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At least 433 records · Page 24Linked to original sources

Oscillatory mechanics of the respiratory system in neuromuscular disease.

Respiratory impedance measurements by means of the technique of forced oscillations together with spirometry and measurements of maximal mouth pressures were performed in 27 patients with a variety of neuromuscular disorders to assess the value of adding respiratory impedance measurements in the evaluation of lung function in neuromuscular disease. Using the technique of forced oscillations, impedance measurements are easily performed in physically disabled persons, since they require little active cooperation and no forced respiratory maneuvers. Normal respiratory impedance characteristics were found, although resistance values were somewhat higher than those found in normal subjects, signifying the absence of airflow limitation. Spirometric values were markedly reduced, as were maximal mouth pressures. No significant correlations were found between the forced expiratory volumes in 1 s (FEV1) and the impedance data. A strong curvilinear relationship was observed between Pemax and the RV/TLC ratio and a strong correlation existed between FEV1 and Premax. It is concluded from our study that forced oscillometry is a useful tool for the assessment or exclusion of airflow obstruction in patients with neuromuscular disorders when plethysmography is difficult to perform and forced expiratory flow-volume data reflect muscle weakness rather than airflow limitation.

Adolescent↗

Allergy to house dust mites in primary health care subjects with chronic or recurrent inflammatory states of respiratory system.

Chronic and recurrent respiratory tract disorders are a frequent problem in general practice. The purpose of the study was to investigate the role of hypersensitivity to house dust mites in respiratory tract diseases in general practice patients. We tried to assess the influence of determined risk factors exposure on development of respiratory tract allergy. Patients from family practitioners surgeries with chronic or recurrent respiratory tract symptoms who had no diagnosis of allergy were recruited to the study (n = 89). All patients responded to a questionnaire focused on history of symptoms, atopic conditions in family and exposure to determined environmental factors like dwelling conditions, obstetrician history, diet in the first year of life. All patients underwent skin prick test with common inhalant allergens. Families of the patients were asked to participate in the study. Families who agreed to take part also responded to the questionnaire and underwent skin tests. In patients and their families blood samples were taken to determine total IgE and specific IgE antibodies to mites allergens. Dust samples were collected by vacuuming of patients' bedroom carpets and mattresses to determine house dust mites allergens concentration. Data on 30 complete patients family sets of their brotherhood, mother and father were collected. Total and specific serum IgE antibodies were determined by disc enzyme-immunoassay (Analco). Mites allergens concentration in dust was measured by simple Acarex strip test (Nexter). The results of the assays (positive skin tests and/or elevated levels of specific IgE) showed allergy to house dust mites in 24 of 89 study patients from general practitioners surgeries (27%). The prevalence of chronic rhinitis, recurrent bronchitis, chronic or recurrent cough, wheezing, dyspnoea was higher in allergic than in nonallergic subjects. Patients with the diagnosis of allergy to house dust mites had usually worse dwelling conditions. Especially the influence of dampness in flats on several respiratory symptoms was observed. Subjects who had been found to be allergic were more frequently exposed to higher concentrations of house dust mites allergens in bedroom carpets and in mattresses. In allergic children early introducing of sensitizing components into the diet in infancy related to shorter breast feeding was observed.

Adolescent↗

Pressure-volume curves of the respiratory system.

The quasi-static pressure-volume (P-V) curve of the respiratory system describes the mechanical behavior of the lungs and chest wall during inflation and deflation. To eliminate resistive and convective acceleration effects, the measurement of volume and pressure must be performed during short periods of apnea or during very slow flow. There are 3 main techniques for acquiring quasi-static P-V curves: the supersyringe method, the constant flow method, and the multiple-occlusion (or ventilator) method. For the information to be interpreted correctly, one must understand the interaction between the lungs and the chest wall, the effects of the supine position, and the meaning of hysteresis. The P-V curve has been studied in many disease states, but it has been applied most extensively to patients with acute respiratory distress syndrome, in hopes that it might allow clinicians to customize ventilator settings according to a patient's individual respiratory mechanics and thus protect the patient from ventilator-induced lung injury. However, lack of standardization of the procedure used to acquire P-V curves, difficulties in measuring absolute lung volume, lack of knowledge regarding how to use the information, and a paucity of data showing a benefit in morbidity and mortality with the use of P-V curves have tempered early enthusiasm regarding the clinical usefulness of the quasi-static P-V curve.

