September 2010

You Have Till Monday to Do This
Last year it was Anne Hamilton. This year it will be ? Get your nominations in for SPECIALTY PRACTITIONER OF THE YEAR. Last chance.

AARC International Respiratory Congress: Lots of Great Presentations for Respiratory Diagnosticians
Thanks to the proposals made by many of us in the Diagnostics Section, this year’s AARC Congress, Dec. 6–9 in Las Vegas, NV, will be full of great lectures and speakers devoted to our specialty. So if you’ve yet to check out the ADVANCE PROGRAM, click over now and page through the agenda, then register for the meeting today. With 25+ CRCEs, it’s the best educational value you’ll find all year long.

Young Children Produce Reproducible PFTs Despite Exacerbation
German researchers publishing in the Aug. 23 Epub edition of Pneumologie looked at the ability of children between the ages of four and seven with intermittent bronchial asthma to produce reproducible lung function measurements when healthy and when suffering from an exacerbation, finding no significant differences between the two states. When healthy, 74.6% of the kids performed at least two, and 59.3% performed three, repeatable measures. When suffering from an exacerbation, the percentages were 87.5% and 68.8%, respectively. The authors note the tests were performed according to the 2007 ATS/ERS guidelines, which simplify the repeatability of forced expiratory maneuvers in young children over the previous guidelines. READ ABSTRACT

The Non-Specific Pulmonary Function Pattern: What Happens Over Time
A new study in the Aug. 19 Epub edition of CHEST sheds light on the long term stability of the non-specific (NS) pulmonary function (PF) pattern and variables that predict changes in subjects with an initial NS PF pattern. The NS PF pattern was defined as a PF test with a normal TLC, a normal FEV1/FVC ratio, and a low FEV1, a low FVC, or both. The investigators followed up with additional PF tests in 1284 subjects with a NS pattern on initial testing. At the final follow up three years later, results showed 64% continued to show the NS pattern, 16% showed a restrictive pattern, 15% showed an obstructive pattern, 3% showed a normal pattern, and 2% showed a mixed pattern. Further analysis revealed increasing values for specific airway resistance (Sraw) and TLC-Va predicted a change to an obstructive pattern. READ ABSTRACT

Targeted Spirometry Testing Could Make a Dent in Undiagnosed Irreversible Airway Obstruction
Targeted spirometry testing in the general population has the potential to significantly reduce undiagnosed irreversible airway obstruction (AO), report Austrian researchers who studied 1258 adults age 40 or older. Results showed:

• 343 participants were eligible for targeted spirometry, and irreversible AO was present in 86 (25.1%).
• 85.9% (171/199) of the participants with irreversible AO did not report a prior diagnosis of COPD.
• Non-diagnosed AO was inversely related to severity, age, self-reported prior respiratory diseases, and cough as a respiratory symptom.
• Targeted spirometry could reduce the underdiagnosis of irreversible AO of any severity by 50.3% (86 of 171).
• The diagnosis of one person with an FEV1 <80% predicted would require spirometry in 8.4 subjects.

The study appeared in the Aug. 19 Epub edition of Respiration. READ ABSTRACT

Measuring Rrs by the Forced Oscillation Technique Improves Sensitivity in Identifying Asthma
French investigators who set out to determine whether the sensitivity of FEV1 detection of exercise-induced bronchconstriction (EIB) to identify asthma could be improved by measuring the respiratory resistance (Rrs) by the forced oscillation technique find the answer is yes. Their study was conducted among 47 children with asthma and 50 controls who underwent testing before and after running for six minutes on a treadmill. Exercise caused significantly larger increases in Rrs in inspiration (Rrsi) and larger decreases in FEV1 in asthmatics versus controls. Asthmatics also showed more bronchodilation by deep inhalation after exercise. At specificity >0.90, sensitivity was 0.53 with a 25% increase in Rrsi and 0.45 with a 27% increase in Rrs expiration or 5% decrease in FEV1. The study was published in the Aug. 24 Epub edition of Pediatric Research. READ ABSTRACT