Application of pulmonary function and fractional exhaled nitric oxide tests in the standardized management of bronchial asthma in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes of pulmonary function and fractional exhaled nitric oxide (FeNO) in the standardized treatment of bronchial asthma in children.</p><p><b>METHODS</b>A total of 254 children who were newly diagnosed with acute exacerbation of bronchial asthma were selected as asthma group, and they were divided into two subgroups: asthma with concurrent rhinitis and asthma without concurrent rhinitis. All patients received the standardized management and treatment for one year. The pulmonary function parameters included forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and mid-expiratory flow at 25%, 50%, and 75% of vital capacity (MEF25, MEF50, and MEF75). The FeNO levels were measured before treatment and at 3, 6, 9, and 12 months after treatment. Another 62 healthy children were selected as the control group, and the pulmonary function and FeNO levels were measured only once.</p><p><b>RESULTS</b>During one year of standardized treatment, FEV1, PEF, MMEF, MEF25, MEF50, and MEF75 gradually increased, and FeNO levels gradually decreased (P<0.05). Indicators of large airway function, such as FEV1 and PEF, almost returned to normal after 6 months of treatment; indicators of small airway function, such as MMEF, MEF25, MEF50, and MEF75 almost returned to normal after 9 months of treatment; there were no significant differences in the above indices between the asthma group and the control group after one year of treatment (P>0.05). However, the asthma group had a significantly higher FeNO levels than the control group after one year of treatment (P<0.05). The asthmatic patients with concurrent rhinitis had significantly higher FeNO levels than those without concurrent rhinitis before treatment and 3 months after treatment (P<0.05). Before treatment, there was a significant negative correlation between FeNO levels and pulmonary function parameters (P<0.05).</p><p><b>CONCLUSIONS</b>With the standardized treatment of bronchial asthma in children, pulmonary function parameters gradually increase and FeNO levels gradually decrease. The recovery of large airway function occurs earlier than the recovery of small airway function. Furthermore, the effect of rhinitis on airway responsiveness should be noted.</p>

[Effect of a course of aerobic exercise and consumption of vitamin d supplementation on respiratory indicators in patients with asthma]

Despite the use of exercise therapy in patients with respiratory disease such as asthma, some researchers have emphasized on taking supplementation as a therapeutic approach. The aim of this research was to investigate the effect of a course of aerobic exercise and consumption of vitamin D supplementation [1000 IU] on respiratory indicators of patients with asthma. This study was designed as a quasi-experimental investigation on a total of 32 female asthmatic patients with a mean age of 20-30 years. Subjects were classified into four eight-person groups: 1- [AT+S] group which had both aerobic training and supplementation consumption; 2- Aerobic training [AT] group that only participated in exercise training; 3- Group [S] that only consumed vitamin D supplementation; 4- Control [C] Group that had neither aerobic training nor supplementation consumption. Statistical analysis was performed by ANOVA and Bonferroni post-hoc test. Significant difference considered as p<0.05. In this study, there was a significant difference in post test [p<0.001] between groups in case of maximum voluntary ventilation [MVV], peak expiratory flow rate [PEF] and maximum expiratory flow at 75% vital capacity [FEF75%] and Maximum expiratory flow between 25% to 75% vital capacity [FEF25%-75%]. These indices increased in group AT and AT+S, whereas, they showed decrease in group S and C. Our results indicated that aerobic exercise together with consumption of vitamin D supplementation for 8 weeks could improve the pulmonary function and level of aerobic performance of asthmatic patients and could be considered as a part of pulmonary rehabilitation programs for asthmatic patients

