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PubMedDate not supplied

[Correlation between Borg's scale and spirometer in asthmatic patients].

BACKGROUND: Spirometry is the ideal evidence to diagnose and evaluate the degree of bronchial obstruction which is present in asthma; however, it is not easy for physicians to have access to it during the first contact due to its high cost. The Borg's scale is an analogous visual scale which has an economical and simple use; it evaluates in a subjective way the respiratory difficulty in a patient in a scale from 0 to 10. It is necessary to have the right tools to know the degree of pulmonary obstruction that asthmatic patients have and to be able to give them the right medical treatment. The use of the Borg's scale to evaluate the severity of the asthmatic patients causes controversy. OBJECTIVE: To determine the correlation between the spirometry and the Borg's scale in adult asthmatic patients. PATIENTS AND METHODS: One hundred and one cases of male and female asthmatic patients were studied (GINA2002) from the consultation of specialties in Allergy and Clinic Immunology. A spirometry was done to all patients (Multispiro 2000) and the Borg's scale method was applied to them. The project was approved by the local research committee. The SPSS program version 12.0 was used and the Pearson's correlation test was applied. RESULTS: The correlation between the spirometry and the Borg's scale was r = 0.345, with p < 0.05. CONCLUSIONS: There is a scarce correlation between the spirometry and the Borg's scale. The result obtained in this study does not support the use of the Borg's scale to appreciate the bronchial obstruction in adult asthmatic patients.

Adolescent↗

PubMed1987

Pulmonary function in patients with sarcoidosis. A three year follow-up.

During a 3 year period, 101 patients were consecutively diagnosed as having sarcoidosis. During the 3 year follow-up 9 patients died, 6 of them directly or indirectly due to their sarcoidosis. In 78 patients bronchoscopy and spirometry were performed at the primary investigation, and after 3 years a new spirometry was performed. A positive bronchial mucosal biopsy, bronchial sarcoidosis, was found in 31 (40%) of the 78 patients. Mean values of vital capacity, total lung capacity and forced expiratory volume in one second were normal in both patients with bronchial sarcoidosis and those without. Abnormal spirometry was found in 16 (21%) patients at the initial examination and in 11 (14%) at the follow-up. There were 10 (32%) patients with and 6 (13%) without bronchial sarcoidosis who had an abnormal spirometry. At follow-up a normalized lung function was found in 8 (50%) of the 16 patients with abnormal spirometry. Only 3 (4.8%) patients with initially normal lung function had abnormal lung function at follow-up. Our findings indicate a very little risk of developing abnormal lung function if there are normal findings at the primary investigation. Corticosteroids seem to have some effect, especially in patients with endobronchial sarcoidosis.

Adult↗

PubMed1992

Unrecognized exercise-induced bronchospasm in adolescent athletes.

OBJECTIVE--As part of their preparticipation physical examinations, 1241 middle and high school student athletes completed a questionnaire and were interviewed to elicit risk factors for unrecognized exercise-induced bronchospasm (EIB). Spirometry was then performed when the students were at rest. RESEARCH DESIGN--All participants completed a questionnaire, were interviewed, and underwent baseline testing to determine forced expiratory volume in 1 second (FEV1). SETTING--All testing was performed in a school setting. SELECTION PROCEDURES--Athletes known to have EIB who were receiving appropriate treatment (46 athletes [4%]) and athletes with no risk factors based on medical history and normal results of spirometry (847 athletes [68%]) were eliminated from further evaluation. Students with medical histories indicating risk of unrecognized EIB and students with abnormal results of spirometry were eligible for exercise challenge by standard treadmill protocol. MEASUREMENTS AND RESULTS--Of the 348 eligible students, 230 (66%) completed the exercise challenge. Sixty-six of the 230 students had greater than 15% reduction in FEV1, and 50 of the 66 students had greater than 20% reduction, representing a 29% occurrence of previously undiagnosed EIB in a population of students identified with screening to be at risk of unrecognized EIB. Of the 179 students identified to be at risk based on medical history only, 28% had EIB. Of 33 students with positive results of spirometry but no medical history that put them at risk, 15% had EIB. Of the 18 students with medical histories that put them at risk and positive results of spirometry, 61% had EIB. Including the subpopulation with reduction in FEV1 of greater than 15%, students shown to be at risk after screening, and students previously identified as having EIB, 145 students were identified as having EIB (12%). CONCLUSIONS--These data are in accord with results of previously reported studies of college and Olympic athletes. The data may have implications for more extensive screening in the adolescent population.

