Values Of Forced Expiratory Volume Research Articles

Impaired glycemic control as a risk factor for reduced lung function in the Indian diabetic population

Diabetes mellitus (DM) is a metabolic syndrome associated with chronic hyperglycemia, which results in various acute and chronic complications. DM leads to a state of chronic low-grade inflammation, which can have adverse effects on pulmonary functions. There have been contradictory studies related to the relationship between defects in lung functions in diabetic individuals and their correlation with glycemic control and systemic inflammatory markers. The present study aims to compare pulmonary function in controlled and uncontrolled diabetes in the Indian population while exploring the link between inflammatory markers and lung functions in diabetic patients. This observational, case-control study was conducted in the Department of Biochemistry at Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar, Punjab, on 116 subjects suffering from DM in the age group of 30-65 years. 58 diabetic patients with poor glycemic control [glycated hemoglobin (HbA1c)>7%] and 58 diabetic patients with good glycemic control served as controls (HbA1c≤7%). The duration of the study was two years. Blood samples of each patient were investigated for glycemic control, high-sensitivity C-reactive protein (hsCRP), and serum fibrinogen. Spirometry as a pulmonary function test was undertaken for all participants. The statistical analysis of good and poor glycemic control diabetics showed that the average duration of disease (in years) was 8±5 and 10.2±5.4, respectively. A significant positive correlation was found between inflammatory markers (hsCRP and fibrinogen) and HbA1c and fasting blood glucose. A substantial decline in forced vital capacity and normal values of forced expiratory volume in the first second was observed in poor glycemic control diabetics, depicting a restrictive pattern of lung disease. Lung damage is seen to be more prevalent in patients with a longer duration of disease and increased levels of inflammatory markers. Chronic inflammation due to DM can lead to fibrosis and destruction of lung tissue, resulting in the development of diabetic lung disease, which includes a decline in lung function, an increased risk of infection, and an increased risk of respiratory failure. Therefore, it is essential for individuals with DM to have regular pulmonary function tests and to manage their diabetes to minimize the impact on their lung health.

The cutoff value of small airway dysfunction in children with bronchial asthma

Objective: To explore the cutoff value for assessing small airway dysfunction in children with asthma. Methods: A total of 364 asthmatic children aged 5 to 14 years, with normal ventilatory function, followed up at the Asthma Clinic of the Children's Hospital of Capital Institute of Pediatrics from January 2017 to January 2018, were selected as the case group. Concurrently, 403 healthy children of the same age range and without any symptoms in the community were chosen as the control group, and pulmonary function tests were conducted. The values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow at 50% of FVC (FEF50), forced expiratory flow at 75% of FVC (FEF75) and maximum mid-expiratory flow (MMEF) were compared between case group and control group. Statistical tests such as t-test, χ2 test, or Mann-Whitney U test were used to analyze the differences between the groups. Receiver operating characteristic (ROC) curves were constructed, and the maximum Youden Index was utilized to determine the optimal cutoff values and thresholds for identifying small airway dysfunction in asthmatic children. Results: This study comprised 364 children in the case group (220 boys and 144 girls) and 403 children in the control group (198 boys and 205 girls). The small airway parameters (FEF50%pred, FEF75%pred, MMEF%pred) in the asthmatic group were significantly lower than in the control group (77% (69%, 91%) vs. 95% (83%, 109%), 67% (54%, 82%) vs. 84% (70%, 102%), 76% (66%, 90%) vs. 97% (86%, 113%), Z=12.03, 11.35, 13.66, all P<0.001). The ROC curve area under the curve for FEF50%pred, FEF75%pred, MMEF%pred was 0.75, 0.74, and 0.79, respectively. Using a cutoff value of 80% for FEF50%pred achieved a sensitivity of 56.9% and specificity of 81.4%. A cutoff value of 74% for FEF75%pred resulted in a sensitivity of 67.3% and specificity of 69.2%. Finally, using a cutoff value of 84% for MMEF%pred achieved a sensitivity of 67.9% and specificity of 77.2%. Conclusion: In the presence of normal ventilatory function, utilizing FEF50<80% predicted or MMEF<84% predicted can accurately serve as criteria for identifying small airway dysfunction in children with controlled asthma.

