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PubMed1995

Perception of dyspnoea during acute changes in lung function in patients with either asthma or COPD.

The aim of the study was to evaluate the relationship between several lung function indices and perceived dyspnoea during bronchoconstriction. Acute changes in lung function were induced by inhaled histamine followed by terbutaline, in 12 asthmatics and 12 subjects with chronic obstructive pulmonary disease (COPD). A bipolar visual analogue scale (VAS), allowing subjects to report either improvement or worsening when moving off from a 'nochange' midpoint, was used to rate shortness of breath. Large swings in ratings were seen in all asthmatics and in seven out of 12 COPD subjects (high perceivers). Using linear regression of VAS rating against parallel change in lung function, on a within-subject basis, the highest degree of correlation between dyspnoea and objective response was found to involve the change in specific inspiratory resistance (sRin) in the asthmatics. In the five low perceivers, the ability to discriminate an increase in airway obstruction, estimated as the VAS/change in lung function slope, was very poor. Using a stepwise multiple regression analysis, the sensation of dyspnoea was found to be significantly related to the FEV1 and the sRin in the asthmatics, to the inspiratory vital capacity and the maximal inspiratory flow at 50% FVC (MIF50) in the COPD subjects with high perception, and to the MIF50 in the COPD subjects with low perception.

Aged↗

PubMed1996

Longitudinal decline in lung function in patients with occupational asthma due to western red cedar.

BACKGROUND: There are few reports about longitudinal changes in lung function in asthmatic patients. Patients with asthma had a greater loss of lung function than normal healthy adults. To date, there have been no studies about the longitudinal changes in lung function in patients with occupational asthma. METHODS: 280 male patients with red cedar asthma (RCA) who were followed up for at least one year were the study group. The exposed controls consisted of 399 male sawmill workers. Forced expiratory volume in one second (FEV1) was measured with a Collins water spirometer. Changes in FEV1 over time (FEV1 slope) were calculated by a two point method for each subject. Atopy was considered to be present if the subjects showed at least one positive response to three allergens by skin prick test. RESULTS: Multiple regression analysis was carried out to examine factors that might affect longitudinal decline in FEV1. Patients with RCA who were still exposed had a greater decline in FEV1 slope (-26 ml/y) than sawmill workers. Smokers also showed a greater rate of decline in FEV1 (-43 ml/y) than non-smokers. CONCLUSIONS: Patients with RCA who continued to be exposed had a greater rate of decline in FEV1 than sawmill workers. Early diagnosis of occupational asthma and removal of these patients from a specific sensitiser is important in the prevention of further deterioration of lung function and respiratory symptoms.

Adult↗

PubMed1984

The relationship of respiratory symptoms and lung function loss in cotton textile workers.

We explored the relationship between a number of respiratory symptoms or symptom complexes (e.g., cough, recent wheeze, byssinosis) and lung function in white cotton textile workers (CTW) and control subjects 45 yr of age or older. The CTW were studied in 1973 and in 1979 in Columbia, South Carolina, and the control subjects were studied in 1972 and in 1978 in Lebanon, Connecticut. The CTW had a high prevalence of byssinosis (18%) and other symptoms. For each symptom or symptom complex, among persons with the symptom, CTW had lower lung function on the average than did control subjects. Also, among persons without the particular symptom, CTW had lower lung function than did control subjects. This pattern also occurred for persons without any respiratory symptoms (i.e., asymptomatic). Moreover, persons (CTW or control subjects separately) reporting the presence of a particular symptom had, in general, lower lung function than did those without the symptom. Among nonsmokers, all these same patterns usually held, but differences were often not statistically significant because of the small numbers of persons with symptoms. We conclude that on a group basis, respiratory function is more impaired in CTW than in control subjects with respiratory symptoms, that respiratory function is more impaired in persons (CTW or control subjects) with symptoms than in those without, and that even asymptomatic CTW have significantly greater lung function impairment than do control subjects.

