ABSTRACT
Background: Walk tests, especially the 6-min walk-test [6MWT], are commonly used in order to evaluate submaximal exercise capacity. The primary outcome of the 6MWT is the 6-min walk-distance [6MWD]. Numerous demographic, physiological and anthropometric factors can influence the 6MWD in healthy adults
Objective: The purpose of the present review is to highlight and discuss the 6MWD influencing factors in healthy of the healthy adult Arab populations
Methods: It is a review including a literature search, from 1970 to September 31th 2015 using the PubMed, the Science Direct databases and the World Wide Web on Google search engine. Reference lists of retrieved English/French articles were searched for any additional references
Results: Six studies, conducted in Tunisia [n=2], Saudi Arabia [n=3] and Algeria [n=1] were included. All studies were conducted according to the 2002-American-thoracic-society guidelines for the 6MWT. In addition to anthropometric data [sex, age, height, weight, body mass index, lean mass], the following data were recognized as 6MWD influencing factors: schooling and socioeconomic levels, urban origin, parity, physical activity score or status, metabolic equivalent task for moderate activity, spirometric data, end-walk heart-rate, resting diastolic blood pressure, dyspnoea Borg value and niqab-wearing
Conclusion: The 6MWD influencing factors in adult Arab populations are numerous and include some specific predictors such as parity, physical activity level and niqab-wearing
ABSTRACT
Different spirometric criteria are recommended to diagnosis chronic obstructive pulmonary disease [COPD]: -American Thoracic Society/European Respiratory Society [ATS/ERS], Global initiative for chronic Obstructive Lung Disease [GOLD]: a post bronchodilator [PBD] ratio between the 1st second Forced Expiratory Volume and Forced Vital Capacity [FEV1/FVC] < 0.70; -Thoracic Society of Australia and New Zealand [ANZTS]: a PBD FEV1/FVC < 0.70 and a PBD FEV1 < 80%; -British Thoracic Society [BTS]: a before BD [BBD] FEV1/FVC < 0.70 and a BBD FEV1 < 80%; -Old criterion retained, till 2010, by the French Society of Pneumology [SPLF]: a PBD ratio between FEV1 and slow vital capacity < 0.70. To determine, according to the different recommendations, the percentage of smokers having COPD among a population of smokers of more than 40 Packets/Year [PY] addressed for plethysmography. The plethysmographic data of 531 consecutive stable male smokers that underwent reversibility testing [400 micro g of Salbutamol[registered sign]] were analyzed. The mean + - SD of age, cigarettes consumption, PBD FEV1 [%], were, respectively, 61 + - 11 Yr, 64 + - 20 PY and 52 + - 21%. The percentages of subjects having COPD according to the above criteria were 75.5% [SPLF old criterion]; 71.2% [ATS/ERS, GOLD]; 70.8% [BTS] and 69.7% [ANZTS]. The diagnosis of COPD depends on which guidelines are used for defining the disease. This forms a barrier to early diagnosis, affects public health decisions and wrong planning strategies
ABSTRACT
Tunisian pulmonary functional laboratories accept the default settings for reference equations [European Respiratory Society/European Community for Steel and Coal [ERS/ECSC1983] offered by the manufacturer even though adult Tunisian reference equations [Tunisian1995] are available. To compare the spirometric profile of Tunisian subjects, according to the two reference equations. Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality [LLN] were calculated using the two reference equations. Applied definitions: large airway obstructive ventilatory defect [LAOVD]: ratio between the 1st second expiratory volume and forced vital capacity [FEV1/FVC] < LLN. Small AOVD [SAOVD]: FEV1/FVC > LLN and FVC > LLN and maximal midexpiratory flow < LLN. Tendency through a restrictive ventilatory defect [TRVD]: FEV1 and FVC < LLN. The spirometric profile, according the two reference equations, was determined. Using Tunisian1995 reference equations, 34%, 7%, 37% and 19% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using ERS/ECSC1983 reference equations, 85%, 3%, 9% and 2% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using the ERS/ECSC1983 reference equations, misclassification was worse for LAOVD, for SAOVD and for TRVD, respectively, 68%, 94% and 89%. Our results showed that the use of the old Caucasian reference equations resulted in misinterpretation of spirometry data in a significant proportion of subjects. This could result in inappropriate diagnosis and/or management
ABSTRACT
The rheumatoid polyarthritis [PR] is a frequent pathology in Tunisia. The most frequent extra articular expression of this disease is in the respiratory tract. To determine the lung functional profile of PR of the Tunisian population by establishing possible relations between ventilatory variables and clinico-biological parameters of PR. It is a cross sectional study which concerned 87 patients [77 women] having a confirmed PR. They benefited from a measure of the lung function by a total physical Pléthysmography and by the technique of double transfer NO-CO. Clinical and biological checkup were realized. Three kinds of pulmonary function defects were found: obstructive ventilatory defect [13%], restrictive defect [7%] and mixed defect [1%]. Ventilatory flows and the lung volumes correlated negatively with the inflammatory syndrome [p<0.05]. Alveolar-capillary diffusion capacity [DLco] was altered in an isolated way or associated with the respiratory functional syndromes [obstructive and restrictive] [6%]. This abnormality had a vascular origin with an isolated fall of the lung capillary volume [Vc], a membrane origin with an isolated fall of the diffusion membrane [DM] or a combined origin with the decline of Vc and DM. This latter case was found at a late stage of PR. 58% of PR patients had a normal pulmonary function. All these functional findings were linked to PR itself [inflammatory and auto-immune origin] or to the lung toxicity due to the treatment by Methotrexate [alveolar and bronchial damage]