Prevalence of abnormal findings when adopting new national and international Global Lung Function Initiative reference values for spirometry in the Finnish general population

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Responses of FEV6, FVC, and FET to inhaled bronchodilator in the adult general population

<p>Abstract</p> <p>Background</p> <p>The assessment of bronchodilator-induced change in forced vital capacity (FVC) is dependent on forced expiratory time (FET) in subjects with airflow limitation. Limited information is available on the concurrent responses of FVC, forced expiratory volume in six seconds (FEV₆), and FET in the bronchodilation test among patients with obstructive airways disease or in the general population. The aim of this study was to assess the changes in FEV₆, FVC, and FET, and their relationships in a standardized bronchodilation test in the general population.</p> <p>Methods</p> <p>We studied bronchodilation response in a general adult population sample of 628 individuals (260 men, 368 women) with flow-volume spirometry. The largest FVC, the corresponding FET and the largest FEV₆both at the baseline and after 0.4 mg of inhaled salbutamol were selected for analysis.</p> <p>Results</p> <p>After administration of salbutamol FEV₆decreased on average -13.4 (95% CI -22.3 to -4.5) ml or -0.2% (-0.4% to 0.0%) from the baseline. The 95^thpercentile of change in FEV₆was 169.1 ml and 5.0%. FVC decreased on average -42.8 (-52.4 to -33.3) ml or -1.0% (-1.2% to -0.7%). Concurrently FET changed on average -0.2 (-0.4 to 0.0) seconds or 0.4% (-1.4% to 2.3%). There were four subjects with an increase of FVC over 12% and only one of these was associated with prolonged FET after salbutamol. Changes in FEV₆and FVC were more frequently positive in subjects with reduced FEV₁/FVC in baseline spirometry.</p> <p>Conclusion</p> <p>In general adult population, both FEV₆and FVC tended to decrease, but FET remained almost unchanged, in the bronchodilation test. However, those subjects with signs of airflow limitation at the baseline showed frequently some increase of FEV₆and FVC in the bronchodilation test without change in FET. We suggest that FEV₆could be used in assessment of bronchodilation response in lieu of FVC removing the need for regulation of FET during bronchodilation testing.</p

Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis

Background: Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations. Methods: In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate. Results: Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts. Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms. Conclusions: Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).Peer reviewe

COPD in Helsinki, Finland: socioeconomic status based on occupation has an important impact on prevalence

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Spirometrian suorittaminen ja tulkinta : uudet suomalaiset ja monikansalliset viitearvot käyttöön - Suomen Kliinisen Fysiologian yhdistyksen ja Suomen Keuhkolääkäriyhdistyksen suositus 2015

•Hil­jattain on jul­kaistu uu­det suoma­laiset ai­kuisten spi­ro­metrian vii­tearvot, joi­den mit­taukset kat­tavat myös vanhus­väestön 84 vuo­den ikään as­ti. •Uu­sien ar­vojen tulkin­nassa otetaan käyt­töön mi­tatun ar­von poik­keaman mää­rä viitear­vo­po­pu­laation ­kes­kiar­vosta z-yksik­köinä (sama kuin SD). Muu­toksen vaikeu­saste ar­vioidaan z-ar­von mu­kaan. •Nor­maalin va­riaation ala­raja on klii­ni­sissä tutki­muk­sissa kai­kille spi­ro­met­ria­muut­tu­jille sa­ma (z-ar­vona –1,65). Ter­veistä 95 % asettuu tä­män ra­jan ylä­puo­lelle. •Syn­ty­pe­rältään ulko­maa­laisten las­ten ja ai­kuisten tutki­muk­sissa suosi­tellaan käytet­tä­väksi uu­sia kansain­vä­lisiä GLI2012-vii­tear­voja. •Suo­ma­laisten las­ten tutki­muk­sissa suosi­tellaan käytet­tä­väksi edelleen van­hoja suoma­laisia viitear­voja, mut­ta nii­den klii­ni­sessä sovel­ta­mi­sessa suosi­tellaan nyt z-ar­vojen käyt­töä. •Ai­kuisten van­hat suoma­laiset vii­tearvot ei­vät ole perus­tuneet todel­lisiin mittaus­tu­loksiin yli 64-vuo­tiailla. Van­hojen ar­vojen käyt­tö on aiheut­tanut toden­nä­köi­sesti hengi­tys­tieobst­ruktion yli­diag­nos­tiikkaa vanhem­missa ikä­ryh­missä.Peer reviewe

The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

Background: Mortality and hospitalization due to asthma have decreased in many European countries, but asthma symptoms still cause a lot of morbidity and costs. Objectives: We evaluated prevalence trends of asthma, asthma symptoms and allergic rhinoconjunctivitis in adults aged 20-69 years during a 20-year period from 1996 to 2016 in the city of Helsinki, the capital of Finland. Methods: Three cross-sectional postal surveys were conducted in random population samples 10 years apart. In 1996, 2006 and 2016, a total of 6062 (response rate 75.9%), 2449 (61.9%) and 4026 subjects (50.3%) took part, respectively. Results: In all responders, the prevalence of physician-diagnosed asthma was 6.6% in 1996, 10% in 2006 and 10.9% in 2016. The prevalence increased from 1996 to 2006, but stabilized from 2006 to 2016, both in men and women and in smokers and non-smokers. The prevalence of current asthma (8.5% in 2006 and 8.8% in 2016) and of asthma with rhinoconjunctivitis (7.6% in 2006 and 7.5% in 2016) remained also at the same level. Allergic rhinoconjunctivitis decreased significantly from 2006 (42.7%) to 2016 (39.0%, p=0.004). Those with physician diagnosed asthma reported significantly less symptoms in 2016 compared to 2006 and 1996, although there was no change in smoking habits or medication use. Young asthmatics (20-29 years) without rhinoconjunctivitis reported least symptoms. Conclusion: Previously observed increase of physician-diagnosed asthma prevalence in adults seems to be levelling off in Helsinki, and patients have fewer symptoms than 20 years ago. In addition, allergic rhinoconjunctivitis is less frequent than 10 years earlier. (247 words).Peer reviewe

Hengitysäänten kuuntelu ja suomenkieliset termit

Vertaisarvioitu. Näin tutkin.Hengitysäänten kuuntelulla saadaan helposti ja nopeasti tietoa keuhkojen tilasta. Hengitysäänten sanalliseen kuvaamiseen on kansainväliset suositukset, mutta suomenkieliset termit vaihtelevat. Teimme lääkäreille kyselyn hengitysäänten suomenkielisistä termeistä ja pyysimme niistä kannanoton Lääketieteen sanastolautakunnalta. Esitämme myös hengitysäänten kuunteluun ja tulkintaan liittyvät perusasiat. Kyselyyn vastasi kaikkiaan 154 lääkäriä. Vastaajat eivät olleet aivan yksimielisiä suomenkielisistä termeistä. Kyselyn ja sanastolautakunnan arvion perusteella ehdotamme käyttöön suomenkielisiä termejä kurkkuvinkuna (stridor), vinkuna (wheezing), rohina (rhonchus), ritinä (fine cracles), rahina (coarse cracles), vingahdus (squawk) ja keuhkopussin hankausääni (pleural friction rub). Samojen termien käyttäminen löydöksen kirjaamisessa parantaa hengitysäänten kuuntelun arvoa potilastyössä. Hengitysäänten kuuntelua voidaan jatkossa tarkentaa elektronisilla apuvälineillä ja tietokoneanalyysillä