Airways responsiveness determined by consecutive histamine challenges in asymptomatic asthmatics

1989 ◽  
Vol 67 (6) ◽  
pp. 2622-2626 ◽  
Author(s):  
M. Kung ◽  
G. C. Scott ◽  
N. K. Burki
Keyword(s):  
Bronchial Asthma ◽  
Recovery Time ◽  
Forced Expiratory Volume ◽  
Base Line ◽  
Characteristic Finding ◽  
Normal Value ◽  
Control Value ◽  
The Mean ◽  
Buffer Control ◽  
Initial Base

The effect of two consecutive histamine inhalation challenges on airways responsiveness was assessed in a group of eight nonsmoking nonmedicated asthmatics aged 19-27 yr. All subjects had a base-line forced expiratory volume in 1 s (FEV1) of greater than 80% of their predicted normal value before the initial challenge and were allowed to recover to greater than 95% of the initial base-line FEV1 value before the second challenge was initiated. The average airways recovery time after the first challenge was 44 min but ranged between 30 and 90 min. The mean +/- SD values of cumulative histamine dose units provoking a 20% decrease of the FEV1 from the buffer control value (PD20FEV1) were 10.79 +/- 5.95 determined with the first and 30.50 +/- 46.36 with the second challenge (P greater than 0.05). We conclude that sequential histamine challenges performed in mild asthmatics with closely controlled prechallenge airways function are well tolerated. Although some variance does exist in intersubject airways recovery time and in intra-subject histamine airways responsiveness determined by sequential challenges, our data do not support recent observations (J. Appl. Physiol. 63: 1572-1577, 1987) that histamine tolerance is a characteristic finding associated with bronchial asthma.

Airway reactivity and lung function in triiodothyronine-induced thyrotoxicosis

1985 ◽  
Vol 58 (5) ◽  
pp. 1485-1488 ◽  
Author(s):  
R. S. Irwin ◽  
M. R. Pratter ◽  
D. H. Stivers ◽  
L. E. Braverman
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Base Line ◽  
Airway Reactivity ◽  
Percent Change ◽  
Serum T3 ◽  
The Mean

To evaluate the possible relationship between asthma and hyperthyroidism, airway reactivity and lung function were prospectively compared in healthy volunteers before, during, and after liothyronine (triiodothyronine, T3)-induced hyperthyroidism. Base-line evaluation of the 10 subjects included clinical evaluation, thyroid and pulmonary function tests, and airway reactivity assessed by methacholine inhalational challenge (MIC). All studies were normal. During T3-induced hyperthyroidism, no subject developed respiratory symptoms or changes in pulmonary function or airway reactivity. The mean percent change in forced expiratory volume at 1 s from base line (delta FEV1) of -2.4 +/- 3.0 after MIC was not significantly different from that obtained before T3 administration (-1.4 +/- 1.5, P greater than 0.2). When all serum T3 concentrations and delta FEV1 values before, during and after T3-induced hyperthyroidism were compared, there was no significant correlation. We conclude that T3-induced hyperthyroidism of 3-wk duration has no effect on airway reactivity or lung function in normal volunteers.

scholarly journals Study on absolute eosinophil count correlation with severity of bronchial asthma

2019 ◽  
Vol 7 (4) ◽  
pp. 1229
Author(s):  
Benjamin Lalrinpuia ◽  
Naveen P.
Keyword(s):  
Bronchial Asthma ◽  
Peripheral Blood ◽  
Eosinophil Count ◽  
Tracheobronchial Tree ◽  
Forced Expiratory Volume ◽  
Eosinophil Infiltration ◽  
Absolute Eosinophil Count ◽  
Airway Caliber ◽  
Asthma Patients ◽  
The Mean

