Ventilatory Lung Function Research Articles

Diagnostic efficacy of serum 14-3-3β protein combined with fractional exhaled nitric oxide and conventional ventilatory lung function parameters for bronchial asthma in children

To explore the diagnostic efficacy of serum 14-3-3β protein combined with fractional exhaled nitric oxide (FeNO) and conventional ventilatory lung function parameters in diagnosing bronchial asthma (referred to as "asthma") in children. A prospective study included 136 children initially diagnosed with asthma during an acute episode as the asthma group, and 85 healthy children undergoing routine health checks as the control group. The study compared the differences in serum 14-3-3β protein concentrations between the two groups, analyzed the correlation of serum 14-3-3β protein with clinical indices, and evaluated the diagnostic efficacy of combining 14-3-3β protein, FeNO, and conventional ventilatory lung function parameters for asthma in children. The concentration of serum 14-3-3β protein was higher in the asthma group than in the control group (P<0.001). Serum 14-3-3β protein showed a positive correlation with the percentage of neutrophils and total serum immunoglobulin E, and a negative correlation with conventional ventilatory lung function parameters (P<0.05). Cross-validation of combined indices showed that the combination of 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume had an area under the curve of 0.948 for predicting asthma, with a sensitivity and specificity of 88.9% and 93.7%, respectively, demonstrating good diagnostic efficacy (P<0.001). The model had the best extrapolation. The combination of serum 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume can significantly improve the diagnostic efficacy for asthma in children. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 723-729.

Sleep Apnea Physiological Burdens and Cardiovascular Morbidity and Mortality.

Rationale: Obstructive sleep apnea is characterized by frequent reductions in ventilation, leading to oxygen desaturations and/or arousals. Objectives: In this study, association of hypoxic burden with incident cardiovascular disease (CVD) was examined and compared with that of "ventilatory burden" and "arousal burden." Finally, we assessed the extent to which the ventilatory burden, visceral obesity, and lung function explain variations in hypoxic burden. Methods: Hypoxic, ventilatory, and arousal burdens were measured from baseline polysomnograms in the Multi-Ethnic Study of Atherosclerosis (MESA) and the Osteoporotic Fractures in Men (MrOS) studies. Ventilatory burden was defined as event-specific area under ventilation signal (mean normalized, area under the mean), and arousal burden was defined as the normalized cumulative duration of all arousals. The adjusted hazard ratios for incident CVD and mortality were calculated. Exploratory analyses quantified contributions to hypoxic burden of ventilatory burden, baseline oxygen saturation as measured by pulse oximetry, visceral obesity, and spirometry parameters. Measurements and Main Results: Hypoxic and ventilatory burdens were significantly associated with incident CVD (adjusted hazard ratio [95% confidence interval] per 1 SD increase in hypoxic burden: MESA, 1.45 [1.14, 1.84]; MrOS, 1.13 [1.02, 1.26]; ventilatory burden: MESA, 1.38 [1.11, 1.72]; MrOS, 1.12 [1.01, 1.25]), whereas arousal burden was not. Similar associations with mortality were also observed. Finally, 78% of variation in hypoxic burden was explained by ventilatory burden, whereas other factors explained only <2% of variation. Conclusions: Hypoxic and ventilatory burden predicted CVD morbidity and mortality in two population-based studies. Hypoxic burden is minimally affected by measures of adiposity and captures the risk attributable to ventilatory burden of obstructive sleep apnea rather than a tendency to desaturate.

Ventilatory Muscle Strength Six Months After Coronary Artery Bypass Grafting in Patients Submitted to Inspiratory Muscular Training Based on Anaerobioc Threshold: A Clinical Trial

Introduction Coronary artery bypass grafting (CABG) surgery is associated with a decline in ventilatory muscle strength and lung function. Inspiratory muscle training (IMT) based on anaerobic threshold (AT) has been used to minimize the impact of CABG on these parameters, but the long-term impact is unknown. Objective To test the hypothesis that AT-based IMT improves inspiratory muscle strength and lung function even six months after CABG. Methods This is a randomized controlled clinical trial. In the preoperative period, maximum [...]

