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Lung function in adults with mycoplasmal pneumonia.

We prospectively studied on lung function of 17 patients (7 men and 10 women) of acute Mycoplasma pneumoniae pneumonia. Lung function tests including %VC, FEV1.0%, Peak flow, V75/HT, V25/HT, V50/V25 and MMF were measured during the acute and convalescent stage. The results showed dysfunction of peripheral airway because of reduction in V50/HT, V25/HT and MMF. It was suggested that lung function in patients with Mycoplasma pneumoniae pneumonia was impaired at the high lung volume as well as low lung volume.

Adolescent

[Presurgical determination of lung function in patients with bronchogenic carcinoma].

90 out of 202 lung cancer patients hospitalized for preoperative investigations were scheduled for radical surgery. 15 patients were not operated on because of insufficient lung function data. The operation was performed in 75 patients. The complication rate was 11% and mortality 8%. 7 out of 8 patients who subsequently developed severe complications had fulfilled the criteria for lung resection only after intensive antibronchitic treatment. Nearly all the survivors showed the predicted preoperative minimal lung function values after the operation. The limit of 1000 ml for postoperative FEV1 is justified, since patients with these or larger functional reserves nearly all had a favourable early and late postoperative course, and also because lung function values continuously deteriorate in chronic obstructive lung disease.

Aged

The UCLA population studies of chronic obstructive respiratory disease. VIII. Effects of smoking cessation on lung function: a prospective study of a free-living population.

We evaluated effects of smoking cessation on lung function and respiratory symptoms of residents 25 to 64 yr of age from 3 communities in the Los Angeles area who completed a detailed respiratory questionnaire and measurements of forced expired volumes and flow rates, closing volume, and closing capacity at 2 times (T1 and T2) 5 yr apart. Results were analyzed in 2,401 participants who fit into 4 smoking categories: never smokers (414 males, 737 females); former smokers (294 males; 172 females); quitters between T1 and T2 (106 males, 62 females); and continuing smokers (278 males, 338 females). Covariance analysis was used to determine differences in lung function across smoking categories at T1 and T2 (adjusted for T1 values) and differences in decline in lung function between T1 and T2. Chi-square analysis was used to compare continuing smokers and quitters with respect to changes in respiratory symptoms. In this population, smoking at T1 was associated with impairment in all indexes of lung function evaluated. Smoking cessation led to significant improvement in symptoms of cough, wheeze, and phlegm production, and to significantly less decline in indexes of small airway function during 5 yr compared with measurements in continuing smokers. However, at T2, lung function still was lower among quitters compared with former and never smokers. Forced expiratory volume in one second (FEV1) was marginally improved in women who quit compared with those who continued to smoke.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Smoking and lung function.

In a cross-sectional survey of 3 separate communities, we studied the white residents 7 year of age and older in order to determine the relation between cigarette smoking and lung function. We identified 2,817 nonsmokers, 664 ex-smokers, and 1,209 smokers who were further classified as light smokers (1 to 20 cigarettes per day) and heavy smokers (greater than 20 cigarettes per day). Residual lung function (observed-predicted) was examined in these groups for forced expiratory volume in one second (rFEV1) and for maximal expiratory flow rates at 50% and 25% of the vital capacity (rVmax50% and rVmax 25%). Mean residuals by sex, age, and smoking category were compared and revealed an increasing progression of lung function loss with advancing age in males and females in all smoking categories. These age-related trends were due primarily to the amount smoked by persons in each group. The age of onset of these abnormalities was found to be as early as the age group 15 to 24 yr. Abnormalities were greater in smokers than ex-smokers, even when the amount smoked was taken into account. This is suggested improvement in lung function after cessation of smoking. Men and women were found to experience the same relative degree of gain. Also, the contribution of the various smoking habits to lung function loss was assessed using regression analyses and accounted for no more than 15% of the variation of the residual lung function. Combinations of variables were found to explain only slightly more variation than a single variable. The two most important variables were duration of smoking and pack-years. Inhalation and use of filters were not significant. Although the same amount of variation explained by the smoking variables after accounting for age, height, weight, and sex was small, this variation accounted for almost all of the decrease, over age, in residual lung function for smokers and ex-smokers.

Adolescent

Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study.