The short-term effects of particulate matter on lung function of college students in autumn and winter in Wuhan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of indoor and outdoor PM2.5 (fine particulate matter, particulate matter with an aerodynamic diameter ≤ 2.5 µm) on lung function of college students in autumn and winter in Wuhan.</p><p><b>METHODS</b>In this panel study, 37 college students (excluded subject of respiratory disease and smoking history) aged 19 - 21 were investigated by cluster sampling in a university in Wuhan. The follow-up study lasted for 28 days in total, including two study periods, Oct. 29 to Nov. 11, 2009 (autumn) and Dec. 23, 2009 to Jan.5, 2010 (winter), the peak expiratory flow (PEF) of the college students were measured daily in the morning and evening in the university. PM10 and PM2.5 were monitored indoors and outdoors. The effects of PM on lung function of college students were analyzed by using generalized estimating equation (GEE).</p><p><b>RESULTS</b>Average daily concentrations of indoor, outdoor PM2.5 in autumn were (91.3 ± 43.7) and (104.2 ± 49.4) µg/m(3) respectively, while in winter the concentrations of indoor and outdoor PM2.5 were (110.6 ± 42.3) and (143.5 ± 51.2) µg/m(3). The single pollutant model showed that in winter, the evening PEF decrement was significantly associated with increasing outdoor PM2.5. With an increase of 10 µg/m(3) outdoor PM2.5, the PEF measured in the evening decreased 1.27 L/min (95%CI: 0.02 - 2.52 L/min, respectively). Meanwhile, the results showed that 2-days lagged outdoor PM2.5 was also significantly associated with morning PEF. An increase of 10 µg/m(3) 2-days lagged outdoor PM2.5 caused the decrease of 1.82 L/min (95%CI: -3.53 - -0.11 L/min) of PEF measured in the morning. Controlling the influence of gaseous pollutants and building the two pollutants models, the results indicated that no significant changes of PEF of students being exposed to PM2.5 on same day (lag 0) were observed. However, under consideration of SO2 effect, significant association between an increase of 10 µg/m(3) 2-days lagged outdoor PM2.5 and changes of morning PEF (-1.81 L/min, 95%CI: -3.51 - -0.11 L/min, P = 0.037) was found. The relationship between changes of concentrations and PEF was not observed in autumn in this study.</p><p><b>CONCLUSION</b>In our panel study, exposure to outdoor PM2.5 is significantly associated with PEF among college students in winter, but not in autumn.</p>

Periodontitis as a potential risk factor for chronic obstructive pulmonary disease: A retrospective study.

Aims and Objectives : A relationship between poor periodontal health and respiratory disease has been suggested by a number of recent studies. The present study was undertaken to evaluate potential association between respiratory diseases and periodontal health status and to co-relate the severity of periodontal disease with that of chronic obstructive pulmonary disease (COPD). Materials and Methods : 150 patients of COPD (test group) and 50 Patients without COPD (control group) were recruited for the study. Information regarding patient's demographic and socioeconomic status and lifestyle (history of smoking) were considered in the study. Patients with COPD were grouped into mild, moderate and severe category on the basis of Spirometry. Periodontal health was assessed by measuring probing pocket depth, Clinical Attachment Loss (CAL) and Oral Hygiene Index (OHI). Results : The results showed that the subjects with COPD had significantly more mean CAL) and a higher mean OHI than those without COPD. The risk for COPD appeared to be significantly elevated when attachment loss was found to be severe. A trend was noted in that lung function appeared to diminish as the amount of attachment loss increased. Conclusion : On the basis of the observed results of the study it can be concluded that the risk for COPD appeared to be significantly elevated when attachment loss was found to be severe. It is conceivable that oral interventions that improve oral health status may prove to lower the severity of lung infection in susceptible populations.

Accuracy of mid expiratory flow and dysanapsis parameters for evaluation of methacholine provocation test

The most sensitive parameter for evaluation of airway hyper-responsiveness is PC35 [35% decrease in specific airway conductance]. But assessment of this parameter requires expensive equipments. This study aimed to evaluate mid expiratory flow and dysanapsis parameters in standard spirometry for possible substitution of PC35.Thirty-seven subjects with clinical findings suggestive of asthma who had normal standard spirogram were entered in this case-control prospective study. Thirty- seven healthy volunteers were also included in this study as controls. Airway responsiveness was examined by methacholine challenge test and measurement of PC20 and PC35. In addition, concentration of methacholine needed for 20% reduction in FEF25-75%, MEF50%, and FEF25-75%/FVC was determined and compared with PC35 as the gold standard. FEF25-75%/FVC ratio was used for evaluation of dysanapsis. PC35 was more sensitive than PC20 and was obtained in 93% [68/73] of patients in both groups. Although PC35 and new parameters could be positive in both groups, the concentrations in two groups were significantly different. Regression model showed that in asthmatic patients all the conventional and new parameters had good and comparable correlations with PC35. But in the control group alone and in both asthmatic and control groups, PC 20 of FEF25-75%/FVC showed a significant correlation with PC35. PC20 of FEF25-75/FVC was also significantly correlated with PC20 of FEV1 in asthmatic and control groups. PC20 of FEF25-75/FVC and MEF50% revealed the best accuracy. An equation was determined for calculation of PC35 according to PC20 of FEF25-75/FVC and MEF50% when PC35 was unavailable. PC20 of FEF25-75/FVC ratio and MEF50% are sensitive parameters for diagnosis of airway responsiveness. PC20 of FEF25-75/FVC is the best substitution for PC35

