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PubMed1998

Inspiratory flow rate and dynamic lung function in cystic fibrosis and chronic obstructive lung diseases.

STUDY OBJECTIVES: The peak inspiratory flow rates (PIFRs) generated by cystic fibrosis (CF) and COPD patients through a range of clinically relevant resistances have not yet been reported (to our knowledge). The objectives of this study were to (1) explore a relevant range of resistive loads and address whether patients with stable CF and COPD can generate the PIFR sufficient to disperse dry-powder inhalants (DPI) and (2) determine whether the optimal inspiratory flow rate effective for delivery of aerosolized pharmacologic therapeutic agents can be attained with a comfort rating acceptable to subjects. DESIGN: Prospective, controlled, subject-blinded study. SETTING: Pulmonary function laboratory at the VA Palo Alto Health Care System. PATIENTS OR PARTICIPANTS: Thirty-six subjects, including 12 healthy volunteers, 12 subjects with CF, and 12 subjects with COPD were studied. MEASUREMENTS: Studies of dynamic lung function and PIFR without and with varying resistances were obtained at a single laboratory visit. RESULTS: Dynamic lung function and PIFR varied inversely with the resistive load for all patient groups and did not correlate with the disease severity, as indicated by FEV1 of percent predicted. The average subjective comfort rating for any given resistive load was similar for subjects with CF and COPD. CONCLUSIONS: These results support the conclusion that subjects with stable CF and COPD of varying severity can comfortably generate the necessary flow rates to operate new and currently available DPIs over a wide range of inspiratory resistances.

Adolescent↗

PubMed2006

Parental smoking and lung function: misclassification due to background exposure to passive smoking.

We evaluated the role played by background exposure (i.e. exposure to Environmental Tobacco Smoke, ETS, from sources other than parental smoking) when evaluating the effect of parental smoking on lung function of adolescents. We performed a cross-sectional survey (937 adolescents) in the Lazio Region. Data were collected by a questionnaire, lung function tests and urinary cotinine to creatinine ratios (CCR) were measured. We found that 62.1% of subjects were exposed to current parental smoke. Among the 355 adolescents not exposed to parental smoke, a total of 92 (25.9%) had CCR levels greater than the median value of the distribution (17.3 ng/mg). Subjects with smoking parents had higher FVC and significant lower FEV(1)/FVC ratios than subjects without smoking parents. When "Background" ETS exposure was removed from the unexposed group by separately studying those without parental exposure but with CCR>17.3, results showed a reduction in lung function due to parental smoking which is greater compared to the previous model. Our study adds further evidence regarding the detrimental effect of ETS on lung function of adolescents. Negative results on the effect of parental smoking on lung function should be revisited if background exposure has not been considered in the analysis.

Adolescent↗

PubMed1982

Lung function and radiographic change in chrysotile workers in Swaziland.

The effect on lung function and radiographic indices of exposure to chrysotile asbestos was investigated by cross-sectional studies in two groups of men at Havelock Mine, Swaziland. The first group consisted of 214 employees and ex-employees, mean age 52, who had been employed for at least 10 years, and whose dust exposure ranged from minimal for surface workers to very heavy for those in the grading and bagging sections of the mill. In this group 29% had category 1 or more simple pneumoconiosis and 4.5% category 2 or more. For surface and mine workers, the estimated annual deterioration in FEV1 and FVC and the increase in category of pneumoconiosis was similar to that due to age alone, while the heaviest exposure almost doubled the decline in lung function and trebled the rate of progression of pneumoconiosis. The second group consisted of 224 men, mean age 33, all currently working in the mill and having been employed there for at least a year. In this group 30% had category 1 or more simple pneumoconiosis, and 2.7% category 2. Exposure in the dustiest sections of the mill more than doubled the estimated annual decline in lung function and doubled the rate of progression of pneumoconiosis.

Adult↗

PubMed2005

Polymorphisms in signal transducer and activator of transcription 3 and lung function in asthma.

