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Article
Lung Diffusing Capacity for Carbon Monoxide (DLco-SB): the Influence of Cigarette Smoking

Author: Najeeb Hassan Mohammed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 3 Pages: 328-334
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Most tests of lung function used in the evaluation and follow-up of the pulmonary effect of smoking reflect airway function alone such as standard spirometry. Whereas, the best established test that reflect alveolar function is the single-breath carbon monoxide diffusing capacity (DLco-SB) especially when this is expressed per liter of alveolar volume (DLco/VA). Accordingly, to study the effect of smoking on both airway and alveolar functions, it is necessary to use DLco/VA test in addition to standard spirometry.OBJECTIVE:The present study was designed to evaluate the effect of cigarette smoking on lung diffusion, to correlate the effect of cigarette smoking and smoking cessation on lung diffusion and to find out whether the effect of cigarette smoking on lung diffusion is reversible.SUBJECTS AND METHODS:The effect of cigarette smoking on spirometric indicators of ventilatory function (FVC, FEV1%, PEFR) and on lung diffusing capacity for carbon monoxide (DLco-SB/VA) was evaluated on two occasions 6 months apart in 94 middle-aged, asymptomatic, male subjects, 56 smokers and 38 nonsmokers.RESULTS:All subjects were within the normal predicted spirometric and lung diffusion values (80-120%). The values of FVC, FEV1, FEV1/FVC% and PEFR averaged more than 94% in never smokers (n = 38, mean age 43.57 years), 85% predicted in smokers (n = 56, mean age 42.54 years). However, the mean rate of decrease in spirometric and lung diffusion values (DLco/VA) between smoker and non-smokers were significant (p<0.05). fourteen subjects (14) who initially were smokers became sustained ex-smokers within six months of the first measurement, however, comparing the mean values of these parameters between the two groups reveals statistically significant differences (p<0.05); since that the values of DLco and DLco/VA in ex-smokers were significantly greater than those of current smokers and approached the values of those who had never smoked. In ex-smokers the mean values of DLco/VA rose, averaging 90% predicted at the first assessment but 97% predicted six months later.CONCLUSION:The values of FVC, FEV1, FEV1/FVC%, PEFR and Lung diffusing capacity for carbon monoxide (DLco/VA) were lower in smokers than in never smokers. Ex-smokers had spirometric and lung diffusion values similar to those of never smokers even when spirometric values and DLco/VA were known to have been reduced while they were smoking.

Keywords

dLco-SB --- spirometry --- smoking


Article
Evaluation of Lung diffusing capacity for Carbonmonoxide (DLco) in healthy adolescents

Author: AMJAD F. AHMAD
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2006 Volume: 6 Issue: 1 Pages: 15-24
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

In pulmonary function tests (PFT), the selection of prediction equation for lung diffusing capacity for carbonmonoxide (DLco), remains a problem. If a single equation is selected and used by all laboratories, the variation in percent predicted values would be large enough to cause numerous diagnostic errors. The present study involved 36 healthy adolescents (20 boys and 16 girls aged 13-19 years) with body height (157-170 cm) and body weight (38-63 Kg). Normal values were reported for lung volumes, ventilation and diffusing capacity using spirographic, helium dilution and carbon monoxide single-breath techniques. Values observed in the present study were comparable to Asians studies but lower than those of Westerns. All pulmonary function parameters were significantly higher in boys, mainly due to larger lung volume, in addition to differences in the level of physical activity and social patterns of life. Regardless to sex, indices of lung volume and diffusion increased with age, body height, and surface area, however, best correlation was observed with body height. Gender specific prediction equations were generated for lung diffusing capacity. Lung diffusion corrected for volume (DLco/VA) seemed independent to sex or body size. In conclusion, it is not appropriate to rely on prediction equations derived from western populations who had higher levels of normality for DLco. Furthermore, height was the best single predictor for lung diffusion in adolescence age group.

Keywords

PFT --- DLco --- prediction equations --- adolescence


Article
Evaluation of the Lung Diffusing Capacity for Carbonmonoxide (Dlco) in Healthy Male Teenagers in Relation To Physical Activity
تقييم كفاءة الرئتين لانتشار اول اوكسيد الكاربون في عينة من الاصحاء البالغين وعلاقتها بالنشاط الرياضي

Author: Amjad F. Ahmad د. امجد فوزي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 3 Pages: 215-219
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Intensive research work has been conducted on lung function changes during exercise, however, little is known about the influence of physical activity on the resting lung function especially in younger age group. The present study involved (25) healthy male teenagers (13-19 years) with body height(170±5.9 cm) and body weight(63±10.23 Kg).Lung volumes(VC and TLC), ventilation(FEV1% and MMEF25-75%) and diffusion parameters (DLco and DLco/VA) were measured by computerized spirographic , helium dilution and carbonmonoxide single-breath techniques.All tested lung function parameters except, lung diffusion per unit lung volume (DLco/VA), had increased significantly with higher level of daily physical activity. The observed increase in the resting lung diffusion seemed to be related to the increase in lung volume brought about by higher physical activity rather than to changes in lung diffusing capacity per unit of lung volume (DLco/VA). The effect of cigarette smoking habit on lung diffusing capacity was evaluated. In conclusion, physical activity has a definite beneficial effect on resting lung diffusion, an effect which seemed unopposed by mild cigarette smokingKey words: PFT, DLco, adolescence, physical activity.

الملخص:مع أن هناك دراسات كثيرة تناولت التغيرات الحاصله في وظائف الرئة إثناء اجراء التمارين الرياضية ,الا انه لا تزال هناك فجوه واضحة في دراسة تأثير التمارين، متمثلة بالنشاط الجسمي اليومي، على وظائف الرئه عند الراحه ,لاجله شملت الدراسة الحالية (25) متطوعا من المراهقين الذكور الأصحاء(13-19 سنه) بطول(170± 5.9سم) و بوزن(63±10.23 كغم) حيث تم قياس وظائف الرئة (حجم الرئة , تهويه الرئة إضافة الى كفاءة الرئة على انتشار غاز أول اوكسيد الكربونDLco))) وذلك باستخدام برامج الحاسوب الخاصة بوظائف الرئة وبواسطة استخدام غاز الهليوم و غاز اول اوكسيد الكربون.لوحظ بأن هناك زيادة مهمة إحصائيا في جميع وظائف الرئة ألمقاسه (عدا قابلية انتشار غاز أول اوكسيد الكربون بالنسبة الى حجم الرئه DLco/VA ) وذلك تبعا لزيادة النشاط الجسمي اليومي . وقد أعزيت الزيادة في قابلية الرئة على انتشار غاز اول اوكسيد الكربونDLco)) الى الزيادة المصاحبة في حجم الرئة جراء ممارسة الرياضة في حين لم تلعب قابلية انتشار غاز اول اوكسيد الكربون بالنسبة الى حجم الرئه DLco/VA) ) دورا مهما في هذه الزيادة . أظهرت نتائج البحث العلاقة الايجابية بين النشاط الجسمي و وظائف الرئة عند الراحة اضافة الى استمرار التأثير الايجابي للنشاط الجسمي على وظائف الرئه ولكن بدرجة اقل في حالة التدخين البسيط

Keywords

PFT --- DLco --- adolescence --- physical activity.

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