Airwave oscillometry and patient reported outcomes in persistent asthma

Airwave oscillometry (AOS: Tremoflo, Thorasys, Montreal) is a modern forced oscillation technique (FOT) using a vibrating mesh to superimpose forced oscillations of sound waves on top of normal tidal breathing to measure respiratory impedance as lung resistance (R) and reactance (X), whereas the older impulse oscillometry (IOS: Jaeger Masterscreen, Carefusion Hoechberg, Germany) uses a loudspeaker source. Airwave oscillometry measurements strongly correlate with IOS1,2 and quantify the degree of small airways dysfunction (SAD) as either peripheral airway resistance in terms of heterogeneity (AOS: R5-R19; IOS: R5-R20) or peripheral reactance (ie, compliance) as area under the reactance curve (AX).<br/

Low-Grade B Cell Lymphoproliferative Disorder Masquerading as Chronic Rhinosinusitis

Chronic rhinosinusitis (CRS) is one of the most common persistent disorders of the developed world, requiring input from various specialists including primary care physicians, otolaryngologists, respiratory physicians, and allergologists. B-cell lymphoproliferative disorders (BLPDs) are a heterogenous group of malignant conditions defined by an accumulation of mature B lymphocytes in the bone marrow, blood, and lymphoid tissues. We present a case report of an elderly man with rhinosinusitis-like symptoms and atypical features prompting further investigations that culminated in a diagnosis of BLPD

A retrospective cohort study to evaluate the relationship of airway hyperresponsiveness to type 2 biomarkers in persistent asthma

Airway hyperresponsiveness (AHR) is a hallmark of persistent asthma measured using direct or indirect airway bronchial challenge testing. The purpose of this study is to investigate the putative relationships between type 2 inflammatory biomarkers, airway geometry (FEV1 and FEF25-75) and specific IgE (RAST or skin prick) to AHR. We performed a retrospective analysis of our database (n = 131) of patients with asthma. Of these subjects, 75 had a histamine challenge and 56 had a mannitol challenge. Fractional exhaled nitric oxide (FeNO) and specific immunoglobulin E (IgE) but not blood eosinophils were significantly higher in patients with AHR to either histamine or mannitol. FEV1 % and FEF25 - 75 % were significantly lower in patients with AHR. Elevated Type 2 biomarkers including FeNO and specific IgE but not blood eosinophils were associated with AHR. Highlights: FeNO and specific IgE but not blood eosinophils are raised in patients with airway hyperresponsiveness