Adolescent↗

PubMed1992

The effect of inhaled terbutaline on FEV1, FVC, dyspnoea and walking distance in patients with chronic obstructive lung disease.

This double-blind, placebo-controlled, crossover study was performed to evaluate the effect of terbutaline administered by a turbuhaler on spirometry, walking distance and dyspnoea during exercise in patients with chronic obstructive lung disease (COLD) and to evaluate relationships between changes in spirometry and working indices. The patients had a maximum reversibility in FEV1 of 15% predicted, and to ensure the option of studying correlations between changes in spirometry and working indices in patients with COLD a wide range of reversibility in FVC was ensured. Eighteen patients (M, 12; F, 6; mean age 68.5 years) were included in the trial. Mean baseline FEV1 was 0.921 and FVC 2.081. Six minutes unpaced walking distance on flat ground (WD) and Brog dyspnoea index scale (BS) were used as working indices. Baseline mean WD was 467.9 m, and median BS 3.2. No significant difference was found in the effect of terbutaline compared to placebo on the spirometry findings or WD. However, BS during exercise improved significantly on the terbutaline day. No significant correlation was found between changes in working indices and change in spirometry. Thus, the use of exercise testing and dyspnoea-scoring may reveal patients who benefit from acute bronchodilation without significant improvement in lung function.

Administration, Inhalation↗

PubMed1996

Respiratory function after cardiac surgery.

STUDY OBJECTIVE: Cardiac surgery is complicated by decreased postoperative respiratory muscle strength and spirometry with accompanying increased atelectasis. The specific respiratory symptoms attributable to these physiologic changes are unknown, and this study looked at the symptoms and underlying physiology. DESIGN: Convenience sampling of observational cohort. SETTING: Tertiary care university hospital. PATIENTS: One hundred thirty-eight patients undergoing elective surgery were enrolled. INTERVENTIONS: Changes from admission to 8-week postoperative values in atelectasis, pleural effusions, spirometry (forced vital capacity and forced expiratory volume in one second), and respiratory muscle strength (negative inspiratory pressure) were measured. These physiologic changes were compared with changes in respiratory symptoms of cough, wheeze, phlegm, and dyspnea on walking up a slight hill noted from admission to 8-week follow-up by stepward logistic regression. MEASUREMENTS AND RESULTS: Spirometry and negative inspiratory pressure decreased and atelectasis increased from admission to discharge. These disturbances had only incompletely resolved at 8-week follow-up. Some patients reported fewer symptoms of cough (11%), phlegm (9%), wheeze (35%), and dyspnea (46%) at 8 weeks follow-up. Other patients reported increased symptoms of cough (15%), phlegm (10%), wheeze (6%), and dyspnea (4%) at 8 weeks follow-up. Residual atelectasis at 8 weeks was predictive of fewer symptoms of dyspnea (odds ratio [OR] 0.335, p = 0.199; 95% confidence interval [CI] 0.188, 0.597), increased symptoms of dyspnea (OR 855, p = 0.006; 95% CI 6.6, 11052), and increased symptoms of cough (OR 260, p = 0.023; 95% CI 2.13, 31829). Negative inspiratory pressure at 8 weeks was predictive of fewer symptoms of dyspnea (OR 1.05, p = 0.032; 95% CI 1.02, 1.09) and increased symptoms of wheeze (OR 0.7, p = 0.45; 95% CI 0.533, 0999). Forced vital capacity at 8 weeks was predictive of increased symptoms of wheeze (OR 0.005; p = 0.015; 95% CI 0.0060, 0.775). CONCLUSIONS: Postoperative changes in respiratory muscle strength and spirometry can persist up to at least 8 weeks postoperatively. Many patients report a change in respiratory symptoms of cough, phlegm, dyspnea, or wheeze. The change in respiratory symptoms at 8 weeks is correlated with residual respiratory muscle weakness, decrease in spirometry, and residual atelectasis.

