Lung Function Tests in Infants and Children

Lung function testing is an essential modality of investigation in children as it provides objective evidence of lung disease/ health. With advances in technology, various tests are available that can aid in the diagnosis of lung disease, assess the progression and response to therapy and document the lung development and evolving lung diseases in infants. This narrative review discusses lung function tests in infants and children. Currently, lung function tests can be performed in every age group, from neonates to the elderly. Spirometry and peak expiratory flow rate (PEFR) are the most employed tests in children more than six years of age. Spirometry helps diagnose and monitoring of both obstructive and restrictive diseases. There is a need for expertise to perform and interpret spirometry correctly. The forced oscillation technique (FOT) or impulse oscillometry (IOS) is done with tidal volume breathing and is feasible even in preschool children. Their utility is mainly restricted to asthma in children at present. Lung function tests can be performed in neonates, infants and children using infant pulmonary function test (PFT) equipment, although their availability is limited. Diffusion capacity for carbon monoxide (DLCO) is a valuable tool in restrictive lung diseases. Lung volumes can be assessed by body plethysmography and multiple washout technique. The latter can also assess lung clearance index. It is essential to perform and interpret the lung function test results correctly and correlate them with the clinical condition for optimum treatment and outcome.

Post-COVID-19 pulmonary function tests in young health care workers in South Indian population – An observational study

Background: The risk of exposure to COVID-19 pandemic was substantially higher in frontline young health care workers. Due to repeated exposure while treating patients, the viral load is exponentially higher than the other population. Lungs being the earliest organ to be affected carry more risk of long-term morbidity. Thus, pulmonary function tests (PFTs) on post-COVID young health care workers provide a better view on the impact, recovery and residual effects. Aim and Objectives: The objectives of the study are as follows: (i) To assess the PFT in study group who have recovered from COVID-19 within the past 3 months; (ii) to compare their lung function with that of health care workers who have not been infected by COVID-19; and (iii) to determine obstructive, restrictive or mixed pulmonary changes if any in health care workers after 3 months of recovery. Materials and Methods: This study involving 50 young health care workers was done in the department of pulmonary medicine for a period of 4 months between January and April 2021. The study (mild COVID-19 positive) control group involved 25 participants each. PFT and diffusing capacity of lung for carbon monoxide (DLCO) were measured using computerized spirometer and single breath method. Results were analyzed using Shapiro–Wilk test, Independent sample t test, and Chi-square test. Results: A statistically significant difference was observed among the subjects of case and control group with respect to the level of FEV1 (P < 0.05), FEV1/Forced vital capacity (FVC) (P < 0.01), and FEF. FVC, Peak expiratory flow (PEF), forced expiratory time, DLCO, and peak inspiratory flow (PIF) were not statistically different between the study and control group. (P > 0.05).The 3-month post recovery values were high in males when compared to females, except for PIF, PEF and FEV1%. Conclusion: PFT and DLCO values were normal in young health care workers after 3 months of COVID-19 infection except for a decrease in FEF 25–75%.

Study of lung function tests in tea garden factory workers in relation to duration of exposure to tea dust

Background: Occupational hazard is a common health problem in the world today. The tea industry is also no exception. Tea dust inhalation leads to development of many respiratory symptoms: Acute as well as chronic. Workers in the tea factory often are not aware of the ill effects of inhalation of tea dust. There is therefore a need to make them aware of their working environment and take necessary precautions to keep themselves healthy to earn their livelihood. Aims and Objectives: The aim of the study was to assess the pulmonary function tests (PFT) in tea garden factory workers and assess the outcome of exposure duration to tea dust in them. Materials and Methods: The study had been carried out on 210 male tea garden factory workers (cases) and 70 male field workers (control) employed in various tea gardens of Dibrugarh, in Assam. Computerized spirometer was used to evaluate PFTs. The cases were categorized into three categories (70 numbers in every category) according to their exposure duration, namely – Category 1: Exposure duration <1 year; Category 2: Exposure duration of 1–2 years; and Category 3: Exposure duration of >2 years up to 5 years. Statistical analysis was done using ANOVA. Results: On comparing with control group values, statistically significant decline of forced vital capacity and forced expiratory volume (FEV)1 values were seen in Category 1 while highly significant decline were seen for Categories 2 and 3. Decline of FEV1% in Category 3 was highly significant. Decline of peaked expiratory flow rate values in Category 2 and Category 3 was significant. Conclusion: Increase in exposure duration to tea dust causes a significant decline in lung functions.

