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PubMed2002

Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants.

To evaluate whether acute effects of ozone, nitrogen dioxide, and particulates with mass median diameter less than 10 micro m could be attenuated by antioxidant vitamin supplementation, we conducted a randomized trial using a double-blinded design. Children with asthma (n = 158) who were residents of Mexico City were randomly given a daily supplement of vitamins (50 mg/day of vitamin E and 250 mg/day of vitamin C) or a placebo and were followed from October 1998 to April 2000. Pulmonary function tests were carried out twice a week in the morning. During the follow-up observation period, the mean 1-hour maximum ozone level was 102 ppb (SD = 47), and the mean 24-hour average PM(10) level was 56.7 micro g/m(3) (SD = 27.4). In children with moderate and severe asthma, ozone levels 1 day before spirometry were inversely associated significantly with forced expiratory flow (FEF(25-75)) (-13.32 ml/second/10 ppb; p = 0.000), FEV(1) (-4.59 ml/10 ppb; p = 0.036), and peak expiratory flow (PEF) (-15.01 ml/second/10 ppb; p = 0.04) in the placebo group after adjusting for potential confounding factors. No association between ozone and lung functions was observed in the supplement group. We observed significant differences in lung function decrements between groups for FEF(25-75) and PEF. Our results suggest that supplementation with antioxidants might modulate the impact of ozone exposure on the small airways of children with moderate to severe asthma.

Air Pollutants↗

PubMed1999

Effects of smoking in pregnancy on neonatal lung function.

AIMS: To assess the effects of smoking during pregnancy on lung mechanics and lung volumes in the immediate neonatal period, before infants are exposed to passive smoking. METHODS: Lung function tests were carried out within 72 hours of delivery in infants born to 100 non-smoking and 189 smoking mothers. Lung growth was assessed by plethysmography and lung mechanics using the single breath occlusion technique and oesophageal balloon/pneumotachography. Antenatal maternal serum cotinine values were obtained from 133 mothers. RESULTS: Smoking was associated with a significant reduction in birthweight (mean 256 g, 95% CI 0.164 to 0.392), and length (mean 1.26 cm, 95% CI 0.48 to 2.00). Lung volume was not reduced when related to weight. Smoking was associated with a highly significant reduction in static compliance (Crs). This effect remained significant after relating Crs to weight and lung volume. Regression analyses showed that the Crs association was limited to the boys. Smoking was associated with a small but significant reduction in respiratory system conductance (Grs) (single breath occlusion technique) and total pulmonary conductance (Gp). These associations were limited to girls. CONCLUSIONS: Smoking in pregnancy reduces static compliance in boys and conductance in girls. There was no evidence that maternal smoking adversely affected fetal lung growth.

Adult↗

PubMed1993

Regular inhaled beta agonist in asthma: effects on exacerbations and lung function.

