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At least 19 recordsLinked to original sources

The effect of dialyzer reuse on peak expiratory flow rate.

Peak expiratory flow rates were measured during routine haemodialysis in 18 patients with chronic renal failure who were in receipt of thrice weekly haemodialysis treatment, using both a new cuprophan dialyzer and then the same dialyzer after reprocessing. Acetate buffered dialysate was used on both occasions. The peak expiratory flow rates fell by 10 +/- 0.3%, mean +/- sem, during the first hour of treatment with the new dialyzer, and in seven patients (39%) the fall was greater than 15%. Whereas the reduction in peak expiratory flow rates was significantly less with reuse, 4 +/- 0.1% (P less than 0.5). Similarly, the fall in arterial oxygen tension was also reduced on reuse from 28 +/- 1.2% to 14 +/- 1.3% at 30 min (P less than 0.05) and from 30 +/- 1.4% to 18 +/- 3.1% (P less than 0.05) at 60 min of dialysis. There was also a reduction in the fall in the peripheral platelet count at 30 min of dialysis from 14 +/- 0.8% to 9 +/- 0.4% with reuse (P less than 0.05). However, there was no change in dialysis associated leukopenia with reuse of the dialyzer membrane. These results suggest that reprocessing the dialyzer membrane alters its biocompatibility characteristics resulting in an improvement in biocompatibility and further supports the role of inflammatory cell mediator release in the pathogenesis of dialysis associated hypoxaemia and pulmonary dysfunction during the first hour of dialysis treatment.

Bicarbonates↗

Lung functions with spirometry: an Indian perspective--I. Peak expiratory flow rates.

Peak expiratory flow rate is an effective measure of effort dependent airflow. It is relatively a simple procedure, and may be carried out in the field using portable instruments. The average PEFR of healthy young Indian males and females is around 500 and 350 lpm respectively. The PEFR reaches a peak at about 18-20 years, maintains this level up to about 30 years in males, and about 40 years in females, and then declines with age. Common regression equations for Indians enveloping major studies from various parts of the country have been formulated. Indian PEFR values compare favourably with other ethnic groups such as Americans and Europeans.

Humans↗

The relationship between peak expiratory sound intensity and peak expiratory flow rate in the thoroughbred horse during exercise.

Peak expiratory sound intensity (dB SPL), obtained by means of a radiostethoscope, and peak expiratory flow rate, obtained using a mask incorporating a thermistor flow sensor, were measured in six Thoroughbreds over a range of stride rates from 100 to 140 strides per min. The results show linear relationships between peak dB SPL and stride rate, peak expiratory flow rate and stride rate and also between peak expiratory flow rate and peak dB SPL. Peak expiratory dB SPL can therefore indicate peak expiratory flow rate.

Animals↗

Fluticasone propionate/salmeterol combination compared with montelukast for the treatment of persistent asthma.

BACKGROUND: Asthma is a chronic disease characterized by inflammation and bronchoconstriction. Medications that are able to effectively treat both components are advantageous. OBJECTIVE: To compare the efficacy of an inhaled corticosteroid and a long-acting beta2-agonist combination product with a leukotriene antagonist for initial maintenance therapy in patients who were symptomatic while receiving short-acting beta2-agonists alone. METHODS: A 12-week, randomized, double-blind, double-dummy, multicenter study was conducted in 432 patients 15 years of age and older with persistent asthma who were symptomatic on short-acting beta2-agonists alone. Fluticasone propionate 100 microg and salmeterol 50 microg combination product (FSC) twice daily or montelukast 10 mg once daily was administered. RESULTS: At endpoint, compared with montelukast, FSC significantly increased morning predose forced expiratory volume in 1 second (0.61 +/- 0.03 L vs 0.32 +/- 0.03 L), morning peak expiratory flow rate (peak expiratory flow rate; 81.4 +/- 5.9 L/minute vs 41.9 +/- 4.8 L/minute), evening peak expiratory flow rate (64.6 +/- 5.3 L/minute vs 38.8 +/- 4.7 L/minute), the percentage of symptom-free days (40.3 +/- 2.9% vs 27.0 +/- 2.7%), the percentage of rescue-free days (53.4 +/- 2.8% vs 26.7 +/- 2.5%), and the percentage of nights with no awakenings (29.8 +/- 2.5% vs 19.6 +/- 2.1%) (P < or = 0.011, all comparisons). At endpoint, FSC significantly reduced asthma symptom scores (-1.0 +/- 0.1 vs -0.7 +/- 0.1) and rescue albuterol use (-3.6 +/- 0.2 puffs/day vs -2.2 +/- 0.2 puffs/day) compared with montelukast (P < 0.001). At endpoint, patients treated with FSC also had a significantly greater improvement in quality of life scores and were more satisfied with their treatment compared with montelukast-treated patients (P < or = 0.001). Both treatments were well tolerated. CONCLUSIONS: Initial maintenance therapy with FSC provides greater improvement in asthma control and patient satisfaction than montelukast.

