Wheezing in Infants with Cystic Fibrosis: Clinical Course, Pulmonary Function, and Survival Analysis

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 703-706
Author(s):  
Joseph Reisman ◽  
Mary Corey ◽  
Gerard Canny ◽  
Henry Levison ◽  
Eitan Kerem ◽  
...  

Wheezing is a common finding in infants with cystic fibrosis (CF). This study was undertaken to determine the prevalence of wheezing in infants with CF and to compare the clinical outcome of those who wheezed in infancy with that of those who did not. The study cohort included 229 CF patients born between 1965 and 1979 with CF diagnosed before 2 years of age. Fifty-seven (25%) had physician-documented wheezing during the first 2 years of life. Wheezing had resolved by the age of 2 years in 50% of the patients and by the age of 4 years in 75%. Although wheezing seemed to be linked to a family history of allergy and asthma, the frequency of the ΔF508 mutation was similar to that of the non-wheezers. There was no significant difference in survival at the age of 13 years between the two groups. At the age of 7 years, patients who had wheezed had significantly lower forced expiratory flow rate at mid-expiratory phase (85 ± 34% predicted) compared with those with no wheezing history (101 ± 34% predicted). At the age of 13 years, forced expiratory volume in 1 second values was lower in the wheezing group (69 ± 24% predicted vs 78 ± 21% predicted), as was forced expiratory flow rate at mid-expiratory phase (56 ± 33% predicted vs 69 ± 30% predicted). In conclusion, although wheezing in infants with CF seems to have diminished with age, pulmonary function abnormalities were more evident at 7 and 13 years of age in the group that wheezed than in the group that did not.

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 313-318
Author(s):  
Thomas J. Fischer ◽  
Timothy D. Guilfoile ◽  
Hemant H. Kesarwala ◽  
John G. Winant ◽  
Gregory L. Kearns ◽  
...  

Because aspirin (ASA) is often reported to have an adverse effect on pulmonary function in children with chronic asthma, acetaminophen is commonly used as an ASA substitute in these children. To study acetaminophen effects on pulmonary functions, double-blind, oral challenges of ASA (600 mg), acetaminophen (600 mg), or lactose were administered on separate days to 25 chronic asthmatics, ten boys and 15 girls, ranging in age from 8 to 18 years (mean age ± 1 SD: 12.5 ± 2.8 years). No patient had a past history of adverse reactions to either drug. Forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEFR), maximal mid-expiratory flow rate (FEF25-75), forced vital capacity (FVC), maximal voluntary ventilation (MVV), and flow volume curves were measured at base line and ½, 1, 2, 3, and 4 hours after ingestion of drug or placebo. Persistent decreases from base line FEV1 (> 20%) or FEF25-75 (> 30%) occurred in four ASA- and two acetaminophen-challenged patients. One ASA-sensitive patient was placebo intolerant; another reacted to acetaminophen. The acetaminophen responses were of less intensity than the ASA responses. Analysis of group mean pulmonary function responses to ASA, acetaminophen, and lactose showed no significant difference among the three agents at any time. Aspirin should be used cautiously in asthmatic children. Acetaminophen appears to be an adequate, although not completely, innocuous ASA substitute.


1984 ◽  
Vol 56 (6) ◽  
pp. 1655-1658 ◽  
Author(s):  
I. S. Davey ◽  
J. E. Cotes ◽  
J. W. Reed

The results of divers' annual medical examinations were used to assess the effects of diving exposure independent of age, stature, and smoking on forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Cross-sectional analysis of records for 858 men showed a significant positive association between the maximal depth that subjects had experienced and FVC but not FEV1. There was a significant negative association for FEV1/FVC%, and this index was also positively correlated with years of diving exposure. Among a subsample of 81 men the forced expiratory flow rate at low lung volume was reduced relative to that of control subjects similarly assessed; the extent of the reduction from the reference value was significantly correlated with the diving exposure. Longitudinal analysis of results for 255 men over a minimum of 5 yr showed that the change in FVC per annum (positive or negative) was correlated with the change in maximal depth; there were no similar associations for FEV1 or FEV1/FVC%. Thus diving exposure affects the vital capacity and the forced expiratory flow rate at small lung volumes. The latter is evidence for narrowing of airways that might be secondary to diving-induced loss of lung elastic tissue; this hypothesis merits further investigation.