BACKGROUND: A comparison of the effects of regular upsilon as needed inhaled beta agonist treatment on the control of asthma in the last 16 weeks of each of two 24 week treatment periods has been reported. This paper presents additional information on exacerbations of asthma and trends in lung function, airways hyperresponsiveness to methacholine, and bronchodilator responsiveness during the entire 24 week periods of regular or as needed beta agonist treatment. METHODS: Subjects undertook a year long randomised, double blind crossover study of regular upsilon as needed inhaled beta agonist treatment. Fenoterol (400 micrograms) or matching placebo was inhaled as a dry powder four times daily for 24 weeks, then subjects crossed over to the alternative regimen. Treatment with inhaled corticosteroids was used by 50 of the 64 subjects in constant doses throughout the study. Symptoms, peak expiratory flow rates, and drug use were recorded daily, spirometry was performed every four weeks, and methacholine and bronchodilator responsiveness were measured every eight weeks. RESULTS: Exacerbations of asthma symptoms occurred earlier and more often during regular treatment with fenoterol and four of five severe exacerbations requiring admission to hospital occurred during the period of regular treatment. Prebronchodilator forced expiratory volume in one second (FEV1) was on average 0.15 litres lower (95% confidence interval (95% CI) 0.11-0.19) and vital capacity (VC) 0.12 litres lower (95% CI 0.08-0.16) than during the placebo period. Morning peak flow rates were significantly lower and evening peak flow rates significantly higher, with an increase in diurnal variation from 9.8% (95% CI 6.9-12.8) to 17.5% (95% CI 13.8-21.3) during regular treatment. Geometric mean concentration of methacholine causing a 20% fall in FEV1 from the value after saline (PC20) decreased significantly from 1.63 to 1.15 mg/ml, indicating increased bronchial hyperresponsiveness during regular treatment. Response to bronchodilator, as measured by the % increase in postbronchodilator FEV1 related to prebronchodilator FEV1, was maintained with no evidence for tachyphylaxis. CONCLUSION: Chronic use of inhaled fenoterol resulted in more exacerbations, a significant decline in baseline lung function, and an increase in airway responsiveness to methacholine in asthmatic subjects, but did not alter bronchodilator responsiveness. These findings support the previous report that regular inhaled beta agonist treatment is deleterious in the long term control of asthma.

Administration, Inhalation↗

PubMed2002

Chasing the dragon, related to the impaired lung function among heroin users.

AIM: To describe the pulmonary function and prevalence of dyspnoea among methadone patients and to study the relation with exposure to heroin by inhaling. STUDY POPULATION: A sample of 100 patients from methadone maintenance treatment (84% male, average age 42 years). MEASUREMENTS: Questionnaires were used to measure life-time exposure to heroin, cocaine, cannabis, tobacco, and symptoms of dyspnoea. Spirometry was performed and residual difference of measured FEV(1) from the age, sex, height and ethnicity predicted value (delta FEV(1)) was used as a main outcome parameter. FINDINGS: The median delta FEV(1) was -0.26 l (inter quartile range -0.70; +0.12). Twenty per cent experienced dyspnoea while 'walking at a normal pace with someone of their own age'. History of cigarette smoking was reported by 98%; heroin smoking by 88%. Multiple linear regression analysis showed a statistically significant association between heroin-smoking and delta FEV(1), logistic regression analysis showed an association between heroin-smoking and prevalence of dyspnoea. CONCLUSIONS: Chronic heroin smoking seems to be related to an impaired lung function and higher prevalence of dyspnoea. However, part of the observed lung function impairment will be caused by tobacco smoking. Further research is needed to quantify the effect of heroin smoking and disentangle the effect of smoking heroin and tobacco.

Adult↗

PubMed1990

Influence of age and duration of follow-up on lung function after combined chemotherapy for Hodgkin's disease.

Pulmonary function was studied in 48 patients 4-13 yrs after treatment for Hodgkin's disease with mantle-field irradiation followed by standard mechlorethamine, Oncovin, procarbazine and prednisone (MOPP) chemotherapy. The patients were found to have a restrictive lung disease suggestive of pulmonary fibrosis. Low age at therapy (less than or equal to 30 yrs, median 24 yrs) was associated with a significantly more pronounced restrictive lung function impairment than older age (greater than 30 yrs, median 40 yrs) suggesting a higher susceptibility to the pulmonary side-effects of therapy. In addition younger smokers had a significantly greater reduction in diffusion capacity and forced expiratory volume in one second than older smokers, suggesting a higher susceptibility to the additional adverse effect of smoking. With longer follow-up nonsmokers had an increase in static lung volumes. It is suggested that this may be the result of more frequent pulmonary infections in such patients as compared with the general population. However, the duration of follow-up was not associated with changes in other indices of lung function.

Adult↗

PubMed1977

Lung function and long-term exposure to cement dust.