Aged↗

PubMed1993

Lung function, respiratory illness, and passive smoking in British primary school children.

BACKGROUND: Many studies have reported a significant association between parents' smoking and reduced lung function in their children, but often the association has been found to be significant only in relation to maternal smoking. There have been few epidemiological studies on this topic in Britain. METHODS: Spirometry, in 2756 children aged 6.50-11.99 years, was carried out in a representative sample of English children, an inner city and ethnic minority sample, and a Scottish sample. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow rates of 25-75% and 75-85% (FEF25-75 and FEF75-85) were measured and standardised scores obtained separately for the English representative sample, the Scottish sample and subgroups in the inner city sample, white and Afro-Caribbean children and those originating from the Indian subcontinent. Multiple regression analyses were used to assess associations of FVC, FEV1, FEF25-75 and FEF75-85 with the passive smoking and respiratory illness, with adjustment for a large number of potential confounders. Passive smoking was defined in terms of reported number of cigarettes smoked at home by each parent. The respiratory symptoms and illnesses assessed were wheeze, asthma and bronchitis attacks, cough in the morning, and cough at any other time as reported by parents. RESULTS: Maternal smoking, but not paternal smoking, was associated with reduced FEF25-75 and FEF75-85 in boys. No association was found between passive smoking and lung function in girls, but in an analysis including both sexes the interaction of sex and parental smoking on lung function was not significant. With few exceptions, FEV1, FEF25-75 and FEF75-85 were reduced in children with wheeze and asthma attacks. CONCLUSIONS: The effect of passive smoking may depend on the close contact of a parent with a susceptible child as only maternal smoking in boys was significantly associated with impaired lung function. However, this explanation remains unsubstantiated. A parent's report of wheeze and asthma attacks in the child is reflected in reduced lung function.

Child↗

PubMed2000

Effects of ambient ozone on lung function in children over a two-summer period.

There is a general consensus that short term exposure to ozone (O3) causes a decrease in lung function parameters such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). The objective of this study was to assess the reproducibility of lung function decrements after ambient O3 exposure over a two-summer period. The authors studied 797 children with a mean age of 8.2 yrs (95% confidence interval: 6.9-9.5) from the second and third grades of ten elementary schools in Austria and southwestern Germany. At the outset the various study locations were stratified into three groups with low (L), medium (M) and high (H) O3 exposure (range of mean O3 concentration in the locations April-October 1994: 24-30 (L); 33-38 (M); 44-52 (H) parts per billion (ppb)). Four lung function tests were performed on each child between March 1994 and November 1995. The increases in FVC and FEV1 recorded from one test period to the next were expressed as mL x day(-1). A significantly lower FVC and FEV1 increase was observed in children exposed to high ambient O3 concentration during the summer season. (FVC in summer 1994: 0.83 (L); 0.56 (M); 0.55 (H) mL x day(-1); p=0.004; and summer 1995: 0.80 (L); 0.63 (M); 0.56 (H) mL x day(-1); p=0.011; FEV1 in summer 1994: 0.48 (L); 0.34 (M); 0.18 (H) mL x day(-1); p=0.004 and summer 1995: 0.68 (L); 0.45 (M); 0.41 (H) mL x day(-1), p=0.006). There was no significant difference in FVC or FEV1 increase between the groups during the winter period. Adjusting for sex, age, height and passive smoke exposure, linear regression revealed a statistically significant negative association of average ambient O3 concentration with the FVC and FEV1 increase in both summers. During the winter period no association of O3 with FVC or FEV1 was observed. In conclusion, in two consecutive summer periods the authors found reproducible lung function decrements in children exposed to high levels of ambient ozone. Reoccurrence of ozone associated lung function deficits might increase the likelihood of persisting effects on the childrens' airways.

Child↗

PubMed1989

[Epidemiologic cross-sectional study of the prevalence of chronic bronchitis and lung function disorders in swine breeders and milkers].