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):  
Gayatri Devi R ◽  
Sethu G

Objectives: The main aim of this study is to compare the oronasal and nasal spirometry among adenoid hypertrophy children before and after surgery.Methods: A total of 40 healthy and 40 adenoid hypertrophy children were recruited for this study with the age range from 6 to 15 years. All the children were examined by two measurements (1) oronasal spirometry and (2) nasal spirometry. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1), FEV 1/FVC%, forced expiratory time (FET), peak expiratory flow rate, peak inspiratory flow rate (PIFR), and forced expiratory flow (FEF)25-75, FEF25%, FEF50%, FEF75%, FIF25%, FIF50%, and FIF75% were recorded.Results: All the parameters were significantly reduced in adenoid hypertrophy by nasal spirometry when compared to oronasal spirometry. FEV1/ FVC% was insignificant from oral to nasal values among adenoid hypertrophy in both the sexes. FET can act as an indicator for upper airway obstruction which shown significantly in adenoid hypertrophy but insignificant among control and adenoidectomy. Inspiratory parameters also had shown more variation in nasal than oronasal spirometry.Conclusion: Significant differences were found in many parameters between oronasal and nasal spirometry among adenoids and adenoidectomy. Nasal spirometry is a portable one, simple, and less cost-effective and so it can be used to determine the obstruction in the nose nasopharynx region.


2020 ◽  
Vol 7 (1) ◽  
pp. e000436
Author(s):  
Prawin Kumar ◽  
Aparna Mukherjee ◽  
Shivani Randev ◽  
Guruprasad R Medigeshi ◽  
Kana Ram Jat ◽  
...  

IntroductionAcute respiratory infections (ARIs) in infancy may have a long-term impact on the developing respiratory system. We planned a prospective cohort study to determine the impact of ARI during infancy on the pulmonary function test indices at 3 years of age.MethodsA cohort of normal, full-term newborns were followed up 6 monthly and during ARI episodes. Infant pulmonary function tests (IPFTs) were performed at baseline and each follow-up visit using tidal breathing flow-volume loop, rapid thoracoabdominal compression (RTC) and raised volume RTC manoeuvres. During each ARI episode, nasopharyngeal aspirates were tested for respiratory pathogens by real-time PCR.ResultsWe screened 3421 neonates; 310 were enrolled; IPFT was performed in 225 (boys: 125 (55.6%)) at 3 years. During infancy, 470 ARI episodes were documented in 173 infants. At 3 years, children with history of any ARI episode during infancy had lower forced expiratory volume in 1 s (FEV1.0), forced expiratory volume in 0.75 s (FEV0.75), forced expiratory volume in 0.5 s (FEV0.5), forced expiratory flow between 25% and 75% of FVC (FEF25–75), and maximal expiratory flow at 25% of FVC (MEF25) as compared with those without any ARI episode during infancy. The ratio of tidal expiratory flow (TEF) at 25% or 50% of tidal expiratory volume to peak TEF (TEF50 or TEF25/peak TEF) at 3 years was significantly increased in children who had ARI in infancy.ConclusionsARI during infancy is associated with impaired pulmonary function indices such as increased resistance and decreased forced expiratory flow and volume at 3 years of age.