In a cross-sectional epidemiological survey a selected group of former and present cement factory workers and a random sample of the corresponding urban population underwent dynamic spirometry. Based upon life experience the subjects were grouped into four occupational categories. Three hundred and one men were grouped as cement factory workers, 649 were grouped as blue collar workers, 218 as white collar workers and 102 men had predominantly been occupied in farming, forestry and fishing. On the average the investigated men had spent more than 75% of their total occupational life in their main occupational category. Each occupational category was further subdivided according to smoking habits and in all categories the well-known association between tobacco consumption and decrease in ventilatory capacity was found. White collar workers, who smoke less and had experienced better housing conditions throughout life had better ventilatory lung function than any of the other three occupational categories. No significant differences in lung function between cement factory workers and other blue collar workers with comparable smoking habits could be demonstrated by use of the maximal midexpiratory flow (MMEF), or any other of the calculated indices from the dynamic spirometry, when standardized for age, height and body weight.

Aged↗

PubMed1977

An inexpensive apparatus (airflometer) to assess lung function.

The Airflometer is presented as an inexpensive instrument suitable for lung function testing in general clinical practice. Utilizing the close correlation between the Airflometer (AFM) reading and the forced expiratory volume in 1 second (FEV1), we have produced a nomogram from which the AFM reading for normal males and females can be predicted.

Adolescent↗

PubMed1993

Smoking and lung function in elderly men and women. The Cardiovascular Health Study.

OBJECTIVE: To investigate relationships between cigarette smoking and pulmonary function in elderly men and women. DESIGN: Cross-sectional analysis of baseline data from a prospective, population-based study of risk factors, preclinical, and overt cardiovascular and pulmonary disease. SETTING: Defined communities in Forsyth County, North Carolina; Pittsburgh, Pa; Sacramento County, California; and Washington County, Maryland. POPULATION: A total of 5201 noninstitutionalized men and women 65 years of age and older. MAIN OUTCOME MEASURES: Pulmonary function; means of forced expiratory volume in 1 second (FEV1) and forced vital capacity and prevalence of low FEV1 levels. RESULTS: Prevalence of cigarette smoking was 10% to 20% and higher in women than men and in blacks than whites. Forced vital capacity and FEV1 levels were related positively to height and white race and negatively to age and waist girth. Age- and height-adjusted FEV1 means were 23% and 18% lower in male and female current smokers, respectively, than in never smokers but not reduced in never smokers currently living with a smoker. Smokers who quit before age 40 years had FEV1 levels similar to never smokers, but FEV1 levels were lower by 7% and 14% in smokers who quit at ages 40 to 60 years and older than 60 years, respectively. Lung function was related inversely to pack-years of cigarette use. Prevalence rates of impaired lung function were highest in current smokers and lowest in never smokers. Regression coefficients for the smoking variables were smaller in persons without cardiovascular or respiratory conditions than in the total cohort. CONCLUSIONS: Cigarette smoking is associated with reduced pulmonary function in elderly men and women. However, smokers who quit, even after age 60 years, have better pulmonary function than continuing smokers.

Aged↗

PubMedDate not supplied

[The interrelationship between lung functional disorder and blood transfusion].

Interrelationship was studied of the haemotransfusion volume with the purpose of correcting the oxygen-transport to functional inadequacy of the lungs, inadequate patency of the organ's vessels in patients presenting with abdominal haemorrhage. Transfusion of donor blood was accompanied in some cases by pulmonary function disorders manifested by development of pneumonia. The larger the volume of haemotransfusion, the higher probability for lung function impairement. But we failed to find an immediate association between the volume of the donor blood transfused, blood flow and ventilation in the lungs. A conclusion was drawn to the effect that there exist secondary mechanisms of injury to the organ and development of pneumonia. Of these, weakening of immunologic resistance because of donor blood is considered to be most probable mechanism contributing to the above injury.

Acid-Base Equilibrium↗

PubMed1990

[Disorders and correction of lung functions in acute destructive cholecystitis].