Pulmonary function parameters changes at different altitudes in healthy athletes

Hypoxia and hypocapnia can cause broncho-constriction in human subjects, and this could have a bearing on performance at high altitude. The object of this study was to examine how pulmonary ventilatory functions during high-altitude trekking. This study is a cohort study on spirometric parameters at different altitudes. Fifty six healthy male volunteers from a university student population were enrolled in the study [ages 22.9 +/- 5.3 years]. Pulmonary function was assessed with a Spirolab II in all participants before ascending at baseline [1150 meter], after ascending at different altitudes [2850, 4150 meter], and after descending at sea level during a 3-day trek in Sialan Mount. This study indicates that in an actual trek, ascending results in significant decrease in forced vital capacity [FVC]. FVC significantly decreased with increasing altitude from baseline level and at the sea level it was significantly less than baseline level. Peak flow increased with increasing altitude from baseline [1150 m] to 2850 m and decreased with decreasing altitude [p < 0.01]. Maximal midexpiratory flow rate [FEF 25-75%] and forced expiratory volume in 1 second to forced expiratory volume ratio [FEV1.0%] significantly increased with increasing and decreasing altitude from baseline level [p < 0.001]. There was no significant change in FEV1. It could be concluded that changes in some pulmonary ventilatory parameters were proportional to the magnitude of change in altitude during a high-altitude trek. These changes are significant at the beginning of ascending

Effect of resveratrol on chronic obstructive pulmonary disease in rats and its mechanism / 药学学报

The purpose of this study is to establish COPD animal model by intra-tracheal instillation of bleomycin (BLM) once and exposure to cigarette smoke for continuous 27 d, and to observe the effects of the inhalation on the model. At the 29th day, blood samples were taken from cervical artery for blood-gas analysis and parameters of lung function were recorded. Bronchoalveolar lavage fluid (BALF) was collected to measure intercellular adhesion molecule-1 (ICAM-1) concentration. The results showed that atomization inhaled resveratrol could alleviate rat COPD lung injury accompanied by amelioration of pathological changes, increase the ratio of forced expiratory volume in 0.3 s (FEV0.3) and forced vital capacity (FVC), and decrease the ICAM-1 level in BALF. The ultimate reduction of inflammatory factors was involved, at least in part, in the mechanism of resveratrol effects.

Determination of positive bronchodilating response using impulse oscillation system in children / 中华儿科杂志