Association of Serum Level of Vitamin D3 and Pulmonary Function in Bronchial Asthma Patients in A Tertiary Care Hospital of South Gujarat, India

Introduction: Asthma is a chronic lung disease characterised by reversible airway obstruction, cellular infiltration, and airway inflammation. The reaction is characterised by the interaction of genetic and environmental variables, as well as the activation of cells in the innate and adaptive immune systems. Method: The study was conducted in the Department of General medicine, in Tertiary Care Center, to study association of serum level of Vitamin D3 and pulmonary function in bronchial asthma patients. As per inclusion and exclusion criteria ,137 patients of bronchial asthma were included in the study. Result: In cases having serum vitamin D3 level <20 ng/ml mean value of FVC, FEV1, FEV1/FVC ratio, was 108.10�.89, 68.56�.40, and 62.35�17. In cases having serum vitamin D3 20-29 ng/ml, mean value of FVC, FEV1, and FEV1/FVC ratio was 109.72�.22, 72.34�.48, and 64.39�97. In cases having serum vitamin D3 >30 ng/ml mean value of FVC, FEV1, and FEV1/FVC ratio, was 115.0�27, 81.0�09, and 70.52�00. Conclusion: Vitamin D3 deficiency was highly prevalent in asthmatic patients, there was a strong correlation between asthma severity and vitamin D3 concentrations and there was a direct and a positive significant correlation between vitamin D3 levels and pulmonary function test in asthmatic patients.

Study of Pulmonary Function and Chest Radiographic Abnormalities in Patients with Rheumatoid Arthritis

Background: Interstitial lung disease (ILD) is one of the important contributors for morbidity and mortality in rheumatoid arthritis (RA) patients. There is paucity of reliable published data on burden of lung disease in RA patients from Andhra Pradesh, India. Materials and methods: This was an observational study in which 88 patients were evaluated. History and clinical features, including disease-severity score, imaging, and pulmonary function tests were recorded. The data were subjected to statistical analysis. Results: The mean age was 49.4 � 10.3 years. Females outnumbered males. Disease duration was less than 2 years in 60.2% of subjects. Respiratory complaints were noted in 12 patients. Seropositivity was noted in 59% of patients. Based on Disease Activity Score 28, high disease activity was seen in 70.5%, moderate activity in 25%, remission in 3.4%, and low activity in 1.1%. Chest radiography showed abnormalities in 4.5%. Pulmonary function tests revealed abnormalities in 23.9% of patients. High disease activity, duration of disease, and seropositivity were not significantly associated with respiratory abnormalities in our study. Conclusion: Patients with RA should be evaluated for pulmonary involvement during their routine follow-up, which can be helpful in early detection and intervention of ILD and therefore reducing morbidity and mortality.