Trajectory of lung function in diabetic adults: A 16-year follow-up study of community-based prospective cohorts.

To investigate the difference in lung function according to diabetes status in a community-based prospective study. Individuals aged 40-69 years from two community-based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross-sectional and longitudinal analyses based on diabetes status. Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, -1.853; 95% confidence interval [CI] -2.715 to -0.990 for prediabetes and mean, -4.088; 95% CI -5.424 to -2.752 for diabetes) and forced vital capacity (FVC) (mean, -2.087; 95% CI -2.837 to -1.337 for prediabetes and mean, -4.622; 95% CI -5.784 to -3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, -0.227; 95% CI -0.366 to -0.089) and FVC % predicted (mean, -0.232; 95% CI -0.347 to -0.117) during follow-up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow-up. Diabetes is associated with a lower baseline lung function and a faster rate of deterioration.

SPECT/CT to quantify early small airway disease and its relationship to clinical symptoms in smokers with normal lung function: a pilot study.

Smokers frequently display respiratory symptoms despite the fact that their pulmonary function tests (PFTs) can be normal. Quantitative lung ventilation single-photon emission computed tomography (SPECT/CT) can provide a quantification of lung ventilatory homogeneity and could prove useful as an early marker of airway disease in smokers. We measured the effects of smoking on regional ventilation distribution in subjects with normal lung function and evaluated whether ventilation distribution in these subjects is related to lung function tests results and clinical symptoms. Subjects without any history of respiratory disease were prospectively recruited and separated in two groups: active smokers (AS: ≥10 cigarettes/day and history of ≥15 pack-years) and never smokers (NS: lifetime exposure of <5 cigarettes). All subjects performed PFTs (which had to be normal, defined as z-score values of forced expiratory volume in 1s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, total lung capacity (TLC) residual volume and diffusion capacity (DLCO) all falling between -1.65 and +1.65) and underwent SPECT/CT with Technegas, which generated subject- specific ventilation heterogeneity maps. The area under the compensated coefficient of variation (CV) density curve for CV values > 40%, (AUC-CV40%) was used as the measure of ventilation heterogeneity. 30 subjects were recruited (15 per group). Subjects in the AS group displayed higher dyspnea levels (1 [1-2] vs. 0 [0-1] units on mMRC scale, p < 0.001). AUC- CV40% was significantly higher in the AS group (0.386 ± 0.106 vs. 0.293 ± 0.069, p = 0.004). AUC-CV40% was significantly correlated to FEV1 (rho = -0.47, p = 0.009), DLCO (rho = -0.49, p = 0.006), CAT score (rho = 0.55, p = 0.002) and mMRC score (rho = 0.54, p = 0.002). Subjects with mMRC >0 had higher AUC-CV40% values than those without dyspnea (0.289 ± 0.071 vs. 0.378 ± 0.102, p = 0.006), while FEV1 and DLCO were not different between those groups. ROC analyses showed that the AUC for AUC-CV40% in identifying subjects with mMRC score >0 was 0.78 (95%CI 0.61-0.95, p = 0.009), which was significantly higher than that of FEV1 and DLCO. In smokers with normal lung function, ventilatory inhomogeneities can be quantified using SPECT/CT. AUC-CV40% values are related to lung function decline and to respiratory symptomatology, suggesting a potential role for this marker in the evaluation of symptomatic smokers.

Effects of Delayed-Onset Muscle Pain on Respiratory Muscle Function.

