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PubMed1997

Effects of psychotherapy in moderately severe COPD: a pilot study.

Anxiety is common in the "pink puffer" syndrome associated with chronic obstructive pulmonary disease (COPD). The degree of anxiety correlates well with perceived dyspnoea. This pilot study examines the effect of group psychotherapy on anxiety, exercise tolerance, dyspnoea and quality of life. Ten patients with moderately severe, stable COPD (mean forced expiratory volume in one second (FEV1)-1.15 L) had six 90 min sessions of cognitive and behavioural psychotherapy at weekly intervals. Patients completed the Hospital Anxiety and Depression Scale (HADS), Medical Research Council Questionnaire (MRCQ) and St George's Respiratory Questionnaires (SGRQ), 1 week before and after therapy. FEV1, forced vital capacity (FVC), slow vital capacity (SVC), blood gas tensions and 6 min walking distance (6MWD) were measured. Eight control patients attended weekly for lung function and 6MWD for 6 weeks, but had no psychotherapy. Mean baseline HADS score was significantly higher in the psychotherapy group (12) than in controls (7), but otherwise there were no differences in lung function, blood gas tensions, 6MWD, or the other questionnaire scores between groups. After treatment, the physiological and psychological parameters where unchanged in both groups with the exception of the mean 6MWD, which had improved in the psychotherapy group only, from 351 to 423 m (p<0.001), an increase of 24%. Three months after treatment, the 6MWD was still 16% above the baseline value (p=0.02). In conclusion, six sessions of cognitive and behavioural psychotherapy produced a sustained improvement in exercise tolerance in a group of 10 anxious patients with severe chronic obstructive pulmonary disease, without any change in anxiety scores on the Hospital Anxiety and Depression Scale. Further studies of more prolonged, intensive psychotherapy would establish whether better symptom and quality of life scores accompany more dramatic increases in exercise tolerance in "pink puffers".

Aged↗

PubMed1994

Interrelationships between pulmonary and extrapulmonary involvement in systemic sclerosis. A longitudinal analysis.

PURPOSE: (1) To evaluate the relationship between the degree of pulmonary involvement by systemic sclerosis (SSc) and the degree of involvement of other organ systems by SSc at baseline. (2) To assess the degree of impairment in lung function at presentation and the annual rate of change in lung function to predict the rate of progression of involvement of extrapulmonary organ systems by SSc over time. (3) To determine whether survival in patients with SSc can be predicted from the degree of lung function impairment at baseline or from the annual rate of change in lung function. METHODS: Semiquantitative indices of pulmonary and extrapulmonary involvement and pulmonary function tests (PFTs) were analyzed and compared in 62 nonsmoking scleroderma patients enrolled in a 3-year prospective drug trial, vs 47 in a "study group" who underwent serial evaluation. The other 16 "early withdrawals" withdrew prior to the second evaluation. The indices of organ system involvement were based on clinical, physiologic, and biochemical findings as previously published. The PFTs included total lung capacity (TLC), forced vital capacity (FVC), FEV1, and single-breath diffusing capacity for carbon monoxide (Dsb). Annualized rates of change in PFTs and indices of extrapulmonary involvement were calculated for each subject from data collected on at least 2 separate occasions at least 6 months apart. Spearman rank correlations were performed between individual baseline PFTs (expressed as percent predicted) and (a) indices of extrapulmonary involvement at baseline, (b) annualized rates of change in PFTs, and (c) annualized rates of change in indices of extrapulmonary involvement. Correlations also were performed between the rate of change in each lung function measure and rates of change in indices of extrapulmonary involvement. The ability of PFTs at baseline and their rates of change to predict cumulative survival was assessed by Cox stepwise regression. RESULTS: The degree of impairment in baseline PFTs was related to involvement of the right side of the heart but not to other extrapulmonary system involvement. Baseline PFTs were not related to the rate of subsequent decline of lung function or worsening of extrapulmonary organ system involvement. Subsequent annual rates of decline in lung function were related to worsening skin and upper gastrointestinal involvement. Cumulative survival may be related to the rate of decline in DCO, TLC, and FVC, but was not predicted by impairment in any measure of lung function. CONCLUSION: With the exception of involvement of the right side of the heart consistent with cor pulmonale, the degree of pulmonary involvement by SSc was not correlated with the extent of extrapulmonary involvement. The degree of pulmonary involvement by SSc did not predict subsequent worsening of either pulmonary or extrapulmonary involvement. Worsening pulmonary involvement by SSc, in general, does not correlate with worsening involvement of extrapulmonary organ systems, except for the skin and upper gastrointestinal tract. A rapid decline in DCO or lung volumes may predict poor survival.

