The Differences of Interstitial Lung Diseases in High-Resolution Computerized Tomography and Pulmonary Function Test among Different Connective Tissue Diseases, and the Correlated Factors

Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.

Preoperative Exercise Testing Is a Better Predictor of Postoperative Complications than Pulmonary Function Testing for Patients with Lung Cancer

Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.

Clinical Significance of Pulmonary Function Tests in Long-Term Survivors after Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58;score 1, n = 14;score 2, n = 6;score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.

Occupational Health Surveillance: Pulmonary Function Test in Proppant Exposures

Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. 100 male workers from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected from the Third National Health and Nutrition Examination Survey (NHANES III) spirometry laboratory subset. No pulmonary function deficits were found in the worker group in comparison to the NHANES III population. Mean FEV1 and FVC values in workers were 3.8 and 4.8 liters respectively, and were greater as compared to the NHANES III population of similar demographics. An FEV1/FVC ratio of less than 0.8, when compared to the NHANES III group, produced an odds ratio of 0.44 in worker group, indicating less risk of preclinical pulmonary dysfunction. Overall, exposure to ceramic proppant was not found to produce an adverse impact on pulmonary function in workers engaged in the manufacture of ceramic proppant.

Respiratory Tract, Ventilation, and Pulmonary Functions Tests

Breathing is considered the common factor that links studying,sleeping,and activities.It is one of the primary indicators that is frequently considered when determining whether or not an unconscious individual is still alive.The evolution and development process of the respiratory system that occurs in a foetus is primarily from head to tail(cephalocaudal).Many changes occur throughout this period until the 28th week of pregnancy at which the foetus^respiratory system will attain adequate development for the rest of his or her life.The respiratory system comprises of the lungs and the encompassing thoracic wall,which includes the thoracic cages,midriff(diaphragm),and the abdominal wall.Spirometry is a procedure used for estimating air volumes that enter and exit the pulmonary system with the aid of a spirometer.The various pulmonary parameters that reflect pulmonary ventilation are of great significance in diagnosing respiratory diseases.The respiratory system will be discussed in more detail in this article.

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique(FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in preschool children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyperresponsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.

Effects of left ventricular assist device on pulmonary functions and pulmonary hemodynamics:A meta-analysis

BACKGROUND Given current evidence,the effect of left ventricular assist device(LVAD)implantation on pulmonary function tests remains controversial.AIM To better understand the factors contributing to the changes seen on pulmonary function testing and the correlation with pulmonary hemodynamics after LVAD implantation.METHODS Electronic databases were queried to identify relevant articles.The summary effect size was estimated as a difference of overall means and standard deviation on a random-effects model.RESULTS A total of four studies comprising 219 patients were included.The overall mean forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and diffusion lung capacity of carbon monoxide(DLCO)after LVAD implantation were significantly lower by 0.23 L(95%CI:0.11-0.34,P=00002),0.18 L(95%CI:0.03-0.34,P=0.02),and 3.16 mmol/min(95%CI:2.17-4.14,P<0.00001),respectively.The net post-LVAD mean value of the cardiac index was significantly higher by 0.49 L/min/m2(95%CI:0.31-0.66,P<0.00001)compared to pre-LVAD value.The pulmonary capillary wedge pressure and pulmonary vascular resistance were significantly reduced after LVAD implantation by 8.56 mmHg(95%CI:3.78-13.35,P=0.0004),and 0.83 Woods U(95%CI:0.11-1.55,P=0.02),respectively.There was no significant difference observed in the right atrial pressure after LVAD implantation(0.61 mmHg,95%CI:-2.00 to 3.32,P=0.65).Overall findings appear to be driven by studies using HeartMateII devices.CONCLUSION LVAD implantation might be associated with a significant reduction of the spirometric measures,including FEV1,FVC,and DLCO,and an overall improvement of pulmonary hemodynamics.

