May 2008

Open Forum Deadline Extended Till June 15
If you’ve attended an AARC Congress, you know the Open Forum is one of the highlights of the event. Nowhere else will you find as many reports of original research performed by your colleagues in respiratory care. Hopefully, we’ll have lots of presentations from section members this December – and now you have more time to submit your abstracts. The AARC has just extended the deadline from June 1 to June 15. GO TO EASY STREET TO SUBMIT ONLINE

Weak Agreement Seen for ATS/ERS PFT Strategy and Clinical Diagnosis
South Korean researchers question the new interpretative strategy for pulmonary function tests proposed by the American Thoracic Society/European Respiratory Society in a study published in the April 10 Epub edition of Respirology. The research involved a retrospective review of 681 patients with normal FEV1/FVC and low FVC who were clinically diagnosed by two respiratory physicians. The PFT interpretation revealed an obstructive pattern in 205 patients and a restrictive pattern in 476. A comparison between the PFT interpretation and clinical diagnosis showed:

• Of the 205 patients with an obstructive pattern on PFT, 44 were clinically diagnosed with obstructive disease, 97 with restrictive disease, 17 with mixed disease, and 47 with no disease.
• Of the 476 patients with a restrictive pattern on PFT, 11 were clinically diagnosed with obstructive disease, 369 with restrictive disease, 60 with mixed disease, and 36 with no disease.

The authors conclude, “The weak agreement between the clinical diagnosis and the PFT interpretation in patients showing concomitant decreases in FEV1 and FVC suggests that other clinical findings should be assessed in addition to PFT.” READ ABSTRACT

Obesity Affects Asthma Assessment
A new study out of New Zealand is shedding light on the effects of obesity on asthma. Researchers measured lung function in 30 women before and immediately after bronchoconstriction induced by methacholine. After adjusting for baseline airway caliber and hyperresponsiveness, the investigators found body mass index was linked to changes in lung volume, with increased functional residual capacity and decreased inspiratory capacity significantly greater in obese patients. “Changes in respiratory function, notably dynamic hyperinflation, are greater in obese individuals with bronchoconstriction,” write the authors. “This may potentially alter the perception and assessment of asthma severity in obese patients with asthma.” The study appeared in the May 1 issue of the American Journal of Respiratory and Critical Care Medicine. READ ABSTRACT

Assessing Cough Variant Asthma
Which is better for measuring airway hyperresponsiveness (AHR) in cough variant asthma (CVA): methacholine (MCh) or adenosine 5’-monophosphate (AMP)? Brazilian researchers asked that question in a study involving 113 patients that also assessed whether extrathoracic airway hyperresponsiveness (EAHR) during MCh and AMP can assist in the evaluation of CVA. Patients underwent both tests in a randomized, cross-over fashion. The researchers conclude, “Adenosine challenges correlate well with MCh in patients with CVA. A minority (c. 10%) of CVA patients have EAHR as measured by these tests, while most had AHR as assessed with each of the challenge agents.” The report appears in this month’s Allergy. READ ABSTRACT

FeNO Levels Impacted by Seasonal, Environmental Changes
Baseline levels of the fraction of exhaled nitric oxide (FeNO) should be considered when using FeNO to assess children with asthma, conclude Cincinnati Children’s Hospital researchers who studied the affects of seasonal and environmental factors on the measure in 225 asthmatic children ages 6 to 12. All were assessed for FeNO levels and seasonal and environmental factors over the course of a year. Results associated higher baseline FeNO levels, atopy, and fall season with increased FeNO levels, while inhaled steroid use, summer season, and increasing nicotine exposure were associated with lower FeNO levels. Sensitization to dust mite and cat allergens were also associated with increased FeNO levels. “These results indicate that FeNO levels are responsive to common environmental triggers as well as therapy for asthma in children,” write the investigators. “Clinicians and researchers may need to consider an individual’s baseline FeNO levels to manage children with asthma.” The research appeared in the April 21 Epub edition of Pediatric Pulmonology. READ ABSTRACT