The Experts below are selected from a list of 3261 Experts worldwide ranked by ideXlab platform
Jeanluc Desfougeres - One of the best experts on this subject based on the ideXlab platform.
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salmeterol fluticasone propionate vs double dose fluticasone propionate on lung function and asthma control in children
Pediatric Allergy and Immunology, 2009Co-Authors: Jacques De Blic, L M Ogorodova, Rabih Klink, Irina Sidorenko, Arunas Valiulis, Jerzy Hofman, Olav Bennedbaek, Sally Anderton, Valerie Attali, Jeanluc DesfougeresAbstract:There is a large body of data to support the use of an inhaled corticosteroid (ICS) plus a long-acting β2-agonist vs. increasing the dose of ICS in adults, but less data in children. This double-blind, parallel group, non-inferiority study compared lung function and asthma control, based on Global Initiative for Asthma guidelines, in children receiving either salmeterol/fluticasone propionate (SFC) 50/100 μg bd (n = 160) or fluticasone propionate (FP) 200 μg bd (n = 161) for 12 wks. Change from baseline in mean morning peak Expiratory Flow increased following both treatments, but was significantly greater in the SFC group compared with FP [Adjusted mean change (s.e.) (l/min): SFC: 26.9 (2.13), FP: 19.3 (2.12); treatment difference: 7.6 (3.01); 95% CI: 1.7, 13.5; p = 0.012)]. Asthma control improved over time in both groups. Mean pre-bronchodilator Maximal-Expiratory Flow at 50% vital capacity and percentage rescue-free days showed significantly greater improvements in the SFC group compared with FP. All other efficacy indices showed comparable improvements in each group. Treatment with SFC 50/100 μg bd compared with twice the steroid dose of FP (200 μg bd), was at least as effective in improving individual clinical outcomes and overall asthma control, in asthmatic children previously uncontrolled on low doses of ICS.
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salmeterol fluticasone propionate vs double dose fluticasone propionate on lung function and asthma control in children
Pediatric Allergy and Immunology, 2009Co-Authors: Jacques De Blic, L M Ogorodova, Rabih Klink, Irina Sidorenko, Arunas Valiulis, Jerzy Hofman, Olav Bennedbaek, Sally Anderton, Valerie Attali, Jeanluc DesfougeresAbstract:There is a large body of data to support the use of an inhaled corticosteroid (ICS) plus a long-acting beta(2)-agonist vs. increasing the dose of ICS in adults, but less data in children. This double-blind, parallel group, non-inferiority study compared lung function and asthma control, based on Global Initiative for Asthma guidelines, in children receiving either salmeterol/fluticasone propionate (SFC) 50/100 microg bd (n = 160) or fluticasone propionate (FP) 200 microg bd (n = 161) for 12 wks. Change from baseline in mean morning peak Expiratory Flow increased following both treatments, but was significantly greater in the SFC group compared with FP [Adjusted mean change (s.e.) (l/min): SFC: 26.9 (2.13), FP: 19.3 (2.12); treatment difference: 7.6 (3.01); 95% CI: 1.7, 13.5; p = 0.012)]. Asthma control improved over time in both groups. Mean pre-bronchodilator Maximal-Expiratory Flow at 50% vital capacity and percentage rescue-free days showed significantly greater improvements in the SFC group compared with FP. All other efficacy indices showed comparable improvements in each group. Treatment with SFC 50/100 microg bd compared with twice the steroid dose of FP (200 microg bd), was at least as effective in improving individual clinical outcomes and overall asthma control, in asthmatic children previously uncontrolled on low doses of ICS.
Anders Lindblad - One of the best experts on this subject based on the ideXlab platform.
