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PubMed1989

Lung function testing and AIDS.

Lung function testing on patients with acquired immune deficiency syndrome (AIDS) has been restricted because of the risks of cross infection. We have adapted equipment which is currently used for routine lung function testing with inexpensive disposable components to remove the risk of contamination. Results from the modified equipment were compared with those obtained using conventional equipment on 56 subjects. We found an excellent correlation between compared values for all parameters.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Lung function in fire fighters.

Lung function tests were performed on 49 fire fighters of the city of New Haven. Their mean age was 36.4 years, with a mean of 11.7 years as fire fighters. The lung function tests were compared to a control group with a mean age of 33.4 years. There was no significant difference between the mean normal pulmonary function tests of the fire fighters and the control group. The results showed that in this group of fire fighters long-term occupational exposure was not associated with pulmonary function abnormalities.

Adolescent↗

PubMed1992

Respiratory measurements. 2: Interpreting simple measurements of lung function.

1. When lung function is being measured, it is important that it is accurately interpreted and reported. 2. Clinical history and previously recorded values should be taken into account. 3. When correctly interpreted, measurements can provide useful information to aid diagnosis.

Adult↗

PubMed1992

Relations between occupation, smoking, lung function, and incidence and mortality of chronic non-specific lung disease: the Zutphen Study.

Information gathered in the "Zutphen study", the Dutch contribution to the Seven Countries Study was used for the present study. Follow up data from 1965 to 1 July 1985 were used. During this follow up, the morbidity state of the participants was verified at regular intervals. In 1965 lung function was measured by spirometry and the vital capacity (VC) and forced expiratory volume in one second (FEV1) were available. A complete set of data was available for 668 men. The occurrence of chronic non-specific lung disease (CNSLD) at a specific time was coded by one physician, using strict criteria. Information about the cause of death was obtained and coded by one physician in 1985. Occupation was coded and a distinction between blue and white collar workers was made. For the analysis of the relation between age, lung function, smoking habits, and occupational state with CNSLD incidence and mortality, proportional hazard models were used. Blue collar workers had a significantly raised risk for incidence of CNSLD only. The hazard ratio for blue v white collar workers with CNSLD mortality was 1.4 but not statistically significant. It was concluded that occupation is clearly related to incidence of CNSLD. There were indications that occupation is related to mortality from CNSLD. A reduced FEV1 was a strong predictor of both CNSLD incidence and mortality. It is noteworthy that small differences in age and height standardised lung function were significantly related to incidence of CNSLD, mortality from CNSLD, and total mortality. Although these differences in lung function have no direct clinical importance for the individual subject, they indicate a raised morbidity and mortality risk for the population.

Age Factors↗

PubMed1990

Exposure to grain dust and changes in lung function.

Respiratory symptoms and lung function were assessed in 41 seasonal grain handlers and related to duration of employment and level of exposure to grain dust. Ten public works department employees, not exposed to grain dust, were examined during the same period. Respiratory symptoms, forced expired volume in one second (FEV1), and bronchial responsiveness (dose of methacholine provoking a 20% fall in FEV1-PD20) were assessed before starting work and at weekly intervals during a period of employment lasting up to four weeks. Two atopic grainhandlers with pronounced bronchial hyperresponsiveness (PD20 less than 1 mumol) and a history of asthma withdrew from the study within two weeks because they developed severe asthma. Respiratory symptoms were more frequent and more often attributed to work in the grainhandlers than in the non-exposed subjects. In the grainhandlers the FEV1 decreased by a mean (95% confidence intervals) of 321 ml (198-444) (p less than 0.05) and the mean (95% confidence interval) PD20 decreased from 20.6 mumol (10.3-41.2) to 6.0 mumol (2.8-12.5) (p less than 0.05) after one week of work. Over the next three weeks the mean FEV1 returned towards the prestudy values. The mean PD20, however, remained significantly lower than the initial value. The mean FEV1 and PD20 did not change significantly in the non-exposed subjects. The frequency of symptoms and decreases in FEV1 were greater in grainhandlers when working in jobs where total exposure to dust was greater than 20 mg/m3 than when working in jobs where it was less than 10 mg/m3. The results indicate that occupational exposure to grain dust results in respiratory symptoms and changes in lung function, including increased airway responsiveness, within the first week of exposure to grain dust at work. These changes appear to be determined by the degree of dust exposure and suggest a direct effect of grain dust on the lung in these subjects.

