scholarly journals Among respiratory symptoms, wheeze associates most strongly with impaired lung function in adults with asthma: a long-term prospective cohort study

2021 ◽  
Vol 8 (1) ◽  
pp. e000981
Author(s):  
Nicolás Bermúdez Barón ◽  
Anne Lindberg ◽  
Caroline Stridsman ◽  
Martin Andersson ◽  
Linnea Hedman ◽  
...  
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Study Entry ◽  
Health Concern ◽  
Common Disease ◽  
Productive Cough ◽  
Recurrent Wheeze ◽  
Annual Decline

BackgroundAsthma is a common disease and a major public health concern. Respiratory symptoms are related to its prognosis, which in turn associates with lung function. Still this association on a long-term basis is not entirely understood.AimTo study the association of the type and number of respiratory symptoms with FEV1 and FEV1 decline in women and men with asthma.MethodA population-based cohort of adults with asthma was examined at study entry between 1986 and 2001 and at follow-up between 2012 and 2014, and n=977 had valid measurements of FEV1 on both occasions. Data regarding respiratory symptoms at study entry (recurrent wheeze, dyspnoea, longstanding cough and productive cough) were analysed in relation to FEV1 and annual decline in FEV1, both unadjusted and adjusted for other potentially associated factors by linear regression.ResultsFor both sexes recurrent wheeze and dyspnoea were associated with lower FEV1 at study entry and follow-up, while productive cough was associated with lower FEV1 only at follow-up. No associations were found between the type of symptoms and annual decline in FEV1. In adjusted analyses, the association between recurrent wheeze and lower FEV1 both at study entry and follow-up remained significant among women. Also, the association between a higher number of symptoms with lower FEV1 both at study entry and follow-up were present for both sexes and remained after adjustment.ConclusionsParticularly recurrent wheeze and a higher number of respiratory symptoms may predict lower lung function also in the long run among women and men with asthma.

scholarly journals Long-term Follow-up in Patients Diagnosed and Treated for Pulmonary Tuberculosis: What Really Happened With the Lung Function?

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 951A
Author(s):  
Pedro Marcos ◽  
Isabel Otero ◽  
Maria Fernández-Marrube ◽  
Maria Rodriguez-Valcarcel ◽  
Luis Mariñas ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Tuberculosis ◽  
Long Term Follow Up

The association between lung function in adults and the socioeconomic profile in a long-term follow-up

2021 ◽  
Author(s):  
Lene Maria Ørts ◽  
Bodil Hammer Bech ◽  
Torsten Lauritzen ◽  
Anders Helles Carlsen ◽  
Annelli Sandbæk ◽  
...  
Keyword(s):  
Lung Function ◽  
Long Term Follow Up ◽  
Socioeconomic Profile

scholarly journals Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study in Malawi

2020 ◽  
Author(s):  
Martin Njoroge ◽  
Sarah Rylance ◽  
Rebecca Nightingale ◽  
Stephen Gordon ◽  
Kevin Mortimer ◽  
...  
Keyword(s):  
Health Economic ◽  
Lung Function ◽  
Low Income ◽  
Respiratory Symptoms ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Sub Saharan ◽  
Lung Health

AbstractPurposeThe Chikwawa lung health cohort was established in rural Malawi in 2014 to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa.ParticipantsA total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, a mean age of 43.8 (SD:17.8) and mean body mass index (BMI) of 21.6 Kg/m2 (SD: 3.46)Findings to dateCurrently, two studies have been published. The first reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9 – 15.4), spirometric obstruction (8.7%, 95% CI, 7.0 – 10.7), and spirometric restriction (34.8%, 95% CI, 31.7 – 38.0). The second reported annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1).Future plansThe ongoing current phase of follow-up will determine the annual rate of decline in lung function as measured through spirometry, and relate this to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.Strengths and limitations of this studyThis is an original cohort study comprising adults randomly identified in a low-income Sub-Saharan African Setting.The repeated follow up of the cohort has included objective measures of lung function.The cohort has had high rates of case ascertainment that include verbal autopsies.The study will include an analysis of the health economic consequences of rate of change of lung function and health economic modelling of impact of lung diseases and potential interventions that could be adopted.A main limitation of our study is the systematic bias may be introduced through the self-selection of the participants who agreed to take part in the study to date and the migration of individuals from Chikwawa.

