scholarly journals Correlation between diaphragmatic sagittal rotation and pulmonary dysfunction in patients with ankylosing spondylitis accompanied by kyphosis

2019 ◽  
Vol 47 (5) ◽  
pp. 1877-1883 ◽  
Author(s):  
Chao Liu ◽  
Bing Wu ◽  
Yue Guo ◽  
Kai Song ◽  
Xiangyu Tang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Sagittal Plane ◽  
Pulmonary Function Tests ◽  
Influencing Factor ◽  
Three Dimensional ◽  
Lung Parenchyma ◽  
Pedicle Subtraction Osteotomy ◽  
Pulmonary Dysfunction

Objective This study was performed to investigate the correlation between pulmonary dysfunction patterns and diaphragmatic sagittal rotation in patients with ankylosing spondylitis accompanied by kyphosis. Methods Thirty patients (27 male, 3 female) with kyphotic deformity secondary to ankylosing spondylitis underwent pedicle subtraction osteotomy and were retrospectively reviewed. All patients had undergone preoperative computed tomography with three-dimensional reconstruction, full-length spine radiographs, and pulmonary function tests. The diaphragmatic angle in the median sagittal plane (DA), pulmonary function test results, and radiological parameters were studied. Results Correlation coefficients were used to present the correlation between the DA and pulmonary function and the global kyphosis (GK), respectively. The data analysis presented positive correlations between the DA value and vital capacity (VC), forced vital capacity (FVC), expiratory reserve volume (ERV), inspiratory reserve volume (IRV) and peak expiratory flow (PEF). There was likewise a negative correlation between DA value and the global kyphosis (GK). Additionally, there were further significantly statistical improvements for DA, ERV, IRV, FVC, and VC, PEF, postoperatively. Conclusions Except for the restriction of the chest wall motion and the abnormalities of lung parenchyma, the diaphragmatic sagittal rotation is also an influencing factor of pulmonary dysfunction in patients with ankylosing spondylitis accompanied by kyphosis.

scholarly journals Longitudinal Assessment of Pulmonary Function and Bronchodilator Response in Pediatric Patients With Post-infectious Bronchiolitis Obliterans

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiuhua Yu ◽  
Jiaoyang Wei ◽  
Yanchun Li ◽  
Lu Zhang ◽  
Hongming Che ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Bronchiolitis Obliterans ◽  
Pediatric Patients ◽  
Average Rate ◽  
Pulmonary Function Tests ◽  
Case Series ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Longitudinal Assessment ◽  
Bronchodilator Response

Backgroud: Postinfectious bronchiolitis obliterans (PIBO) is a rare respiratory disease. In recent years, the disease has been recognized and diagnosed increasingly in children. Pulmonary function is important for diagnosis, identifying the severity of the PIBO and monitoring progression. But there have been only a few studies that followed the evolution of PIBO on the basis of pulmonary function tests (PFTs).Objective: The study targeted the evolution of pulmonary function and bronchodilator response in a case series of Chinese children with PIBO.Methods: Twelve children between the ages of 6–99 months with PIBO were studied retrospectively from 2009 to 2019. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and maximal midexpiratory flow velocity 25–75% (MMEF25−75%) were collected at each PFT, and bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data.Results: The median baseline PFT values for FVC, FEV1, the FEV1/FVC ratio, and MMEF25−75% were 41.6, 39.75, 90.7, and 22.2%, respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by 8.212%/year and 5.007%/year, respectively, and the FEV1/FVC ratio decreased by an average of 3.537%/year. MMEF25−75% showed improvement at an average rate of 1.583% every year. Overall, FEV1 and MMEF25−75% showed different degrees of improvement after the use of inhaled bronchodilators at each PFT session for 10 patients, and FEV1 measures demonstrated significant (>12%) β2-bronchodilation in 56% of PFT sessions.Conclusions: Pediatric patients with PIBO showed an obstructive defect in pulmonary function. The FVC, FEV1, and MMEF25−75% improved as they grew older, while the FEV1/FVC ratio decreased. This may be due to the development of lung parenchyma more than airway growth. Airway obstruction in some patients improved with the use of β2 agonists.