Bone Diseases↗

PubMed2004

[Spirometric reversibility to salbutamol in chronic obstructive pulmonary disease (COPD). Differential effects on FEV1 and on lung volumes].

BACKGROUND: In recent years it has been suggested that in COPD, lung volumes can be modified more than expiratory flows, with bronchodilators. AIM: To study the acute effects of salbutamol on FEV1 and lung volumes at rest. SUBJECTS AND METHODS: Forty stable COPD patients were studied using a single dose of salbutamol (200 microg). Forced expiratory volume in 1 second (FEV1), slow vital capacity (SVC), forced vital capacity (FVC), and inspiratory capacity (IC) were measured at baseline and after salbutamol administration. RESULTS: After salbutamol, 39/40 patients exhibited a clinically significant increase in volumes (SVC, FVC or IC > or = 10% predicted). A significant increase in FEV1 (> or = 10% predicted) was observed in only 13 patients. CONCLUSIONS: Our results demonstrate that changes in lung volumes, and consequently in dynamic lung hyperinflation, take place more frequently than changes in maximal expiratory flows during the spirometric test in patients with COPD. Assessment of spirometric reversibility based only on changes in FEV1 underestimates the effect of bronchodilator drugs in these patients.

Administration, Inhalation↗

PubMed1999

Functional and high-resolution computed tomographic studies of divers' lungs.

OBJECTIVES: Several cross-sectional studies have described a decrease in the expiratory flow rates of divers. The objective of this study was to determine whether the combined application of high-resolution computed tomography (HRCT) and lung function testing supports the reported development of small airway obstruction in divers. METHODS: Thirty-two navy divers, 27 commercial divers, and 48 referents matched for age and smoking history underwent pulmonary function testing and HRCT of the lungs supplemented by a limited number of expiratory scans. The commercial divers were older and dived longer than the navy divers. Multivariate regression analysis was used to assess the relevant correlations of age, height, pack-years of cigarette smoking, and indices of diving exposure with lung function parameters. RESULTS: The inspiratory vital capacity and forced vital capacity (FVC) were greater, while the FEV% [(100 x FEV10)FVC] and maximum expiratory flow (MEF) at 25% (MEF25) of the FVC were lower for the navy divers than for the referents. The lung volumes and expiratory airflow pattern did not differ between the commercial divers and the corresponding referents. The forced expiratory volume in 1 second (FEV10), FEV%, MEF75, and MEF25 correlated negatively with the years of diving experience. This association was independent of age, height, and pack-years of cigarette smoking. For the majority of the divers and referents the expiratory HRCT revealed minor lobular air trapping without any difference between the groups. The HRCT did not show relevant morphologic abnormalities of small or large airways. CONCLUSIONS: The data confirm that diving may affect pulmonary function. However, there is no radiologic evidence for the development of small airway disease in these 2 subgroups of divers.

Adult↗

PubMed1997

Comparison of pulmonary function amongst Ladakhi, Delhi, Vanvasi and Siddi female athletes.

Lung functions were studied in contemporary healthy Indian female athletes of Ladakhi, Delhi, Vanvasi and Siddi origin training for running events of varying distances. The aim of the study was to compare the lung function in females belonging to these four groups to examine lung function in relation to ethnic and environmental factors. Vital Capacity (VC), Forced Vital Capacity (FVC), Forced Expiratory Volume in Ist second (FEV1), Expiratory Reserve Volume (ERV), and Inspiratory Capacity (IC) were recorded using conventional closed circuit spirometry. Maximum Voluntary Ventilation (MVV) was estimated by collecting expired air during deep and rapid breathing in a 100 liters meterological balloon for a period of 15 seconds and measuring its volume. It was found that Ladakhi females were having significantly higher VC, FVC and FEV1 values than their counterparts. However, there was no significant difference in MVV amongst Delhi, Siddi and Vanvasi young females. The average MVV of Ladakhi females was only significantly higher than Siddi females (P < 0.05).