<p><b>OBJECTIVE</b>Impulse oscillation system (IOS) as an approach to lung function determination is suitable for children, especially for preschool children in that it only requires the individual to be examined to breathing stably with tidal volume. However, until now there have been no uniformly agreed criteria for positive bronchial reversibility test in clinical practice. A screening method was applied to seek for answer when this question in the hope of providing objective evidence for clinical diagnosis of respiratory diseases, esp. asthma.</p><p><b>METHODS</b>One hundred and fifty-six children patients during asthma attack were recruited randomly for this study from January to December, 2004. These patients included 103 boys and 53 girls aged from 5 to 18 years with mean age of 8.84 +/- 2.58 years, who visited the doctors in the Clinical and Educational Centre for Asthma, Capital Institute of Pediatrics and were diagnosed as asthma. Maximal expiratory flow volume and IOS lung function were determined followed by bronchodilator reversibility test in all patients. The sensitivity and specificity of IOS parameters, total respiratory impedance (Zrs), respiratory resistance at 5 Hz (R5) and reactance at 5 Hz (X5) for diagnosing asthma at different improvement levels after inhalation of bronchodilator were calculated respectively using forced expiratory volume in first second (FEV(1)) and maximal mid-expiratory flow (MMEF) as gold standard. And the regression equation between parameters of lung function which were determined with the two different methods was analyzed.</p><p><b>RESULTS</b>After inhalation of bronchodilator, the lung function of the children was improved significantly (P < 0.01), with the FEV(1), MMEF increase and Zrs, R5, and X5 decrease. There were significantly positive correlations (P < 0.01) between the improvement rate of parameters of lung functions determined with the two methods, and the highest correlation coefficients existed between X5 and FEV(1) and MMEF (respectively 0.676, 0.571), correlation coefficients between X5 and Zrs ranked second (0.519 and 0.505, respectively). When an increase of FEV(1) equal to or greater than 15%, or increase of MMEF equal to or greater than 30% was used as reference for positive bronchial reversibility, the sensitivity and specificity were relatively high for considering positive bronchial reversibility test with at least 20% decrease of Zrs, R5, and 30% decrease of X5 with IOS lung function. The sensitivity and specificity of Zrs, R5 and X5 calculated from FEV(1) were 0.62, 0.51; 0.49, 0.54; 0.70, and 0.54, respectively. The sensitivity and specificity of Zrs, R5 and X5 calculated from MMEF were 0.63, 0.54; 0.53, 0.60; 0.60, and 0.58, respectively. The regression equation showed that the decrease of Zrs, R5 and X5 corresponding to 15% increase of FEV(1) and 30% increase of MMEF were 21.7%, 21.3%; 19.9%, 19.5%; 30.1%, and 29.6%, respectively.</p><p><b>CONCLUSION</b>When lung function is determined with IOS in children, only when decrease of Zrs and R5 is equal to or more than 20% and decrease of X5 is 30% or more after inhalation of bronchodilator, can the bronchial reversibility test be considered as positive.</p>

significance of spirometry in bronchial asthma

To assess the behavior and usefulness of FEV[1%], FEF[25%] FEF[50%], and FEF[75%], in bronchial asthma and to determine the effect of age, sex and smoking on the PFTs used in the follow up of bronchial asthma. Retrospective study of the data from 104 patients with bronchial asthma. The study was performed at Ibn Sena Teaching Hospital, at the pulmonary function tests unit, Mosul. One hundred and four patients with bronchial asthma, 60 males and 44 females. Their ages ranging from 11 to 71 years. The inclusion criteria and case definition of the patients depended on clinical diagnosis of asthma and on Spirometric tests; all patients performed FEV[1%], FEF[25%], FEF[50%], and FEF[75%]. The analysis of variance, the calculated[F] and the tabulated[F] values were utilized to detect any statistically significant difference between the studied variables. The Duncan range tests were used to see which pulmonary function test is the best for the diagnosis of asthma. In the patients examined the percentages of predicted values of FEV[1%], FEF[25%], FEF[50%], and FEF[75%] are [84.8, 20, 33.6 and 52.3 respectively]. The analysis of variance indicates a statistically significant difference between the studied variables as the calculated [F] value is 168.78 which is more than the tabulated [F] value at 0.05 which is 2.01. Further analysis of the results by Duncan range test showed that FEV[1%] is the leading test followed by FEF[75%] then FEF[25%] is trailing the last. Age has an inverse relation with FEF[25%], FEF[50%]. Female sex proved to have an inverse relation with FEF[75%] only. While smoking has no effect on the various PFT's. This study confirms that there is a decrease in the values of FEV[1%], FEF[75%], FEF[50%] and FEF[25%] with age. Furthermore it confirms that FEV[1%], FEF[75%], FEF[50%] and FEF[25%] are still valid and sensitive tests for the follow-up of bronchial asthma, also indicates that there is an inverse relationship between female sex and FEF[75%]. Smoking surprisingly shows no effect

Relationship between bronchial hyperresponsiveness and the peripheral obstruction in stable asthmatic children / 中华儿科杂志

