February 2008

AARC Congress Power Point Presentations Available Online
Section members can now review the Power Point presentations for four of the key diagnostics lectures at last year’s AARC Congress in Las Vegas. The section has just posted slides for the following:

• Quality Control Spirometry & Lung Volumes: Gregg L. Ruppel, MEd, RRT, RPFT, FAARC
• Exhaled Nitric Oxide: Application Measurement Interpretation: Marshall B. Dunning III, PhD, MS, RPFT, RCP
• Interpretation of Indirect Calorimetry: Charles McArthur, BA, RRT, RPFT
• Quality Control of Exercise and Gas Exchange Equipment: Carl D. Mottram, BA, RRT, RPFT, FAARC

Go to the SECTION WEB SITE and click on “Resources” to view these great presentations.

Primary Care Spirometry Identifies Undiagnosed COPD
Polish researchers who assessed 1,960 patients in one primary care practice uncovered a significant number of previously undiagnosed COPD cases. All of the participants were 40 or older and completed a questionnaire on smoking, respiratory symptoms, education, and social status. Following a physical exam, they underwent pre- and post-bronchodilator spirometry. Airflow limitation was identified in 299 patients pre-bronchodilator and 211 post-bronchodilator. COPD was diagnosed in 183. Among that group, only 18.6% had previously been diagnosed. Asthma was diagnosed in 122 patients as well. The authors conclude, “The prevalence and under-diagnosis of COPD in the adult patients in this primary care setting made case-finding worthwhile. Large number[s] of newly detected patients were symptomatic and needed treatment.” They also note that limiting the participants to smokers only in this study would have reduced the number of COPD diagnoses by 26%. The report appeared in the Jan. 30 Epub edition of Thorax. READ ABSTRACT

FeNO Higher in Wheezy Kids with Higher Likelihood of Developing Asthma
A new study out of Switzerland suggests fractional exhaled nitric oxide (FeNO) measurements are higher in wheezy children with a stringent index for the prediction of asthma at school age. Researchers compared three groups of children between the ages of 3 and 47 months: children with recurrent cough but no history of wheeze (group 1), those with early recurrent wheeze and a loose index for the prediction of asthma at school age (group 2), and those with frequent recurrent wheeze and a stringent index for the prediction of asthma at school age (group 3). Children in the third group had significantly higher median FeNO levels than those in the other two groups. FeNO levels in groups 1 and 2 were similar. The study was published in the Jan. 2 Epub edition of the Journal of Allergy and Clinical Immunology. READ ABSTRACT

SELDI-TOF Mass Spectrometry Analysis of BAL Fluid in CF Patients
Analyzing bronchoalveolar lavage (BAL) fluid using surface enhanced laser desorption ionisation time of flight (SELDI-TOF) mass spectrometry may provide a better way to evaluate evolving disease and the effect of therapy in cystic fibrosis patients. That’s the key finding from British researchers who used the technique to assess BAL fluid from 39 children with CF and 39 respiratory disease controls. The researchers detected 1,277 proteins/peptides, >4 kDa, using 12 different surfaces and binding conditions; 202 proteins/peptides were differentially expressed in the CF samples (167 up-regulated and 35 down-regulated). The most discriminatory biomarker had a mass of 5.163 kDa, and the most abundant, with a mass of 10.6 kDa, was identified as s100 A8 (calgranulin A). “The application of SELDI-TOF mass spectrometry allows evaluation of proteins in BAL fluid avoiding the limitations of only analysing predetermined proteins and potentially identifying proteins not previously appreciated as biomarkers,” write the authors. The research appeared in the Jan. 31 Epub edition of the Journal of Cystic Fibrosis. READ ABSTRACT

Pre-eclampsia Linked to Airway Hyperresponsiveness
Women who experience pre-eclampsia during pregnancy may be more likely to have airway hyperresponsiveness (AHR), report British researchers publishing in the Jan. 16 Epub edition of BJOG. Noting previous studies have linked pre-eclampsia to asthma, they decided to measure AHR using methacholine challenge in 19 women, some of whom had recently suffered from pre-eclampsia during pregnancy. The women were also assessed for atopy. The geometric mean concentration of methacholine required to produce a >20% fall in the FEV1 was 8.9 mg/ml in pre-eclamptics versus 72 mg/ml in controls. It was 9 mg/ml in atopic pre-eclamptics without asthma versus 54 in matched controls. “This association and its possible mechanisms warrant further investigation,” write the investigators. READ ABSTRACT