Acetates↗

Studies of cardioselectivity and partial agonist activity in beta-adrenoceptor blockade comparing effects on heart rate and peak expiratory flow rate during exercise.

1 The effects of beta-adrenoceptor antagonists given in single doses by oral or intravenous routes were examined in two double-blind controlled studies performed in healthy volunteers. Heart rate and peak expiratory flow rate (PEFR) were measured at rest and during standardized exercise. 2 Propranolol 80 mg and metoprolol 100 mg orally tended to reduce, and propranolol and metoprolol 0.2 mg/kg intravenously did reduce the physiological increase in PEFR during exercise; oxprenolol 80 mg orally and 0.2 mg/kg intravenously did not. Practolol 200 mg orally reduced this increase, but practolol 1 mg/kg intravenously did not. 3 In a third study of similar design, pindolol 0.05 mg/kg intravenously did not affect exercise-induced increase in PEFR. 4 Heart rate during exercise was reduced to a comparable extent at different times by all the active treatments. 5 Oxprenolol and pindolol share with practolol the property of partial agonist activity, which might contribute to their apparent lack of effect on airways resistance. A further possibility is that alpha-adrenoceptor blockade helps to maintain exercise-induced increase in PEFR.

Adrenergic beta-Antagonists↗

Measurements of morning and evening airflow grossly underestimate the circadian variability of FEV1 and peak expiratory flow rate in asthma.

Peak expiratory flow rate (PEF) or forced expiratory volume in 1 s (FEV1) monitoring is an important clinical tool to assess the degree of 24-h variation (circadian) in lung function, which correlates with the degree of airway hyperresponsiveness. Ideally, PEF measurements should be taken frequently during the 24-h period to reflect the true variability. In practice, however, measurements are generally taken twice daily, usually upon arising and in the evening before bedtime. The effect of reducing the frequency of lung function measurement on the reported 24-h time average (mesor) and the circadian variability were evaluated. Four measurements taken 8 h apart and two measurements derived upon arising and the other, either 12 h later or before retiring, were compared with the full 24-h lung function profile, which included thirteen 2-hourly measurements. Based on the data from a 24-h lung function study in 20 adult patients with asthma, the corresponding values were separately compared at baseline and under two theophylline treatments, one being administered twice daily and the other once daily. The results are as follows: Whereas the 24-h time average (mesor) is hardly effected by the reduced measurements schemes, variability was grossly underestimated. Only 60 to 80% of the actual variability is picked up in the case of the four 8-hourly measurements, and only 20 to 45% in the case of the two measurements. The loss of accuracy in assessing 24-h airflow variability has potentially important implications on clinical practice and the investigation of therapeutics in asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Peak expiratory flow rates in Libyan adolescents.