Adult↗

PubMed2001

Predictors of loss of lung function in the elderly: the Cardiovascular Health Study.

Pulmonary function, as measured by spirometry (FEV1 or FVC), is an important independent predictor of morbidity and mortality in elderly persons. In this study we examined the predictors of longitudinal decline in lung function for participants of the Cardiovascular Health Study (CHS). The CHS was started in 1990 as a population-based observational study of cardiovascular disease in elderly persons. Spirometry testing was conducted at baseline, 4 and 7 yr later. The data were analyzed using a random effects model (REM) including an AR(1) error structure. There were 5,242 subjects (57.6% female, mean age 73 yr, 87.5% white and 12.5% African-American) with eligible FEV1 measures representing 89% of the baseline cohort. The REM results showed that African-Americans had significantly lower spirometry levels than whites but that their rate of decline with age was significantly less. Subjects reporting congestive heart failure (CHF), high systolic blood pressure (> 160 mm Hg), or taking beta-blockers had significantly lower spirometry levels; however, the effects of high blood pressure and taking beta-blockers diminished with increasing age. Chronic bronchitis, pneumonia, emphysema, and asthma were associated with reduced spirometry levels. The most notable finding of these analyses was that current smoking (especially for men) was associated with more rapid rates of decline in FVC and FEV1. African-Americans (especially women) had slower rates of decline in FEV1 than did whites. Although participants with current asthma had a mean 0.5 L lower FEV1 at their baseline examination, they did not subsequently experience more rapid declines in FEV1.

Age Factors↗

PubMed1997

Measurement of respiratory resistance in the emergency department: feasibility in young children with acute asthma.

OBJECTIVES: To assess, in acutely ill asthmatic children, the feasibility of obtaining reproducible measurements of two independent lung function tests, namely spirometry and respiratory resistance, using the forced oscillation technique (Rfo). DESIGN/SETTING: A prospective observational study of 150 previously untrained children, aged 2 to 17 years, treated for acute asthma in a tertiary-care pediatric emergency department. MEASUREMENTS: Following a standardized physical examination, three measurements of respiratory resistance by forced oscillation were attempted at 8 Hz (Rfo8) and at 16 Hz (Rfo16), followed by spirometry, all using the same instrument (Custo Vit R; Custo Med; Munich, Germany). RESULTS: On the initial assessment, 98 (65%) children, aged 2 to 17 years, were able to reproducibly perform the Rfo8 measurement, 77 (51%) were able to reproducibly perform the Rfo16 measurement, while only 65 (43%) subjects managed to reliably perform spirometry. A notable proportion of preschool-aged children cooperated with the Rfo8 technique: 19% of 3-year-olds, 40% of 4-year-olds, and 83% of 5-year-olds. The superior success rate with Rfo8 as compared with spirometry was seen in all age groups but was most striking both in preschoolers (relative risk [RR]=10.5; 95% confidence interval [CI], 8.0 to 13.8) and in children aged 6 to 9 years (RR= 1.28; 95% CI, 1.18 to 1.39). Rfo8 values correlated significantly with clinical markers of asthma severity such as respiratory rate (r=0.38) and heart rate (r=0.23) as well as with FEV1 values (r2=0.73). CONCLUSIONS: This study demonstrates the feasibility of obtaining reproducible measurements of respiratory resistance in a notable proportion of untrained, acutely ill, asthmatic children. The forced oscillation technique appears as an attractive alternative to objectively assess lung function in children too young or too ill to cooperate with spirometry.

Acute Disease↗

PubMed1997

Determination of reliability and validity in home monitoring data of pulmonary function tests following lung transplantation.

Electronic spirometry units were used to monitor lung transplantation recipients upon their return home. The data from 77 participants were used to develop methods to verify that the pulmonary function measurements, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were reliable and valid. The standard deviation was calculated for the best daily effort on consecutive days of home spirometry. An acceptable upper limit for the standard deviation, as the measure of day-to-day reliability, was 0.20 for FVC and 0.15 for FEV1. Validity was determined by examining the mean difference (bias) between the spirometry done in the pulmonary function laboratory and the home monitoring results. The clinic values were slightly higher, with an average difference of 0.15 for FVC and 0.12 for FEV1. Therefore, the home spirometry measurements have a high degree of reliability and validity and can now be used for early detection of serious complications.