In an epidemiological cross-sectional study the influence of occupation in swine production confinements on development of chronic bronchitis and lung function impairments was investigated. The study population comprised 307 swine confinement workers and 165 cattle workers without significant differences in age distribution and smoking habits. For evaluation of respiratory symptoms a standardized questionnaire was used. The following lung function tests were carried out: FVC, FEV1, RV, MEF25, MEF50, PEF and Raw. Regarding the prevalence of chronic bronchitis and lung function impairments no statistically significant differences were found between the two groups. Indeed swine confinement workers indicated a distinct trend to a higher prevalence of chronic bronchitis in correlation to the duration of employment. Workers in swine confinement buildings with more than 10 y exposure showed significantly worse mean values of the measured lung function parameters and significantly more frequent pathological lung function values than the control group of cattle workers.

Adult↗

PubMed2000

Relationship between clinical signs and lung function in horses with recurrent airway obstruction (heaves) during a bronchodilator trial.

During a trial to determine the dose response to the beta2-adrenergic agonist pirbuterol, we judged the severity of airway obstruction by use of a clinical scoring system and compared this to objective data obtained by quantitative measures of lung function. Six horses affected by recurrent airway obstruction were used in this trial. Four hundred and sixty-eight measurements of lung function and clinical scores were obtained from 13 measurement periods when horses received each of 6 doses of pirbuterol. Scores of 1-4 were assigned to degree of nasal flaring and abdominal effort and summed for a total score. The veterinarian scoring the signs did not know the dose of pirbuterol received by the horse and was unaware of the lung function data. Nasal, abdominal and total scores were significantly related to changes in lung function and changes in breathing pattern. There were significant differences between total scores greater than 5 in indices that reflected changes in breathing strategy (peak inspiratory and expiratory flow), peripheral airway obstruction (dynamic elastance), and effort of breathing (maximal change in pleural pressure). Below a total score of 5, there were fewer significant differences in lung function even though measurements of pulmonary resistance and dynamic elastance indicated considerable airway obstruction. Failure of clinical score to reflect this low-grade airway obstruction suggests that airway disease is underdiagnosed and its detection would be helped by the availability of a convenient lung function test.

Airway Obstruction↗

PubMed1988

Lung function following upper sleeve lobectomy for bronchogenic carcinoma.

Eight patients who underwent upper sleeve lobectomy and six who underwent upper simple lobectomy for lung cancer were studied. The two groups were matched for age and preoperative lung function as assessed by standard spirometry. Post-operative lung function studies, including measurements of regional ventilation (Vr) and perfusion (Qr) by 133 Xenon technique showed that: 1) two weeks after surgery, forced expiratory volume at 1 s was more reduced after simple than after sleeve lobectomy, but in both groups Vr and its vertical gradient were similarly reduced in the operated lung compared to the contralateral; 2) one year after sleeve lobectomy, the vertical gradient of Vr tended to disappear in both lungs while Vr and Vr/Qr of the operated side increased significantly. These results indicate that early after surgery lung function may be less impaired after sleeve than simple lobectomy; however, long-term changes of regional lung function may occur after sleeve lobectomy resulting into a high Vr/Qr ratio in the operated lung.

Adult↗

PubMed2002

Effects of glutathione-S-transferase M1, T1, and P1 on childhood lung function growth.

