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1.
Praxis (Bern 1994) ; 110(11): 629-636, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34465192

RESUMO

Spirometry in the Medical Practice - Part 1: Measuring Abstract. Today, every practitioner, as well as every hospital emergency, should be able to perform spirometry. However, the measurement requires solid basic knowledge as well as a certain amount of experience so that consistent and reproducible measurements are possible. Since the measurement depends heavily on the cooperation of the patient, typical errors must be recognised and corrected immediately. A rounded forced expiratory flow volume curve, or a sudden drop of the curve towards zero at the end of exhalation as well as clearly deviating curves or values in the minimum required three measurement manoeuvres are clear hints for an insufficiently forced expiration or an expiration that was stopped too early. Pulmonary function assistants need instructions as to when application of a rapid acting beta agonist with repeated spirometry to detect possible reversibility is necessary. This includes knowing how long therapeutic bronchodilators must be stopped prior to the test.


Assuntos
Broncodilatadores , Pulmão , Volume Expiratório Forçado , Humanos , Espirometria , Inquéritos e Questionários , Capacidade Vital
2.
Artigo em Inglês | MEDLINE | ID: mdl-34501557

RESUMO

BACKGROUND: Duchenne muscular dystrophy (DMD) is the most common, progressive, irreversible muscular dystrophy. Pulmonary function is crucial for duration of life in this disease. Currently, the European Respiratory Society is focused on digital health, seeking innovations that will be realistic for digital respiratory medicine to support professionals and patients during the COVID-19 pandemic. AIMS: The aim of this study was to investigate whether it is possible to monitor pulmonary function at home using an individual electronic spirometry system in boys with Duchenne muscular dystrophy. MATERIALS AND METHODS: In this observational, prospective study, conducted from March 2021 to June 2021, twenty boys with DMD (aged 8-16) were enrolled. The patients were recruited from the Rare Disease Centre, University Clinical Centre, of Gdansk, Poland. Medical history and anthropometric data were collected, and spirometry (Jaeger, Germany) was performed in all patients at the start of the study. Each patient received an electronic individual spirometer (AioCare) and was asked to perform spirometry on their own every day, morning and evening, at home for a period of 4 weeks. The number of measurements, correctness of performing measurements, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF) were evaluated. RESULTS: Finally, 14 out of 20 boys enrolled in the study with a mean age of 12.5 years (7 non-ambulatory) applied and received a home spirometer (AioCare). A total of 283 measurements were performed by all patients at home for 4 weeks. Half of the patients were able to perform measurements correctly. There were no significant differences between mean values of FVC, FE1, PEF between home and hospital spirometry (p > 0.05) expect PEF pv% (p < 0.00046). Patients with higher FEV1 (p = 0.0387) and lower BMI (p = 0.0494) were more likely to take home spirometer measurements. The mean general satisfaction rating of home-spirometry was 4.33/5 (SD 0.78), the mean intelligibility rating was 4.83/5 (SD 0.58). Reasons for irregular measurements were: forgetting (43%), lack of motivation (29%), difficulty (14%), lack of time (14%). CONCLUSION: Home electronic monitoring of pulmonary function in patients with DMD is possible to implement in daily routines at home. This protocol should be introduced as early as possible in patients 7-8 years old with good, preserved lung function. Patients accept this form of medical care but require more education about the benefits of e-monitoring. There is a need to implement a system to remind patients of the use of electronic medical devices at home, e.g., via SMS (short message service).


Assuntos
COVID-19 , Distrofia Muscular de Duchenne , Criança , Humanos , Pulmão , Masculino , Distrofia Muscular de Duchenne/epidemiologia , Pandemias , Projetos Piloto , Estudos Prospectivos , SARS-CoV-2 , Espirometria , Capacidade Vital
3.
Artigo em Inglês | MEDLINE | ID: mdl-34348534

RESUMO

Objective: To study the association between ventilatory function and cognitive and behavioral impairment in ALS patients accounting for the effects of pertinent covariates. Methods: Four hundred and eighty-one patients were identified from the Mayo Clinic Florida ALS registry who had concurrent forced vital capacity (FVC) and cognitive and behavioral testing using the ALS Cognitive Behavioral Screen (ALS-CBS). Multiple linear regression analysis was used to study the effects of FVC and relevant covariates on the ALS-CBS cognition score, subscores, and caregiver behavioral inventory. Results: FVC was positively correlated to the cognitive and behavioral subscores on the ALS-CBS (p < 0.001), and the correlation was independent of the effects of site of ALS onset, age, and years of education. Conclusion: Cognitive and behavioral function may be adversely affected by ventilatory impairment in ALS. The presence of cognitive and behavioral impairment warrants a detailed assessment of ventilatory function.