On the day of operation for acute destructive cholecystitis functions of external ventilation prove to be disturbed due to deterioration of pulmonary blood flow (2-6 times) and ventilation (1.3-3 times). The degree of these disturbances are in direct dependence on the degree of the inflammatory process in gallbladder and time of preoperative observation. At the same terms after emergency cholecystectomy the lung functions were reestablished considerably quicker and was more valuable than after operations on urgent indications. Inclusion of adrenoblocking agents into conservative treatment of acute cholecystitis before and after operation facilitates more effective and quicker recovery of lung functions.

Acute Disease↗

PubMed2000

The effect of regular salbutamol on lung function and bronchial responsiveness in patients with primary ciliary dyskinesia.

STUDY OBJECTIVE: There is growing evidence that regular beta(2)-agonist use in patients with asthma is associated with decreased airway caliber and increased bronchial responsiveness. The aim of this study was to determine whether regular treatment with beta(2)-agonists induces changes in lung function and bronchial responsiveness in patients with primary ciliary dyskinesia. DESIGN: A randomized, double-blind, placebo-controlled, crossover study. PATIENTS: Nineteen children with primary ciliary dyskinesia. INTERVENTIONS: Subjects received inhaled salbutamol or identical placebo (2 x 100 microg qid) for periods of 6 weeks with a wash-out period of 4 weeks. MEASUREMENTS AND RESULTS: FEV(1) was measured before and 3 weeks and 6 weeks after salbutamol or placebo treatment. High-dose methacholine inhalation tests were performed before and 6 weeks after each treatment. The provocative concentration of methacholine producing a 20% fall in FEV(1) (PC(20)) and maximal airway narrowing (MDeltaFFEV(1)) was measured. No significant change in FEV(1) was observed during the salbutamol or placebo periods. No significant differences in the parameters of bronchial responsiveness (PC(20) and MDeltaFFEV(1)) were noted as the result of either salbutamol or placebo treatment. CONCLUSION: Our data have shown that salbutamol, inhaled regularly for 6 weeks, did not cause either a decline in lung function or an increase in bronchial responsiveness in subjects with primary ciliary dyskinesia.

Administration, Inhalation↗

PubMed1989

Relation of lung function and exercise capacity to mood and attitudes to health.

Results of psychometric tests were obtained on 161 male welders and other tradesmen in heavy industry who had recently been made redundant. Anxiety and depression were scored on the Hospital Anxiety and Depression Scale, and negative attitudes and beliefs regarding breathlessness and related aspects of respiratory health on a semantic differential scale. Scores for attitudes and beliefs about health and personal disability were pooled to give a general attitude score. Personality was rated on a standard scale. Subjects completed a questionnaire on respiratory symptoms and underwent routine spirometry, measurement of carbon monoxide transfer factor for the lung, and a progressive exercise test on a cycle ergometer. Scores for anxiety, depression, and negative mental attitudes were significantly intercorrelated; subjects with disordered personality profiles had above average scores for anxiety and depression. The psychometric scores were associated with clinical grade of breathlessness, lung function, and the physiological response to exercise. The general attitude score could be predicted from the anxiety and depression scores and from lung function expressed relative to age and stature, the combination of mood score and FEV1 explaining 38% of the variance in general attitude score. The general attitude score accounted for more than half the explained variance in the clinical grade of breathlessness and contributed more to the variance in maximal oxygen uptake (R2 = 0.11) than FEV1. It was associated with the level of habitual activity but not with smoking category, wheeze, chronic cough or phlegm. Thus attitude to disability reflected the subject's assessment of his exercise capacity and was closely related to the clinical grade of breathlessness.

Adult↗

PubMed1991

Corticosteroid and thyrotropin-releasing hormone effects on preterm sheep lung function.

