PubMed HealthSearch

Biomedical subjects

D B Teculescu

Publications and source records attributed to D B Teculescu.

At least 19 recordsLinked to original sources

Snoring in French preschool children.

The prevalence of habitual snoring and its associations with respiratory symptoms, personal and familial risk factors, ear, nose, and throat (ENT) abnormalities, and its influence on ventilatory function were studied in a sample of 190 children aged 5 to 6 years from nine kindergartens in Nancy (northeastern France). Nineteen (10%; 95% CI 5.7-14.3%) of the children were habitual snorers; the prevalence was the same in boys and girls. In univariate analysis habitual snoring was significantly associated with a personal history of exercise-induced bronchospasm [relative risk (RR) 4.50]; a history of adenotonsillectomy (RR, 2.56); a personal history of allergy (RR, 2.83); a sibling history of atopy (RR, 2.39); and doctor-assessed tonsillar hypertrophy (RR, 2.51). These factors were entered into a logistic regression model that retained as independent determinants exercise-induced asthma, personal history of allergy, sibling history of allergy, and tonsillar hypertrophy. The height-adjusted peak expiratory flow rate was slightly, non-significantly lower in habitual snorers as compared to non-snorers (2.01 +/- 0.32 vs 2.10 +/- 0.38 L/s/m2). Due to the limited numbers in the sample, the increased risk for paternal (RR, 1.8) and maternal (RR, 1.6) smoking at home remained nonsignificant.

Child

Pertussis in French adolescents: risk factors and respiratory sequels.

An analysis of the risk factors for pertussis and the possible respiratory sequels was carried out in a sample of 499 children and adolescents aged 10-16 years from the general population in north-eastern France. 44 subjects (8.8%) had pertussis during childhood; and the sex ratio was 1 in these cases. Pertussis was significantly associated with a maternal history of respiratory disease, residence in a rural area and coal heating. In a multiple logistic regression model, a maternal history of respiratory disease was the only significant factor (p = 0.01), the number of siblings being of borderline significance (p = 0.06). No increase in respiratory symptoms or asthma prevalence was found in our subjects who had pertussis during childhood.

Adolescent

Determinants of alveolar nitrogen slope and closing volumes in healthy adolescents.

The alveolar nitrogen slope (PIII), closing volume (CV), and closing capacity (CC) were measured by the single-breath nitrogen washout method (SBN2) in a group of 187 healthy children and adolescents (92 boys, 95 girls), 10 to 16 yr old, from the general population of Lorraine, France. The test was performed using a computerized system, which also made the calculations. About one out of five healthy subjects in this population were unable to satisfactorily perform the test; the failure rate was the same for the two sexes (20% in boys, 21.5% in girls) and significantly higher in younger children (26.6 and 14.5% for children under and over the age of 13, respectively; p = 0.03). The distribution of results was skewed for PIII and practically normal for log PIII, CV, VC, and CV/VC or CC/TLC ratios. PIII was highly significantly, inversely related to anthropometric variables; the highest coefficient was that for the age-weight interaction term in boys (= r -0.57 for PIII, -0.62 for log PIII) and for weight in girls (r = -0.57 for both PIII and log PIII). Because the anthropometric variables were strongly interrelated (r between 0.45 and 0.79), multiple regressions did not materially improve the prediction of PIII. In simple regression, weight alone explained 36% of the variability of log PIII in boys and 32% in girls. The mean PIII was significantly higher in girls as compared to boys (1.14 +/- 0.38 versus 0.98 +/- 0.17% N2/L, p = 0.02); CV and CC in milliliters were related to body build as other lung volumes; the CV/VC in girls and CC/TLC ratio in both sexes were not related to anthropometric variables. In boys, CV/VC decreased significantly with height (p = 0.035 for CV/VC versus height3).

Adolescent

Small airways dysfunction in asymptomatic ex-smokers.