Assuntos
Esclerose Amiotrófica Lateral , Esclerose Amiotrófica Lateral/complicações , Cognição , Escolaridade , Humanos , Testes Neuropsicológicos , Capacidade Vital
4.
Artigo em Inglês | MEDLINE | ID: mdl-34348537

RESUMO

In this study, we present and provide validation data for a tool that predicts forced vital capacity (FVC) from speech acoustics collected remotely via a mobile app without the need for any additional equipment (e.g. a spirometer). We trained a machine learning model on a sample of healthy participants and participants with amyotrophic lateral sclerosis (ALS) to learn a mapping from speech acoustics to FVC and used this model to predict FVC values in a new sample from a different study of participants with ALS. We further evaluated the cross-sectional accuracy of the model and its sensitivity to within-subject change in FVC. We found that the predicted and observed FVC values in the test sample had a correlation coefficient of .80 and mean absolute error between .54 L and .58 L (18.5% to 19.5%). In addition, we found that the model was able to detect longitudinal decline in FVC in the test sample, although to a lesser extent than the observed FVC values measured using a spirometer, and was highly repeatable (ICC = 0.92-0.94), although to a lesser extent than the actual FVC (ICC = .97). These results suggest that sustained phonation may be a useful surrogate for VC in both research and clinical environments.


Assuntos
Esclerose Amiotrófica Lateral , Estudos Transversais , Humanos , Acústica da Fala , Espirometria , Capacidade Vital
5.
Artigo em Inglês | MEDLINE | ID: mdl-34348538

RESUMO

Objective: To develop an ALS respiratory symptom scale (ARES) and evaluate how ARES compares to Medical Research Council Modified Dyspnea Scale (MRC), Borg dyspnea scale, and respiratory subscores from ALSFRS-R (ALSFRS-Resp) in detecting respiratory symptoms, correlation with pulmonary function and ALSFRS-R, and deterioration of pulmonary function and ALSFRS-R over time.Methods: The ARES scale consists of 9 questions addressing dyspnea during activities and 3 questions addressing symptoms of worsening pulmonary function. 153 subjects with ALS completed MRC, Borg, ALSFRS-R, and ARES questionnaires at baseline, 16, 32, and 48 weeks, and spirometry at baseline. 73 of these subjects had spirometry, maximum inspiratory (MIP) and expiratory pressures (MEP), nasal inspiratory pressure (SNIP), and maximum voluntary ventilation (MVV) measured at each visit. Sensitivity of each scale and correlations between symptom scores, pulmonary function, and ALSFRS-R were evaluated at baseline and over the study duration.Results and conclusions: ARES was more sensitive than MRC, Borg and ALSFRS-Resp scales at baseline and for detecting changes at 16 and 32 weeks. ARES and ALSFRS-Resp correlated significantly with vital capacity at baseline, but Borg and MRC did not. Only ALSFRS-Resp correlated with respiratory pressures. Changes in ALSFRS-Resp and ARES both correlated with vital capacity decline; however, changes in ARES had superior correlation with respiratory pressure decline. Comparisons between telephone and in-person administration of ARES met criteria for satisfactory test-retest correlation in different settings one week apart. These findings suggest that the ARES may be more useful in monitoring symptom progression in ALS than other available scales.


