Spirometry: Measurement of volume of air inhaled or exhaled by the lung.Forced Expiratory Volume: Measure of the maximum amount of air that can be expelled in a given number of seconds during a FORCED VITAL CAPACITY determination . It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity.Vital Capacity: The volume of air that is exhaled by a maximal expiration following a maximal inspiration.Respiratory Function Tests: Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc.Pulmonary Disease, Chronic Obstructive: A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.Asthma: A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).Bronchodilator Agents: Agents that cause an increase in the expansion of a bronchus or bronchial tubes.Airway Obstruction: Any hindrance to the passage of air into and out of the lungs.Lung Diseases, Obstructive: Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent.Lung Diseases: Pathological processes involving any part of the LUNG.Lung: Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.Maximal Midexpiratory Flow Rate: Measurement of rate of airflow over the middle half of a FORCED VITAL CAPACITY determination (from the 25 percent level to the 75 percent level). Common abbreviations are MMFR and FEF 25%-75%.Forced Expiratory Flow Rates: The rate of airflow measured during a FORCED VITAL CAPACITY determination.Dyspnea: Difficult or labored breathing.Peak Expiratory Flow Rate: Measurement of the maximum rate of airflow attained during a FORCED VITAL CAPACITY determination. Common abbreviations are PEFR and PFR.Pulmonary Medicine: A subspecialty of internal medicine concerned with the study of the RESPIRATORY SYSTEM. It is especially concerned with diagnosis and treatment of diseases and defects of the lungs and bronchial tree.Oscillometry: The measurement of frequency or oscillation changes.Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow.Respiration Disorders: Diseases of the respiratory system in general or unspecified or for a specific respiratory disease not available.Respiratory Tract DiseasesBronchial Provocation Tests: Tests involving inhalation of allergens (nebulized or in dust form), nebulized pharmacologically active solutions (e.g., histamine, methacholine), or control solutions, followed by assessment of respiratory function. These tests are used in the diagnosis of asthma.Bronchospirometry: Spirometric technique in which the volume of air breathed in the right and left lung is recorded separately.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Maximal Expiratory Flow Rate: The airflow rate measured during the first liter expired after the first 200 ml have been exhausted during a FORCED VITAL CAPACITY determination. Common abbreviations are MEFR, FEF 200-1200, and FEF 0.2-1.2.Lung Volume Measurements: Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Exhalation: The act of BREATHING out.Plethysmography, Whole Body: Measurement of the volume of gas in the lungs, including that which is trapped in poorly communicating air spaces. It is of particular use in chronic obstructive pulmonary disease and emphysema. (Segen, Dictionary of Modern Medicine, 1992)Respiratory Therapy: Care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It includes the therapeutic use of medical gases and their administrative apparatus, environmental control systems, humidification, aerosols, ventilatory support, bronchopulmonary drainage and exercise, respiratory rehabilitation, assistance with cardiopulmonary resuscitation, and maintenance of natural, artificial, and mechanical airways.Pulmonary Diffusing Capacity: The amount of a gas taken up, by the pulmonary capillary blood from the alveolar gas, per minute per unit of average pressure of the gradient of the gas across the BLOOD-AIR BARRIER.Breathing Exercises: Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration.Respiratory Sounds: Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation.Albuterol: A short-acting beta-2 adrenergic agonist that is primarily used as a bronchodilator agent to treat ASTHMA. Albuterol is prepared as a racemic mixture of R(-) and S(+) stereoisomers. The stereospecific preparation of R(-) isomer of albuterol is referred to as levalbuterol.Methacholine Chloride: A quaternary ammonium parasympathomimetic agent with the muscarinic actions of ACETYLCHOLINE. It is hydrolyzed by ACETYLCHOLINESTERASE at a considerably slower rate than ACETYLCHOLINE and is more resistant to hydrolysis by nonspecific CHOLINESTERASES so that its actions are more prolonged. It is used as a parasympathomimetic bronchoconstrictor agent and as a diagnostic aid for bronchial asthma. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1116)Cough: A sudden, audible expulsion of air from the lungs through a partially closed glottis, preceded by inhalation. It is a protective response that serves to clear the trachea, bronchi, and/or lungs of irritants and secretions, or to prevent aspiration of foreign materials into the lungs.Administration, Inhalation: The administration of drugs by the respiratory route. It includes insufflation into the respiratory tract.Occupational Diseases: Diseases caused by factors involved in one's employment.