Lung Function before and after a Large Chlorine Gas Release in Graniteville, South Carolina

Abstract Background/Aims Intravenous immunoglobulin (IVIg) confers significant benefit in range of connective tissue diseases (CTD) including inflammatory myopathy (IM) of which interstitial lung diseases (ILD) are a major complication. This study aimed to assess the efficacy of IVIg on pulmonary involvement in refractory active CTD including systemic sclerosis (SSc). Methods All patients with CTD-ILD confirmed on HRCT either with IM or SSc overlap myositis who did not achieve satisfactory clinical response to standard immunosuppressive agents and subsequently received regular IVIg infusions for IM were retrospectively identified. Serial lung function tests and immunosuppressive treatment regimen 9-12 months prior and 9-12 months after repeat courses of IVIg were recorded. Progressive ILD was considered when, despite immunosuppressive treatment, a relative FVC decline≥10% and/or relative DLco decline ≥15% were identified during the 9-12 months preceding IVIg treatment. The significance of median DLco and FVC percentage relative change to IVIg treatment was assessed by Wilcoxon signed-rank test. Results 22 patients (mean age 50.5±13.1 years old) with IM-ILD treated with IVIg were identified. ILD occurred in association with IM in 10 patients, overlap SSc myositis in another 11 patients, while one had mixed connective tissue disease with myositis. Lung function results were available for 19/22 (86%). Eight patients (42.1%) were found to have progressive ILD(four with IM and four with overlap SSc-myositis). The median change in FVC% predicted and DLco% predicted in the 9-12 months before and after IVIg treatment is presented in Table 1. There was a significant difference in the DLco% predicted rate of relative change before and after IVIg treatment (p = 0.035) for the overall cohort. However, no differences in lung function were observed in the rate of relative change between patients with IM and patients with SSc myositis overlap. Significant improvement in DLco% predicted values was identified in the subgroup analysis of patients with progressive ILD(p = 0.012). P157 Table 1:The median change in FVC and DLco% predicted values prior and after the IVIg treatmentPatients with myositis related ILD9-12 months before IVIg treatment (relative change)9-12 months after IVIg treatment (relative change)p-valueAll (n = 19)FVC % predicted-3.8 (-54.4 - 14.6)2.1 (-33 - 33.7)0.145DLco % predicted-9.2 (-60.7 - 9.2)-2.3 (-26 - 41.9)0.035PM/DM (n = 10)FVC % predicted-1.8 (-20.2 - 14.6)0.8 (-33 - 30.9)0.401DLco % predicted-9.6 (-60.7 - 9.2)-2.4 (-26 - 41.9)0.093SSc-PM/DM overlap (n = 11)FVC % predicted-6 (-54.4 - 10.6)3.4 (-19.9 - 33.7)0.139DLco % predicted-10.8 (-47.1 - 2.5)4.2 (-22.7 - 16.8)0.173Progressive ILD (n = 8)FVC % predicted-14.5 (-54.4 - 14.6)5.7 (-11.9 - 33.7)0.123DLco % predicted-25.3 (-60.6 - -14.1)12 (-2.3 - 41.9)0.012 Conclusion IVIg may be an effective rescue therapy in the prevention of further lung function decline in refractory myositis and SSc overlap in particular in subgroups with progressive ILD. Future studies to determine its role in CTD-ILD are warranted. Disclosure V. Kouranos: None. L.V. Host: None. C. Campochiaro: None. A. Wells: None. C.P. Denton: None. V.H. Ong: None. E. Renzoni: None.

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Respiratory symptoms and lung function 8–10 months after community exposure to chlorine gas: a public health intervention and cross-sectional analysis

BMC Public Health ◽

10.1186/1471-2458-13-945 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 18

Author(s):

Kathleen A Clark ◽

Debjani Chanda ◽

Pallavi Balte ◽

Wilfried J Karmaus ◽

Bo Cai ◽

...

Keyword(s):

Public Health ◽

Lung Function ◽

Respiratory Symptoms ◽

Public Health Intervention ◽

Health Intervention ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Chlorine Gas ◽

Community Exposure ◽

Sectional Analysis

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Omalizumab reduces bronchial mucosal IgE and improves lung function in non-atopic asthma

European Respiratory Journal ◽

10.1183/13993003.01501-2015 ◽

2016 ◽

Vol 48 (6) ◽

pp. 1593-1601 ◽

Cited By ~ 30

Author(s):

Prathap Pillai ◽

Yih-Chih Chan ◽

Shih-Ying Wu ◽

Line Ohm-Laursen ◽

Clare Thomas ◽

...