Assuntos
Esclerose Amiotrófica Lateral , Esclerose Amiotrófica Lateral/complicações , Esclerose Amiotrófica Lateral/diagnóstico , Humanos , Espirometria , Inquéritos e Questionários , Capacidade Vital
6.
Artigo em Inglês | MEDLINE | ID: mdl-34348540

RESUMO

Background: There has been no comprehensive longitudinal study of pulmonary functions (PFTS) in ALS determining which measure is most sensitive to declines in respiratory muscle strength. Objective: To determine the longitudinal decline of PFTS in ALS and which measure supports Medicare criteria for NIV initiation first. Methods: Serial PFTs (maximum voluntary ventilation (MVV), maximum inspiratory pressure measured by mouth (MIP) or nasal sniff pressure (SNIP), maximum expiratory pressure (MEP), and Forced Vital Capacity (FVC)) were performed over 12 months on 73 ALS subjects to determine which measure showed the sentinel decline in pulmonary function. The rate of decline for each measure was determined as the median slope of the decrease over time. Medicare-based NIV initiation criteria were met if %FVC was ≤ 50% predicted or MIP was ≤ 60 cMH2O. Results: 65 subjects with at least 3 visits were included for analyses. All median slopes were significantly different than zero. MEP and sitting FVC demonstrated the largest rate of decline. Seventy subjects were analyzed for NIV initiation criteria, 69 met MIP criteria first; 11 FVC and MIP criteria simultaneously and none FVC criteria first. Conclusions: MEP demonstrated a steeper decline compared to other measures suggesting expiratory muscle strength declines earliest and faster and the use of airway clearance interventions should be initiated early. When Medicare criteria for NIV initiation are considered, MIP criteria are met earliest. These results suggest that pressure-based measurements are important in assessing the timing of NIV and the use of pulmonary clearance interventions.


Assuntos
Esclerose Amiotrófica Lateral , Idoso , Humanos , Estudos Longitudinais , Pressões Respiratórias Máximas , Medicare , Estados Unidos , Capacidade Vital
7.
Artigo em Inglês | MEDLINE | ID: mdl-34348541

RESUMO

Background: Although noninvasive ventilation (NIV) improves survival and quality of life (QOL) in ALS, use of NIV is suboptimal. Objective: To determine compliance with "early" NIV initiation, requisite for the feasibility of a large study of early NIV initiation, and examine factors impacting compliance. Methods: Seventy-three ALS participants with forced vital capacities (FVC) >50% were enrolled. Participants with FVC over 80% (Group 1) were initiated on NIV early (FVC between 80 and 85%). Participants with FVC between 50 and 80% (Group 2) started NIV at FVC between 50 and 55%. Symptom surveys, QOL scores, and NIV compliance (machine download documenting use ≥4 hours/night >60% of time) were collected following NIV initiation. Results: 53.6% of Group 1 and 50% of Group 2 were compliant 28 days following NIV initiation, with increased compliance over time. Participants who were unmarried, had lower income, lower educational attainment, or limited caregiver availability were less likely to be compliant. Bothersome symptoms in non-compliant participants included facial air pressure, frequent arousals with difficulty returning to sleep, and claustrophobia. Both compliant and noncompliant participants felt improved QOL with NIV; improvement was significantly greater in compliant participants. Conclusions: These data suggest ALS patients can comply with NIV early in their disease, and potentially benefit as evidenced by improved QOL scores, supporting both feasibility and need for a study comparing early versus late NIV initiation. Moreover, modifiable symptoms were identified that could be optimized to improve compliance. Further studies are needed to determine the impact of "early" intervention on survival and QOL.


Assuntos
Esclerose Amiotrófica Lateral , Ventilação não Invasiva , Insuficiência Respiratória , Esclerose Amiotrófica Lateral/terapia , Humanos , Cooperação do Paciente , Qualidade de Vida , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Capacidade Vital
8.
Artigo em Inglês | MEDLINE | ID: mdl-34348539

RESUMO

Introduction: Vital capacity (VC) is routinely used for ALS clinical trial eligibility determinations, often to exclude patients unlikely to survive trial duration. However, spirometry has been limited by the COVID-19 pandemic. We developed a machine-learning survival model without the use of baseline VC and asked whether it could stratify clinical trial participants and a wider ALS clinic population. Methods. A gradient boosting machine survival model lacking baseline VC (VC-Free) was trained using the PRO-ACT ALS database and compared to a multivariable model that included VC (VCI) and a univariable baseline %VC model (UNI). Discrimination, calibration-in-the-large and calibration slope were quantified. Models were validated using 10-fold internal cross validation, the VITALITY-ALS clinical trial placebo arm and data from the Emory University tertiary care clinic. Simulations were performed using each model to estimate survival of patients predicted to have a > 50% one year survival probability. Results. The VC-Free model suffered a minor performance decline compared to the VCI model yet retained strong discrimination for stratifying ALS patients. Both models outperformed the UNI model. The proportion of excluded vs. included patients who died through one year was on average 27% vs. 6% (VCI), 31% vs. 7% (VC-Free), and 13% vs. 10% (UNI). Conclusions. The VC-Free model offers an alternative to the use of VC for eligibility determinations during the COVID-19 pandemic. The observation that the VC-Free model outperforms the use of VC in a broad ALS patient population suggests the use of prognostic strata in future, post-pandemic ALS clinical trial eligibility screening determinations.


