A novel spirometric measure identifies mild COPD unidentified by standard criteria

BACKGROUND: In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometric ratios, including the ratio of forced expiratory volume in 3 and 6 seconds (FEV3/FEV6), and small airways measures and gas trapping at quantitative chest CT scanning, and clinical outcomes in the Genetic Epidemiology of COPD (COPDGene) cohort. METHODS: Seven thousand eight hundred fifty-three current and ex-smokers were evaluated for airflow obstruction by using recently defined linear iteratively derived equations of Hansen et al to determine lower limit of normal (LLN) equations for prebronchodilator FEV1/FVC, FEV1/FEV6, FEV3/FEV6, and FEV3/FVC. General linear and ordinal regression models were applied to the relationship between prebronchodilator spirometric and radiologic and clinical data. RESULTS: Of the 10,311 participants included in the COPDGene phase I study, participants with incomplete quantitative CT scanning or relevant spirometric data were excluded, resulting in 7,853 participants in the present study. Of 4,386 participants with FEV1/FVC greater than or equal to the LLN, 15.4% had abnormal FEV3/FEV6. Compared with normal FEV3/FEV6 and FEV1/FVC, abnormal FEV3/FEV6 was associated with significantly greater gas trapping; St. George's Respiratory Questionnaire score; modified Medical Research Council dyspnea score; and BMI, airflow obstruction, dyspnea, and exercise index and with shorter 6-min walking distance (all P < .0001) but not with CT scanning evidence of emphysema. CONCLUSIONS: Current and ex-smokers with prebronchodilator FEV3/FEV6 less than the LLN as the sole abnormality identifies a distinct population with evidence of small airways disease in quantitative CT scanning, impaired indexes of physical function and quality of life otherwise deemed normal by using the current spirometric definition.United States Department of Health & Human Services - R01 HL 08 9856 - R01 HL 08 9897National Institutes of Health (NIH) - USA - 1KL2TR001419NIH National Heart Lung & Blood Institute (NHLBI) - UL1TR001417 - KL2TR001419 - UL1TR001881NIH National Center for Advancing Translational Sciences (NCATS) - U01HL089897 - U01HL089856 - R01HL124233 - R01HL089856 - R01HL08989

Laparoscopic Sleeve Gastrectomy Improves Excessive Daytime Sleepiness and Sleep Quality 6 Months Following Surgery: A Prospective Cohort Study

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s12325-016-0323-8">https://link.springer.com/article/10.1007/s12325-016-0323-8</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Turkish Thoracic Society Consensus Report: Interpretation of Spirometry

Currently, the criteria for applying and evaluating spirometer measurements have been defined by American and European Respiratory Societies. Several pulmonary function test laboratories in Turkey as well as in the world use these standards. However, different interpretation results are observed in different pulmonary function test laboratories. This report is prepared to provide a basis for a standardized asssessment in our pulmonary function test in our country

Turkish Thoracic Society national spirometry and laboratory standards

The application quality of pulmonary function tests (PFT) carries high importance since it affects the quality of health services. "Chronic Diseases and Risk Factors in Turkey Study," which was published in 2013 showed that only 22.6% of PFTs performed in the secondary care institutions in our country were compatible with the standards. This finding reveals the standardization problem in spirometry applications in our country. Currently, the criteria for the application and evaluation of spirometer measurements were defined by American and European Respiratory Societies standards. Several laboratories use these standards in our country as in the world. But, national laboratory standards that are suitable for the conditions in our country have not been defined yet. This report was prepared to ensure the application of spirometry in optimal conditions, to minimize intra-laboratory and inter-laboratory differences and mistakes, and to standardize in our country. In this report, we focused on the standards concerning laboratory conditions, equipment, and technician specifications, test application, evaluation of test quality, infection control, and reference values

Birt-Hogg-Dube Syndrome: Diagnostic Journey of Three Cases from Skin to Gene

Birt-Hogg-Dube syndrome (BHDS) is a rare disorder characterized by the triad of cutaneous lesions, renal tumors, lung cysts and inactivation of the gene folliculin (FLCN). Here, we present three female patients diagnosed with BHDS. First case a 55-year-old female had flesh moles histopathology compatible with angiofibroma, multiple cysts in the lung and kidneys, FLCN gene mutations ('c.1285dupC [p.His429Profs*]' 11th exon and 'c.653G>A [p.Arg258His]' 7th exon). The second case a 76-year-old female had trichodiscoma on her skin, multiple cysts in the lung, spontaneous pneumothorax, FLCN gene mutation 'c.1285dupC (p.His429Profs*27) 11th exon' and, her son had renal carcinoma history under 50 years of age. Our third case, also the daughter of case 2, had dermal papules histopathology compatible with trichodiscoma, spontaneous pneumothorax, FLCN gene mutation 'c.1285dupC (p.His429Profs*27) 11th exon' and, parotid oncocytoma. Through our cases, we document the first case of two mutations ('c.1285dupC [p.His429Profs*]' 11th exon and 'c.653G>A [p.Arg258His]' 7th exon) in the same FLCN gene and the 11th known case of parotid oncocytoma associated with BHDS in the light of the literature

European Respiratory Society International Congress 2018: four shades of epidemiology and tobacco control

In this article, early career members and experienced members of the Epidemiology and Environment Assembly of the European Respiratory Society highlight and summarise a selection of six sessions from the Society&apos;s annual congress, which in 2018 was held in Paris, France. The topics covered in these sessions span from cutting-edge molecular epidemiology of lung function to clinical, occupational and environmental epidemiology of respiratory disease, and from emergent tobacco products to tobacco control