BACKGROUND: Identifying genetic determinants for lung function is important in providing insight into the pathophysiology of asthma. Signal transducer and activator of transcription 3 is a transcription factor latent in the cytoplasm; the gene (STAT3) is activated by a wide range of cytokines, and may play a role in lung development and asthma pathogenesis. METHODS: We genotyped six single nucleotide polymorphisms (SNPs) in the STAT3 gene in a cohort of 401 Caucasian adult asthmatics. The associations between each SNP and forced expiratory volume in 1 second (FEV1), as a percent of predicted, at the baseline exam were tested using multiple linear regression models. Longitudinal analyses involving repeated measures of FEV1 were conducted with mixed linear models. Haplotype analyses were conducted using imputed haplotypes. We completed a second association study by genotyping the same six polymorphisms in a cohort of 652 Caucasian children with asthma. RESULTS: We found that three polymorphisms were significantly associated with baseline FEV1: homozygotes for the minor alleles of each polymorphism had lower FEV1 than homozygotes for the major alleles. Moreover, these associations persisted when we performed an analysis on repeated measures of FEV1 over 8 weeks. A haplotypic analysis based on the six polymorphisms indicated that two haplotypes were associated with baseline FEV1. Among the childhood asthmatics, one polymorphism was associated with both baseline FEV1 and the repeated measures of FEV1 over 4 years. CONCLUSION: Our results indicate that genetic variants in STAT3, independent of asthma treatment, are determinants of FEV1 in both adults and children with asthma, and suggest that STAT3 may participate in inflammatory pathways that have an impact on level of lung function.

Adult↗

PubMed2002

Lung function, arterial pressure and growth in sheep during early postnatal life following single and repeated prenatal corticosteroid treatments.

BACKGROUND: Antenatal corticosteroid therapy is of great benefit to preterm infants, owing largely to effects on lung maturation. In sheep, repeated betamethasone injections given to the ewe improve lung function following preterm birth but also cause intrauterine growth restriction (IUGR). In humans and in animal models, IUGR is associated with impaired postnatal lung function. The effects on lung function of repeated prenatal betamethasone treatments and associated IUGR following term delivery are unknown. AIM AND STUDY DESIGN: To determine the effects of antenatal betamethasone treatments on postnatal arterial pressure, blood gases, ventilation, pulmonary gas volumes and compliance in serial studies of four groups of lambs until 4 weeks of age. SUBJECTS: Treatment groups were (1) maternal injections of saline at 104, 111 and 118 days of gestation, (2) a single maternal injection of betamethasone (0.5 mg/kg) at 104 days followed by saline at 111 and 118 days, (3) repeated betamethasone injections at 104, 111 and 118 days, or (4) no intervention (term is approximately 150 days). RESULTS: Repeated maternal betamethasone injections reduced birthweight and resulted in reduced postnatal body weights and arterial pressure throughout the first postnatal month. Lung function was not deleteriously affected by single or repeated maternal betamethasone treatments: blood gases, minute ventilation, lung volumes and compliance were not different between groups of lambs. CONCLUSIONS: The absence of alterations in postnatal blood gases contrasts with other models of IUGR in sheep and suggests that changes in lung structure caused by betamethasone may benefit IUGR neonates born at term.

Adrenal Cortex Hormones↗

PubMed1996

[Effects of smoking on lung function in populations of Beijing and Guangzhou].

OBJECTIVE: To analyse the relationship between cigarette smoking and lung function in populations of Beijing and Guangzhou. METHODS: Complete lung function and smoking habit data were recruited from 7983 men and women aged 35-59 in or around Beijing and Guangzhou. Comparisons were made between smokers and never smokers. RESULTS: The mean values of FEV1/H2, FEF/H2 and FEV1/FVC are all lower in smokers than in never smokers for male smokers, the observed mean value of FEV1/H2 for each age group in smaller than the respective predicted value, and its descending trend with aging is more obvious than the predicted value when re-examination after 2-4 years; furthermore, smokers had higher prevalences of respiratory symptom and COPD. CONCLUSION: Cigarette smoking is harmful to lung function.

Adult↗

PubMed2001

Polyethylene glycol/surfactant mixtures improve lung function after HCl and endotoxin lung injuries.

