Athletics-The World's Most Measurable Sport, but at What Price? A Comparison of Fully Automatic Timing with Times Measured with Standard Mobile Phones.

The aim of this study is to quantify potential systemic timing bias between fully automatic timing (FAT) and timing with iPhone camera (Apple Inc., Cupertino, CA, USA) and then consider whether an iPhone can be used as an inexpensive timing system for sprint events at athletics competitions. A flashlight was aimed at FAT camera (Lynx System Developers, Haverhill, MA, USA) and two iPhones, at 120 and 240 frames per second (fps), respectively, so that they could capture the light from it. By turning the flashlight on and off at varying intervals (1-33 s, average 9.5 s), the cameras captured a series of light beams. The time intervals between the start of two light beams were measured 31 times on the recordings from all the cameras. On each recording with the iPhones, two analyses were performed: one where the video image before the light beam (start before light) from the flashlight was set to 0 s and one where the first image with the light beam (start on light) was set to 0 s. Start on light showed no significant time differences compared to FAT. With 240 fps the standard deviation was ± 0.001 s, 29% of the times were the same as FAT, while 81% of the times are within ± 0.001 s. The largest deviation was a time of -0.003 s from FAT. With 120 fps there was a standard deviation of ± 0.003 and a maximum deviation of -0.006 s, where 39% of the times were within ± 0.001 s. At start before light, a significant but expected difference was found with an average deviation of +0.008 s with 120 fps and +0.004 s with 240 fps, with maximum deviations of +0.014 and +0.006 s. It can be concluded that the camera on an iPhone is accurate as we did not find any systematic bias from FAT with start on light.

Participation in organized sports is associated with decreased likelihood of unhealthy lifestyle habits in adolescents.

Adolescence is a pivotal time for investing in both present and future health. Thus, it is important to identify arenas for promoting positive adolescent health behaviors and preventing negative ones. The aim of this study was to investigate the associations between organized sports participation (OSP) and a broad range of lifestyle habits in Norwegian adolescents. A comprehensive survey was completed by 13 269 junior high and high school students in southern Norway. Multivariable binary logistic regression models, adjusted for gender, age, and parental education, were used to investigate the associations between OSP and adolescent substance use, dietary habits, physical activity level, passive vs active transportation, screen time, and sleep duration. Inverse associations were found between OSP and adolescent substance use (odds ratio 0.40 [95% confidence interval 0.30-0.52] to 0.68 [0.61-0.76]), irregular consumption of main meals (0.58 [0.53-0.63] to 0.78 [0.70-0.89]), high intake of unhealthy food and beverages (0.55 [0.47-0.65] to 0.86 [0.75-0.98]), low intake of healthy food items (0.57 [0.51-0.63] to 0.77 [0.70-0.84]), low physical activity level (0.15 [0.14-0.17]), high screen-based activity (0.61 [0.55-0.67]), passive vs active transportation (summer; 0.79 [0.72-0.86] and winter; 0.84 [0.77-0.92]), and short sleep duration, during both weekdays (0.57 [0.52-0.63]) and weekends (0.79 [0.69-0.89]). In conclusion, adolescents participating in organized sports had decreased odds for engaging in several unhealthy lifestyle habits compared with non-participants, indicating that organized sports may be a relevant setting for promoting healthy behaviors among adolescents. Future studies are, however, needed to confirm a possible causal relationship.

Childhood football play and practice in relation to self-regulation and national team selection; a study of Norwegian elite youth players.

