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At least 469 records · Page 26Linked to original sources

Assessment of lung disease in children with cystic fibrosis using hyperpolarized 3-Helium MRI: comparison with Shwachman score, Chrispin-Norman score and spirometry.

This study assesses the feasibility of hyperpolarized 3-Helium MRI in children with cystic fibrosis (CF) and correlates the findings with standard clinical parameters based on chest radiograph (CXR) and pulmonary function tests (PFT). An uncontrolled, observational study in eighteen children with cystic fibrosis aged 5 - 17 years (median 12.1 years), with different severity of disease was carried out. All subjects underwent routine clinical assessment including PFT and standard auxology; CXR was obtained and Shwachman and Chrispin-Norman scores calculated. Hyperpolarized 3-He magnetic resonance imaging (MRI) was carried out using a spin-exchange polarizer and a whole body 1.5 T scanner. Ventilation distribution images were obtained during a 21-second breath-hold and scored according to previously defined criteria. Spearman's non-parametric correlations test was performed to assess for statistical significance at the p<0.05 level. The children tolerated the procedure well. No desaturation events were observed during 3-He MRI. A significant, albeit moderate, correlation was found between MRI score and FEV1% predicted (r=-0.41; p=0.047) and FVC% predicted (r=-0.42; p=0.04), while there were trends of correlations between Shwachman score and MRI score (r=-0.38; p=0.06) and Shwachman score and FEV1% predicted (r=0.39; p=0.055). The feasibility of hyperpolarized 3-He MRI in children with CF was demonstrated. MRI appears to be able to demonstrate functional lung changes, although correlations with routine clinical tests are only moderate to poor. This non-ionising radiation technique could be useful for monitoring lung disease and assessing therapy in this patient population.

Adolescent↗

The impact of body-weight components on forced spirometry in healthy italians.

Many studies have investigated lung function in relation to age and height among Caucasians, however, most of these studies did not consider the individual components of body weight. The objective of the present study was to study the effect of body weight components [bone-free lean body mass (BF-LBM), bone mineral content (BMC), and fat mass (FM)] measured by dual x-ray absorptiometry (DXA) on the lung-function variables (FVC, FEV1, and PEF) and to derive prediction equations for these variables in healthy adult Italians. Dynamic spirometric tests and body composition analysis by DXA were performed on 58 nonsmoking males, mean age ( +/-SE) 26.72 +/- 1.98 years and BMI 25.51 +/- 0.64 kg/m2, and 60 nonsmoking females matched for age and BMI (29.61 +/- 1.65 years and 26.45 +/- 1.05 kg/m2, respectively). Bivariate linear regression analysis showed the variables age, height, BF-LBM, BMC, and the interaction term BF-LBM*Height, but not weight and FM, to correlate significantly with lung-function variables for males and for females separately. Multiple linear regression analysis showed that sex, age, height, and BF-LBM*Height were significantly associated with FVC, FEV1, and PEF. The prediction equations developed for FVC, FEV1, and PEF on the basis of the independent variables i.e. sex, age (y), height (m), and BF-LBM*Height (kg. m) had a significantly higher cumulative correlation coefficient and a lower SEE compared with those based on age and height only. The present report suggests that the BF-LBM, expressed independently from height, can be considered for predicting lung-function variables.

Adolescent↗

Studies on inspiratory and expiratory glossopharyngeal breathing in breath-hold divers employing magnetic resonance imaging and spirometry.

