31 research outputs found
Seasonal variations of cough reflex sensitivity in elite athletes training in cold air environment
Associations of airway inflammation and responsiveness markers in non asthmatic subjects at start of apprenticeship
<p>Abstract</p> <p>Background</p> <p>Bronchial Hyperresponsiveness (BHR) is considered a hallmark of asthma. Other methods are helpful in epidemiological respiratory health studies including Fractional Exhaled Nitric Oxide (FENO) and Eosinophils Percentage (EP) in nasal lavage fluid measuring markers for airway inflammation along with the Forced Oscillatory Technique measuring Airway resistance (AR). Can their outcomes discriminate profiles of respiratory health in healthy subjects starting apprenticeship in occupations with a risk of asthma?</p> <p>Methods</p> <p>Rhinoconjunctivitis, asthma-like symptoms, FEV1 and AR post-Methacholine Bronchial Challenge (MBC) test results, FENO measurements and EP were all investigated in apprentice bakers, pastry-makers and hairdressers not suffering from asthma. Multiple Correspondence Analysis (MCA) was simultaneously conducted in relation to these groups and this generated a synthetic partition (EI). Associations between groups of subjects based on BHR and EI respectively, as well as risk factors, symptoms and investigations were also assessed.</p> <p>Results</p> <p>Among the 441 apprentice subjects, 45 (10%) declared rhinoconjunctivitis-like symptoms, 18 (4%) declared asthma-like symptoms and 26 (6%) suffered from BHR. The mean increase in AR post-MBC test was 21% (sd = 20.8%). The median of FENO values was 12.6 ppb (2.6-132 range). Twenty-six subjects (6.7%) had EP exceeding 14%. BHR was associated with atopy (p < 0.01) and highest FENO values (p = 0.09). EI identified 39 subjects with eosinophilic inflammation (highest values of FENO and eosinophils), which was associated with BHR and atopy.</p> <p>Conclusions</p> <p>Are any of the identified markers predictive of increased inflammatory responsiveness or of development of symptoms caused by occupational exposures? Analysis of population follow-up will attempt to answer this question.</p
EFFETS DE LA PRATIQUE DâUN SPORT OU DâUNE ACTIVITĂ PHYSIQUE SUR LA SANTĂ CARDIO-RESPIRATOIRE : DES EFFETS BĂNĂFIQUES DU RĂENTRAĂNEMENT AUX EFFETS DĂLĂTĂRES DU SPORT DE HAUT-NIVEAU
Mesure du débit cardiaque à l'exercice chez des patients porteurs d'une bronchopneumopathie chronique obstructive (BPCO) (impédancemetrie vs méthode directe de Fick)
La réhabilitation respiratoire des patients atteints de bronchopneumopathie chronique obstructive (BPCO) inclut des programmes de réentraßnement à l effort (REE). Parmi les différents programmes existants, le programme d entraßnement personnalisé en créneaux (PEP C), utilisé dans notre laboratoire et qui est un effort intermittent intense, a montré son efficacité sur l amélioration de la capacité physique des sujets, dans différentes pathologies. Chez les patients BPCO, il est important de suivre l hémodynamique pulmonaire et le débit cardiaque au cours au cours des efforts intenses. Nous avons donc mesuré la pression artérielle pulmonaire (PAP) et le débit cardiaque ( mesuré à la fois par le principe de Fick appliqué à l oxygÚne et par impédancemétrie) chez 8 patients BPCO. Nous avons montré que la PAP augmentait plus lors d un tel effort que chez les sujets sains mais sans dérive inacceptable au cours des 30 minutes de PEP C. Nous avons également observé que le mesuré par le principe de Fick était stable aprÚs la 6Úme minute d effort jusqu à la 30Úme minute. Néanmoins, il n est pas possible d utiliser en routine une méthode invasive (principe de Fick) pour la mesure du . C est pourquoi nous avons comparé mesuré par le principe de Fick à mesuré par impédancemétrie (Physio Flow, Manatec Biomedical, Macheren, France). Nos résultats montrent que les valeurs de mesurées par impédancemétrie sont plus élevées que mesuré par la méthode de Fick, ceci dû surtout à un volume d éjection systolique plus élevé, sans différence notable de la fréquence cardiaque. Par ailleurs l adéquation entre les méthodes n est pas bonne dans notre série, puisque pour beaucoup de mesures, la différence entre les deux méthodes était de plus de 20%. L impédancemétrie cardiaque ne permet donc pas de suivre l hémodynamique chez ces patients obstructifs et distendus au cours d un effort intense.STRASBOURG-B.N.U.S. (674821001) / SudocSudocFranceF
Dyspnoea: a multidimensional and multidisciplinary approach.
