Spirometric Values Research Articles

Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD: continuous measurement of lung density by 4-dimensional dynamic-ventilation CT.

PurposeFour-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT.Materials and methodsThirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing. CT data were continuously reconstructed every 0.5 sec. Mean lung density (MLD) of the five lobes (right upper [RU], right middle [RM], right lower [RL], left upper [LU], and left lower [LL]) was continuously measured by commercially available software using a fixed volume of volume of interest which was placed and tracked on a single designated point in each lobe. Concordance between the MLD time curves of six pairs of lung lobes (RU-RL, RU-RM, RM-RL, LU-LL, RU-LU, and RL-LL lobes) was expressed by cross-correlation coefficients. The relationship between these cross-correlation coefficients and the forced expiratory volume in one second/forced vital capacity (FEV1.0/FVC) values was assessed by Spearman rank correlation analysis.ResultsIn all six pairs of the pulmonary lobes, the cross-correlation coefficients of the two MLD curves were significantly positively correlated with FEV1.0/FVC (ρ =0.60–0.73, P<0.001). The mean value of the six coefficients strongly correlated with FEV1.0/FVC (ρ =0.80, P<0.0001).ConclusionThe synchrony of respiratory movements between the pulmonary lobes is limited or lost in patients with more severe airflow limitation.

Ocena wpływu wczesnej rehabilitacji poszpitalnej na czynność wentylacyjną płuc u chorych z chorobami układu krążenia

Objective. An assumption as made that tests performed before and after a 3-week cardiovascular rehabilitation would allow the assessment of its effect on the lung ventilation function in patients post MI and CABG. Material and methods. The analysis involved determination of mean values of all spirometric values and comparing them with expected values before and after the rehabilitation program. In order to check if mean values of both tests were significantly different, they were compared using the t Student test for paired samples, and mean increases of all indexes were calculated. Test results. Lung function tests performed in study subjects gave results allowing precise analysis of lung ventilation function in patients post MI and CABG, and an assessment o the effect of comprehensive cardiovascular rehabilitation, including respiratory exercises, on ventilation function of those patients. t-Student test was applied for the assessment of differences with the significance level of p &lt; 0.01. Conclusions. The program of cardovascular rehabilitation involving respiratory exercises, accounts for improved lung ventilation function in patients post MI and CABG, and should be used at each stage of rehabilitation of those patients.

Ocena wpływu wczesnej rehabilitacji poszpitalnej na czynność wentylacyjną płuc u chorych z chorobami układu krążenia

bjective. An assumption as made that tests performed before and after a 3-week cardiovascular rehabilitation would allow the assessment of its effect on the lung ventilation function in patients post MI and CABG. Material and methods. The analysis involved determination of mean values of all spirometric values and comparing them with expected values before and after the rehabilitation program. In order to check if mean values of both tests were significantly different, they were compared using the t Student test for paired samples, and mean increases of all indexes were calculated. Test results. Lung function tests performed in study subjects gave results allowing precise analysis of lung ventilation function in patients post MI and CABG, and an assessment o the effect of comprehensive cardiovascular rehabilitation, including respiratory exercises, on ventilation function of those patients. t-Student test was applied for the assessment of differences with the significance level of p &lt; 0.01. Conclusions. The program of cardovascular rehabilitation involving respiratory exercises, accounts for improved lung ventilation function in patients post MI and CABG, and should be used at each stage of rehabilitation of those patients.

Depression and Asthma Outcomes in Older Adults: Results from the National Health and Nutrition Examination Survey

Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults. The objective of this study was to determine the association of depression with asthma outcomes in older adults (age ≥ 55) from the National Health and Nutrition Examination Survey (NHANES). Data from the NHANES survey (2007-2012) were analyzed. Bivariate analyses and multivariate Poisson regression models were used to examine associations between depression and asthma outcomes among adults above the age of55. Approximately 7.01% (n= 509) of the sample reported a physician diagnosis of asthma. Older adults with asthma and depression (n= 196) had increased asthma episodes (prevalence ratio [PR], 1.53; 95% confidence interval [CI], 1.00-2.35), ED/urgent care visits for asthma (PR, 2.24; 95% CI, 1.15-4.34), sleep disturbances due to asthma (PR 2.75; 95% CI, 1.54-4.92), and activity limitation (PR, 1.77; 95% CI, 1.00-3.18; P= .05) compared with older asthmatics without depression. They also reported worse health-related quality of life measures across 4 domains including days of poor general health, physical health, mental health, and inactivity (P < .001 for all). No significant differences in spirometric values were observed. Older adults with asthma and depression are nearly twice as likely to have poor asthma outcomes across several indicators, including asthma-related ED/urgent care visits compared with those without depression. Screening for depression and providing supportive resources may decrease the burden of asthma among older adults.

