| 61. |
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| 62. |
- Haccuria, Amaryllis, et al.
(författare)
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Small airways dysfunction : the link between allergic rhinitis and allergic asthma
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 51:2
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Tidskriftsartikel (refereegranskat)abstract
- Abnormal airway reactivity and overproduction of nitric oxide (NO) occurring in smallairways have been found in asthma. If the“one airway, one disease”concept is consistent, suchdysfunctions should also be detected in the peripheral airways of patients suffering from allergicrhinitis.We investigated whether peripheral airway reactivity and NO overproduction could bedocumented in distal airways in patients with allergic rhinitis. Exhaled NO fraction (FeNO)andtheslope (S) of phase III of the single-breath washout test (SBWT) of helium (He) and sulfurhexafluoride (SF6)weremeasuredin31patientswithallergicasthma,23allergicrhinitispatientsand 24 controls, before and after sputum induction. SBWT is sensitive to airway calibre changeoccurring in the lung periphery.TheFeNOdecrease was more significant in asthma and rhinitis than in controls (−55.1% and−50.0%,respectively,versus−40.8%) (p=0.007 and p=0.029, respectively). SSF6and SHeincreased in all groups.Change in SHe(ΔSHe)>ΔSSF6was observed in rhinitis (p=0.004) and asthma (p<0.001), whereasΔSSF6=ΔSHein controls (p=0.431).This study provides evidence of peripheral airway dysfunction in patients with allergic rhinitis quitesimilar to that described in asthma. Furthermore, a large proportion of the increased NO productionreported in allergic rhinitis appears to originate in the peripheral airways.
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| 63. |
- Hagman, Carina, et al.
(författare)
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Measuring breathing patterns and respiratory movements with the respiratory movement measuring instrument
- 2016
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X. ; 36:5, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The respiratory movement measuring instrument (RMMI) is a laser-based non-invasive technique to measure breathing patterns and respiratory movements (RMs). Little knowledge is known about the ability of the RMMI to measure breathing patterns and the correlation between RMs and breathing volumes.OBJECTIVES: One aim was to investigate whether the RMMI could discriminate between normal versus abdominal versus high costal breathing patterns in different body positions. A second aim was to determine the correlation between RMs and breathing volumes in different body positions.METHOD: Twenty adult, healthy subjects (10 women) were included in the study. The RMMI was used to study the above-mentioned breathing patterns in supine, sitting and standing positions. A subgroup of 12 subjects (6 women) simultaneously performed measurements of breathing volumes while RMs were recorded.RESULTS: The RMMI was able to discriminate between different breathing patterns in different body positions (P<0·001). The upper thoracic contribution to RMs in the sitting position was 47% for natural breathing, 32% for abdominal breathing and 64% for high costal breathing; similar results were found in the supine and standing positions. A strong correlation was observed between RMs as measured by the RMMI and different breathing volumes in all three body positions (Spearman's rho 0·86-1·00).CONCLUSION: The RMMI can be used to measure and analyse different breathing patterns in different body positions, and the correlation between measured RMs and breathing volumes is strong.
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| 64. |
- Heffler, Enrico, et al.
(författare)
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Personalized Approach to Severe Asthma
- 2018
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 65. |
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| 66. |
- Heijkenskjöld-Rentzhog, Charlotte, et al.