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Background: The combination of the clinical features, HRCT score and echocardiographic evidence of pulmonary hypertension help assess the prognosis in bronchiectasis. Aim: To test whether pulmonary and cardiac functions associated with bronchiectasis would differ according to its type (cystic versus cylindrical) utilizing HRCT score, PFTs and echocardiography. Patients and Methods: A cross-sectional study of patients with bronchiectasis was conducted at Chest and Internal Medicine Departments at Assiut University Hospital, Egypt. The diagnosis of bronchiectasis type was based on HRCT findings. PFTs, HRCT score and echocardiography were assessed in all cases. Results: We studied 56 patients with bronchiectasis;31 were cystic (group A) and 25 were cylindrical (group B). Forced vital capacity (FVC%) and Dlco% were significantly lower in group A (P as compared with group B;whereas FEF 25%-75% and FEV1 (0.04) were lower in group B. Global HRCT score, RVD and SPAP were significantly higher in group A (P = 0.002) and correlated with FEV1% (r = ?0.51), and with SPAP (r = 0.16). Conclusions: Airway obstruction and small airway dysfunction were more significantly seen in cylindrical bronchiectasis. Patients with cystic bronchiectasis had significantly, higher global HRCT scores, RVD and SPAP. HRCT scores correlate with FEV 1% and SPAP and could be a predictor of future PH. Routine echocardiographic assessment of patients with bronchiectasis, particularly in those with cystic disease is highly recommended.

Immediate effect of fomentation on pulmonary function in patient with bronchial asthma:a case series

Background:Asthma is a major non-communicable disease affecting both children and adult populations,characterized by inflammation and narrowing of airways.Hydrotherapy is a naturopathy treatment modality effectively used to manage bronchial asthma.This case series presents the immediate effect of one such hydrotherapy treatment hot fomentation on pulmonary function in bronchial asthma.Case presentation:Three women who had chief complaints of wheezing,sneeze and breathlessness due to chronic bronchial asthma.Hot fomentation over the inter-scapular region was given to the patient for a duration of 20 minutes.Pulmonary function test was performed using Recorders&Medicine Systems Pvt Ltd.Helios 401 before and immediately after the intervention to assess the efficacy of hot fomentation.Result:When compared to baseline,the pulmonary function’s parameters,such as forced vital capacity,forced expiratory volume in the first second,forced expiratory volume in the first second/forced vital capacity ratio,forced expiratory flow(25–75%)and peak expiratory flow showed significant improvement immediately after the fomentation.Conclusion:After 20 minutes of hot fomentation,significant improvement in pulmonary function was observed.Hot fomentation over the interscapular region,could thus be used to improve clinical outcomes in the management of bronchial asthma by improving pulmonary function and relieving acute symptoms.

慢性阻塞性肺疾病MSCT肺测量与PFT检查的对比研究

目的探讨慢性阻塞性肺疾病(COPD)患者多排螺旋CT(MSCT)肺测量指标与肺功能检查(PFT)指标的相关性。方法选择2015年6月至2016年3月因COPD入成都医学院第一附属医院治疗,且同时行MSCT和PFT检查CT容积重建成功的患者共70例;双肺各选择上、中、下3个层面点值法测量肺CT值,再利用后处理软件分析全肺容积及肺气肿率,行肺CT值、肺容积、肺气肿率与PFT检查结果的相关性。结果双肺上、中、下3个层面肺CT值与FEV1%具有较强的相关性(P<0.05),右侧、左中层面CT值与RV/TLC弱相关(P<0.05),全肺平均CT值与FEV1%、FEV1/FVC和RV/TLC具有较强的相关性(P<0.05)。CT测量肺总容积与TLC、MVC、RV和RV/TLC弱相关(P<0.05)。CT测量肺气肿率与PFT各指标均有相关性(P<0.05),其中,与RV/TLC、FEV1%的相关性较强(rs>0.5)。结论 MSCT肺部扫描CT值、肺容积及肺气肿率等测量值与PFT部分指标具有相关性,具有辅助评估COPD患者肺通气功能的应用价值。