Validity and interpretation of spirometric recordings to diagnose COPD in UK primary care.

BackgroundThe diagnosis of COPD is dependent upon clinical judgment and confirmation of the presence of airflow obstruction using spirometry. Spirometry is now routinely available; however, spirometry incorrectly performed or interpreted can lead to misdiagnosis. We aimed to determine whether spirometry undertaken in primary care for patients suspected to have COPD was of sufficient quality and whether their spirometry was correctly interpreted.MethodsTwo chest physicians re-read all spirometric readings for both quality of the procedure and interpretation, received as a part of COPD validation studies using data from the Clinical Practice Research Datalink (CPRD). We then used logistic regression to investigate predictors of correct interpretation.ResultsSpirometry traces were obtained for 306 patients, of which 221 (72.2%) were conducted in primary care. Of those conducted in primary care, 98.6% (n=218) of spirometry traces were of adequate quality. Of those traces that were of adequate quality and conducted in primary care, and in whom a general practitioner (GP) diagnosis of COPD had been made, 72.5% (n=218) were consistent with obstruction. Historical records for asthma diagnosis significantly decreased odds of correct interpretation.ConclusionThe quality of the spirometry procedure undertaken in primary care is high. However, this was not reflected in the quality of interpretation, suggesting an unmet training in primary care. The quality of the spirometry procedure as demonstrated by spirometric tracings provides a re-assurance for the use of spirometric values available in the electronic health care record databases for research purposes.

Predictors of pulmonary function in fire-fighters

Introduction: Fire-fighters are at great risk of being exposed to intense smoke. This occupational hazard may have an effect on their pulmonary function, as observed in many studies. This study was done to identify various factors that predict pulmonary function among fire-fighters. Methodology: All the fire-fighters of Puducherry region were recruited in our study after obtaining an informed consent. After enrolment, socio-demographic variables and anthropometric measurements were recorded in a pre-structured proforma, following which every participant underwent spirometry testing. The Spirometric parameters FVC, FEV1, FEV1/FVC ratio, PEF, FEF25-75 were recorded and the results were analysed. Results: There was a statistically significant negative correlation between years of service and Spirometric values FVC, FEV1, PEF, and FEF 25-75 except FEV1/FVC (%). Out of a total of 115 fire-fighters, 87(75.7%) had a normal spirometry and 28(24.3%) showed evidence of obstructive airway disease (OAD). There was no statistically significant difference between fire-fighters with OAD and without OAD in terms of age, duration of service in the department, height, weight and body mass index (BMI). Among fire-fighters, the odds of having OAD was high for smokers, subjects with history of atopy and those who had recent history of wheeze and respiratory infection, compared to those without these risk factors. However the results were not statistically significant. Conclusions: As the duration of service increases, there is a decline in the Spirometric parameters FVC, FEV1, PEF and FEF25-75, for all the fire-fighters. 28(24.3%) showed evidence of obstructive airway disease by spirometry. Age, duration of service in the fire department, height, weight and Body mass index may not be useful predictors that a fire-fighter would develop obstructive airway disease. However, longitudinal studies with large sample size are necessary for robust evidence. Keywords: Fire-fighters; FVC –forced vital capacity, FEV1-Forced expiratory volume in one second; OAD–Obstructive airway disease

Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: Results of acontrolled clinical trial.