Peak expiratory flow rates of 578 Libyan boys and 527 Libyan girls aged 12 to 21 years were determined. The prediction formulae that best describe the data are as follows: Boys: PEFR = 160 X Stature 1.87 Girls: PEFR = 130 X Stature2.44 Statistically significant correlations were found between peak expiratory flow rate (PEFR) and standing height, sitting height, body mass index, body surface area and age in both sexes. Stature (standing height) is marginally better as an index of body size in explaining the variability of the ventilatory capacity. The relationship between PEFR and age in girls appears to correlate with the relationship between PEFR and body mass index. The difference in the slope for girls when compared with that for boys is attributed to the obesity/over weight of the girls.

Adolescent↗

Peak expiratory flow rates in elderly Indians.

Peak expiratory flow rates were measured in 124 normal elderly men (55-85 yr) using the Wright's peak flow meter. In the less than 60 yrs age group (n = 32; mean age 57.7 yr) the PEFR was 431 +/- 13 lpm, while for the group greater than 60 yr (mean age 69.0 +/- 6.0; n = 92), the PEFR value was 373 +/- 11 1pm. These values are similar to those reported in other Indian studies, suggesting that the ethnic variations amongst Indian subjects do not affect the PEFR. However, the reported values are lower than those observed in Europeans, but greater than those of Chinese. The PEFR regressed at a rate of 4.47 1pm/year increase in age, but is positively correlated to the subjects' height (cm), and their FVC and FEVI. The smokers had a significantly higher PEFR as compared with the non-smokers. This finding was contrary to what was expected.

Adult↗

Age and height as predictors of peak expiratory flow rate in Indian girls.

Peak expiratory flow rate (PEF) was measured on 175 healthy Indian girls in the age range 8-18 years with the help of Wright's Peak Flow Meter. PEF was recorded in the post absorptive phase at least 1 h after breakfast. The subjects rested for 0.5 h before the test procedure and tests were carried out between 1000-11000 hrs to avoid diurnal changes. The highest of three recordings was noted as the subject's PEF. PEF, age, height and body weight were correlated with each other and an intercorrelation matrix between these variables has been designed. It was observed, after performing multivariate regression analysis, that age and height are significant predictors of PEF. A multiple linear regression equation and a nomogram have been constructed for predicting PEF from age and height in young healthy Indian girls.

Adolescent↗

Evaluation of the suitability of weekly peak expiratory flow rate measurements in monitoring annual decline in lung function among patients with asthma and chronic bronchitis.

BACKGROUND: Early detection and treatment of patients with asthma or chronic bronchitis who have a rapid annual decline in lung function is essential in order to improve their long-term prognosis. This annual rate of decline can be assessed accurately by monitoring the forced expiratory volume in one second (FEV1) which is a routine procedure in hospital respiratory laboratories but not in general practice. General practitioners usually measure patients' peak expiratory flow rate (peak flow) to evaluate lung function. If annual decline in lung function can be assessed by monitoring peak flow, this method could be used in general practice for detecting patients at an early stage who have a rapid decline. AIM: A study aimed to investigate the long-term correlation between FEV1 and peak flow among a group of patients in Nijmegen, the Netherlands. METHOD: FEV1 and peak flow were monitored in 53 patients with moderate asthma and 78 patients with moderate chronic bronchitis over four years. FEV1 was measured in a laboratory once every six months and peak flow was measured by patients once a week. The correlation between the two sets of measurements was studied for each patient. RESULTS: Four-year data for 83 of the 131 patients were analysed; the other 48 patients received inhaled steroids during the second half of the study period so their data were not considered for all the analyses. Of the 83 patients, 35 (42%) showed a decrease in both FEV1 and peak flow. Thirty six patients (43%) showed a decrease in FEV1 and an increase in peak flow. Four patients (5%) showed an increase in FEV1 and a decrease in peak flow and eight patients (10%) showed an increase in both rates. Approximately similar results were seen in a separate analysis of all 131 patients during the first two years of the study. CONCLUSION: No long-term correlation was found between FEV1 and peak flow. Peak flow is not capable of detecting annual decline in lung function. Therefore it cannot be used to detect patients with asthma or chronic bronchitis who have a rapid annual decline in lung function. Spirometers, which measure peak flow and FEV1, could be used in general practice. These would allow general practitioners to continue measuring peak flow in order to assess short-term changes in lung function while providing an important means for monitoring FEV1 to assess long-term changes in lung function.

