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May 2007
Notes from the Section
- The Spring issue of the Diagnostics Section Bulletin is ONLINE now, with articles on getting ready for CAP accreditation and the Westgard rules and how they apply to pulmonary function laboratories.
- The section web site has a great new feature: an online ARCHIVE containing past issues of the E-Bulletin.
Open Forum Deadline Coming Up June 1
The AARC International Respiratory Congress, scheduled for Dec. 1-4 in Orlando, FL, will feature 18 Open Forums, providing a great way for attendees to share the results of their original research and/or case studies. The deadline for submitting an abstract or case report for the 2007 sessions, however, is quickly approaching – June 1, 2007. So take a few moments to LEARN MORE about the online submission process, and then consider how you can share results of your work with your peers via the 2007 Open Forum.
BMI’s Impact on Asthma
Noting body mass index (BMI) has been linked to a reduction in exhaled nitric oxide (NO) in people with asthma, researchers set out to discover how these changes may be affecting
levels of airway oxidative stress and systemic levels of leptin and adiponectin. The study compared BMI, leptin, and adiponectin with exhaled NO and exhaled 8-isoprostanes in 67 non-smoking asthmatics and 47 controls. BMI and the ratio of leptin to adiponectin were associated with reduced levels of exhaled NO in asthmatics, and BMI was associated with increased levels of exhaled 8-isoprostanes. Similar associations were not seen in the control group. The authors conclude, “In adults with moderate to severe persistent asthma, but not in controls, BMI is associated with reduced exhaled NO and increased exhaled 8-isoprostanes, suggesting that rising BMI in asthmatics may increase airway oxidative stress and could explain the BMI-related reductions in exhaled NO.” The study appeared in the April 16 issue of Respiratory Research. READ ABSTRACT
Gender Makes a Difference in Advanced Emphysema
New results out of the National Emphysema Treatment Trial illustrate gender differences in advanced emphysema. University of Michigan researchers found that:
- Women were younger and exhibited a lower BMI, shorter smoking history, less severe airflow obstruction, lower DLCO and arterial PO2, higher arterial PCO2, shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry.
- For a given FEV1 percent predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being.
- Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung.
- Females had thicker small airway walls relative to luminal perimeters.
The authors conclude, “These striking gender-specific differences demonstrate the clinical heterogeneity among patients with advanced emphysema, and emphasize the importance of increased research into COPD pathogenesis.” The report appeared in the April 12 issue of the American Journal of Respiratory and Critical Care Medicine. READ ABSTRACT
Traffic Impacts Pulmonary Function in Women
A new government study involving 15,792 middle-aged men and women links exposure to traffic to poorer lung function in women. Researchers found significantly lower FEV1 and FVC in females living in higher traffic areas, even after adjusting the findings to take other factors like smoking and air pollution into account. Compared to the lowest quartile of traffic density, the adjusted differences across increasing quartiles were 5.1, -15.4 and -21.5 mL for FEV1 and 1.2, -23.4 and -34.8 mL for FVC. When distance from major roads was used as an index of traffic related air pollution exposure, women living within 150 meters had an FEV1 that was -15.7 mL lower and FVC that was -24.2 mL lower when compared to women living farther away. Men were not similarly affected, and traffic exposure did not appear to affect the FEV1/FVC ratio in either men or women. The research was published in the April 18 issue of Thorax. READ ABSTRACT
Alternative to Exercise Challenge Testing in Kids with Asthma
German researchers find a combination of tests may provide an alternative to exercise challenge testing in identifying exercise-induced bronchoconstriction (EIB) in children with asthma. They studied 85 children with a mean age of 11 using measurements of exhaled nitric oxide (eNO), spirometry, whole body plethysmography, and standardized exercise testing. A respiratory symptom questionnaire was also completed about two weeks prior to the testing. In 12 out of 85 children (14%), FEV1 was significantly reduced by > or = 15% after exercise testing, and eNO was significantly elevated in this group when compared to patients without EIB. Normal eNO levels were seen in all of the children with normal lung function results after exercise, making the negative predictive value of elevated eNO levels for prediction of EIB 100%. While the positive predictive value (PPV) was only 28%, adding recent symptom history to elevated eNO improved the PPV to 40%. The authors believe these results show “eNO measurements, symptom questionnaires and most efficiently a combination of both surrogate tests can be used as time-saving methods to exclude EIB in atopic childhood asthma.” The findings were published in the March issue of Pediatric Pulmonology. READ ABSTRACT
Upcoming Educational Opportunities from the AARC
- AARC International Respiratory Congress: Dec. 1-4, Orlando, FL
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