'Conventional' (lung volumes, airway conductance, CO transfer factor) and 'small-airway dysfunction' (single-breath N2 washout, maximal expiratory flows with air and a helium-oxygen mixture) tests were performed in a group of asymptomatic male ex-smokers (n = 20) with normal spirometry and compared to those of a similar group of middle-aged nonsmokers (n = 41). The study group had a mean life-long consumption of 13.2 +/- (SD) 8.8 pack-years and had stopped smoking 1-21 years ago, mean 7.3 +/- (SD) 5.8 years. Among the conventional tests, a minimal increase in residual volume and residual volume/total lung capacity ratio was found. Ex-smokers had a steeper phase III slope, a higher closing volume/vital capacity ratio, lower forced flows with air and a higher volume of isoflow, but neither difference between the group means was significant. There was a trend to more abnormal small-airway tests as a function of increased smoking, but only the correlation between percent of predicted closing volume and pack-years reached significance (r = +0.51, p less than 0.05). We conclude that small-airway function normalizes in the long term in most ex-smokers if they become asymptomatic, with less than 10% still having abnormal results years after they stopped smoking.

Adult

Lung function in adolescents after uncomplicated whooping cough in childhood.

Ventilatory function (forced vital capacity, forced expiratory volume in one second, forced expiratory flows), static lung volumes, phase III slope and closing volume (single-breath nitrogen washout test) were measured in 499 children and adolescents aged 10-16 yrs from a general population sample in North-East France. A history of whooping cough was given by 44 children (22 of each sex); their results were compared to those of the 455 children (215 girls) with a negative history. The only difference between the two groups was a minimal increase in the residual volume/total lung capacity ratio in cases (19.2 +/- 3.1 vs 18.0 +/- 2.9%). We conclude that uncomplicated whooping cough in early childhood did not lead to significant pulmonary function abnormality in this population of children born after 1967.

Adolescent

Pulmonary function following mild respiratory tract infections ("common cold") in teenagers.

Ventilatory function--forced vital capacity (VC)--forced expiratory volume (in 1-sec forced expiratory flows) static lung volumes, closing volume, and phase III slope (single-breath N2 test) were compared in 94 children with and 436 children without a history of recent mild acute respiratory infection. Their age ranged from 10 to 16 years; subjects with symptoms on the day of the study were excluded. We found no difference in lung function between the two groups, with the exception of a slight (inconsistently significant) increase in closing volume (CV) and the CV/VC ratio. Although the influence of a persistent increase in interstitial lung pressure leading to early small airways closure cannot be ruled out, this isolated functional abnormality probably represents a spurious positive result, arising by chance when a large number of statistical tests are done.

Acute Disease

Computerized single-breath nitrogen washout in children: variability and reproducibility.

The variability, short-term (1 hour) and long-term (2 weeks) reproducibility of the variables derived from the single-breath N2 test were evaluated in a group of 56 healthy children aged 10 to 16 years with a computerized system. The variability was low for vital capacity and total lung capacity (coefficient of variation less than 3%), moderate for residual volume and phase III N2 slope (9 and 13%) and very high for closing volume (more than 50%). A closing volume could not be identified by the computer algorithm in 18.3% of the trials. The reproducibility of the variables was satisfactory both at 1 hour and at 2 weeks, with the exception of the closing volume, whose increase at 2 weeks seemed to be due to methodological factors. We conclude that reliable results of static lung volumes and phase III N2 slope, but not of closing volume, may be obtained in children by a computerized system in epidemiological studies.

Adolescent

[Evaluation of the performance of 2 mini-flow meters].

Two mini-peak flow meters, the Airmed (mini-Wright) and the Medicheck (Pulmonary Monitor), were assessed against a reference electronic spirometer (Spiromatic, based on a pneumotachograph, integrator and an Apple II computer) in a series of 10 healthy subjects and 20 patients with chronic obstructive lung disease. The devices to be tested were mounted in series with the reference instrument; each subject did five trials. It was found that the Airmed instrument overestimated the flows up to 9 l X s-1 (i.e. in patients, average difference 0.86 l X s-1, p less than 0.001; in healthy subjects, average difference 0.35 l X s-1, p less than 0.001). The correlation with the results of the reference instrument was high (r = 0.992) in healthy subjects, whose regression slope was less than unity (0.763). In patients the correlation was satisfactory (r = 0.974), and the slope close to 1 (1.05). The Medicheck overestimated slightly the results of patients (difference 0.17 l X s-1, p less than 0.01); in normal subjects the overestimation was present only below 10 l X s-1 and the difference with the reference instrument nonsignificant (average 0.19 l X s-1). The results were closely related to those of the reference spirometer in both healthy subjects (r = 0.960) and patients (r = 0.936). As for the first instrument the slope of the regression was below 1 in healthy subjects (0.751) and practically one (1.01) in patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Relationships of carbon dioxide retention to ventilatory impairment and hypoxemia in chronic obstructive lung disease.