Adult↗

Peak expiratory flow rate in Nigerian school children.

Peak expiratory flow rate (PEFR) was measured using the Wright's peak flow meter in 263 school boys and 275 school girls living in Lagos, Nigeria. Their ages ranged from 6.0 years to 19.0 years (mean 11.9 +/- 3.8 yrs. for boys and 11.8 +/- 3.9 yrs. for girls). Mean PEFR was 359.2 +/- 102.0 L/min (range 160.0-610.0 L/min) in boys and 327.7 +/- 81.3 L/min (range 160.0-500.0 L/min) in girls. Apart from ages 17, 18 and 19, peak expiratory flow rates were similar in both boys and girls. In both sexes, PEFR correlated positively and significantly with age, height, weight and body surface area. Also in both sexes and in all age groups studied, PEFR was significantly higher than predicted values obtained from previous Nigerian and caucasian prediction equations. When compared with values obtained from a second caucasian prediction equation, observed values were significantly higher in the 6-10 years and 16-19 years age groups in boys and 11-15 years and 16-19 years age groups in girls. New prediction equations for calculating PEFR in Nigerian boys and girls are presented. Observed PEFR may be due to enhanced stature in Nigerian children resulting from improved environment and genetic factors.

Adolescent↗

Peak expiratory flow rate in normal Nigerian children.

Peak expiratory flow rate was estimated in 569 school children in Ibadan to determine normal values in Nigerians. Two hundred and seventy-six boys and 293 girls, aged 6-18 without antecedent history of respiratory disease, from different socio-economic backgrounds were selected. The peak expiratory flow rate (PFR) was estimated using the Wright peak flowmeter. The results indicated that the mean values of Nigerian children were lower than those of Caucasians of the same height, sex and age. The possible reasons for this are discussed. The PFR values were found to correlate highly (P less than 0.01) with age, weight and height, and also with FVC and FEV1. In this study, PFR correlated more closely with weight than height, contrary to the results observed in Caucasian children. Since there is a positive correlation between PFR and FVC or FEV1, PFR can therefore be used in assessment of respiratory function in clinical practice, particularly in younger children, who cannot adequately cooperate when the spirometer is used for lung-function studies.

Adolescent↗

Predictive value of monitoring expiratory peak flow rates in hospitalized adult asthma patients.

This prospective single-blind study monitored the progress and outcome of 18 hospitalized asthmatic patients on intravenous corticosteroids by daily peak expiratory flow rate (PEFR) measurements to determine whether daily flow monitoring was useful as a guide for predicting response to therapy over the short- and long-term course posthospitalization. Daily monitoring of PEFR was helpful in demonstrating the response to therapy during hospitalization and at follow-up visit (1 to 2 weeks) posthospitalization. This change in PEFR during acute hospitalization and at initial follow-up visit did not correlate well with relapse or repeat hospitalization during the 5- to 17-month follow-up period.

Adrenal Cortex Hormones↗

Peak expiratory flow rate in normal pregnancy.

