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PubMedDate not supplied

[The Pulma-01 automated microprocessor system for testing external respiratory function].

The automated system consisting of a pneumotachographic transducer, a differential pressure gauge, a precision amplifier and a microcomputer with a built-in printer is designed for the analysis of 20 main indices of external respiration functioning during forced expiration. It evaluates the measured data, compares them with the normal values and automatically diagnoses the pulmonary disease type.

Computers↗
PubMed1988

Adult maltase acid deficiency myopathy: treatment with long-term home mechanical ventilation.

We report a study of an adult with a maltase acid deficiency myopathy. A restrictive respiratory syndrome due to respiratory muscle weakness is associated with paralysis of other muscular groups. In 1982 the patient presented with an alveolar hypoventilation, and mechanical ventilation was required after acute respiratory failure. The patient has received nocturnal mechanical ventilation by tracheostomy at home for 5 years. His clinical status gradually improved in parallel to amelioration of his respiratory condition. Functional respiratory tests improved: initial hypoxia-hypercapnia disappeared, vital capacity increased. The possible mechanisms underlying the improvement are discussed. Increase in pulmonary compliance is an argument to explain the functional improvement observed. Ventilatory response to carbon dioxide was abnormal whereas the ventilatory response to exercise and maxima minute ventilation test were normal. Results are consistent with a respiratory control impairment. The role of mechanical ventilation is difficult to assess in the improvement we observed.

Adult↗
PubMed1990

[Clinical diagnosis of asthma].

Paroxysmal wheezing dyspnea, asthma may evolve from a simple crisis to an asthmatic attack that repeats several crises daily with duration up to several weeks, in some months when the asthmatic illness becomes life-threatening. Chronology of asthma is related to bronchial inflammation without knowing how to avoid the development of complications. Childhood types and those of subjects of more than 65 years are well characterised by mechanisms of bronchial hyper-reactivity that are always found and are identical to the type found in young adults. There are "limited" types that need respiratory function tests for confirmation of asthma.

Adolescent↗
PubMed2004

[The examination of induced sputum in diagnosis of pulmonary diseases, in general, and in occupational asthma, in particular].

Occupational bronchial asthma is one of the most frequent occupational lung diseases in many countries throughout the world. The diagnosis of this disease is based on clinical and occupational histories, positive immunological tests with potentially allergic agents and functional respiratory tests. However, over the recent years, the induced sputum method has become a new test with promising results for the study of occupational airway diseases. The current state of knowledge of the role of induced sputum in occupational asthma and other respiratory diseases is presented in this article.

Asthma↗
PubMed1997

Lung development and early origins of childhood respiratory illness.

In the last two decades, 5 cohort studies have been initiated to examine the association of infant respiratory function with genetic and environmental risk factors, as well as with subsequent lower respiratory illness in early childhood. While the current complexity of respiratory function tests in this age group precludes study samples with sufficient power to examine more complex issues, information from these studies has provided an exciting adjunct to that available from the longer cohort studies. Premorbid alterations in airway function or lung development increase the risk of wheezing lower respiratory illnesses during the preschool years and the risk of impaired airway function at 5-6 years of age. In addition, gender differences in airway function and the response to maternal smoking have been observed. Larger collaborative population-based studies are needed to explore the environmental, genetic and immunological mechanisms responsible, but will depend on the development of less invasive tests of airway function appropriate for use in healthy infants.

Adolescent↗
PubMed1984

[Can the results of pulmonary function tests and evidence of tobacco-related respiratory symptoms be used to dissuade adolescents from smoking?].

The purpose of this paper is to review arguments recently used to dissuade youth from smoking, nd to propose new ones based on the results obtained in an epidemiological study carried out between 1978 and 1980 among young people attending school. A questionnaire focused on respiratory symptoms and smoking habits was filled out by 2,269 students between 10 and 19 years of age. Among them, a representative sample of 971 underwent a respiratory function test. Two years later, the students who had shown an impaired respiratory function were again examined--along with a representative control group--using the same protocol. During the first examination, we had found a very meaningful relationship between smoking and respiratory symptoms. MOreover, girl smokers evidenced significantly diminished expiratory flows. The students were informed of the results at the time. When the second examination was carried out, some smokers had increased their cigarette consumption, while others had cut back- and it was the latter group that, during the first examination, had had a significantly higher proportion of symptoms and lower respiratory function values. This suggests that showing proof of the real problems caused by smoking could be used as an element in antismoking campaigns among school-attending youth.

Adolescent↗
PubMed2006

Preservation of pleural integrity during coronary artery bypass surgery affects respiratory functions and postoperative pain: a prospective study.