Lung function and respiratory symptoms in a randomized smoking cessation trial of electronic cigarettes

2016 ◽  
Vol 130 (21) ◽  
pp. 1929-1937 ◽  
Author(s):  
Fabio Cibella ◽  
Davide Campagna ◽  
Pasquale Caponnetto ◽  
Maria Domenica Amaradio ◽  
Massimo Caruso ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Lung Function ◽  
Respiratory Symptoms ◽  
Electronic Cigarettes ◽  
Controlled Trial ◽  
Substantial Reduction ◽  
Cigarette Consumption ◽  
Phenotype Classification ◽  
Quitting Smoking

Quitting smoking is the most important step smokers can take to improve their health. Nonetheless, there is little information on long-term improvements in lung function and/or respiratory symptoms after smoking cessation. Here we illustrate long-term changes in spirometric indices as well as in respiratory symptoms in smokers invited to quit or reduce their cigarette consumption by switching to electronic cigarettes (ECs). Prospective evaluation of cigarette consumption, spirometry and symptoms was performed in a 1-year randomized controlled trial of smokers receiving EC containing 2.4%, 1.8% or 0% nicotine. Spirometric data are presented on the basis of participants’ pooled continuous smoking phenotype classification (Quitters, Reducers, Failures), whereas respiratory symptoms on the basis of their point prevalence-smoking phenotype. Smoking phenotype classification (Quitters, Reducers, Failures) had no significant effect on spirometric indices (FEV1, FVC and FEV1/FVC) with the exception of FEF25–75%, which significantly (P  =0.034) increased over the time among Quitters; their FEF25–75% (% predicted) improving from (means±S.D.) 85.7±15.6% at baseline (BL) to 100.8±14.6%. High prevalence of cough/phlegm (43.1%) and shortness of breath (SoB; 34.8%) was reported at BL with substantial reduction in their frequency at subsequent follow-up visits. These symptoms virtually disappeared very quickly in both quitters and reducers. Smokers invited to switch to ECs who completely abstained from smoking showed steady progressive improvements in their FEF25–75%. Normalization of peripheral airways function was associated with improvement in respiratory symptoms, adding to the notion that abstaining from smoking can reverse tobacco harm in the lung.

Treatment with Hydroxyurea in Sickle Cell/ ß Thalassemia: A Long-Term Experience.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1678-1678 ◽  
Author(s):  
Aurelio Maggio ◽  
Paolo Rigano ◽  
Disma Renda
Keyword(s):  
Sickle Cell ◽  
Brain Mri ◽  
Heavy Smoker ◽  
Acute Chest Syndrome ◽  
Common Disease ◽  
Long Term Treatment ◽  
Sickle Cell Crises ◽  
New Onset

Abstract Sickle cell/ß-Thalassemia is a common disease in areas where ß-Thal and ßS genes are endemic, like in Sicily. In the current study we evaluated clinical and hematological data of Sicilian patients with Sickle cell/ß-Thalassemia treated with Hydroxyurea (HU). The endpoint of the study was to evaluate the efficacy of HU in terms of reduction of sickle cell crises after 2 years of treatment in comparison with the 2 years before. Moreover, we evaluated the outcome after long-term treatment. Fortytwo patients (18 males, mean age 36, range 18–53) were treated with HU (mean dosage 15 mg/kg, range 10–30) for an average 6.6 years follow-up (range 3–9 years). Twentytwo were ß0/ßS and 20 ß+/ßS genotype. All had 3 or more crises in the year before starting HU. We observed a significant reduction in sickle cell crises (7.8 ± 6.9 crises per year versus 0.9 ± 1.8 per year, P < 0.0001), hospitalizations (2.5 ± 2.9 per year versus 0.3 ± 1.5, P < 0.0001), and days in hospital (22.4 ± 21.9 per year versus 1.2 ± 2.3, P < 0.0001). Altogether, there was a 86% reduction in vasoocclusive events in comparison with the 2 years before (P < 0.001). Moreover, there was a significant increase of MCV (71.4 versus 97.5fl, P < 0.0001), HbF (7.5 versus 25.2 %, P < 0.0001), and decrease of WBC (11.4 versus 9.2 109/L P < 0.01) and reticulocytes (14.1 versus 10.2%, P< 0.01). Finally, redution of hyperdense cells and increase of erithropoyetin were seen. After a mean follow-up of 6.6 years, 39 patients are alive. Three died (2 end stage HCV related liver disesases, 1 bleeding after ERCP). Nine of the 40 alive patients developed complications: 1 acute chest syndrome, 2 strokes, 2 myocardial infarctions, 4 bone necrosis. Brain MRI of 15 patients after and during a mean of 6.9 years of HU treatment showed 2 new onset strokes, 1 of which in a patient with a previous stroke. Moreover, 4 patients developed new onset asymptomatic ischemic brain lesions. In every case there had been a significant reduction of sickle cell crises. There were two cases of cancer, occurring in two patients who were brother and sister: lung cancer in the former, a proeviously heavy smoker, breast cancer in the latter. No further serious adverse events were seen. Five patients with iron overload were treated with Deferiprone: no drug interaction with HU was noticed. Our study confirms that HU is effective in reducing clinical relevant crises of patients with Sickle cell/ß-Thalassemia. However, our preliminary data suggest that chronic organ damages are not prevented by HU. Safety has to be assessed by more prolonged studies.

scholarly journals BPI-ANCA and Long-Term Prognosis among 46 Adult CF Patients: A Prospective 10-Year Follow-Up Study