Assuntos
Esclerose Amiotrófica Lateral , COVID-19 , Esclerose Amiotrófica Lateral/epidemiologia , Humanos , Aprendizado de Máquina , Pandemias , SARS-CoV-2 , Capacidade Vital
9.
Indian J Med Res ; 153(4): 465-474, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34380793

RESUMO

Background & objectives: Upregulation of matrix metalloproteinases (MMPs) is related to the pathogenesis of chronic obstructive pulmonary disease (COPD). We aimed at assessing the tolerability and impact of long-term use of MMP inhibitor doxycycline in COPD. Methods: A cohort of COPD patients was randomized to continue a uniform COPD treatment with or without add-on long-term oral doxycycline. The lung exacerbations (spirometry), adverse events and health status (COPD Assessment Test score) were noted at 3, 6, 9 and 12 months of therapy. Measurement of the serum MMP-2, and 9 and high-sensitive C-reactive protein (hs-CRP) levels was done at the start of the study and at three months, whenever possible. Results: There were 27, 19, 13 and 10 patients with add-on doxycycline group and 22, 19, 11 and 7 patients with COPD treatment alone at 3, 6, 9 and 12 months of treatment respectively. The improvement was obvious and mostly (at 6 and 12 months) significant (P >0.05) for lung function parameters [forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) and forced expiratory flow at 25-75% of FVC (FEF25-75)] and universal for health status at all measurements, with an overall 26.69 per cent reduction in exacerbations. The analysis with the lung function changes in the available population with protocol violation also supported the same trend. The concomitant reduction in serum MMP-9 (P =0.01), MMP-2 (P =0.01) and hs-CRP (P =0.0001) levels (n=21) at three months was also significant. The adverse reactions with add-on doxycycline appeared acceptable. Interpretation & conclusions: Long-term doxycycline appears well tolerated and seems to improve lung function, health status and exacerbations in COPD. The claim needs further scientific validations.


Assuntos
Doxiciclina , Doença Pulmonar Obstrutiva Crônica , Progressão da Doença , Doxiciclina/efeitos adversos , Volume Expiratório Forçado , Humanos , Pulmão , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Capacidade Vital
10.
Eur J Radiol ; 142: 109866, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34365304

RESUMO

PURPOSE: The pulmonary function test (PFT) has played an essential role in diagnosing and managing interstitial lung disease (ILD) but has its contraindications and difficult conditions to perform. Therefore, the present study aimed to evaluate dynamic chest radiography (DCR) ability to predict forced vital capacity (FVC) and other PFT parameters of ILD patients. METHOD: The prospective observational study included 97 patients who underwent DCR at Tenri Hospital (Tenri, Japan) between June 2019 and April 2020. Twenty-five patients with stable disease status underwent DCR twice to evaluate test-retest reliability using the intraclass correlation coefficient. From the lung field areas measured by DCR, lung volumes at maximum inspiration (V.ins) and expiration (V.exp) were estimated. Correlation coefficients between the measured values of DCR and PFT parameters were calculated. Multilinear models for predicting FVC and other PFT parameters were developed. RESULTS: Intraclass correlation coefficients between first and second measurements of V.ins and V.exp were 0.94 (95% CI: 0.89-0.97, p < 0.001) and 0.88 (95% CI: 0.78-0.94, p < 0.001), respectively. The correlation coefficient between V.ins and FVC was 0.86 (95% CI: 0.79-0.90, p < 0.001). A multilinear model for predicting FVC was developed using V.ins, V.exp, age, sex, and body mass index as predictor variables, wherein the adjusted coefficient of determination was 0.814. CONCLUSIONS: Lung volumes measured by DCR correlated with the lung function of ILD patients. Prediction models with high predictive power and internal validity were developed, suggesting that DCR can predict FVC and other PFT parameters of ILD patients.