Adolescent↗

PubMed2006

Reduced exhaled nitric oxide in children after testing of maximal expiratory pressures.

Spirometry in adult subjects can induce a fall in concentration of exhaled nitric oxide (FE(NO)). Scarce information is available on the FE(NO) decrease after spirometry or after other forced lung-function maneuvers in children. We compared changes in FE(NO) induced by repeated spirometry and testing of maximal expiratory pressures (P(Emax)). Twenty-four sex- and age-matched children aged 9-18 years (mean age +/- SD, 13.3 +/- 2.8 years; 12 healthy, 12 asthmatic) were allocated to 1-week-apart sessions of repeated maneuvers of either forced vital capacity (FVC) or P(Emax). Baseline FE(NO) measurements were followed by FVC or P(Emax) maneuvers every 15 min for 45 min, whereas FE(NO) was measured at each step for 60 min. After repeated P(Emax) but not after FVC maneuvers, FE(NO) values decreased significantly from baseline in both groups. In healthy children, geometric mean FE(NO) (95% confidence intervals) decreased from 9.1 (7.0-11.8) ppb at baseline to 8.2 (6.3-10.6) ppb at 15 min and 7.7 (5.6-10.6) ppb at 30 min (P < 0.05 and P < 0.01, respectively), and remained unchanged at 45 and 60 min. In asthmatic children, FE(NO) levels fell from 21.6 (13.3-34.9) ppb at baseline to 15.1 (9.1-25.1) ppb at 15 min and remained low at 30, 45, and 60 min: 17.8 (10.7-29.5) ppb, 17.5 (10.2-30.1) ppb, and 17.6 (10.6-29.2) ppb, P < 0.01, for all differences from baseline. Repeated P(Emax) and FVC maneuvers increased FE(NO) variability, as compared with repeated FE(NO) measurements alone. Previous forced lung-function maneuvers may affect FE(NO) measurements in children. Although P(Emax) testing has a greater influence than spirometry on FE(NO) levels in children, both procedures should be avoided before measuring FE(NO).

Adolescent↗

PubMed1997

Non-invasive quantification of diaphragm kinetics using m-mode sonography.

PURPOSE: The standard conditions of spirometry (i.e., wearing a noseclip and breathing through a mouthpiece and a pneumotachograph) are likely to alter the ventilatory pattern. We used "time motion" mode (M-mode) sonography to assess the changes in diaphragm kinetics induced by spirometry during quiet breathing. METHODS: An M-mode sonographic study of the right diaphragm was performed before and during standard spirometry in eight patients without respiratory disease (age 34 to 68 yr). RESULTS: During spirometry, the diaphragm inspiratory amplitude (DIA) increased from 1.34 +/- 0.18 cm to 1.80 +/- 0.18 cm (P = 0.007), whereas the diaphragmatic inspiratory (T1 diaph) increased from 1.27 +/- 0.15 to 1.53 +/- 0.23 sec, (P = 0.015, without change in diaphragmatic total time interval (Ttot diaph). Therefore, the diaphragm duty cycle (T1 diaph/Ttot diaph) increased from 38% +/- 1% to 44% +/- 4% (P = 0.023). The diaphragm inspiratory (DIV) and expiratory (DEV) motion velocity (P = 0.007). CONCLUSION: M-mode sonography enabled us to demonstrate that the wearing of a nose clip and breathing through a mouthpiece and a pneumotachograph induce measurable changes in diaphragm kinetics.

Adult↗

PubMed1984

Time course of exercise-induced bronchoconstriction in asthmatics exposed to sulfur dioxide.