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Dust: Earth or other matter in fine, dry particles. (Random House Unabridged Dictionary, 2d ed)Breath Tests: Any tests done on exhaled air.Pulmonary Ventilation: The total volume of gas inspired or expired per unit of time, usually measured in liters per minute.Total Lung Capacity: The volume of air contained in the lungs at the end of a maximal inspiration. It is the equivalent to each of the following sums: VITAL CAPACITY plus RESIDUAL VOLUME; INSPIRATORY CAPACITY plus FUNCTIONAL RESIDUAL CAPACITY; TIDAL VOLUME plus INSPIRATORY RESERVE VOLUME plus functional residual capacity; or tidal volume plus inspiratory reserve volume plus EXPIRATORY RESERVE VOLUME plus residual volume.Residual Volume: The volume of air remaining in the LUNGS at the end of a maximal expiration. Common abbreviation is RV.Pulmonary Emphysema: Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions.Maximal Expiratory Flow-Volume Curves: Curves depicting MAXIMAL EXPIRATORY FLOW RATE, in liters/second, versus lung inflation, in liters or percentage of lung capacity, during a FORCED VITAL CAPACITY determination. Common abbreviation is MEFV.Pulmonary Atelectasis: Absence of air in the entire or part of a lung, such as an incompletely inflated neonate lung or a collapsed adult lung. Pulmonary atelectasis can be caused by airway obstruction, lung compression, fibrotic contraction, or other factors.Respiratory Physiological Phenomena: Physiological processes and properties of the RESPIRATORY SYSTEM as a whole or of any of its parts.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Bronchial Hyperreactivity: Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.Bronchoconstrictor Agents: Agents causing the narrowing of the lumen of a bronchus or bronchiole.Plethysmography: Recording of change in the size of a part as modified by the circulation in it.Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality.Asthma, Occupational: Asthma attacks caused, triggered, or exacerbated by OCCUPATIONAL EXPOSURE.Respiratory Mechanics: The physical or mechanical action of the LUNGS; DIAPHRAGM; RIBS; and CHEST WALL during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc.Respiratory Muscles: These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES.Bronchitis: Inflammation of the large airways in the lung including any part of the BRONCHI, from the PRIMARY BRONCHI to the TERTIARY BRONCHI.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Skin Tests: Epicutaneous or intradermal application of a sensitizer for demonstration of either delayed or immediate hypersensitivity. Used in diagnosis of hypersensitivity or as a test for cellular immunity.Cystic Fibrosis: An autosomal recessive genetic disease of the EXOCRINE GLANDS. It is caused by mutations in the gene encoding the CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR expressed in several organs including the LUNG, the PANCREAS, the BILIARY SYSTEM, and the SWEAT GLANDS. Cystic fibrosis is characterized by epithelial secretory dysfunction associated with ductal obstruction resulting in AIRWAY OBSTRUCTION; chronic RESPIRATORY INFECTIONS; PANCREATIC INSUFFICIENCY; maldigestion; salt depletion; and HEAT PROSTRATION.Education, Nursing, Continuing: Educational programs designed to inform nurses of recent advances in their fields.Scopolamine Derivatives: Analogs or derivatives of scopolamine.Anti-Asthmatic Agents: Drugs that are used to treat asthma.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Bronchitis, Chronic: A subcategory of CHRONIC OBSTRUCTIVE PULMONARY DISEASE. The disease is characterized by hypersecretion of mucus accompanied by a chronic (more than 3 months in 2 consecutive years) productive cough. Infectious agents are a major cause of chronic bronchitis.Auscultation: Act of listening for sounds within the body.Air Pollutants, Occupational: Air pollutants found in the work area. They are usually produced by the specific nature of the occupation.Early Diagnosis: Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Sputum: Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Respiratory Therapy Department, Hospital: Hospital department which is responsible for the administration of diagnostic pulmonary function tests and of procedures to restore optimum pulmonary ventilation.Inspiratory Capacity: The maximum volume of air that can be inspired after reaching the end of a normal, quiet expiration. It is the sum of the TIDAL VOLUME and the INSPIRATORY RESERVE VOLUME. Common abbreviation is IC.Deinstitutionalization: The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system.September 11 Terrorist Attacks: Terrorism on September 11, 2001 against targets in New York, the Pentagon in Virginia, and an aborted attack that ended in Pennsylvania.Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.Rhinitis, Allergic, Perennial: Inflammation of the mucous membrane of the nose similar to that found in hay fever except that symptoms persist throughout the year. The causes are usually air-borne allergens, particularly dusts, feathers, molds, animal fur, etc.Tasmania: An island south of Australia and the smallest state of the Commonwealth. Its capital is Hobart. It was discovered and named Van Diemen's Island in 1642 by Abel Tasman, a Dutch navigator, in honor of the Dutch governor-general of the Dutch East Indian colonies. It was renamed for the discoverer in 1853. In 1803 it was taken over by Great Britain and was used as a penal colony. It was granted government in 1856 and federated as a state in 1901. (From Webster's New Geographical Dictionary, 1988, p1190 & Room, Brewer's Dictionary of Names, p535)Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Ipratropium: A muscarinic antagonist structurally related to ATROPINE but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic.Bronchial DiseasesMaximal Voluntary Ventilation: Measure of the maximum amount of air that can be breathed in and blown out over a sustained interval such as 15 or 20 seconds. Common abbreviations are MVV and MBC.Exercise Test: Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.Bronchiectasis: Persistent abnormal dilatation of the bronchi.Adrenal Cortex HormonesWeldingIntermittent Positive-Pressure Breathing: Application of positive pressure to the inspiratory phase of spontaneous respiration.Emphysema: A pathological accumulation of air in tissues or organs.Functional Residual Capacity: The volume of air remaining in the LUNGS at the end of a normal, quiet expiration. It is the sum of the RESIDUAL VOLUME and the EXPIRATORY RESERVE VOLUME. Common abbreviation is FRC.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.