支气管哮喘儿童IOS指标与PFT指标的变化及相关性分析

目的探讨支气管哮喘儿童脉冲振荡肺功能检查(IOS)指标与常规肺功能检查(PFT)指标的变化及其相关性。方法回顾性分析2020年1月至2021年3月东莞市人民医院收治的100例支气管哮喘患儿的临床资料,根据患儿病情不同分为急性发作期21例、慢性持续期54例和临床缓解期25例。比较三组患儿的IOS指标[呼吸总阻抗(Zrs)、呼吸道总阻力(R_(5))、中心呼吸道阻力(R_(20))、周边呼吸道阻力(R_(5)~R_(20))、周边弹性阻力(X_(5))、响应频率(Fres)]以及PFT指标[第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、呼气峰值流量(PEF)、用力呼出25%、50%、75%肺活量时的瞬间呼气流量(PEF_(25)、PEF_(50)、PEF_(75))及最大呼气中期流量(MMEF)],并采用Pearson相关性分析法分析IOS指标和PFT指标的相关性。结果急性发作期患儿Zrs、R_(5)、R_(20)、R_(5)~R_(20)、X_(5)、Fres分别为(1.33±0.19)kPa/(L·s)、(126.82±20.51)%pred、(98.67±9.10)%pred、(198.75±25.17)%pred、(143.03±17.86)%pred、(18.76±2.10)Hz,明显高于慢性持续期患儿的(1.17±0.16)kPa/(L·s)、(84.19±15.66)%pred、(83.32±7.69)%pred、(109.24±16.53)%pred、(79.23±10.14)%pred、(12.05±1.73)Hz和临床缓解期患儿的(0.92±0.14)kPa/(L·s)、(72.53±10.74)%pred、(73.00±7.15)%pred、(85.81±10.62)%pred、(45.96±6.92)%pred、(8.42±1.61)Hz,且慢性持续期患儿上述指标均明显高于临床缓解期,差异均有统计学意义(P<0.05);急性发作期患儿FEV1、FEV1/FVC、PEF、PEF_(25)、PEF_(50)、PEF_(75)、MMEF分别为(1.28±0.13)L、(76.50±4.86)%、(2.40±0.36)L/s、(1.98±0.16)L/s、(1.05±0.14)L/s、(0.50±0.06)L/s、(0.96±0.08)L/s,明显低于慢性持续期患儿的(1.43±0.15)L、(85.61±6.77)%、(3.51±0.44)L/s、(2.57±0.26)L/s、(1.63±0.17)L/s、(0.78±0.10)L/s、(1.28±0.13)L/s和临床缓解期患儿的(1.57±0.16)L、(93.15±5.48)%、(4.60±0.53)L/s、(3.69±0.40)L/s、(2.50±0.23)L/s、(1.06±0.12)L/s、(1.52±0.18)L/s,且慢性持续期患儿上述指标均明显低于临床缓解期患儿,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,IOS与PFT各项指标均呈负相关(P<0.05)。结论支气管哮喘患儿IOS指标与PFT指标之间具有明显的负相关,IOS对临床诊断更有意义,临床应用价值高。

Portable spirometer-based pulmonary function test willingness in China:A nationwide cross-sectional study from the"Happy Breathing Program"

Background:Understanding willingness to undergo pulmonary function tests(PFTs)and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease(COPD).This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs.Methods:We collected data from participants in the"Happy Breathing Program"in China.Participants who did not follow physicians’recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs.We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs.We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs.Results:A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study.Out of these participants,7660(90.4%)were willing to undergo PFTs.Among those who were willing to undergo PFTs but actually did not,the main reasons for not doing so were geographical inaccessibility(n=3304,43.1%)and a lack of trust in primary healthcare institutions(n=2809,36.7%).Among the 815 participants who were unwilling to undergo PFTs,over half(n=447,54.8%)believed that they did not have health problems and would only consider PFTs when they felt unwell.In the multivariable regression,individuals who were≤54 years old,residing in rural townships,with a secondary educational level,with medical reimbursement,still working,with occupational exposure to dust,and aware of the abbreviation"COPD"were more willing to undergo PFTs.Conclusions:Willingness to undergo PFTs was high among high-risk populations.Policymakers may consider implementing strategies such as providing financial incentives,promoting education,and establishing community-based programs to enhance the utilization of PFTs.