EFFECT OF RECREATIONAL SCUBA DIVING ON CARDIORESPIRATORY FITNESS IN MALAYSIAN NOVICE DIVERS

Objective: The aim of this study was to investigate scuba diving induced exercise response in novice divers as required in open water scuba diving certification. Methods: Maximal cardiopulmonary exercise test (CPET) was performed in 30 novice divers before and within 24 hours after a standard scuba diving open water certification diving protocol of four open water dives. Results: A significant increase in maximal oxygen consumption (VO2max) in mL·kg-1·min-1 after scuba diving training [25.84 (6.0) vs. 27.04 (7.0)] (p&lt;0.05) suggestive of an increase in exercise performance. Ventilatory drive (VE/VCO2) also showed a significant increase 27.95 (2.7) vs. 30.07 (5.3). Ventilatory anaerobic threshold (VAT), blood pressure and lung function parameters showed no significant differences with open water scuba diving certification training. Conclusion: In novice divers, repeated training exposure during open water scuba diving certification results in increased cardiorespiratory fitness. Although further corroborating studies are needed, this would suggest that recreational scuba diving may be an option for exercise promotion in the future.

IL-36 Cytokines Promote Inflammation in the Lungs of Long-Term Smokers.

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease with high morbidity and mortality. The IL-36 family are proinflammatory cytokines that are known to shape innate immune responses, including those critical to bacterial pneumonia. The objective of this study was to determine whether IL-36 cytokines promote a proinflammatory milieu in the lungs of long-term smokers with and without COPD. Concentrations of IL-36 cytokines were measured in plasma and BAL fluid from subjects in a pilot study (n = 23) of long-term smokers with and without COPD in vivo and from a variety of lung cells (from 3-5 donors) stimulated with bacteria or cigarette smoke components in vitro. Pulmonary macrophages were stimulated with IL-36 cytokines in vitro, and chemokine and cytokine production was assessed. IL-36α and IL-36γ are produced to varying degrees in murine and human lung cells in response to bacterial stimuli and cigarette smoke components in vitro. Moreover, whereas IL-36γ production is upregulated early after cigarette smoke stimulation and wanes over time, IL-36α production requires a longer duration of exposure. IL-36α and IL-36γ are enhanced systemically and locally in long-term smokers with and without COPD, and local IL-36α concentrations display a positive correlation with declining ventilatory lung function and increasing proinflammatory cytokine concentrations. In vitro, IL-36α and IL-36γ induce proinflammatory chemokines and cytokines in a concentration-dependent fashion that requires IL-36R and MyD88. IL-36 cytokine production is altered in long-term smokers with and without COPD and contributes to shaping a proinflammatory milieu in the lungs.

Association of Reduced Lung Function With Major Depressive Disorder

Background: Major Depressive Disorder (MDD) is associated with reduced lung function.Objectives: To observe &amp; compare FEF25%-75% in Major Depressive Disorder patients with control group.Methods: This prospective study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January to December, 2014 to assess the lung function status in newly diagnosed MDD patients. For this, 30 newly diagnosed female MDD patients (group B), aged 20 to 50 years were enrolled from the Department of Psychiatry of BSMMU. For control (group A) age, BMI, and occupation matched 30 apparently healthy females were randomly selected by personal contact. FEF25%-75% of all subjects were assessed by a portable digital spirometer (PONY FX, Cosmed, Italy). For statistical analysis, ANOVA, Independent sample‘t’ test were done and p value ?0.05 was considered as level of significance.Results: FEF25%-75%was significantly lower (p?0.001) in all MDD patients than control.Conclusion: From this study it may be concluded that the ventilatory lung function is significantly reduced in newly diagnosed MDD patients.Bangladesh Crit Care J September 2017; 5(2): 126-128

Survival of localized NSCLC patients without active treatment or treated with SBRT