Addition of nonionic polymers such as polyethylene glycol (PEG) and dextran ameliorates inactivation of Survanta by a variety of substances in vitro. Addition of polymers to Survanta also improves pulmonary function when used to treat rats with lung injury caused by instillation of human meconium. To find whether this approach is effective in lung injuries that more closely resemble adult respiratory distress syndrome (ARDS), we have compared the use of Survanta with Survanta + PEG in two additional models of lung injury caused by either lipopolysaccharide (LPS) or HCl in adult rats. Significant improvement of serial measures for arterial oxygenation and of postmortem pressure-volume measurements were found after treatment with Survanta + PEG compared with Survanta alone. PEG added to Survanta increased resistance to inactivation caused by tracheal fluid taken from animals injured with HCl. Other work suggests that PEG promotes surfactant aggregation, separates surfactant from surfactant inhibitors, and enhances access of surfactant to the gas-liquid interface. The addition of polymers to surfactants may also be useful in the treatment of lung injury where inactivation of surfactant has already occurred.

Animals↗

PubMed2006

Respiratory symptoms and lung function in Bangkok school children.

BACKGROUND: Previous epidemiological studies have shown acute effects of ambient air pollutants in children with respiratory disorders. METHODS: The chronic effects of air pollution in Bangkok children were investigated. Children aged 10-15 years were examined for lung functions using spirometry tests and for respiratory symptoms by the American Thoracic Society's Division of Lung Diseases (ATS-DLD-78-C) questionnaire during May-August 2004. Effects of residential area were estimated by multiple logistic regression analysis. Of the 878 children, 722 (82%) had completed lung function test and ATS-DLD questionnaire. RESULTS: In children, who live in roadside (R) and general (G) areas with high (H) pollution, the prevalence of respiratory symptoms increased significantly [odds ratios (95% confidence interval) in HR and HG are 2.44 (1.21-4.93) and 2.60 (1.38-4.91), respectively]. Children with normal lung function were less observed in H- and M-polluted roadside and general area [HR, OR = 1.41 (95% CI 0.89-2.22); HG, 1.08 (0.71-1.64); and MR, 0.99 (0.63-1.57)]. Residential locations and family members were associated with the prevalence of respiratory symptoms, whereas factors such as the responder of ATS-DLD, gender, age, residential years, home size, parental smoking habits, use of air conditioners, and domestic pets were not associated. Age was associated with the impaired lung function, whereas others factors were not associated. CONCLUSION: The prevalence of respiratory symptoms and impaired lung function were higher among children living in areas with high pollution than those in areas with low pollution.

Adolescent↗

PubMed1998

Blood eosinophil and monocyte counts are related to smoking and lung function.

The aim of this study was to investigate the predictive value of peripheral eosinophil and monocyte blood counts regarding lung function in smokers and non-smokers, and to investigate the influence of smoking on these cell counts. Forced expiratory volume in 1 s (FEV1) measurements and blood samples were collected from 298 non-atopic smokers and 136 never-smokers. Blood samples were repeated in 160 smokers after cessation of smoking (quitters) and 30 continuing smokers, 2, 6, 12 and 26 weeks after smoking cessation. Monocyte (P < 0.05) but not eosinophil blood counts were higher in never-smokers compared to smokers. In never-smokers, blood eosinophil counts and monocyte counts correlated inversely (P < 0.05) and directly (P < 0.01), respectively, with standardized FEV1 residuals (FEVR). In smokers, blood eosinophil (P < 0.05) and monocyte (P < 0.05) counts correlated directly with FEVR independent of smoking history. After smoking cessation, monocyte blood counts (P < 0.05) increased. Both eosinophil and monocyte blood counts showed a greater increase in quitters with decreased lung function (P < 0.05). Former heavy smokers had higher blood eosinophil (P < 0.05) but lower monocyte (P < 0.05) count increase than had former light smokers. These data suggest that smoking influences eosinophil and monocyte blood counts and that this is associated with a small negative effect on lung function. Eosinophil blood counts had an opposite relation to lung function in smokers and non-smokers. Further research should include investigations of relations between smoking and stimulatory factors for recruitment and activity of eosinophils and monocytes.

Adult↗

PubMed1996

Lung function in children of upper Silesian industrial zone, Poland: results of the cross-sectional study in two towns of different ambient air pollution levels.