<p><b>OBJECTIVE</b>Asthma is the most common chronic respiratory disease of children. The association between asthma and bronchial hyperresponsiveness (BHR) has been well-demonstrated. The objective of the study was to investigate relationship between the bronchial responsiveness and the peripheral obstruction in stable asthmatic children.</p><p><b>METHODS</b>Thirty-nine children with stable asthma, 28 boys and 11 girls with a mean age of 128 (77 - 197) months, received the bronchial provocation test by the maximal expiratory flow-volume (MEFV) curve measurement. The children were divided into two groups: one with maximal mid-expiratory flow (MMEF) < 80% (n = 15) and the other with MMEF >/= 80% (n = 24). Positive rates of bronchial provocation test were compared between groups of MMEF < 80% and >/= 80% and between the children whose relief duration was </= 12 months (n = 26) and > 12 months (n = 13). Statistical analysis was performed by using Chi-square, rank sum test or t test (SPSS10.0), P values < 0.05 were considered significant.</p><p><b>RESULTS</b>In the 39 stable asthmatic children, 15 (38%) were detected MMEF < 80% and 28 (72%) had BHR. There was no significant difference in BHR between the children with MMEF < 80% and those with MMEF >/= 80% (P > 0.05). There was no significant difference in BHR between the children whose relief duration was </= 12 months and > 12 months (P > 0.05), either.</p><p><b>CONCLUSIONS</b>The stable asthmatic children still had peripheral obstruction and BHR, which indicated the presence of airway inflammation. There was no significant difference in BHR between the children whose relief duration was </= 12 months and > 12 months.</p>

Clinical Impact of Bronchial Reactivity and Its Relationship with Changes of Pulmonary Function After Asthmatic Attack Induced by Methacholine / 결핵

BACKGROUND: Bronchial reactivity is known to be a component of airway hyperresponsiveness, a cardinal feature of asthma, with bronchial sensitivity, and is increments in response to induced doses of bronchoconstric tors as manifested by the steepest slope of the dose-response curve. However, there is some controversy regarding methods of measuring bronchial reactivity and clinical impact of such measurements. The purpose of this study was to evaluate the clinical significance and assess the clinical use by analyzing the relationship of the bronchial sensitivity, the clinical severity and the changes in pulmonary function with bronchial reactivity. METHOD: A total of 116 subjects underwent a methacholine bronchial provocation test. They were divided into 3 groups : mild intermittent, mild persistent, moderate and cough asthma. Severe patients were excluded. Methacholine PC20 was determined from the log dose-response curve and PC40 was determined by one more dose inhalation after PC20. The steepest slope of log dose-response curve, connecting PC20 with PC40, was used to calculate the bronchial reactivity. Body plethysmography and a single breath for the DLCO were done in 43 subjects before and after methacholine test. RESULTS: The average bronchial reactivity was 38.0 in the mild intermittent group, 49.8 in the mild persistent group, 61.0 in the moderate group, and 41.1 in the cough asthma group. There was a weak negative correlation between PC20 and bronchial reactivity. A heightened bronchial reactivity tends to produce an increased clinical severity in patients with a similar bronchial sensitivity and basal spirometric pulmonary function. There were significant correlations between the bronchial reactivity and the initial pulmonary function before the methacholine test in the order of sGaw, Raw, FEV1/FVC, MMFR. There were no correlations between the bronchial sensitivity and the % change in the pulmonary function parameters after the methacholine test. However, there were significant correlations between the bronchial reactivity and the PEF, FEV1, DLCO. CONCLUSION: There was weak significant negative correlation between the bronchial reactivity and the bronchial sensitivity, and the bronchial reactivity closely reflected the severity of the asthma. Accordingly, measuring both the bronchial sensitivity and the bronchial reactivity can be of assistance in assessing of the ongoing disease severity and in monitoring the effect of therapy.