Agricultural Workers' Diseases↗

PubMed1991

Longitudinal analysis of lung function growth in healthy children and adolescents.

Lung function and height in 242 8-yr-old and 299 12-yr-old children without known or suspected predisposition to lung disease were measured annually over 6 and 8 yr, respectively. Growth of forced expiratory volume in 1 s (FEV1), vital capacity, and expiratory flow after expiring 50% of vital capacity were statistically modeled by age and height by use of a multivariate normal model for longitudinal data. This method has the flexibility to fit an appropriate (not necessarily linear) mathematical description of average lung function while concurrently modeling the covariance between measures on the same individual. Differences in lung function growth between girls and boys, pre- and post-puberty, showed that girls had a steadier though less pronounced increase in lung function with height. In boys, before puberty there was deficit in lung volume relative to height (not evident in girls), which was compensated for by rapid growth after puberty. The standard error of FEV1 predictions based on current height and age were more than halved when measurements of FEV1, age, and height taken 1 yr before were incorporated. We found evidence for dysanaptic growth in childhood. Fitted models have application to early detection of departures from healthy lung function.

Adolescent↗

PubMed1990

Lung function associated with histologically diagnosed acute lung rejection and pulmonary infection in heart-lung transplant patients.

A group of 34 heart-lung transplant patients were studied with serial pulmonary function measurements, chest radiographs, and transbronchial biopsies from the time of surgery. These investigations were carried out routinely at 3 and 6 months and then annually after transplantation as well as on clinical suspicion of acute lung rejection or infection. A total of 61 transbronchial biopsies and concurrent lung function and chest radiographs were obtained. Of the biopsies, 30 (49.2%) showed histologic evidence of lung rejection, 12 (19.7%) demonstrated various opportunistic infections, and 19 (31.1%) were normal. Compared to during episodes of normal biopsies, FEV1 decreased significantly with lung rejection (p less than 0.001) and with infection (p less than 0.01). Vital capacity (VC) and DLCO also fell with these acute lung complications. Using histologic diagnosis as a standard, lung function testing had a sensitivity of 86% in detecting lung rejection in the first 3 months postoperation and 75% in the subsequent period. Its sensitivity for detecting lung infection was 75%. Although not distinguishing between these two complications, lung function had a specificity of 84% for detecting occurrence of an acute lung complication. Chest radiographs, although of similar sensitivity in the first 3 months postsurgery, had a sensitivity of only 19% for rejection in subsequent months and 58% for infection. Its specificity was 100%. Lung function testing changes in a predictable fashion with lung rejection and infection, offers an improvement over chest radiographs, and provides a quantitative measurement to aid the decision of when to undertake transbronchial lung biopsy.

Biopsy↗

PubMed1979

A comprehensive on-line computerised lung function screening test.

An on-line computerised lung function screening test is described which prints out 22 lung function parameters and a functional diagnosis. The complete test with print-out data takes less than 8 min per patient which implies that more than 60 out-patients can be 'screened' per day. Furthermore, for patients about to undergo major surgery a lung function operative risk grading is also available. The developed computer system is comparatively inexpensive, simple to operate and can be immediately on-lined to most apparatus without special interfacing. The total screening system can be operated by a single technologist and the required respiratory manoeuvres can be performed by almost all patients irrespective of the degree of lung function impairment. Although comprehensive in itself the screening test has been invaluable in deciding upon which patients require more intensive and time-consuming lung function investigations.

Computers↗

PubMed1989

Changes in lung function after working with the shotcrete lining method under compressed air conditions.

Shotcrete techniques under compressed air are increasingly applied in the construction of tunnels. Up to now little is known about the influence of shotcrete dusts on the function of the lung. The lung function of 30 miners working with shotcrete under compressed air (before and after one shift) was measured. They carried personal air samplers to assess the total dust exposure. Long term effects were studied on a second group of 29 individuals exposed to shotcrete dusts and compressed air for two years. A significant increase of airway resistance and a significant decrease of some flow-volume parameters were found after one workshift. These changes partially correlate close to the dust exposure. After two years exposure a significant decrease of mean expiratory flow (MEF)50 and MEF25 was found. These results point to damage in the small airways and emphasise the major role of the lung function test--including the flow-volume manoeuvre for the medical examination of the workers. Additionally, they should carry filter masks.

Adult↗

PubMed1977

Lung function, respiratory disease, and smoking in families.