Adolescent↗

PubMed2002

An epidemiological study of pulmonary function tests in geriatric population of central India.

We have studied Pulmonary Function Tests (PFTs) namely Vital Capacity (VC). Forced Vital Capacity (FVC), and Forced Expiratory Volume in First Second (FEV1). Forced Expiratory Flow(FEF 25-50%) in 1200 elderly subjects above 60 years of age of which 570 were females and 630 males. Mean age was 69.22 +/- 5.57 years in males and 68.77 +/- 5.44 in females. The mean value of ventilatory parameters were as follows-1) VC 2.99 +/- 0.5 lt in males and 1.89 +/- 0.29 lt in females. 2) FVC 2.69 +/- 0.58 lt. in males and 1.76 +/- 0.21 lt in females. 3) FEV1/FVC% 83.82 +/- 10.62% in males and 83.37 +/- 11.93% in females. 4) FEF 25-75% was 2.81 +/- 1.20 lt/sec in males and 2.13 +/- 1.27 lt/sec. Physical as well as ventilatory parameters were less in females than for males. The correlation of age with VC and FEV1 was highly significant (P < 0.01) but with FVC was not significant (P > 0.05). The correlation of height, weight and body surface area was not significant with any ventilatory parameter (P > 0.05). Multiple regression equations for VC, FVC and FEV1 were formulated for males and females taking height and age as variables. The predicted values correlated excellently with observed values.

Age Factors↗

PubMedDate not supplied

A multivariate study of some lung function tests at different age groups in healthy Indian males.

Considerable attempts have been made to study the changes in lung function in man in different age groups using univariate statistical techniques in which the lung function tests were assumed to be independent of each other. Actually the lung function tests are well correlated with each other and, thus, the inferences drawn on the basis of univariate statistical analysis may be misleading due to the violation of the assumption of independence. On the other hand, simultaneous changes in lung function in man in different age groups cannot be tested using univariate statistical techniques. Keeping in view such shortcomings of the univariate statistical techniques, an attempt has been made in the present investigation to study simultaneous changes in some lung function tests [viz. vital capacity (VC), forced vital capacity (FVC), forced expiratory volume for one second (FEV1), expiratory reserve volume (ERV), inspiratory capacity (IC) and maximum voluntary ventilation (MVV)] at different age groups (viz. 21-25, 26-30, 31-35, 36-40, 41-45, 46-50, 51-55, 56-60 and 61-70 years) in healthy Indian males using multivariate statistical techniques (viz. Wilks' statistic (A) and Mahalanobis' D2 statistic) for drawing valid statistical inferences. It is concluded that remarkable significant changes take place in lung function after the age of forty years.

Adult↗

PubMedDate not supplied

Comparison of postoperative pulmonary function tests after cholecystectomy performed through Kocher's incision and mini-incision.

Comparative pulmonary function after cholecystectomy performed through Kocher's incision and mini-incision were evaluated. One hundred patients were included and systematically divided into two groups of 50 each. The first group underwent conventional cholecystectomy and the second group underwent mini-cholecystectomy. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), and peak expiratory flow rate (PEFR) were determined on the preoperative day and on postoperative days 1, 2, and 3. The percentage of reduction of VC on postoperative day 1 (P < 0.01), 2 (P < 0.01), and 3 (P < 0.01) after Kocher's incision was more than the percentage of reduction after mini-incisions on the corresponding day, respectively (P < 0.01, P < 0.01, and P < 0.01). The percentage of reduction of FVC (P = 0.0001, 0.0001, and 0.0001) was lesser after mini-incision cholecystectomy than after Kocher's incision cholecystectomy on the three corresponding postoperative days. The percentage of reduction of FEV1 after mini-incision was lesser than after Kocher's incision cholecystectomy on the three corresponding postoperative days (P = 0.001, 0.000, and 0.000). There was no significant difference in PEFR between the two groups on the three corresponding postoperative days (P = 0.731, 0.652, and 0.393). It is observed that min-incision cholecystectomy is followed by superior postoperative pulmonary function to that seen after Kocher's incision.

