

Lower airway colonisation with species of potentially pathogenic bacteria (PPB) is associated with defective bacterial phagocytosis, in monocyte-derived macrophages (MDMs) and alveolar macrophages, from tobacco smoke-associated chronic obstructive pulmonary disease (S-COPD) subjects. In the developing world, COPD among nonsmokers is largely due to biomass smoke (BMS) exposure; however, little is known about PPB colonisation and its association with impaired innate immunity in these subjects.We investigated the PPB load (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Pseudomonas aeruginosa) in BMS-exposed COPD (BMS-COPD) subjects compared with S-COPD and spirometrically normal subjects. We also examined the association between PPB load and phagocytic activity of MDMs and lung function. Induced sputum and peripheral venous blood samples were collected from 18 healthy nonsmokers, 15 smokers without COPD, 16 BMS-exposed healthy subjects, 19 S-COPD subjects and 23 BMS-COPD subjects. PPB load in induced sputum and MDM phagocytic activity were determined using quantitative PCR and fluorimetry, respectively.Higher bacterial loads of S. pneumoniae, H. influenzae and P. aeruginosa were observed in BMS-COPD subjects. Increased PPB load in BMS-exposed subjects was significantly negatively associated with defective phagocytosis in MDMs and spirometric lung function indices (p<0.05).Increased PPB load in airways of BMS-COPD subjects is inversely associated with defective bacterial phagocytosis and lung function.

Acute Reduction in Spirometry Values After Prolonged Exercise Among Recreational Runners.

Prolonged endurance running may acutely reduce spirometric lung values. This study examined changes in spirometry before and immediately after prolonged endurance exercise (running and/or walking). Specifically, we examined potential factors that predict the presence of at least a 10% postexercise reduction in FEV1. After institutional review board approval, recruitment occurred at a pre-race exposition, where informed consent was obtained. Pre-and post-race spirometry measurements were taken from 79 study subjects who competed in a half-marathon (n = 66) or a marathon (n = 13). Spirometry was performed 1-2 days before the marathon or half-marathon and 25 min after finish the race. We identified a subgroup of 23 subjects with a postexercise decrease in FEV1 of ≥10%. In this subgroup, the mean post-race values for FEV1, FVC, and peak expiratory flow were 19-24% lower than the pre-race values. In the 56 subjects with a change in FEV1 of <10%, the mean post-race changes in spirometry values were not >6%. There was no difference between the 2 groups in sex distribution or between subjects who completed the half-marathon or the full marathon. For every 1-y increase in age, the likelihood of developing a postexercise reduction in FEV1 of at least 10% decreased by nearly 10% (R2 = 0.15, P = .003). Exercise-induced bronchoconstriction (EIB) is the most probable explanation for the reduction in post-race FEV1. Prolonged endurance exercise reduced spirometric lung function by ∼20% in those with EIB. Age was the only predictor for EIB, and EIB did not affect the finish times among recreational runners and/or walkers.

Neighbours affect each other; pulmonary affection after cardiac surgery

IntroductionLungs and heart are in close relation all the time; they affect each other. Pulmonary complications due to cardiac surgeries may alter the surgery outcome and patient survival.AimThe aim of this study was to report the most frequent respiratory complications after cardiac surgeries.Materials and methodsThe study included 22 patients (group 1) who underwent coronary artery bypass grafting and 56 patients (group 2) who underwent valve replacement surgery. Preoperative and postoperative investigations such as chest radiology, spirometric lung functions and PaO2/FiO2 were performed. Pleural effusion, pneumothorax, acute respiratory distress syndrome, pneumonia, atelectasis, wound infection or sternal dehiscence were reported.ResultsPleural effusion, pneumothorax, acute respiratory distress syndrome, pneumonia, atelectasis, and sternal wound infection in group 1 were found among 81.81, 4.55, 9.10, 31.82, 86.36 and 18.18% of the included patients, respectively, whereas in group 2 they were found among 33.93, 0, 0, 35.71, 64.29 and 10.71%, respectively.ConclusionComplications after cardiac surgeries are common and precautions must be taken to decrease them and to improve outcome.

Effects of exposure to ambient ultrafine particles on respiratory health and systemic inflammation in children

It is known that ultrafine particles (UFP, particles smaller than 0.1 μm) can penetrate deep into the lungs and potentially have adverse health effects. However, epidemiological data on the health effects of UFP is limited. Therefore, our objective was to test the hypothesis that exposure to UFPs is associated with respiratory health status and systemic inflammation among children aged 8 to 11 years.We conducted a cross-sectional study among 655 children (43.3% male) attending 25 primary (elementary) schools in the Brisbane Metropolitan Area, Australia. Ultrafine particle number concentration (PNC) was measured at each school and modelled at homes using Land Use Regression to derive exposure estimates. Health outcomes were respiratory symptoms and diagnoses, measured by parent-completed questionnaire, spirometric lung function, exhaled nitric oxide (FeNO), and serum C reactive protein (CRP). Exposure-response models, adjusted for potential personal and environmental confounders measured at the individual, home and school level, were fitted using Bayesian methods.PNC was not independently associated with respiratory symptoms, asthma diagnosis or spirometric lung function. However, PNC was positively associated with an increase in CRP (1.188-fold change per 1000 UFP cm−3 day/day (95% credible interval 1.077 to 1.299)) and an increase in FeNO among atopic participants (1.054 fold change per 1000 UFP cm−3 day/day (95% CrI 1.005 to 1.106)).UFPs do not affect respiratory health outcomes in children but do have systemic effects, detected here in the form of a positive association with a biomarker for systemic inflammation. This is consistent with the known propensity of UFPs to penetrate deep into the lung and circulatory system.

Asthma Does Not Explain A Decline In Post Bronchodilator Lung Function In Early Adult Life

Using the Isle of Wight Birth Cohort (IOWBC), we investigated lung function deficits in young adults with asthma to identify whether airways obstruction in that group accounted for a decline in post-bronchodilator lung function within the overall population seen by 26-years. The IOWBC is a population based cohort (n=1456), recruited in 1989- 90 and assessed at birth, 1, 2, 4, 10, 18 and 26 years for asthma, allergic diseases and environmental exposures. Spirometric lung function tests were carried out using standardized methodology at 18 (n=839) and 26 years (n=555) before and after inhaled bronchodilator (salbutamol 400mcg). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and mid-expiratory flows (FEF25-75) at 26 years plus changes in these indices between 18 and 26 were assessed. Asthma was defined as physician diagnosis plus current wheeze and/or on treatment. Pre-bronchodilator FEV1, FEV1/FVC, and FEF25-75 were all significantly reduced (P<0.001) in those with asthma (3.52L, 0.73 and 3.11L) compared to those without asthma (3.90L, 0.73, and 3.89L). However, there was no significant difference in post-bronchodilator FEV1, FEV1/FVC, and FEF25-75 between the two groups. Airways obstruction at 26 years of age is usually fully reversible in most people with asthma. An observed decline in postbronchodilator FEV1, FEV1/FVC, and FEF25-75 from 18 to 26 years in this cohort therefore does not appear to be accounted for by the influence of asthma.