The objective was to evaluate whether preoperative administration of dexamethasone improved postoperative nausea and vomiting (PONV), pain and respiratory function tests in women undergoing conservative surgery for breast cancer. This was a controlled clinical trial conducted between June 2013 and October 2014. Eighty patients were evaluated. Patients received a preoperative dose of 8mg of dexamethasone (n=40) or placebo (n=40). The data on PONV and pain intensity was obtained and forced spirometry tests were performed, 1hr before and at 1, 6, 12 and 24hr after surgery. Any use of additional analgesic/antiemetic drugs was recorded. Patients were followed until 30days after surgery for any surgical or medical complications. The pain intensity was lower in the treatment group for all periods; PONV was lower at 6, 12 and 24hr; Additional analgesics/antiemetics were required less frequently (all p<.05). Both groups exhibited a restrictive ventilatory pattern immediately after surgery, which was reversed in the following hours. However, spirometric values were higher in the dexamethasone group. There were no pulmonary or metabolic complications after surgery. Our conclusions were that dexamethasone significantly reduced the incidences of PONV, pain and improved respiratory parameters, and reduced the need for additional postoperative analgesic and antiemetic drugs.

Comparison of extracorporeal photopheresis and alemtuzumab for the treatment of chronic lung allograft dysfunction

Survival after lung transplantation is limited by chronic lung allograft dysfunction (CLAD). Immunomodulatory therapies such as extracorporeal photopheresis (ECP) and alemtuzumab (AL) have been described for refractory CLAD, but comparative outcomes are not well defined. We retrospectively reviewed spirometric values and clinical outcomes after therapy with ECP, AL, or no treatment (NT) in patients with CLAD who underwent transplant between January 2005 and December 2014. We used inverse probability-weighted regression adjustment (IPWRA) to adjust for potential confounders affecting treatment choice. Of 267 patients, 31 received immunomodulatory therapies for CLAD, and 78 received NT. The slope of forced expiratory volume in 1 second (FEV1) decline significantly improved after treatment with AL and with ECP compared with pre-treatment FEV1 slope; however, there was no significant change in slope of forced vital capacity (FVC). Comparison with NT was limited because of clinical differences in treatment groups. After IPWRA, we found no significant difference in mean difference of FEV1 slope (ml/month) when comparing treatment with NT, suggesting stabilization of lung function in the treatment group. We found no difference between the 2 immunomodulatory therapies 1, 3, and 6 months post-treatment (-49.9 [95% CI -581.8, +482.0], p = 0.85; +27.7 [95% CI -167.6, +223.0], p = 0.78; -9.6 [95% CI -167.5, +148.2], p = 0.91). We found no difference in mean FVC slope or differences between ECP and AL in infection rates or survival after treatment. Immunomodulatory therapy for CLAD with ECP or AL was associated with a significant change in FEV1 slope post-treatment compared with pre-treatment slope, with minimal effect on FVC. There was no difference between the 2 therapies in their effect on pulmonary function.

THE EFFECTIVENESS OF PRE OPERATIVE DEEP BREATHING EXERCISE ON POST OPERATIVE PATIENTS OF ABDOMINAL SURGERY

Introduction : Pulmonary complications have a significant impact on morbidity and mortality after major abdominal surgery. One of the major causes of pulmonary dysfunction after such surgery is restricted breathing due to pain and diaphragmatic dysfunction.Methodology : this study investigated the effects of pre operative breathing exercises training on the vital capacity and peak expiratory flow rate of upper abdominal surgery patients. The patient were divided into 2 groups, control and experimental. Patient in experimental group were given three supervised session of diaphragmatic deep breathing exercise daily. Spirometric and peak flow meter values of vital capacity and peak expiratory flow rate were obtained one day before and 1st , 3rd , 5th, and 7th day after surgery.Result and conclusion : The data obtained were analyzed in terms of descriptive(frequency, percentage, mean and standard deviation) and inferential statistics by using soft ware SPSS – 16.1 version. The analysis showed a significant difference in the pre and post training vital capacity and peak expiratory flow rate for experimental group compared to control group. So, diaphragmatic deep breathing exercise improves the pulmonary functions after the abdominal surgery.