Double-blind intervention trial on modulation of ozone effects on pulmonary function by antioxidant supplements. (1/2225)

The aim of this study was to investigate whether the acute effects of ozone on lung function could be modulated by antioxidant vitamin supplementation in a placebo-controlled study. Lung function was measured in Dutch bicyclists (n = 38) before and after each training session on a number of occasions (n = 380) during the summer of 1996. The vitamin group (n = 20) received 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks. The average ozone concentration during exercise was 77 microg/m3 (range, 14-186 microg/m3). After exclusion of subjects with insufficient compliance from the analysis, a difference in ozone exposure of 100 microg/m3 decreased forced expiratory volume in 1 second (FEV1) 95 ml (95% confidence interval (CI) -265 to -53) in the placebo group and 1 ml (95% CI -94 to 132) in the vitamin group; for forced vital capacity, the change was -125 ml (95% CI -384 to -36) in the placebo group and -42 ml (95% CI -130 to 35) in the vitamin group. The differences in ozone effect on lung function between the groups were statistically significant. The results suggest that supplementation with the antioxidant vitamins C and E confers partial protection against the acute effects of ozone on FEV1 and forced vital capacity in cyclists.  (+info)

Decline in FEV1 related to smoking status in individuals with severe alpha1-antitrypsin deficiency (PiZZ). (2/2225)

Severe alpha1-antitrypsin (AAT) deficiency predisposes to emphysema development. Highly variable rates of decline in lung function are reported in PiZZ individuals. The annual decline in forced expiratory volume in one second (FEV1; delta FEV1) was analysed in relation to smoking status in a cohort of 608 adult PiZZ individuals included in the Swedish national AAT deficiency register. Delta FEV1 was analysed in 211 never-smokers, in 351 exsmokers, and in 46 current smokers after performing at least two spirometries during a follow-up time of 1 yr or longer (median 5.5 yrs, range 1-31). The adjusted mean delta FEV1 in never-smokers was 47 mL x yr(-1) (95% confidence interval (CI) 41-53 mL x yr(-1)), 41 mL x yr(-1) (95% CI 36-48 mL x yr(-1)) in exsmokers, and 70 mL x yr(-1) (95% CI 58-82 mL x yr(-1)) in current smokers. A dose-response relationship was found between cigarette consumption and delta FEV1 in current smokers and exsmokers. In never-smokers, a greater delta FEV1 was found after 50 yrs of age than before. No sex differences were found in delta FEV1. In conclusion, among PiZZ individuals, the change in forced expiratory volume in one second is essentially the same in never-smokers and exsmokers. Smoking is associated with a dose-dependent increase in the change in forced expiratory volume in one second.  (+info)

Exhaled and nasal NO levels in allergic rhinitis: relation to sensitization, pollen season and bronchial hyperresponsiveness. (3/2225)

Exhaled nitric oxide is a potential marker of lower airway inflammation. Allergic rhinitis is associated with asthma and bronchial hyperresponsiveness. To determine whether or not nasal and exhaled NO concentrations are increased in allergic rhinitis and to assess the relation between hyperresponsiveness and exhaled NO, 46 rhinitic and 12 control subjects, all nonasthmatic nonsmokers without upper respiratory tract infection, were randomly selected from a large-scale epidemiological survey in Central Norway. All were investigated with flow-volume spirometry, methacholine provocation test, allergy testing and measurement of nasal and exhaled NO concentration in the nonpollen season. Eighteen rhinitic subjects completed an identical follow-up investigation during the following pollen season. Exhaled NO was significantly elevated in allergic rhinitis in the nonpollen season, especially in perennially sensitized subjects, as compared with controls (p=0.01), and increased further in the pollen season (p=0.04), mainly due to a two-fold increase in those with seasonal sensitization. Nasal NO was not significantly different from controls in the nonpollen season and did not increase significantly in the pollen season. Exhaled NO was increased in hyperresponsive subjects, and decreased significantly after methacholine-induced bronchoconstriction, suggesting that NO production occurs in the peripheral airways. In allergic rhinitis, an increase in exhaled nitric oxide on allergen exposure, particularly in hyperresponsive subjects, may be suggestive of airway inflammation and an increased risk for developing asthma.  (+info)

Acute saline infusion reduces alveolar-capillary membrane conductance and increases airflow obstruction in patients with left ventricular dysfunction. (4/2225)

BACKGROUND: Impaired alveolar-capillary membrane conductance is the major cause for the reduction in pulmonary diffusing capacity for carbon monoxide (DLCO) in heart failure. Whether this reduction is fixed, reflecting pulmonary microvascular damage, or is variable is unknown. The aim of this study was to assess whether DLCO and its subdivisions, alveolar-capillary membrane conductance (DM) and pulmonary capillary blood volume (Vc), were sensitive to changes in intravascular volume. In addition, we examined the effects of volume loading on airflow rates. METHODS AND RESULTS: Ten patients with left ventricular dysfunction (LVD) and 8 healthy volunteers were studied. DM and Vc were determined by the Roughton and Forster method. The forced expiratory volume in 1 second (FEV1), vital capacity, and peak expiratory flow rates (PEFR) were also recorded. In patients with LVD, infusion of 10 mL. kg-1 body wt of 0.9% saline acutely reduced DM (12.0+/-3.3 versus 10.4+/-3.5 mmol. min-1. kPa-1, P<0.005), FEV1 (2.3+/-0.4 versus 2.1+/-0.4 L, P<0.0005), and PEFR (446+/-55 versus 414+/-56 L. min-1, P<0.005). All pulmonary function tests had returned to baseline values 24 hours later. In normal subjects, saline infusion had no measurable effect on lung function. CONCLUSIONS: Acute intravascular volume expansion impairs alveolar-capillary membrane function and increases airflow obstruction in patients with LVD but not in normal subjects. Thus, the abnormalities of pulmonary diffusion in heart failure, which were believed to be fixed, also have a variable component that could be amenable to therapeutic intervention.  (+info)