Delayed-onset muscle soreness (DOMS) has been widely examined in the peripheral muscles; however, studies showing the potential effects of DOMS on respiratory function are limited. DOMS in trunk muscles has a negative effect on respiratory function parameters, respiratory muscle strength, respiratory muscle endurance, and exercise capacity. Prospective cohort study. Level 2. In 24 healthy participants with a mean age of 21 ± 2 years, DOMS was induced for the trunk muscles with a load equal to 80% of the maximum repetitive voluntary contraction. Pulmonary function parameters, respiratory muscle strength and endurance, exercise capacity, pain, fatigue, and dyspnea perception severity were recorded before DOMS and at 24 and 48 hours after DOMS. After DOMS, decreases were observed in respiratory function parameters, namely, forced vital capacity, forced expiratory volume in the first second, vital capacity, and 25% to 75% flow rate value of forced expiratory volume (25% to 75%) (P = 0.02, P = 0.02, P < 0.01, P = 0.01, respectively). Maximal inspiratory pressure and exercise capacity also decreased (P = 0.02, P < 0.01, respectively). No difference was observed between all 3 measurements of maximal expiratory pressure (MEP) and MEP% values (P1 = P2 = P3 ≥ 0.99). The results of the respiratory muscle endurance tests did not reveal a significant difference in terms of load and time in all 3 conditions (P > 0.05). After DOMS, there was a 4% to 7.5% decrease in respiratory function parameters, and a 6.6% decrease in respiratory muscle strength. The occurrence of DOMS before a competition can have a detrimental impact on pulmonary performance. Hence, it is imperative to consider this factor when devising training and exercise programs. In addition, the development of treatment protocols becomes crucial if DOMS arises.

Investigation of the chronic respiratory symptoms and pulmonary function of adult residents in Hongtong County, Shanxi Province

Objective: To investigate the chronic respiratory symptoms and pulmonary function of adult residents in 3 towns of Hongtong County, Shanxi Province, and to explore their risk factors. Methods: The investigation of chronic respiratory symptoms and lung function status of adult residents in Hongdong County is based on the regional population of the entire county in Hongdong County. The project was initiated by the Science and Technology Department of Linfen City and coordinated by the Hongdong County Government. The investigation will be conducted in 3 townships in Hongdong County, Linfen City, Shanxi Province from April to November 2021: Demographic characteristics, respiratory symptoms, smoking dust exposure and other personal history were collected through questionnaires. Physical examination, routine blood tests and lung function tests were also performed on each individual. SPSS 22.0 software was used to conduct t test, χ2 test, ANOVA or Kruskal-Wallis test for statistical analysis of the collected information. Results: 10 945 subjects aged 18-102 years were included in the analysis, of whom 3 754 (34.3%) were male, 1 222 (11.2%) had a history of dust exposure, 7 164 (65.5%) had used straw and firewood as cooking fuel, and 3 296 (30.1%) had a history of smoking. Among the participants, 394 (3.6%), 339 (3.1%), and 1 543 (14.1%) had respiratory symptoms such as chronic cough, sputum, and dyspnea. Statistics showed that the population with chronic respiratory symptoms was more elderly and had a smoking history, and the incidence of chronic respiratory symptoms was higher in those who smoked more than 40 packs a year (all P<0.05). Men with a history of dust exposure were more likely to suffer from chronic cough and expectoration, while emaciation and biofuel use for more than 40 years were more likely to suffer from chronic expectoration and dyspnea (all P<0.05). The median values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC in 1 second were 2.19 L/s, 3.24 L and 69.16%, respectively. Among them, the lung function of 5 801 (53.0%) respondents was lower than the expected value. The median FEV1/FVC decreased with the increase of age. The FEV1/FVC of people over 40 years old with smoking history was lower, the dust exposure history of people with decreased lung function was more than that of people with normal lung function, and the incidence of chronic expectoration and dyspnea was higher in people with decreased lung function (all P<0.05). The absolute value and ratio of eosinophils in patients with decreased ventilation function over 60 years old were significantly higher than those with normal ventilation function, but the level of body mass index (BMI) was lower (all P<0.05). Conclusion: In Hongdong County, Shanxi Province, grassroots residents have poor medical awareness, low lung function examination rate, chronic respiratory symptoms and lung function decline are associated with more risk factors. Primary medical institutions need to formulate prevention strategies and carry out lung function detection according to the actual situation, focusing on monitoring and follow-up of high-risk groups to achieve early and timely prevention, diagnosis and treatment of chronic obstructive pulmonary disease.