Adult↗

PubMedDate not supplied

Respiratory function after esophagectomy for patients with esophageal cancer.

BACKGROUND/AIMS: Postoperative respiratory hypofunction sometime ruins quality of life of patients with esophageal cancer. From 1993, we introduced transhiatal esophagectomy without thoracotomy as a less invasive surgery to prevent postoperative respiratory complications for patients who have relatively early stage of esophageal cancer and have preoperative respiratory complication, or who are older in age. In this study, postoperative long-term evaluation of respiratory functions of patients with esophageal cancer who underwent esophagectomy was performed. METHODOLOGY: Among the patients with esophageal cancer who underwent esophagectomy in our hospital between 1993 and 1995, we selected 13 patients who underwent transhiatal esophagectomy (transhiatal group) and 9 patients who underwent transthoracic esophagectomy (transthoracic group). Conventional respiratory function tests (VC, vital capacity; FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; FEV1/FVC, ratio of FEV1 to FVC; PEF, peak expiratory flow) were compared between the two groups at 3, 6, and 12 months after operation. RESULTS: In the transhiatal group, postoperative average values of VC, FVC, and FEV1 recovered 92%, 98%, and 93% of preoperative average values at 6 months after operation, while in the transthoracic group, the average values of VC, FVC, and FEV1 were still 78%, 78%, and 72% of preoperative average values at 6 months after operation. Postoperative respiratory complications were detected in 4 patients (transhiatal: 2 and transthoracic: 2). The recovery rates of VC, FVC, FEV1, FEV1/FVC, and PEF at 6 months after operation of these 4 patients were not different from those of 18 patients without postoperative respiratory complications. CONCLUSIONS: In patients treated with transthoracic esophagectomy, postoperative respiratory hypofunctions continued over 6 months after surgery. However, postoperative respiratory complications may not be related with the long-term postoperative respiratory hypofunction in patients with esophageal cancer.

Aged↗

PubMed2003

Effect of 2-5 years of tobacco smoking on ventilatory function tests.

Smoking is a pernicious scourge of the world today. There is paucity of literature on the effect of acute smoking on ventilatory functions. The present work is undertaken to study the effect of 2-5 years of tobacco smoking on ventilatory functions. The study group consisted of 30 male, young, healthy subjects, free from cardiopulmonary diseases and with history of smoking of 2-5 years duration, on an average of 10 cigarettes per day. The control group consisted of 30 age-and sex-matched healthy individuals who had naver smoked tobacco. The ventilatory function tests were carried out using electronic spriolyser. There was a significant lowering of the following parameters in smokers: Vital capacity (VC), inspiratory reserve volume (IRV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume at the end of first second (FEV1), maximum midexpiratory flow (MMEF), peak expiratory flow (PEF), midexpiratory flow75 (MEF75), maximum voluntary ventilation (MVV). This study shows that 2-5 years of tobacco smoking leads to a definite tendency to narrowing of both the large and the small airways.

Adult↗

PubMed2003

A longitudinal study of antenatal changes in lung function tests and importance of postpartum exercises in their recovery.

A study of changes in lung function tests during pregnancy was undertaken in fifty pregnant women beginning from third month of gestation. Fifty nonpregnant age and height matched women formed the controls. Forced Vital Capacity (FVC), Timed Vital Capacity (FEV1), Inspiratory Capacity (IC), Expiratory Reserve Volume (ERV) and peak Expiratory Flow Rate (PEFR) were performed in each month of pregnancy. However ten subjects were not available for follow-up during postpartum period. Remaining forty women were divided into two groups of twenty each. Group I performed daily graded active exercises to strengthen the anterior abdominal wall muscles. Group II women did not perform any exercises. It was observed that the antenatal changes in percent FVC and FEV1 were insignificant, but the decline in ERV and PEFR were very highly significant (P < 0.001) and the increment in IC was significant (P < 0.05). In the postpartum period the percentage variation of values in group I was less than 5% from controls (P > 0.05) and in group II it was 15-20% from controls (P < 0.05), resulting in a significant variation in group II women as compared to the controls. It is concluded that there are adaptive changes in lung functions in the antenatal period. We stress the importance of regular graded active exercises in the postpartum period for the speedy recovery of these changes.