scholarly journals Serum biomarker CA 15-3 as predictor of response to antifibrotic treatment and survival in idiopathic pulmonary fibrosis

2020 ◽  
Vol 14 (11) ◽  
pp. 997-1007
Author(s):  
Sofia A Moll ◽  
Ivo A Wiertz ◽  
Adriane DM Vorselaars ◽  
Pieter Zanen ◽  
Henk JT Ruven ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Mixed Model ◽  
Pulmonary Function Tests ◽  
Hazard Ratio ◽  
Poor Survival ◽  
Function Test

Aim: Cancer antigen 15-3 (CA 15-3) is a baseline biomarker in idiopathic pulmonary fibrosis (IPF), but its value during follow-up is unknown. Materials and methods: Associations between serum CA 15-3 and pulmonary function tests during 1-year follow-up were evaluated by a mixed model in 132 IPF treated with pirfenidone or nintedanib. Results: Increased baseline (median: 56 kU/l) and follow-up CA 15-3 levels were inversely associated with forced vital capacity and diffusing capacity of the lung for carbon monoxide (estimates respectively: -5.21 and -4.69; p < 0.001). Baseline and 6-month CA 15-3 above 58.5 (hazard ratio: 1.67; p = 0.031) and 50.5 kU/l (hazard ratio: 2.99; p < 0.001), respectively, showed impaired survival compared with lower levels. Conclusion: CA 15-3 is associated with pulmonary function test during follow-up in IPF on antifibrotic treatment. Higher (follow-up) values are related with poor survival. Therefore, CA 15-3 is a promising follow-up biomarker in IPF.

Pulmonary Function Improvement in Patients With Ankylosing Spondylitis Kyphosis After Pedicle Subtraction Osteotomy

Spine ◽  
2014 ◽  
Vol 39 (18) ◽  
pp. E1116-E1122 ◽  
Author(s):  
Jun Fu ◽  
Guoying Zhang ◽  
Yonggang Zhang ◽  
Chao Liu ◽  
Guoquan Zheng ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Pulmonary Function ◽  
Pedicle Subtraction Osteotomy

scholarly journals Pulmonary Involvement in Patients with Guillain–Barré Syndrome in Subacute Phase

2017 ◽  
Vol 08 (03) ◽  
pp. 412-416
Author(s):  
Meeka Khanna ◽  
Nidhi Rawat ◽  
Anupam Gupta ◽  
Madhu Nagappa ◽  
Arun B. Taly ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Guillain Barre Syndrome ◽  
Pulmonary Dysfunction ◽  
Duration Of Symptoms ◽  
Subacute Phase ◽  
Chest Expansion ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ABSTRACT Objectives: To evaluate the pulmonary function in Guillain�Barre syndrome (GBS) patients in subacute phase and find clinical correlates of pulmonary dysfunction. Methods: This was a single-center, prospective, cross-sectional, hospital-based study in GBS patients performed in Department of Neurological Rehabilitation at a tertiary care institute. Clinical examination for pulmonary function was done by measuring chest expansion. The pulmonary function tests were carried out by Spirometry kit Microquark Cosmed, Italy. Fatigue was assessed by Fatigue Severity Scale, disability status by Hughes Disability Scale (HDS), and muscle weakness by Medical Research Council sum scores. Statistical Analysis: Statistical analysis was performed by Stata 11. The significance of P value was adjudged against an alpha of 0.05. Results: Twenty-eight patients were included with 17 (61%) men and mean age of 31 years. Median duration of symptoms was 16.5 days. There were 10 (36%) demyelinating and 18 (64%) axonal variants. Twenty-six (93%) patients scored more than 2 on HDS. All study participants reported fatigue. Twenty-two (78.6%) patients had chest expansion of <2.5 cm. Spirometry showed restrictive pulmonary dysfunction in 23 (79%) patients. Significant correlation was found between abnormal pulmonary function test and chest expansion (P = 0.003). Conclusion: Pulmonary dysfunction in GBS is common even during subacute phase. It needs to be identified and managed appropriately for better clinical outcome.

