scholarly journals Are preterm-born survivors at risk of long-term respiratory disease?

2017 ◽  
Vol 11 (7) ◽  
pp. 277-287 ◽  
Author(s):  
Katarzyna Kaczmarczyk ◽  
Ida Wiszomirska ◽  
Magdalena Szturmowicz ◽  
Andrzej Magiera ◽  
Michalina Błażkiewicz

Background: To evaluate the long-term impact of preterm birth on respiratory function in female patients born preterm, we undertook spirometric examinations twice, as they reached the age of puberty, then follow-up examinations of part of the same cohort in adulthood. We sought evidence that preterm birth is correlated with poorer spirometric results into adulthood. Methods: A total of 70 girls (aged 12.2 ± 1.5 years in 1997) who had been born preterm (at 34.7 ± 1.86 weeks, none having experienced bronchopulmonary dysplasia) took part in spriometric examinations in 1997 and again in 1998. Of those, after a gap of 17 years, a group of 12 were successfully recontacted and participated in the 2015 examination as adults (then aged 27.6 ± 2.6 years, born at 34.5 ± 1.92 weeks). We compared spirometric results across the adolescent and adult examinations, and compared the adult results with an adult reference group. Results: The percentage values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity) and MVV (maximal voluntary ventilation) showed significant improvement between the two examinations in the early adolescent period. In adulthood, FEV1%pred (percentage predicted forced expiratory volume in 1 s) showed no statistically significant difference. The mean values of both FVC and FVC%pred (percentage predicted forced vital capacity) for the preterm-born group were lower than for the reference group, but this was not statistically significant. The preterm-born group showed lower values of such parameters as forced expiratory flow at 25–75% of FVC, MEF25 (maximal expiratory flow at 25% of forced vital capacity) and FEV1/FVC as compared with the reference group, but again without statistical significance. Conclusions: (1) A somewhat below-norm level of respiratory parameters among preterm-born girls entering pubescence may attest to continued negative impact on their respiratory system. (2) A significant improvement in their spirometric results 1 year later may indicate that pubescence helps compensate for the earlier negative effect of preterm birth. (3) No significant differences were seen in lung function in preterm-born adults as compared with a reference group of adults, although the preterm-born group did exhibit lower values of all parameters studied and more frequent obstructive disorders.

2019 ◽  
Vol 43 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Gozde Yagci ◽  
Gokhan Demirkiran ◽  
Yavuz Yakut

Background:Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied.Objective:The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis.Methods:A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace).Results:Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions.Conclusion:The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis.Clinical relevanceBracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.


Author(s):  
Ju Sun Heo ◽  
Jiwon M. Lee

The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate.


2002 ◽  
Vol 93 (4) ◽  
pp. 1384-1390 ◽  
Author(s):  
Emanuele Crimi ◽  
Riccardo Pellegrino ◽  
Manlio Milanese ◽  
Vito Brusasco

Deep breaths taken before inhalation of methacholine attenuate the decrease in forced expiratory volume in 1 s and forced vital capacity in healthy but not in asthmatic subjects. We investigated whether this difference also exists by using measurements not preceded by full inflation, i.e., airway conductance, functional residual capacity, as well as flow and residual volume from partial forced expiration. We found that five deep breaths preceding a single dose of methacholine 1) transiently attenuated the decrements in forced expiratory volume in 1 s and forced vital capacity in healthy ( n = 8) but not in mild asthmatic ( n = 10) subjects and 2) increased the areas under the curve of changes in parameters not preceded by a full inflation over 40 min, during which further deep breaths were prohibited, without significant difference between healthy ( n = 6) and mild asthmatic ( n = 16) subjects. In conclusion, a series of deep breaths preceding methacholine inhalation significantly enhances bronchoconstrictor response similarly in mild asthmatic and healthy subjects but facilitates bronchodilatation on further full inflation in the latter.


1991 ◽  
Vol 71 (3) ◽  
pp. 878-885 ◽  
Author(s):  
J. M. Clark ◽  
R. M. Jackson ◽  
C. J. Lambertsen ◽  
R. Gelfand ◽  
W. D. Hiller ◽  
...  