In two groups of children aged 7-9 years residing in two towns in the most industrial region of Poland, Chorzów (C - "higher air pollution") and Mikołów (M - "lower air pollution"), lung function testing was performed in a cross-sectional manner in order to examine if the spirometric indices in children depended on the ambient air pollution level as assessed by area measurements. The between-town difference in ambient air quality was statistically significant with respect to particulate and gaseous pollutants (SO2 and NO2). In Chorzów 855 and in Mikołów 356 children were studied. Both groups (C and M) were similar in terms of sex, age, height and weight. In boys, the group mean values of lung function indices (in% of predicted values) were for FVC: c-98.1, M-98.0; FEV1: C-109.5, M-107.8; PEF; C-84.3, M-80.0 (p < 0.05); MEF50: C-105.5, M-100.4 (p < 0.05); MEF25: C-100.5, M-93.7 (p < 0.05). In girls, the respective values were for FVC: C-100.4, M-100.3; FEV1: C-107.6 M-107.1; PEF: C-78.4, M-77.6; MEF50: C-103.5, M-104.2; MEF25: C-97.6 M-99.9. Stratification for the presence of respiratory symptoms or exposure to environmental tobacco smoke did not change the between-town differences in boys' lung function. The findings were confirmed by the results of multivariate analyses. The study did not provide evidence that children living in Chorzów had poorer lung function compared with children living in Mikołów. The results highlight problems regarding a cross-sectional approach to the investigation into the effect of ambient air pollution of lung function, such as the study design, the validity of exposure assessment by means of stationary monitoring, the subjects' age and sensitivity of the evaluation of lung function.

Air Pollution↗

PubMed2005

Weight history from birth through childhood and youth in relation to adult lung function, in Danish juvenile obese and non-obese men.

OBJECTIVE: To investigate the associations of birth weight, body mass index (BMI) during childhood and youth, and current BMI with adult lung function. DESIGN: Population-based longitudinal study of juvenile obese and non-obese men, who were identified at draft board examination (age range: 19-27 y) and who participated in a follow-up examination in 1981-1983 (age range: 25-48 y). Birth weight, childhood weight and height measurements from 7 to 13 y of age were obtained from school health records. Current BMI and lung function were assessed at follow-up. SETTING: Copenhagen and adjacent regions, Denmark. SUBJECTS: In total, 193 juvenile obese men at draft board examination and 205 randomly selected nonobese controls from the same population. MAIN OUTCOME MEASURES: Lung function measured by forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC), adjusted for age and height. RESULTS: After adjusting for current BMI, smoking and education, birth weight was positively related to FEV(1), although only with borderline statistical significance. BMI at age 7 y was positively associated with both FEV(1) and FVC, whereas BMI at later ages in childhood and in youth was not associated with these measures. There was a strong negative linear relation between current BMI and lung function among those currently overweight and obese (BMI 25 kg/m(2)), whereas no association was seen in the non-obese (BMI <25 kg/m(2)). CONCLUSION: Our findings confirm the detrimental effect of high current BMI on adult lung function, and further suggest that early childhood growth has a protective influence.

Adolescent↗

PubMed2005

Lung function in Greenlandic and Danish children and adolescents.

Respiratory morbidity in Inuit children is high. However, little is know regarding lung function measures in this population. The forced expiratory volumes in one second (FEV(1)) and forced vital capacity (FVC) in 888 Greenlandic Inuits (N=888) and Danes (N=477) aged 6-18 years were compared. Furthermore, associations between level of lung function and atopy and lifestyle factors were estimated in Greenlanders. The effect of height on FEV(1) and FVC was significantly different in Greenlanders and Danes, this difference in lung function increased with increasing height, and could not be explained by differences in age weight and BMI. Thus, Greenlanders taller than 130 cm had up to 300-400 ml higher FEV(1) and FVC compared with Danes of the same height. Among Greenlanders, those living in settlements had the highest levels of both FEV(1) and FVC. Greenlanders had elevated levels of FEV(1) and FVC compared with Danes. The Inuit having a shorter limb length in relation to trunk height may account for these differences. However, our finding that Greenlanders living in settlements had the highest lung function level also suggests a possible role of factors in the traditional Greenlandic lifestyle.

Adolescent↗

PubMed1992

The effects of mid-trimester amniocentesis on lung function in the neonatal period.