Spirometric reference equations for older adults. (5/2225)

The objective of this study was to develop spirometric reference equations for healthy, never-smoking, older adults. It was designed as a cross-sectional observational study consisting of 1510 Seventh Day Adventists, ages 43-79 years enrolled in a study of health effects of air pollutants. Individuals were excluded from the reference group (n = 565) for a history of current respiratory illness, smoking, or chronic respiratory disease, and for a number of 'non-respiratory' conditions which were observed in these data to be related to lower values of FEV1. Gender-specific reference equations were developed for the entire reference group and for a subset above 65 years of age (n = 312). Controlling for height and age, lung function was found to be positively related to the difference between armspan and height, and in males was found to be quadratically related to age. The predicted values for this population generally fell within the range of those of other population groups containing large numbers of adults over the age of 65 years. Individuals with lung function below the 5th percentile in this sample, however, could not be reliably identified by using the lower limits of normal predictions commonly used in North America and Europe.  (+info)

The role of domestic factors and day-care attendance on lung function of primary school children. (6/2225)

The results of studies examining the relationship of domestic factors to lung function are contradictory. We therefore examined the independent effects of maternal smoking during pregnancy, exposure to environmental tobacco smoke (ETS), the presence of a cat, type of heating and cooking used in the home and day-care attendance on lung function after controlling for socioeconomic status (SES). Nine hundred and eighty-nine children from 18 Montreal schools were studied between April 1990 and November 1992. Information on the child's health and exposure to domestic factors was collected by questionnaire. Spirometry was performed at school. The data were analysed by multiple linear regression with percent predicted FEV1, FVC, and FEV1/FVC as dependent variables. In the overall sample (both sexes combined), cat in the home (regression coefficient, beta = -1.15, 95% confidence interval, CI: -2.26-(-)0.05) and electric baseboard units (beta = -1.26, 95% CI: -2.39-(-)0.13) were independently associated with a lower FEV1/FVC, while day-care attendance (beta = -2.05, 95% CI: -3.71-(-)0.40) significantly reduced FEV1. Household ETS was significantly associated with increasing level of FVC (beta = 2.86, 95% CI: +0.55 to +5.17). In boys but not girls, household ETS (beta = -2.13, 95% CI: -4.07-(-)0.19) and the presence of a cat (beta = -2.19, 95% CI: -3.94-(-)0.45) were associated with lower FEV1/FVC. By contrast, day-care attendance was associated with lower FEV1 (beta = -2.92, 95% CI: -5.27-(-)0.56) and FEV1/FVC (beta = -1.53, 95% CI: -2.73-(-)0.33) in girls only. In conclusion, the results provide evidence that domestic factors and day-care attendance primarily affected airway caliber and gender differences were apparent in the effects of these factors.  (+info)

Time course of respiratory decompensation in chronic obstructive pulmonary disease: a prospective, double-blind study of peak flow changes prior to emergency department visits. (7/2225)

The aim of this study was to look at changes in peak expiratory flow rates (PEFR) prior to emergency department visits for decompensated chronic obstructive pulmonary disease (COPD). It was designed as a prospective, double-blind study at the Albuquerque Veterans Affairs Medical Center. Twelve patients with an irreversible component of airflow obstruction on pulmonary function tests were assessed. At entry, all subjects were instructed in the use of a mini-Wright peak flow meter with electronic data storage. They then entered a 6-month monitoring phase in which they recorded PEFR twice daily, before and after bronchodilators. The meter displays were disabled so that the patients and their physicians were blinded to all values. Medical care was provided in the customary manner. Patients were considered to have respiratory decompensation if they required treatment for airflow obstruction in the Emergency Department (ED) and no other causes of dyspnea could be identified. Simple linear regression was used to model changes in PEFR over time. The 12 subjects had 22 episodes of respiratory decompensation during 1741 patient-days of observation. Two episodes could not be analysed because of missing values. Ten episodes in seven subjects were characterized by a significant linear decline in at least one peak flow parameter prior to presentation. The mean rates of change for the four daily parameters varied from 0.22% to 0.27% predicted per day (or 1.19 to 1.44 1 min-1 day-1). The average decrement in these parameters ranged from 30.0 to 33.8 1 min-1 (or 18.6%-25.9% of their baseline values). No temporal trends were found for the 10 episodes occurring in the other five subjects. We concluded that respiratory decompensation is characterized by a gradual decline in PEFR in about half of cases. Future studies should be done to elucidate the mechanisms of respiratory distress in the other cases.  (+info)

Plasma levels of enalaprilat in chronic therapy of heart failure: relationship to adverse events. (8/2225)