HRCT Findings of Hypersensitivity Pneumonitis: Correlation with Pulmonary Function Test

PURPOSE: To evaluate the HRCT findings of hypersensitive pneumonitis and to correlate the findings with the results of the pulmonary function test (PFT). MATERIALS AND METHODS: Seven patients in whom hypersensitive pneumonitis was histologically confirmed (by transbronchial lung biopsy in two, thoracoscopic lung biopsy in one, open lung biopsy in two, and typical clinical and laboratory findings in two) were involved in this study. Their radiological patterns were assessed by HRCT and the extent of each finding was evaluated semi-quantitatively and correlated with the results of the pulmonary function test. RESULTS: The HRCT findings were as follows: lobular overinflation (n = 7), ground glass attenuation (n = 7), centrilobular nodule (n = 6), reticular opacity (n = 5), interlobular septal thickening (n = 3), consolidation (n = 2), and irregular subpleural line (n = 1). Five patients showed lower lung predominance and two, middle lung predominance. In all, a restrictive pattern and diminished diffusion capacity was noted. The grade score of reticular opacity showed significant correlation with forced vital capacity and forced expiratory volume. There was, however, no significant correlation between other HRCT findings and PFT results. Two patientsin whom lobular overinflation associated with parenchymal fibrosis was noted showed a decreased maximal midexpiratory flow rate of 25 -75. CONCLUSION: Lobular overinflation, ground-glass attenuation and centrilobular nodules are commonly observed in hypersensitive pneumonitis. The only significant correlation between each HRCT finding and the pulmonary function test was that between reticular opacity and both forced expiratory volume and forced vital capacity. In cases of chronic hypersensitive pneumonitis presenting as pulmonary fibrosis, associated lobular overinflation could be helpful for differential diagnosis.

Spirometric impairments in undernourished children.

The present study elucidates the effect of undernutrition on pulmonary functions in children. The study was carried out in healthy normals, wasted, wasted and stunted children. Spirometry was performed with Vitalograph Compact-II spirometer. Wasted, wasted and stunted children showed lower lung volumes, forced mid expiratory flow time and inspiratory flow rates than healthy normals. Wasted and stunted children had lower VC, FVC and FIF50% than wasted children. The reduction in lung volumes and flow rates in wasted children may be due to ventilatory muscle wasting. But in wasted and stunted children along with muscular wasting diminished skeletal growth is also a reason for lower lung functions. No airflow limitation was observed in undernourished children.

A Study of Effect on Pulmonary Function of Pleural Effusion in Tuberculous pleurisy patients / 결핵

BACKGROUND: Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long term effect after thoracentesis. METHOD: We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. RESULT: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, PO2 are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and PO2 is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. CONCUSION: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery

Efecto de tres esquemas terapéuticos sobre el flujo máximo espiratorio y la estancia hospitalaria en la crisis asmática / Effect of three therapeutic modalities upon peak expiratory flow and hospital staying in asthmatic crisis

El objetivo del presente estudio es evaluar el impacto de tres esquemas terapéuticos sobre el flujo máximo espiratorio (FME) y la estancia hospitalaria en pacientes adultos con crisis asmática. Se trata de un diseño causiexperimental, prospectivo, aleatorio, ciego simple y comparativo. Se estudiaron 38 pacientes adultos con diagnóstico de crisis asmática que se distribuyeron en tres grupos: 14 (36.84 por ciento) fueron tratados con aminofilina, 11 (28.94 por ciento con hidrocortisona y 13 (34.22 por ciento) con metilprednisolona. En cada grupo se asoció salbutamol nebulizado y se igualaron dosis de esteroides por la distinta potencia antiinflamatoria. Se medió el flujo máximo espiratorio (FME), grado de broncoespasmo, frecuencia cardiaca y respiratoria, repitiéndose dichas mediciones cada seis horas antes de la administración de los fármacos correspondientes. Se anotó la hora en que desaparecieron las sibilancias en cada grupo y se compararon entre sí. Los datos obtenidos sugieren que los tres esquemas terapéuticos empleados son adecuados y no impactan significativamente uno sobre el otro respecto al FME y la estancia hospitalaria

Pulmonary function tests--a comparison between urban industrial and rural agricultural workers of Andhra Pradesh.