Сognitive impairment in patients with chronic obstructive pulmonary disease

We conducted a systematic review of 23 original studies published from 2010 to 2022, which participated a total of 168 thousand people, including 48 thousand patients with chronic obstructive pulmonary disease (COPD) aged 45 to 93 years.Results. The prevalence of cognitive impairment (CI) in patients with COPD varies from 6 to 63%. COPD patients have a higher risk of developing mild CI (HR from 1.1 to 1.9; OR from 1.4 to 2.4) and dementia (HR from 1.3 to 1.9; OR = 1.2). The risk of cognitive dysfunction increases along with a decrease in the values of forced expiratory volume in one second as a percentage of its expected value (FEV1%) (OR = 1.34), arterial oxygen partial pressure (PaO2) (OR = 5.45), oxygen saturation (SaO2) and an increase in the level of arterial carbon dioxide partial pressure (PaCO2). There is a significant direct relationship between FEV1% and Mini-Mental State Examination (MMSE) (p &lt; 0.0001) and an inverse relationship between COPD severity and MMSE (p &lt; 0.0001). The MMSE score is correlated with FEV1% (r = 0.46, p &lt; 0.01) and PaO2 (r = 0.43, p &lt; 0.05).Conclusion. The available data confirm the association of COPD with an increased risk of occurrence and progression of CI. It is discussed that this is due to the unfavorable course of concomitant vascular and neurodegenerative diseases against the background of chronic hypoxia.

Outcome of Lung Functions in Covid-19 Patients at a Tertiary Care Center of Eastern Nepal

Background: Novel coronavirus infection has myriad clinical manifestations, such as headache, respiratory failure, and long coronavirus disease syndrome. A common cause for admission is pneumonia, and such patients have shown longer periods of respiratory symptoms and exercise intolerance after discharge. The study aimed to determine short-term and long-term lung function outcomes in coronavirus disease patients.&#x0D; Materials and Methods: The prospective, cross-sectional study was conducted in coronavirus disease facility of Birat Medical College Teaching Hospital. A structured proforma including symptoms, modified medical research council dyspnea scale, 6-minute walk test and portable spirometry were recorded during 3 months follow up.&#x0D; Results: A total of 58 coronavirus disease patients were admitted, 4 expired. Common symptoms were dyspnea (98.28%), fever (94.8%), dry cough (86.2%), myalgia (17.2%). Mean Forced expiratory volume in 1 second to forced vital capacity ratio was normal. The mean forced vital capacity was 46.52% at admission, 53.33% at 3 months. The mean forced expiratory flow at 25% to 75% of forced vital capacity was 56.91% at admission, 59.31% at 3 months. Mean values of forced expiratory volume predicted was 47.40% at admission, 51.69% at 3 months. Mean 6-minute walk test distance did not improve during follow-up (240.09m at 1 month, 239.35m at 3 months) and there was no improvement in oxygen saturation at 3 months compared to the first month.&#x0D; Conclusion: Short-term lung function outcome demonstrated persistent dyspnea and development of mixed airways disease in all the survivors. Long-term lung function outcome observed was persistence of dyspnea, mixed airways disease, and low exercise capacity.

Genetic differences according to onset age and lung function in asthma: A cluster analysis.