OBJECTIVE: To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functional status in patients undergoing coronary revascularization. METHODS: Two hundred forty patients undergoing on-pump coronary artery bypass grafting between March 2004 and February 2005 were included in the present study. The patients were prospectively randomized and divided into either an opened pleura (OP) group (n=120, patients with an OP) or a closed pleura (CP) group (n=120, patients whose pleural integrity was preserved). Preoperative patient characteristics were similar. Postoperative respiratory functions were compared between the groups by chest x-rays, respiratory functional tests and arterial blood gas analyses. Postoperative pain was compared by using a multidimensional pain score. All the tests were examined by the same blinded clinician. RESULTS: The mean age of the patients was 60.4+/-8.8 years. Postoperative bleeding and the duration of hospital stay were markedly higher in the OP group than in the CP group. The incidences of atelectasis and pleural effusion were also significantly higher in the OP group (P<0.01). Respiratory functions and postoperative pain scores were better in the CP group (P<0.01 and P=0.008, respectively). CONCLUSIONS: Preserving pleural integrity has beneficial effects on the respiratory functions and postoperative pain after coronary revascularization. The preservation of pleural integrity results in better respiratory function, decreased hospital stay and cost, and as a consequence, a better surgical outcome.

Aged↗
PubMed1986

Diagnostic, therapeutic, and prognostic features of cancers of the esophagus: results of the international prospective study conducted by the OESO group (790 patients).

The prospective study conducted by the Organisation internationale d'Etudes Statistiques pour les maladies de l'Oesophage (OESO) (International Organization for Statistical Studies of Esophageal Diseases) created in 1979 concerns 790 patients operated on for a tumor of the esophagus or the mouth of the esophagus. Among the preoperative investigations, endoscopic examinations were associated with a high error rate (20%). Respiratory function tests cannot constitute a formal contraindication to surgery. The value of extended surgical excision is confirmed by the results, although the need for extensive lymphatic resection has not been clearly demonstrated. The incidence of fistula has decreased, but it still remains an important element of operative deaths. However, the complications of esophagectomy are essentially pulmonary and the problem of preoperative identification of high-risk patients has not yet been resolved. The influence of various modalities of postoperative ventilation techniques were evaluated. The overall mortality rate was 14.7%, and a much broader definition of this term is required. Because of a number of contradictions in prognostic factors, the OESO group is currently testing a new clinical and histologic classification.

Combined Modality Therapy↗
PubMed1998

Respiratory symptoms and pulmonary function among stainless steel welders.

In the last few years, many studies have been carried out concerning the effects of fumes from stainless steel (SS) welding on the health of welders. The respiratory effects of exposure to SS welding fumes have already been studied, but the results of lung function investigations have not been consistent. However, the main factor of risk for the welders' health seems to be related to the great concentration of chromium and nickel contained in fumes coming from SS welding. The aim of this study was to detect the chronic effects of SS welding exposure on pulmonary symptoms and ventilatory function tests. Respiratory symptoms and lung function tests were studied in 134 SS welders and 252 controls (C). Welders and controls were of similar average age, height, and duration in employment. The smoking habits of the groups were also similar. The medical questionnaire on respiratory symptoms was a version of the Medical Research Council questionnaire, modified by the British Occupational Hygiene Society. The flow-volume curves were performed with a calibrated pneumotachograph spirometer before each subject started working. After adjustment for tobacco habits, the SS welders presented a higher prevalence of bronchial irritative symptoms such as cough (P = 0.01) or sputum production (P = 0.02) than the controls. On the other hand, chronic bronchitis appeared to be significantly linked to tobacco consumption. The pulmonary function analysis underscored no significant difference between stainless steel welders and controls (forced expiratory volume in one second, observed/predicted: SS = 0.99 vs C = 0.98; maximal midexpiratory flow, observed/predicted: SS = 0.90 vs C = 0.92; maximal expiratory flow at 50 % of the forced vital capacity, observed/predicted: SS = 0.95 vs C = 0.95). On the other hand, by the mean of the two-ways analysis, a significant tobacco effect was found, without exposure or interaction of tobacco-exposure effects. There was no influence of the specific welding processes on the spirographic parameters, but a decrease in spirographic values after 25 years of welding activity was evident. The results of multiple regression indicated that age was not a confounding factor.

Adult↗
PubMed1999

Respiratory function in childhood following repair of oesophageal atresia and tracheoesophageal fistula.

AIM: To determine the relation between respiratory function in infancy and at school age in children who have undergone oesophageal atresia and tracheoesophageal fistula repair, and assess the value of infant respiratory function testing; and to examine the effect of bronchodilators. METHOD: Fourteen children (6 girls, and 8 boys) who had undergone respiratory function testing in infancy were retested at school age (7-12 years). Measurements included lung volume, airways resistance, peak flow, and spirometry. Clinical problems were investigated by questionnaire. Twelve children had repeat measurements after taking salbutamol. RESULTS: Predominant complaints were non-productive cough and dysphagia, but even those children with major problems in infancy reported few restrictions at school or in sport or social activities. Respiratory function and clinical findings at school age appeared unrelated to status in infancy, such that even the patients with severe tracheomalacia requiring aortopexy did not have lung function testing suggestive of malacia at school age. Most patients showed a restrictive pattern of lung volume which would appear to result from reduced lung growth after surgery rather than being a concomitant feature of the primary congenital abnormality. Although six children reported wheeze and four had a diagnosis of asthma, only one responded to salbutamol. This suggests that a tendency to attribute all lower respiratory symptoms to asthma may have led to an overdiagnosis of this condition in this patient group. CONCLUSION: Respiratory function testing in infancy is of limited value in medium term prognosis, but may aid management of contemporary clinical signs. In children respiratory function testing is valuable in assessing suspected asthma and effects of bronchodilators.