Four groups of twin sheep fetuses were catheterized at 121 days of gestational age and intravenously infused with saline, 0.75 mg.kg-1.h-1 cortisol for 60 h, five intermittent bolus injections of 5 micrograms/kg thyrotropin-releasing hormone (TRH) at 12-h intervals, or both hormones before delivery at 128 days. At birth, the lambs were randomized to receive surfactant or no treatment. Surfactant treatment improved lung function of all the groups. Corticosteroids alone and in combination with TRH improved compliance and gas exchange as well as pressure-volume curves. Corticosteroids alone dramatically decreased the recovery of intravenously administered radiolabeled albumin in the lung tissue and air space and improved the pulmonary response to surfactant treatment. There were no additional effects of TRH when given with corticosteroids on lung function or albumin leak. There were no changes in alveolar surfactant-saturated phosphatidylcholine pool sizes after any hormone treatment. The single significant effect of combined corticosteroid and TRH treatment was a fivefold increase in surfactant protein A in alveolar lavage fluid relative to all other groups.

Animals↗

PubMedDate not supplied

Effect of one hour of passive cigarette smoking on lung function and airway responsiveness in adults and children with asthma.

We exposed 18 adults with bronchial asthma, 16 healthy controls and 11 children with asthma for 1 h either to ambient air (AA) or to environmental tobacco smoke (ETS). Exposure was performed at rest in an exposure chamber. Before and after exposure symptom scores and lung function were determined. After exposure bronchoprovocation tests with methacholine (adults) or histamine (children) were performed to determine the concentrations causing a 100% increase in SRaw (PC100SRaw), and a 20% fall in FEV1 (PC20FEV1). In adult asthmatics mean (SD) SRaw before and after Sham was 8.8 (3.6) and 8.4 (3.6) cmH2O.s, and mean FEV1 (SD) was 3.18 (0.97) and 3.14 (0.9) 1, respectively. Before and after passive smoking mean SRaw (SD) was 7.5 (3.0) and 7.2 (2.7) cmH2O.s, and mean FEV1 (SD) was 3.31 (1.0) and 3.21 (0.88) 1, respectively. Geometric mean (SD) PC100SRaw and PC20FEV1 after Sham were 0.38 (4.5) and 0.29 (4.1) mg/ml, after passive smoking 0.39 (5.1) and 0.36 (4.7) mg/ml, respectively. In healthy controls there was no consistent effect on the respective parameters during exposure. In children mean (SD) SRaw before and after Sham was 8.7 (3.6) and 9.0 (3.2) cmH2O.s, and mean FEV1 (SD) was 1.97 (0.32) and 1.98 (0.40) 1, respectively. Before and after passive smoking mean SRaw (SD) was 10.4 (5.3) and 9.4 (3.3) cmH2O.s, and mean FEV1 (SD) was 1.95 (0.37) and 1.94 (0.35) 1, respectively. Geometric mean (SD) PC100SRaw and PC20FEV1 after Sham were 1.39 (3.0) and 0.70 (2.7) mg/ml, and after passive smoking 1.65 (2.5) and 0.96 (2.3) mg/ml, respectively. There were no significant differences in lung function and airway responsiveness between exposure to ambient air or ETS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1977

The place of radioisotopic lung function studies in paediatrics.

An analysis of the clinical value of radioisotopic lung function (RLF) tests has been carried out on the results of studies in 123 children with heart or lung disease. The overall incidence of useful RLF tests was 53%, but in children between 6 months and 6 years the incidence was higher (69%). The incidence of useful RLF test was similar whatever the question to be answered, although rather higher when information about differential pulmonary blood flow was required. Lists of conditions are presented for which the incidence of useful RLF tests is likely to be high (72%), moderate (46%), and low (14%).

Adolescent↗

PubMed2000

Sensitization and lung function in workers occupationally exposed to natural thickening products.