Adult↗

PubMed2004

[Idiopathic pulmonary fibrosis: correlation between helical CT findings and pulmonary function test results].

OBJECTIVE: To determine the correlation between helical CT findings and pulmonary function test (PFT) results from patients with idiopathic pulmonary fibrosis(IPF). METHODS: Helical CT scan was performed in 32 cases with clinically and/or pathologically proved idiopathic pulmonary fibrosis. Pulmonary function test for each patient was performed within 5 days before or after CT scan. The correlation between CT findings and pulmonary function test results was assessed. RESULTS: Pulmonary function test revealed characteristic restrictive ventilatory defect with reduction of total lung capacity, residual volume, vital capacity, and diffusing capacity of the lung for carbon monoxide. The patients with different severities of pulmonary function impairment had different CT features. 4 of 5 cases with slight impairment of the pulmonary function had the ground-glass opacity, 11 cases with moderate impairment showed the thickened interlobular septa (11/11, 100%), thickened lobular interstitium (9/11, 82%), distorted lobular structures (11/11, 100%) and thickened bronchovascular bundles (10/11, 91%). 16 cases with marked impairment showed the honeycombing (16/16, 100%) and the traction bronchiectasis (9/16, 55%). CONCLUSION: CT can provide significant information for the assessment of the pathologic severity of idiopathic pulmonary fibrosis. There is good correlation between CT findings and pulmonary function test results. CT combined with pulmonary function test can predict the progression, long term survival and response to therapy.

Adult↗

PubMed1989

[Effects of aging in smokers on respiratory function].

A test was carried out to investigate the effect of aging in smokers and non-smokers on respiratory function, for which forced vital capacity (FVC), % forced vital capacity (%FVC), % forced expiratory volume in one second (FEV1.0%) and peak expiratory flow volume (PF) were studied. The results obtained were as follows. Subjects selected were 560 adult male smokers (smoking group) and 282 male adults with no smoking habit (non-smoking group) who were aged 22 to 59 years and with no anamnesis of serious heart disease and respiratory disorders. A total a mount of smoking was calculated using Brinkman Index (BI). 1. Each measured value index. Measured values including FVC, FEV1.0% and PF were decreased with aging together with the increase in Brinkman Index (BI). Each measured value showed a low level in smoking group as compared to that in non-smoking group. A significant decrease, in particular, of FEV1.0% shown in those aged 25 to 44 years suggested that air way obstructive ventilatory impairment resulting from smoking is manifested itself in younger generation. 2. Correlation among aging, FEV1.0% and PF. The correlation was as follows, i.e., in non-smoking group Y = -0.354X + 95.83 (r = -0.708) and Y = -0.069X + 10.82 (r = 0.720) in FEV1.0% and in PF respectively. Negative correlation also was observed in smoking group, that is, Y = -0.306X + 90.48 (r = 0.467) and Y= -0.084X + 10.93 (r = -0.594) in FEV1.0% and PF respectively. These indicate the decrease in values with aging, in particular, in smoking group that showed a marked lowering in PF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1988

[Evaluation of the reliability of 2 portable electronic spirometers].

Two portable electronic spirometers, Vitalograph Compact (C) and Vitalograph Alpha (A), were evaluated for measurement of forced expiratory volume in the first second (FEV1), slow vital capacity (VC), forced vital capacity (FVC) and peak expiratory flow rate (PEF) compared with a high quality Gould 2400 spirometer (G). Ten normal subjects and 10 patients with obstructive lung disease performed spirometry at the same time of day and in randomized order. The results showed a close agreement between G and C or A for FEV1 (r = 0.99 and 0.97 respectively); for VC (r = 0.99 and 0.98 respectively); for FVC (r = 0.99 and 0.97 respectively), and for PEF (r = 0.95 and 0.93 respectively). The results show that these 2 portable spirometers are highly accurate for the parameters measured.

Evaluation Studies as Topic↗

PubMed1985

Lung function studies of asbestos workers.