Respiratory symptoms, disease and lung function were studied in 376 families with 816 children who participated in a survey in three USA towns. Parental smoking had no effect on children's symptoms and lung function. Also, there was no evidence that passive smoking affected either lung function or symptoms of adults. There was no association between prevalence of self-reported cough and/or phlegm in parents and their children. There was a highly significant association between the prevalence of wheeze in parents and their younger children, for whom parents reported this symptom. Wheeze in children was also significantly associated with a parental history of asthma, and lung function was lower in children with a family history of asthma. Even after accounting for height, weight, age, sex and race, children's lung function correlated significantly with parents' lung function. However, the contribution of familial factors (i.e., parents' lung function, smoking, and history of asthma) to children's lung function is small compared to the effects of height, weight and age.

Adolescent↗

PubMed1987

Regional lung function in long-term survivors after chemotherapy for small cell lung cancer.

In order to evaluate the regional lung function in patients with small cell lung cancer with long-term survival, we measured the regional lung function in 17 patients. We studied the patients with 81m-krypton ventilation scans and 99m-technetium perfusion scans, as well as measurements of static lung volumes (VC, RV, TLC), flow volume indices (FEV1, FVC, MEF50), and carbon monoxide diffusing capacity (DLCO). We found both the ventilation and the perfusion of the affected lung to be slightly but significantly lower (P less than 0.05), while no obvious ventilation or perfusion defects could be identified at the former tumor site. The static volumes of the lungs, the FVC and the FEV1 were within predicted normal values, while a significant decrease was seen in the PEF, MEF50, and DLCO. It is concluded that patients with small cell lung cancer who obtain complete remission with normalization of the chest X-ray and long-term survival after 18 months of intensive chemotherapy also have a nearly normal lung function.

Aged↗

PubMed2026

The impact of supernormal lung function on mortality risk in adults with and without sleep-disordered breathing.

BACKGROUND: In the general population, supernormal lung function is associated with a lower risk of all-cause mortality. RESEARCH QUESTION: It remains unclear whether sleep-disordered breathing (SDB) affects this relationship. METHODS: This cohort analysis included 4,839 adults. Lung function was categorised as supernormal (FEV1 > ULN), normal (LLN ≤ FEV1 ≤ ULN), and below normal (FEV1 < LLN). SDB severity was classified using apnoea-hypopnoea index categories: no SDB (<5 events/hour), mild SDB (5-<15 events/hour), moderate SDB (15-<30 events/hour), and severe SDB (≥30 events/hour). The association between lung function and all-cause mortality was assessed using Cox proportional hazards models with subgroup analyses according to SDB severity and formal testing for interaction. Analyses were repeated using FVC-defined lung function groups as an alternative definition of supernormal lung function. RESULTS: Among the included participants, 4,068 (84.1%) had normal lung function, 369 (7.6%) had supernormal lung function, and 402 (8.3%) had below normal lung function. During 52 421.5 person-years of follow-up (median 11.72 years; IQR, 10.46-12.56), 1,188 deaths occurred. Compared with the normal lung function group, the supernormal lung function group had a lower prevalence of baseline hypertension and cardiovascular disease. The association between lung function and all-cause mortality varied across SDB severity strata (P for interaction = 0.034). A lower mortality risk associated with supernormal lung function was observed in participants without SDB (HR: 0.24, 95% CI: 0.06-0.97), whereas this association was not statistically significant in the mild, moderate, or severe SDB strata. Below normal lung function was generally associated with an increased all-cause mortality risk. Sensitivity analyses using FVC-defined lung function groups yielded broadly consistent findings. CONCLUSION: Supernormal lung function was associated with lower all-cause mortality primarily among individuals without SDB. These findings underscore the importance of considering SDB severity when assessing the health implications of lung function.

Humans↗

PubMed1989

The influence of anesthesia and postoperative analgesic management of lung function.

General anesthesia itself may influence postoperative lung function. It leads to a depression of the functional residual capacity, which, in combination with surgical trauma and postoperative pain, can provoke insufficient breathing, retention of bronchial secretions, and atelectasis. Regional anesthesia has no influence on lung function. After upper abdominal or thoracic surgery, postoperative epidural analgesia causes a significant increase of lung function as compared with systemic analgesia. The combination of regional anesthesia and general anesthesia intraoperatively appears to reduce lung function much less than general anesthesia alone.