1995 ◽  
Vol 23 (4) ◽  
pp. 284-293 ◽  
Author(s):  
G Caramia ◽  
R Gagliardini ◽  
E Ruffini ◽  
P Osimani ◽  
A Nobilini

The effectiveness of carbocysteine lysine salt monohydrate (SCMC-Lys) and ambroxol hydrochloride (ABX) in the management of respiratory impairment was compared in a single-blind, randomized study of 26 cystic fibrosis patients with similar baseline characteristics. Adults received either SCMC-Lys 900 mg or ABX 33 mg three times a day and children under 14 years of age either SCMC-Lys 270 mg three times a day or ABX 10 mg four times a day. All treatments were given orally for 80 days and at the end of this control period both groups showed significant improvement in chest sound score but improvement in cough score was observed only in those receiving SCMC-Lys. Expectorate viscosity and elasticity decreased significantly in both groups. In SCMC-Lys-treated patients paCO2 decreased and paO2 and Hb O2 saturation increased while only paO2 increased significantly in those treated with ABX. An increase in tidal volume, peak expiratory flow values and forced expiratory volume were evident in those receiving SCMC-Lys while significant increases in forced expiratory flow were recorded in those receiving ABX. SCMC-Lys patients' Shwachmann index improved significantly and conversely to the ABX patients. No adverse events were recorded in either treatment group. The study concluded that SCMC-Lys is at least as effective as ABX in improving respiratory function in patients with cystic fibrosis.


Author(s):  
Yuanni Huang ◽  
Mian Bao ◽  
Jiefeng Xiao ◽  
Zhaolong Qiu ◽  
Kusheng Wu

Exposure to fine particulate matter 2.5 (PM2.5) is associated with adverse health effects, varying by its components. The health-related effects of PM2.5 exposure from ore mining may be different from those of environment pollution. The aim of this study was to investigate the effects of different concentrations of PM2.5 exposure on the cardio-pulmonary function of manganese mining workers. A total of 280 dust-exposed workers who were involved in different types of work in an open-pit manganese mine were randomly selected. According to the different concentrations of PM2.5 in the working environment, the workers were divided into an exposed group and a control group. The electrocardiogram, blood pressure, and multiple lung function parameters of the two groups were measured and analyzed. The PM2.5 exposed group had significantly lower values in the pulmonary function indexes of forced expiratory volume in one second (FEV1.0), maximum mid expiratory flow (MMEF), peak expiratory flow rate (PEFR), percentage of peak expiratory flow out of the overall expiratory flow volume (PEFR%), forced expiratory flow at 25% and 75% of forced vital capacity (FEF 25, FEF75), forced expiratory flow when 25%, 50%, and 75% of forced vital capacity has been exhaled (FEF25%,FEF50%, FEF75%), and FEV1.0/FVC% (the percentage of the predicted value of forced vital capacity) than the control group (all p < 0.05). Both groups had mild or moderate lung injury, most of which was restrictive ventilatory disorder, and there was significant difference in the prevalence rate of restrictive respiratory dysfunction between the two groups (41.4% vs. 23.6%, p = 0.016). Electrocardiogram (ECG) abnormalities, especially sinus bradycardia, were shown in both groups, but there was no statistical difference of the prevalence rate between the two groups (p > 0.05). Also, no significant difference of the prevalence rate of hypertension was observed between the PM2.5 exposure and control groups (p > 0.05). PM2.5 exposure was associated with pulmonary function damage of the workers in the open-pit manganese mine, and the major injury was restrictive ventilatory disorder. The early effect of PM2.5 exposure on the cardiovascular system was uncertain at current exposure levels and exposure time.


1983 ◽  
Vol 54 (4) ◽  
pp. 1120-1124 ◽  
Author(s):  
H. H. Rotman ◽  
M. J. Fliegelman ◽  
T. Moore ◽  
R. G. Smith ◽  
D. M. Anglen ◽  
...  