Pulmonary Dysfunction in Transfusion-Dependent Thalassemia and Response to Intensive Chelation Therapy

Objectives: To evaluate pulmonary functions in children with transfusion-dependent thalassemia, and its reversal (lung dysfunction) using intensive intravenous chelation with desferrioxamine (DFO) (4 weeks). Methods: This descriptive study enrolled 77 children with transfusion-dependent thalassemia. Pulmonary function test (PFT) and iron load (serum ferritin (SF) & T2* MRI of heart and liver) were done. PFT included spirometry, total lung capacity (TLC) by helium dilution test and diffusion capacity by carbon monoxide (DLCO). Follow-up PFT was available for 13 children with moderate to severe lung dysfunction given intravenous DFO. Results: 50 (68.8%) patients had lung dysfunction, most commonly diffusional impairment (48; 96%), and reduced TLC (11; 22%); and none had obstructive pattern. 9 (81.8%) patients with restrictive defect had moderate to severely deranged DLCO. PFT and T2* MRI values were inversely correlated with serum ferritin. Among 13 patients receiving intensive chelation for 4 weeks, significant improvement was noticed in forced expiratory volume in one minute/ forced vital capacity ratio (?FEV1/FVC) (P=0.009), ?DLCO (P=0.006) and ?SF (P=0.01). Conclusions: Pulmonary dysfunction is common in children with multi-transfused thalassemia, and routine screening by PFT needs to be part of the management guidelines.

Correlation of serum ferritin levels with pulmonary function tests in thalassemia patients

Background: Iron overload is an inevitable complication of thalassemia. Pulmonary function test (PFT) abnormalities have been described but the results of the studies correlating serum ferritin levels with PFTs have shown inconsistent results. Aims and Objectives: The objectives of the study were (1) to determine the frequency of PFTs abnormalities and (2) to correlate serum ferritin levels with PFTs. Materials and Methods: PFTs were done in 50 patients with thalassemia over 8–27 years of age using spirometer. Mean serum ferritin level in the preceding 1 year was taken. Results: PFTs were normal in 54%, restrictive in 34%, obstructive in 10%, and combined restrictive and obstructive in 2% of the patients, respectively. There was inverse correlation between serum ferritin and FEV1 and FVC but it was not statistically significant. Conclusion: Abnormalities of PFTs are common in thalassemia patients. Inverse relation of serum ferritin with FEV1 and FVC may indicate possible role of iron in the etiopathogenesis of PFTs abnormalities but its significance needs to be evaluated further.

A cross-sectional study of pulmonary function test in traffic policemen of Gangtok, East Sikkim, North East India

Background: Vehicular or automobile emission constitutes a significant health injury to traffic policemen posted at thenumerous traffic junctions. Aim and Objectives: Evaluating the spirometric lung function test parameters of traffic policemen posted in Gangtok town and to compare and measure the findings with general police personnel and also to study the effect of exposure to long-term automobile pollution. Materials and Methods: In this study, after matching for anthropometric variables such as weight, height, and body mass index, 40 traffic policemen were taken as case and 40 general duty policemen were taken as control groups. The exclusion criteria were duly screened, and only those subject who fulfilled the inclusion criteria were included after which the spirometric pulmonary function tests (PFT) ‘s evaluation was done. The indices measured in the study included (1) Forced vital capacity (FVC) (2) Forced expiratory volume in 1 s (FEV1) (3) FEV1/FVC ratio (4) Peak expiratory flow rate (PEFR) (5) Forced mid expiratory flow (FEF 25–75%). Spirometric indices of the subjects and controls were statistically analyzed using the student’s t test and p value computed against the degree of freedom. Results: The traffic policemen showed decline in various PFT indices as compared to controls in terms of FVC(L), FEV1 (L), FEV1/FVC, FEF 25–75%, PEFR, although it was not statistically significant. Conclusion: The traffic policemen working in Gangtok town had decreased PFT, although it was not statistically significant in this study. Even then, we strongly recommend for the adoption and practice of various preventive measure from vehicular pollution and conduction of further studies on larger samples.