Young adult asthmatic volunteers (N = 17) were exposed to 0.75 ppm sulfur dioxide (SO2) for 3-hr periods, exercising vigorously for the first 10 min and resting thereafter. Specific airway resistance (SRaw) and symptoms were recorded preexposure, immediately postexercise, and after 1, 2, and 3 hr of exposure. Symptoms and SRaw were significantly increased after exercise, relative to preexposure measurements. Group mean SRaw and symptom increases were no longer significant at 1 hr. In a few individuals, effects may have persisted for 2 hr or more. On separate occasions, comparable exposures were conducted, and forced expiratory spirometry was performed preexposure and postexercise, in addition to the other tests. Inclusion of spirometry did not significantly affect the other results. Spirometry and SRaw showed nearly equal significance in changes postexercise. Thus, in general, asthmatics' bronchoconstriction induced by exercise in SO2 seems to reverse quickly with rest, even if SO2 exposure continues. Spirometry may be useful for studying pollution-induced bronchoconstriction when SRaw measurements are impractical.

Adult↗

PubMed2026

Lung function after randomization to metformin, lifestyle intervention or placebo in the Diabetes Prevention Program Outcomes Study (DPPOS).

INTRODUCTION: Metformin and physical activity have been suggested as beneficial for chronic lung disease; however, there are no prior randomized trials. METHODS: The Diabetes Prevention Program (DPP) was a 3-year trial that randomized 3234 individuals at risk for diabetes to metformin, lifestyle intervention or placebo. After the DPP, 88% of participants enrolled in the DPP Outcomes Study that offered lifestyle intervention to all and open-label continuation of metformin. Spirometry was performed at approximately 19 and 22 years post-randomization. Lung function measures were compared in an intention-to-treat (ITT) analysis by original randomization group. Models were unadjusted and adjusted for demographics, body size, smoking and sitting/standing at spirometry. Additional analyses tested prevalence of obstruction (FEV1/FVC <70%), restrictive pattern (FVC < LLN and FEV1/FVC ≥70%), preserved ratio impaired spirometry (PRISm: FEV1 <80% predicted, FEV1/FVC ≥70%) and symptoms (COPD Assessment Test [CAT] score ≥10). RESULTS: The 1888 participants with spirometry were a mean (±SD) age of 68.2 ± 9.3 years, 70% female and 6% currently smoked and 33% had previously smoked cigarettes. Mean follow-up time was 19.0 ± 0.8 years. The mean FEV1 was 2.14 ± 0.60 L, FVC 2.74 ± 0.74 L, FEV1/FVC 78.4 ± 6.4%, mean BMI was 32.4 ± 6.7 kg/m2 and 58% had diabetes. In both unadjusted and adjusted ITT analyses, randomization group was not associated with FEV1, FVC or FEV1/FVC. Likewise, rates of obstruction, restrictive pattern, PRISm or symptoms did not differ by randomization group. CONCLUSIONS: In this long-term follow-up after a randomized trial, we found no significant associations between randomization to metformin or lifestyle intervention and lung function or respiratory symptoms.

Humans↗

PubMed1984

Effect of sodium cromoglycate on histamine inhalation tests.

Sixteen adult asthmatic subjects in a clinical steady state were included in the study. On day 1, after baseline assessment of spirometry (FEV1, FEV1/FVC, FEF25-75), they underwent three to four consecutive inhalation tests using twofold increasing doses of histamine to measure the provocative concentration causing a fall in FEV1 of 20% (PC20). Baseline FEV1 was back to +/- 5% of the initial assessment before each histamine inhalation test (HIT). On days 2, 3, and 4, after baseline spirometry which confirmed that FEV1 was within 10% of initial day 1 assessment, placebo-lactose (P) or 40 mg of sodium cromoglycate (SCG) were nebulized in a double-blind randomized 4.3.1. two-treatment crossover study design. Ten minutes later, spirometry was repeated and followed by an HIT. Baseline spirometry was not significantly different on each day or after P and SCG. There was no statistical difference between the geometric means of the three or four PC20's done on day 1, indicating that there is no tachyphylaxis induced by repeated HIT. There was no statistical difference between mean PC20 after P (0.52 +/- 3.3 (SD) mg/ml), after SCG (0.50 +/- 3.2), and of the three to four HIT done on day 1 (0.40 +/- 3.6). We conclude that in asthmatic subjects SCG has no acute bronchodilator effect and does not alter the response to inhaled histamine.