Assuntos
Doenças Pulmonares Intersticiais , Humanos , Pulmão/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Radiografia , Reprodutibilidade dos Testes , Testes de Função Respiratória , Capacidade Vital
11.
Int J Chron Obstruct Pulmon Dis ; 16: 2351-2362, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34429593

RESUMO

Purpose: This study aimed to identify the COPD molecular subtypes reflecting pulmonary function damage on the basis of metabolism-related gene expression, which provided the opportunity to study the metabolic heterogeneity and the association of metabolic pathways with pulmonary function damage. Methods: Univariate linear regression and the Boruta algorithm were used to select metabolism-related genes associated with forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity (FVC) in the Evaluation of COPD to Longitudinally Identify Predictive Surrogate Endpoints (ECLIPSE) cohort. COPD subtypes were further identified by consensus clustering with best-fit. Then, we analyzed the differences in the clinical characteristics, metabolic pathways, immune cell characteristics, and transcription features among the subtypes. Results: This study identified two subtypes (C1 and C2). C1 exhibited higher levels of lower pulmonary function and innate immunity than C2. Ten metabolic pathways were confirmed as key metabolic pathways. The pathways related to N-glycan, hexosamine, purine, alanine, aspartate and glutamate tended to be positively associated with the abundance of adaptive immune cells and negatively associated with the abundance of innate immune cells. In addition, other pathways had opposite trends. All results were verified in Genetic Epidemiology of COPD (COPDGene) datasets. Conclusion: The two subtypes reflect the pulmonary function damage and help to further understand the metabolic mechanism of pulmonary function in COPD. Further studies are needed to prove the prognostic and therapeutic value of the subtypes.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Volume Expiratório Forçado , Humanos , Pulmão , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/genética , Testes de Função Respiratória , Capacidade Vital
12.
Zhen Ci Yan Jiu ; 46(7): 598-604, 2021 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-34369681

RESUMO

OBJECTIVE: To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on lung function, clinical symptoms, exercise tolerance and risk of acute exacerbation in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 49 outpatients with COPD were randomly divided into TEAS group and control group by using a digital table. The clinical trials were conducted by using randomized, single-blinded and placebo-controlled method. Patients in the TEAS group were treated by TEAS of Feishu (BL13), Dingchuan (EX-B1), Zusanli (ST36) and Pishu (BL20) for 40 min, once every other day for 4 weeks, while patients in the control group were treated with placebo TEAS which the electrode plates were adhered to the same acupoints but without electrical current outputs. The treatment was conducted every 3 months in one year. In addition, patients of the two groups had no restriction on their original treatment with conventional western medicines and Chinese Materia medica. The lung function (forced expiratory volume in 1 second predicted,FEV1%, forced vital capacity predicted,FVC%) was detected using a spirometer), clinical symptom scores (CAT) for coughing, phlegm, chest tightness, climbing, family activities, out-door activities, sleeping and energy status were given. The patient's exercise tolerance was assessed using walking distance in 6 min, and the risks of acute exacerbation (times of exacerbation and hospitalization in 1 year) were recorded. RESULTS: Correlative analysis showed a negative correlation between the risks of acute exacerbation and the levels of FEV1% and FVC% (P<0.01) and a positive correlation between the risks of acute exacerbation and CAT score (P<0.01). Self-comparison showed that 1 month after the treatment, the FEV1% and FVC% levels, 6MWD in the control group were significantly decreased (P<0.001, P<0.01), while the CAT score in the control group, and FEV1% and 6MWD in the TEAS group were obviously increased in comparison with their own pretreatment (P<0.05, P<0.001), but FVC% in the TEAS group and the times of exacerbation and hospitalization in the control group had no obvious changes in comparison with their own pre-treatment (P>0.05). One year (1 year) after the treatment, FEV1% and FVC% levels, 6MWD in the control group, and CAT score and times of exacerbations and hospitalization in the TEAS group were significantly decreased (P<0.001, P<0.01, P<0.05), while CAT score in the control group and 6MWD in the TEAS group were markedly increased (P<0.05, P<0.01), but FEV1% in the TEAS group and the times of exacerbation and hospitalization in the control group had no significant change compared with their own pretreatment (P>0.05). Comparison between two groups showed that after the treatment, the FEV1% (1 month) and FVC% (1 month and 1 year), 6MWD (1 month and 1 year) were significantly higher in the TEAS group than in the control group (P<0.05), while the CAT (1 month and 1 year) and times of exacerbation and hospitalization (1 year) were significantly lower in the TEAS group than in the control group (P<0.05, P<0.01, P<0.001), without significant difference in the FEV1% (1 year) level (P>0.05). CONCLUSION: TEAS can improve the lung function, clinical symptoms, exercise tolerance, and reduce the risks of acute exacerbation in patients with COPD.