(författare)
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Alveolar and exhaled NO in relation to asthma characteristics : effects of correction for axial diffusion
- 2014
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 69:8, s. 1102-1111
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Tidskriftsartikel (refereegranskat)abstract
- Background: Inflammation in the small airways might contribute to incomplete asthma disease control despite intensive treatment in some subgroups of patients. Exhaled NO (FeNO) is a marker of inflammation in asthma and the estimated NO contribution from small airways (Calv(NO)) is believed to reflect distal inflammation. Recent studies recommend adjustments of Calv(NO) for trumpet model and axial diffusion (TMAD-adj). This study aimed to investigate the clinical correlates of Calv(NO), both TMAD-adjusted and unadjusted. Methods: Asthma symptoms, asthma control, lung function, bronchial responsiveness, blood eosinophils, atopy and treatment level were assessed in 410 subjects, aged 10-35 years. Exhaled NO was measured at different flow-rates and Calv(NO) calculated, with TMAD-adjustment according to Condorelli. Results: Trumpet model and axial diffusion-adjusted Calv(NO) was not related to daytime wheeze (P = 0.27), FEF50 (P = 0.23) or bronchial responsiveness (P = 0.52). On the other hand, unadjusted Calv(NO) was increased in subjects with daytime wheeze (P < 0.001), decreased FEF50 (P = 0.02) and with moderate-to-severe compared to normal bronchial responsiveness (P < 0.001). All these characteristics correlated with increased FeNO (all P < 0.05). Unadjusted Calv(NO) was positively related to bronchial NO flux (J'aw(NO)) (r = 0.22, P < 0.001) while TMAD-adjCalv(NO) was negatively related to J'awNO (r = -0.38, P < 0.001). Conclusions: Adjusted Calv(NO) was not associated with any asthma characteristics studied in this large asthma cohort. However, both FeNO and unadjusted Calv(NO) related to asthma symptoms, lung function and bronchial responsiveness. We suggest a potential overadjustment by current TMAD-corrections, validated in healthy or unobstructed asthmatics. Further studies assessing axial diffusion in asthmatics with different degrees of airway obstruction and the validity of proposed TMAD-corrections are warranted.
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| 67. |
- Heijkenskjöld-Rentzhog, Charlotte, et al.
(författare)
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New method for single-breath fraction of exhaled nitric oxide measurement with improved feasibility in preschool children with asthma
- 2015
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 26:7, s. 662-667
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Respiratory societies recommend use of standardized methodologies for fraction of exhaled nitric oxide (FeNO) measurements in adults and children, but in preschoolers, feasibility remains a problem. The exhalation time needed to obtain steady-state FeNO is unclear. Our primary aim was to study the feasibility of an adapted single-breath FeNO method with age-adjusted exhalation times. We also studied the association between time to steady-state NO level and height, as well as FeNO in relation to asthma and current treatment with inhaled corticosteroids (ICS).METHODS: Sixty-three children aged 3-10 years performed FeNO measurements with a hand-held electrochemical device with a newly developed flow-control unit. Exhalation times were pre-adapted to age. Exhaled air was simultaneously sampled to a chemiluminescence analyzer to measure time to steady-state NO level.RESULTS: Eighty-one percent of the children achieved at least one approved measurement. From 4 years upwards, success rate was high (96%). Time to steady-state [NO] (median and interquartile range) was 2.5 s (2.4-3.5) at the age of 3-4 years and 3.5 s (2.7-3.8) at the age of 5-6 years. Height was associated with time to steady state (r(2) = 0.13, p = 0.02). FeNO (geometric mean [95% CI]) was higher in ICS-naïve asthmatic children (n = 19): 15.9 p.p.b. (12.2-20.9), than in both healthy controls (n = 8) 9.1 p.p.b. (6.6-12.4) and asthmatic subjects on treatment (n = 24) 11.5 p.p.b. (9.7-13.6).CONCLUSION: We found this adapted single-breath method with age-adjusted exhalation times highly feasible for children aged 4-10 years. ICS-naïve asthmatic children had FeNO levels under the current guideline cutoff level (20 p.p.b.), highlighting the importance of taking age into account when setting reference values.
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| 68. |
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| 69. |
- Heijkenskjöld Rentzhog, Charlotte, et al.
(författare)
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Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.
- 2017
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 47:12, s. 1546-1554
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control.METHODS: ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight.RESULTS: and R5-R19) were associated with uncontrolled asthma (P-values < .05).CONCLUSIONS: /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements.
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| 70. |
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