scholarly journals Longitudinal Assessment of Pulmonary Function and Bronchodilator Responses in Pediatric Patients with Post-Infectious Bronchiolitis Obliterans

2021 ◽  
Author(s):  
Xiuhua Yu ◽  
Jiaoyang Wei ◽  
Yanchun Li ◽  
Lu Zhang ◽  
Hongming Che ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Bronchiolitis Obliterans ◽  
Pediatric Patients ◽  
Pulmonary Function Tests ◽  
Case Series ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Longitudinal Assessment ◽  
Bronchodilator Response ◽  
Post Infectious

Abstract Objective: We aimed to further assess the evolution of pulmonary function and bronchodilator response in the Chinese case series with post-infectious bronchiolitis obliterans (PIBO). Methods: Twelve children with PIBO, aged 59-110 months, were retrospectively studied between 2011 and 2019. According to the ATS/ERS recommendations, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and maximal midexpiratory flow velocity 25%-75% (MMEF25%-75%) were collected at each pulmonary function tests (PFTs), as well as bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data. Results: The median baseline PFT values for FVC, FEV1, FEV1/FVC ratio and MMEF25% -75% were 41.6%, 39.75%, 90.7% and 22.2% respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by a mean of 8.212%/year and 5.007%/year, and FEV1/FVC ratio with an average decrease of 3.537%/year. MMEF25-75% showed an average increase of 1.583% per year. Over all, FEV1 and MMEF25%-75% showed different degrees of improvement after inhaled bronchodilators at each PFT sessions for ten patients, and FEV1 was with significant (>12%) β2-bronchodilation in 53% of PFT sessions. Conclusions: Pediatric patients with PIBO showed an obstructive defect of pulmonary function. The FVC, FEV1 and MMEF25%-75% improved as they grew old, while FEV1/FVC ratio decreased. It may be due to the development of lung parenchyma more than airway growth. Airway obstruction of some patients improved with the use of β2 agonists.

scholarly journals Effects of exercise on pulmonary function tests: A comparative study between athletes and non-athletes in Nepalese settings

2017 ◽  
Vol 6 (1) ◽  
pp. 21
Author(s):  
N B Mahotra ◽  
T M Amatya ◽  
B SJB Rana ◽  
D Banstola
Keyword(s):  
Comparative Study ◽  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Institute Of Medicine ◽  
Cross Sectional ◽  
Pulmonary Functions ◽  
Inspiratory Muscles ◽  
Function Tests

<p> Due to regular exercises, athletes tend to have an increase in pulmonary functions when compared to non exercising individuals, especially when the exercise is strenuous. Intensity and severity of sports engaged in by the athletes determines the extent of strengthening of the inspiratory muscles with a resultant increase in the lung volumes and capacities. Pulmonary parameters like tidal volume and forced vital capacity are significantly higher in athletes than in non athletes. A cross sectional comparative study was carried out in national sports council, Tribhuvan army club and institute of medicine, Kathmandu, Nepal. The athletes were footballers from Tribhuvan army club and sprinters from national sports council. The non-athletes were medical students from the institute of medicine, Kathmandu. Data were collected after performing spirometry and mean values were compared between athletes and non-athletes. Pulmonary functions were assessed based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) expressed as percent predicted for the age, sex, height, weight and race. Spirometry was performed in 169 subjects, out of which 84 were athletes and 85 were non-athletes. Athletes had a significantly superior FVC (P =0.00) compared to non-athletes. FEV1 was also recorded significantly higher in athletes than in non-athletes (P=0.023). Athletes have better pulmonary function tests than non-athletes because exercise in athletes strengthens the muscles of respiration. </p>

Thoracic Volumes Correlated With Pulmonary Function Tests in Adult Scoliosis Patients Following Different Treatments in Adolescence

2017 ◽  
Author(s):  
Po-Chih Lee ◽  
Charles Ledonio ◽  
A. Noelle Larson ◽  
Arthur Erdman ◽  
David Polly
Keyword(s):  
Pulmonary Function ◽  
Lung Disease ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Adult Scoliosis ◽  
Pulmonary Mechanics ◽  
Spine Deformity ◽  
Restrictive Lung Disease ◽  
Lung Capacity ◽  
Lung Expansion