Childhood sport participation is argued to be important to understand differences in self-regulation and performance level in adolescence. This study sought to investigate if football-specific activities in childhood (6-12 years of age) is related to self-regulatory skills and national under 14- and 15-team selection in Norwegian elite youth football. Data of practice histories and self-regulatory skills of 515 youth football players selected at Norwegian regional level were collected and further analysed using multilevel analyses. The results revealed that high self-regulated players were more likely to be selected for national initiatives, and increased their involvement in peer-led football practice and adult-led football practice during childhood, compared to players with lower levels of self-regulation. While national level players reported higher levels of peer-led football play in childhood, the interaction effect suggest that the regional level players increased their involvement in peer-led play during childhood compared to national level players. In conclusion, the findings indicate that childhood sport participation may contribute to later differences in self-regulation, and highlights the importance of childhood engagement in football-specific play and practice in the development of Norwegian youth football players.

The role of gender in the relationship between physical activity, appearance evaluation and psychological distress.

BACKGROUND: Based on previous research, the aim of this cross-sectional study was to examine the indirect effect of physical activity on psychological distress through appearance evaluation. The indirect effect was hypothesized to be conditional on gender, with the effect being more profound among females than among males. METHOD: A total of 2055 adolescents (Mage  = 15.3) completed a self-report questionnaire. RESULTS: Physical activity was indirectly related to psychological distress through appearance evaluation in both males and females, but the indirect effect was stronger for females than for males. CONCLUSIONS: Physical activity may prevent distress through enhanced appearance evaluation.

Optimization of Sprint Training Among European Coaches: Quality Over Quantity.

PURPOSE: To describe how high-level European sprint coaches (from 100 to 400 m) work to improve important factors associated with the quality of the holistic training process and the quality of the specific training session. METHODS: A descriptive analysis was conducted using questionnaires from 31 European elite sprint coaches (ie, training athletes defined as tiers 3, 4, and 5) who participated voluntarily. RESULTS: The coaches used traditional periodization (45%) with a 10- to 15-day tapering phase (48%) that includes a reduction in volume, maintenance of intensity, and focus on correct technical execution. In the 3 mesophases, coaches prioritized the basic development of strength and sprint work in the first phases of the season and emphasized more sprint-specific work in the competitive phase. Before sessions, adjustments were made based on factors such as psychological (77%), technical (48%), and physical (39%) parameters. In-session load management relies on a combination of objective and subjective measures (55%), in which the dialogue with athletes (65%) was regarded as the main resource. Feedback during and after sessions covers technical (54%), psychological (48%), and physical (35%) aspects. Recovery protocols after sessions mainly involve rest and professional guidance (42%). For performance assessment and testing, coaches utilize countermovement jump (52%), force-velocity profile (45%), and 30-m flying (61%) as main tools. CONCLUSIONS: European sprint coaches demonstrated a comprehensive approach to planning and management, shedding light on the multifaceted nature of their training methodologies and the diverse tools employed for athlete testing and monitoring.

Lung disease, T-cells and inflammation in common variable immunodeficiency disorders.

INTRODUCTION: Besides hypogammaglobulinemia and recurrent infections, abnormalities of T-cells might contribute to lung damage in common variable immunodeficiency disorders (CVID). MATERIALS AND METHODS: In 16 adult patients, the majority of whom had pulmonary abnormalities, we studied T-cell subsets and markers of inflammation in bronchoalveolar lavage fluid (BALF) and blood and their relations with pulmonary function and high resolution computed tomography (HRCT). RESULTS: We demonstrated that some of the lymphocyte abnormalities previously demonstrated in peripheral blood from CVID patients, such as low CD4/CD8 T-cell ratio, were also present in BALF. Moreover, low BALF CD4/CD8 ratio (≤ 1), found in seven patients, was significantly associated with higher blood CD8⁺ cell count and to lower values of the lung function variables; forced expiratory volume (FVC), total lung capacity (TLC), vital capacity (VC) and residual volume (RV) in % of predicted. The expression of the inflammatory markers HLA-DR and CCR5 on T-cells was significantly higher, and the expression of CCR7 significantly lower, in BALF compared to blood, possibly reflecting an inflammatory/cytotoxic T-cell phenotype within pulmonary tissue in CVID. Furthermore, patients with bronchiectasis had higher concentrations of the pro-inflammatory cytokine TNFα in plasma, compared to those without. CONCLUSION: Our findings suggest that inflammation and T-cell activation may be involved in the immunopathogenesis of pulmonary complications in CVID.