Keyword(s):

Mast Cells ◽

Lung Function ◽

Plasma Cells ◽

Placebo Treatment ◽

Forced Expiratory Volume ◽

Atopic Asthma ◽

Before And After ◽

Bronchial Biopsies ◽

Withdrawal Of Therapy ◽

Therapy Reduction

Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE and inflammation and preserves/improves lung function when disease is destabilised by staged withdrawal of therapy.18 symptomatic, non-atopic asthmatics were randomised (1:1) to receive omalizumab or identical placebo treatment in addition to existing therapy for 20 weeks. Bronchial biopsies were collected before and after 12–14 weeks of treatment, then the patients destabilised by substantial, supervised reduction of their regular therapy. Primary outcome measures were changes in bronchial mucosal IgE+ cells at 12–14 weeks, prior to regular therapy reduction, and changes in lung function (forced expiratory volume in 1 s) after destabilisation at 20 weeks. Quality of life was also monitored.Omalizumab but not placebo therapy significantly reduced median total bronchial mucosal IgE+ cells (p<0.01) but did not significantly alter median total mast cells, plasma cells, B lymphocytes, eosinophils and plasmablasts, although the latter were difficult to enumerate, being distributed as disperse clusters. By 20 weeks, lung function declined in the placebo-treated patients but improved in the omalizumab treated patients, with significant differences in absolute (p=0.04) and % predicted forced expiratory volume in 1 s (p=0.015).Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE+ mast cells and improves lung function despite withdrawal of conventional therapy.

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Impact of Lung Biopsy on Lung Function in Idiopathic Pulmonary Fibrosis

Respiration ◽

10.1159/000509557 ◽

2020 ◽

pp. 1-8

Author(s):

Pierre-Henri Aussedat ◽

Nader Chebib ◽

Kais Ahmad ◽

Jean-Charles Glerant ◽

Gabrielle Drevet ◽

...

Keyword(s):

Lung Function ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Forced Vital Capacity ◽

Lung Biopsy ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Surgical Lung Biopsy ◽

Before And After ◽

The Impact

Background: Video-assisted surgical lung biopsy (SLB) is performed in 10–30% of cases to establish the diagnosis of idiopathic pulmonary fibrosis (IPF). Objectives: The aim of the study was to analyze the impact of SLB on lung function in patients eventually diagnosed with IPF. Methods: This is an observational, retrospective, monocentric study of all consecutive patients eventually diagnosed with IPF in multidisciplinary discussion who underwent SLB over 10 years in a specialized center. The primary end point was the variation in forced vital capacity (FVC) before and after the SLB. The secondary end points were the variations in forced expiratory volume in one second (FEV1), total lung capacity (TLC), carbon monoxide diffusion capacity (DLCO), and morbidity and mortality associated with the SLB. Results: In 118 patients who underwent SLB and were diagnosed with IPF, a relative decrease in FVC of 4.8% (p < 0.001) was found between measurements performed before and after the procedure. The mean FVC decrease was 156 ± 386 mL in an average period of 185 days, representing an annualized decline of 363 ± 764 mL/year. A significant decrease was also observed after SLB in FEV1, TLC, and DLCO. Complications within 30 days of SLB occurred in 14.4% of patients. Two patients (1.7%) died within 30 days, where one of them had poor lung function. Survival at 1 year was significantly poorer in patients with FVC <50% at baseline. Conclusion: In this uncontrolled study in patients ultimately diagnosed with IPF, SLB was followed by a significant decline in FVC, which appears to be numerically greater than the average decline in the absence of treatment in the literature. Summary at a Glance: This study evaluated the change in lung function in 118 consecutive patients diagnosed with idiopathic pulmonary fibrosis by surgical lung biopsy. Forced vital capacity decreased by 156 ± 386 mL in a mean of 185 days between the last measurement before and first measurement after biopsy, representing an annualized decline of 363 ± 764 mL/year.

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Mechanical effects of obesity on airway responsiveness in otherwise healthy humans

Journal of Applied Physiology ◽

10.1152/japplphysiol.00083.2009 ◽

2009 ◽

Vol 107 (2) ◽

pp. 408-416 ◽

Cited By ~ 36

Author(s):

Roberto Torchio ◽

Alessandro Gobbi ◽

Carlo Gulotta ◽

Raffaele Dellacà ◽

Marco Tinivella ◽

...

Keyword(s):