The extent of differences between genetic risks associated with various asthma subtypes is still unknown. To better understand the heterogeneity of asthma, we employed an unsupervised method to identify genetic variants specifically associated with asthma subtypes. Our goal was to gain insight into the genetic basis of asthma. In this study, we utilized the UK Biobank dataset to select asthma patients (All asthma, n=50,517) and controls (n=283,410). We excluded 14,431 individuals who had no information on predicted values of forced expiratory volume in one second percent (FEV1%) and onset age, resulting in a final total of 36,086 asthma cases. We conducted k-means clustering based on asthma onset age and predicted FEV1% using these samples (n=36,086). Cluster-specific genome-wide association studies were then performed, and heritability was estimated via linkage disequilibrium score regression. To further investigate the pathophysiology, we conducted eQTL analysis with GTEx and gene-set enrichment analysis with FUMA. Clustering resulted in four distinct clusters: early onset asthmanormalLF (early onset with normal lung function, n=8172), early onset asthmareducedLF (early onset with reduced lung function, n=8925), late-onset asthmanormalLF (late-onset with normal lung function, n=12,481), and late-onset asthmareducedLF (late-onset with reduced lung function, n=6508). Our GWASs in four clusters and in All asthma sample identified 5 novel loci, 14 novel signals, and 51 cluster-specific signals. Among clusters, early onset asthmanormalLF and late-onset asthmareducedLF were the least correlated (rg =0.37). Early onset asthmareducedLF showed the highest heritability explained by common variants (h2 =0.212) and was associated with the largest number of variants (71 single nucleotide polymorphisms). Further, the pathway analysis conducted through eQTL and gene-set enrichment analysis showed that the worsening of symptoms in early onset asthma correlated with lymphocyte activation, pathogen recognition, cytokine receptor activation, and lymphocyte differentiation. Our findings suggest that early onset asthmareducedLF was the most genetically predisposed cluster, and that asthma clusters with reduced lung function were genetically distinct from clusters with normal lung function. Our study revealed the genetic variation between clusters that were segmented based on onset age and lung function, providing an important clue for the genetic mechanism of asthma heterogeneity.

Assessment of health status and its correlation with lung function in patients with chronic obstructive pulmonary disease: a study from a tertiary care center in north India.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 recommends a comprehensive multidimensional assessment for patients with chronic obstructive pulmonary disease (COPD) and stresses the need for evaluation of their health status and quality of life (QOL). The COPD assessment test (CAT), clinical COPD questionnaire (CCQ), and St. George respiratory questionnaire (SGRQ) are recommended by GOLD for such assessments. However, their correlation with spirometry in the Indian population is not known. Other similar questionnaires like the COPD and sleep impact scale (CASIS), functional performance inventory-short form (FPI-SF), and COPD and asthma fatigue scale (CAFS), though used internationally as a research tool, are still in the offspring stage and have never been used in India. A cross-sectional study was hence conducted in the Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India, on 100 COPD patients. Patients were assessed for health status and QOL by CAT, CCQ, SGRQ, CASIS, FPI-SF, and CAFS. The relationship between these questionnaires and airflow limitations was investigated. The majority of the patients were males (n=97), >50 years of age (n=83), illiterate (n=72), had moderate/severe COPD, and belonged to group B (n=66). The mean value of forced expiratory volume in one second (FeV1) decreased with a deterioration in CAT and CCQ score grouping (p<0.001). Patients with poorer CAT and CCQ scores belonged to higher GOLD grades (k=0.33, p<0.001). The correlation of health-related quality of life (HRQL) questionnaires among each other, with FEV1 predicted and with GOLD grade, was strong to very strong in most of the comparisons (p<0.01 in the majority). On comparison of GOLD grade with mean scores of HRQL questionnaires, it was seen that with the increase in GOLD grading from 1 to 4, the mean values of CAT, CCQ, SGRQ, CASIS, FPI-SF, and CAFS also deteriorated (p<0.001, p<0.001, p<0.001, p<0.005, p<0.001 and p<0.001, respectively). Various easy-to-use HRQL scores should be routinely used in outpatient departments for a comprehensive assessment of COPD patients. These questionnaires, in combination with clinical features, can help in providing a rough estimate of the severity of the disease in places where lung function assessments are not readily available.