Tracheal Stenosis Caused by Thoracic Malignancy: Correlation between CT-Based Tracheal Measurement and Spirometric Values before and after Tracheal Stenting

Background: The correlation between computed tomography (CT)-based tracheal size and spirometry values is unknown in patients with tracheal stenosis by thoracic malignancy, which is often treated by tracheal stenting. Objectives: To evaluate the correlation between the tracheal cross-sectional area (CSA) and spirometric values before and after tracheal stenting, and to confirm that greater improvement in tracheal CSA leads to a larger improvement in spirometry values. Methods: A total of 32 patients with malignant tracheal stenosis underwent tracheal stenting. Before (n = 32) and after (n = 27) treatment, patients underwent chest CT, measuring mean and minimum tracheal CSA values, and spirometry. The correlation between tracheal CSA and each spirometric value was evaluated using Spearman rank correlation analysis. Differences in the pre- and posttreatment tracheal CSA and spirometric values were evaluated using the Wilcoxon matched-pairs test. Results: Significant improvement in the minimum tracheal CSA and in spirometric values was observed after stenting (P P P < 0.05). Conclusions: The tracheal size measured on chest CT correlates with patients’ spirometric values, particularly at the prestenting examination, in patients with malignant tracheal stenosis. The increase in the minimum tracheal CSA after stenting on CT is a predictor for improved spirometric values, which is first demonstrated by this study.

Verification of the new ‘all ages’ spirometric reference values for use in young Polish children of Caucasian origin

Interpretation of the spirometric results in young children aged 3 years and onward was a difficult task, because existing reference values usually covered age range of 7–18 years. Recently two big studies concerning ‘all ages’ reference equations were published: the study of The Asthma UK Initiative (Stanojevic et al. AJRCCM 2009) and the so called GLI2012 values (Quanjer et al. ERJ 2012); both providing equations with LMS approach for spirometric reference values for age range of 3–95 years. The aim of the study was to test the applicability of the new sets of equations in a group of healthy Polish children of Caucasian descent.The analysis was performed on a data gathered from children admitted to outpatient department for diagnostic reasons. Children performed impulse oscillometry (IOS) measurements and spirometry. Elevated value of oscillometric resistance at 5Hz (R5) eliminated children from analysis as well as forced expiratory time less than 1.5s. Final analysis was performed on results obtained from 142 children aged 4–10 years.Z-scores and percent of predicted values were calculated for FEV1, FVC and FEV1/FVC using both sets; additionally z-score and percent predicted was also calculated for FEV0.75/FVC using Stanojevic's equation. The distribution of all calculated z-scores was normal. For FEV1/FVC mean±SD of z-score was 0.01±0.80 using GLI2012 and −0.15±0.79 using Stanojevic's set. Mean value of percent predicted values using GLI2012 was 100.2±5.5% for FEV1/FVC, 107.4±9.4% for FEV1 and 106.6±10.1% for FVC. Our results confirm applicability of the new sets of reference values in young Caucasian children from Poland and point out the potential diagnostic value of FEV0.75/FVC.

Six Minute Walk Test: A Tool for Predicting Mortality in Chronic Pulmonary Diseases.

Six Minute Walk Test (6MWT) is a simple test used to measure exercise capacity in Chronic Pulmonary Diseases (CPDs). Decreased exercise capacity significantly affects the quality of life. The 6MWT is a known tool to measure exercise capacity and quality of life in CPD. However, the role of change in follow up Six Minute Walk Distance (6MWD) in assessing mortality and its correlation with known prognostic factors haven't been tested to the best of our knowledge. To study the correlation of change in 6MWD with change in spirometry and to study the role of 6MWD in predicting mortality in CPD. Prospective cohort study. A total of 139 CPD patients were grouped into obstructive, restrictive and post Tuberculosis (TB) sequelae. Optimized treatment was given and they were followed up regularly. Spirometry and 6MWT was done at the beginning and after one year. Mean decline in FEV1, FVC was correlated with mean decline in 6MWD. With STATA 13.1 correlation between 6MWT and spirometric values were done using Wilcoxon signed rank test. Predictors of mortality were studied using multivariate analysis. Overall mean decline in 6MWD was 16.07 m/year. There was no correlation between mean change in 6MWD and change in FEV1, FVC, and FEV1/FVC. On multivariate analysis, 6MWD was the better predictor of mortality than FEV1 (p<0.001), FVC (p<0.001). At cut off value of 240 meters, sensitivity and specificity of 6MWT in predicting mortality was 71.05% and 81.94% respectively. The 6MWD changes independently and has no correlation with change in spirometry, it is an independent predictor of mortality in CPD.