Assuntos
Pontos de Acupuntura , Doença Pulmonar Obstrutiva Crônica , Volume Expiratório Forçado , Humanos , Pulmão , Doença Pulmonar Obstrutiva Crônica/terapia , Capacidade Vital
13.
Respir Res ; 22(1): 237, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446020

RESUMO

Follow-up studies of COVID-19 patients have found lung function impairment up to six months after initial infection, but small airway function has not previously been studied. Patients (n = 20) hospitalised for a severe SARS-CoV-2 infection underwent spirometry, impulse oscillometry, and multiple measurements of alveolar nitric oxide three to six months after acute infection. None of the patients had small airway obstruction, nor increased nitric oxide concentration in the alveolar level. None of the patients had a reduced FEV1/FVC or significant bronchodilator responses in IOS or spirometry. In conclusion, we found no evidence of inflammation or dysfunction in the small airways.


Assuntos
COVID-19/complicações , COVID-19/fisiopatologia , Doenças Respiratórias/fisiopatologia , Adulto , Idoso , Feminino , Finlândia , Seguimentos , Volume Expiratório Forçado , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Alvéolos Pulmonares/metabolismo , Testes de Função Respiratória , Doenças Respiratórias/etiologia , Espirometria , Sobreviventes , Capacidade Vital
14.
Undersea Hyperb Med ; 48(3): 239-245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34390628

RESUMO

Breathing less than 50 kPa of oxygen over time can lead to pulmonary oxygen toxicity (POT). Vital capacity (VC) as the sole parameter for POT has its limitations. In this study we try to find out the changes of acid-base status in a POT rat model. Fifty male rats were randomly divided into five groups, exposed to 230 kPa oxygen for three, six, nine and 12 hours, respectively. Rats exposed to air were used as controls. After exposure the mortality and behavior of rats were observed. Arterial blood samples were collected for acid-base status detection and wet-dry (W/D) ratios of lung tissues were tested. Results showed that the acid-base status in rats exposed to 230 kPa oxygen presented a dynamic change. The primary status was in the compensatory period when primary respiratory acidosis was mixed with compensated metabolic alkalosis. Then the status changed to decompensated alkalosis and developed to decompensated acidosis in the end. pH, PCO2, HCO3-, TCO2, and BE values had two phases: an increase and a later decrease with increasing oxygen exposure time, while PaO2 and lung W/D ratio showed continuously increasing trends with the extension of oxygen exposure time. Lung W/D ratio was significantly associated with PaO2 (r = 0.6385, p = 0.002), while other parameters did not show a significant correlation. It is concluded that acid-base status in POT rats presents a dynamic change: in the compensatory period first, then turns to decompensated alkalosis and ends up with decompensated acidosis status. Blood gas analysis is a useful method to monitor the development of POT.


Assuntos
Desequilíbrio Ácido-Base/sangue , Acidose Respiratória/metabolismo , Alcalose Respiratória/metabolismo , Oxigenação Hiperbárica/efeitos adversos , Oxigênio/toxicidade , Desequilíbrio Ácido-Base/etiologia , Animais , Pressão Atmosférica , Bicarbonatos/sangue , Análise Química do Sangue , Gasometria , Dióxido de Carbono/sangue , Oxigenação Hiperbárica/métodos , Pulmão/patologia , Masculino , Modelos Animais , Tamanho do Órgão , Pressão Parcial , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fatores de Tempo , Capacidade Vital
15.
Artigo em Inglês | MEDLINE | ID: mdl-34348533