Effect of age, gender, and body mass index on peak expiratory flow rate and other pulmonary function tests in healthy individuals in the age group 18–60 years

Background: Normal ageing and increasing body mass index (BMI) are related to decline in lung functions in adults in both genders. Females are more likely than age and height-matched males to show smaller lung size and diffusion surface, lower maximal expiratory flow rate, and reduced airway diameter. Lung mechanics and respiratory muscle strength, thoracic compliance, airway resistance, and elastic recoil of the lungs determine the pulmonary function tests (PFTs), and these tests are known to differ with age, sex, socio-economic status, cultural factors, and geographical region of the subject and are related to weight, height and BMI of the individuals. Aim and Objectives: The present study is planned to assess the peak expiratory flow rate (PEFR) and other PFTs and to evaluate the effect of age, gender and BMI on these lung functions. Materials and Methods: This study consists of 200 healthy individuals of age group 18–60 years. A sample was stratified into 5 age groups, and on the basis of BMI, the subjects were categorized as underweight, normal, overweight, and obese. Anthropometric measurements were recorded using standard procedures. PEFR was recorded using Wright’s peak-flow meter and forced vital capacity (FVC), Forced Expiratory Volume in 1 s (FEV1), FEV1/FVC, FEF25–75%, FEF2–1.2, slow vital capacity (SVC), and maximum voluntary ventilation (MVV) were analyzed using Expirograph (Helios 401, RMS, India). Chi-square test was used for analysis of categorical variables. For comparison of two groups, unpaired t-test was used and to assess the relation between the variables, Pearson’s co-relation was used. One way ANOVA was used to compare the difference between the means of more than two groups and Tukey post hoc analysis was done for multiple comparisons. Results: There was highly significant difference in the mean values of PEFR and other PFTs (P < 0.000) among the 5 age groups and a significant difference between younger and older age groups. PEFR, FVC, FEV1, FEV1/FVC, FEF25–75%, FEF0.2–1.2, SVC, and MVV were negatively correlated with age (r = ?0.514, ?0.535, ?0.568, ?0.255, ?0.566, ?0.516, ?0.304, ?0.523, respectively). Females showed reduced mean values of PEFR, FVC, FEV1, FEF25–75%, FEF0.2–1.2, SVC, MVV when compared to males (P < 0.000), and the differences in the mean values were significantly high. Highly significant difference was seen in the mean values of PEFR and other PFTs among the categories of BMI (P < 0.000). The mean values of FVC, FEV1, FEV1/FVC, FEF25–75%, FEF0.2–1.2, MVV were lower among underweight compared to their mean values among individuals with normal BMI. There was negative correlation between PEFR, FVC, FEV1, FEF25–75%, FEF0.2–1.2, SVC, MVV, and BMI (r = ?0.327, ?0.254, ?0.238, ?0.269, ?0.254, ?0.236, ?0.195, respectively). Conclusions: PFTs aid in the prompt and accurate diagnosis of respiratory disorders, such as asthma, chronic obstructive pulmonary disease allowing for efficient management by encompassing a thorough understanding of the disease and exercise respiratory training regimens even in otherwise healthy individuals. The present study showed that PEFR and other PFTs decrease with advancing age and BMI and females showed reduced lung functions compared to males.

A cross-sectional study of post-COVID syndrome at a tertiary care center in Turkey

Objective: To investigate long-term symptoms after acute COVID-19, the link between symptoms and respiratory function, radiological changes in the post-COVID period, and risk factors for post-COVID syndrome. Methods: In this cross-sectional study, 123 participants who were admitted within the first 3 months were categorized as group 1, and those who applied after 3 months were categorized as group 2. According to thoracic imaging and pulmonary function tests, patients were split into 3 groups as mild, moderate and severe. Results: At least one symptom was present in 91.9% and 61.8% in acute and post-COVID period, respectively. Pulmonary function tests were normal in 60 (70.6%) in the first three months, and 30 (78.9%) in 91-days to 1-year period after acute COVID-19 infection. After 3 months, 22.4% of chest X-rays and 7.9% of computerized tomography revealed progression. Patients who developed acute complications (OR 9.91, 95% Cl 1.93-50.87), had 2 or more symptoms at admission (OR 7.73, 95% CI 2.56-23.33), had 1% to 14% CT involvement (OR 3.05, 95% CI 1.06-8.79), or had 50% or more CT involvement (OR 14.68, 95% CI 1.24-172.55) had a higher risk of developing post-COVID syndrome. Conclusions: COVID-19 symptoms can last for long time. Severity of symptoms, acute complications, and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome. As a result, patients with COVID-19 should be checked for long-term clinical difficulties on regular basis.