The effects of glutathione-S-transferase (GST) M1, GSTT1, and GSTP1 genotypes on lung function growth were investigated in 1,940 children enrolled in the Children's Health Study as fourth graders (aged 8-11 years) in two cohorts during 1993 and 1996 and were followed annually over a 4-year period. Genotypes for GSTM1 and GSTT1 and GSTP1 codon 105 variants (ile105 and val105) were determined using DNA from buccal cell specimens. We used two-level regression models to estimate the effects of GSTM1, GSTT1, and GSTP1 genotypes on the adjusted annual average lung function growth. GSTM1 null was associated with deficits in annual growth rates for FVC (-0.21%; 95% confidence interval [CI], -0.40, -0.03) and FEV(1) (-0.27%; 95% CI, -0.50, -0.04). Children who were homozygous for the GSTP1 val105 allele had slower lung function growth (FVC -0.35%; 95% CI, -0.62, -0.07; and FEV(1) -0.34%; 95% CI, -0.68, 0.00) than children with one or more ile105 alleles. Children with asthma who were homozygous for the GSTP1 val105 allele had substantially larger deficits in FVC, FEV(1), and maximal mid-expiratory flow than children without asthma. The deficits in FVC and FEV(1) growth associated with both GSTM1 null and the GSTP1 val105 allele were largest and were statistically significant in non-Hispanic white children. We conclude that GSTM1 and GSTP1 genotypes are associated with lung function growth in school children.

Case-Control Studies↗

PubMed2006

Interferon gamma polymorphisms and their interaction with smoking are associated with lung function.

Interactions between genetic and environmental determinants are likely to be important in the pathogenesis of chronic obstructive pulmonary disease. We hypothesized that interferon gamma (IFNG) single nucleotide polymorphisms (SNPs) and their interaction with smoking are associated with the rate of decline or level of lung function in smokers. We studied four SNPs in IFNG in 585 non-Hispanic whites (NHW) who had the fastest (n =280) or the slowest (n=305) decline of FEV(1)% predicted selected from among continuous smokers followed for 5 years in the NHLBI Lung Health Study. We also studied 1061 NHW with the lowest (n=530) or the highest (n=531) baseline lung function at the beginning of the LHS. Two SNPs were associated with baseline levels of lung function and the p values were 0.008 for +2197T/C in a dominant model and 0.002 for +5171A/G in a recessive model. However, after adjusting for confounding factors, only +5171A/G was still significant (p=0.001 for the recessive model). In addition, there was a significant genotype and smoking interaction with p=0.006 for the +5171A/G (GG vs.GA + AA) for the baseline lung function. When comparing individuals with GG versus individuals with AG + AA for low lung function, the adjusted odds ratios decreased significantly as pack-years increased. No association was found in the rate of decline study. There was an association between IFNG genotype and baseline of lung function and this association was modified by cigarette smoking.

Case-Control Studies↗

PubMed1995

The role of three dimensional functional lung imaging in radiation treatment planning: the functional dose-volume histogram.

PURPOSE: During thoracic irradiation (XRT), treatment fields are usually designed to minimize the volume of nontumor-containing lung included. Generally, functional heterogeneities within the lung are not considered. The three dimensional (3D) functional information provided by single photon emission computed tomography (SPECT) lung perfusion scans might be useful in designing beams that minimize incidental irradiation of functioning lung tissue. We herein review the pretreatment SPECT scans in 86 patients (56 with lung cancer) to determine which are likely to benefit from this technology. METHODS AND MATERIALS: Prior to thoracic XRT, SPECT lung perfusion scans were obtained following the intravenous injection of approximately 4 mCi of 99mcTc-labeled macro-aggregated albumin. The presence of areas of decreased perfusion, their location relative to the tumor, and the potential clinical usefulness of their recognition, were scored. Patients were grouped and compared (two-tailed chi-square) based on clinical factors. Conventional dose-volume histograms (DVHs) (DVFHs) are calculated based on the dose distribution throughout the computed tomography (CT)-defined lung and SPECT-defined perfused lung, respectively. RESULTS: Among 56 lung cancer patients, decreases in perfusion were observed at the tumor, adjacent to the tumor, and separate from the tumor in 94%, 74%, and 42% of patients, respectively. Perfusion defects adjacent to the tumor were often large with centrally placed tumors. Hypoperfusion in regions separate from the tumor were statistically most common in patients with relatively poor pulmonary function and chronic obstructive pulmonary disease (COPD). Considering all SPECT defects adjacent to and separate from the tumor, corresponding CT abnormalities were seen in only approximately 50% and 20% of patients, respectively, and were generally not as impressive. Following XRT, hypoperfusion at and separate from the tumor persisted, while defects adjacent to the tumor improved in several patients. In four patients who achieved a complete response scored by CT with chemotherapy prior to XRT, persistent hypoperfusion was present at and adjacent to the tumor site in three. Among 30 patients with cancers not arising in the lung (14 breast, 12 lymphoma, 4 others), perfusion defects were seen in only 4 (2 adjacent and 2 apart). Recognition of decreases in perfusion mainly impacted on treatment planning for a few patients with poor pulmonary function and limited target volumes. DVFHs have been useful in beam selection for patients with marked perfusion heterogeneities. CONCLUSIONS: Lung perfusion scans provide functional information not provided by CT scans that can be useful in designing radiation treatment beams that minimize incidental irradiation of the function regions of the lung. This approach appears to be most helpful in patients with gross intrathoracic lung cancer, especially those with small targets and relatively poor pulmonary function. One limitation of this approach is that some of the defects adjacent to the tumor site reperfuse following treatment, indicating that these scans identify perfusion rather than potential perfusion. Three dimensional functional data can be used to generate DVFHs that may be more predictive of the physiological consequences of the radiation than conventional DVHs. Additional work is currently underway to test this hypothesis.

