Impulse oscillometry for detection of small airway dysfunction in subjects with chronic respiratory symptoms and preserved pulmonary function

Abstract Background Subjects with chronic respiratory symptoms and preserved pulmonary function (PPF) may have small airway dysfunction (SAD). As the most common means to detect SAD, spirometry needs good cooperation and its reliability is controversial. Impulse oscillometry (IOS) may complete the deficiency of spirometry and have higher sensitivity. We aimed to explore the diagnostic value of IOS to detect SAD in symptomatic subjects with PPF. Methods The evaluation of symptoms, spirometry and IOS results in 209 subjects with chronic respiratory symptoms and PPF were assessed. ROC curves of IOS to detect SAD were analyzed. Results 209 subjects with chronic respiratory symptoms and PPF were included. Subjects who reported sputum had higher R5–R20 and Fres than those who didn’t. Subjects with dyspnea had higher R5, R5–R20 and AX than those without. CAT and mMRC scores correlated better with IOS parameters than with spirometry. R5, R5–R20, AX and Fres in subjects with SAD (n = 42) significantly increased compared to those without. Cutoff values for IOS parameters to detect SAD were 0.30 kPa/L s for R5, 0.015 kPa/L s for R5–R20, 0.30 kPa/L for AX and 11.23 Hz for Fres. Fres has the largest AUC (0.665, P = 0.001) among these parameters. Compared with spirometry, prevalence of SAD was higher when measured with IOS. R5 could detect the most SAD subjects with a prevalence of 60.77% and a sensitivity of 81% (AUC = 0.659, P = 0.002). Conclusion IOS is more sensitive to detect SAD than spirometry in subjects with chronic respiratory symptoms and PPF, and it correlates better with symptoms. IOS could be an additional method for SAD detection in the early stage of diseases.

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Small Airway Dysfunction by Impulse Oscillometry in Symptomatic Patients with Preserved Pulmonary Function

The Journal of Allergy and Clinical Immunology In Practice ◽

10.1016/j.jaip.2019.06.035 ◽

2020 ◽

Vol 8 (1) ◽

pp. 229-235.e3 ◽

Cited By ~ 4

Author(s):

Hwa-Yen Chiu ◽

Yi-Han Hsiao ◽

Kang-Cheng Su ◽

Yu-Chin Lee ◽

Hsin-Kuo Ko ◽

...

Keyword(s):

Pulmonary Function ◽

Small Airway ◽

Impulse Oscillometry

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Respiratory Symptoms, Pulmonary Function and The Role of Interlukin-1Β in The Inflammatory Reaction among Workers at a Cement Factory in Cairo, Egypt

The Egyptian Journal of Community Medicine ◽

10.21608/ejcm.2018.22999 ◽

2018 ◽

Vol 36 (4) ◽

pp. 77-86 ◽

Cited By ~ 2

Keyword(s):

Pulmonary Function ◽

Inflammatory Reaction ◽

Respiratory Symptoms ◽

Cement Factory

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Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis

Dentistry Journal ◽

10.3390/dj9030030 ◽

2021 ◽

Vol 9 (3) ◽

pp. 30

Author(s):

Mai Thi Giang Thanh ◽

Ngo Van Toan ◽

Do Thi Thanh Toan ◽

Nguyen Phu Thang ◽

Ngoc Quang Dong ◽

...

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Visual Inspection ◽

Early Stage ◽

Meta Analysis ◽

Diagnostic Value ◽

Caries Detection ◽

Permanent Teeth ◽

Visual Examination ◽

Initial Caries

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

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Circular RNAs in Sudden Cardiac Death Related Diseases: Novel Biomarker for Clinical and Forensic Diagnosis

Molecules ◽

10.3390/molecules26041155 ◽

2021 ◽

Vol 26 (4) ◽

pp. 1155

Author(s):

Meihui Tian ◽

Zhipeng Cao ◽

Hao Pang

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Early Stage ◽

Diagnostic Value ◽

Circular Rnas ◽

Cardiac Damage ◽

Postmortem Diagnosis ◽

Specific Expression ◽

Forensic Practice ◽

Artery Disease

The prevention and diagnosis of sudden cardiac death (SCD) are among the most important keystones and challenges in clinical and forensic practice. However, the diagnostic value of the current biomarkers remains unresolved issues. Therefore, novel diagnostic biomarkers are urgently required to identify patients with early-stage cardiovascular diseases (CVD), and to assist in the postmortem diagnosis of SCD cases without typical cardiac damage. An increasing number of studies show that circular RNAs (circRNAs) have stable expressions in myocardial tissue, and their time- and tissue-specific expression levels might reflect the pathophysiological status of the heart, which makes them potential CVD biomarkers. In this article, we briefly introduced the biogenesis and functional characteristics of circRNAs. Moreover, we described the roles of circRNAs in multiple SCD-related diseases, including coronary artery disease (CAD), myocardial ischemia or infarction, arrhythmia, cardiomyopathy, and myocarditis, and discussed the application prospects and challenges of circRNAs as a novel biomarker in the clinical and forensic diagnosis of SCD.

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AB0597 PULMONARY FUNCTION IN PATIENTS DIAGNOSED OF EARLY SYSTEMIC SCLEROSIS: A NEW TOOL FOR SYSTEMIC SCLEROSIS CLASIFFICATION?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4423 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1595.1-1595

Author(s):

F. M. Ortiz Sanjuan ◽

C. Pávez Perales ◽

E. Vicens Bernabeu ◽

C. Alcañiz Escandell ◽

I. Cánovas Olmos ◽

...