Angiotensin-converting enzyme (ACE) inhibitors are established as first-line therapy in chronic heart failure (CHF). However, little is known about the dosage-plasma-level relationship of ACE inhibitors in CHF and its relation to drug-induced adverse effects. We investigated 45 patients (age 55 +/- 10 years) with stable CHF who presented with a maintenance dosage of enalapril of either 5 mg b.i.d. (E10, n = 16), 10 mg b.i.d. (E20, n = 18), or 20 mg b.i.d. (E40, n = 11). This dosage was changed three times to treat all patients with lower, higher, and, finally, the initial dosage for 4 weeks each. Patients were examined clinically, by questionnaire, and by spiroergometry. In addition, neurohormones (atrial and brain natriuretic peptide and norepinephrine), enalaprilat trough levels, and serum potassium and creatinine were measured. Enalaprilat trough levels differed significantly between the three groups at study entry but also varied markedly within each group. In addition to the dose of enalapril, serum creatinine, severity of CHF, basal metabolic rate, and body weight significantly influenced enalaprilat trough levels (R2 =.84, p <.001). Within-patient comparisons revealed that serum creatinine (107 +/- 26 versus 102 +/- 20 micromol/liter) and potassium (3.8 +/- 0.4 versus 3.7 +/- 0. 3mmol/liter) were higher, cough was more common (scored on a scale of 0-8: 1.7 +/- 2.1 versus 1.4 +/- 1.8), and blood pressure was lower (systolic, 112 +/- 14 versus 117 +/- 13 mm Hg; diastolic, 66 +/- 9 versus 69 +/- 11 mm Hg) on the highest than on the lowest enalaprilat trough level (all p <.05). Highly variable enalaprilat trough levels and the fact that adverse effects were more common on high enalaprilat trough levels provide a rationale for individually adjusting ACE-inhibitor dose in case of adverse effects.  (+info)