Pulmonary function tests have been conducted on 155 asbestos workers and 130 referents. It was found that the lung function impairment in asbestos workers is predominantly a restrictive ventilatory defect appearing even when radiographic changes are not detectable. There was, however, no evidence of airway obstruction. As the disease progressed, all the pulmonary function indices, including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), maximal ventilation volume (MVV), total lung capacity (TLC), and pulmonary diffusing capacity (DLCO), were reduced dramatically, with the exception of FEV1.0/FVC(%). It is suggested that both radiographic examination and pulmonary function tests should be used as early detection measures of asbestos-induced lung disorders. VC, FVC, and FEV1.0 are the simplest, most reproducible, and most valid indices for the health surveillance of asbestos workers, while the FVC test is the most valuable for epidemiologic study. With stepwise regression analysis a quantitative relationship between dust exposure and pulmonary function was demonstrated. There was no significant difference in the small airway function of the exposed workers and the referents. Further study is needed to investigate the possibility of asbestos-induced small airway obstruction and to estimate the roles played by cigarette smoking and air pollution.

Adult↗

PubMed1994

A longitudinal study of pulmonary function tests during pregnancy.

The study deals with evaluation of pulmonary function status in fifty normal pregnant women tested monthly. The parameters studied were Vital Capacity (VC) Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1st second (FEV1) using Vitalograph Spirometer; tidal volume (VT), inspiratory capacity (IC) and expiratory reserve volume (ERV) using Expirograph and resting minute ventilation (VE) using Tissot's spirometer. Control values were obtained in the same subject 8-10 weeks after delivery. The increase seen in VT, VE and IC was very highly significant. The small increment in frequency of respiration is significant and the declining trend observed in ERV is very highly significant. VC and FVC were maintained by the rise in IC and a concomitant fall in ERV. Rise in VC is attributed mainly to rise in VT than rise in frequency. The results suggest that though pulmonary function is altered during pregnancy, it is not compromised and hence does not induce any mechanical stress on the respiratory efficiency of the pregnant woman.

Adult↗

PubMed1995

Comparison of pulmonary function amongst Ladakhi, Delhi, Vanvasi and Siddi boy athletes.

Lung functions were studied in contemporary healthy boy athletes of Ladakhi, Delhi, Vanvasi and Siddi origin. As lung function are related to ethnic and environmental factors, the aim of the study was to compare the lung function in boys belonging to these four groups. Vital Capacity (VC), Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st second (FEV1), Expiratory Reserve Volume (ERV) and Inspiratory Capacity (IC) were recorded using conventional closed circuit spirometry. Maximum Voluntary Ventilation (MVV) was estimated collecting expired air during deep and rapid breathing in a 100 litres meterological balloon for a period of 15 seconds and measuring its volume. It was found that Ladakhi boys were having significantly higher VC, FVC and FEV1 values than their counterparts. However, there was no significant difference in MVV amongst Ladakhi, Delhi, Vanvasi and Siddi boys. Our results suggest that size of the lung is governed by genetic, environmental and nutritional factors and confirm that physical training during growth may help in developing a greater endurance in respiratory muscles.

Adolescent↗

PubMed1976

Spirometry in the evaluation of pulmonary function.

Spirometry should be more widely used in routine examinations. Equipment should meet the individual physician's or hospital's needs and include either a dependable water-sealed spirometer or an easily calibrated and accurate electronic spirometer. Justifiable concern over the reliability of electronic spirometers has resulted in requests to determine performance standards for these medical devices. Predicted normal standards must apply to the particular spirometer. Recommended tests are those of vital capacity (VC), forced vital capacity (FVC), one-second forced expiratory volume (FEV(1)), the ratio of one-second forced expiratory flow (FEF200-1200) and forced midexpiratory flow (FEF25-75 percent). The maximum voluntary ventilation (MVV) test may be useful for evaluation of work disability and detection of extrathoracic obstruction. Additional consideration may be given to measurements of total lung capacity (TLC) to discriminate between restrictive and obstructive impairment and the forced end-expiratory flow (FEF75-85 percent) to detect mild small airway obstruction. At this time, flow-volume curves measurement cannot be justified for routine clinical use.

Humans↗