As a pulmonary component of Predictive Studies V, designed to determine O2 tolerance of multiple organs and systems in humans at 3.0–1.5 ATA, pulmonary function was evaluated at 1.0 ATA in 13 healthy men before and after O2 exposure at 3.0 ATA for 3.5 h. Measurements included flow-volume loops, spirometry, and airway resistance (Raw) (n = 12); CO diffusing capacity (n = 11); closing volumes (n = 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). Chest discomfort, cough, and dyspnea were experienced during exposure in mild degree by most subjects. Mean forced expiratory volume in 1 s (FEV1) and forced expiratory flow at 25–75% of vital capacity (FEF25–75) were significantly reduced postexposure by 5.9 and 11.8%, respectively, whereas forced vital capacity was not significantly changed. The average difference in maximum midexpiratory flow rates at 50% vital capacity on air and HeO2 was significantly reduced postexposure by 18%. Raw and CO diffusing capacity were not changed postexposure. The relatively large change in FEF25–75 compared with FEV1, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow. Postexposure pulmonary function changes in one subject who convulsed at 3.0 h of exposure are compared with corresponding average changes in 12 subjects who did not convulse.


2019 ◽  
Vol 13 ◽  
pp. 117955651986228
Author(s):  
Selma Ben Fraj ◽  
Amira Miladi ◽  
Fatma Guezguez ◽  
Mohamed Ben Rejeb ◽  
Jihène Bouguila ◽  
...  

Purpose: Several studies raised the effects of Ramadan fasting on healthy adults spirometric data, but none was performed in children. The aim of this study was to compare the spirometric data of a group of faster adolescents (n = 26) with an age-matched non-faster one (n = 10). Methods: This comparative quasi-experimental study, including 36 healthy males aged 12 to 15 years, was conducted during the summer 2015 (Ramadan: June 18 to July 16). Three sessions (Before-Ramadan [Before-R], Mid-Ramadan [Mid-R], After-Ramadan [After-R]) were selected for spirometry measurements. Spirometry was performed around 5.5 to 3.5 h before sunset and the spirometric data were expressed as percentages of local spirometric norms. Results: The two groups of fasters and non-fasters had similar ages and weights (13.35 ± 0.79 vs 12.96 ± 0.45 years, 46.8 ± 9.2 vs 41.7 ± 12.6 kg, respectively). There was no effect of Ramadan fasting on forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow, and maximal mid-expiratory flow. For example, during the Before-R, Mid-R, and After-R sessions, there was no significant difference between the fasters and non-fasters mean FVC (101 ± 11 vs 99 ± 14, 101 ± 12 vs 102 ± 14, 103 ± 11 vs 104 ± 13, respectively) or FEV1 (101 ± 13 vs 96 ± 16, 98 ± 11 vs 97 ± 16, 101 ± 10 vs 98 ± 16, respectively). Conclusions: Ramadan fasting had no interaction effect with the spirometric data of Tunisian healthy male adolescents.


2019 ◽  
Vol 7 ◽  
pp. 205031211882461 ◽  
Author(s):  
Gashaw Garedew Woldeamanuel ◽  
Teshome Gensa Geta

Background: Chronic consumption of khat affects many organ systems and leads to various health disturbances in the chewers. Few studies examined the acute effects of khat ingestion on lung function parameters. However, studies which assessed the long-term effects of khat chewing on pulmonary function parameters and oxygen saturation are lacking. Objective: The aim of this study was to assess the impact of chronic Khat chewing on pulmonary function parameters and oxygen saturation among chronic Khat chewers in Wolkite, Ethiopia. Methods: A community-based comparative cross-sectional study was conducted in Wolkite, Ethiopia from 1 June 2018 to 15 August 2018. A total of 324 participants, 162 khat chewers and 162 non-chewers were included in the study. The data were collected through face-to-face interview by trained data collectors. British Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A spirometer was used to assess various lung function parameters. Moreover, oxygen saturation of hemoglobin was measured using pulse oximeter. Data were entered into CSPro version 6.2 and analyzed using SPSS version 23. Results: This study showed statistically significant (p < 0.05) reduction in the mean values of forced vital capacity, forced expiratory volume in first second and maximum ventilation volume among khat chewers as compared to non-chewers. There was no significant difference in the mean values of other lung function parameters between the two groups. Similarly, there was no significant difference (p = 0.642) in mean oxygen saturation of hemoglobin (SaO2) across the two groups. Conclusion: It is evident from this study that long-term khat consumption is associated with decreased mean forced vital capacity, forced expiratory volume in first second and maximum ventilation volume. Hence, there is a need for further study to strengthen the current findings and to explore the mechanisms of khat chewing effect on lung function parameters.