Lung function tests were carried out on 39 healthy full term babies born after pregnancies subjected to mid-trimester amniocentesis. The results were compared to 42 babies born after normal pregnancies. There were no significant differences in gestational age, birth weight, thoracic gas volume or crying vital capacity. Babies subjected to amniocentesis had a significantly lower dynamic compliance (6.96 ml/cm H2O vs. 8.60 ml/cm H2O) and tended to have higher resistance compared to controls (52.8 cm H2O/l/s vs. 37.3 cm H2O/l/s). This provides further evidence that mid-trimester amniocentesis does have an adverse effect on lung growth and development.

Adolescent↗

PubMed1988

Smoking and lung functions in sportsmen.

Ten smoker sportsmen and 17 non-smoker sportsmen and 41 smoker non-sportsmen were studied. Lung function was assessed by means of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), the ratio of FEV1 to FVC (FEV1%) and Peak Expiratory Flow Rate (PEFR). For the smokers, all the tests were conducted before smoking (BS) and 30 min after smoking (AS) two cigarettes consecutively to observe the acute effect of smoking. In the smoker sportsmen there was no significant difference between BS and AS measures of lung function. Before smoking smoker sportsmen had lower values for FEV1, FEV1% and PEFR than non-smoker sportsmen (p less than 0.05). However, smoker sportsmen show higher BS values of FEV1 (p less than 0.01), FEV1% (p less than 0.01) and PEFR (p less than 0.05) compared with those of smoker non-sportsmen who had similar smoking indices. These results indicated that the smoker sportsmen, despite exhibiting some degree of lung function impairment in relation to non-smoker sportsmen, still maintained rather better lung function status than the smoker non-sportsmen.

Adolescent↗

PubMed2004

[Does nCPAP-therapy change the lung function of patients with obstructive sleep apnea syndrome?].

BACKGROUND: nCPAP-therapy is standard for patients with obstructive sleep apnea syndrome (OSAS). This study investigated, if nCPAP changed the patients lung function. PATIENTS AND METHODS: Lung function of 228 OSAS patients without co-prevalent lung disease, who received nCPAP for the first time, was examined (whole body plethysmography, spirometry, and blood gas analysis). After 1, 2, and 3 years the results of the re-examined patients were compared with their individual starting results. RESULTS: The results of the patients in the basic and in the follow-up examinations was within standard range. During reexamination, an improvement of inspiratory vital capacity was registered repetitively, especially in smokers. On the other hand, MEF 50 decreased within the first two years and FEV (1) %VC, but not FEV (1), decreased after 2 and 3 years of reexamination. CONCLUSIONS: Neither obstructive nor restrictive lung diseases were diagnosed under nCPAP-therapy within three years. This study with a retrospective design showed significant improvements of vital capacity (VC) in patients with OSAS, especially in smokers, under nCPAP-therapy. This increase can be explained by an effect of practice in the examination and by recruitment of formerly hypoventilated lung areas. As MEF 50 and FEV (1) %VC depend on VC, the decrease of both parameters may be caused by the increase of VC. In summary, nCPAP did not cause negative effects of lung function in the investigated patients over a period of 3 years.

Continuous Positive Airway Pressure↗

PubMed2002

Dietary magnesium, potassium, sodium, and children's lung function.

To investigate the effects of dietary magnesium, potassium, and sodium on children's lung function, the authors examined cross-sectional dietary data and pulmonary function tests from 2,566 children aged 11-19 years who attended schools in 12 southern California communities during 1998-1999. During school visits, each child completed a health update questionnaire, a validated food frequency questionnaire, and spirometric lung function testing. Low magnesium and potassium intakes were associated with lower lung function. Girls with low magnesium intake had lower forced expiratory flow at 75% of the forced vital capacity (FEF(75)) (-8.3%, 95% confidence interval: -14.8, -1.4) than did girls with higher intake; reductions were larger in girls with asthma (forced expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75)) (-16.2%, 95% confidence interval: -22.7, -9.1) and FEF(75) (-24.9%, 95% confidence interval: -32.8, -16.1)) than in girls without asthma (FEF(25-75) (-2.0%, 95% confidence interval: -7.4, 3.8) and FEF(75) (-4.1%, 95% confidence interval: -11.3, 3.7)). Boys with low magnesium intake showed deficits in forced vital capacity (-2.8%, 95% confidence interval: -5.4, -0.2) compared with boys with higher intake. The effects of low magnesium intake did not vary substantially in boys with and without asthma. Among girls, low potassium intake was also associated with deficits in forced expiratory volume in 1 second (-2.7%, 95% confidence interval: -5.2, -0.1) and forced vital capacity (-2.4%, 95% confidence interval: -4.7, -0.1). In summary, low magnesium and potassium intakes were associated with lower lung volumes and flows.