Forced Expiratory Volume↗

PubMed2000

Lung function measurement in general practice. General practice measurements compared with laboratory measurements during the DIMCA trial.

BACKGROUND: Lung function measurement in the general practice setting (GPS) is of growing importance. OBJECTIVE.:The aim of this study was to compare results from a lung function laboratory (LFL) with those in a GPS. METHODS: Comparisons were made for decline calculated from GPS and LFL measurements and intra-individual paired measurements. Test characteristics of the spirometer used in the GPS were also assessed. RESULTS: The mean decline in lung function was: -0.037 l/year [95% confidence interval (CI) -0.202 to 0.129] from LFL data and -0.027 l/year (95% CI -0.242 to 0.188) from GPS data. The mean intra-individual difference was -0.0025 l (95% CI -0.493 to 0.488 l). The test characteristics of the spirometer used in GPS did not meet all of the American Thoracic Society guidelines; in particular, the random error was too large. The difference in assessments between measurement in LFL and GPS were such that misclassification might occur if slopes were calculated. CONCLUSIONS. :Repeated measurement in this study showed that GPS measurements are not interchangeable with LFL measurements. Therefore, one has to be cautious when interchanging lung function data from an LFL and a GPS.

Clinical Trials as Topic↗

PubMed1976

Models of respiratory insufficiency in view of lung function diagnostics and pathogenetic analysis (author's transl).

Organizing principles of lung function diagnostics and of research in the field of pathophysiology of respiratory insufficiency are developed starting from fundamental requirements, which are practical effectivity, scientific basement, technical development and teamwork of specialists in a complementary system. Technique of screening level, primary oriented of effectivity, is based on the simple monoalveolar model of ventilation. Basal lung function diagnostics, primary oriented on objectivity, representing the total of pulmonary impairment is based on the model of arterial hypoxemia. Condition and limitations of these models are discussed preparing its substitution by models of complex lung function analysis in the higher level diagnostic system.

Binding Sites↗

PubMed2001

A study of mechanisms underlying amitriptyline-induced acute lung function impairment.