2019 ◽  
Vol 56 (2) ◽  
pp. 369-376 ◽  
Author(s):  
Matthew S Yong ◽  
Michael Z L Zhu ◽  
Douglas Bell ◽  
Nelson Alphonso ◽  
Johann Brink ◽  
...  

Abstract OBJECTIVES Pulmonary artery (PA) sling is a rare vascular anomaly often associated with congenital tracheal stenosis. We describe the long-term outcomes with repair of this condition. METHODS A retrospective study was conducted at 2 institutions. From 1984 to 2018, 33 patients with PA sling underwent repair. RESULTS The median age at the time of surgery was 5.9 months (quartile 1–3: 2.5–12 months). Concomitant tracheal surgery was required in 21 patients (64%) where slide tracheoplasty was used in 11 patients (52%). There were no early deaths in patients who did not require tracheal surgery (n = 12). Operative mortality was 22% (2 of 9 patients) between 1984 and 1993, 11% (1 of 9 patients) between 1994 and 2003 and 6.7% (1 of 15 patients) between 2004 and 2018. The 15-year probability of survival for patients who had PA sling repair alone was 100%, and for patients who required PA sling and tracheal repair was 76 ± 10% (95% confidence interval 51–89%) (P = 0.08). The mean follow-up for survivors was 14 ± 9.8 years (3 months–33 years). All survivors were in the New York Heart Association functional class I/II at the last follow-up. Spirometry performed at a median age of 10.4 years after PA sling and tracheal surgery demonstrated obstructive lung defects with median forced expiratory volume in 1 s of 1.0 l (48% predicted), forced vital capacity of 1.5 l (74% predicted) and forced expiratory volume in 1 s/forced vital capacity of 0.69 (78% predicted). CONCLUSIONS Early mortality after PA sling repair is determined by the need for tracheal surgery. Though late survival was excellent, and the majority of survivors remained asymptomatic, long-term respiratory assessment and follow-up is warranted for these patients.


e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Maniata F. Bata ◽  
Maarthen C.P. Wongkar ◽  
Bisuk P. Sedli

Abstract: Smoking is one of the factors causing decline of lung function characterized by impairment of Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), and FEV1/FVC. This study was aimed to obtain the differences in FEV1 between smokers and non smokers, among smokers based on duration of smoking, and among smokers based on the number of cigarettes per day in medical students of University of Sam Ratulangi Manado. This was an observational analytic study. Data were analyzed by using the independent T test and the ANOVA with the F Test. Subjects were 40 males, consisted of 20 smokers and 20 non-smokers. Six smokers had smoked for 2-5 years and 14 smokers had smoked for >5 years. Smoking less than10 cigarettes/day, 10-20 cigarettes/day, and more than 20 cigarettes/day were found in 8, 9, and 3 subjects respectively. The independent T-test showed that there was no significant difference in FEV1 between smokers and non-smokers (p=0.250). The independent T-test also showed that there was no significant difference in FEV1 between smokers of 2-5 years and smokers of more than 5 years (p=0.117). The ANOVA test showed that there was no significant difference in FEV1 between smokers of <10 cigarettes/day, 10-20 cigarettes/day, and >20 cigarettes/day (p=0.481). Conclusion: In this study there were no significant differences in FEV1 between smokers and non smokers, among smokers based on duration of smoking, and among smokers based on the number of cigarettes per day.Keywords: smoker, non smoker, FEV1, duration of smoking, number of cigarette Abstrak: Merokok adalah salah satu faktor penyebab penurunan fungsi paru yang ditandai oleh penurunan nilai volume Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), dan rasio FEV1/FVC. Penelitian ini bertujuan untuk mengetahui perbedaan FEV1 antara subjek perokok dan non perokok, antar subjek perokok berdasarkan lama merokok, dan antar subjek perokok berdasarkan jumlah batang rokok yang dihisap per hari pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi. Jenis penelitian ialah observasional analitik dengan uji T independent dan uji ANOVA dengan uji F. Subjek penelitian ialah 40 orang laki-laki terdiri dari 20 subjek perokok dan 20 subjek non perokok. Hasil penelitian mendapatkan terdapat 6 subjek perokok yang telah merokok selama 2-5 tahun dan 14 subjek telah merokok selama >5 tahun sedangkan yang menghisap rokok <10 batang/hari, 10-20 batang/hari, dan >20 batang/hari ialah masing-masing 8 orang, 9 orang, dan 3 orang. Uji T-independent menunjukkan tidak terdapat perbedaan bermakna antara FEV1 subjek perokok dan non perokok (p=0,250). Hasil uji T independent terhadap perbedaan FEV1 subjek perokok yang telah merokok 2-5 tahun dengan yang telah merokok >5 tahun mendapatkan p=0,117. Uji ANOVA terhadap perbedaan nilai FEV1 antara subjek perokok yang menghisap rokok sebanyak <10 batang/hari, 10-20 batang/hari, dan >20 batang/hari mendapatkan p=0,481. Simpulan: Pada penelitian ini tidak terdapat perbedaan bermakna antara FEV1 subjek perokok dan non perokok, antar subjek perokok berdasarkan lama merokok, dan antar subjek perokok berdasarkan jumlah batang rokok yang dihisap per hari.Kata kunci: perokok, non perokok, FEV1, lama merokok, jumlah batang rokok