Most patients with progressive systemic sclerosis (PSS) exhibit lung involvement. However, the natural history of lung disease in PSS remains poorly defined. To evaluate lung function over time in PSS, a battery of lung function tests were prospectively performed serially between 1973 and 1982 in 61 patients with PSS. Functional indexes of restriction (vital capacity and total lung capacity) and diffusion impairment (diffusing capacity) showed greater-than-expected annual rates of change. Male subjects showed a trend toward faster declines in forced vital capacity, forced expired volume in one second, total lung capacity, and functional residual capacity and a more rapid increase in static recoil pressure at 90 percent of total lung capacity than did female subjects. Nonsmokers had greater rates of decline in total lung capacity and static lung compliance (but not in forced vital capacity or diffusing capacity) and a greater rate of increase in static recoil pressure than did current and former smokers. Level of lung function at initial study visit, age, race, and chlorambucil therapy had no significant effect on the annual rates of change in lung function, whereas longer duration of disease prior to study entry was associated with a slower annual decrease in lung volumes. Between the first and last visits (mean interval 3.1 years, maximum nine years), the frequency of abnormality in pulmonary function test results showed significant change only in the diffusing capacity (60 percent increasing to 82 percent) and static lung compliance (40 percent increasing to 54 percent), whereas the frequency of respiratory symptoms showed little change. These findings indicate an overall indolent progression of PSS-related lung disease, with substantial individual variability.

Adult

Effect of moderate NO2 air pollution on the lung function of children with asthmatic symptoms.

In the course of a 2 1/2-year longitudinal study, the influence of outdoor NO2 and of the heating device at home on lung function was investigated in 467 children of school age in the urban area of Freiburg. Data were gathered in three surveys using standardized interviews, lung function measurements, skin prick tests with inhalant allergens, and NO2 measurements from October to April near the child's home. Regarding the lung function of a subpopulation with asthmatic symptoms (n = 106) in the three consecutive surveys, multivariate regression analyses adjusted for confounders indicate negative associations between five dependent variables, FEV1%FVC (P = 0.004), FEV1% (P = 0.02), MEF75% (P = 0.038), MEF50% (P = 0.052), and MEF25% (P = 0.002), on the one hand, and outdoor NO2 for average NO2 concentrations exceeding 40 micrograms/m3 on the other. The use of individual room heaters is associated with decreased lung function and is significant only for FEV1%FVC (P = 0.033). Neither NO2 nor individual room heating is significantly associated with one of the lung function parameters in the subpopulation without asthmatic symptoms (n = 361). In conclusion, children with asthmatic symptoms are identified as being susceptible to having reduced lung function under outdoor air pollution where average NO2 concentrations exceed 40 micrograms/m3.

Air Pollutants

Longitudinal lung function decline in subjects with respiratory symptoms.

The relation of respiratory symptoms and lung function has not been extensively investigated. To determine better the rate of FEV1 decline in subjects reporting persistent wheeze, chronic cough, chronic phlegm, and/or dyspnea, longitudinal data from an adult population sample of 3,948 subjects (1,757 men; 2,191 women) followed for 12 yr were analyzed. At the initial and subsequent follow-up visits, subjects completed a standardized respiratory questionnaire and performed spirometry using the same methods and spirometers. Subjects were categorized based on the presence or absence of self-reported respiratory symptoms (persistent wheeze, chronic cough, chronic phlegm, or shortness of breath) at the initial visit. Six-specific linear regression models were fitted to determine the effect of these respiratory symptoms on lung function. In both men and women, reporting of any respiratory symptoms was associated with both a reduction in initial lung function and more rapid decline in height-adjusted FEV1. Furthermore, after adjustment for height, age, and cigarette smoking, men with cough or phlegm and women with cough alone showed accelerated loss in FEV1. Clinicians should be aware of the predictive value of these respiratory symptoms, because therapeutic intervention may modify the associated decline in lung function.

Cough

Lung function in children of low birth weight.

Lung function was recorded in a cohort of 130 age specific children of low birth weight (under 2000 g) and a reference population of 120 unselected local schoolchildren at 7 years of age. Children of the cohort were similar in height and forced vital capacity to the reference group, but had significantly reduced forced expiratory volume in 0.75 second and expiratory flow indices. Although neonatal respiratory illness was associated with reduced airway function, we were unable to confirm that this was a consequence of oxygen treatment or mechanical ventilation. Low birth weight, however, was closely associated with poor airway function independent of neonatal respiratory illness. Other factors of importance included the male gender and maternal smoking. The reduction in airway function observed in the low birthweight children was associated with cough but not wheeze. The disparity between the relatively well preserved vital capacity and reduced airway function suggests that very low birth weight, and hence prematurity, has its greatest effect on the subsequent growth of airway function. The absence of an association between neonatal oxygen score or mechanical ventilation and childhood lung function suggests that the long term effect of neonatal respiratory treatment is small compared with that of birth weight, maternal smoking, and male sex.

Birth Weight

Lung function and bronchial reactivity in farmers.