Adult↗

PubMed2002

Activity related increase of exhaled nitric oxide in Crohn's disease and ulcerative colitis: a manifestation of systemic involvement?

Nitric oxide (NO) is an important mediator of inflammation in several pathological conditions. Patients with lung diseases, like asthma, have higher levels of exhaled NO (eNO) in active disease in comparison with healthy volunteers. Aspirated colonic gas in patients with ulcerative colitis (UC) showed more than 100 times higher levels of NO in comparison with normal subjects. Crohn's disease (CD) and UC are associated with a variety of systemic manifestations, although lung diseases as an extra-intestinal expression of inflammatory bowel disease (IBD) are not well investigated. In some studies, clinical and subclinical pulmonary abnormalities are described in active IBD as well as in the stable situation. The aim of the present study is to evaluate whether eNO is increased in patients with active IBD and to investigate whether there exists a correlation between (1) the eNO levels and the disease activity, and (2) the spirometry and the disease activity in a subgroup of patients. In 31 patients with CD (mean age 36.8 +/- 12.9 years) and 24 patients with UC (mean age 38.0 +/- 14.7 years) the Crohn's Disease Activity Index (CDAI) and Colitis Activity Index (CAI) were measured, respectively. Exhaled NO was measured with a chemiluminescence analyzer, according to standardized criteria. In a subgroup of CD patients, spirometry was also performed according to standardized criteria. The mean CDAI in CD patients was 192.4 +/- 94.3 and their mean eNO value was 13.5 +/- 4.6 ppb. For UC the mean CAI was 6.2 +/- 4.8 and the mean eNO value was 15.8 +/- 6.2 ppb. In a matched control group of 27 healthy, non-smoking volunteers (mean age of 33.7 +/- 13.2 years) the eNO was 10.2 +/- 2.5 ppb (P < 0.05 compared to CD and P < 0.01 compared to UC). There was a disease-activity-related increase of the eNO level in patients with IBD. For patients with UC the correlation coefficient (r = 0.63, P < 0.001) was more pronounced than for CD (r = 0.39, P < 0.05). In 17 patients with CD, spirometry was available at the time of the eNO measurement. We found a significant negative correlation between the CDAI and the FEV1 and FVC in these patients (r = -0.559, P = 0.02 and r = -0.634, P = 0.006, respectively). We conclude that eNO is increased in active IBD and correlates with the activity of the disease; furthermore, we found a negative correlation between spirometry and disease activity in patients with CD. These observations strengthen the arguments that IBD is a systemic disease. Further research is needed to try to explain the significance of an increased eNO in IBD.

Acute Disease↗

PubMedDate not supplied

Lung disease and asthma severity in adults with asthma: data from the Third National Health and Nutrition Examination.

Risk factors for obstructive or restrictive lung disease among persons with asthma are not well defined. Data from the Third National Health and Nutrition Examination Survey were used to determine predictors of poor lung function among 1063 adults, aged 20 years and older, who self-report physician-diagnosed asthma any time during their life regardless of current asthma status. Obstructive lung disease and restrictive lung disease were defined by using spirometry and modified Global Initiative for Chronic Obstructive Lung Disease criteria. Reported symptoms were used to grade asthma severity. Logistic regression models were used to examine associations between lung disease, respiratory symptom severity, and adults who ever had asthma. Risk factors for spirometry-defined obstructive lung disease included increasing age, body mass index < 18.5, current asthma, and non-white race (p < 0.05). Risk factors for spirometry-defined restrictive lung disease included older age at asthma diagnosis, low socioeconomic status, current asthma, and being female (p < 0.05). Risk factors for moderate or severe respiratory symptoms included older age at diagnosis and current smoking status (p < 0.05). Asthma is a known risk factor for chronic obstructive lung disease; these data also suggest that adults, particularly females, who are older at the time of asthma diagnosis, may be at risk to develop spirometry-defined restrictive lung disease as well. These data also suggest that a significant proportion of people with lifetime asthma have impaired lung function; however, it is unclear if more aggressive therapy for asthma would prevent these complications. To further examine the role of these factors in predicting poor lung function among adults with asthma, additional information is needed on these patients' asthma therapy, natural history, and environmental exposures.