Competitive breath-hold divers use glossopharyngeal breathing in order to increase their performance. Glossopharyngeal inhalation (GI) increases the volume of air in the lungs above the total lung capacity, thereby increasing the volume of gas available for pressure equalization at great depth. The reverse procedure, glossopharyngeal exhalation (GE), is used to suck air out of the lungs at great depth when the lungs are compressed, thus providing air in the mouth for equalization of pressure in the middle ear. Five Swedish apnea athletes were tested. Their vital capacity (VC) and the volume of air exhaled after GI were measured with a turbine spirometer, while the residual volume (RV), and the volume of gas in the lungs following GE was determined using a helium dilution procedure. Thereafter subjects performed these maneuvers during magnetic resonance imaging (MRI) of the thorax. All subjects exhibited a higher VC + GI (7.8-11.9l) than VC (6.2-9.5l) and lower RV-GE (1.16-1.77l) than RV (1.37-2.40l). MRI revealed pronounced changes in the volume of intrathoracic blood, with a small heart and compressed vessels following GI and the opposite, i.e., enlarged vessels during GE. MRI also showed an invagination of the posterior wall of the trachea, in connection with GE in certain subjects.

Adult↗

Variables associated with changes in spirometry in patients with obstructive lung diseases.

One hundred fifty subjects were enrolled in a long-term study of obstructive lung diseases; 84 of these were subjected to five or more spirometric studies over a period of two or more years. Stepdown regression analysis was performed to determine the association between many different variables and the annual rates of change in the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). The following associations were noted to be significant (p less than 0.03); more favorable rates of change of the FVC and FEV1 were associated with a higher alpha1-antitrypsin level and older age. Less favorable changes were associated with more years of cigarette smoking, more airway reactivity and more frequent lower respiratory tract illnesses.

Age Factors↗

Spirometry and flow-volume curves in healthy, normal Pakistanis.

Previous studies have indicated that lung volumes in healthy, normal Pakistani adults are smaller than measurements reported in comparable healthy European populations; in order to confirm these findings and to examine the relationship of maximal expiratory flow rates to lung volumes, we studied 250 non-smoking healthy subjects (116 men and 114 women) between the ages of 18 and 65 years. The population sample was drawn from urban and rural areas of Pakistan, with low levels of air pollution. The results indicate that the forced vital capacity (FVC) and forced expired volume in 1 second (FEV1) were lower in the Pakistani population compared to European populations and North American populations of European descent. These data are in conformity with previous studies; however, in Pakistani men the effects of age on FVC and FEV1 were slight so that, after the fourth decade, the FVC and FEV1 values are very comparable between the European and Pakistani populations. Amongst Pakistani women, on the other hand, FVC and FEV1 remained lower than in their European counterparts throughout adult life. Maximal expiratory flow rates amongst the men did not correlate with age, and these values were very similar to those reported in age-matched European populations. In women, however, there was a significant correlation of maximal flow rates with age and height, and the maximal expiratory flows were decreased compared to European populations. These data indicate that in Pakistani men pulmonary mechanics may be different to their European counterparts, allowing for higher maximal expiratory flows at any given lung volume.

Adolescent↗

A mathematical model for spirometry.

A model originally designed to fit population growth data was investigated to determine whether it could fit spirometric traces as a function of time in normal and ill humans and in normal rats, obtained, respectively, by spirometer and whole-body plethysmography. The model showed great accuracy when applied to a simple spirometer coupled with an analog-to-digital converter interfaced with a personal computer. It also proved to be a good alternative for the more expensive and less accurate electronic devices, as derivative systems, and may be an attractive method for research and/or diagnostic centers.

Animals↗

[Right diaphragmatic kinetics measured by TM-mode ultrasonography with concomitant spirometry in normal subjects and asthmatic patients. Preliminary results].

The purpose of this study was to assess the diaphragmatic excursion using the TM-mode ultrasonography with concomitant pneumotachography in eight normal and five asthmatic subjects before and after salbutamol. We report the results in normal and asthmatic patients of this procedure. Particular findings were demonstrated in asthma. Different significant correlations were found between sonographic and respiratory measurements. In view of the safety of this direct and real-time diaphragmatic investigation, we conclude that this new method could offer an effective and reliable procedure in the evaluation of patients with diaphragmatic dysfunction. However, our study was limited by the small number of patients included and definite conclusions should await further investigations.

Adrenergic beta-Agonists↗