The clinical significance of pulmonary function tests in children with community acquired pneumonia / 国际儿科学杂志

Objective:To explore the value of early pulmonary function tests in children with community acquired pneumonia(CAP)by analyzing the clinical and imaging manifestations and pulmonary function tests of children with CAP.Methods:The clinical data of children diagnosed with CAP and undergoing routine pulmonary ventilation tests within 24 hours of admission were retrospectively collected from January 2016 to June 2018 in the Department of Pediatric Respiratory Medicine of Shengjing Hospital Affiliated to China Medical University.The children′s pulmonary ventilation function test data were statistically analyzed with clinical manifestations, laboratory tests and imaging data.Results:A total of 154 children were included in the study, of which 54(35.06%)had normal pulmonary ventilation function, and the remaining 100 children(64.94%)had different degrees of pulmonary ventilation impairment, which were manifested as restrictive ventilation disorder in 54 cases(35.06%), obstructive ventilation disorder in 8 cases(5.19%), mixed ventilation disorder in 30 cases(19.48%), and small airway ventilation dysfunction in 8 cases(5.19%). According to the results of pulmonary ventilation function, the mixed ventilation dysfunction group had a greater probability of pulmonary imaging changes to consolidation than the normal group( χ2=7.83, P=0.007). Mycoplasma pneumoniae infection was negatively correlated with forced expiratory volume in the first second, 75% forced expiratory flow, one second rate and maximal mid-expiratory flow level( r=-0.23, r=-0.22, r=-0.25, r=-0.23, all P<0.05), and there was no significant correlation with the level of forced vital capacity. Conclusion:Early pulmonary ventilation test has important clinical significance in the diagnosis and treatment of CAP in children.

Recommendations for pulmonary function laboratories in the COVID-19 era / Recomendaciones para el laboratorio de función pulmonar en la era COVID-19

Abstract The airborne spread is the main route of human-to-human transmission of coronavirus, including he SARS CoV-2 virus causing the disease known as COVID-19. The implicit risk of aerosolization of SARS CoV-2 infective microdroplets while carrying out respiratory function tests has caused a significant limitation of activity in most Pulmonary Function Laboratories since the beginning of the pandemic. This document aims to update the recommendations for the management of Pulmonary Function Laboratories in the context of the COVID-19 outbreak in Argentina. New recommendations include ways to carry out pulmonary function testing during the context of a high and low community viral spread phase, the evaluation of post-COVID-19 patients, as well as several aspects of biosafety for patients and operators. Measures consist of promoting air circulation in the environment, the use of antimicrobial filters, the protection of airways and mucous membranes, and hand washing.

Resumen La diseminación aerógena del virus SARS CoV-2 es la principal forma de transmisión interhumana de este coronavirus causante de la enfermedad conocida como COVID-19. El riesgo implícito de la aerosolización de microgotas infectantes del SARS CoV-2 durante la ejecución de las pruebas funcionales respiratorias ha provocado una importante limitación de la actividad en la mayoría de los laboratorios de función pul monar desde el inicio de la pandemia. Este documento tiene por objetivo actualizar las recomendaciones para el manejo del laboratorio de función pulmonar en el contexto de la epidemia COVID-19 en Argentina. Se incorporan nuevas recomendaciones para realizar pruebas funcionales respiratorias en el contexto de una fase alta y baja de circulación viral comunitaria, para pacientes post COVID-19, así como para la bio seguridad de pacientes y operadores. Las medidas incluyen la ventilación del ambiente, el uso de filtros antimicrobianos, la protección de vía área y mucosas y el lavado de manos.