The purpose of this study was to evaluate the prevalence and type of lung function disorders in Danish farmers. Three samples of farmers were drawn from a group of unselected farmers who had participated in an epidemiological study. Group I (47 persons) was a sample of the 8% of all farmers who had reported that they had asthma; group II (63 persons) was a sample of the 28% of farmers who had had wheezing, shortness of breath, or cough without phlegm; and group III (34 persons) a sample of the farmers (64% of the total) who had no asthma and no respiratory symptoms. The farmers with symptoms (groups I and II) had low mean levels of FEV1 and high values for residual volume, whereas the symptomless farmers had normal lung function and no airways obstruction. The proportion of farmers with an FEV1 below the 95% confidence limit for predicted values was 43% in group I and 23% in group II; there were none in group III. Bronchial hyperreactivity to histamine occurred in 96% of asthmatic farmers, 67% of farmers with wheezing or shortness of breath, and 59% of symptomless farmers. A low level of FEV1 was associated with the number of years in pig farming and bronchial hyperreactivity in group II but not group I or III. Most of the bronchial hyperreactivity was explained in the multiple regression analysis by a low FEV1, though this was significant only for farmers in group II. Thus farmers who reported asthma, wheezing, shortness of breath, or a dry cough in general had airways obstruction with an increased residual volume, whereas symptomless farmers had normal lung function. Severe bronchial hyperreactivity was mostly explained by a diagnosis of asthma and poor lung function, though some farmers with normal lung function and no respiratory symptoms had increased bronchial reactivity.

Adult

[Examination of the correlation between lung function and voice quality after glottoplasty or Blom-Singer-puncture (author's transl)].

The correlation between lung function and the quality of oesophageal speech was investigated in 36 patients who had undergone laryngectomy with glottoplasty. It was found that this correlation did not depend on any important lung function parameters. Lung tests were carried out on 10 patients before and after laryngectomy. No changes in lung function could be found that may have been directly attributed to a laryngectomy. This means that restrictive or obstructive lung disturbances do not contra-indicate glottoplasty or a Blom-Singer-puncture.

Aged

Lung function abnormalities and decline of spirometry in scleroderma: an overrated danger?

To document the prevalence and progression of pulmonary involvement in scleroderma (systemic sclerosis including the CREST syndrome), the clinical notes and lung function records of 113 cases were reviewed. Lung function was normal in 39 cases, isolated impairment of DLCO was found in 38 patients, a restrictive defect was present in 27 cases and there was evidence of airflow obstruction in 9 cases. The median duration of symptoms was 10 years. Dyspnoea and an interstitial pattern on chest X-ray were associated with impaired lung function. Death during the period of review was significantly related to initial impairment of the DLCO. Sixty-six patients (53 women and 13 men) underwent repeat spirometry at least 1 year after initial testing. The rates of change in VC and FEV1 were no more rapid than would be expected for normal subjects. There was no significant difference in rates of change between men and women or between dyspnoeic patients and those who were asymptomatic. The extent of skin involvement and the presence of interstitial fibrosis on chest X-ray were unrelated to the rate of loss of lung function. It is concluded that most scleroderma patients in this study had abnormal lung function when first tested, but overall significant worsening of spirometry was not found.

Adolescent

Acute effects of herbal tea dust extracts on lung function.

The acute effect of herbal tea dust extracts on lung function was studied in 15 of 25 healthy subjects responding to the inhalation of these extracts. Bronchial inhalation challenge was performed with tea extracts (sage, dog rose and gruzyan) and with normal saline solution as a control substance to assess their baseline airway reactivity to an isotonic aerosol. Lung function testing was performed before exposure and at 0, 15, 30, and 60 minutes after the cessation of exposure. The same subjects were also tested by challenge with methacholine. Lung function was measured by recording FVC, FEV1, FEF50, FEF25, SGaw, and Raw. Subjects were skin tested by the skin prick method and serum IgE levels were determined. The findings suggested that neither baseline nonspecific airway reactivity nor specific markers of immediate sensitivity to tea predict airway responses to tea extracts. Further evaluation of immunologic markers may help to explain the onset and progression of airway disease in workers.

Adult

Lung function in Maoris and Samoans working in New Zealand.

The lung function of 79 Maori workers was compared with that of 31 workers from Western Samoa and with 616 Europeans from the same factory. No significant difference was found in either forced expiratory volume in one second (FEV1) or in forced vital capacity (FVC) between the two Polynesian groups. The combined 110 Polynesians had a lung function which was significantly lower, by about 9%, than that of the Europeans working in the same factory. The lung function differences did not appear to be related to smoking, occupational or environmental factors. While it seems likely that the cause of the differences is a major gene effect a non-job-related social factor cannot yet be completely excluded. Charts for predicting FEV1 and FVC in male Maori and Samoan workers in New Zealand are given.

Adult

Ethnic origin and lung function of infants born prematurely.