Albuterol↗
PubMed1995

Breathing during sleep in myasthenia gravis.

The aim of this study was to assess breathing patterns during sleep in patients with generalized mild myasthenia gravis. Fourteen patients (13 F; 1M, age range 20-40 years) in a stable clinical and functional state underwent a sleep questionnaire, baseline respiratory function tests and standard nocturnal polysomnography. All of the patients had normal daytime blood-gas values, except one who showed mild hypoxemia. No patient complained of disturbed sleep; six patients reported snoring. In five patients nocturnal polysomnography showed the occurrence of short and infrequent central apneas mainly during REM sleep, together with a drop in HbSaO2 levels of more than 5% of the baseline wakefulness value. Our data indicate that, in patients with mild generalized MG in a stable functional state, breathing pattern instability during sleep is infrequent and, when it occurs, is mild and mainly related to REM sleep.

Adult↗
PubMed1999

Can amyotrophic lateral sclerosis patients with respiratory insufficiency exercise?

The authors have shown in a recent paper that survival with amyotrophic lateral sclerosis (ALS) can be increased by the use of non-invasive methods of assisted ventilation (Bipap). However, the progression of muscle weakness was not affected and the quality of life was not positively enhanced. In ALS, reduced physical activity may partially be secondary to alveolar hypoventilation syndrome. This leads to deconditioning of ALS/motor neuron disease (ALS/MND) patients. The authors decided to investigate the possibility of reducing motor decline by exercising these patients to the anaerobic threshold, but simultaneously compensating the respiratory insufficiency with the Bipap STD. We conducted a controlled single blind study, exercising eight consecutive ALS/MND patients and used a control group of 12 ALS/MND patients. The patients were all evaluated during a 1 year period. Respiratory function tests (RFT) were performed at entry and then at 6 month intervals. Barthel, Functional Independent Mobility scale (FIM) and Spinal and Bulbar Norris scores were recorded every 3 months. There was a significant difference between the two groups with respect to FIM scores (P<0.03), but not Barthel scores (P<0.8). A slower clinical course (Spinal Norris score P<0.02) and a significant difference in the slope of the RFT (P<0.008) were observed in the treated group, suggesting that exercise may be beneficial in ALS patients once Bipap is used to control peripheral and muscle oxygenation.

Adult↗
PubMed1987

[Respiratory manifestations of ankylosing spondylitis (50 cases)].

Fifty patients with ankylosing spondylitis underwent radiography of the chest. In addition, 2 of them had bronchography, 3 had computerized tomography (CT) of the chest, 9 had respiratory function tests and 8 head ventilation/perfusion study by the Xenon method. Seven thoracic images were questionably specific of spondylitis, showing plural symphysis, strips of atelectasis, pleural thickening, apical pulmonary sclerosis and opacities of the diaphragmatic hilum. CT proved valuable in 1 case to confirm pulmonary fibrosis and in 2 cases to reveal that pleural thickening was continuous with an opacity ensheathing the vertebral body. In 7 out of 9 cases the functional restrictive deficit was accompanied by normal or supranormal functional residual capacity and increased residual volume. In all patients explored by the Xenon method, there was apical-caudal inversion of the ventilation/perfusion ratio. These findings suggest 3 pathogenic hypotheses: mere sequelae of hypoventilation, specific lung tissue fibrosis, extension by continuity of the vertebra-ensheathing process to the subpleural spaces.

Humans↗
PubMed2002

Postoperative pulmonary dysfunction after bilateral inguinal hernia repair: a prospective randomized study comparing the Stoppa procedure with laparoscopic total extraperitoneal repair (TEPP).

The infraumbilical incision required for open repair of bilateral inguinal hernia with a giant prosthesis is associated with postoperative pain and respiratory impairment. The aim of this study was to evaluate the postoperative respiratory dysfunction after bilateral hernia surgery. Thirty-nine patients were randomized into two groups: open repair according to the Stoppa technique and laparoscopic extraperitoneal repair (TEPP). Respiratory function tests were performed before and 24 hours after surgery. The two groups were well matched for age, American Society of Anesthesiologists (ASA) risk score, type of hernia, and preoperative lung function. The postoperative forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume in 1 second (FEV 1.0) were significantly altered in both groups. The PEF dropped 15% in both groups. The FVC dropped 22% after Stoppa versus 25% after laparoscopy (P = 0.7). The FEV 1.0 dropped 21% after Stoppa versus 9% after laparoscopy (P = 0.12). We conclude that laparoscopic preperitoneal and open bilateral hernia repair are followed by similar ventilatory dysfunction, although a trend toward better postoperative FEV 1.0 was noted after laparoscopy. This might play a role in selected patients with severe pulmonary limitations. Overall, the limited drop in pulmonary function following bilateral hernia repair under general anesthesia may serve to explain the low pulmonary morbidity that follows these procedures.

Adult↗