High-resolution CT pulmonary findings in children with severe asthma

Abstract Objective: To compare quantitative CT parameters between children with severe asthma and healthy subjects, correlating to their clinical features. Methods: We retrospectively analyzed CT data from 19 school-aged children (5-17 years) with severe asthma and 19 control school-aged children with pectus excavatum. The following CT parameters were evaluated: total lung volume (TLV), mean lung density (MLD), CT air trapping index (AT%) (attenuation ≤856 HU), airway wall thickness (AWT), and percentage of airway wall thickness (AWT%). Multi-detector computed tomography (MDCT) data were correlated to the following clinical parameters: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), FEV1/FVC ratio, sputum and bronchoalveolar lavage analysis, serum IgE levels, and previous hospitalizations due to asthma. Results: Asthma patients presented higher mean values of AT% (23.8 ± 6.7% vs. controls, 9.7 ± 3.2%), AWT (1.46 ± 0.22 mm vs. controls, 0.47 ± −735 ± 28 HU vs. controls, −666 ± 19 HU). Mean AT% was 29.0 ± 4.7% in subjects with previous hospitalization against 19.2 ± 5.0% in those with no prior hospitalization (p < 0.001). AT% presented very strong negative correlations with FVC (r = −0.933, p < 0.001) and FEV1 (r = −0.841, p < 0.001) and a moderate correlation with FEF 25-75% (r = −0.608, p = 0.007). AT% correlation with FEV1/FVC ratio and serum IgE was weak (r = −0.184, p = 0.452, and r = −0.363, p = 0.202) Conclusion: Children with severe asthma present differences in quantitative chest CT scans compared to healthy controls with strong correlations with pulmonary function tests and previous hospitalizations due to asthma.

Predictors of functional capacity as measured by the Glittre activities of daily living test in women with rheumatoid arthritis

Although pulmonary involvement is the most common extra-articular manifestation of rheumatoid arthritis (RA), traditional pulmonary function tests (PFTs) do not show a good correlation with the field tests usually performed in these patients. In recent decades, measurement of ventilation distribution heterogeneity through the nitrogen single-breath washout (N2SBW) test and evaluation of functional capacity during exercise using the Glittre activities of daily living test (GA-T) have been increasingly used. Therefore, the objective of this study was to evaluate predictors of GA-T outcomes in women with RA considering demographic, anthropometric, clinical, functional variables, and chest computed tomography (CT) findings. Forty-three women with RA underwent the GA-T, the N2SBW test, spirometry, measurement of the diffusing capacity for carbon monoxide (DLco), measurement of respiratory muscle strength, and evaluation of physical function of the lower and upper limbs through the Health Assessment Questionnaire Disability Index (HAQ-DI). Chest CT scans were analyzed retrospectively. The GA-T time showed significant correlations with the DLco (rs=-0.397, P=0.008), forced vital capacity/DLco (rs=0.307, P=0.044), phase III slope of the N2SBW test (SIIIN2, rs=0.644, P<0.0001), and the HAQ-DI (rs=0.482, P=0.001). Disease extent as assessed by chest CT was associated with the GA-T time. On multiple regression analysis, the SIIIN2 and HAQ-DI were the only predictors of the GA-T time, explaining 40% of its variability. Thus, ventilation distribution heterogeneity and worse physical function substantially explain the variability in GA-T time in women with RA and varying extents of disease on chest CT.