Smoking-induced oxidant/antioxidant imbalance in chronic obstructive pulmonary disease: Assessment of auditory evoked potential: A comparative study of smokers and non-smokers with or without chronic obstructive pulmonary disease

Background: Oxidative stress, inflammation, and hypoxia, which are associated with chronic obstructive pulmonary disease (COPD) may contribute to auditory impairment. Aims and Objectives: The present study was undertaken to assess the brainstem auditory evoked potential (BAEP) of smokers and non-smokers with or without COPD. Materials and Methods: The study comprised smokers with (n = 25) or without COPD (n = 15) and also healthy non-smokers (n = 30). Oxidative stress was assessed by malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP). Pulmonary functions were determined. Data were analyzed using ANOVA and Pearson’s correlation tests. P < 0.05 was considered statistically significant. Results: Spirometric values were significantly lower in COPD group in comparison with other two groups. Oxidant/antioxidant imbalance was more in smokers with COPD. BAEP result (both right and left ear) showed no significant difference between non-smokers and smokers without COPD in Wave I (P = 0.885 and 0.085, respectively) and in wave II (P = 0.554 and 0.396, respectively). Significant difference (both ears) was found between non-smokers and smokers with and without COPD in waves III, IV, V, and IPL I-V. MDA showed significant negative and positive correlations with FRAP, wave latencies, and IPL. Significant negative correlation was found between pack years and FRAP. However, non-significant positive correlation was found with MDA. Significant positive correlation was found between pack years and wave latencies III, IV, and V and interpeak latency I-V in both ears. Conclusion: Smoking-induced oxidative stress as well as increased susceptibility to COPD, which in turn led to hypoxia and effects the auditory mechanisms and these are responsible for BAEP abnormalities.

Effect of Recumbent Body Positions on Dynamic Lung Function Parameters in Healthy Young Subjects.

The change in body position can alter pulmonary functions parameters, therefore it is important to understand the physiological basis of these alteration. Ideally, spirometry is done in sitting position until the subject is unable to do so. Hospitalized patients often assume recumbent body positions irrespective of underlying pathology. Hence, need arises to find out best recumbent body positions for the benefit of these patients to make breathing comfortable for them. The aim of this study was to find out whether the change from the supine position to crook lying and Fowler's position (45° dorsal elevation) causes change in spirometric parameters. The present work was carried out at Department of Physiology, King George's Medical University, Lucknow. A total 131 apparently healthy individuals were enrolled in this cross-sectional study. Lung function was assessed using a PC-based spirometer according to American Thoracic Society guideline in the supine, crook lying and Fowler's position (45° dorsal elevation). The study consisted of 131 subjects (male 66%, female 34%), with mean age of 20.15±2.71 years and BMI 21.20±3.28 Kg/m2. Repeated measures ANOVA with post hoc Bonferroni test was used to compare the mean values between each body position. Compared with the other two positions, Fowler's position showed significantly (p<0.05) higher values for FVC, FEV1, PEF, FEF25-75%. Recumbent body position influences spirometric parameters in young healthy subjects. We demonstrated that spirometric values are higher in the Fowler's position than in the supine or crook lying position. The results of this study will help in the selection of the best alternative position for the spirometry in bed ridden patients.

Comparative Study on Changes in Spirometric Lung Function Indices of Cobblestone Workers

Cobblestone workers exposed to dust inhalation and physical injuries during cobblestone work activities exposed to respiratory problems due to proliferation and fibrotic alteration changing in their spiro metric lung function indices. This study was designed to determine changes in spirometric lung function indices of cobblestone workers. Comparative cross-sectional study was applied. Cobblestone workers exposed for one and above years and proportional non exposed non-smoking normal study participants with similar age range and anthropometric values were participated. The study showed higher change in Spiro metric lung function indices. Mean values and percent predicted mean values of lung functions (FVC, FEV1, FEV1/FVC, PEFR, PIFR and FEF25-75) were significantly reduced (p<0.05). Reduction in spirometric values was more marked in chiseling workers. Thus, dust emission during cobblestone preparation adversely affects pulmonary function of workers. Further studies should be conducted on many workers to make standing decisions and regulations. Workers should be trained and appropriate PPEs should be provided. Guideline has to be developed to provide guidance on how to assess and reduce health impacts of dust emissions.

Impact of chemotherapy on symptom profile, oxidant-antioxidant balance and nutritional status in non-small cell Lung Cancer.