Pulmonary involvement in inflammatory bowel disease

AIM:To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease(IBD).METHODS:Thirty ulcerative colitis(UC)and nine Crohn's disease patients,and 20 control subjects were enrolled in this prospective study.Detailed clinical information was obtained.Extent and activity of the bowel disease were established endoscopically.Each patient underwent pulmonary function tests and high-resolution computed tomography(HRCT).Blood samples for measurement of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),angiotensin converting enzyme and total IgE were delivered by the patients.RESULTS:Ten(25.6%)patients had respiratory symptoms.A pulmonary function abnormality was present in 22 of 39 patients.Among all patients,the most prevalent abnormalities in lung functions were a decrease in forced expiratory volume in 1 s(FEV1),FEV1/forced vital capacity(FVC),forced expiratory flow(FEF)25%-75%,transfer coefficient for carbon monoxide(DLCO),DLCO/alveolar volume.Increased respiratory symptoms score was associated with high endoscopic activity index in UC patients.Endoscopic and clinical activities in UC patients were correlated with FEV1,FEV1/FVC,and FEF 25%-75%.Smoking status,duration of disease and medication were not correlated with pulmonary physiological test results,HRCT abnormalities,clinical/endoscopic disease activity,CRP,ESR or total IgE level or body mass index.CONCLUSION:It is important that respiratory manifestations are recognized and treated early in IBD.Otherwise,they can lead to destructive and irreversible changes in the airway wall.

Effects of neoadjuvant chemotherapy on respiratory function in patients with breast cancer

Objective: To evaluate changes in chest X-rays, pulmonary function tests(PFTs) and quality of life in female breast cancer patients who had been treated with four cycles of neoadjuvant chemotherapy consisting of a regimen of cyclophosphamide, epirubicin and 5-fluorouracil(CEF regimen), and to determine the correlation between pulmonary function parameters and declined quality of life.Methods: Twenty-nine eligible female patients diagnosed with breast cancer at the first visit who were 20-60 years old, were classified as the American Society of Anesthesiologists(ASA) Ⅰ-Ⅱ and patients whose body mass index(BMI) <30 kg/m^2 were recruited and subjected to chest X-ray examinations, PFTs and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30(EORTC QLQ-C30)questionnaire before and after receiving 4 cycles of the CEF regimen.Results: In this study, chest X-rays showed no abnormal changes after chemotherapy, but significant decreases in carbon monoxide diffusing capacity(DLCO) and percentage of the DLCO predicted value(DLCO%)(P<0.001). A significant increase in maximal ventilatory volume(MVV)(P=0.004) was observed, and most patients experienced dyspnea(P=0.031) and fatigue(P<0.001). However, there was no significant correlation between the changes in these PFTs parameters and the results of the EORTC QLQ-C30(P>0.05).Conclusions: Neoadjuvant chemotherapy can reduce lung diffusion function and quality of life in females with breast cancer.

PFT_S在青少年特发性脊柱侧凸术前检查中的临床意义

目的 :探讨青少年特发性脊柱侧凸后路矫正融合术患者术前肺功能检查异常发生率 ,以及其与术后肺部并发症相关性。方法 :回顾性复习了 131例符合条件青少年特发性脊柱侧凸患者的病历记录和影像检查如术前、术后出现的心肺系统的症状和体征。结果 :绝大多数患者术前PFTS 正常 (73 .2 8% ) ,术前出现的呼吸系统症状和PFTS 结果异常显著相关 (P <0 .0 0 1)。 131例患者中仅 4例发生了术后肺部并发症 (发生率 3 .0 1% ) ,未行胸廓成形术的患者没发生术后肺部并发症。结论 :拟行后路矫正融合术的中度青少年特发性脊柱侧凸患者 ,术前PFTS 检查意义并不象在重度脊柱侧凸那样重要。同期行胸廓成形术 ,是术后肺部并发症的唯一风险因素。