Background: Little information on the natural history of patients with localized NSCLC is available since many of the studies covering the subject lack information on pathological confirmation, staging procedures and comorbidity. No randomized studies have compared SBRT with no treatment for patients with localized NSCLC. The purpose of this study was to evaluate whether SBRT has influence on overall survival for patients with localized NSCLC and investigate the effect of baseline ventilatory lung function on overall survival.Material and methods: From 2007 to 2013, 136 patients treated with SBRT at Odense University Hospital were prospectively recorded. The thoracic SBRT consisted of three fractions of 15–22 Gy delivered in 9 days. For comparison, a national group of 73 untreated patients in the same time period was extracted from the Danish Lung Cancer Registry. All patients had histologically/cytologically proven NSCLC T1-2N0M0 with a tumour diameter ≤5 cm.Results: The 5-year relative survival was 44% versus 7% for the SBRT and untreated groups, respectively. In a propensity score matched comparison the median overall survival was 47 months versus 11 months for the SBRT and untreated groups, respectively (p < .05). On multivariate analysis, SBRT was significantly associated with improved prognosis while ECOG performance status 2+ and tumour diameter ≥3 cm significantly predicted poorer prognosis. Severe to very severe reduction of forced expiratory volume in one second (FEV1) did not predict poorer survival for the SBRT treated patients with localized NSCLC.Conclusions: SBRT offers more favourable survival than no treatment for patients with localized NSCLC. Performance status of 0–1, tumour diameter less than 3 cm and SBRT predicted improved survival. SBRT should not be withheld for patients with localized NSCLC based on poor ventilatory lung function.

CORRECTION OF VASCULAR DISTURBANCES IN PATIENTS WITH CHRONIC OBSTRUCIVE PULMONARY DISEASE IN COMBINATION WITH THE HYPERTONIC DISEASE: NEW DIRECTIONS OF PATHOGENETIC THERAPY

The purpose of the study was to study of effects of sulodexide on clinical and functional parameters in patients with chronic obstructive pulmonary disease (COPD) in combination with hypertension. 40 COPD patients were examined. Patients were divided into two groups of 20 people. One group received only basic COPD therapy and antihypertensive treatment, the other group - basic and antihypertensive therapy in combination with sulodexide. After a year of observation the assessment of the clinical course of the disease, and ventilatory lung function, cardiopulmonary hemodynamics, endothelium-dependent vasomotor function was done. In patients, additionally treated with sulodexide, the following parameters were marked: stabilization of blood pressure parameters, reduction of dizziness and headaches, increase of tolerance to physical load, reducing the number of exacerbations, improvement in spirometry, lung diffusion capacity, improvement of pulmonary hemodynamics parameters and improvement of endothelium-dependent vasodilation. Thus, the positive effect of sulodexide on clinical and functional parameters indicates the feasibility of further study of the use of angioprotectors in complex pathogenetic therapy of COPD.

Respiratory Health Problems Among Endoscopy Nurses Exposed to Glutaraldehyde in Zagazig University Hospitals, Egypt

Introduction: Glutaraldehyde is still used for sterilization of endoscopes in Egypt and known to be associated with many respiratory problems, so this study aims to establish control program guidelines to promote the respiratory health of endoscopy nurses in Zagazig University Hospitals with the objectives to assess the frequency of respiratory health problems among endoscopy nurses and to identify associated occupational and personal risk factors. Methods: A comparative cross-sectional study carried on 42 endoscopy nurses exposed to glutaraldehyde compared to non-exposed 84 nurses working at outpatient clinics. All nurses were subjected to a questionnaire (socio-demographic and occupational characteristics, chronic respiratory problems), checklist for assessment of glutaraldehyde related work practice and pulmonary function tests. Results: Chronic cough was found in 52.0% of endoscopy nurses while asthma was only in 19.0% of nurse. Chronic respiratory problems increased in endoscopy nurses with increased work duration, poor work practices especially handling procedures and lack of training. All ventilatory lung function parameters of endoscopy nurses showed statistically significant decline with both increased work duration ≥ 15 years and increased working hours ≥ 36 hours per week. Majority of endoscopy nurses 30.0% had mild airflow obstruction. Conclusions: Highlighting the respiratory health problems and airway obstruction resulting from exposure to glutaraldehyde will raise the importance to use safer alternatives. Results will lead to implementing of training programs for proper cleaning and sterilization processes, also raising awareness and providing information about proper work practices of handling hazardous substances.