A Study of Respiratory Symptoms and Disorders among Rice Mill Workers

In India, rice is the staple food for most people and many people are employed in rice mills. With lack of specific guidelines for rice mills’ establishment and operation, workers face a lot of problems especially from respiratory illness. We wanted to determine the pattern of respiratory symptoms and pulmonary function disorders among rice mill workers and provide health education to reduce respiratory morbidity. METHODSA cross-sectional study was conducted during the period October 2016 – 2018. A total of 50 rice mill workers and 50 normal individuals were assigned to the exposure and control groups respectively. Each individual was interviewed using the British Medical Research Council questionnaire and was later subjected to physical examination, routine laboratory investigations, and pulmonary function tests (PFT). Data was statistically analysed and presented. RESULTSThere was a higher prevalence of respiratory symptoms among the rice mill workers when compared to their control counterparts. Cough (28 %) was the predominant symptom and was high in those involved in sweeping and cleaning activities (80 %). There was a statistically significant difference (p < 0.05) among all the spirometric parameters tested like FEV1, FVC, FEV1 / FVC and PEFR except for FEF. About 74 % had respiratory morbidity and obstructive lung diseases (36 %) were predominant as compared to restrictive lung diseases (26 %) and mixed lung disorders (12 %) in the exposure group. Obstructive pattern was predominantly seen in those with a working history of < 10 years and restrictive and mixed patterns were predominantly seen in those with a working history of >10 years. With increase in duration of work, prevalence of respiratory symptoms as well as the severity increased. CONCLUSIONSIt can be concluded that rice mill workers are at a higher risk of acquiring respiratory symptoms and lung impairments. Therefore, it is necessary to implement preventive measures by means of controlling dust emission, educating the workers, etc. Workers should also have periodical clinical and spirometric evaluation and those showing significant impairment should be readjusted in other sections of the industry.

Effect of obesity on lung volumes among adults

Background: Obesity has long been recognized to have significant effect on respiratory functions. Many studies have reported exponential decrease in pulmonary function test (PFT) with increasing body mass index (BMI), which is a crude indicator of obesity. Also, the relationship between BMI and PFTs varies with age, race, geographical region and the different obesity standards used. To the best of our knowledge, not many studies have been done to examine the relationship between obesity and lung volumes among adults in our region, Jammu. This cross-sectional study was carried out with the objective of evaluating the effect of obesity on lung function test in obese but otherwise healthy adults of Jammu region.Methods: This cross-sectional study was conducted in Jammu region on subjects selected randomly from different colleges in the age group of 18-40 years. The study involved 300 subjects; divided into three groups of 100 each, based on BMI into normal, overweight and obese groups. Four respiratory parameters viz. FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 second), FEV3 (Forced Expiratory Volume in 3 seconds), and MVV (Maximum Voluntary Ventilation) were used to assess their lung functions.Results: All the respiratory parameters exhibited statistically significant decrease in obese groups as compared to normal and overweight groups.Conclusions: The present study suggests that obesity alters the respiratory physiology by producing a restrictive ventilatory pattern.

Sarcoidosis: Analysis of 24 cases

Sarcoidosis is a systemic granulomatous inflammatory disease of unknown etiology and variable incidence. For the purpose of de­scribing the clinical presentation of a group of patients diagnosed with sarcoidosis in a community hospital, we reviewed the medical records of patients whose diagnosis was consistent with sarcoidosis between 2007 and 2017. In this period, 24 patients were included and staged at presentation according to radiological data, showing that 75% were Stage I, 5% stage II, 10% stage III, and 10% stage IV. 60% of patients were treated. This study describes the patients' characteristics with the aim of helping to identify this entity and optimize early diagnosis and treatment.

Biomedical system to evaluate pulmonary function in patients with post-stroke hemiparesis / Sistema biomédico para avaliação da função respiratória de pacientes hemiparéticos por acidente vascular encefálico

Abstract Introduction: Stroke is a neurological disorder considered the second major cause of death worldwide, leading to severe respiratory dysfunctions, evident in reduced respiratory muscle strength and the presence of muscle imbalances that directly affect the pulmonary mechanics of these patients. Objective: Evaluate the possible metric properties of a biomedical system, the IBI. Method: the study was conducted with 25 hemiparetic stroke patients of both sexes, using a manovacuometer, peak flow, and SG IBI for respiratory measurements. Results: Moderate to strong correlations were observed between the IBI biomedical system and peak flow and manovacuometer measurements, which were smaller than the predicted values. Conclusion: The results suggest that the IBI biomedical system is potentially valid for pulmonary function measurement, sensitive to air flow variations and generates maximum respiratory pressure. As such, it is an important resource for prescribing intensity and controlling progression in pulmonary rehabilitation.

