The clinical respiratory journal
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Some patients cannot perform forced vital capacity (FVC). We conducted a study to answer three questions: Can the ability to perform components of spirometry be predicted by the Mini Mental State Examination (MMSE)? What proportion of subjects can perform forced expiratory volume in 3 s (FEV3) but not FVC? Does the forced expiratory volume in 1 s (FEV1)/FEV3 ratio concord with FEV1/FVC ratio in patients with airflow obstruction? ⋯ Patients with an MMSE < 24 are usually unable to reach FVC reliably when tested on a single occasion, but some can reach FEV3. Patients with MMSE < 20 cannot do spirometry. An FEV1/FEV3 ratio < 80% can be used to help identify patients with airflow obstruction if they are unable to perform full spirometry to FVC.
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Comparative Study
Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance.
To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs. ⋯ Different degrees of immunologic and fibroelastotic airway remodeling processes occur in the major types of IIPs with impact on physiological tests and survival.
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The role of inhaled corticosteroids (ICS) on disease progression in asthmatic children is not yet clear. ⋯ One-fifth of young children with recurrent bronchial obstruction had received inhaled corticosteroids by age 2 years. Lung function appeared to improve in children using ICS from the start of symptoms of OAD until 2 years of age, mostly in children with the longest duration of treatment. However, use of ICS during the first 2 years of life in children with OAD did not reduce asthma present 8 years later. A scoring system based on severity and frequency of OAD during the first 2 years of life predicted current asthma at 10 years of age. One in five 10-year-old children in the city of Oslo at some time had asthma.
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Comparative Study
COPD 'diagnosis' based on spirometric reference equations.
Chronic obstructive pulmonary disease (COPD) is suspected if the ratio between forced expired volume in 1 s (FEV(1)) and forced vital capacity is below 0.7 after bronchodilatation, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). As this ratio varies with age and gender, the lower limit of normality (LLN) of appropriate reference equations appears more adequate. ⋯ The GOLD criterion is inadequate because of substantial overestimation in 60-year-old never-smokers. LLNs of the various reference equations are unreliable because of obvious lack of consistency. Spirometric criteria for airway obstruction, and suspicion of COPD, therefore need to be revised.
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Quantifying the prevalence of asthma, chronic obstructive pulmonary disease (COPD) and restrictive pulmonary diseases in Norway is needed to document the burden of chronic respiratory inflammatory diseases on disability, health care costs and impaired quality of life. To introduce effective interventions for prevention, cure and care, there is a prerequisite to know the environmental causes. Furthermore, using relevant and precise phenotypes from community-based studies are important for detecting molecular-genetic causes for diseases. ⋯ Great challenges for future population-based studies are (i) to keep the participation rates high in community studies; (ii) to standardise the basic clinical-epidemiological methods over decades of follow-up and to systematically transfer these methods into new populations with different languages and cultures and (iii) to focus on important research questions on respiratory health for the community.