Towards More Sustainable Sports: Analyzing the Travel Behavior of Adolescent Soccer Players in Southern Norway.

Mitigating climate change is a global challenge demanding effort from all sectors, and sports are no exception. While transportation is one of the key issues regarding sustainable sports, the methods by which children and adolescents get to practice have not received much attention. The objectives of this study were, therefore, to present how adolescents in Southern Norway travel to soccer practice and assess how the mode of transportation is related to sex, socioeconomic status, age, ethnicity, and distance from home to practice. Cross-sectional data were collected from 558 adolescent soccer players (398 boys and 190 girls) representing 30 different clubs from settlements of varying rurality. While most of the participants lived within cycling distance from the field of practice, the majority opted for passive modes of transportation (55% passive vs. 45% active). A logistic regression analysis found that traveling distance and age were associated with active transportation habits, while sex, ethnicity, and socioeconomic status were not. Further research is needed to examine the main barriers to active travel for this already active population, as active transport represents an opportunity for sports to become more sustainable.

Pulmonary outcome in juvenile dermatomyositis: a case-control study.

OBJECTIVES: To compare pulmonary function in patients with juvenile dermatomyositis (JDM) with that of matched controls; and to examine associations between pulmonary function impairment, high-resolution CT (HRCT) abnormalities and other disease variables in patients with JDM. METHODS: A total of 59 patients with JDM clinically examined a median 16.8 years (range 2-38 years) after disease onset were compared with 59 age-matched and sex-matched controls. Pulmonary function tests included spirometry, diffusing capacity for carbon monoxide (DLCO) and body plethysmography. In patients with JDM, HRCT scans were performed and cumulative organ damage and patient-reported health status assessed. RESULTS: Patients with JDM had lower total lung capacity (TLC) and DLCO compared to controls (p=0.003 and <0.001, respectively). A low TLC was found in 26% of patients versus 9% of controls (p=0.026), and a low DLCO in 49% of patients versus 9% of controls (p<0.001). HRCT abnormalities were found in 37% of patients, and included interstitial lung disease (ILD) (14%), chest wall calcinosis (14%) and airway disease (15%). Three patients were diagnosed as having ILD prior to the follow-up visit. A low TLC was more often found in patients with than without abnormal HRCT (50% vs 12%, p=0.002). HRCT abnormality correlated with cumulative organ damage (r(s)=0.346, p=0.008) and patient-reported health status at follow-up (p<0.005). CONCLUSIONS: Patients with JDM had smaller lung volumes than controls; a restrictive ventilatory defect was found in 26% and HRCT abnormality in 37% of the patients, and these findings were associated. Although mostly subclinical, the relatively high frequency of pulmonary involvement highlights the systemic nature of JDM.

Experiences of Older Adults Preparing for Their First Triathlon: "A Qualitative Study of the Participation in an Endurance Training Intervention."

Purpose: The overall aim of the present study was to explore the experiences of older adult exercisers participating in an individualized training program lasting 3 months preparing for completing a triathlon competition. Methods: Fourteen older Norwegian adults (median age (interquartile range, IQR) for males (N=10) and females (N=4) were 70.0 (65.0-75.5) and 57.5 (56.3-62.5) years, respectively) participated in 3-month individualized training program comprising three weekly sessions of running, cycling, and swimming. Both field- and laboratory-based testing were conducted. The participants attended two sports nutrition and competitive psychology seminars focusing on triathlon competition. The participants were interviewed in depth in three different focus groups. Thematic analysis was utilized to analyze the findings. Results: Participants improved their performance in all field-based tests. After completion of the thematic data analysis the main finding and overarching theme of well-being and being fit emerged. Additionally, three main themes were identified: 1) motivation; 2) progress and coping; and 3) breaking barriers. Conclusion: Psychological well-being and satisfaction of being fit seem to be vital to participate in a triathlon competition. Promoting specific age-appropriate participation in sports activities can be an effective strategy for promoting a healthy lifestyle among the elderly.

