Exhaled breath condesate nitric oxide end products and pH in controlled asthma

Asthma imposes a growing burden on the society in terms of morbidity, quality of life, and healthcare costs. It has the highest morbidity amongst inflammatory lung diseases and its prevalence continues to increase over the world. Inquiry into recent day or nighttime symptoms alone underestimates the burden of asthma and may lead to inadequate treatment of asthma. The aim of the present work is to evaluate the role of nitric oxide [NO] and hydrogen ion concentration [pH] levels in exhaled breath condensate [EBC] in cases of controlled bronchial asthma. The present study was conducted on 49 controlled asthmatic patients and 12 control subjects. All patients were subjected to thorough history taking, complete clinical examination and plain postero-anterior chest X-ray. All asthmatics and control subjects were subjected to routine laboratory investigations, spirometric study, EBC collection, processing and analysis for its content of both nitric oxide end products: nitrite and nitrate [NOx] and pH. All asthmatics represented Group IT which was further divided into Group Ia: 34 patients on regular inhaled corticosteroid [ICS] therapy and Group Ib: 15 patients on no regular therapy. The control subjects represented Group II. The forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], FEV1/FVC, peak expiratory flow rate [PEFR] and forced expiratory flow during the middle portion of a forced expiration [FEF 25-75%] were significantly lower in asthmatics than control subjects. The EBC-NOx mean +/- SD in micro mol/L in Group IT [5.99 +/- 1.63], in Group Ia [5.27 +/- 1.26] and in Group Ib [7.63 +/- 1.15] were significantly higher than in Group II [3.66 +/- 0.67] with, respectively [p = 0.000], [p = 0.000] and [p = 0.000]; and was significantly higher in Group Ib than Group Ia [p = 0.000]. The EBC-pH mean +/- SD in Group IT [7.32 +/- 0.27], in Group Ia [7.35 +/- 0.25] and in Group Ib [7.27 +/- 0.3] were significantly lower than in Group II [7.82 +/- 0.09] with, respectively [p = 0.000], [p = 0.000] and [p = 0.000]; with no significant difference between Group Ia and Group Ib. The EBC-NOx was significantly directly correlated to eosinophils count [p = 0.017] and neutrophils count [p = 0.002]; and inversely correlated to FEV1 [p = 0.016], FEV1/FVC [p = 0.001], PEFR [p = 0.030] and EBC-pH [p = 0.003]. The EBC-pH was significantly inversely correlated to eosinophils count [p = 0.017] and neutrophils count [p = 0.036]; and directly correlated to FVC [p = 0.004], FEV1 [p = 0.004] and PEFR [p = 0.000]. EBC-NOx is significantly higher and EBC-pH is significantly lower in asthmatic patients than in control subjects. Asthmatics receiving ICS have a lower EBC-NOx level than those not. EBC-NOx and EBC-pH were significantly correlated and both of them showed significant correlations with spirometric parameters of airway obstruction

Cardiopulmonary evaluation before and after gastroplasty for morbid obesity

This work was conducted to evaluate cardiopulmonary performance before and after gastroplasty in morbid obesity. Fifteen male patients with morbid obesity were included in this study. The results showed a significant reduction in body weight of about 38% and there was about 31% reduction in BMI after surgery. The improvement in VC [L] and MVV was statistically significant. The parameters of exercise tolerance were improved after surgery. The power attained at maximal exercise was significantly increased after surgery. It was concluded that vertical band gastroplasty was followed by a marked reduction in body weight with a subsequent improvement in pulmonary function, exercise tolerance, ventilatory reserve as well as cardiac reserve

Ultrasound evaluation of respiratory function of abdominal muscles in normal subjects and chronic obstructive lung disease patients

Ultrasonography has been widely used to evaluate diaphragmatic motion and thickness. Little work has been done to evaluate abdominal muscles thickness and function either in normal or disease state using ultrasonography. This work is conducted to evaluate abdominal muscles function in normal and chronic obstructive lung disease patients using ultrasound. We investigated ten COPD patients and ten healthy male control subjects using 7.5 MHz Bmode ultrasound. Thickness of external oblique [EO], Internal oblique [I0], transversus abdominis [TA] and rectus abdominis [RA] was assessed at functional residual capacity [FRC], at residual volume [RV], at total lung capacity [TLC], during maximal expiratory effort [MEE] and progressive expiratory effort [PEE]. In both healthy subjects and COPD, at RV the thickness of I0. TA, RA were increased in thickness compared to FRC. During MEE, the thickness was increased in I0, TA, RA, while there was no change in E0. During PEE, thickness of TA and RA were increased in COPD and control subjects. In all our data the changes in TA were evident with a lesser extent RA and I0. We conclude that transversus abdominis seems to be the major contributor of abdominal muscle function and the use of ultrasound is a useful tool in investigating abdominal muscles