Background:Lung cancer is associated with an oxidant-antioxidant imbalance that is implicated in tumor progression. However, the association of this imbalance on disease burden and treatment response is unclear. The effect of chemotherapy on oxidative stress, antioxidant status, and nutritional profile in patients with advanced nonsmall cell lung cancer (NSCLC) was prospectively evaluated.Subjects and Methods:Patients with confirmed cytological/histological diagnosis of NSCLC were recruited. Performance status was determined using the Eastern Cooperative Oncology Group grading and the Karnofsky Performance Scale. Skin fold anthropometry was done for nutritional assessment. All patients received chemotherapy with intravenous carboplatin and paclitaxel at three-weekly intervals. Response was assessed after four cycles by repeat imaging. Plasma levels of total antioxidant status (TAS), malondialdehyde (MDA), and glutathione peroxidase (GPx) levels were estimated using commercially available kits, and the change was correlated with clinical outcome, response to chemotherapy, performance status, and nutritional profile.Results:Thirty-five cases were studied (92% males), with a mean (SD) age of 56.2 (9.3) years. Following treatment, majority of patients demonstrated stable disease (n = 15 [42%]), followed by partial response (29%), progressive disease (22%), and complete remission (6%). Significant improvement occurred in respiratory symptoms. Body fat declined while subscapular skinfold thickness and 6-min walk distance increased. Spirometric values and performance status remained unchanged. GPx levels declined significantly while no notable change was observed in MDA and TAS levels.Conclusions:Chemotherapy for NSCLC improves symptoms, nutritional status, and exercise capacity but worsens the antioxidant status.

Assessment for Efficacy of Additional Breathing Exercises Over Improvement in Health Impairment Due to Asthma Assessed using St. George's Respiratory Questionnaire.

Background:Breathing exercises have been described to be useful in asthma management by few researchers in the past.Objective:To assess the efficacy of breathing exercises (Pranayamas) added to regular optimal medications in asthma patients in improving health impairment using St. George's Respiratory Questionnaire (SGRQ).Methods:Sixty stable asthma patients (34 females) receiving optimal treatment at our institute for 3 months or more as per the Global Initiative for Asthma guidelines were included in the study. They performed seven breathing exercises under supervision at yoga center of our institute for 3 months in addition to their regular medications. SGRQ (1 month symptoms version) was used to assess the quality of life before and after breathing exercises intervention for following subsets: Symptom score, activity score, impact score, and total score to assess the efficacy of breathing exercises.Results:Of 60 asthma patients, 34 were females and 26 were males, and their mean age was 25.45 ± 5.41 years. Their baseline spirometric values were as follow: Forced expiratory volume in 1 s (FEV1) - 2.492 ± 0.358 L and peak expiratory flow rate (PEFR) - 283.82 ± 51.12 L/min. The SGRQ scores after breathing exercises intervention decreased from 45.98 ± 5.61 to 38.78 ± 4.92 for symptom subset, from 15.45 ± 3.33 to 12.34 ± 2.39 for activity subset, from 17.95 ± 4.22 to 12.12 ± 3.82 for impact subset, and from 25.83 ± 8.31 to 19.20 ± 7.09 for total scores. All these reductions were statistically highly significant (P < 0.001). Decrease in symptoms, activity, and total SGRQ scores each was significantly correlated with FEV1, FEV1/forced vital capacity (FVC) ratio, and PEFR; decrease in impact score was significantly related only with FEV1/FVC ratio.Conclusions:Breathing exercises significantly decreased all component scores of SGRQ, signifying a global improvement in health impairment due to asthma; this improvement was in addition to that was achieved with optimal asthma therapy alone.