RESUMO

Objective: To measure the correlation between single breath counting (SBC) and forced vital capacity (liters, FVCL) in amyotrophic lateral sclerosis (ALS) patients and to define the utility of SBC for determining when patients meet the threshold for initiation of noninvasive positive pressure ventilation (FVC < 50% predicted [FVCpred]). Methods: Both patient paced (SBCpp) or externally paced (SBCep) counting along with FVCL+pred and standard clinical data were collected. Linear regression was used to examine SBCpp and SBCep as a predictor of FVCL. Receiver operating characteristic curve analysis evaluated the sensitivity and specificity of SBC categorically predicting FVCpred of ≤50%. Results: In 30 ALS patients, SBC explained a moderate proportion of the variance in FVCL (SBCpp: R2= 0.431, p < 0.001; SBCep: R2 = 0.511, p < 0.01); this proportion improved when including covariates (SBCpp: R2= 0.635, p < 0.01; SBCep: R2= 0.657, p < 0.01). Patients with minimal speech involvement performed similarly in unadjusted (SBCpp: R2 = 0.511, p < 0.01; SBCep: R2= 0.595, p < 0.01) and adjusted (SBCpp: R2 = 0.634, p < 0.01; SBCep: R2= 0.650, p < 0.01) models. SBCpp had 100% sensitivity and 60% specificity (area under curve (AUC) = 0.696) for predicting FVCpred <50%. SBCep had 100% sensitivity and 56% specificity (AUC = 0.696). With minimal speech involvement SBCpp and SBCep both had 100% sensitivity and 76.1% specificity (SPCpp: AUC = 0.845; SBCep: AUC = 0.857). Conclusions: SBC explains a moderate proportion of variance in FVC and is an extremely sensitive marker of poor FVC. When FVC cannot be obtained, such as during the current COVID-19 pandemic, SBC is helpful in directing patient care.


Assuntos
Esclerose Amiotrófica Lateral , COVID-19 , Esclerose Amiotrófica Lateral/diagnóstico , Humanos , Pandemias , SARS-CoV-2 , Capacidade Vital
16.
Artigo em Inglês | MEDLINE | ID: mdl-34444488

RESUMO

To develop a methodology for predicting success in artistic swimming based on a set of morphofunctional indicators and indices, 30 schoolgirls, average age (12.00 ± 0.22), were divided into two groups. Group 1: 15 athletes, training experience 4-5 years. Group 2: 15 schoolgirls without training experience. For each participant, we determined the length and weight of the body, the circumference of the chest, vital lung capacity, and the circumference of the biceps in a tense and at rest. The Erisman index, biceps index, and the ratio of proper and actual vital lung capacity was calculated. Them, we conducted the Stange and Genchi hypoxic tests, and flexibility tests for "Split", "Crab position", and "Forward bend". Prediction was conducted using the Wald test with the calculation of predictive coefficients and their informativeness. A predictive table containing results of functional tests and indices of artistic swimming athletes is developed. It includes nine criteria, which informativeness varied in the range of 395.70-31.98. The content of the prediction consists of evaluating the results, determining the appropriate predictive coefficient, and summing these coefficients before reaching one of the predictive thresholds. The conducted research allowed us to substantiate and develop a method for predicting the success of female athletes with the use of morphofunctional indicators and indices.


Assuntos
Atletas , Natação , Feminino , Humanos , Hipóxia , Capacidade Vital
17.
Chin Med J (Engl) ; 134(13): 1552-1560, 2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34250960

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD. METHODS: A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES. RESULTS: The mean age of the 2421 participants was 56.63 ±â€Š9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%-13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43-0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49-0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index. CONCLUSIONS: Education, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , Classe Social , Espirometria , Capacidade Vital
18.
Artigo em Chinês | MEDLINE | ID: mdl-34218571