  • Spirometry is helpful in assessing breathing patterns that identify conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD. (wikipedia.org)
  • Spirometry is a common pulmonary function test used to diagnose various pulmonary diseases, like asthma and chronic obstructive pulmonary disease (COPD). (aarc.org)
  • Spirometry in health checkup may contribute to early diagnosis of chronic obstructive pulmonary disease (COPD) and asthma. (go.jp)
  • Post-bronchodilator spirometry in health checkup would reduce the number of subjects with probable COPD to two-third. (go.jp)
  • Given that COPD and asthma is revealed by airway limitation in spirometry, involvement of spirometry to community-based health checkup may become an "easy access" improving early diagnosis. (go.jp)
  • Importantly, post-bronchodilator spirometry is essential for definite diagnosis of COPD to demonstrate airway limitation that is not fully reversible ( Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2014) Global strategy for the diagnosis, management and prevention of COPD. [ Updated : January, http://www.goldcopd.com [ Accessed : January 23, " data-html="true" data-placement="bottom" data-toggle="tooltip">Global Initiative for Chronic Obstructive Lung Disease 2014 ). (go.jp)
  • Spirometry is a pulmonary examination used to diagnose conditions such as asthma and chronic obstructive pulmonary disease (COPD). (towerallergy.com)
  • Spirometry is a test used for lung conditions, such as COPD* or asthma. (allergy-asthma-clinic.com)
  • Spirometry can detect COPD before symptoms become severe. (allergy-asthma-clinic.com)
  • Explain to interested patients that COPD is a common diagnosis among long-time smokers and suggest that spirometry testing may be needed for patients who have clinical signs of the disease. (copdsupport.ie)
  • Explain to interested patients that it may be necessary to conduct a post-bronchodilator spirometry test to definitively confirm COPD diagnosis. (copdsupport.ie)
  • ANN ARBOR, Mich., Aug. 14 - Only one in three patients who are told they have chronic obstructive pulmonary disease (COPD) have had that diagnosis confirmed with spirometry. (copdsupport.ie)
  • The researchers analyzed data from five health plans recruited by the National Committee for Quality Assurance to determine the proportion of newly diagnosed COPD patients who had received spirometry during the interval beginning 720 days before COPD diagnosis and ending 180 days after diagnosis. (copdsupport.ie)
  • Only 15% of newly diagnosed COPD patients 85 or older underwent spirometry testing. (copdsupport.ie)
  • The findings of this study "are in contrast to those obtained by investigators who have queried physicians regarding their use of spirometry to confirm COPD diagnosis, in which at least 70% of physicians reported using spirometry for establishing a diagnosis," wrote Dr. Han. (copdsupport.ie)
  • Drs. Enright and Quanjer wrote that either a widespread promotion of spirometry for COPD screening - as "generously funded by pharmaceutical companies in some countries" - or continued promotion of office spirometry testing for every adult smoker have the potential for causing more harm than good. (copdsupport.ie)
  • A better response, they said, would be to use spirometry to detect COPD in current or former smokers who have "high pretest probability of COPD. (copdsupport.ie)
  • 50% of predicted "from a good quality baseline spirometry test, the diagnosis of COPD should not be made without performing spirometry after an inhaled bronchodilator (post-BD), as recommended by the Global Initiative for Chronic Obstructive Lung Disease guidelines. (copdsupport.ie)
  • Introduction We compared the predictive value of prebronchodilator and postbronchodilator spirometry for chronic obstructive pulmonary disease (COPD) features and outcomes. (bmj.com)
  • Conclusions Postbronchodilator spirometry may be a more accurate predictor of COPD features and outcomes. (bmj.com)
  • The chronic obstructive pulmonary disease (COPD) prevalence was higher using prebronchodilator spirometry. (bmj.com)
  • We found no difference in COPD features and outcomes between subjects with discordance in prebronchodilator and postbronchodilator spirometry. (bmj.com)
  • Although both prebronchodilator and postbronchodilator spirometries are associated with COPD features and outcomes, postbronchodilator spirometry may be a more accurate predictor. (bmj.com)
  • Background: Studies indicate that not all physicians in clinical practice use spirometry routinely in the diagnosis of COPD. (northwestern.edu)
  • Understanding the patterns of spirometry use across geographic regions in patients with newly diagnosed COPD may help to identify the factors associated with the use of spirometry and to improve the quality of COPD care. (northwestern.edu)
  • The objective of this study was to characterize the regional variation in spirometry use for patients with newly diagnosed COPD using the Healthcare Effectiveness Data and Information Set (HEDIS) 2006 spirometry performance measure. (northwestern.edu)
  • Conclusions: Overall, the use of spirometry in patients with newly diagnosed COPD was low using the new HEDIS spirometry measure with a significant regional variation comprising a more than threefold difference between the regions with the lowest and highest rates of spirometry use. (northwestern.edu)
  • A UK study of patients participating in low-dose CT lung cancer screening highlights the importance of spirometry (breathing tests) in the assessment of possible chronic obstructive pulmonary disease (COPD), and demonstrates that over-reliance on radiological changes alone may result in detection of clinically insignificant disease. (axisimagingnews.com)
  • Since individuals at risk for lung cancer are also at risk for COPD, we recommend including spirometry in low-dose CT lung cancer screening programs, in order to assist in making accurate diagnoses. (axisimagingnews.com)
  • BACKGROUND: Diagnosis of chronic obstructive pulmonary disease (COPD) and its severity determination is based on spirometry. (unibas.ch)
  • Office spirometry provides a simple and quick means of detecting airflow limitation, allowing earlier diagnosis and intervention in many patients with early COPD. (unibas.ch)
  • Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. (ox.ac.uk)
  • Background: Using the COPD Diagnostic Questionnaire (CDQ) as a selection tool for spirometry could potentially improve the efficiency and accuracy of chronic obstructive pulmonary disease (COPD) diagnosis in at-risk patients. (edu.au)
  • Aim: To identify an optimal single cut point for the CDQ that divides primary care patients into low or high likelihood of COPD, with the latter group undergoing spirometry. (edu.au)
  • Conclusions: The CDQ can be used to select patients at risk of COPD for spirometry using one cut point. (edu.au)
  • Another major limitation is the fact that many intermittent or mild asthmatics have normal spirometry between acute exacerbation, limiting spirometry's usefulness as a diagnostic. (wikipedia.org)
  • If we consider that most asthma patients in primary care have normal spirometry (with only a small minority exhibiting substantial changes in airway calibre after bronchodilator challenge), 2 the approach of Kaplan and Stanbrook would result in the undertreatment of most asthma patients who are likely to be encountered in primary care. (cfp.ca)
  • Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. (ox.ac.uk)
  • Thoracic, abdominal, or cerebral aneurysms Cataracts or recent eye surgery Recent thoracic or abdominal surgery Nausea, vomiting, or acute illness Recent or current viral infection Undiagnosed hypertension The spirometry test is performed using a device called a spirometer, which comes in several different varieties. (wikipedia.org)
  • When you take a spirometry test, you breathe into the mouthpiece of a recording device called a spirometer. (humana.com)
  • During spirometry, a patient breathes through a tube attached to a spirometer, which calculates and records results. (towerallergy.com)
  • Flow oriented incentive spirometry: Incentive spirometry is a method of voluntary deep external respiration by supplying ocular provender back about inspiratory volume utilizing a specially designed spirometer, the patient inhales until a preset volume is reached so sustains the inspiratory volume by keeping the breath for 3-5 sec. (phdessay.com)
  • General practitioners received spirometry training and were provided with an EasyOne spirometer. (unibas.ch)
  • RATIONALE: Accurate reference values for spirometry are important because the results are used for diagnosing common chronic lung diseases such as asthma and chronic obstructive pulmonary disease, estimating physiologic impairment, and predicting all-cause mortality. (rti.org)
  • Rebuttal: Must family physicians use spirometry in managing asthma patients? (cfp.ca)
  • It is not appropriate for Drs Kaplan and Stanbrook to suggest that physicians who do not use spirometry should not manage patients with asthma. (cfp.ca)
  • To date, there are no studies that outline how to best make use of spirometry for asthma diagnosis and evaluation of undifferentiated respiratory symptoms in primary care. (cfp.ca)
  • 2 Recommendations related to the role of spirometry in asthma diagnosis and management should be based on medical evidence that is strong and relevant to clinical challenges encountered in primary care. (cfp.ca)
  • However, by linking underuse of office-based spirometry to substandard care, they are sending a message that family physicians might be part of the problem of suboptimal asthma management, including diagnosis. (cfp.ca)
  • 1 Although the many guidelines cited by Kaplan and Stanbrook recommend spirometry testing for asthma management, the benefits of this strategy remain unproven in the primary care setting. (cfp.ca)
  • More research is needed to understand whether office-based spirometry is superior to other approaches in terms of confirming diagnosis and improving relevant asthma control end points. (cfp.ca)
  • On average, children with a history of asthma or wheeze performed better quality spirometry than did others. (elsevier.com)
  • Spirometry tests play a large role in controlling and maintaining asthma. (aluna.io)
  • A spirometry exam will be given before you are diagnosed with asthma to determine if asthma is really the problem. (aluna.io)
  • Aluna is an innovative, scientifically-accurate, and portable spirometry exam and asthma management platform paired with a mobile game kids love. (aluna.io)
  • Purpose: This document addresses aspects of the performance and interpretation of spirometry that are particularly important in the workplace, where inhalation exposures can affect lung function and cause or exacerbate lung diseases, such as asthma, chronic obstructive pulmonary disease, or fibrosis. (nebraska.edu)
  • Purpose: The National Asthma Education and Prevention Program (NAEPP) and the American Thoracic Society provide guidelines stating that physicians should use spirometry in the diagnosis and management of asthma. (utmb.edu)
  • The aim of this study was to evaluate the trends, over a 10-year period, in the utilization of spirometry in patients newly diagnosed with asthma. (utmb.edu)
  • We hypothesized that spirometry use would increase in physicians who care for asthma patients, especially since 2007, when the revised NAEPP guidelines were published. (utmb.edu)
  • Methods: This retrospective cohort analysis of spirometry use in subjects newly diagnosed with asthma used a privately insured adult population for the years 2002-2011. (utmb.edu)
  • Our primary outcome of interest was spirometry performed within a year (± 365 days) of the initial date of asthma diagnosis. (utmb.edu)
  • Lastly, even without spirometry, a significant portion of patients (78.3%) was prescribed asthma drugs. (utmb.edu)
  • Conclusions: Our study suggests that spirometry is underutilized in newly diagnosed asthma patients. (utmb.edu)
  • Moreover, the use of controller medications in those diagnosed with asthma without spirometry remains high. (utmb.edu)
  • Measurements: Spirometry was performed annually for 3 years, with the recording of maneuver quality measures of forced expiratory time, end-of-test volume, back-extrapolated volume, and time to peak expiratory flow (PEFT), and the recording of differences between best and second-best FVC, FEV 1 , and peak expiratory flow (PEF) values. (elsevier.com)
  • Spirometry measurements include two primary results. (towerallergy.com)
  • Can You Take Spirometry Measurements at Home? (aluna.io)
  • Only spirometry tests graded A-C (reproducible measurements) were included in the analysis of airflow limitation. (unibas.ch)
  • Spirometry generates pneumotachographs, which are charts that plot the volume and flow of air coming in and out of the lungs from one inhalation and one exhalation. (wikipedia.org)
  • Spirometry can also be part of a bronchial challenge test, used to determine bronchial hyperresponsiveness to either rigorous exercise, inhalation of cold/dry air, or with a pharmaceutical agent such as methacholine or histamine. (wikipedia.org)
  • This falls under the "inhalation" portion of the spirometry exam. (aluna.io)
  • These results suggest that spirometry during RMC for all persons can detect a significant number of Patients with AFO particularly among the middle and older age groups with a low BMI. (aku.edu)
  • This two-day 'hands-on' course is designed for health professionals who conduct spirometry testing in industrial and clinical settings. (abcspirometrytraining.com)
  • Spirometry is a quick and powerful tool for the screening and clinical evaluation of work-place related lung disease.The practice of occupational health with respiratory programs can help identify whether exposure to particular inhalants in the work environment can affect lung function or exacerbate existing chronic lung disease in workers. (inofab.health)
  • Dr. Enright said he had received income from Pfizer and Schering for consulting on spirometry quality assurance for phase III clinical trials. (copdsupport.ie)
  • The Purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). (aku.edu)
  • Spirometry can be used to help diagnose a lung condition if you have symptoms of a problem, or your doctor feels you're at an increased risk of developing a particular lung condition. (mediwellclinic.co.uk)
  • Additionally, a doctor might order a spirometry exam before surgery or after a sudden surge of poor respiratory symptoms. (aluna.io)