Physical parameters and pulmonary function tests (VC, FEV1, FEV1% and FEF25-75%) were collected in 112 urban industrial workers and 104 rural agricultural workers. These average values, values according to age and smoking habits were compared between urban and rural workers. Inspite of no differences in age, rural workers average height, weight, BSA is significantly lower than urban workers. A significant increase in VC value to the extent of 0.22 lit (7.1%), significantly lower FEV 1% value by 4.7% and reduce FEF25-75% value (4.7%) is demonstrated in rural than urban workers. Smoking is shown to produce airway obstruction in both urban and rural workers. A wide variation of PFT values between the present workers and other reported values in India is observed. This study indicates rural workers have better pulmonary capacity and less flow rates than their urban counterpart.

Efecto del humo del cigarro en las vías aéreas de los niños asmáticos / The effect of the sigarrete smoke in the respiratori trackt of astmatic childs

Se estudiaron 62 niños asmáticos para observar el efecto agudo del tabaquismo pasivo durante una hora. Se realizaron pruebas de función pulmonar antes y después de la exposición al humo del cigarro. Se estudiaron tres parámetros: capacidad vital forzada CVF, volumen espiratorio forzado del primer segundo FEV1 y el flujo medio máximo espiratorio FEF 25-75 25-75%. De estas mediciones, el FEF 25-75% mostró una caída más importante en el 23% de los pacientes. El tabaquismo pasivo produjo cambios en el 32.25% de los pacientes asmáticos en cualquiera de las pruebas de función pulmonar. Finalmente, se correlacionaron los antecedentes de tabaquismo de los padres y ls pruebas de sensibilidad cutánea al antígeno del tabaco, pero no se encontró correlación entre estos parámetros

Resultados del estudio de la función pulmonar en un grupo de niños asmáticos en período intercrisis y su comparación con una muestra similar de adultos / Results of the study of pulmonary function in a group of asthmatic children in intercrisis period and its comparison with a similar adult sample

Se realiza un estudio comparativo de dos muestras: una conformada por 24 niños y la otra por 25 adultos, procedentes de los Servicios de Neumología del Hospital Pediátrico Provincial y del Hospital Clinicoquirúrgico Provincial de Pinar del Río, respectivamente, con historia de ingresos reiterados por presentar status asmaticum en el primer semestre de 1986. A todos los pacientes se les realizó estudio espirométrico antes y después de la aplicación de un aerosol de salbutamol al 0,5 %, en las dosis usualmente recomendadas. Los resultados porcentuales para cada paciente fueron obtenidos mediante un programa de computación, en el que se tuvieron en cuenta las tablas de normalidad de Bates; el procesamiento estadístico de los datos se realizó a través de las pruebas de chi cuadrado, de la t de Student y el análisis de correlación. Después de la investigación se pudo apreciar que la proporción de niños y adultos que en período intercrisis tienen obstrucción de vías aéreas, es alrededor del 50 %, sin diferencias significativas entre la edad; asimismo, alrededor del 40 % evidencia un patrón normal en ese período. Se encontró correlación significativa entre el tiempo de evolución y el grado de obstrucción de las vías aéreas. El efecto broncodilatador del salbutamol fue comprobado en la intercrisis, tanto en niños como en adultos, y no se manifestaron diferencias en cuanto al efecto en niños y adultos

Estudo comparativo entre testes espirométricos na avaliaçäo da obstruçäo brônquica / Comparative study of spirographic tests in the evaluation of bronchial obstruction

Em 100 pacientes portadores de obstruçäo brônquica crônica os AA. analisam as seguintes provas: VVM, VEF, VEF, IT, FEF e FEF max. Consideram como valores normais aqueles estabelecidos por Pennock e col. A análise estatística mostrou que a diferença entre os valores previstos e os observados se apresentou com distribuiçäo normal. Em todas as provas estudadas, os valores decrescentes dos limites de confiança e do valor de t do teste de Student permitiram fazer o seu escalonamento. Verificou-se que o FEF e a VVM estäo em 1§ e 2§ lugar, o VEF e o FEF max em 3§ ou 4§ e o IT em 5§. Isto traduzia, em ordem decrescente a sua maior sensibilidade em avaliar a obstruçäo parcial dos brônquios. Houve correlaçäo estatisticamente significante entre VVM e VEF VVM e IT, VVM e FEF, VVM e FEF max, VEF e IT, VEF e FEF, VEF e FEF max, IT e FEF e FEF max