Epidemiology of pediatric asthma in a Nigerian population

Background: Reports have identified a rising prevalence of bronchial asthma, with the highest pediatric burden in the 6–11 years old. Aim: This study aimed at determining the epidemiology of asthma among primary school pupils, aged 6–11 years in Kano metropolis. Settings and Design: This study was prospective, descriptive, cross-sectional study carried out among 811 primary school pupils in Kano metropolis from October 2012 to December 2013. Materials and Methods: Information was obtained using pretested questionnaires, and enlisted pupils had their spirometric values recorded. Diagnosis of asthma was based on two or more of the following: recurrent cough, especially nocturnal, recurrent wheeze, recurrent difficulty in breathing with a response to a bronchodilator, and spirometric features of airway obstruction. Statistical Analysis: The data were analyzed with SPSS version 16 using percentages, mean values, standard deviation, Chi-square test, Student's t-test, and multiple logistic regression. P value was significant at ≤0.05. Results: Asthma prevalence was 12.5%. The disease prevalence was comparable across ethnic groups and socioeconomic classes. Neither weight nor height differed significantly between the asthmatic and nonasthmatic pupils. Family history of asthma and physical stigmata of cutaneous atopy were significantly associated with the disease. Conclusions: The prevalence of bronchial asthma among the pupils studied suggests a current local disease burden that is comparable to those of communities in the industrialized countries. There is a need for improved health education and campaigns about the disease not only for Nigerians but also for other countries with the high prevalence.

Respiratory Symptoms and Lung Function among Greek Cotton Industry Workers: A Cross-Sectional Study.

Background: Workers in cotton industry are occupationally exposed to various dust-related hazards. The nature of these agents and the respective exposure levels depend on the cotton industry specific sector. These exposures could be associated with respiratory symptoms and changes in lung function parameters. Objective: To evaluate associations between occupational exposure and respiratory function as well as reported symptoms in several groups of workers at different stages of the cotton industry in a vertical approach that covers all the major sectors—from cotton ginning to weaving and fabric production. Methods: A questionnaire on respiratory symptoms and individual as well as workplace characteristics was completed by 256 workers at the cotton industry and 148 office workers (control group). Both groups underwent spirometry. Results: Workers in cotton industry reported a higher prevalence of severe dyspnea (p=0.002) and wheezing (p=0.004) compared to the control group. Also they were found to have a lower predicted FEV1% (p<0.029) and lower FEV1/FVC (p<0.001) values. In addition, a higher prevalence of FEV1% <80% (p<0.001) and FEV1/FVC <70% (p=0.041) were found among textile workers. Similar results were found for non-smoker textile workers compared to non-smoker control group workers. Those working in cotton ginning mills recorded the highest decrease of spirometric values. Duration of employment in cotton industry and smoking use were found to be predictors of lung function decline for cotton industry workers. Conclusion: Occupational exposure to cotton dust was associated with increased prevalence of respiratory symptoms and obstructive pattern in pulmonary function test.

IL-17RB+ granulocytes are associated with airflow obstruction in asthma

BackgroundInterleukin (IL)-25 (IL-17E) is a proinflammatory cytokine that plays an important role in the T-helper type 2 cell pathway. The effects of IL-25 are mediated by its specific receptor, IL-17RB. Previous studies have defined an IL-17RB+ granulocyte population known as type 2 myeloid (T2M) cells that express T-helper type 2 cell cytokines. The correlation of IL-17RB+ granulocytes, T2M cells, and asthma parameters is unknown. ObjectiveTo investigate the relation of IL-17RB+ granulocytes (and its subset, T2M cells) in patients with asthma with clinical parameters including spirometric values and the Asthma Control Test (ACT). MethodsPeripheral blood from subjects with asthma and healthy controls was collected and analyzed by flow cytometry. Granulocytes were gated for IL-17RB+, T2M (CD11b+CD16+CD177+IL-17RB+), and eosinophil (CD16−) populations. Spirometry testing was performed on subjects with asthma. ACT scores and medical histories were collected by questionnaire and chart review. Correlations of IL-17RB+ cells and T2M cells with spirometry and ACT score were analyzed. ResultsPercentages of IL-17RB+ granulocytes and T2M cells were larger in subjects with asthma than in controls. Furthermore, percentages of the 2 cell populations were negatively correlated with degree of airway obstruction as measured by the ratio of percentage-predicted forced expiratory volume in 1 second to force vital capacity (r = −0.17, P = .043 for IL-17RB+ granulocytes; r = −0.32, P = .03 for T2M cells). There was no correlation with ACT score. The percentage of eosinophils was increased in subjects with asthma. However, IL-17RB+ eosinophil percentages were similar between subjects with asthma and controls and did not correlate with any clinical parameter. ConclusionIL-17RB+ granulocytes and T2M cells from peripheral blood were increased in subjects with asthma, and the 2 cell types correlated with degree of airflow obstruction.