  • Your company provides National Institute for Occupational Safety and Health (NIOSH) approved spirometry training to physicians or other licensed health care professionals (PLHCP). (osha.gov)
  • This National Institute for Occupational Safety and Health (NIOSH)-approved training is designed to provide a review of current spirometry testing standards and guidelines, common errors and corrective actions, and how to differentiate between normal, obstructive, restrictive, and mixed lung disease patterns. (uiowa.edu)
  • The National Institute for Occupational Safety and Health (NIOSH)-approved course is designed to provide a comprehensive theoretical framework combined with practical training necessary to conduct spirometry testing and screening for workers. (abcspirometrytraining.com)
  • Thank you for your letter to the Occupational Safety and Health Administration's (OSHA) Directorate of Enforcement Programs, regarding the retention of spirometry records under OSHA's Respirable Crystalline Silica standards, 29 CFR 1910.1053 and 29 CFR 1926.1153, and OSHA's Respiratory Protection standard, 29 CFR 1910.134. (osha.gov)
  • Earlier studies have suggested that women were less likely to undergo spirometry, but this analysis found that use of the technique was more common for women than men (33.5% versus 29.4%, P =0.001), wrote MeiLan K. Han, M.D., M.S., of the University of Michigan here, and colleagues. (copdsupport.ie)
  • Where an employer contracts with a PLHCP to provide spirometry tests to employees, who is responsible for maintaining records of the results for such tests? (osha.gov)
  • This hands-on workshop is tailored to the needs of your lab/office and staff required to conduct spirometry tests. (michener.ca)
  • The economic impact of 9039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied. (archbronconeumol.org)
  • He listened to my lungs, told me it all sounded good but if it'd help me sleep better, he'd order a spirometry for me. (copdfoundation.org)
  • Do the Respirable Crystalline Silica and Respiratory Protection standards allow PLHCPs to provide employers with records of the results of spirometry tests for purposes of maintaining those records? (osha.gov)
  • Faulty spirometry results? (copdfoundation.org)
  • Study objective: To determine the ability of children and adolescents to meet the American Thoracic Society (ATS) goals for spirometry quality that were based on results from adults. (elsevier.com)
  • Whilst spirometry is used primarily for diagnostic purposes in clinics, it has a different purpose in the field of occupational health where there is an employee-healthcare provider-employer relationship to be considered and results will affect employment-related decisions. (inofab.health)
  • Incorrect spirometry results due to flawed technique or inaccurate interpretations can have significant impacts on conclusions drawn on an employees respiratory health. (inofab.health)
  • Spirometry can be physically difficult for many people as it generally requires forced breathing manoeuvers and the correct breathing technique for accurate results. (inofab.health)
  • Workplace spirometry programs must therefore address how employees will be prepared for spirometry sessions, training and refresher courses for technicians or operators and the interpretation of results in light of each worker's personal details such as baseline or prior tests. (inofab.health)
  • Results: Spirometry performed in the work setting should be part of a comprehensive workplace respiratory health program. (nebraska.edu)
  • Then, the spirometry machine averages the results by looking for two maneuvers that were very similar and averaging those. (workplacetesting.com)
  • ME T HODS : We conducted a systematic review of studies reporting spirometry results in healthy children and adults in Africa. (edu.au)
  • Employers who are implementing workplace respiratory health programs can incorporate methods for implementing these points that have been raised and brought to closer attention of late by many of the leading authorities on spirometry and lung function testing. (inofab.health)
  • EasyOne ® Air is a flexible, accurate and proven spirometry solution designed for healthcare providers large and small. (amtronix.co.za)
  • This course is intended for nurses, medical assistants, and other occupational health and safety practitioners who are responsible for conducting spirometry in the workplace or other settings. (uiowa.edu)
  • Methods: Issues that previous American Thoracic Society spirometry statements did not adequately address with respect to the workplace were identified for systematic review. (nebraska.edu)
  • Conclusions: Important aspects of workplace spirometry are discussed and recommendations are provided for the performance and interpretation of workplace spirometry. (nebraska.edu)
  • however artp have recommenced our hca's course and the main thing she needs to complete her file is the spirometry so we were a little confused. (forumbee.com)
  • Screening for the OA is mainly performed by questionnaire but in our country spirometry is used more commonly. (theijoem.com)
  • We also performed a pre-shift spirometry as the screening spirometry and a post-shift spirometry. (theijoem.com)
  • The efficacy of spirometry as a screening tool in detection of air flo" by Nabeel Manzar, A. Suleman Haque et al. (aku.edu)
  • Kaplan and Stanbrook's comments that spirometry testing "can provide your patients with better care" are not followed by a single cited reference. (cfp.ca)
  • For patients with certain heart conditions, or those who have had recent heart attacks, spirometry may be contraindicated. (towerallergy.com)
  • Spirometry was least likely to be used when diagnosing patients 75 or older. (copdsupport.ie)
  • We are still not undertaking spirometry in primary care, there will be the added complication of winter soon, but diagnosis really does need to start and patients cant be sent to the labs who are already working at reduced capacity. (forumbee.com)
  • Cases with complete CDQ data and spirometry meeting quality standards were analysed (1,054 out of 1,631 patients). (edu.au)
  • The 19.5 cut point excludes a higher proportion of patients from undergoing spirometry with the trade-off of more false negatives. (edu.au)
  • Younger patients, males, and those residing in the Northeast were more likely to receive spirometry. (utmb.edu)
  • Spirometry was performed using standardized methods with central quality control monitoring. (rti.org)
  • Workplaces should also have internal quality control procedures to ensure that technicians and employees are performing and reporting spirometry sessions correctly. (inofab.health)
  • It is also recommended that anyone performing spirometry to become familiar with American Thoracic Society (ATS) standards (see ATS standardization statement) . (carolinadiagnosticsolutions.com)
  • Furthermore, Spirometry may be ordered before a planned surgery to check if your lung function is adequate for the rigors of an operation. (google.com)
  • Spirometry is used to assess lung function by measuring the amount of air inhaled and exhaled, and the speed of exhalation. (towerallergy.com)
  • Spirometry is the cornerstone of respiratory function laboratories and clinics as it is one of the most direct ways of determining the lung function and capacity of an individual. (inofab.health)