Adult↗

PubMed2003

Quality of spirometric performance in older people.

OBJECTIVES: chronic obstructive pulmonary disease and asthma are major causes of hospitalisation and mortality among older patients but respiratory diseases are often under- or misdiagnosed because spirometry is not extensively used at this age. DESIGN: we examined 715 elderly subjects with respiratory symptoms; all underwent a spirometric test and were administered the Mini Mental State Examination, Activities of Daily Living, Instrumental Activities of Daily Living and Geriatric Depression Scale questionnaires for cognitive, functional and effective evaluation. Their educational level and Body Mass Index were also taken into consideration. RESULTS: a total of 585 patients (81.8%) were able to perform spirometry according to ATS'94 criteria while 130 (18.2%) were unable to do it. As regards educational level, Mini Mental State Examination, Activities of Daily Living and Instrumental Activities of Daily Living scores showed a significant difference (P<0.001) between the groups of patients with high-quality spirometries and those with inadequate ones. There was no difference between the two groups in terms of age, Body Mass Index or Geriatric Depression Scale score. CONCLUSIONS: the majority of elderly subjects can perform spirometry according to international guidelines; age itself cannot be considered a risk factor for a bad spirometric performance, but it becomes influential if it is associated with cognitive and functional impairment.

Aged↗

PubMed2005

Evaluation of lung volumetry using dynamic three-dimensional magnetic resonance imaging.

RATIONALE AND OBJECTIVES: We sought to investigate lung volume and surface measurements during the breathing cycle using dynamic three-dimensional magnetic resonance imaging (3D MRI). MATERIALS AND METHODS: Breathing cycles of 20 healthy volunteers were examined using a 2D trueFISP sequence (3 images/second) in combination with a model and segmented 3D FLASH sequence (1 image/second) MR images using view sharing. Segmentation was performed semiautomatically using an interactive region growing technique. Vital capacity (VC) was calculated from MRI using the model (2D) and counting the voxels (3D) and was compared with spirometry. RESULTS: VC from spirometry was 4.9+/-0.9 L, 4.4+/-1.2 L from 2D MRI measurement, and 4.7+/-0.9 L for 3D MRI. Using the 3D technique, correlation to spirometry was higher than using the 2D technique (r>0.95 vs. r>0.83). Using the 3D technique, split lung volumes and lung surface could be calculated. There was a significant difference between the left and right lung volume in expiration (P<0.05). CONCLUSIONS: Dynamic 3D MRI is a noninvasive tool to evaluate split lung volumes and lung surfaces during the breathing cycle with a high correlation to spirometry.

Adult↗

PubMed2000

The prevalence of reversible airway obstruction in professional football players.

PURPOSE: To determine the prevalence of reversible airway obstruction in a group of professional football training camp participants. METHODS: All attendees at a Canadian Football League team rookie preseason training camp were invited to participate in a protocol designed to elicit symptoms and signs of reversible airway obstruction (asthma) during the initial preparticipation examination. Those agreeing to the protocol completed a questionnaire containing standardized inquiries about a past history of asthma and the presence of symptoms. Participants then underwent spirometry testing to determine lung function before and after receiving a standardized dose of bronchodilator medication. Players showing evidence of airway obstruction during initial testing and still on the team roster underwent repeat spirometry testing and formal pulmonary function testing during the football season. The follow-up pulmonary function tests were performed to determine those that might benefit from treatment for asthma. RESULTS: Nineteen of 34 (56%) players agreeing to participate had significant reversible airway obstruction as defined by a 12% or greater reversibility in forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), and/or forced expiratory flow rate between 25 and 75% of forced vital capacity (FEF 25-75). In most participants, the diagnosis was made on the basis of spirometry alone. Of those testing positive during initial inquiry, 88% remained positive on repeat spirometry, and 73% had reversible airway obstruction during more stringently controlled hospital-based pulmonary function testing. Those players treated for previously undiagnosed asthma noted an improvement in subjective athletic performance during the football season. CONCLUSION: Based on the remarkably high prevalence of undiagnosed asthma in this group, it may prove worthwhile to test elite football players using lung function parameters.

Adult↗