Keyword(s):

Systemic Sclerosis ◽

Pulmonary Function ◽

Airway Obstruction ◽

Pulmonary Involvement ◽

Classification Criteria ◽

Small Airway ◽

University Hospital ◽

Ventilatory Pattern ◽

Small Airway Obstruction

Background:Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc) and is often progressive and has a poor prognosis. A restrictive ventilatory defect could suggest ILD either alone or in combination with pulmonary arterial hypertension.Nowadays, Early-SSc is well defined as preliminary stage of SSc. Patients who meet criteria for Early-SSc could benefit from an early diagnosis of pulmonary involvement.Objectives:Our aim was to assess the pulmonary function in patients diagnosed of Early SSc.Methods:Retrospective observational study of a wide and unselected series of patients diagnosed as Early-SSc from a single university hospital from 2012 to 2019. Patients were classified as Early-SSc following Le Roy criteria. Despite this, patients already did not meet 2013 ACR/EULAR classification criteria for SSc. We reviewed pulmonary function through conventional spirometry and diffusing capacity of lung for carbon monoxide (DLCO).Results:We included 56 patients with a mean age of 52.3±12.1 years (96.4% women; 3.6% men).At the diagnosis of Early-SSc, no one of our patients evidenced a restrictive ventilatory pattern. DLCO was below normal limits in 18 patients (32.1%). Small airway obstruction expressed according decreased maximal (mid-) expiratory flow (MMEF) 25-75 was present in 24 patients (42.8%).After a mean follow-up period of 38.3±2.4 months, 29 (51.8%) patients fulfilled 2013 ACR/EULAR criteria. The average time between diagnosis of Early-SSc and achieve SSc classification was 24.4±1.8 months. The remaining 27 patients continued classified as Early-SSc.An analysis of the subgroup of patients which progressed to SSc showed that DLCO was decreased in 15 of those 29 patients (51.7%) and 18 of 29 patients (62.1%) presented decreased MMEF 25-75. Comparing with the subgroup of patients which not progressed to SSc were significant differences (Decreased DLCO: 51.7% vs 11.1%; p=0.02 and decreased MMEF 25-75: 42.8% vs 22.2%; p=0.05).The analysis of pulmonary function of the subgroup of patients continued classified as Early-SSc after follow-up period did not show significative changes after follow-up.Conclusion:In our study, a third of the patients classified as Early-SSc presented at diagnosis abnormal values of DLCO and/or signs of small airway obstruction without the presence of a restrictive ventilatory pattern. Moreover, this pulmonary disfunction was significantly more frequent in patients who progressed to definitive SSc. Patients which remains classified as Early-SSc did not experience significative changes.Our results support the concept that pulmonary function was impaired in Early-SSc and that I should probably be considered for future Early-SSc classification criteria.Disclosure of Interests:None declared

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Impact of air pollution on pulmonary function and respiratory symptoms in children. Longitudinal repeated-measures study

BMC Pulmonary Medicine ◽

10.1186/1471-2466-10-62 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 32

Author(s):

Benigno Linares ◽

Juan M Guizar ◽

Norma Amador ◽

Alfonso Garcia ◽

Victor Miranda ◽

...

Keyword(s):

Air Pollution ◽

Pulmonary Function ◽

Repeated Measures ◽

Respiratory Symptoms

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Clinical Characteristics of and Risk Factors for Small Airway Dysfunction Detected by Impulse Oscillometry

Respiratory Medicine ◽

10.1016/j.rmed.2021.106681 ◽

2021 ◽

pp. 106681

Author(s):

Jieqi Peng ◽

Fan Wu ◽

Heshen Tian ◽

Huajing Yang ◽

Youlan Zheng ◽

...

Keyword(s):

Risk Factors ◽

Clinical Characteristics ◽

Small Airway ◽

Impulse Oscillometry

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Grading, Time Course, and Incidence of Exercise-Induced nduced Airway Obstruction and Hyperinflation in Asthmatic Children

PEDIATRICS ◽

10.1542/peds.56.5s.868 ◽

1975 ◽

Vol 56 (5s) ◽

pp. 868-879

Author(s):

Gerd J. A. Cropp ◽

I. J. Schmultzler

Keyword(s):

Pulmonary Function ◽

Airway Obstruction ◽

Clinical Status ◽

Small Airway ◽

Strenuous Exercise ◽

Normal Children ◽

Asthmatic Children ◽

Ergometer Exercise ◽

Exercise Induced ◽

Small Airway Obstruction

We evaluated clinical status and pulmonary function in 60 perennially asthmatic and 11 normal children before and repeatedly after incrementally increasing bicycle ergometer exercise. The changes in clinical status and pulmonary function which were elicited by strenuous exercise were graded by an air exchange and a physiological grading system respectively. Normal children showed no significant clinical or physiological changes after exercise. Strenuous exercise elicited significant deteriorations in clinical and physiological measurements in 36% to 77% of asthmatic girls and 46% to 90% of asthmatic boys, the frequency depending on the test used to determine exercise-induced abnormalities. The incidence of exercise-induced asthma (EIA) was statistically significantly higher in asthmatic boys than girls. The higher incidence of EIA in boys was primarily due to a larger number of very severe attacks in boys than girls; mild and moderate EIA was about equally common in the two sexes. Most patients with EIA developed large and small airway obstruction, although large airway obstruction tended to be the predominant and the more severe abnormality. Clinical and physiological abnormalities, regardless of severity, were usually most marked during the first ten minutes after exercise and lessened thereafter. Mild EIA usually lasted for only 15 minutes or less; severe EIA improved, but usually did not resolve within 35 minutes of exercise. There were three patients in whom the severity of EIA got worse after exercise and an additional seven in whom the improvement was minimal. In these ten patients isoproterenol aerosol terminated EIA, indicating that exercise-induced large and small airway obstruction in asthmatic children is primarily. if not solely. due to bronchospasm.

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