In a group of 80 male patients (average age 52.5 years) with severe obstructive ventilatory impairment (FEV1.0 less than 40% of predicted) due to chronic bronchitis and/or emphysema, the blood carbon dioxide tension measured at rest, in a stable clinical status, was confronted to the spirometric variables and the oxygen tension. PaCO2 (range 31--60 mm Hg) was loosely related to the VC (r = -0.28) and the FEV (r = -0.30, both p less than 0.05) and strongly related to the PaO2 (r = 0.60; p less than 0.001). When patients were classified as bronchitic or emphysematous according to clinical, roentgenologic and biological criteria, the correlations above were found to be higher for bronchitics. In patients with chronic bronchitis with severe obstruction a very good estimation of PaCO2 is possible from PaO2: PaCO2 = 75.8-0.44 PaO2 (SEE 0.4 MM Hg).

Adult

Smoking and blood oxygen tension in healthy middle-aged males.

The blood oxygen tension (PaO2) was measured using a Clark-type microelectrode on 'arterialised' capillary blood samples obtained from 74 sitting subjects; these were asymptomatic and spirographically normal men aged 42-63 (average 53.7) years. The mean PaO2 of smokers (83.8+/-6.0 mm Hg) was slightly, non-significantly lower as compared to non-smokers (85.5+/-4.9 mm Hg). The trend towards lower mean values with increase in current cigarette consumption or amount smoked in life did not result in significant differences between smoker sub-groups. The lower normal limit for the whole group was 73.3 and the average PaO2 85.3 mm Hg. Though no significant influence of tobacco use could be demonstrated, the histogram of specific subjects shows a bi-modal distribution in smokers, suggesting the existence of a sub-group (about one third of the smokers) who tend to have lower PaO2s, possibly as a consequence of sub-clinical 'small airway disease'.

Adult

Breathlessness and transfer factor for the lung in chronic obstructive lung disease.

The breath-holding CO transfer factor and transfer coefficient were correlated with the severity of dyspnea in 37 patients with moderate or severe obstructive lung disease FEV 1.0 less than 1.5 1) No correlation was evident when the whole group was considered. When the patients were subdivided into "bronchitics", "intermediate" and "emphysematous" a correlation between dyspnea severity and gas transfer appeared for the latter subgroup; this correlation was statistically significant for the transfer coefficient.

Age Factors

Transfer factor for the lung, airway obstruction and hyperinflation in chronic bronchitis and emphysema.

The interrelationships of breath holding lung transfer factor (TCO) and transfer coefficient (KCO) with ventilatory obstruction (FEV1.0) and FEV1.0/VC) and hyperinflation (RV and RV/TLC) were studied in 37 patients with chronic nonspecific lung disease with a FEV1.0 of 1.5 litre or less classified as "bronchitic", "emphysematous" or "intermediate" according to Nash, Briscoe and Cournand (1965). No relationships could be found between TCO and airway obstruction or hyperinflation. KCO tended to decrease as RV increased (r=-0.26) and was weakly related to the FEV1.0/VC ratio in "intermediate" (r=0.34) and "emphysema" (r=0.29) patients but these relationships were nonsignificant.

Adult

Breathlessness and blood oxygen tension in patients with chronic bronchitis and emphysema.

The dyspnea grade (MRC scale) was confronted with the arterial oxygen tension (PaO2) measured at rest in a group of 51 patients with chronic obstructive lung disease with moderate or severe impairment of ventilatory function (FEV 1.0 less than 1.5 1). For the group as a whole no correlation was found, but in the "bronchitic" subgroup (clinical-roentgenologic and biologic criteria) a tendency of PaO2 to decrease with the increase in dyspnea severity was apparent. The linear correlation coefficient did not attain the significance threshold owing to the limited number of observations (r = 0.46; p greater than 0.05).

Adult