Background: Bronchial asthma is defined as chronic inflammatory disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli. Eosinophil infiltration is a characteristic feature of asthmatic airways. It presents as an obstructive type of ventilator defect usually diagnosed from a reduced FEV1% (Forced Expiratory Volume) or from a reduced peak expiratory flow (PEF) associated with reduced airway caliber during expiration. Allergen inhalation results in a marked increase in activated eosinophils in the airways. Correlation between the degree of bronchial hyperresponsiveness (a cardinal feature of asthma) and peripheral blood eosinophilia has been observed in patients with dual response following allergen challenge.Methods: The study comprises a total number of 50 bronchial asthma patients of both sexes (male and female) between the age groups of 13-65 years. Based on severity, asthma patients were classified into mild, moderate and severe asthmatics, assessed by FEV1% computerized Spirometry Helios model number 701, recorders and medicare system. Peripheral blood sample was collected from each patient for absolute eosinophil count, the count was done on the same day.Results: The mean±SD absolute eosinophil count of 50 patients is 330±88.64 which is slightly above normal (300 cells/mm3). Author found that the mean±SD absolute eosinophil count of 405±83.16 in severe asthma patients is quite high, corresponding with a steep decline in the FEV1% 45.3±12.6.Conclusions: Absolute eosinophil count and FEV1% are important indicators of bronchial asthma severity and can even be used to predict disease progression.

scholarly journals Effect of anulom vilom pranayama as an adjuvant treatment modality to improve the level of dyspnea in chronic asthma patients

2018 ◽  
Vol 5 (2) ◽  
pp. 241
Author(s):  
Jane Mary Jose ◽  
Vadakken Devassy Thomas ◽  
Kollanur Janso
Keyword(s):  
Bronchial Asthma ◽  
Adjuvant Treatment ◽  
Treatment Modality ◽  
Forced Expiratory Volume ◽  
Female Dominance ◽  
Asthma Patients ◽  
Post Test ◽  
History Of ◽  
Dyspnea Score ◽  
The Mean

Background: Dyspnea is the main symptom suffered by bronchial asthma patients who are even under medical treatment. This study was aimed to evaluate the use of alternate nostril breathing as an adjuvant treatment modality to improve the level of dyspnea in patients with bronchial asthma.Methods: Patients who were diagnosed to have bronchial asthma for more than 6 months with the modified Borg dyspnea score of more than 3 and forced expiratory volume (FEV1) for one second less than 80% included in the study. Anulom Vilom Pranayama was instructed to practice daily for 10 minutes for 4 weeks. The level of dyspnea in pre and post test was conducted using modified Borg dyspnea scale after doing six minute walk. Spirometer was used to assess the FEV1. The data was analysed statistically.Results: Twenty patients were included in the study. Majority belonged to the age group of 20-29 with female dominance and no history of smoking. There was a significant (p = 0.0001) reduction in dyspnea after practicing Anulom Vilom Pranayama for one month. The median of Borg dyspnea scale in the pre-test was 4.5 and that of post-test was 3.5. The mean FEV1 score in the pre-test was 57.20 and that of post-test was 68.75 which was found to be statistically significant (p=0.0001).Conclusions: One-month anulom vilom pranayama daily for 10 minutes improved the Borg dyspnea scale and FEV1 score. This indicates it as an effective intervention in reducing the level of dyspnea in chronic bronchial asthma patients.

Airway reactivity in infants: a positive response to methacholine and metaproterenol

1987 ◽  
Vol 62 (3) ◽  
pp. 1155-1159 ◽  
Author(s):  
R. S. Tepper
Keyword(s):  
Challenge Test ◽  
Threshold Concentration ◽  
Base Line ◽  
Tidal Breathing ◽  
Airway Reactivity ◽  
Bronchial Smooth Muscle ◽  
Bronchial Challenge ◽  
Control Value ◽  
Residual Capacity ◽  
The Mean