Lung function and fractional exhaled nitric oxide among petroleum refinery workers.

BackgroundOccupational and environmental exposure to petroleum refinery products poses a great threat to human health. This study aimed to assess the lung function and Fractional Exhaled Nitric Oxide (FeNO) among petroleum refinery workers.MethodsIn this cross-sectional study, 112 participants (56 petroleum refinery workers with mean age 35.20 ± 1.62 years, and 56 age, weight, height, ethnicity and socioeconomically matched control subjects with mean age 30.02 ± 1.76 years) were recruited. A comprehensive clinical history and examination was conducted to decide whether to include in the study or not. Ventilatory lung function test parameters were recorded by using a Spirometer and Fractional Exhaled Nitric Oxide (FeNO) was measured by Niox Mino.ResultsA significant decline in lung function parameters FEV1 (p = 0.0001), FEV1/FVC Ratio (p = 0.01), PEF (p = 0.0001), FEF 25 % (p = 0.0001), FEF-50 % (p = 0.012) was observed among oil refinery workers compared to their matched controls. However, there was no difference in the mean values of FeNO between the groups.ConclusionSubjects working in the petroleum refinery have significantly impaired lung functions. However, there was no change in the values of FENO between the groups. The lung function impairment pattern provide evidence in the favor of an obstructive lung disease.

Small airways involvement in coal mine dust lung disease.

Inhalation of coal mine dust results in a spectrum of symptoms, dysfunction, and pathological changes in the respiratory tract that collectively have been labeled coal mine dust lung disease. Recent reports from periodic health surveillance among underground and surface coal miners in the United States have demonstrated an increasing prevalence and severity of dust diseases, and have also documented that some miners experience rapid disease progression. The coal macule is an inflammatory lesion associated with deposited dust, and occurs in the region of the most distal conducting airways and proximal respiratory bronchioles. Inflammatory changes in the small airways have long been recognized as the signature lung pathology among coal miners. Human and laboratory studies have suggested oxidant injury, and increased recruitment and activity of macrophages play important roles in dust-induced lung injury. However, the functional importance of the small airway changes was debated for many years. We reviewed published literature that documents a pervasive occurrence of both physiologic and structural abnormalities in small airways among coal miners and other workers exposed to airborne particulates. There is increasing evidence supporting an important association of abnormalities in the small peripheral airways with the development of respiratory symptoms, deficits in spirometry values, and accelerated declines in ventilatory lung function. Pathologic changes associated with mineral dust deposition in the small airways may be of particular importance in contemporary miners with rapidly progressive respiratory impairment.