Changes in mortality among patients with chronic obstructive pulmonary disease from the 1990s to the 2000s: a pooled analysis of two prospective cohort studies

ObjectivesThis study aimed to identify and investigate changes in the mortality of patients with chronic obstructive pulmonary disease (COPD) at the same institute from the 1990s to the 2000s. We...

Risk Factors for Bronchiolitis Obliterans Syndrome after Initial Detection of Pulmonary Impairment after Hematopoietic Cell Transplantation

Pulmonary chronic graft-versus-host-disease (cGVHD), or bronchiolitis obliterans syndrome (BOS), is a highly morbid complication of hematopoietic cell transplantation (HCT). The clinical significance of a single instance of pulmonary decline not meeting the criteria for BOS is unclear. We conducted a retrospective analysis in a cohort of patients who had an initial post-HCT decline in the absolute value of forced expiratory volume in 1 second (FEV1) of ≥10% or mid-expiratory flow rate of ≥25% but not meeting the criteria for BOS (pre-BOS). We examined the impact of clinical variables in patients with pre-BOS on the risk for subsequent BOS. Pre-BOS developed in 1325 of 3170 patients (42%), of whom 72 (5%) later developed BOS. Eighty-four patients developed BOS without detection of pre-BOS by routine screening. Among patients with pre-BOS, after adjusting for other significant variables, airflow obstruction (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1 to 3.7; P=.02), percent-predicted FEV1 on decline (HR, .98; 95% CI, .97 to 1.0; P=.02), active cGVHD (HR, 7.7; 95% CI, 3.1 to 19.3; P < .001), peripheral blood stem cell source (HR, 3.8; 95% CI, 1.7 to 8.6; P=.001), and myeloablative conditioning (HR, 2.0; 95% CI, 1.1 to 3.5; P=.02) were associated with subsequent BOS. The absence of airflow obstruction and cGVHD had a negative predictive value of 100% at 6 months for subsequent BOS, but the positive predictive value of both factors was low (cGVHD, 3%; any obstruction, 4%; combined, 6%). Several clinical factors at the time of pre-BOS, particularly active cGVHD and airflow obstruction, increase the risk for subsequent BOS. These factors merit consideration to be included in screening practices to improve the detection of BOS, with the caveat that the predictive utility of these factors is limited by the overall low incidence of BOS among patients with pre-BOS.

Correlation Between Ultrasonographic Evaluation of Diaphragm Excursion, Thickness and Spirometry in COPD patients: A Case-Control Study

Background: Weakness of the diaphragm is associated with dyspnea and exercise intolerance and affects survival in chronic obstructive pulmonary disease (COPD) patients. The present study aimed to evaluate diaphragm excursion, and thickness using ultrasonography (USG) and spirometry values in patients with COPD, correlate these values and compare them with healthy controls. Methodology: This case-control study was conducted in a tertiary care center in South India for 1 year. A total of 70 patients with COPD and 70 healthy controls were recruited. Data were collected and statistically analyzed. Results: The absolute value of forced expiratory volume 1 (FEV1) and the percentage of predicted FEV1, forced vital capacity (FVC), and FEV1/FVC was significantly lower in COPD patients (p &lt; 0.0001). Diaphragm excursion at normal inspiration, deep inspiration, and while sniffing was significantly lower in COPD patients (p &lt; 0.01). Diaphragm thickness at end-inspiration, end-expiration, and diaphragm thickness fraction (DTF) was significantly lower in COPD patients compared to normal healthy subjects (p &lt; 0.01). Conclusion: A mild positive correlation was found between diaphragm excursion at normal inspiration and FEV1. There was a strong correlation between FEV1 and diaphragm excursion during deep inspiration and sniffing. A linear equation was developed to calculate FEV1. FEV1 = 2.99 – (0.042 × age) + (0.224 × deep inspiration) + (0.015 × sniffing). This could predict risks for any major surgeries, decide on treatment options for COPD patients, and can be used for prognosis and follow-up while the patient is on inhaler therapy

The importance of aeroallergen sensitivity in children with cystic fibrosis.