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multiple breath inert gas washout and spirometry versus structural lung disease in cystic fibrosis
Thorax, 2007Co-Authors: Per M Gustafsson, P A De Jong, Harm A W M Tiddens, Anders LindbladAbstract:Background: A sensitive and valid non-invasive marker of early cystic fibrosis (CF) lung disease is sought. The lung clearance index (LCI) from multiple-breath washout (MBW) is known to detect abnormal lung function more readily than spirometry in children and teenagers with CF, but its relationship to structural lung abnormalities is unknown. A study was undertaken to determine the agreements between LCI and spirometry, respectively, with structural lung disease as measured by high-resolution computed tomography (HRCT) in children and teenagers with CF. Methods: A retrospective study was performed in 44 consecutive patients with CF aged 5–19 years (mean 12 years). At an annual check-up inspiratory and Expiratory HRCT scans, LCI and spirometric parameters (forced Expiratory volume in 1 s (FEV1) and Maximal Expiratory Flow when 75% of forced vital capacity was expired (FEF75)) were recorded. Abnormal structure was defined as a composite HRCT score of >5%, the presence of bronchiectasis or air trapping >30%. Abnormal lung function was defined as LCI above the predicted mean +1.96 residual standard deviations (RSD), or FEV1 or FEF75 below the predicted mean −1.96 RSD. Sensitivity/specificity assessments and correlation analyses were done. Results: The sensitivity to detect abnormal lung structure was 85–94% for LCI, 19–26% for FEV1 and 62–75% for FEF75. Specificity was 43–65% for LCI, 89–100% for FEV1 and 75–88% for FEF75. LCI correlated better with HRCT scores (Rs +0.85) than FEV1 (−0.62) or FEF75 (−0.66). Conclusions: LCI is a more sensitive indicator than FEV1 or FEF75 for detecting structural lung disease in CF, and a normal LCI almost excludes HRCT abnormalities. The finding of an abnormal LCI in some patients with normal HRCT scans suggests that LCI may be even more sensitive than HRCT scanning for detecting lung involvement in CF.
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multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis
Thorax, 2004Co-Authors: Paul Aurora, Anders Lindblad, Per E Gustafsson, Andrew Bush, C Oliver, C Wallis, Janet StocksAbstract:Background: Multiple breath inert gas washout (MBW) has been suggested as a tool for detecting early cystic fibrosis (CF) lung disease. A study was undertaken to compare the relative sensitivity of MBW and spirometry for detecting abnormal lung function in school age children with CF and to compare MBW results obtained from healthy children in the UK with those recently reported from Sweden. Methods: Forced Expiratory volume in 1 second (FEV1) and Maximal Expiratory Flow when 25% of forced vital capacity remains to be expired (MEF25) were compared with the lung clearance index (LCI) derived from sulphur hexafluoride MBW in 22 children with CF aged 6–16 years and in 33 healthy controls. Results: LCI was higher in children with CF than in healthy controls (mean difference 5.1 (95% CI of difference 4.1 to 6.1) and FEV1 and MEF25 z-scores were lower (mean difference −2.3 (95% CI −2.9 to −1.7) and −1.8 (95% CI −2.4 to −1.3), respectively; p<0.001 for all). There was a significant negative correlation between LCI and FEV1 ( r 2 = 0.62) and MEF25 ( r 2 = 0.46). However, while normal (⩾−1.96 z-scores) FEV1 and MEF25 results were seen in 11 (50%) and 12 (53%) children with CF, respectively, all but one of these children had an abnormally increased LCI. LCI was repeatable in both groups (within subject CV for three measurements 6% for CF and 5% for healthy children). In healthy subjects LCI was independent of age and virtually identical in the British and Swedish children (mean difference 0.1 (95% CI −0.1 to 0.4), p = 0.38) Conclusions: MBW is reproducible between laboratories, generates normal ranges which are constant over childhood, and is more frequently abnormal than spirometry in children with CF.
William A Sheel - One of the best experts on this subject based on the ideXlab platform.
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quantifying the shape of the Maximal Expiratory Flow volume curve in mild copd
Respiratory Physiology & Neurobiology, 2015Co-Authors: Paolo B. Dominelli, Glen E. Foster, Jordan A. Guenette, Hans C Haverkamp, Neil D Eves, Giulio S Dominelli, William R Henderson, Denis E Odonnell, William A SheelAbstract:Maximal Expiratory Flow-volume (MEFV) curve evaluation using absolute and percent predicted values of Flow and volume are used to diagnose respiratory disease, but the shape of the curve is rarely used. Three mathematical methods were used to quantify shape of MEFV curves in subjects with mild COPD (n=19) and matched healthy controls (n=15). Those with mild COPD had a significantly greater slope-ratio (SR) (1.90 ± 0.24 vs. 1.28 ± 0.32) and Beta-angle (160 ± 6.7 vs. 186 ± 15.0) compared to healthy individuals (p<0.05). The Flow-ratio method showed no difference between groups. A significant positive SR-volume relationship during expiration was observed in a greater number of mild COPD subjects (94%) compared to controls (20%) (p<0.001). With its increased spatial resolution and the potential to discern etiology behind specific curvature, we suggest using the SR method when available. The change in SR throughout expiration could help identify those who fall within the lower limit of normal lung function and those who may have pathological obstruction.