BRICK KILN INDUSTRY AND WORKERS’ CHRONIC RESPIRATORY HEALTH PROBLEMS IN MIT GHAMR DISTRICT, DAKAHLIA GOVERNORATE

Introduction: Brick manufacturing industry is an old and important industry in Egypt. It involves three main steps: clay shaping with water (molding), drying with solar energy and firing with fuel (baking). Aim of work: To study the respiratory health problems among workers engaged in brick kiln industry. Materials and Methods: a comparative cross sectional study was conducted among 173 male brick kilns workers in Mit Ghamr District, Dakhlia Governorate. A control group of 170 seller men matched with the exposed brick kilns workers were included for comparison. After dust sampling in the brick kiln factories, the included persons were subjected to: 1-a modified pre-constructed questionnaire inquiring about: socio-demographic data, detailed occupational history, present history of acute and chronic respiratory symptoms and relevant past and smoking history 2-pulmonary function test 3- Environmental assessment of the working place. Results: measured mean dust concentration from 10 factories was 31.2 mg/m3 exceeding the permitted level in the Egyptian work law 2003 (10mg/m3). This study showed that brick kilns workers had significant higher frequency of chronic respiratory problems compared to their control group and the most common chronic respiratory symptoms among them were chronic cough followed by dyspnea, chest wheeze chronic bronchitis, and asthma. Moreover, 39.91% of brick kilns workers were complaining of more than one respiratory symptom compared to 11.70% among their control group. A significant increase of chronic respiratory problems in brick kilns workers ≥10 years work duration was detected compared to the workers 5-10 years. All ventilatory lung function measurements of brick kilns workers were significantly lower than that of their control group. Regarding the smoking habits, this study showed that there was a significant higher prevalence of chronic respiratory health problems among smoking workers (60.91%). Conclusion and Recommendations: A significant high prevalence of respiratory problems was found among brick kiln workers especially the bakers, smokers, and those >10 years work duration. For safe work environment, we recommend for developing the brick kilns sector under supervision of Ministry of Industry and Environment, recent technology transfer, substitution by natural gas and enforcement for using personal protective equipments.

Forced Vital Capacity (FVC), Forced Expiratory Volume in 1stSecond (FEV1) and Forced Expiratory Ratio (FEV1/FVC) In Petrol Pump Workers at Jhalawar and Jhalarapatan (Rajasthan)

Background and Objective: In India, petrol filling workers are employed rather than self employed, increasing the potential danger for exposure to harmful vapours during fuel fillings. Long-term exposure to petrol vapour has been blamed to affect the different physiological systems in the body adversely. The present study is carried out to assess the dynamic ventilatory lung function in petrol pump workers so as to comment on the long-term effects of work environment on lung function. Material and Method: The present study was conducted on 30 males of 20-40 years age, who were working in various petrol filling stations as petrol filling attendants, working 8 hours per day for more than 2 years in Jhalawar and Jhalrapatan city. For comparison 30, age and BSA matched apparently healthy control group, who were not exposed to petroleum vapours, from the preclinical and para clinical departments of Jhalawar Medical College, Jhalawar were studied simultaneously. Spirometry was performed with an electronic spirometer Helios-401. The parameters studied were Forced vital capacity (FVC), Forced expiratory volume in 1st second (FEV1) and Forced expiratory ratio (FEV1/FVC). Results and Interpretation: The two groups did not differ significantly on physical parameters. Both forced vital capacity (FVC) and forced expiratory volume at first second (FEV1) were decreased significantly while their ratio did not differ much between the two groups. Conclusion: Our findings point towards adverse effects of petroleum vapours on lung function, mainly on lower airways with restrictive pattern of disease. Keywords and Abbreviations: Forced vital capacity(FVC), Forced expiratory volume in 1st second (FEV1) and Forced expiratory ratio (FEV1/FVC)

Long term effects of prenatal and postnatal airborne PAH exposures on ventilatory lung function of non-asthmatic preadolescent children. Prospective birth cohort study in Krakow

The main goal of the study was to test the hypothesis that prenatal and postnatal exposures to polycyclic aromatic hydrocarbons (PAH) are associated with depressed lung function in non-asthmatic children. The study sample comprises 195 non-asthmatic children of non-smoking mothers, among whom the prenatal PAH exposure was assessed by personal air monitoring in pregnancy. At the age of 3, residential air monitoring was carried out to evaluate the residential PAH exposure indoors and outdoors. At the age of 5 to 8, children were given allergic skin tests for indoor allergens; and between 5 and 9 years lung function testing (FVC, FEV05, FEV1 and FEF25–75) was performed. The effects of prenatal PAH exposure on lung function tests repeated over the follow-up were adjusted in the General Estimated Equation (GEE) model for the relevant covariates. No association between FVC with prenatal PAH exposure was found; however for the FEV1 deficit associated with higher prenatal PAH exposure (above 37ng/m3) amounted to 53mL (p=0.050) and the deficit of FEF25–75 reached 164mL (p=0.013). The corresponding deficits related to postnatal residential indoor PAH level (above 42ng/m3) were 59mL of FEV1 (p=0.028) and 140mL of FEF25–75 (p=0.031). At the higher residential outdoor PAH level (above 90ng/m3) slightly greater deficit of FEV1 (71mL, p=0.009) was observed. The results of the study suggest that transplacental exposure to PAH compromises the normal developmental process of respiratory airways and that this effect is compounded by postnatal PAH exposure.