Cystic fibrosis (CF) is an inherited autosomal recessive disorder that causes chronic airway disease. In addition to genetic factors, environmental factors may affect the clinical phenotype of CF. In this study, the presence of aeroallergen sensitivity in our patients with CF and its effects on clinical findings are evaluated. In this study, patients included were diagnosed with CF and followed in the Pediatric Respiratory and Allergy Clinic of the Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. Demographic characteristics, clinical and laboratory findings, skin prick test (SPT) results, and modified Shwachman-Kulczycki (MSK) scores of the patients were evaluated. We evaluated 51 patients with CF with a median age of 10 (6-18) years. The mean MSK score of the patients was 72.54±11.50, and the mean predictive value of forced expiratory volume (FEV1) in the initial (1st) second was 80.43±19.50. According to SPT, aeroallergen sensitivity was detected in 17 (33.3%) patients. The prevalence of bacterial colonization and bronchiectasis was higher, and MSK scores were lower in Aspergillus fumigatus (AF)-sensitive patients (P ≤ 0.01). However, no similar difference was found in other allergen sensitivities. MSK scores (P = 0.001) and predictive FEV1 values (P = 0.005) of 25 (49%) patients with bacterial colonization were significantly lower than those without colonization. Aeroallergen sensitivity was detected in approximately one-third of CF patients. Although it has been emphasized in studies that environmental factors may have an impact on lung functions and clinical conditions in CF, the effect of allergens other than AF sensitivity may be less important compared to other environmental factors, such as the presence of bacterial colonization.

Socioeconomic position over the life course and impaired lung function of older adults in Central and Eastern Europe: the HAPIEE study

BackgroundSocial differences in lung functioning have been reported, but the role of socioeconomic position (SEP) at different stages of life is less well understood, particularly in Central and Eastern Europe....

Lung function in young adults born small for gestational age at term.

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The Efficacy and Safety of Azithromycin for Patients with Cystic Fibrosis: A Systematic Review

Chronic inflammation of the lungs is a major cause of morbidity and mortality in patients with cystic fibrosis. One of the macrolides, azithromycin has antimicrobial, immunomodulatory, and anti-inflammatory effects that are useful in diseases with chronic inflammatory processes such as cystic fibrosis. This systematic review aimed to determine the efficacy and safety of azithromycin administration for cystic fibrosis patients in improving lung function. Pulmonary function was assessed by measuring the value of forced expiratory volume in one second (FEV1) in patients after intervention. The process of searching literature through PUBMED and Cochrane Library uses the keywords "Cystic Fibrosis" and "Azithromycin" with the Boolean operator "AND". There were seven studies selected, with criteria RCT studies, patients of all ages, patients with cystic fibrosis, and compared azithromycin with placebo. After reviewing seven studies, 71.4% of the studies stated that there was a significant increase of mean FEV1 value after being given azithromycin therapy. Other outcomes assessed were FVC values, pro-inflammatory indicators, exacerbations, changes in body weight, and quality of life. Azithromycin administration is considered relatively safe and well-tolerated by patients.

Comparison of Postural Drainage and Percussion Techniques in Cystic Fibrosis Patients

Aim: To determine the effects of postural drainage and percussion techniques in patients with cystic fibrosis. Methods: This research was carried out in the ‘South Punjab Clinics, Hospital Multan' as a randomized clinical trial. From December 2020 to June 2021, the research was completed in about six months. This study used a sample size of 32 cystic fibrosis patients to determine the effects of postural drainage and percussion treatments. Two groups of patients were formed. Suctioning and aerosol medicines were used as a common treatment for both groups. Postural drainage, aerosol drugs, and suctioning were used in Group A, while the percussion method, aerosol medications, and suctioning were used in Group B. The frequency of sputum, forced spirometry FEV1 and patient satisfaction are also used. Results: The mean age and standard deviation of 32 patients was 281.009, including 20 males and 12 females. The pretreatment mean value of forced expiratory volume (FEV1) for the percussion and postural drainage groups was 4.25 and 2.38, and the post-treatment mean value was 1.00 and 2.22 respectively. The pretreatment mean value of sputum production for the percussion and postural drainage groups was 1.00 and 1.00, and the post treatment mean value was 2.25 and 2.19 respectively. Data was not normally distributed, so a non-parametric test (Mann-Whitney) was applied. The calculated p value was greater than 0.05. Conclusion: In cystic fibrosis patients, there was no substantial difference in the benefits of percussion and postural draining techniques. Keywords: Cystic fibrosis, percussion, postural drainage, airway clearance technique,