In this study possible mechanisms underlying the vaso- and bronchoconstriction caused by the tricyclic antidepressant drug amitriptyline in isolated rat lungs were investigated. Some features here are similar to those apparent in adult respiratory distress syndrome and acute lung injury. Amitriptyline exposure (50 and 100 microM) caused a dose-related, pronounced, and rapid vaso- (50 microM, 30 min, p < 0.001 and 100 microM, 30 min, p < 0.001) and bronchoconstriction (50 microM, 30 min, p = 0.01 and 100 microM, 30 min, p < 0.001). The maximal noted decrease in perfusion flow was 28 +/- 2.9% at 25 min and 80 +/- 4.5% at 30 min for 50 and 100 microM amitriptyline, respectively. The maximal noted decrease in airway conductance was 29 +/- 4.7% at 25 min and 68 +/- 5.0% at 30 min. To investigate mechanisms thought to be involved in amitriptyline-induced lung function impairment, lungs were treated with several different substances including antiinflammatory agents, antioxidants, inhibitors of enzymes involved in the arachidonic acid cascade, physiological antagonists, and neurogenic antagonists. A significant reduction of amitriptyline-induced vasoconstriction was observed when lungs were treated with the protein kinase inhibitor staurosporine (3 microM, 30 min, p < 0.001), the NO-donor S-nitrosoglutathione (100 microM, 30 min, p < 0.001) and the combined endothelin A/endothelin B receptor antagonist PD 145065. This latter inhibitor caused a significant attenuation of late vasoconstriction (1 microM, 60 min, p = 0.03). The amitriptyline-induced bronchoconstriction was attenuated by the beta(2)-agonist salbutamol (1 microM, 30 min, p = 0.03) and the platelet-activating factor antagonist WEB2086 (10 microM, 30 min, p = 0.03). Staurosporine had an initial protective effect on bronchoconstriction (3 microM, 5 min, p = 0.003), while PD145065 significantly decreased bronchoconstriction 60 min after start of amitriptyline exposure (1 microM, 30 min, p = 0.003). This indicates that endothelin as well as platelet activating factor and protein kinase activation are important in mediating amitriptyline-induced lung function impairment in our experimental model and perhaps also in acute lung injury.

Acute Disease↗

PubMed2003

Measuring the lung function in the mouse: the challenge of size.

Measurement of the effects of drugs, mediators and infectious agents on various models of lung disease, as well as assessment of lung function in the intact mouse has the potential for significantly advancing our knowledge of lung disease. However, the small size of the mouse presents significant challenges for the assessment of lung function. Because of compromises made between precision and noninvasiveness, data obtained may have an uncertain bearing on the mechanical response of the lung. Nevertheless, considerable recent progress has been made in developing valid and useful measures of mouse lung function. These advances, resulting in our current ability to measure sophisticated indices of lung function in laboratory animals, are likely to lead to important insights into the mechanisms of lung disease.

Airway Resistance↗

PubMedDate not supplied

[A follow-up study of lung function among ex-asbestos workers with and without pleural plaques].

BACKGROUND: Pulmonary function testing is widely accepted as an integral part of medical surveillance of occupational lung diseases. There are several cross-sectional studies evaluating lung function among asbestos-exposed workers, but only few longitudinal surveys have been performed. OBJECTIVES: To evaluate, over a mean follow-up period of 3.7 (SD 1.8) years, the loss of lung function in a group of 103 workers with previous exposure to asbestos (mainly ship building/repairing), according to the presence or absence of pleural plaques at radiological examination. METHODS: Chest radiographic examination was used to ascertain the presence/absence of pleural plaques. If chest X-ray films were positive for pleural plaques, HRCT (High Resolution Computed Tomography) was used to exclude any parenchymal disease. The assessment of lung function over time included repeated measurement of vital capacity (VC), forced expiratory volume in one second (FEV1) and total lung capacity (TLC). Smoking was assessed in terms of pack-years. A Generalized Estimating Equations (GEE) approach to repeated spirometric measurement was used to investigate the relationship between the loss of pulmonary function and (i) presence/absence of pleural plaques, (ii) smoking status, and (iii) work seniority in workplaces with exposure to asbestos. RESULTS: In the ex-asbestos workers, mean age at the first examination was 49 (SD 6) years and work seniority averaged 25 (SD 7) years; 36% were non-smokers, 27% smoked < 15 pack-years, and 37% smoked > or = 15 pack-years. Thirty-six workers showed pleural plaques at radiological examination. Overall, 236 measurements of VC and FEV1, and 234 determinations of TLC were available. Multivariate GEE approach to age- and height-adjusted spirometric data showed that pleural plaques were not associated with a significant loss of pulmonary function during the follow-up. When compared with non-smokers, heavy smokers (> or = 15 pack-years) showed on average a significant loss of VC (-5.3%, IC 95%: -9.4 - -1.2%), FEV1 (-8.4%, IC 95%: -13.2 - -3.5%), and TLC (-4.0%, IC 95%: -7.4 - -0.5%). An occupational history of previous exposure to asbestos was significantly associated with an 10-year decrease in VC (-3.1%, IC 95%: -5.9 - -0.3%) and FEV1 (-4.9%, IC 95%: -8.3 - -1.5%). CONCLUSIONS: The results of this follow-up study showed that smoking and previous asbestos exposure were associated with a mild, but statistically significant, loss of lung function. Radiological findings of pleural plaques were not related to deterioration of lung function over the follow-up period.