Author(s):  
Snehunsu Adhikari ◽  
Adilakshmi Perla ◽  
Suresh Babu Sayana ◽  
Mithilesh K. Tiwari ◽  
Tambi Medabala

Background: Spirometry is an essential tool to evaluate lung function of health and disease. Adaptability of lung and chest among athletes can be assessed by lung function test (LFT). The quest of our study was to evaluate the lung function (LF) of highly trained Indian female weighting athletes, and intended to appraise the adaptation of LF among trained elite athletes.Methods: Top ranked Indian female professional weightlifters (study group, n=6) were recruited for this study. Three out of the six weightlifters were from top ten world ranking of 6th, 7th and 9th. Age matched controls (control group, n=6) were selected for this study. Maximum voluntary ventilation (MVV), vital capacity (VC), forced vital capacity (FVC), percentage of forced expiratory volume in first second (FEV1%) and ratio of forced expiratory volume in first second and forced vital capacity (FEV1/FVC%) have been evaluated as per the ATS/ERS guidelines.Results: Statistically higher significant values of VC and FVC were noted in study group, where as other values (MVV, FEV1% and FEV1/FVC%) found no significant difference between two groups.Conclusions: Power, strength and explosiveness of the skeletal muscles are vital domains in weightlifting sport. Weightlifting is such a sport doesn’t require much ventilatory efforts during training as well as competition. This study clueing that physiological adaptation/ improvement of the pulmonary function (PF) depends on the type of the sport being engaged by the athletes.


1985 ◽  
Vol 71 (3) ◽  
pp. 167-170
Author(s):  
R. Herrmann ◽  
G. M. Clifford ◽  
D. J. Smith ◽  
Caroline S. M. Searing

AbstractA prospective study of an early diagnostic test of small airway dysfunction, the forced expiratory flow between 75 and 85% of the forced vital capacity, was carried out in 230 RN submariners. All the subjects were male caucasians, of whom 105 were smokers and 125 non-smokers. Measurements were performed using a single breath wedge spirometer (Vitalograph®) and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of the FEV1 to the FVC (FEV1/FVC%) and the forced expiratory flow between 75 and 85% of the forced vital capacity (FEF75–85) obtained from the tracings in accordance with the recommendations of the American Thoracic Society. Multiple linear regression analysis of these four measurements together with height, age and smoking habit showed age to be the most significant factor for FEF75–85, followed by height Height was the most significant factor for FVC and FEV1 followed by age. Age was the only significant factor for FEV1/FVC%. FEF75-85 was highly correlated with FEV1/FVC% (r = 0.72) and to a lesser extent with FEV1 and FVC (r = 0.70 and 0.37 respectively). In the presence of age and height no significant effect of smoking habit on FEF75–85 could be demonstrated. However when the FEV1/FYC%, age and smoking habit were examined, there was found to be a significantly greater decrease in FEV1/FYC% with age in the smokers. It would appear that in this study FEV1/FVC% is a more sensitive index of early obstructive changes induced by smoking than measurement of flow at low lung volumes.


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