Because the presence of bronchial smooth muscle reactivity in infants remains controversial, airway reactivity was assessed in 10 normal, asymptomatic male infants less than 15 mo of age by measuring the changes that occurred in the maximal expiratory flows at functional residual capacity (VmaxFRC) during a methacholine bronchial challenge test. Sleeping infants inhaled doubling concentrations of methacholine by 2 min of tidal breathing, starting with a concentration of 0.075 mg/ml, and the bronchial challenge was stopped when VmaxFRC decreased by at least 40%. The threshold concentration of methacholine required to produce a decrease in VmaxFRC by 2 SD's of the control value was 0.43 mg/ml (0.11–0.90). By a methacholine concentration of 1.2 mg/ml, all infants decreased VmaxFRC by at least 40% (range 40–75%), and the mean dose required to produce a 40% decrease was 0.72 mg/ml. The airway reactivity was not related to base-line flows. During the methacholine challenge, no infant developed wheezing, but the percent oxygen saturation for the group decreased significantly (P less than 0.05) from 94 to 92%. Following the methacholine, the infants inhaled the bronchodilator metaproterenol, and 10 min later, VmaxFRC returned to base line. This study demonstrates that infants exhibit airway reactivity as evidenced by bronchoconstriction with methacholine and the subsequent bronchodilation with metaproterenol.

scholarly journals Study of efficacy and adverse effect of fluticasone and formoterol combination in bronchial asthma

2020 ◽  
Vol 9 (10) ◽  
pp. 1509
Author(s):  
Sharad Chaddha ◽  
Tajinder Kaur
Keyword(s):  
Adverse Effect ◽  
Bronchial Asthma ◽  
Forced Expiratory Volume ◽  
Dose Inhaler ◽  
Inflammatory Disorder ◽  
Pulmonary Medicine ◽  
Chronic Inflammatory Disorder ◽  
Medical College ◽  
Metered Dose ◽  
The Mean

Background: Bronchial asthma is a chronic inflammatory disorder of the airways associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning.Methods: This study has recruited 25 newly (male/female) cases of Bronchial Asthma diagnosed on the basis of spirometry in the Department of Pulmonary Medicine, Era’s Lucknow Medical College & Hospital (ELMC&H). Patients were received Fluticasone/Formoterol (200/10 μg OD). The drugs were administered through metered-dose inhaler (MDI).Results: The mean forced expiratory volume recorded before treatment 54.92±4.47 in a group who were treated with formoterol/fluticasone combination changed to 75.48±5.03 after the treatment. No significant adverse effect of this regimens was observed.Conclusions: The results of this study revealed this regimen showed a significant improvement in lung functions without any significant adverse event.

scholarly journals Comparison of clinical outcomes of inhaled formoterol or fluticasone versus formoterol or mometasone in the patients of bronchial asthma

2020 ◽  
Vol 9 (12) ◽  
pp. 1797
Author(s):  
Sharad Chadda ◽  
Mushtaq Ahmed ◽  
Tajinder Kaur ◽  
Prashant Singh ◽  
Amit Kumar Mehto
Keyword(s):  
Bronchial Asthma ◽  
Forced Expiratory Volume ◽  
Dose Inhaler ◽  
Metered Dose Inhaler ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Metered Dose ◽  
Group A ◽  
The Mean ◽  
Group B

Background: This study was undertaken because of paucity of literature regarding outcomes of inhaled formeterol/fluticasone versus formoterol/mometasone in asthmatic patients.Methods: Fifty newly (male/female) recruited cases of bronchial asthma were diagnosed on the basis of spirometry. The patients were allocated to two groups viz group A and B. Group-A received mometasone furoate/formoterol (200/10 μg OD) and Group-B received fluticasone/formoterol (200/10 μg OD) respectively. The drugs were administered through metered-dose inhaler (MDI).Results: The mean FEV1/FVC ratio recorded (64.40±9.01) before starting the treatment has significantly changed to (68.92±8.58) after starting the treatment. Mean forced expiratory volume (47.56±14.73%) noted before the use of bronchodilator also changed to mean FEV1 63.98±15.17. Mean forced expiratory volume recorded before treatment (55.02±5.01) in a group who were treated with formoterol/mometasone combination changed to (72.06±5.86) after treatment. However, the mean forced expiratory volume recorded before treatment 54.92±4.47 in a group who were treated with formoterol/fluticasone combination changed to 75.48±5.03 after the treatment. While comparing the two treatment regimens, it is evident from the results that there is no significant difference in FEV1 between the groups. However, the post bronchodilator FEV1 was significantly (p<0.001) higher among the patient group which were treated with fluticasone/formoterol combination than the group who were treated with mometasone/formoterol combination. No significant adverse effect of either of two regimens was observed thus showing that both the combinations are comparatively safe for use.Conclusions: This study reveals that both the treatment regimens showed a significant improvement in lung functions without any significant adverse event.