RESUMO

Objective: To explore the short-term effects of welding fumes on workers' lung function in the welding environment preliminarily, and provide reference for future research. Methods: In October 2020, the lung function of the subjects was repeatedly measured before and after the working shift with a panel study. The paired t test was used to compare the lung function before and after the shift, and the linear mixed effects model was used to analyze the short-term changes of lung function. Results: 36 male welders were included, and the average age was (30.72±5.21) years, average employed year was (4.36±2.17) years. And the average concentration of welding fume was (1.27±0.49) mg/m(3). The forced vital capacity (FVC) , forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF) of welders after the shift were significantly lower than those before the shift (t=19.52, 48.13, 62.03, P<0.05) . After adjusting the workers' age, BMI and employed years, the changes of FVC% and FEV1% with the concentration of welding fume were statistically significant (ß=-1.02, 95%CI: -1.54--0.52; ß=-1.56, 95%CI: -1.95--1.16; P<0.01) . In another word, for the 1 mg/m(3) increase of welding fume in the working environment, compared with the baseline, the FVC decreases by 1.02%, and FEV1 decreases by 1.56%. Conclusion: Short-term exposure to welding fumes in workplace can reduce the lung function of welders.


Assuntos
Poluentes Ocupacionais do Ar , Doenças Profissionais , Exposição Ocupacional , Soldagem , Adulto , Humanos , Pulmão , Masculino , Capacidade Vital
19.
Artigo em Inglês | MEDLINE | ID: mdl-34209104

RESUMO

Nickel is a well-known skin allergen; however, few studies to date have investigated the association between nickel exposure and lung function impairment. The present study, therefore, evaluated the relationship between blood nickel concentrations and lung function profiles in the Korean general population (n = 1,098). Dose-response relationships between blood nickel quartiles and pulmonary function were assessed by sex in multivariate models, after adjustment for potentially confounding factors such as age, height, and smoking status. Quartiles of blood nickel concentrations were significantly associated with markers of pulmonary function in Korean men, such as forced expiratory volume in 1 second (FEV1) and forced expiratory flow 25-75% (FEF25-75%). Relative to the first quartile, the estimated coefficients (standard error (SE)) of blood nickel levels for FEV1 in the third and fourth quartiles of Korean men were -126.6 mL (59.1) and -138.5 mL (59.8), respectively (p < 0.05). Relative to the first quartile, the estimated coefficients (SE) of blood nickel levels for FEF25-75% in the second and fourth quartiles were -244.9 mL (109.5) and -266.8 mL (111.5), respectively (p < 0.05). Dose-response relationships were observed between quartiles of blood nickel concentrations and the pulmonary function markers FEV1 and FEF25-75% in Korean men aged 40 or older.


Assuntos
Pulmão , Níquel , Exposição Ambiental/efeitos adversos , Volume Expiratório Forçado , Humanos , Masculino , Níquel/toxicidade , República da Coreia/epidemiologia , Capacidade Vital
20.
Artigo em Inglês | MEDLINE | ID: mdl-34209922

RESUMO

Diabetes mellitus is a highly challenging global health care problem. This study aimed to assess the effect of glycated hemoglobin (HbA1c) and duration of diabetes on lung function in type 2 diabetic patients and assess whether duration or high HbA1c is more noxious to damage the lung functions. A total of 202 participants, 101 patients with type 2 diabetes mellitus (T2DM), and 101 age-, gender-, height-, and weight-matched controlled subjects were recruited. The HbA1c was measured through a clover analyzer, and lung function test parameters were recorded by spirometry. The results revealed a significant inverse correlation between HbA1c and Vital Capacity (VC) (r = -0.221, p = 0.026), Forced Vital Capacity (FVC) (r = -0.261, p = 0.008), Forced Expiratory Volume in First Second (FEV1) (r = -0.272, p = 0.006), Forced Expiratory Flow 25% (FEF-25%) (r = -0.196, p = 0.050), Forced Expiratory Flow 50% (FEF-50%) (r = -0.223, p = 0.025), and Forced Expiratory Flow 75% (FEF-75%) (r = -0.169, p = 0.016). Moreover, FEV1 (p = 0.029), FEV1/FVC% (p = 0.006), FEF-50% (p = 0.001), and FEF-75% (p = 0.003) were significantly lower in the diabetic group with duration of disease 5-10 and >10 years compared to the control group. The overall results concluded that high HbA1c or uncontrolled diabetes mellitus has a more damaging effect on lung function impairment compared to the duration of diabetes mellitus. Physicians must regularly monitor the HbA1c level while treating diabetic patients, as good glycemic control is essential to minimize the complications of DM, including lung function impairment in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Volume Expiratório Forçado , Hemoglobina A Glicada/análise , Humanos , Pulmão , Espirometria , Capacidade Vital
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