Referee Bias in Professional Football: Favoritism Toward Successful Teams in Potential Penalty Situations.

Past studies have indicated that multiple factors may influence sport referees' decisions, such as pressure from spectators and athletes' reputation. Grounded in the social impact theory framework, this study examined whether Norwegian Premier League (NPL) referees are biased by a team's success when awarding penalties. Using video footage (similar to video assistant referees), an expert panel (EP) of four NPL referees evaluated all potential penalty situations (N = 43) involving either of two successful teams during an entire NPL season. Fifty-five potential penalty situations from matches without successful teams were also rated. Overall, the match referees identified 73.3% (22 of 30) of the EP-identified penalties during matches without successful teams. Successful teams were awarded 110% (11 of 10) of the EP-identified penalties, while their opponents were awarded 12.5% (1 of 8). Chi square statistic revealed that successful teams were more likely to receive an incorrect penalty compared with their opponents, and less likely to be denied a penalty they should have been awarded. These findings indicate that referees' decisions may be unintentionally biased by a team's success, extending our knowledge about how football referees may be influenced by social forces.

A Preliminary Analysis of the Importance of Distance, Angle, and Insight When Soccer Referees Make Penalty Decisions.

Soccer referees move freely on the pitch to place themselves in the best location for making decisions. While Football Association UK (FA) highlights that a referee should never be more than 20 m away from the playing situation, previous studies have been inconsistent in indicating appropriate distance to a situation for increasing the likelihood of a correct decision. Further, appropriate angle and insight are also likely to influence the correctness of referees' decisions. The aim of this study was to provide an initial investigation of elite referees' positioning in the field (distance, angle, and insight) when making correct and erroneous decisions in potential penalty situations. An expert panel (EP) consisting of two active referees with relevant academic background analyzed referees positioning when making correct or erroneous decisions regarding penalties. The EP were asked to qualitatively analyze referees positioning in selected video clips by using recommended technical refereeing criteria and practical guidelines (i.e., the referee's distance from, angle to, and insight into the penalty situations). Of the 42 situations evaluated, the results revealed that the EP termed the referees positioning as good in terms of angle and insight in 25 and 21 situations, respectively. The angle was average in seven situations and poor in 10 situations, and the insight were average in 10 situations and poor in 11 situations. The match referee was <10 meters away in 12 situations, 10-20 m away in 22 situations, and >20 meters away in eight situations. Results revealed that referees' positioning that resulted in the highest rate of correct decisions were when the distance were under 10 meters (83% correct decisions), good angle (88%), and good insight (86%). In contrast, referees were poorly positioned in terms of angle and/or insight in nine of the 15 erroneous decisions made. Although the present study was a preliminary qualitative investigation containing a limited number of potential penalty situations, the findings indicated that soccer referees are more likely to produce a correct decision in potential penalty situations when the distance to the situation is under 10 meters, when the insight to the situation is good and the angle to the incident is good. In contrast, the match referees generally had a poor starting position to assess the penalty situations where they landed on a wrong decision. While previous studies have been somewhat inconsistent in indicating optimal referee positioning in soccer, the present study highlights the potential value of a more qualitative approach to understand referees' positioning and subsequent decision-making accuracy.

Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women.