Assessing Maximal Exercise Capacity: Peak Work or Peak Oxygen Consumption?

Exercise capacity assessed by cardiopulmonary exercise testing is usually measured by peak oxygen consumption (VO2). However, not uncommonly, patients achieve a relatively higher work load (peak work) compared to their peak VO2. In these situations it is difficult to know which parameter to use in assessing exercise capacity. The purpose of this study was to determine whether there are distinguishing physiological characteristics of patients with discordance between percent-of-predicted peak work versus peak VO2, in order to understand how to use these measurements in interpreting exercise capacity. We conducted a retrospective study of 172 cardiopulmonary exercise tests performed at our institution between 2003 and 2010. The subjects in the higher peak work group demonstrated higher ventilatory efficiency (lower slope of minute ventilation to carbon dioxide production) and lung function (FEV1 and FVC), a greater breathing reserve (higher breathing reserve, lower VE/maximal voluntary ventilation), and achieved a higher maximal heart rate. Subjects in the higher maximum VO2 group were heavier, had lower ventilatory efficiency, and had a reduced breathing reserve. Multivariate logistic regression analysis showed that the predominant independent factors associated with group assignment were body mass index, breathing reserve, and peak heart rate. The subjects with higher percent-of-predicted peak work than peak VO2 had a lower body mass index, a greater breathing reserve, and a higher peak heart rate. The observation that there are distinguishing physiological features between those who have a higher peak work and those who have higher peak VO2 provides insight into the underlying processes determining maximal exercise capacity.

Peak Expiratory Flow Rate (PEFR)-A Simple Ventilatory Lung Function Test

Peak expiratory flow rate (PEFR) is the maximal expiratory flow rate sustained by a subject for at least 10 milliseconds expressed in Litre per minute (L/min). PEFR is a simple, reliable, reproducible and easily measurable ventilatory lung function test. This simple test had been measured by various types and shapes of instruments for long since, now mini- Wright peak flow meter is widely used to measure the of PEFR values. Mini-Wright peak flow meter is cheap, easily portable and reproducible device for PEFR even below the age 5 years. Different countries use their own nomogram or prediction equation to find out mean PEFR values of particular height. Similarly, the prediction equation for calculation of PEFR values of Bangladeshi boys and girls are 5.96XHeight-495 and 5.70XHeight-479 respectively. Peak expiratory flow rate is very useful tool for diagnosis, management and follow up of reversible airway diseases. J Shaheed Suhrawardy Med Coll, 2011;3 (2): 44-47 DOI: http://dx.doi.org/10.3329/jssmc.v3i2.12078

Induced Sputum Evaluation in Restorers and Conservators of Cultural Heritage

ABSTRACT The objective of this study was to examine induced sputum (IS) cells profile from restorers/conservators of cultural heritage (restorers) with no lower airway symptoms and normal ventilatory lung function. The study involved 22 restorers and 48 control workers. Medical interview, physical examination, spirometry, skin prick testing to inhalatory allergens, and IS collection were performed. Compared with control workers, restorers demonstrated higher percentage of neutrophils (34% vs 15.5%; p = .004). This pattern was found only in male workers. They had almost 9 times greater chance to have increased proportion of sputum neutrophils than male controls (odds ratio [OR] 8.98, 95% confidence interval [CI] 1.98–40.7). The mobilization of eosinophils or macrophages into the airways was not established regardless of workers sex. Additional gender difference in sputum cells distribution was found for occupationally unexposed subjects, with higher proportion of sputum neutrophils in women.