Can the Expiratory Disproportion Index Distinguish PVFMD from Subglottic Stenosis in Obese Patients?

2021 ◽  
pp. 000348942199015
Author(s):  
Kevin Calamari ◽  
Stephen Politano ◽  
Laura Matrka
Keyword(s):  
Vocal Fold ◽  
Forced Expiratory Volume ◽  
Subglottic Stenosis ◽  
Obese Patients ◽  
Level Of Evidence ◽  
Prior Literature ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Paradoxical Vocal Fold Movement ◽  
Rule Out

Objectives: Expiratory disproportion index (EDI) is the ratio of forced expiratory volume in 1 second (FEV1) divided by peak expiratory flow rate (PEFR) multiplied by 100. Prominent EDI (>50) values can differentiate subglottic stenosis (SGS) from paradoxical vocal fold movement disorder (PVFMD), but this has not been verified when considering body habitus. We hypothesize that the predictive value of elevated EDI in differentiating SGS from PVFMD will be lower in obese patients than non-obese patients. Methods: Patients ≥ 18 years old with recorded PFT values, BMI, and airway imaging were reviewed retrospectively from 01/2011 to 10/2018. EDI was recorded for 4 cohorts: non-obese/SGS, non-obese/ PVFMD, obese/SGS, and obese/ PVFMD, to determine the mean EDI and the sensitivity/specificity of an elevated EDI. Results: Mean EDI values were 69.32 and 48.38 in the non-obese SGS and PVFMD groups, respectively ( P < .01). They were 58.89 and 47.67 in the obese SGS and PVFMD groups, respectively ( P < .05). At a threshold of >50, EDI had a sensitivity of 90.0% and specificity of 51.6% in differentiating between SGS and PVFMD cases in non-obese patients and 51.6% and 63.6% in obese patients. Conclusion: Prior literature has established that EDI can distinguish SGS from PVFMD in the general population. Our results show that the mean EDI values were significantly different in both cohorts, but an elevated EDI was not as sensitive at identifying SGS cases in obese patients. This suggests that the EDI should be used with caution in obese patients and should not be relied upon to rule out SGS. Level of Evidence: 3.

scholarly journals Use of an Insulation-Tipped Knife during Rigid Bronchoscopic Treatment of Benign Tracheobronchial Stenosis

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 251
Author(s):  
Ji-Won Park ◽  
Yousang Ko ◽  
Changhwan Kim
Keyword(s):  
Tracheal Stenosis ◽  
Treatment Success ◽  
Stable State ◽  
Forced Expiratory Volume ◽  
Rigid Bronchoscopy ◽  
Bronchial Stenosis ◽  
Tracheobronchial Stenosis ◽  
Acute Complications ◽  
The Mean ◽  
Post Intubation