Resumo Introdução: O Acidente Vascular Encefálico (AVE) é um distúrbio neurológico que ocupa o segundo lugar entre os eventos que causam os maiores índices de mortalidade mundialmente, ocasionando diversas disfunções respiratórias, evidenciadas pela redução da força muscular respiratória e presença de desequilíbrios musculares que afetam diretamente a mecânica pulmonar desses pacientes. Objetivo: Avaliar as possíveis propriedades métricas do Sistema Biomédico, I blue It (IBI). Método: O estudo foi realizado com 25 participantes voluntários de ambos os sexos hemiparéticos por AVE, sendo realizado para a mensuração respiratória: Manovacuômetro, Peak Flow e o IBI. Resultados: Moderadas a fortes correlações foram observadas entre o IBI e as medidas no Peak Flow e Manovacuômetro, sendo tais medidas menores que os valores preditos. Conclusão: Os resultados encontrados nesta pesquisa sugerem que o IBI possui potencial validade de mensuração da função respiratória, e é sensível as variações de fluxo aéreo e a capacidade de gerar pressões máximas respiratórias, portanto sendo importante recurso de prescrição de intensidade e controle da progressão em reabilitação respiratória.

Multi detector computed tomography evaluation in chronic obstructive pulmonary disease and correlation with severity of disease

Background: Multi Detector computed tomography (MDCT) may effectively characterize and quantify the extent of emphysema and the air trapping related to the small airway’s disease. Here we highlight the computed-tomography findings of Chronic Obstructive Pulmonary Disease (COPD) and correlation with the Spirometrics values.Methods: The study group included the total of 100 adult patients of either sex with a clinical suspicion of COPD and those who undergone MDCT of thorax. Lung function of the patients with the COPD stages mild to very severe was evaluated by both the MDCT and Spirometrics Pulmonary Function Tests (PFTs). The scanning was done at maximum end inspiration and maximum end expiration.Results: There was a preponderance of male patients with highly significant correlation between values of mean lung density and low attenuation values (p<0.000I). MDCT correlated well with those obtained from spirometric Pulmonary Function Tests in the patients with COPD and that the correlation at expiration was superior to that at inspiration.Conclusions: The study concludes that Multi-detector computed tomography is the invaluable tool in defining and quantifying COPD and the characterization of emphysematous changes.

Study on Impact of Obesity on Lung Volumes in Elderly Population

Introduction: The Pulmonary function tests in subjects withnormal BMI and with obese individuals were done andcorrelated with the severity of obesity. Considering the PFTchanges, normal study was present in 17%. But, remainingindividuals showed proportionate decrease in both FEV1 andFVC values. These changes were independent of age, sex andblood pressure.Methods and Results: Selection of the Subjects Obeseindividuals of about 30 people with BMI >30 of both sexes ofage group between 30 -45 years were included in this study.The healthy volunteers, visitors or relatives of patients visitingS. P. Medical College Hospital, Bikaner Rajasthan were takenas subjects. So, the PFT changes are more of restrictive thanobstructive pattern which can leads to decreased chest walland lung compliance, respiratory muscle strength andendurance which ultimately ends in poor pulmonary ventilation.Hence, this non-invasive procedure may be utilized as aroutine screening test for obese people for better medical care.Conclusion: Thus, obesity is associated with a wide variety ofPFT abnormalities, many of which can be corrected by weightloss