It is established that the level of physical activity in the population generally is too low, and data indicate that pregnant women are no exception. Studies of the effects of aerobic fitness on delivery outcomes are limited. In this observational study, we investigated the effect of aerobic fitness on duration of labor in nulliparous women who started labor spontaneously. Maximal oxygen uptake was measured in 40 nulliparous women at 35-37 weeks of gestation. Duration of labor was defined as the time between 3 cm cervical dilation with regular uterine contractions and delivery. The mean (SD) maximal oxygen uptake was 2.1 (0.3) L/min and duration of labor 583 (317) minutes. Duration of labor was inversely associated with maximal oxygen uptake after adjusting for birthweight (p = 0.034). We conclude that measurement of maximal oxygen uptake is safe in pregnancy at 35-37 weeks and that increased aerobic fitness was associated with shorter labor in nulliparous women who started labor spontaneously.

Abnormal blood lactate accumulation during repeated exercise testing in myalgic encephalomyelitis/chronic fatigue syndrome.

Post-exertional malaise and delayed recovery are hallmark symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Studies on repeated cardiopulmonary exercise testing (CPET) show that previous exercise negatively affects oxygen uptake (VO2 ) and power output (PO) in ME/CFS. Whether this affects arterial lactate concentrations ([Laa ]) is unknown. We studied 18 female patients (18-50 years) fulfilling the Canadian Consensus Criteria for ME/CFS and 15 healthy females (18-50 years) who underwent repeated CPETs 24 h apart (CPET1 and CPET2 ) with [Laa ] measured every 30th second. VO2 at peak exercise (VO2peak ) was lower in patients than in controls on CPET1 (P < 0.001) and decreased in patients on CPET2 (P < 0.001). However, the difference in VO2peak between CPETs did not differ significantly between groups. [Laa ] per PO was higher in patients during both CPETs (Pinteraction  < 0.001), but increased in patients and decreased in controls from CPET1 to CPET2 (Pinteraction  < 0.001). Patients had lower VO2 (P = 0.02) and PO (P = 0.002) at the gas exchange threshold (GET, the point where CO2 production increases relative to VO2 ), but relative intensity (%VO2peak ) and [Laa ] at GET did not differ significantly from controls on CPET1 . Patients had a reduction in VO2 (P = 0.02) and PO (P = 0.01) at GET on CPET2 , but no significant differences in %VO2peak and [Laa ] at GET between CPETs. Controls had no significant differences in VO2 , PO or %VO2peak at GET between CPETs, but [Laa ] at GET was reduced on CPET2 (P = 0.008). In conclusion, previous exercise deteriorates physical performance and increases [Laa ] during exercise in patients with ME/CFS while it lowers [Laa ] in healthy subjects.

Pharmacokinetics of perfluorobutane following intravenous bolus injection and continuous infusion of sonazoid in healthy volunteers and in patients with reduced pulmonary diffusing capacity.

The ultrasound contrast agent Sonazoidtrade mark was administered as an i.v. bolus injection of 0.6 microL microbubbles/kg body weight or as a continuous infusion over 30 min at a rate of 1.2 microL microbubbles/kg body weight to healthy volunteers and patients with reduced pulmonary diffusing capacity. Expired air and blood samples were collected from 32 subjects and perfluorobutane (PFB) gas was analyzed using validated gas chromatography mass spectrometry methods. Blood concentrations of PFB declined biphasicly with a distribution half-life (t(0.5 to 15)) of 2 to 3 min and an elimination half-life (t(15 to 120)) of 30 to 45 min. Area under the curve (AUC) values in patients with impaired gas diffusion were significantly larger than those in healthy volunteers. The exhalation kinetics were somewhat variable with a PFB elimination half-life (t(15 to 120)) of 28 to 111 min. Clearance of PFB was independent of study population and mode of administration. There were no deaths and no serious adverse events that resulted in the withdrawal of a subject from the study. With the exception that arthralgia predominated in healthy volunteers, healthy volunteers and diseased subjects did not show a different adverse event profile whether Sonazoid was administered as a bolus injection or as an infusion. Assessment of laboratory parameters (serum biochemistry, haematology and urinalysis), vital signs, oxygen saturation and electrocardiograms (ECGs) showed no changes which caused safety concern. (E-mail: Kristin.Landmark@ge.com).

