The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Anatomical pharyngeal and craniofacial abnormalities have been reported using upper airway imaging in snorers with or without obstructive sleep apnoea (OSA). However, the influences of the age and weight of the patient on these abnormalities remain to be established. The aim of this study was, therefore, to evaluate in a large population of snorers with or without OSA, the relationship between body mass index (BMI), age and upper airway morphology. ⋯ In conclusion, in lean or young subjects, upper airway abnormalities explain a major part of the variance in apnoea/hypopnoea index and are likely to play an important physiopathogenic role. This study also suggests that the shape of the pharyngeal lumen in awake subjects is more dependent on body mass index than on the presence of obstructive sleep apnoea. Further investigation looking at upper airway imaging for surgical selection in obstructive sleep apnoea should focus on lean and young patients.
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In this study we aimed to assess whether the association between asthma (defined by symptoms and bronchial responsiveness) and total immunoglobulin E (IgE) levels was independent of specific IgE levels to common aeroallergens. A general population-based sample, supplemented with symptomatic individuals, comprising 1,916 young adults, aged 20-44 years, from five areas of Spain, performed a face-to-face respiratory questionnaire, and spirometry, and had total and specific serum IgE levels to mites, pets and moulds recorded. In 1,626 of the subjects, a dose-response methacholine challenge test was completed. ⋯ The association between total IgE and asthma also occurred among those with negative specific IgE antibodies (OR 18.0; 95% CI 13.9-120). Individuals with current wheezing and bronchial responsiveness without attacks of asthma also showed an adjusted association with total IgE (OR 4.96; 95% CI 2.32-10.6), which remained for persons without specific IgE (OR 5.86; 95% CI 2.18-1.7). These findings reinforce previous evidence that asthma is associated with increased levels of total IgE, even in subjects negative for specific IgE to common aeroallergens.
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Lung volume reduction surgery (LVRS) in patients with severe lung emphysema restores the thoracic configuration to a more normal functional capacity. The aim of this study was to investigate whether reduction in intrathoracic volume by LVRS improves the inspiratory muscle force generation of the respiratory pump. Pulmonary function tests, maximal inspiratory mouth pressure (MIP), sniff nasal inspiratory pressure (SNIP), sniff transdiaphragmatic pressure (Pdi), and inspiratory mouth occlusion pressure (P0.1) were measured in 17 emphysematous patients (mean (+/- SEM) age 53 +/- 2 yrs) before and 1 month after LVRS. ⋯ P0.1 decreased on average by 24% from 0.46 +/- 0.03 to 0.35 +/- 0.02 kPa after LVRS. No significant correlations were found between inspiratory muscle (MIP, SNIP, Pdi) and respiratory drive (P0.1) indices, lung function data, 6 min walk distance, or dyspnoea score. In conclusion, the observed clinical improvement of patients with severe emphysema after lung volume reduction surgery results, in part, from an increased ability of the inspiratory muscles to generate force, which is paralleled by a significant decrease in central respiratory drive.