OBJECTIVE: To determine whether peak expiratory flow rate changes with pregnancy and advancing gestation. METHODS: We measured the peak expiratory flow rate in 57 women during each trimester of pregnancy and postpartum. During four visits, all subjects exhaled forcefully three times into a peak flow meter. For each visit, the best of three attempts defined their peak expiratory flow rate. Using accepted standard nomograms, we normalized peak expiratory flow rate with respect to height and age. Using analysis of variance, we compared the mean normalized peak expiratory flow rates in each of the trimesters and postpartum. RESULTS: The subjects' peak expiratory flow rates did not change significantly during the three trimesters and postpartum (P = .317). The mean peak expiratory flow rates for the three trimesters and postpartum were 434 +/- 18, 452 +/- 16, 444 +/- 15, and 450 +/- 16 (values in liters per minute +/- 95% confidence intervals [CIs]). The mean normalized peak expiratory flow rates for the three trimesters and postpartum were 0.92 +/- 0.036, 0.95 +/- 0.032, 0.94 +/- 0.030, and 0.95 +/- 0.031 (values +/- 95% CI). CONCLUSIONS: This study demonstrates that peak expiratory flow rate does not change with pregnancy and advancing gestation. Therefore, testing peak expiratory flow rate in pregnancy is valid, and physicians can use peak expiratory flow rate accurately and reliably in the management of pregnant women with asthma.

Adolescent↗

Peak expiratory flow rate in South Indian adults.

Peak Expiratory Flow Rate (PEFR) was measured with a Wright Peak Flow Meter in 851 healthy men and women of two categories; Group I--students and staff of the Medical College constituting the middle income group, and Group II--healthy individuals from the poorer class with an income of less than Rs.200/-per month, forming the lower income group. In both categories women had much lower values than men, and in both sexes the values in the subjects of the poor income group was significantly lower. The PEFR was found to correlate best with height in subjects below 30 years, and with age in older subjects. The mean values, standard deviations and regression equations are given for the different groups. Present values are also compared with some western and Indian data.

Adolescent↗

Factors affecting the peak expiratory flow rate in children.

Standing height and peak expiratory flow rate (PEFR) were measured in 339 British schoolchildren aged 7-16 years. Enquiry was made into a past history of wheeze or atopy, a family history of asthma or atopy, or a cold within the preceding 2 weeks. A strong correlation was found between PEFR and height, expressed by the equation PEFR = 5.640 Ht - 472.5 (r = 0.89). Neither a recent cold nor a positive personal or family history of wheeze or atopy had any significant effect on the regression equation. Sex was also unimportant. Further examination of the data revealed that age had an effect on peak expiratory flow rate independent of height. The effect of age was linear in girls and curvilinear in boys. Five hundred and sixty-nine Greek schoolchildren were also studied and similar age effects were found on the regression of peak expiratory flow rate on height. The implication of these findings is that any population study of peak expiratory flow rates in children should ensure a normal age distribution at each height interval. Significant error in the prediction of the PEFR will result if the effect of age is ignored, particularly in pubertal boys.

Adolescent↗

The effect of a mechanical glottis on peak expiratory flow rate and time to peak flow during a peak expiratory flow manoeuvre: a study in normal subjects and patients with motor neurone disease.

We have evaluated a mechanical glottis in healthy volunteers and in patients with bulbar motor neurone disease. In healthy volunteers, the mechanical glottis increased peak flow rate and decreased the time to peak flow during forced expiration, but cough produced even higher flow rates and shorter times to peak flow. In patients, the mechanical glottis increased peak flow rate and decreased the time to peak flow. The mechanical glottis also produced higher peak flow rates when compared to the cough manoeuvres, and the time to peak flow was also significantly shorter with the mechanical glottis. We have shown that the use of a mechanical glottis tends to convert the airflow profile of a peak expiratory flow manoeuvre into that of a cough in both healthy volunteers and patients with motor neurone disease. Its potential role as an aid to clearance of airway secretions in patients with impaired laryngeal function remains to be seen.

Adult↗

Monitoring of maximum expiratory peak flow rates and histamine inhalation tests in the investigation of occupational asthma.

A 49 year old carpenter developed asthma after he was employed in a new workshop. Specific inhalation tests carried out in a laboratory with presswood sawdust and the different glues used at work were negative. Monitoring peak expiratory flow rates (PEFR) at work revealed a progressive fall on consecutive days with recovery after periods off-work. Histamine inhalation tests showed a definite increase in bronchial hyperexcitability after working periods. Monitoring of PEFR in conjunction with histamine inhalation tests can thus help in confirming occupational asthma.

Asthma↗