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effect of carrying a weighted backpack on lung mechanics during treadmill walking in healthy men
European Journal of Applied Physiology, 2012Co-Authors: Paolo B. Dominelli, William A Sheel, Glen E. FosterAbstract:Weighted backpacks are used extensively in recreational and occupational settings, yet their effects on lung mechanics during acute exercise is poorly understood. The purpose of this study was to determine the effects of different backpack weights on lung mechanics and breathing patterns during treadmill walking. Subjects (n = 7, age = 28 ± 6 years), completed two 2.5-min exercise stages for each backpack condition [no backpack (NP), an un-weighted backpack (NW) or a backpack weighing 15, 25 or 35 kg]. A Maximal Expiratory Flow volume curve was generated for each backpack condition and an oesophageal balloon catheter was used to estimate pleural pressure. The 15, 25 and 35 kg backpacks caused a 3, 5 and 8% (P < 0.05) reduction in forced vital capacity compared with the NP condition, respectively. For the same exercise stage, the power of breathing (POB) requirement was higher in the 35 kg backpack compared to NP (32 ± 4.3 vs. 88 ± 9.0 J min−1, P < 0.05; respectively). Independent of changes in minute ventilation, end-Expiratory lung volume decreased as backpack weight increased. As backpack weight increased, there was a concomitant decline in calculated Maximal ventilation, a rise in minute ventilation, and a resultant greater utilization of Maximal available ventilation. In conclusion, wearing a weighted backpack during an acute bout of exercise altered operational lung volumes; however, adaptive changes in breathing mechanics may have minimized changes in the required POB such that at an iso-ventilation, wearing a backpack weighing up to 35 kg does not increase the POB requirement.
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effect of thoracic gas compression and bronchodilation on the assessment of Expiratory Flow limitation during exercise in healthy humans
Respiratory Physiology & Neurobiology, 2010Co-Authors: Jordan A. Guenette, Paolo B. Dominelli, Neil D Eves, Sabrina S Reeve, Christopher M Durkin, William A SheelAbstract:Abstract Expiratory Flow limitation (EFL) during exercise may be overestimated or falsely detected when superimposing tidal breaths within a pre-exercise Maximal Expiratory Flow volume (MEFV) curve due to thoracic gas compression (TGC) and bronchodilation. Accordingly, the purpose of this study was to determine the effects of TGC and bronchodilation on the assessment of EFL in 35 healthy subjects. A pre-exercise forced vital capacity (FVC) maneuver was performed that did not account for TGC (MEFVpre). Subjects then performed graded expirations from total lung capacity to residual volume at different efforts to account for TGC (MEFVpre-TGC). Post-exercise FVC (MEFVpost) and post-exercise graded expirations (MEFVpost-TGC) were performed to account for bronchodilation and TGC. EFL occurred in 29 subjects when using MEFVpre. The magnitude of EFL in these subjects was 47 ± 23% which was significantly higher than MEFVpre-TGC (28 ± 28%), MEFVpost (24 ± 27%) and MEFVpost-TGC (19 ± 24%) (P
Janet Stocks - One of the best experts on this subject based on the ideXlab platform.
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multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis
Thorax, 2004Co-Authors: Paul Aurora, Anders Lindblad, Per E Gustafsson, Andrew Bush, C Oliver, C Wallis, Janet StocksAbstract:Background: Multiple breath inert gas washout (MBW) has been suggested as a tool for detecting early cystic fibrosis (CF) lung disease. A study was undertaken to compare the relative sensitivity of MBW and spirometry for detecting abnormal lung function in school age children with CF and to compare MBW results obtained from healthy children in the UK with those recently reported from Sweden. Methods: Forced Expiratory volume in 1 second (FEV1) and Maximal Expiratory Flow when 25% of forced vital capacity remains to be expired (MEF25) were compared with the lung clearance index (LCI) derived from sulphur hexafluoride MBW in 22 children with CF aged 6–16 years and in 33 healthy controls. Results: LCI was higher in children with CF than in healthy controls (mean difference 5.1 (95% CI of difference 4.1 to 6.1) and FEV1 and MEF25 z-scores were lower (mean difference −2.3 (95% CI −2.9 to −1.7) and −1.8 (95% CI −2.4 to −1.3), respectively; p<0.001 for all). There was a significant negative correlation between LCI and FEV1 ( r 2 = 0.62) and MEF25 ( r 2 = 0.46). However, while normal (⩾−1.96 z-scores) FEV1 and MEF25 results were seen in 11 (50%) and 12 (53%) children with CF, respectively, all but one of these children had an abnormally increased LCI. LCI was repeatable in both groups (within subject CV for three measurements 6% for CF and 5% for healthy children). In healthy subjects LCI was independent of age and virtually identical in the British and Swedish children (mean difference 0.1 (95% CI −0.1 to 0.4), p = 0.38) Conclusions: MBW is reproducible between laboratories, generates normal ranges which are constant over childhood, and is more frequently abnormal than spirometry in children with CF.
