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
Background: Objectives of this study were to describe sociodemographic characteristics of Tunisian woman smoker and to study her respiratory functional profile
Methods: all women answered for a questionnaire and benefited of a total physical plethysmography and of a carbon monoxide lung transfer measure [TLCO]
Results: 101 smoking women were selected. These women consumed cigarettes [74%], the snuff "neffa "[10%] and the water pipe [15%]. A chronic bronchitis was present at 22 women. A proximal bronchial obstruction was found at 11 women who were consumer of the "neffa" and cigarettes. A lower airway obstruction was found in all women consumer of water pipe. The TLCO was low at "neffa" group of women
Conclusion: woman smoking has a negative influence on pulmonary function which depends on sociocultural characteristics and on the history of smoking
ABSTRACT
Background: Chronic Obstructive Pulmonary Disease [COPD] is among the leading causes of chronic morbidity and mortality throughout the world. Potentially, COPD can be prevented by the early detection of COPD, which generally entails spirometry. Physicians in smoking cessation outpatient are in an ideal position to detect early-stage of COPD by the simple examination of the patient. They can also perform spirometry to confirm the diagnosis of COPD. The main objective of this study was to assess the frequency of COPD among smokers in smoking cessation outpatient. Secondary objectives were to Compare two methods for COPD screening, the questionnaire [clinical score] and the mini-electronic spirometer [Neo-6] and to assess the degree of motivation to stop smoking by the announcement of lung age to smokers
Methods:a prospective cross-sectional study was carried out in four consultations for smoking cessation. Inclusion criteria were male patients aged over 35 years and seen in smoking cessation outpatient. A clinical score was then calculated to detect COPD. This score is based on age, BMI, the quantity of tobacco smoking and the respiratory clinical signs. By establishing this score, we could classify our smokers on consultants with likely COPD if the clinical score>16. Secondly, a measure of the breath with a portable minispirometre "neo6" was performed with quantification of the first second forced expiratory volume [FEV1], forced expiratory volume in 6 seconds [FEV6] and their ratio [FEV1/FEV6]. A ratio FEV1/FEV6 less than 0.8 was in favor of an obstructive ventilator defect [DVO]. In this case a total body plethysmography was indicated
Results: The sample of the study consisted of 115 male smokers with a mean age of 48 +/- 12 years old. A low socio-economic level and a low level of education were found respectively in 50.4% and 58% of smokers. Cigarette smoking is the most consumed form of tobacco. A significant clinical score predicting COPD, was found in 54 patients. The measurement of the breath through the Neo-6 found that 23 [20%] smokers had FEV1/FEV6 less than or equal to 0.7 predicting bronchial obstruction and 26 had a ratio between 0.7 and 0.8. plethysmography confirmed the diagnosis of COPD for 27 patients. So the prevalence of COPD in our sample was of 23.48%. The clinical score had a sensibility of 81.48% and a specificity of 63.64 with a negative predictive value of 91.8%. The sensitivity of the Neo 6 [70.37%] is smaller than the clinical score but the specificity is better than 95.94% of the clinical score. Its negative predictive value was 91.3%. So when VEMS/VEM6 ratio is greater than 0.7, the probability of COPD remains very low. The announcement of the pulmonary patient age is an important parameter for the motivation to stop smoking
Conclusion: The combination of a standardized questionnaire to the measure of breath by Neo6 can further optimize COPD screening
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]
ABSTRACT
A prospective study has been realised on 2 years [1996-1997] in two suburban zones of the city of Sousse, Elmanazeh City and Kal
a Sghira respectively exposed and not exposed to atmospheric pollution. The sampling is made in two primary schools. The main objective has been to estimate the consequences of the atmospheric pollution on the respiratory child health. Two groups of schoolboys have undertaken the following protocol: reply to a standardised questionnaire, a spirometry and a metacholine challenge test. Atmospheric gas analysis included the following gas: sulfur dioxide, carbon monoxide, nitrogen monoxide and nitrogen dioxide. The inquiry by questionnaire as well as the simple spirometry realised in the two groups do not show a significant difference. Spirometric values are comparable in the two groups. The metacholine challenge test indicate that the prevalence of the bronchial reactivity is higher in schoolboys of the exposed group compared to children of the group not exposed [p<0-01]. The metacholine challenge test is very sensitive to track the effect of the atmospheric pollution and could have contribute a manner objective to the evaluation of the effect of the quality of the air on the respiratory health