Influência do posicionamento dos membros superiores sobre parâmetros ventilatórios em indivíduos adultos

INTRODUÇÃO: A ventilação pulmonar depende da integridade da parede torácica. O posicionamento da parede torácica e/ou as disfunções dos músculos ventilatórios diminuem os volumes e as capacidades pulmonares, o fluxo de ar nas vias aéreas e as pressões inspiratória e expiratória máximas. O posicionamento dos membros superiores interfere na dinâmica da caixa torácica. OBJETIVOS: Verificar o efeito do posicionamento dos membros superiores com o ombro a 90º de abdução e rotação externa, associado à flexão de cotovelo a 90º sobre a função ventilatória pulmonar. MÉTODOS: Os indivíduos foram submetidos ao Questionário Respiratório sugerido pela American Thoracic Society - Division of Lung Diseases (ATS-DLD) e à ficha individual de pesquisa, para avaliação clínica da função ventilatória pulmonar. RESULTADOS: Foi observado que o volume minuto e o volume corrente nos indivíduos saudáveis no pós-posicionamento aumentaram quando comparados à situação de pré-posicionamento, de 9,46 ± 1,15 L/min. para 11,89 ± 1,54 L/min. e de 565,8 ± 83,84 ml para 752,4 ± 105,5 ml, respectivamente. CONCLUSÃO: O posicionamento dos membros pode ser priorizado antes das técnicas reexpansivas pulmonares. Programas de reabilitação pulmonar, de maneira geral, podem incluir o posicionamento correto dos membros superiores, pois isso coloca em vantagem os músculos que atuam sobre a caixa torácica, melhorando o desempenho da ventilação pulmonar.

Influência da idade e da obstrução brônquica na resposta broncodilatadora em idosos.

Bronchodilator response may be influenced by airway flow limitation, age and genetics. Evidence has shown that this response increases with higher levels of airway obstruction and is altered with age and presence of specific genetic polymorphisms of the β2 adrenergic receptors. Correlate the airway flow limitation (FEV1, FVC, IC, RV) with the bronchodilation response, to β-adrenergics (salbutamol (s)) and to anticholinergics (ipratropium bromide (b)), in a group of elderly people with diagnosed asthma. We submitted a group of twelve aged individuals (>65Y), with diagnosed asthma, to a basal ventilatory lung function evaluation, followed by a bronchodilation test, in two consecutive days (in one day using s, in the other using b). They were submitted to a functional ventilatory evaluation followed by a bronchodilator test (one day with s, other day with b). The individuals were in a stable period, without anti-asthmatic medication in the previous 24 hours. Plethismography and spirometry followed ATS/ERS 2005 criteria. Statistic analysis used SPSS for Windows. Correlations were established using the Pearson coefficient (r value). The bronchodilation response after b correlated best, with basal ventilatory evaluated parameters, than bronchodilation response after. - The FEV1 response increased as lower were the basal IC/TLC values, only after b; - The FVC response was increased as lower were the basal IC/TLC values and as higher were basal RV/TLC values, only after b; - The IC/TLC response increased as lower were basal IC/TLC values, only after b; - For both b and s, the RV/TLC responses increased as lower were basal VR/TLC values. The found correlations point out the relation of increased airway flow limitation and better bronchodilation response to b, which assumed importance to the responses related with the RV basal variation. The responses to s didn't show such a grade of dependence. That might be explained by the probable concurrence of other variables for the grade of bronchodilation response to the β-adrenergics. The existence of genetic polymorphisms of ADRB2 gene, already described in the literature, show an increasing in bronchodilation response of Arg/Arg homozygotes when β-adrenergic therapeutic is replaced for the anticholinergic one.

Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica

AimsTo evaluate bagasse (sugar cane fibres) and microbiological exposure among sugar cane refinery workers in Costa Rica and its relationships with respiratory, allergy and eye problems.MethodsVentilatory lung function and total...