Adolescent↗

PubMed1994

Dust exposure indices and lung function changes in longshoremen and dock workers.

A group of Dutch harbor workers involved in loading and unloading bulk products from sea vessels such as coal, cokes, and some other products like alumina, borax, phosphate ore, and vermiculite was studied. Exposures were characterized by personal and environmental monitoring. This information was subsequently used to estimate several dust exposure indices and to study relationships with lung function variables and respiratory symptoms. Average respirable dust exposure levels ranged from 0.3-4.0 mg/m3. Workers involved in unloading products from sea vessels were exposed to the highest dust levels. Supervisors and workers with tasks in the dock had an intermediate to low exposure. Office workers had the lowest exposure to respirable dust. Inhalable dust levels were considerably higher and average exposures ranged from 0.3-80 mg/m3. The ranking of occupational titles by inhalable dust exposure was almost identical to the rank order of respirable dust levels. Workers with higher current and cumulative dust exposures tended to have a lower lung function, and only shortness of breath had a statistically significant relationship with current and cumulative inhalable dust exposure. In general, relationships between lung function and inhalable dust levels tended to be somewhat stronger in terms of statistical significance, because inhalable dust is an estimate of dust deposition in the upper airways and lung function is a measurable parameter of airway obstruction in that region. However, the differences with respirable dust were minimal, and variability in dust exposure levels was extremely large for this population. It was concluded that harbor workers involved in unloading ships containing coal and various kinds of ore can be exposed to high dust levels. Relationships between dust exposure and lung function illustrate that these exposures are a respiratory hazard. Our finding that inhalable dust levels have a somewhat stronger relationship with lung function level than respirable dust levels deserves further attention.

Adult↗

PubMed1997

Surfactant nebulisation: lung function, surfactant distribution and pulmonary blood flow distribution in lung lavaged rabbits.

OBJECTIVE: Surfactant nebulisation is a promising alternative to surfactant instillation in newborns with the respiratory distress syndrome. Although less surfactant is deposited in the lung, it improves gas exchange, probably due to a superior distribution. We hypothesize that a more uniform distribution of nebulised surfactant results in a more uniform pulmonary blood flow and consequently a more efficient gas exchange. We asked whether the pulmonary blood flow changes after surfactant replacement, and to what extent pulmonary blood flow is influenced by the amount of surfactant deposition. Furthermore, we investigated whether sufficient nebulised surfactant is deposited in the lungs to achieve a sustained improvement in lung function. INTERVENTIONS: Surfactant was nebulised or instilled, or saline was nebulised, in 18 lung-lavaged rabbits. After 2 h the rabbits were weaned from mechanical ventilation to continuous positive airway pressure, 40% oxygen. We measured blood gasses, dynamic lung compliance, surfactant distribution using 99m technetium nanocoll label, and the pulmonary blood flow distribution, using microspheres. RESULTS: Partial pressure of oxygen in arterial blood and lung compliance were significantly higher after surfactant nebulisation than after saline nebulisation. Surfactant instillation gave a superior effect with respect to these variables. Nebulised surfactant was distributed more uniformly over the lungs than instilled surfactant. Although pulmonary blood flow changed over time, it remained uniformly distributed following both modes of surfactant treatment. Surfactant deposition was neither strongly related to pulmonary blood flow nor strongly related to the change in blood flow. CONCLUSIONS: Although nebulised surfactant is uniformly distributed, we can provide no evidence that this results in a more uniform pulmonary blood flow distribution. Therefore, other than a superior surfactant distribution, no additional reason was found for the efficient gas exchange after nebulisation.

Animals↗