In clinical settings, doctors classify pulmonary disorders into two main categories, obstructive lung disease and restrictive lung disease. The former is characterized by the airway obstruction which is associated with several disorders like chronic bronchitis, asthma, bronchiectasis, and emphysema [1]. The latter is caused by different conditions where one of the triggers is tied to the spine deformity. In general, a pulmonary function test (PFT) [2] is used to evaluate and diagnose lung function, and physicians depend on the test results to identify the disease patterns of the patients (obstructive or restrictive lung disease). In the PFT, some parameters including total lung capacity (TLC), vital capacity (VC), and residual volume (RV) can infer the lung volume and lung capacity. Other parameters, such as forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), are often employed to assess the pulmonary mechanics. Scoliosis is an abnormal lateral curvature of the spine which involves not only the curvature from side to side but also an axial rotation of the vertebrae. Restrictive lung disease often happens in scoliosis patients, especially with severe spine deformity. Spine deformity if left untreated may lead to progression of the spinal curve, respiratory complications, and the reduction of life expectancy due to the decrease in thoracic volume for lung expansion. However, the relationship between thoracic volume and pulmonary function is not broadly discussed, and anatomic abnormalities in spine deformity (ex: scoliosis, kyphosis, and osteoporosis) can affect thoracic volume. Adequate thoracic volume is needed to promote pulmonary function. Previous literature has shown that the deformity of the thoracic rib cage will have detrimental effects on the respiratory function in adolescent idiopathic scoliosis patients [3–4]. In this paper, we aim to correlate thoracic volume and the parameters in PFTs in adult scoliosis patients 25–35 years after receiving treatments during their adolescence, either with physical bracing or spinal fusion surgery.

Pulmonary Dysfunction in Thalassemia Major Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3814-3814
Author(s):  
Alessandra Gennari ◽  
Maria Paola Bellagamba ◽  
Alessandra di Stasio ◽  
Andrea Ferraro ◽  
Annaluisa Cogo ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Ferritin Level ◽  
Pulmonary Function Tests ◽  
Thalassemia Major ◽  
Lung Damage ◽  
Pulmonary Dysfunction ◽  
Hematopoietic Tissue ◽  
Diffusion Capacity

Abstract The improved survival of patients with Thalassemia Major (TM) has allowed new complications to develop in the adult patients. These previously unknown clinical entities require a new approach to the management of thalassemia. Pulmonary dysfunction is one of the least understood, previously unrecognized, complications of TM. Patients and Methods The aim of our study was to define the spirometric pattern and lung damage in 35 TM patients (18 M and 17 F, age range from 18 to 44 years). All were regularly transfused (pre transfusion hemoglobin level 9+/−0,4 g/dl) and chelated (25 with deferoxamine,5 with deferiprone and 5 with both chelators). Their serum ferritin level was 1071+/−628 ng/ml All patients had normal cardiac ejection fraction. Nine patients were active smokers (10+2 pack/years) while 9 had been smokers in the past (6+2 pack/years). Four had a mild allergic asthma under good clinical control, 1 had a mild pulmonary hypertension and 1 had mediastinal hematopoietic tissue. Pulmonary function tests were performed before transfusion and included pulmonary volumes and flows recorded by spirometry; residual volume (RV) and total lung capacity (TLC)measured by helium closed-circuit rebreathing technique; carbon monoxide diffusion capacity (TLCO)measured by single breath method. Results: Only the patient with mediastinal masses showed an obstructive pattern with the FEV1/FVC ratio of 53% of predicted value. Thirteen patients (37%)had a restrictive pattern (TLC<80%pred). No correlation was found with sex, age, smoking, asthma diagnosis, ferritin levels, chelation regimen. A decreased TLCO (<70%pred) that can be indicative of parenchymal disease was present in 29 patients (85,8%) even after correction for hemoglobin levels (Hb value equal to 12 g requires adjust of 8%, Hb value equal to 10 g requires adjust of 18%, Hb value equal to 7 g requires adjust of 45%). The restrictive lung function abnormality with reduced diffusion capacity found in our patients is suggestive of interstitial lung disease secondary to TM. We were unable to correlate the restrictive and interstitial lung disease to iron loading nor to chelation strategies. Further studies are needed to better understand these results and to determine whether different chelation regimens have different impact on pulmonary function. In order to minimize lung damage, however, every effort should be made to educate TM patients not to smoke, and to identify and properly treat TM patients with asthma.