采用HRCT、CT肺功能成像及PFT在COPD疾病诊断中价值对比

目的对比分析HRCT、CT肺功能成像及PFT用于诊断COPD疾病中的价值。方法选取本院2017年6月至2019年5月在我院确诊为COPD疾病的患者56例作为研究对象,患者均进行了RCT、CT肺功能成像及PFT检查。以PFT为参考,观察HRCT评估肺气肿分级、CT肺功能成像的阻塞性通气功能障碍分级情况。结果PFT检查检查结果显示肺气肿1级、2级、3级例数分别为5、9、8例,阻塞性通气障碍0级21例,1级10例,2级13例,3级6例,HRCT评估肺气肿1级、2级、3级例数分别为12、2、9例,HRCT与PFT的肺气肿分级间比较差异有统计学意义(P<0.05)。CT肺功能成像评估阻塞性通气障碍与PFT比较无差异(P>0.05)。COPD在中肺气肿常表现为异常的低衰减区周围围绕正常衰减的肺实质,累及到小叶中心性肺气肿时,肺小叶中心的点状或者线的密度增高影。结论HRCT诊断肺部病变有着较高的敏感性,但在评估肺气肿分级中有局限性,CT肺功能成像技术评估局部或整体的肺部功能阻塞性通气障碍评估有着较高的价值。

Could Sputum Eosinophilia Act as a Predictive Test for Diagnosis of High Risk Bakery Workers to Asthma?

Background: Occupational flour inhalation has been a culprit in the start of several pulmonary diseases such as asthma. We examined the relationship between occupational wheat flour inhalation in bakery and supermarket employees with pulmonary functions, respiratory symptoms, and sputum eosinophilia to determine hyper-responsiveness in a cross-sectional study in Iran. Methods: 122 subjects from traditional bakeries and 137 subjects from supermarket employees were enrolled in the study. Flour exposure concentrations, respiratory signs, sputum analysis, and respiratory volumes and capacities were measured based on the standard methods. Results: Respirable concentration of flour in the bakery workers was two- to four-fold of ACGIH’s threshold limit value in which bread-bakers with 2.2 mg/m3 experienced maximum exposures. The supermarket employees were not exposed to flour dust. The respiratory volumes in both bakery and supermarket employees were in the normal range. However, the median of voluminal percentage in bakery workers except Forced Vital Capacity (FVC) decreased (p p < 0.05). In addition, we observed increased respiratory symptoms in the bakery workers, again more prevalent in the bread-bakers. There was a significant correlation between flour exposure concentration and sputum eosinophilia in which the percentage of eosinophilia in the bread-bakers was more than other bakery and supermarket employees. Although there were reductions in the respiratory volumes, the results indicated no obstructive spirometric pattern. Conclusions: Sputum eosinophilia might be a suitable screening method to detect airway hyper-responsiveness in workers exposed to known asthmogens.

Effect of Impaired Lung Function on the Development and Progression of Endobronchial Premalignant Lesions

Background: Chronic obstructive pulmonary disease (COPD) and presence of endobronchial premalignant lesions (EPL) are individual risk factors for lung cancer (LC). However, effect of impaired lung function (ILF) on the natural history of EPL has not been explored. Patients and Methods: This study included 217 high-risk participants from a hospital-based LC surveillance cohort who underwent pulmonary function testing followed by bronchoscopy with endobronchial biopsies. Baseline histopathology diagnoses included 91 cases (41.9%) with squamous metaplasia (SM), 25 (11.5%) with squamous dysplasia (SD), 1 (0.5%) with in-situ carcinoma and 5 (2.3%) with invasive LC. Follow-up biopsies were obtained for 69 patients, and 16 (23.2%) patients demonstrated progression to a higher grade lesion. Regression models were used to evaluate the relationship between ILF and EPL. All the models were adjusted for age, gender and tobacco smoking. Results: Patients with FEV1% of <50% had 4.5 times greater risk of being diagnosed with an EPL [95% confidence interval: 1.93-10.80] and 8-fold greater risk of SD, compared to patients with FEV1% ≥80. COPD was associated with 2.7 and 4.8 times greater risk of SM and SD, respectively. The mean time to progression to a higher-grade lesion was shorter in COPD patients compared to patients without COPD (27 versus 50 months, p = 0.02). Conclusion: Our results indicate that ILF may be a predictor of prevalence and progression of EPLs among patients at high risk of LC. Therefore, spirometry can be a complementary pre-screening tool for identifying patients with EPL who need more intense LC surveillance.