Jacques De Blic - One of the best experts on this subject based on the ideXlab platform.
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salmeterol fluticasone propionate vs double dose fluticasone propionate on lung function and asthma control in children
Pediatric Allergy and Immunology, 2009Co-Authors: Jacques De Blic, L M Ogorodova, Rabih Klink, Irina Sidorenko, Arunas Valiulis, Jerzy Hofman, Olav Bennedbaek, Sally Anderton, Valerie Attali, Jeanluc DesfougeresAbstract:There is a large body of data to support the use of an inhaled corticosteroid (ICS) plus a long-acting β2-agonist vs. increasing the dose of ICS in adults, but less data in children. This double-blind, parallel group, non-inferiority study compared lung function and asthma control, based on Global Initiative for Asthma guidelines, in children receiving either salmeterol/fluticasone propionate (SFC) 50/100 μg bd (n = 160) or fluticasone propionate (FP) 200 μg bd (n = 161) for 12 wks. Change from baseline in mean morning peak Expiratory Flow increased following both treatments, but was significantly greater in the SFC group compared with FP [Adjusted mean change (s.e.) (l/min): SFC: 26.9 (2.13), FP: 19.3 (2.12); treatment difference: 7.6 (3.01); 95% CI: 1.7, 13.5; p = 0.012)]. Asthma control improved over time in both groups. Mean pre-bronchodilator Maximal-Expiratory Flow at 50% vital capacity and percentage rescue-free days showed significantly greater improvements in the SFC group compared with FP. All other efficacy indices showed comparable improvements in each group. Treatment with SFC 50/100 μg bd compared with twice the steroid dose of FP (200 μg bd), was at least as effective in improving individual clinical outcomes and overall asthma control, in asthmatic children previously uncontrolled on low doses of ICS.
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salmeterol fluticasone propionate vs double dose fluticasone propionate on lung function and asthma control in children
Pediatric Allergy and Immunology, 2009Co-Authors: Jacques De Blic, L M Ogorodova, Rabih Klink, Irina Sidorenko, Arunas Valiulis, Jerzy Hofman, Olav Bennedbaek, Sally Anderton, Valerie Attali, Jeanluc DesfougeresAbstract:There is a large body of data to support the use of an inhaled corticosteroid (ICS) plus a long-acting beta(2)-agonist vs. increasing the dose of ICS in adults, but less data in children. This double-blind, parallel group, non-inferiority study compared lung function and asthma control, based on Global Initiative for Asthma guidelines, in children receiving either salmeterol/fluticasone propionate (SFC) 50/100 microg bd (n = 160) or fluticasone propionate (FP) 200 microg bd (n = 161) for 12 wks. Change from baseline in mean morning peak Expiratory Flow increased following both treatments, but was significantly greater in the SFC group compared with FP [Adjusted mean change (s.e.) (l/min): SFC: 26.9 (2.13), FP: 19.3 (2.12); treatment difference: 7.6 (3.01); 95% CI: 1.7, 13.5; p = 0.012)]. Asthma control improved over time in both groups. Mean pre-bronchodilator Maximal-Expiratory Flow at 50% vital capacity and percentage rescue-free days showed significantly greater improvements in the SFC group compared with FP. All other efficacy indices showed comparable improvements in each group. Treatment with SFC 50/100 microg bd compared with twice the steroid dose of FP (200 microg bd), was at least as effective in improving individual clinical outcomes and overall asthma control, in asthmatic children previously uncontrolled on low doses of ICS.