Pulmonary Dysfunction in Beta Thalassemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3851-3851
Author(s):  
Amit Kandhari ◽  
Anupam Sachdeva ◽  
Neeraj Jain ◽  
Subash C. Arya ◽  
Virender K. Khanna ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Serum Ferritin ◽  
Pulmonary Function Tests ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
P Value ◽  
Age Group ◽  
Pulmonary Dysfunction ◽  
Function Tests ◽  
Abnormal Results

Abstract Thalassemia is one of the commonest hereditary hemolytic anemia. Survival of patients with thalassemia major has greatly improved during recent years, with the introduction of moderate -transfusion programs and chelation therapy with subcutaneous Desferal (deferrioxamine) and/or Kelfer (Deferiprone). The repeated transfusions in thalassemics lead to deposition of iron in different tissues, leading to damage and dysfunction of various systems. Iron deposition is also reported to exist in the lungs at autopsy. Although lung impairment in thalassemic patients has been reported in the 1980’s, yet it is one of the most under evaluated and functionally not well-characterized complication. Since there have been contradictory results reported in literature ranging from restrictive spirometric pattern to an obstructive one, and there is total paucity of data from India, this study was designed to find out the pulmonary function tests of the beta thalassemic patients attending our hospital. A total of 30 cases of beta thalassemia major who were attending the thalassemia clinic at Sir Ganga Ram Hospital were taken up for the study after a written informed consent. These patients were on moderate -transfusion regimen, maintaining a hemoglobin concentration of more than 9 gm %. Patients with asthma and cardiac disease were excluded. Pulmonary function tests done included Forced vital capacity (FCV), Forced expiratory volume in one second (FEV1), FEV1/FVC percent (FEV1 %) and peak expiratory flow rate (PEFR). Results were interpreted as obstructive, restrictive and normal pulmonary Function test (PFT). The data was analyzed using software SPSS version 10. We included three age groups in our study, with total 30 patients in all. Age group 6–10 yr had 9 patients (mean Serum ferritin 2301 ng/ml), 11–15 yr had 11 children (mean Serum ferritin 3315) and &gt;15 yr had 11 children (mean Serum ferritin 5147 ng/ml) in the study. Mean age was 14.46 with standard deviation of 6.75 (mean ferritin was 3682 ng/ml). Overall out of 30 patients 13 had normal PFT and 17 had abnormal PFT (1 had obstructive PFT and 16 had restrictive PFT). In the age group of 6–10 years 7 had normal and 2 had abnormal PFT and in age group 11–15 yr 3 had normal and 6 had abnormal PFT and in age group &gt;15 yr 3 had normal and 8 had abnormal PFT. Of 17 patients on chelation with Desferal alone 11 had normal and 6 had abnormal PFT. 6 patients were on Kelfer alone of which 1 had normal and 5 had abnormal PFT. Of 7 patients who were on both Desferal and Kelfer, 1 had normal and 6 had abnormal PFT. All patients on Kelfer or Kelfer + Desferal aged &gt;10 years except one which may explain reason for increased number of abnormal results in this group. Critical age above which abnormal results were higher was 11.5 years. Mean Ferritin in patients with normal PFT was 2456 ng/ml and 4621 ng/ml for patients with abnormal PFT. (p value 0.037) We found a negative Pearson correlation between FVC (% of predicted) with increasing ferritin (p value 0.038). There was no difference detected between pre and post transfusion PFT results by using paired t test (p value 0.973). In conclusion the major pulmonary dysfunction in our study group is that of restrictive type. The abnormal PFT were found in older age group. FVC was negatively co-related with increasing ferritin level. The number of abnormal results was higher when the serum ferritin was &gt; 4000 ng/ml and blood transfusion had no effect on the PFT.

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