Analgesia, Epidural↗

PubMed1992

[Lung function of adult patients with bronchial asthma or chronic obstructive lung disease prior to and following a 3-month-stay in the Dutch Asthma Center in Davos].

The effect of a multidisciplinary treatment for obstructive airway disease at high altitude has not been well established for adult patients. One hundred and fifty patients with obstructive airway disease were examined at admission and at discharge after a 3-month hospitalization period in an Alpine clinic. Body plethysmographic data were collected at admission and at discharge as was medication use. Patients were subdivided into three groups, one group (n = 34) with bronchial asthma, one group (n = 97) with moderately severe chronic obstructive pulmonary disease (COPD) and one group (n = 19) with severe COPD. The greatest improvement in lung function data occurred in the moderately severe COPD group (at discharge before salbutamol administration there was an increase in FEV1 of 6%, after salbutamol administration there was an increase in FEV1 of 7%). When we divided the patient groups into atopic and non-atopic, it appeared that the non-atopic moderately severe COPD group showed the greatest improvement in lung function variables. The histamine threshold (expressed in 10logPC20) improved only in the moderately severe COPD group. There was a reduction from mean 7.5 mg per day in oral corticosteroids use to mean 5.0 mg per day in the moderately severe COPD group. We conclude that after 3 months' multidisciplinary treatment in the Alpine climate there is an improvement in lung function and a reduction in medication use in patients with airflow limitation.

Albuterol↗

PubMed1990

[The effect of endonasal paranasal sinus surgery on lung function of patients with bronchial asthma].

Lung function tests of 13 patients suffering from manifest asthma and of 4 patients showing only bronchial hyperreactivity were performed before and on an average of 12 months after endonasal surgery of the paranasal sinuses. In the four subjects, bronchial hyperreactivity was no longer detectable postoperatively by provocation with carbachol. Five asthmatics could stop medication of 1 to 3 of their drugs, five others were able to reduce the dosage of one of their drugs to 50% or more. Lung function and medication was unchanged in two asthmatic patients, one patient had to add a drug to his medication while showing an unchanged lung function. In patients with asthma and chronic paranasal sinusitis, endoscopic endonasal sinus surgery (together with flanking measures, e.g. septal correction) is able to improve antiasthmatic therapy in a high percentage.

Adult↗

PubMed1989

Systemic administration of N-acetylcysteine has no effect on postoperative lung function following elective upper laparotomy in lung healthy patients.

In a randomized, double-blind study, 131 consecutive patients, subjected to elective upper laparotomy, were prophylactically given the recommended dose of N-acetylcysteine (NAC) (Mucomyst, ASTRA) (200 mg x 3) or placebo against postoperative pulmonary complications. The effect was evaluated by lung function tests (VC and FEV1), arterial blood gas analyses and chest x-ray. No benefit could be demonstrated, either to postoperative pulmonary function or in the frequency of atelectasis in the recommended dose. However, no patients with preoperative bronchopulmonary disease demanding treatment with bronchodilatators were included in the study. A positive effect of NAC in this category of patients could not be excluded.

Acetylcysteine↗

PubMed1987

Mortality related to smoking habits, respiratory symptoms and lung function.

The relationship between smoking habits, respiratory symptoms and lung function at the start of the study and mortality during a follow-up period of 11 years was studied in 607 men, aged 50 and 60 years at entry and sampled from the general population. The overall mortality rate in the sample was 18%. In a logistic multiple regression model, mortality rate was significantly related to age, smoking habits, dyspnea and one of the lung function variables FEV1, VC or the slope of phase III. Smokers had a double mortality rate compared to non-smokers (22 versus 10%) after allowing for age, dyspnea and lung function. Similarly, in subjects with abnormal FEV1, VC or slope of phase III, the mortality rate was almost doubled compared to subjects with normal lung function, other factors being equal. Thus, impaired lung function is an important factor to be considered in the assessment of mortality risk, besides smoking and dyspnea.

Age Factors↗

PubMedDate not supplied

Regional and total lung function in patients following pulmonary irradiation.

Regional and total lung function measurements and chest radiographs were obtained from 18 patients with cancer of the breast from 3 months to 6.7 years after the start of treatment. A control group of 20 patients was studied before radiotherapy but after mastectomy. The functional parameter most affected by radiation was blood flow. In some cases in which the radiographic changes were mild the functional measurements indicated severe vascular damage. The radiation appears to reduce the number and efficiency of functioning lung units within the irradiated region.

Adult↗