BACKGROUND: Three workers engaged in the manufacture of natural thickener products (Cassia spp., guar, and tamarind flour) were occupationally sensitized to Cassia spp. Therefore, a cross-sectional study on the prevalence of sensitization among and respiratory health of the employees of this plant was conducted. METHODS AND RESULTS: Sixty-two workers (36 with high, 26 with low exposure) participated in the survey. Skin prick tests and specific IgE tests with extracts of these components revealed that 11.3% were sensitized to Cassia spp. and 9.7% to at least one species of storage mites, with a significantly higher portion of atopic subjects in the sensitized group. Overall, 55% of the subjects reported work-related symptoms (upper and lower airways, eyes, or skin). FVC % pred. was significantly lower in highly exposed workers, while RV % pred. and RV%TLC % pred. were significantly higher in this group. In the multivariate model, sensitization was not a risk factor for impairment of lung function. CONCLUSIONS: Dust exposure to flours may not only cause allergic sensitization but also induce chronic changes in lung function.

Adolescent↗

PubMed1997

The effect of inhaled salbutamol and salmeterol on lung function and endurance performance in healthy well-trained athletes.

The present randomized, double-blind placebo-controlled study aimed at investigating the possible improvement in endurance performance caused by inhaled salmeterol (long-acting beta 2-agonist) and salbutamol (short-acting) compared to placebo in 18 healthy well-trained athletes, aged 17-30 years old. Lung function (flow-volume loops) was measured before and after each inhaled study drug and after run to exhaustion. After inhalation of study drug and 10 min warm-up, anaerobic threshold was measured; thereafter maximum oxygen uptake, peak ventilation and running time until exhaustion during a brief graded exercise were measured. No significant differences were found for ventilation, oxygen uptake or heart rate at anaerobic threshold or at maximum performance between placebo and the beta 2-agonists. Lung function increased significantly after exercise, but without differences between the beta 2-agonists and placebo. Running time till exhaustion was significantly reduced after both the long- and the short-acting beta 2-agonist compared to the placebo.

Administration, Inhalation↗

PubMed1996

A five year follow-up of lung function among chemical workers using flow-volume and impedance measurements.

Impedance of the respiratory system, measured using the forced oscillation technique (FOT), has repeatedly been proposed as a tool for occupational health screening. The aim of this study was to compare the outcome of impedance measurements and flow-volume curves, and to study relationships between lung function decline and specific exposures and smoking. Both measurements were applied in 136 chemical workers from seven main production/personnel groups during a 5 year follow-up (1990-1995). The prevalence of airway obstruction (forced expiratory volume in one second (FEV1) < 80% of predicted) at both time-points was about 5% but did not necessarily include the same subjects. The average decline in FEV1 over 5 yrs was 200 mL (predicted decline 160 mL). Although most impedance parameters correlated to flow-volume parameters in both years, a rapid 5 year decline of FEV1 (> 330 mL) was only accompanied by a significant decrease in the reactance at 8 Hz (X8) and an increase in the resonance frequency (f0). Interestingly, decline in FEV1 was significantly dependent on age, years of employment, pack-years, FEV1, and all impedance parameters at the start in 1990 (r = 0.35; p = 0.01). Similarly, the increase in f0 was significantly dependent on age, years of employment, pack-years, f0, FEV1, forced vital capacity (FVC), peak expiratory flow (PEF) and maximal mid-expiratory flow (MMEF) at the start (r = 0.56; p < 0.01). Those with a rapid decline in FEV1, were relatively more represented among acid workers (relative risk (RR) = 2.14), maintenance workers (RR = 2.1) and bulk/transport workers (RR = 1.78), but none of these was significant. Lung function, however, was significantly lower in the bulk/transport workers (n = 14) compared to the rest, based both on flow-volume (FEV1, FVC) and impedance (X8, f0) measurements. Smoking had a significant effect on most flow-volume parameters but only for frequency dependence among the impedance outcomes. It is concluded that alterations in impedance parameters do reflect changes in flow-volume curves induced by age. smoking and occupational exposure. Therefore, these data are a valuable extension to current cross-sectional data.

Acids↗