BACKGROUND: Ethnic origin has an important influence on the lung function of adults and young children but its effect during infancy, particularly following premature delivery, is unclear. METHODS: The results from infants of pure Afro-Caribbean (subjects) and pure Caucasian (controls) descent, all of whom were born prematurely (median gestational age 28 weeks), were compared. Fifty subjects were each retrospectively matched with a control for gestational age, sex, and requirement for neonatal ventilation. Lung function measurements were performed at similar postnatal ages in each pair. The median postnatal ages of the two groups at the time of study was seven and eight months, respectively. Lung function was assessed by measurement of functional residual capacity (FRC) by a helium gas dilution technique and plethysmographic measurement of thoracic gas volume (TGV) and airways resistance (Raw), from which specific conductance (sGaw) was calculated. RESULTS: No differences were found between the subjects and controls regarding FRC or TGV, but Raw was higher and sGaw lower in the subjects. The mean Raw of the subjects was 50.3 cm H2O/1/s and of the controls was 44.1 cm H2O/1/s (95% confidence intervals of the difference 1.5 to 10.9). CONCLUSIONS: Prematurely born infants of Afro-Caribbean origin have more severe lung function abnormalities at approximately 7-8 months of age than those of Caucasian origin. This merits further investigation.

Black People

The effects of ambient NO2 on lung function in primary schoolchildren.

The effect of ambient NO2 on lung function was investigated in a sample of 423 schoolchildren. At each of four locations NO2 was monitored continuously. Over a 6-month period from January to June 1990 two surveys were performed and spirometry recorded each time for each child. Linear regression was used to estimate the effect of NO2 for different time intervals preceding lung function testing. A decrease of NO2 between surveys was significantly associated with a higher forced vital capacity (FVC) at the second survey. For each microgram/m3 NO2 decrease the model predicted an increase in FVC of 1.5 ml [for the 2-hr mean (P < 0.05)] and 3.1 ml [for the 12-hr mean (P < 0.01)]. We conclude that even at NO2 levels below current air-quality standards children demonstrate significant changes in lung function.

Air Pollutants

Lung function in school-age children who had mild lower respiratory illnesses in early childhood.

We examined the relationship between patterns of mild lower respiratory illness (LRI) experienced in early childhood and lung function in 89 boys and 70 girls 6 to 18 yr of age. The children's histories of outpatient visits for wheezing and nonwheezing LRI during the first 6 yr of life had been documented by physicians in a single pediatric practice. Most children were reported by their parents to have been free of recurrent respiratory symptoms during the 2 yr prior to lung function testing. In sex-specific analyses, average lung function assessed by spirometry was similar in children who had made zero or one physician visit for wheezing LRI during the preschool years. Boys who had experienced two or more episodes of wheezing LRI during the preschool years had lower average FEV1, FEV1/FVC, FEF25-75, Vmax50, and Vmax75 than did boys who had zero or one preschool wheezing illness. The association between recurrent preschool wheezing LRI and later lung function remained after exclusion of data from seven boys who were reported to have wheezed in the 2 yr prior to study. Girls who had experienced two or more preschool wheezing LRI had lower average FEF25-75 and Vmax50 than girls with a history of zero or one such illness, but differences were not statistically significant. Recurrent nonwheezing LRI during the preschool years was not significantly associated with subsequent lung function in either sex, regardless of preschool wheezing LRI history. Detailed information concerning early childhood LRI experience is valuable in epidemiologic studies of factors influencing lung function in children.

Adolescent

Aminophylline therapy for idiopathic apnea in premature infants: effects on lung function.

The effect of aminophylline on lung function was studied in 14 premature infants with apnea (gestational age, 30.2 weeks; birth weight, 1.052 gm). The infants showed compromised pulmonary function with a large difference in alveolar-arterial PO2 gradient (83.9 mm Hg), a low normal lung compliance of 1.1 ml/cm H2O . kg, and a normal inspiratory resistance of 45.3 cm H2O/liter/sec. Aminophylline therapy did not change these functions significantly, but it decreased the incidence of apneic episodes from 29.7 to 4.4 per day. The effectiveness of aminophylline in treating apnea in premature infants must be related to its central stimulating effect and not to an improvement in lung function and oxygenation.

Aminophylline

Lung function among black and white children.

Racial differences in ventilatory lung function were evaluated in a community study of 393 children (158 blacks, 235 whites). Mean forced vital capacity was 18 per cent larger in nonsmoking white males than in nonsmoking black males, and 11 per cent larger in nonsmoking white females than in nonsmoking black females. Similar differences were observed for the 1-sec forced expiratory volume and for the maximal expiratory flow at 50 per cent of the vital capacity. However, when adjusted for lung size (on the basis of forced vital capacity), 1-sec forced expiratory volume and maximal expiratory flow at 50 per cent of the forced vital capacity were larger in the black children compared to the white children. Lung function prediction equations based on race, sex, age, height and weight are presented for healthy nonsmoking children; these allow for an evaluation of normal lung function in both black and white children.

Adolescent