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FEV1 Decline (fev1 + decline)
Selected AbstractsLessons learned from a randomized trial of airway secretion clearance techniques in cystic fibrosis,PEDIATRIC PULMONOLOGY, Issue 3 2010Marci K. Sontag PhD Abstract Rationale Airway secretion clearance therapies are a cornerstone of cystic fibrosis care, however longitudinal comparative studies are rare. Our objectives were to compare three therapies [postural drainage and percussion: (postural drainage), flutter device (FD), and high frequency chest wall oscillation: (vest)], by studying (1) change in pulmonary function; (2) time to need for intravenous (IV) antibiotics, (3) use of pulmonary therapies, (4) adherence to treatment, (5) treatment satisfaction, and (6) quality of life. Methods Participants were randomly assigned to one of three therapies twice daily. Clinical outcomes were assessed quarterly over 3 years. Results Enrollment goals were not met, and withdrawal rates were high, especially in postural drainage (51%) and FD (26%), compared to vest (9%), resulting in early termination. FEV1 decline, time to need IV antibiotics, and other pulmonary therapies were not different. The annual FEF25,75% predicted rate of decline was greater in those using vest (P,=,0.02). Adherence was not significantly different (P,=,0.09). Overall treatment satisfaction was higher in vest and FD than in postural drainage (P,<,0.05). Health-related quality of life was not different. The rate of FEV1 decline was 1.23% predicted/year. Conclusions The study was ended early due to dropout and smaller than expected decline in FEV1. Patients were more satisfied with vest and FD. The longitudinal decline in FEF25,75% was faster in vest; we found no other difference in lung function decline, taken together this warrants further study. The slow decline in FEV1 illustrates the difficulty with FEV1 decline as a clinical trial outcome. Pediatr Pulmonol. 2010; 45:291,300. © 2010 Wiley-Liss, Inc. [source] Excessive longitudinal FEV1 decline and risks to future health: A case,control study,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Mei Lin Wang MD Abstract Background Accelerated loss of forced expiratory volume in 1,s (FEV1) in an individual is considered an indicator of developing lung disease. Methods We investigated longitudinal FEV1 slopes, calculated by simple linear regression, and adverse health outcomes after 10,30 years, among 1,428 chemical plant workers. Cases were defined by FEV1 slopes below 5th percentile values for the cohort. Cases were matched with controls (107 pairs) for race, gender, smoking status, year of birth, age, height, and calendar year at first test. Matched pair statistics were used for comparisons. Results Cases had a higher proportion, compared to controls, of diagnosis of COPD or emphysema (17.8% vs. 1.9%, P,=,0.0002), medication use for respiratory diseases (24.3% vs. 4.7%, P,<,0.0001), dyspnea (15% vs. 3.7%, P,=,0.0042), and wheezing or rhonchi on examination (10.3% vs. 1.9%, P,=,0.0225). Conclusions Chemical plant workers who experienced accelerated FEV1 declines experienced four to nine times as many adverse health conditions over 10,30 years. Am. J. Ind. Med. 52:909,915, 2009. © 2009 Wiley-Liss, Inc. [source] Interpreting longitudinal spirometry: Weight gain and other factors affecting the recognition of excessive FEV1 decline,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2009Mei Lin Wang MD Abstract Background Excessive FEV1 loss in an individual or a group can reflect hazardous exposures and development of lung disease. However, multiple factors may affect FEV1 measurements. Methods Using medical screening data collected in 1884 chemical plant workers between 1973 and 2003, the influence of multiple factors on repeated measurements of FEV1 was examined. Results The FEV1 level was associated with age, height, race, sex, cigarette smoking, changes in body weight, and spirometer model. After controlling for these factors, longitudinal FEV1 decline averaged 23.8,ml/year for white males; an additional loss of 8.3,ml was associated with one pack-year smoking and 5.4,ml with a one pound weight gain. Depending on the spirometer model, FEV1 differed by up to 95,ml. Conclusions The study results provide quantitative estimates of the effect of specific factors on FEV1, and should be useful to health professionals in the evaluation of accelerated lung function declines. Am. J. Ind. Med. 52:782,789, 2009. © 2009 Wiley-Liss, Inc. [source] Excessive longitudinal FEV1 decline and risks to future health: A case,control study,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Mei Lin Wang MD Abstract Background Accelerated loss of forced expiratory volume in 1,s (FEV1) in an individual is considered an indicator of developing lung disease. Methods We investigated longitudinal FEV1 slopes, calculated by simple linear regression, and adverse health outcomes after 10,30 years, among 1,428 chemical plant workers. Cases were defined by FEV1 slopes below 5th percentile values for the cohort. Cases were matched with controls (107 pairs) for race, gender, smoking status, year of birth, age, height, and calendar year at first test. Matched pair statistics were used for comparisons. Results Cases had a higher proportion, compared to controls, of diagnosis of COPD or emphysema (17.8% vs. 1.9%, P,=,0.0002), medication use for respiratory diseases (24.3% vs. 4.7%, P,<,0.0001), dyspnea (15% vs. 3.7%, P,=,0.0042), and wheezing or rhonchi on examination (10.3% vs. 1.9%, P,=,0.0225). Conclusions Chemical plant workers who experienced accelerated FEV1 declines experienced four to nine times as many adverse health conditions over 10,30 years. Am. J. Ind. Med. 52:909,915, 2009. © 2009 Wiley-Liss, Inc. [source] | ||||||||||