Eight healthy unacclimated volunteers were exposed to chlorine gas in concentrations of 0.5 or 1 ppm, and several pulmonary function measurements were made. Comparisons were made by paired t test between the percent change from base-line values obtained at various times after chlorine exposure and the percent change from base line at analogous times after a sham exposure. With the sham vs. 0.5-ppm exposure, there were trivial changes observed. Total lung capacity (TLC) was lower before 0.5-ppm exposure than before sham exposure, and the percent decrease in carbon dioxide pulmonary diffusing capacity was smaller 24 h after 0.5-ppm exposure than 24 h after sham exposure. With the sham vs. 1-ppm exposure, there were many differences in percent change from base line that were significant at the P less than 0.05 level or better. These were in forced vital capacity (FVC), forced expiratory volume at 1 s (FEV1), peak expiratory flow rate (PEFR), forced expiratory flow rate at 50 and 25% vital capacity (FEF50 and FEF25, respectively), and airway resistance (Raw). There were, in addition, significant changes after only 4 h of exposure. These were in FEV1, PEFR, FEF50, FEF25, TLC, Raw, and the difference in nitrogen concentration. Most of the test results had returned to normal by the next day. We conclude that even though chlorine at low concentrations does not produce any serious subjective symptoms, it adversely affects pulmonary function transiently.


2019 ◽  
Vol 3 (3) ◽  
pp. 89
Author(s):  
Arief Bakhtiar ◽  
Renny Irviana Eka Tantri

Pulmonary function is an examination to measure lung volume function using spirometry. Tests with spirometry to detect abnormalities associated with respiratory distress. Spirometry examination is not only to determine the diagnosis but also to assess the severity of obstruction, restriction, and the effects of treatment. Spirometry examination is a test to measure the volume of a person’s static and dynamic lungs with a spirometer tool. Dynamic lung spirometry consists of Forced vital capacity (FVC), Forced expiratory volume (FEVT), Forced expiratory flow200-1200 / FEF 200-1200, Forced expiratory flow25% -75% / FEF 25% -75%, Peak expiratory flow rate / PEFR, Maximum voluntary ventilation / MVV / MBC, FEV1 / FVC Ratio. Ventilation disorders consist of: restriction and obstruction disorders. Restriction is a disorder of lung development by any cause. In obstruction disorder, it shows a decrease in velocity of expiratory flow and normal vital capacity. FEV values, which are widely used are FEV1 / FVC, abnormal when <80%, FEV1 / FVC ratio <80%. This parameter is very important because the accuracy level for obstruction in the central airway is quite large. In obstructive disorder there is generally a decrease in pulmonary dynamic volume. Significant parameters are FEV 1 / FVC, PEFR, and FEF 25-75. The FEV1 / FVC ratio is important because the accuracy level for obstruction in the central airway is considerable, whereas FEF 25-75 indicates obstruction in the small airway.


2019 ◽  
Vol 34 (4) ◽  
pp. 377-390
Author(s):  
Somayeh Rahimi Moghadam ◽  
Mahdi Afshari ◽  
Mahmood Moosazadeh ◽  
Narges Khanjani ◽  
Ali Ganjali

Abstract Introduction Exposure to petrol and gasoline can have harmful effects on the lungs. This review aimed to summarize the reported effects of this exposure on pulmonary function parameters. Methods Relevant studies were identified by a comprehensive search in PubMed, Scopus, Science Direct and Google Scholar databases. Irrelevant studies were excluded. Quality assessment was performed using the Newcastle-Ottawa score (NOS). The standard mean difference of pulmonary parameters between exposed and unexposed petrol station attendants was pooled using random effects. Meta-regression was used to investigate factors probably related to heterogeneity. Studies affecting the total estimates were assessed during sensitivity analysis. The Egger test was performed to investigate any evidence of publication bias. Results Eventually, 26 studies entered the meta-analysis, and the pooled standard difference [95% confidence interval (CI)] of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, vital capacity (VC), peak expiratory flow (PEF), forced expiratory flow (FEF25-75) and maximum voluntary ventilation (MVV) in the exposed minus unexposed groups was −1.08 L (95% CI: −1.38, −0.78), −0.92 L (−1.15, −0.69), −0.65 (−1.01, −0.30), −0.51 L (−0.96, −0.06), −0.96 L/s (−1.21, −0.69), −0.78 L/s (1.14, −0.42) and −0.58 L/min (−0.90, −0.27), respectively, and showed a decrease in all pulmonary parameters in the exposed group. Conclusion Occupational exposure to petrol fumes is a risk factor for lung function and there is a reverse relation between lung function and the duration of exposure.


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