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European Respiratory Society (european + respiratory_society)

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Medical Sciences	100%

Selected Abstracts

American Thoracic Society/European Respiratory Society 2005 standardization of DLCO measurement: Impact on performance

RESPIROLOGY, Issue 5 2008
Simon Kwok Fai LEUNG
Background and objective: An updated standardization statement on measurement of DLCO was issued by the American Thoracic Society (ATS)/European Respiratory Society (ERS) Task Force in 2005. The aim of this study was to evaluate the effects of new recommendations on the success rate, test efficiency, measurement variability and reported results of DLCO testing. Methods: We prospectively evaluated 55 Chinese patients without previous experience of the DLCO test in 2006. Performance and results of the test according to the ATS 1995 and ATS/ERS 2005 acceptability criteria were compared. Results: Using the 2005 criteria, the success rate (maximum four trials) improved from 65% to 85% (change: 20%, 95% CI: 9,31%; P = 0.001). The test efficiency as measured by two-trial and three-trial success rates increased from 25% and 51% to 60% and 78%, respectively (both P < 0.0005). The measurement variability was defined as the mean of absolute differences between two acceptable trial results of DLCO for each patient. The means (SD) were 0.60 (0.53) and 0.53 (0.57) mL/min/mm Hg for the old and new criteria, respectively (P = 0.623). The mean DLCO decreased slightly by 0.5%, from 14.93 ± 5.74 (SD) (old criteria) to 14.86 ± 5.75 mL/min/mm Hg (new criteria) overall, with a mean difference (SD) of ,0.07 (0.20) mL/min/mm Hg for the 36 subjects meeting both criteria (paired t -test, P = 0.048). Conclusions: Success rate and test efficiency for DLCO measurement were improved when the new recommendations were adopted. The effects on measurement variability and reported results were minimal. [source]

Spectrum of Fibrosing Diffuse Parenchymal Lung Disease

MOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 1 2009
Adam S. Morgenthau MD
Abstract The interstitial lung diseases are a heterogeneous group of disorders characterized by inflammation and/or fibrosis of the pulmonary interstitium. In 2002, the American Thoracic Society and the European Respiratory Society revised the classification of interstitial lung diseases and introduced the term diffuse parenchymal lung disease. The idiopathic interstitial pneumonias are a subtype of diffuse parenchymal lung disease. The idiopathic interstitial pneumonias are subdivided into usual interstitial pneumonia (with its clinical counterpart idiopathic interstitial pneumonia), nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, desquamative interstitial pneumonia, respiratory bronchiolitis interstitial lung disease, and lymphocytic pneumonia. Sarcoidosis and hypersensitivity pneumonitis are the 2 most common granulomatous diffuse parenchymal lung diseases. Rheumatoid arthritis, systemic sclerosis, and dermatomyositis/polymyositis (causing antisynthetase syndrome) are diffuse parenchymal lung diseases of known association because these conditions are associated with connective tissue disease. Hermansky-Pudlak syndrome is a rare genetic diffuse parenchymal lung disease characterized by the clinical triad of pulmonary disease, oculocutaneous albinism, and bleeding diathesis. This review provides an overview of the chronic fibrosing diffuse parenchymal lung diseases. Its primary objective is to illuminate the clinical challenges encountered by clinicians who manage the diffuse parenchymal lung diseases regularly and to offer potential solutions to those challenges. Treatment for the diffuse parenchymal lung diseases is limited, and for many patients with end-stage disease, lung transplantation remains the best option. Although much has been learned about the diffuse parenchymal lung diseases during the past decade, research in these diseases is urgently needed. Mt Sinai J Med 76:2,23, © 2009 Mount Sinai School of Medicine [source]

Current and future use of the mannitol bronchial challenge in everyday clinical practice

THE CLINICAL RESPIRATORY JOURNAL, Issue 4 2009
Celeste Porsbjerg
Abstract Objectives:, Asthma is a disease associated with inflammation, airway hyperresponsiveness (AHR) and airflow limitation. Clinical diagnosis and management of asthma often relies on assessment of lung function and symptom control, but these factors do not always correlate well with underlying inflammation. Bronchial challenge tests (BCTs) assess AHR, and can be used to assist in the diagnosis and management of asthma. Data Source:, Data presented at the symposium ,Use of inhaled mannitol for assessing airways disease' organised by the Allied Respiratory Professionals Assembly (9) of the European Respiratory Society (ERS) at the ERS Congress, Berlin 2008. Results:, Indirect challenge tests such as exercise testing, hypertonic saline or adenosine 5,-monophosphate (AMP) are more specific though less sensitive than direct challenge tests (such as methacholine) for identifying patients with active asthma. Indirect BCTs may be used to diagnose exercise-induced bronchoconstriction or AHR consistent with active asthma, to evaluate AHR that will respond to treatment with anti-inflammatory drugs and to determine the effectiveness and optimal dosing of such therapy. An ideal indirect challenge test should be standardised and reproducible, and the test result should correlate with the degree of airway inflammation. The mannitol BCT provides a standardised and rapid point-of-need test to identify currently active asthma, and is clinically useful in the identification of patients with asthma who are likely to benefit from inhaled corticosteroid therapy. Conclusion:, In the future, mannitol BCT may be added to lung function and symptom assessment to aid in the everyday management of asthma. Please cite this paper as: Porsbjerg C, Backer V, Joos G, Kerstjens HAM and Rodriguez-Roisin R. Current and future use of the mannitol bronchial challenge in everyday clinical practice. The Clinical Respiratory Journal 2009; 3: 189,197. [source]

Association among lung function, exhaled nitric oxide, and the CAN questionnaire to assess asthma control in children,

PEDIATRIC PULMONOLOGY, Issue 5 2010
O. Sardón-Prado MD
Abstract Background The aim of this study was to investigate the association among a validated symptom-based questionnaire for asthma control in children (CAN), forced expiratory volume in 1,sec (FEV1), and fractional exhaled nitric oxide (FENO). Methods Observational cross-sectional study was performed in a consecutive sample of asthmatic children aged between 7 and 14 years old from December 2007 to February 2008. FENO was measured with a portable electrochemical analyzer and forced spirometry was performed according to American Thoracic Society/European Respiratory Society. The CAN questionnaire was completed by the parents (aged <9 years old) or by the children (,9 years old). The strength of the association among FEV1, FENO, and CAN questionnaire was studied using Spearman's rho, and the degree of agreement for asthma control among FEV1, FENO, and CAN questionnaire, with classification of these variables according to values of normality, was studied using Pearson's ,2 test and Cohen's kappa (KC). Results We studied 268 children, mean age 9.7,±,2.1 years. Significant correlations were found between FENO and CAN (r,=,0.2), between FEV1 and CAN (r,=,,0.3), and between FENO and FEV1 (r,=,,0.12). On classifying the variables according to values of normality, no agreement was found to establish the degree of asthma control between FENO and CAN (KC,=,0.18, ,2 Pearson,=,9.63); between FEV1 and CAN (KC,=,0.29, ,2,=,38.5); or between FENO and FEV1 (KC,=,0.07, ,2,=,4.9). Conclusions The association among the three measurement instruments used to assess asthma control (FEV1, FENO, and CAN) was weak. These are instruments that quantify variables that influence asthma in different ways, in this sense, none can be used instead of another in asthma management although they are complementary. Pediatr Pulmonol. 2010; 45:434,439. © 2010 Wiley-Liss, Inc. [source]