Emphysema↗

Historical cohort study of US man-made vitreous fiber production workers: III. Analysis of exposure-weighted measures of respirable fibers and formaldehyde in the nested case-control study of respiratory system cancer.

The most recent findings of our nested case-control study of respiratory system cancer (RSC) among male fiberglass workers showed some evidence of elevated RSC risk associated with non-baseline levels of average intensity of exposure (AIE) to respirable fibers (RFib). When adjusted for smoking, this was not statistically significant, and no trend was apparent with increasing levels of exposure. Similar findings for RSC were noted for both cumulative exposure (Cum) and AIE to formaldehyde (FOR). In this reanalysis of our nested case-control study, we explored a possible exposure-response relationship between RSC and exposure to RFib or FOR using exposure weighting as an alternative characterization of exposure. Because of the uncertainties in selecting an appropriate exposure-weighting scheme, a range of plausible time lags and unlagged/lagged time windows was considered. As in the initial analysis of the nested case-control study, RFib and FOR exposures were categorized at the deciles of the RSC case distribution. For none of the exposure weighting schemes considered did we observe an increasing RSC risk with increasing levels of RFib_Cum or RFib_AIE. The exposure-weighted estimated risk ratios (RR) for both RFib_Cum and RFib_AIE were generally lower than those obtained from an unweighted model. For FOR_Cum, RRs were generally lower for the time-lagged and unlagged time window models than for the unweighted models, although some decile-specific RRs were higher for the lagged time window models. The exposure-weighted RRs for FOR_AIE were generally lower than the unweighted RRs for all of the weighting schemes considered. This reanalysis in terms of categorized exposures reveals no exposure-response relationships that were undetected in the original analysis where unweighted exposure measures were used. In the schemes considered, exposure weighting generally reduced the estimated risk of RSC.

Adult↗

Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties.

The classic model of the respiratory system (RS) is comprised of a Newtonian resistor in series with a capacitor and a viscoelastic unit including a resistor and a capacitor. The flow interruption technique has often been used to study the viscoelastic behavior under constant inspiratory flow rate. To study the viscoelastic behavior of the RS during complete respiratory cycles and to quantify viscoelastic resistance (Rve) and compliance (Cve) under unrestrained conditions, we developed an iterative technique based on a differential equation. We, as others, assumed Rve and Cve to be constant, which concords with volume and flow dependency of model behavior. During inspiration Newtonian resistance (R) was independent of flow and volume. During expiration R increased. Static elastic recoil showed no significant hysteresis. The viscoelastic behavior of the RS was in accordance with the model. The magnitude of Rve was 3.7 +/- 0.7 cmH2O.l-1 x s, i.e., two times R. Cve was 0.23 +/- 0.051 l/cmH2O, i.e., four times static compliance. The viscoelastic time constant, i.e., Cve.Rve, was 0.82 +/- 0.11s. The work dissipated against the viscoelastic system was 0.62 +/- 0.13 cmH2O x 1 for a breath of 0.56 liter, corresponding to 32% of the total energy loss within the RS. Viscoelastic recoil contributed as a driving force during the initial part of expiration.

Adult↗

Physiology and disease of the respiratory system in pregnancy. A review.

This review has attempted to describe the changes in respiratory physiology which occur during pregnancy and to use this knowledge to aid in the understanding of respiratory disease. Three forms of respiratory failure have been described and representative examples of each discussed.

Anesthesia, Obstetrical↗

Effect of occupational and nonoccupational factors on the respiratory system of vinyl chloride and other workers.

There are suggestions in the literature that vinyl chloride (VC) acts as a lung irritant. Respiratory questionnaires and lung function tests were administered to 174 chemical (VC) workers, 81 polyvinyl chloride (PVC) workers, 72 former VC workers, and 136 rubber workers, and 68 maintenance workers with exposure to VC, PVC, and rubber. Except for small airways obstruction associated with rubber, increased respiratory symptoms and decreased pulmonary function were not associated with working in chemicals, plastics, or rubber. Some increases in baseline pulmonary function were associated with VC exposure. Acute reductions in pulmonary function were observed in smokers working in chemicals, plastics, and rubber. Heavier cigarette smokers over 40 years of age had the most adversely affected respiratory system. Work was not associated with chronic respiratory effects, but all exposure groups experienced some acute respiratory insult.

Adult↗