Assessment of household air pollution exposure of tribal women

There is a growing evidence that the burning of unprocessed biomass fuels is associated with adverse health impacts. This study estimated the gaseous pollutants (CO, CO2, O3, SO2, and NO2) and particulate matters (PM2.5 and PM10) during the burning of biomass and liquefied petroleum gas (LPG) fuels and their impacts on the health of tribal women. The results revealed that the tribal women mainly used six types of unprocessed biomass fuels (dry leaves, cow dung cake, dry woods, twigs, rice straw, and agricultural residues) along with five types of traditional earthen stoves. The concentration of gaseous and PM was recorded as in the order of CO2 > SO2 > CO > O3 and total suspended particulate matter (TSPM) > PM10 > PM2.5, respectively. The pollutant concentration inside the kitchen room for biomass users was significantly (p < 0.001) higher than LPG users. The biomass using tribal women might be suffering from higher cardiovascular risk than LPG users. The lung function study results also indicated that the mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were lower among biomass users than LPG users. The correlation study shows that tribal women who were exposed to biomass smoke were in a more vulnerable position than those who used LPG. Moreover, the toxicological risk among tribal biomass users was observed high (3.52) compared to LPG users (0.39). On the other hand, the Monte Carlo probabilistic simulation model for uncertainty analysis revealed that the mean value of Hazard Quotient (HQ) for PM2.5 in kitchen room was observed as 4.31E-00 and 9.40E-01 for biomass and LPG users, respectively. Modelling study also revealed that exposure of duration and cooking time are extremely important for toxicological risk assessment. However, further long-term comprehensive studies are extremely important.

Evaluation of pulmonary function tests in allergic rhinitis patients attending a rural tertiary care hospital in South India

Background: Pulmonary function tests (PFTs) include a variety of tests such as spirometry, the volume of lung measurement, and diffusing capacity of lung quantification. Allergic rhinitis (AR) is a kind of rhinitis related to complex symptomatology characterized by rhinorrhea, obstruction of the nasal cavity, attacks of sneezing, and irritation of the nose, palate, and eyes. PFT could be deranged in AR patients, as they sustain anomalous airway function, determined by obstruction. Hence, assessing PFT's are a crucial part of the patient workup with AR. Aim: The current study evaluated the variations in pulmonary function among AR patients. Materials and Methods: A sum of 100 people were included in the study, of which 50 people were with AR meeting inclusion criteria, whereas the same age- and gender-matched 50 persons were regarded as a “control group.” PFTs were performed after getting informed consent from both groups. Data were charted and analyzed for statistical significance by the Student's t-test. Results: P value of maximal voluntary ventilation (MVV) has been observed to be the most significant, pointing toward a marked reduction of MVV in the AR patients in comparison to the control group. The P value of forced expiratory volume 1 (FEV1) is moderately significant, depicting a mild decrease in FEV1 among the study group. The P value of FEV1% has been highly significant, pointing toward a marked decrease in FEV1% among the study group participants. The P value of peak expiratory flow rate (PEFR) has been highly significant, denoting a substantial decrease in PEFR in the study group. Conclusion: Alterations in the pulmonary function were evaluated by applying the PFT's among the AR patients of Salem. It was observed that PFT values such as “FEV1, FEV1%, MVV, and PEFR” demonstrated a notable reduction in the allergic patients compared to control.