Asbestosis↗

PubMed2000

Effect of thoracic sympathectomy on arm and leg exercise capacity and on lung function.

BACKGROUND: Thoracic T(2-4) sympathectomy (TS) relieves palmar hyperhidrosis. These same roots innervate the heart and the lung. Thoracoscopic TS minimizes damage to the chest wall so that the effect of sympathectomy itself on these organs can be studied. We attempted to determine whether attenuated sympathetic output affects arm or leg exercise tolerance and lung function in young adults who underwent this operation. METHODS: Seven subjects, aged 17-30 years, had lung function tests (water spirometer, Godart, Holland), and leg and arm maximal exercise (CPX, MedGraphics, USA), before and 3-6 months after TS. RESULTS: After TS, resting and exercise heart rate and blood pressure were reduced. Baseline leg and arm peak O(2) uptake, 2.08 (0.6) and 1.44 (0.5) liters/min, respectively, were not different from the post-TS values, 2.06 (0.7) and 1.54 (0.5) liters/min (nonsignificant). Post-TS lung functions were not significantly reduced. CONCLUSION: Thoracoscopic T(2-4) sympathectomy does not lead to a clinically important fall in lung function and does not compromise arm or leg exercise capacity. Therefore, TS can be done safely in young subjects with palmar hyperhidrosis.

Adolescent↗

PubMed2005

Comparison of lung function after myeloablative and 2 Gy of total body irradiation-based regimens for hematopoietic stem cell transplantation.

Lung function decline is a well-recognized occurrence after myeloablative hematopoietic stem cell transplantation (HCT) that has not been studied after nonmyeloablative conditioning regimens. We examined the lung function of patients before and after 2-Gy total body irradiation-based nonmyeloablative and myeloablative preparative regimens. Before HCT, at day 100, and 1 year after HCT, nonmyeloablative patients had lower 1-second forced expiratory volume (FEV1), forced vital capacity, total lung capacity, residual volume, and carbon monoxide diffusion capacity. However, after transplantation, the risk for experiencing a >20% per year decrease of FEV 1 was significantly lower for nonmyeloablative than myeloablative patients >50 years of age (odds ratio, 0.3; 95% confidence interval, 0.1-0.8; P = .01). Lower pretransplantation FEV 1 was associated with a higher mortality rate for both groups, with the highest mortality risk among patients with a pretransplantation FEV 1 <60% (nonmyeloablative: hazard ratio, 3.9; 95% confidence interval, 1.9-8.0; myeloablative: hazard ratio, 7.2; 95% confidence interval, 2.5-21.2). These results suggest that despite having worse lung function, patients who receive the 2-Gy total body irradiation-based nonmyeloablative regimen will likely experience less pulmonary toxicity than patients who receive a myeloablative regimen, and this may have important clinical implications when deciding on a conditioning regimen for patients >50 years of age with compromised pretransplantation lung function.

Adult↗