120 research outputs found
Validation of lung densitometry threshold at CT for the distinction between senile lung and emphysema in elderly subjects.
The impact of age on prevalence of positive skin prick tests and specific IgE tests
SummaryAging is associated with modifications of the immune system, defined as immunosenescence. This could contribute to a reduced prevalence of allergic disease in the elderly population. In this regard, atopy has rarely been considered in the clinical assessment of the geriatric respiratory patient. This article is a review of the available literature assessing the impact of age on atopy. In the majority of papers, we found a lower prevalence of atopy in the most advanced ages, both in healthy subjects and in individuals affected by allergic respiratory diseases. Unfortunately, no large, longitudinal studies performed in the general population have been conducted to further explore this observation. Although available data seem to favor the decline of allergen sensitization with age, the prevalence of allergic sensitizations in the elderly population with respiratory symptoms is substantial enough to warrant evaluation of the atopic condition. From a clinical perspective, allergic reactions in older adults can have the same or even worse manifestations compared to young people. For this reasons, the evaluation of the atopic condition also in the geriatric patient is recommended. Thus, the role of atopy as it pertains to the diagnosis, therapy (adoption of preventive measure such as removal of environmental allergen or immunotherapy), and prognosis (influence on morbidity and mortality) of chronic respiratory illnesses in the elderly is addressed
Valutazione della risposta bronchiale ai respiri profondi mediante HRCT nell’asma e nella BPCO
HRCT evaluation of bronchial response to deep inspiration in asthma and chronic obstructive pulmonary disease (COPD)
Do GOLD stages of COPD severity really correspond to differences in health status?
The purpose of this study was to assess whether different stages of chronic obstructive pulmonary disease (COPD) severity defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria correlate with meaningful differences in health status. A total of 381 COPD patients, aged 73+/-6 yrs, were classified in the five GOLD stages. Disease-specific (St George Respiratory Questionnaire (SGRQ)) and generic indexes of health status were measured in all patients. Multivariate analysis of covariance or Kruskal Wallis tests were used to compare health status indexes across the spectrum of GOLD stages of COPD severity. GOLD stages of COPD severity significantly differed in SGRQ components and Barthel's index, but not in the indexes assessing cognitive and affective status and quality of sleep. The largest variation in health status was observed at the transition from stage IIa to stage IIb, while there were no other significant differences between consecutive stages. Both female sex and comorbidity were associated with a greater impact of COPD on the health status. In conclusion, the upper limit of stage IIb (forced expiratory volume in one second of 49%) marks a threshold for dramatic worsening of health status. Progression of chronic obstructive pulmonary disease severity from stage 0 to stage IIa does not correspond to any meaningful difference in health status
Serum low density lipoprotein subclasses in asthma
Background: The levels of serum low-density lipoproteins (LDL) have been implicated in the
inflammatory cascade in a murine model of asthma. Recent findings suggest that LDL may
modulate the inflammatory state of the asthmatic airways in humans.
Objective: We explored whether LDL subclasses are associated with the occurrence and
severity of asthma.
Methods: 24 asthmatics (M/F: 11/13) and 24 healthy individuals, with normal BMI and absence
of metabolic syndrome, matched for age and gender. Serum concentrations of LDL subclasses
were distributed as seven bands (LDL-1 and -2 defined as large, least pro-inflammatory LDL,
and LDL-3 to 7 defined as small, most pro-inflammatory LDL), using the LipoPrintª System
(Quantimetrix Corporation, Redondo Beach, CA, USA).
Results: LDL-1 was similar in the two groups (56 ± 16% vs. 53 ± 11, p = NS), while LDL-2 was
significantly lower in asthmatics as compared to controls (35 ± 8% vs. 43 ± 10%, p = 0.0074).
LDL-3 levels were two-fold higher in the asthmatics, but the difference did not reach the statistical
significance (8± 7.3% vs. 4±3%, p=NS). Smaller subclasses LDL-4 to LDL-7 were undetectable
in controls. In asthmatics, LDL-1 was positively associated with VC% predicted (r=+0.572,
pZ0.0035) and FEV1% predicted (r=+0.492, p=+.0146). LDL-3 was inversely correlated with
both VC% predicted (r =-0.535, p =0.0071) and FEV1% predicted (r =-0.465, p = 0.0222).
Conclusions: The findings of this pilot study suggest a role of LDL in asthma, and advocate for
larger studies to confirm the association between asthma and dyslipidemia
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