Body Mass Index ◽

Lung Function ◽

Body Mass ◽

Airway Hyperresponsiveness ◽

Healthy Subjects ◽

Rest Period ◽

Healthy Humans ◽

Before And After ◽

Maximum Expiratory Flow ◽

Residual Capacity

We investigated whether obesity is associated with airway hyperresponsiveness in otherwise healthy humans and, if so, whether this correlates with a restrictive lung function pattern or a decreased number of sighs at rest and/or during walking. Lung function was studied before and after inhaling methacholine (MCh) in 41 healthy subjects with body mass index ranging from 20 to 56. Breathing pattern was assessed during a 60-min rest period and a 30-min walk. The dose of MCh that produced a 50% decrease in the maximum expiratory flow measured in a body plethysmograph (PD50MCh) was inversely correlated with body mass index ( r2 = 0.32, P < 0.001) and waist circumference ( r2 = 0.25, P < 0.001). Significant correlations with body mass index were also found with the maximum changes in respiratory resistance ( r2 = 0.19, P < 0.001) and reactance ( r2 = 0.40, P < 0.001) measured at 5 Hz. PD50MCh was also positively correlated with functional residual capacity ( r2 = 0.56, P < 0.001) and total lung capacity ( r2 = 0.59, P < 0.001) in men, but not in women. Neither PD50MCh nor body mass index correlated with number of sighs, average tidal volume, ventilation, or breathing frequency. In this study, airway hyperresponsiveness was significantly associated with obesity in otherwise healthy subjects. In obese men, but not in women, airway hyperresponsiveness was associated with the decreases in lung volumes.

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Fungicide Rotation Programs for Managing Phytophthora Fruit Rot of Watermelon in Southeastern United States

Plant Health Progress ◽

10.1094/php-rs-16-0059 ◽

2017 ◽

Vol 18 (1) ◽

pp. 28-34 ◽

Cited By ~ 1

Author(s):

Chandrasekar (Shaker) S. Kousik ◽

Pingsheng Ji ◽

Daniel S. Egel ◽

Lina M. Quesada-Ocampo

Keyword(s):

United States ◽

South Carolina ◽

Phytophthora Capsici ◽

Southeastern United States ◽

Heavy Rain ◽

Integrated Approach ◽

The United States ◽

Fruit Rot ◽

Management Options ◽

Before And After

About 50% of the watermelons in the United States are produced in the southeastern states, where optimal conditions for development of Phytophthora fruit rot prevail. Phytophthora fruit rot significantly limits watermelon production by causing serious yield losses before and after fruit harvest. Efficacy of fungicide rotation programs and Melcast-scheduled sprays for managing Phytophthora fruit rot was determined by conducting experiments in Phytophthora capsici-infested fields at three locations in southeastern United States (North Carolina, South Carolina, and Georgia). The mini seedless cultivar Wonder and seeded cultivar Mickey Lee (pollenizer) were used. Five weekly applications of fungicides were made at all locations. Significant fruit rot (53 to 91%, mean 68%) was observed in the nontreated control plots in all three years (2013 to 2015) and across locations. All fungicide rotation programs significantly reduced Phytophthora fruit rot compared with nontreated controls. Overall, the rotation of Zampro alternated with Orondis was highly effective across three locations and two years. Rotations of Actigard followed by Ranman+Ridomil Gold, Presidio, V-10208, and Orondis, or rotation of Revus alternated with Presidio were similarly effective. Use of Melcast, a melon disease-forecasting tool, may occasionally enable savings of one spray application without significantly impacting control. Although many fungicides are available for use in rotations, under very heavy rain and pathogen pressure, the fungicides alone may not offer adequate protection; therefore, an integrated approach should be used with other management options including well-drained fields.

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Effect of Semi-Recumbent Position on Blood Oxygen Saturation in Postanesthetic Patients After Laparoscopic Cholecystectomy

Connect The World of Critical Care Nursing ◽

10.1891/1748-6254.12.3.82 ◽

2018 ◽

Vol 12 (3) ◽

pp. 82-85

Author(s):

Xiaoling Chen ◽

Yuelan Qin ◽

Fanghua Gong

Keyword(s):

Laparoscopic Cholecystectomy ◽

Lung Function ◽

Oxygen Saturation ◽

Intervention Group ◽

Control Group ◽

Blood Oxygen ◽

Recumbent Position ◽

Blood Oxygen Saturation ◽

Bed Elevation ◽

Before And After

BackgroundUndergoing general anesthesia and pneumoperitoneum could affect the lung function and comprise oxygenation in laparoscopic cholecystectomy patients. Position of patients after surgery may affect lung function of these patients.AimTo observe the effect of semi-recumbent position on blood oxygen saturation (SpO2) in postanesthetic patients after laparoscopic cholecystectomy.MethodsA number of 225 patients who admitted to postanesthetic care unit after laparoscopic cholecystectomy from September 2016 to May 2017 were randomly assigned into the intervention group and the control group. The intervention group adopted a semi-recumbent position with head bed elevation by 10 to 20°, while the control received a supine position without lying on a pillow. Both groups received routine postanesthesia care. Data on SpO2 before and after extubation were collected. Independent t-test was used for data analysis.ResultsThere was no vomiting and cough reactions before and after extubation in both groups. Intervention group reported a significantly higher level of SpO2 at 1 minute and 30 minutes after extubation, compared to the control group (both ps < 0.05).ConclusionSemi-recumbent position with the head bed elevation could significantly increase the SpO2 level of postanesthetic patients, thus ensuring the safety of patients when removing the endotracheal tube.

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