Difference in physical fitness in children with initially high and low gross motor competence: A ten-year follow-up study.

The aim of the study was to investigate the difference in relative physical fitness between children with initially high and low gross motor competence in a ten-year prospective study. A sample of 49 children from a local primary school was tested on gross motor competence and physical fitness in 1st grade (5/6 years old). The children were tested again in 2nd (motor competence only), 7th, and 10th grade (15/16 years old). The sample was divided into two groups; initially high and low gross motor competence, according to score (median-split) on the Körperkoordinationstest für Kinder-test battery in 1st grade. Results suggested that the initially high gross motor competence-group performed significantly better on a multidimensional physical fitness test, compared to the initially low gross motor competence-group at all time-points. There were also statistically significant differences between the groups in gross motor competence in 7th and 10th grade, with the initially high gross motor competence-group scoring most favorable. The findings from the present study highlight the importance of identifying and supporting young individuals with low gross motor competence, to prevent low levels of physical fitness in the future.

Detection of allergens adsorbed to ambient air particles collected in four European cities.

Air pollution has been implicated as one of the factors responsible for the increased incidence of allergic diseases observed in recent years. High concentrations of air pollutants may promote airway sensitization by acting as adjuvants. Ambient particles as carriers of adsorbed allergens are, therefore, of special interest since they may act as mediators of inflammatory as well as allergic responses. Ambient air particles from four cities in Europe were collected, in three different seasons, to examine the variation of allergens and their possible binding to the pollution particles. The particle fraction, PM10, was collected on polycarbonate filters using a low-volume sampling regime. The presence of pollen allergens, latex and beta-glucans was investigated using an immunogold labelling method directly on the collection filters. Scanning electron microscopy revealed mainly the classical carbon particles and aggregates determined to originate from vehicle exhaust. The immunogold labelling visualised in the backscatter electron imaging mode, showed that allergens from pollens, latex and also beta-glucans were bound to and, hence, transported by the combustion particles in ambient air. Thus, combustion particles in ambient air are carriers of allergens and act as depots of allergens inhaled into the airways.

Budesonide and formoterol in a single inhaler improves asthma control compared with increasing the dose of corticosteroid in adults with mild-to-moderate asthma.

BACKGROUND: We evaluated the efficacy and safety of low-dose budesonide/formoterol, 80 micro g/4.5 micro g, bid in a single inhaler (Symbicort Turbuhaler; AstraZeneca; Lund, Sweden) compared with an increased dose of budesonide, 200 micro g bid, in adult patients with mild-to-moderate asthma not fully controlled on low doses of inhaled corticosteroid alone. METHODS: All patients received budesonide, 100 micro g bid, during a 2-week run-in period. At the end of the run-in phase, 467 patients with a mean FEV(1) of 82% predicted received 12 weeks of treatment with budesonide/formoterol in a single inhaler or budesonide alone in a higher dose. Patients kept daily records of their morning and evening peak expiratory flow (PEF), nighttime and daytime symptom scores, and use of reliever medication. RESULTS: The increase in mean morning PEF-the primary efficacy measure-was significantly higher for budesonide/formoterol compared with budesonide alone (16.5 L/min vs 7.3 L/min, p = 0.002). Similarly, evening PEF was significantly greater in the budesonide/formoterol group (p < 0.001). In addition, the percentage of symptom-free days and asthma-control days (p = 0.007 and p = 0.002, respectively) were significantly improved in the budesonide/formoterol group. Budesonide/formoterol decreased the relative risk of an asthma exacerbation by 26% (p = 0.02) compared with budesonide alone. Adverse events were comparable between the two treatment groups. CONCLUSION: This study shows that in adult patients whose mild-to-moderate asthma is not fully controlled on low doses of inhaled corticosteroids, single-inhaler therapy with budesonide and formoterol provides greater improvements in asthma control than increasing the maintenance dose of inhaled corticosteroid.