Background and Objectives: Tracheal or bronchial tears are potential complications of rigid bronchoscopy. This study aimed to investigate the acute complications and outcomes of using an insulation-tipped (IT) knife in combination with rigid bronchoscopic dilatation for treating benign tracheobronchial stenosis. Materials and Methods: We conducted a chart review of patients with benign tracheobronchial stenosis who were treated with rigid bronchoscopy and an IT knife at two referral centers. Treatment success was defined as a clinically stable state without worsening symptoms after 3 months of treatment. Results: Of the 23 patients with benign tracheobronchial stenosis, 15 had tracheal stenosis and 6 had main bronchial stenosis. Among them, three cases were of simple stenosis (13%), while the others were of complex stenosis (87%). The overall treatment success rate was 87.0%. Pneumomediastinum and subcutaneous emphysema occurred due to bronchial laceration in two cases of distal left main bronchial stenosis (8.7%), and no other significant acute complications developed. Silicone stents were inserted in 20 patients, and successful stent removal was possible in 11 patients (55.0%). Six of the seven stents inserted in patients with post-intubation tracheal stenosis were removed successfully (85.7%). However, most of the patients with post-tracheostomy tracheal stenosis required persistent stenting (80%). Pulmonary function was significantly increased after treatment, and the mean increase in the forced expiratory volume in 1 s was 391 ± 171 mL (160–700 mL). Conclusion: The use of an IT knife can be suggested as an effective and safe modality for rigid bronchoscopic treatment of benign tracheobronchial stenosis.

scholarly journals Elimination of nasal obstruction improves pulmonary functions and oxygenation

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eman Sobh ◽  
Fatma Elhussieny ◽  
Taghreed Ismail
Keyword(s):  
Nasal Obstruction ◽  
Blood Gases ◽  
Medical Problem ◽  
Forced Expiratory Volume ◽  
Nasal Packing ◽  
Nasal Pack ◽  
Arterial Blood ◽  
Study Population ◽  
The Mean ◽  
The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

scholarly journals AB0393 EFFICACY OF HYDROXYCHLOROQUINE FOR LUPUS NEPHRITIS IN MAINTENANCE PHASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1496.2-1496
Author(s):  
M. Watanabe ◽  
Y. Haji ◽  
M. Kato ◽  
T. Ito ◽  
Y. Banno ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Therapeutic Option ◽  
Maintenance Phase ◽  
Base Line ◽  
Prednisolone Dose ◽  
Daily Urine ◽  
Group A ◽  
The Mean ◽  
Group B

Background:Hydroxychloroquine (HCQ) is an essential drug for systemic lupus erythematosus. But in Japan, chloroquine and HCQ remain unavailable until mid 2015 because of a series of lawsuits about its retinal toxicity in the 1970s. There is insufficient knowledge regarding renal protective effect of HCQ.Objectives:We aimed to investigate its efficacy of adding HCQ for Lupus nephritis (LN) as a maintenance-phase therapy.Methods:We conducted an observational retrospective cohort study included patients with LN (n=42) in maintenance-phase in Japan. We reviewed medical records of LN patients aged > 18 years who were initiated HCQ from May 2015 to May 2018. Maintenance phase was defined as stabilization in serum creatinine and urinary segment after induction therapy and who achieved complete or partial remission. The annual change of proteinuria was compared between patients on HCQ who have proteinuria (>0.5g/gCr) or not. Other outcome measures were disease flare, dose of steroids, renal and immunologic features.Results:A total of 42 patients were analyzed and allocated to two groups based on their amount of daily urine protein level: HCQ with proteinuria as group A (>0.5g/gCr, n=14) and HCQ without proteinuria as group B(≦0.5g/gCr, n=28). Both groups were comparable, with mean (SD) age of 36.1 (12.9) years and 37.5 (13.8), female 78.6% and 92.9% in each group, mean (SD) disease duration until HCQ of 3.5 (3.25) and 3.3 (2.9) years in group A and group B, with prednisolone dose at base line of 10.3 (7.1) mg and 7.9 (4.4) mg, respectively. The mean (SD) proteinuria at base line was 1.38 (1.11) g/gCr in group A and 0.20 (0.09) g/gCr in group B and after 12 months, proteinuria decreased in group A (-1.34 g/gCr in group A vs +0.03 g/gCr in group B; p<.001;95% CI,0.305-0.736). No relapse was experienced in group A during the study period.Conclusion:In patients with clinically stable LN but with proteinuria, hydroxychloroquine is a good therapeutic option for achievement of complete remission.Disclosure of Interests:None declared

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