October 2008

Notes from the Section

• The Fall issue of our section Bulletin is online now and ready for viewing. READ IT HERE
• Check out the ADVANCE PROGRAM to see what’s on tap for diagnostics at this year’s AARC Congress in Anaheim, December 13–16. Here’s a sample of the great topics you’ll find: Pitfalls in Measurement and Interpretation of Oxygenation Status; The Diagnostic Advantages of Using Endobronchial Ultrasound Bronchoscopy; The Quality of Pulmonary Diagnostic Labs and Clinical Trials; Cardiopulmonary Exercise Testing,
• If you plan to attend the Congress, be sure to make time for our section business meeting, 12 noon–12:30 p.m., Tuesday, December 16.

Exhaled NO Monitoring Adds Little to Asthma Management
Monitoring exhaled nitric oxide levels in adolescents with asthma and using the findings to adjust treatment is no more effective than managing asthma via the National Institutes of Health’s national asthma guidelines. That’s the key result from a government-funded study of about 550 inner city adolescents with asthma in ten U.S. cities. Participants were randomly assigned to asthma management based on the guidelines alone or management based on the guidelines plus exhaled NO monitoring. Over the course of a year, no differences were seen in the two groups for symptoms or asthma exacerbations. Asthma improved significantly in both groups. Study author William Busse, MD, of the University of Wisconsin in Madison, concludes, "Good adherence to the current guidelines can mean good disease management without the need for a biomarker.” The research appeared in the September 20 edition of The Lancet. READ PRESS RELEASE

DLNO, DLCO Linked to VA in Morbidly Obese
Missouri investigators publishing in the September 4 Epub edition of Obesity noted increased pulmonary diffusion per unit increase in alveolar volume (VA) in morbidly obese people during exercise, attributing the finding to a lower rise in VA per unit increase in O2 in these individuals. The results are based on a study involving ten morbidly obese people and nine normal weight controls who were first measured for resting O2 and O(2peak) for determination of wattage equaling 40%, 75%, and 90% of the oxygen uptake reserve, then for pulmonary diffusion from single-breath maneuvers of 5 seconds each, along with heart rate and O2, over three workloads. Diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO), and pulmonary capillary blood volume, were larger in obese participants only when expressed relative to VA. READ ABSTRACT

Microspirometry Identifies Smokers at Risk for COPD
Can so-called “microspirometers” play a significant role in identifying smokers at risk for COPD? Researchers from Finland believe the answer is yes. They assessed 611 smokers or former smokers with a greater than 20 year history of smoking and no previously diagnosed lung disease using microspirometry. Results showed an FEV1 of less than 80% of predicted in 44.6% of the individuals, with the findings correlating well with full blown spirometry. The authors conclude, “Microspirometry finds a considerable number of smokers or ex-smokers with reduced FEV1 values . . . All smokers with reduced microspirometry FEV1 values would benefit from smoking cessation, and all patients with reduced FEV1 values need to be considered for full spirometry to confirm if they actually have COPD.” The research appears in this month’s Primary Care Respiratory Journal. READ ABSTRACT

What Causes the “Nonspecific Pattern” in Pulmonary Function Tests?
Mayo Clinic researchers are shedding some new light on an abnormal pattern of pulmonary function tests characterized by reduced FEV1 and FVC with a normal FEV1/FVC ratio and normal total lung capacity. They culled through a database of 80,929 tests, identifying the nonspecific pattern (NSP) in 7702 subjects. A random sample of 100 subjects was then investigated. Results pointed to airway disease in 68 of the subjects, while restricted expansion of the thorax or lung was implicated in the remaining 32 cases. The investigation appeared in the September 23 Epub edition of CHEST. READ ABSTRACT