Pulmonary Misfortune Ensuing to Petroleum Related Employments

Background: toxic gases and fumes prompted from petrol and gas stations imply their disabling and deadly risks on human lungs. Aim of Work: The aim of this work was to assess the pulmonary function derangements in petrol pump workers at Al-Medina Al-Munawara city. Patients and Methods: This cross sectional study was conducted on 189 cases out of them in control group (group I) with age and sex matched healthy adult males gathered from nonsmokers students and employees in Taibah University. The study group (group II) comprised of 89 males who were working in different petrol pump stations. History, clinical examination and pulmonary functional assessment were carried out by using portable spirometry, Co detector and puls oximeter. Results: The study’s results showoed that the lung function parameters (FEV1, FVC, PEFR, FEFR25% - 75%) were significantly reduced in petrol pump workers (Group II) as compared to the values for these parameters in subjects belonging to Group II (Control group), Similar findings were observed in previous studies on pulmonary functions in petrol-pump workers. This finding specified the restrictive nature of pulmonary involvement in the study group. Measurement of the exhaled CO was slightly higher in Group II than Group I. Conclusion: Fuel vapors and fumes in petrol stations showed direct incapacitating impact on workers pulmonary functions regarding spirometric measurements showing predominantly restrictive pattern and to less extent obstructive. Exhaled CO level was higher in addition to hypoxemia identified in these cases.

远程医疗管理在老年中重度慢性阻塞性肺疾病患者稳定期呼吸康复中的效果:一项随机对照研究

背景我国慢性阻塞性肺疾病(COPD)患者数量巨大,呼吸康复训练作为COPD患者稳定期管理的重要部分,可有效提高患者肺功能及生活质量,减少家庭及社会负担,国外有研究数据显示远程医疗管理下实施呼吸康复可提高患者的肺功能和生活质量(QOL)评分,但是国内,尤其是西部尚缺乏相关实践。目的评估通过远程医疗管理进行呼吸康复训练与传统治疗相结合对老年中重度COPD患者通气能力及肺功能的影响。方法本研究为前瞻性随机对照研究,连续性纳入2021年6月—2022年6月就诊于四川省第四人民医院及5个联合社区的COPD患者,采用随机数字表进行简单随机分组,将患者分为试验组和对照组。对照组接受传统的长期规律吸入支气管扩张剂及口服药物治疗,试验组在对照组治疗方案的基础上采用远程医疗管理。对两组患者进行为期6个月的研究,分别在基线时及干预1、3、6个月后记录患者的肺功能、博格评分(Borg评分)、6 min步行试验(6MWT)、QOL评分。结果研究对象分为对照组(72例)和试验组(73例),两组患者的性别、年龄及基线时肺功能[第1秒用力呼气末容积占预计值百分比(FEV_(1)%pred)及第1秒用力呼气末容积与用力肺活量(FVC)的比值(FEV_(1)/FVC)]比较,差异均无统计学意义(P>0.05)。时间和组间对FEV_(1)%pred、FEV_(1)/FVC、6MWT水平、QOL评分中呼吸困难、情绪存在交互作用(P<0.05)。干预1、3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于对照组(P<0.05);干预3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于干预后1个月时(P<0.05)。结论采用远程医疗管理对老年中重度COPD稳定期患者进行呼吸康复,干预3、6个月后能有效改善该类患者肺功能,提高生活质量及生存质量。