International audienceDyspnoea is a debilitating symptom that affects quality of life, exercise tolerance and mortality in various disease conditions/states. In patients with chronic obstructive pulmonary disease (COPD), it has been shown to be a better predictor of mortality than forced expiratory volume in 1 s. In patients with heart disease it is a better predictor of mortality than angina. Dyspnoea is also associated with decreased functional status and worse psychological health in older individuals living at home. It also contributes to the low adherence to exercise training programmes in sedentary adults and in COPD patients. The mechanisms of dyspnoea are still unclear. Recent studies have emphasised the multidimensional nature of dyspnoea in the sensory-perceptual (intensity and quality), affective distress and impact domains. The perception of dyspnoea involves a complex chain of events that depend on varying cortical integration of several afferent/efferent signals and coloured by affective processing. This review, which stems from the European Respiratory Society research symposium held in Paris, France in November 2012, aims to provide state-of-the-art advances on the multidimensional and multidisciplinary aspects of dyspnoea, by addressing three different themes: 1) the neurophysiology of dyspnoea, 2) exercise and dyspnoea, and 3) the clinical impact and management of dyspnoea
Chapitre 17 : Les maladies respiratoires.
International audienceLa mucoviscidose et lâasthme sont deux pathologies rencontrĂ©es chez les enfants et adolescents et qui touchent le systĂšme respiratoire. Pendant longtemps, lâactivitĂ© physique a Ă©tĂ© dĂ©conseillĂ©e pour les patients porteurs de ces pathologies car elles Ă©taient susceptibles de mettre en danger leur santĂ© et leur vie. Depuis plusieurs dĂ©cennies, il a Ă©tĂ© prouvĂ© quâau contraire la pratique rĂ©guliĂšre dâune activitĂ© physique permet une amĂ©lioration de la condition physique et de la qualitĂ© de vie de ces enfants, ainsi que lâacquisition dâune plus grande autonomie. MalgrĂ© tout, Ă notre Ă©poque, les rĂ©ticences et les peurs sont tenaces et de nombreux enfants atteints de pathologies respiratoires continuent de rĂ©duire leur activitĂ© physique journaliĂšre, aidĂ©s en cela par leur entourage. La cohĂ©sion entre le monde mĂ©dical, les parents et lâentourage scolaire et sportif des enfants devrait ĂȘtre encouragĂ©e. En effet, le manque de connaissances et dâĂ©ducation des bienfaits de lâactivitĂ© physique adaptĂ©e Ă la pathologie ont Ă©tĂ© jusquâĂ prĂ©sent trop souvent un frein majeur Ă la prise en charge des enfants concernĂ©s.Ce chapitre sâintĂ©ressera respectivement Ă la mucoviscidose et Ă lâasthme chez lâenfant. AprĂšs quelques notions de physiopathologie, et une description des obstacles rencontrĂ©s Ă la pratique dâune activitĂ© physique chez ces enfants, nous rĂ©sumerons les recommandations actuelles dâactivitĂ© physique pour chacune de ces pathologies, en prĂ©cisant les prĂ©cautions Ă prendre et apportant quelques exemples de pratique
Bronchial challenges and respiratory symptoms in elite swimmers and winter sport athletes: Airway hyperresponsiveness in asthma: its measurement and clinical significance
International audienceThis study was aimed at the following: (1) the prevalence of airway hyperresponsiveness (AHR) and exercise-induced bronchoconstriction (EIB) in swimmers and winter sport athletes according to the previously recommended regulatory sport agencies criteria, (2) the relationship between respiratory symptoms and AHR/EIB, (3) the impact of the chosen cutoff value for AHR on its prevalence, and (4) the effect on the prevalence of the positive eucapnic voluntary hyperpnea (EVH) test of using the highest vs the lowest spirometric post-EVH values to calculate the magnitude of the airway response. We compared the prevalence of respiratory symptoms with responses to methacholine challenge and EVH in 45 swimmers, 45 winter sport athletes, and 30 controls. Two methacholine challenge cutoffs for AHR were analyzed: <or= 4 mg/mL (the sport agencies' criteria for AHR) and <or= 16 mg/mL. Sixty percent of swimmers, 29% of winter sport athletes, and 17% of controls had evidence of EIB or AHR (with the <or= 4 mg/mL criteria). Among athletes with a methacholine provocative concentration inducing a 20% decrease in the FEV(1) between 4 and 16 mg/mL, 43% of swimmers and 100% of winter sport athletes were symptomatic (P < .05). Prevalence of positive EVH tests were 39% in swimmers, 24% in winter sport athletes, and 13% in controls when the highest FEV(1) value measured at each time point post-EVH was used to identify maximal response for calculation of airway response, although these prevalences were higher if we used the lowest value. This study suggests that AHR/EIB is frequent in swimmers, whereas the frequently reported respiratory symptoms in winter sport athletes are often not related to AHR/EIB. Furthermore, the choice of methods for assessing methacholine challenge and EVH responses influences the prevalences of AHR and EIB.Trial registration: clinicaltrials.gov; Identifier NCT 00686491 and NCT 00686452.Trial registration: ClinicalTrials.gov NCT00686452 NCT00686491