Detection of latex allergens by immunoelectron microscopy in ambient air (PM10) in Oslo, Norway (1997-2003).

The authors collected ambient air along two highways in Oslo to investigate the annual variations in particulate matter (PM10) and the presence of latex as an outdoor allergen. PMI, was monitored for a period of five years, during which time the use of studded winter tires was reduced. The presence of latex and of common aeroallergens was examined directly on the collection filters with immunoelectron microscopy visualized in a scanning electron microscope. The annual variation in PM10 was similar over the five years of sampling, with increased mass concentrations in winter. Statistical analysis indicated no major effect from the change to nonstudded tires. The most important factors influencing the PM10 concentration were meteorological parameters like wind and rain. Immnunolabeling of the filters showed latex as an outdoor allergen that adhered to carbon aggregates from vehicle emission. The results also indicated cross-reactive epitopes among the common allergens investigated, which for sensitized subjects may add to the risk of developing latex allergy.

Development of pulmonary abnormalities in patients with common variable immunodeficiency: associations with clinical and immunologic factors.

BACKGROUND: Patients with common variable immunodeficiency (CVID) have low serum IgG, IgA, and/or IgM levels and recurrent airway infections. Radiologic pulmonary abnormalities and impaired function are common complications. It is unclear to what extent IgG replacement treatment prevents further pulmonary damage and how factors beside infections may contribute to progression of disease. OBJECTIVES: To study the development of pulmonary damage and determine how clinical and immunologic factors, such as serum IgG, may contribute to possible changes. METHODS: In a retrospective, longitudinal study of 54 patients with CVID already treated with immunoglobulins, we examined changes of lung function and findings on high-resolution computed tomography (HRCT), obtained at 2 time points (the date of the last pulmonary function measurement before April 2005 [T1] and the date of the measurement performed closest to 5 years earlier [T0]) 2 to 7 years apart and explored possible relations to clinical and immunologic factors such as levels of IgG, tumor necrosis alpha (TNF-alpha), and mannose-binding lectin (MBL) in serum. RESULTS: Despite a mean (SD) serum IgG level of 7.6 (2.3) g/L for all the patients during the entire study period, lung function decreased from T0 to T1. The combination of a low serum IgA level and serum MBL was associated with the presence of bronchiectasis and lower lung function and with worsening of several HRCT abnormalities from T0 to T1. Increased serum levels of TNF-alpha were related to deterioration of gas diffusion. A mean serum IgG level less than 5 g/L between T0 and T1 was associated with worsening of linear and/or irregular opacities seen on HRCT. CONCLUSION: For a period of 4 years, lung function and HRCT deteriorated in CVID patients treated with immunoglobulins.

High resolution computed tomography and pulmonary function in common variable immunodeficiency.

Patients with common variable immunodeficiency (CVID) have impaired production of immunoglobulins and hence recurrent airway infections, which in turn may lead to radiological changes and impaired lung function. Uncertainty exists about the nature and frequency of the radiological and the physiological abnormalities, and how they relate to each other. We reassessed high resolution computed tomography (HRCT) images in 65 patients, reported results from previously measured lung function tests, and studied relations between radiology, function and clinical variables. Airway obstruction, ventilatory restriction and impaired gas diffusion was found in 40, 34 and 21% of the patients, respectively. HRCT abnormalities were present in 94% of the subjects, mild changes being the most common. Bronchial wall thickening, found in two thirds of the patients, was related to airway obstruction and impaired gas diffusion. Linear and/or irregular opacities, the most frequent interstitial abnormality, was related to impaired gas diffusion. Bronchiectasis was found in more than half, but only severe bronchiectasis was related to airway obstruction. Since bronchial wall thickening and linear and/or irregular opacities are both frequent and important determinants of impaired pulmonary function, more attention should be given to these features in the follow up of CVID patients.