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ulrika Lindberg ◽  
Malin Carlsson ◽  
Claes-Göran Löfdahl ◽  
Mårten Segelmark
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Lung Function ◽  
Adverse Outcome ◽  
Normal Lung ◽  
Free Survival ◽  
Host Pathogen Interaction ◽  
Normal Lung Function ◽  
Long Term Prognosis

Introduction. Anti-neutrophil cytoplasmic antibodies specific for bactericidal/permeability-increasing protein (BPI-ANCA) are frequent in CF patients and mainly develop in response to infection withPseudomonas aeruginosa. It is not known to what extent BPI-ANCA correlates to prognosis.Objectives. To evaluate the prognostic value of IgA-BPI-ANCA, measured at the beginning of the study, for transplantation-free survival.Methods. A cohort of 46 adult, nontransplanted CF patients was generated, 1995–1998, and characterized using Leeds criteria, lung function, and IgA-BPI-ANCA levels measured by ELISA. The cohort was followed until December 2009, using the combined endpoint of death or lung transplantation.Results. Lung function and IgA-BPI-ANCA, but not Leeds criteria, were significantly associated with adverse outcome. No patient with normal lung function at baseline reached endpoint. Within 10 years 8/11 with high BPI-ANCA reached an endpoint compared to 3/17 ANCA-negative patients. A similar result was seen within the Leeds I group where 7 out of 9 BPI-ANCA-positive patients reached endpoint, compared to none of the 5 patients without BPI-ANCA.Conclusions. IgA-BPI-ANCA is associated with adverse outcome amongPseudomonas aeruginosainfected CF patients, suggesting that BPI-ANCA is a biomarker of an unfavourable host-pathogen interaction.

scholarly journals Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study of adults in Malawi

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242226
Author(s):  
Martin W. Njoroge ◽  
Sarah Rylance ◽  
Rebecca Nightingale ◽  
Stephen Gordon ◽  
Kevin Mortimer ◽  
...  
Keyword(s):  
Lung Function ◽  
Low Income ◽  
Respiratory Symptoms ◽  
Airflow Obstruction ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Lung Health

Purpose The aim of this article is to provide a detailed description of the Chikwawa lung health cohort which was established in rural Malawi to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa. Participants A total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, mean age was 43.8 (SD:17.8) and mean body mass index (BMI) was 21.6 Kg/m2 (SD: 3.46) Findings to date The cohort has reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9–15.4), spirometric obstruction (8.7%, 95% CI, 7.0–10.7), and spirometric restriction (34.8%, 95% CI, 31.7–38.0). Additionally, an annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1) has been reported. Future plans The ongoing phases of follow-up will determine the annual rate of decline in lung function as measured through spirometry and the development of airflow obstruction and restriction, and relate these to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.

scholarly journals Long term impact on lung function of patients with moderate and severe COVID-19. A prospective cohort study

2021 ◽  
Author(s):  
Sonia Qureshi ◽  
Nosheen Nasir ◽  
Naveed Haroon Rashid ◽  
Naveed Ahmed ◽  
Zoya Haq ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lung Function ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
List Type ◽  
Long Term Impact ◽  
Study Participants ◽  
The Impact

AbstractIntroductionA significant number of patients continue to recover from COVID-19; however, little is known about the lung function capacity among survivors. We aim to determine the long-term impact on lung function capacity in patients who have survived moderate or severe COVID-19 disease in a resource-poor setting.Methods and analysisThis prospective cohort study will include patients aged 15 years and above and have reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID 19 (nasopharyngeal or oropharyngeal). Patients with a pre-existing diagnosis of obstructive or interstitial lung disease, lung fibrosis and cancers, connective tissue disorders, autoimmune conditions affecting the lungs, underlying heart disease, history of syncope and refuse to participate will be excluded. Pulmonary function will be assessed using spirometry and diffusion lung capacity for carbon monoxide (DLCO) at three- and six-months interval. A chest X-ray at three and six-month follow-up and CT-chest will be performed if clinically indicated after consultation with the study pulmonologist or Infectious Disease (ID) physician. Echocardiogram (ECHO) to look for pulmonary hypertension at the three months visit and repeated at six months if any abnormality is identified initially. Data analysis will be performed using standard statistical software.Ethics and disseminationThe proposal was reviewed and approved by ethics review committee (ERC) of the institution (ERC reference number 2020-4735-11311). Informed consent will be obtained from each study participant. The results will be disseminated among study participants, institutional, provincial and national level through seminars and presentations. Moreover, the scientific findings will be published in high-impact peer-reviewed medical journals.Strengths and Limitations of this study-The study has the potential to develop context-specific evidence on the long-term impact on lung function among COVID-19 survivors-Findings will play key role in understanding the impact of the disease on vital functions and help devise rehabilitative strategies to best overcome the effects of disease-This is a single-center, study recruiting only a limited number of COVID-19 survivors-The study participants may loss-to-follow up due to uncertain conditions and disease reemergence

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