peak expiratory flow rate (pefr)

  • 文章类型: Journal Article
    背景:本研究旨在全面表征帕金森病(PD)患者肺功能异常的范围,并评估左旋多巴治疗对这些呼吸功能障碍的影响。
    方法:招募了通过英国帕金森病学会脑库诊断标准诊断的95名PD患者,排除有吸烟史或无法进行肺功能检查(PFTs)的患者。使用Hoehn和Yahr量表评估严重程度。肺活量测定测量的PFT参数(强制肺活量(FVC),第一秒用力呼气量(FEV1),和最大呼气流速(PEFR))与匹配的预测值进行比较。评估左旋多巴攻击后PFT参数的变化。
    结果:大多数PD患者年龄在51-60岁之间,平均年龄55.89±8.37岁。其中,65.3%为男性。该队列中有很大一部分表现出限制性肺部模式(73.7%),而一小部分显示阻塞性(7.4%)或正常(18.9%)的肺功能模式。值得注意的是,左旋多巴治疗与所有测量的PFT参数的显着改善相关,FVC和FEV1从“关闭”药物阶段到“开启”阶段的增强尤其明显(P=0.0001)。发现呼吸限制的严重程度与PD的持续时间之间存在弱正相关(r=0.139,P=0.021)。提示随着时间的推移,PD的进展对呼吸功能产生越来越不利的影响。
    结论:这项研究的结果表明,在PD患者中,限制性肺部异常比阻塞性模式更为普遍,并且这些患者对左旋多巴治疗反应良好。
    BACKGROUND: This investigation aimed to thoroughly characterize the range of pulmonary function abnormalities present in individuals with Parkinson\'s disease (PD) and to evaluate the effects of levodopa therapy on these respiratory dysfunctions.
    METHODS:  Ninety-five PD patients diagnosed via the UK Parkinson\'s Disease Society Brain Bank Diagnostic Criteria were recruited, excluding those with a smoking history or unable to perform pulmonary function tests (PFTs). Severity was assessed using the Hoehn and Yahr Scale. Spirometry-measured PFT parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow rate (PEFR)) were compared against matched predicted values. The changes in PFT parameters post-levodopa challenge were assessed.
    RESULTS: Most of the PD patients were aged between 51-60 years, with a mean age of 55.89 ± 8.37 years. Of these, 65.3% were male. A significant proportion of the cohort exhibited restrictive pulmonary patterns (73.7%), while a smaller fraction displayed obstructive (7.4%) or normal (18.9%) pulmonary function patterns. Notably, levodopa treatment correlated with marked improvements in all measured PFT parameters, especially evident in the enhancements from the \"off\" medication stage to the \"on\" stage for FVC and FEV1 (P=0.0001). A weak positive correlation between the severity of respiratory restriction and the duration of PD (r = 0.139, P = 0.021) was found, suggesting that PD\'s progression exerts an increasingly adverse effect on respiratory function over time.
    CONCLUSIONS:  The findings of this study illustrate that restrictive pulmonary abnormalities are more prevalent than obstructive patterns in PD patients and that these patients respond favorably to levodopa therapy.
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  • 文章类型: Journal Article
    背景:峰值流量是用于对哮喘急性加重发作的严重程度进行分类的重要但简单的测试。应定期在急诊科出现哮喘急性发作的所有患者中进行。英国胸科学会(BTS)/苏格兰校际指南网络(SIGN)指南规定,使用峰值流量是将急性哮喘分为中度,严重,和危及生命的哮喘.BTS和SIGN指南还指出,峰值流量将用于监测疾病并指导治疗急性哮喘患者。
    方法:本研究旨在确定在地区综合医院评估哮喘急性加重患者的严重程度时,使用呼气峰流速(PEFR)对BTS/SIGN指南的依从性。回顾性队列研究涉及2022年10月至2023年2月从我们医院电子系统收集的数据。将收集的有关PEFR使用的数据以及在这之后患者是否按严重程度分类的数据与BTS/SIGN158哮喘指南进行比较。在此之后,数据分析是使用IBMSPSSStatisticsforWindows完成的,版本21.0(2012年发布;IBMCorp.,Armonk,纽约,美国)。
    结果:对92例患者的数据进行了整理。记录了29.3%(n=27)的患者的PEFR,仅17.4%(n=16)的患者记录了哮喘严重程度的急性加重。
    结论:结果表明,所分析的患者队列中有很大一部分没有峰值流量读数,有明显的改进空间,并且需要进一步的干预,以便该部门遵守黄金标准准则(即,BTS/SIGN158),从而改善哮喘急性发作的管理和监测。未来的方向可以包括部门教育,海报作为提醒,和电子系统上的提示,用于在记录急性哮喘加重的诊断时提醒用户检查PEFR。
    BACKGROUND: Peak flow is a crucial but simple test used to categorize the severity of an episode of an acute exacerbation of asthma. It should be regularly done in all the patients who present with asthma acute exacerbation in the emergency department. The British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines stipulate peak flow use as one of the main tools to categorize acute asthma into moderate, severe, and life-threatening asthma. The BTS and SIGN guidelines also state peak flow is to be utilized in monitoring the disease and to guide in treating patients with acute asthma.
    METHODS: This study aims to identify the adherence to BTS/SIGN guidelines around the use of peak expiratory flow rate (PEFR) in assessing the severity of patients presenting with acute exacerbation of asthma in a district general hospital. The retrospective cohort study involved collating data between October 2022 and February 2023 from our hospital electronic system. The data collected about the use of PEFR and whether the patients were being classified by severity in presentation following this was compared to the BTS/SIGN 158 asthma guidelines. Following this, the data analysis was done using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, New York, United States).
    RESULTS: Data from 92 patients were collated. PEFR was recorded for 29.3% (n=27) of patients and acute exacerbation of asthma severity was documented in merely 17.4% (n=16) patients.
    CONCLUSIONS: The results indicate a significant proportion of the patient cohort analyzed did not have peak flow readings, there is clear room for improvement, and further intervention is needed in order for the department to adhere to the gold standard guidelines (i.e., BTS/SIGN 158), and thus improve the management and monitoring of acute asthma exacerbations. Future directions can include departmental education, posters as a reminder, and prompts on the electronic system used to alert users to check PEFR when a diagnosis of acute asthma exacerbation is documented.
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  • 文章类型: Journal Article
    引言这个前瞻性的,随机对照研究旨在探讨经皮肾镜取石术患者术后疼痛治疗的疗效和呼吸影响。方法60例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级患者,年龄18~65岁,计划接受经皮肾镜取石术,随机分为竖脊肌平面阻滞(ESPB)组或对照组。在ESPB组中,术前使用平面内技术给予T11水平的15mL0.5%布比卡因。在这两组中,术中静脉注射1克扑热息痛。术后疼痛和躁动使用视觉模拟量表(VAS)进行评估,动态VAS为零,六,24小时,和手术后第0小时的Riker镇静-激动量表。术前检查和第0次测量峰值呼气流速(PEFR)和氧饱和度(SpO2),6th,术后24小时。需要镇痛的时间和次数,动员,并记录放电时间。结果0时观察到明显较低的VAS和动态VAS,6th,ESPB组的第24小时和第24小时(每个时间点p<0.05)。对照组术后/术前PEFR比值较低,躁动患者较多(p<0.05)。结论与静脉镇痛相比,在经皮肾镜取石术患者中,竖脊肌平面阻滞在提供有效镇痛的同时可能具有额外的临床优势。
    Introduction This prospective, randomized controlled study aimed to investigate the efficacy and respiratory effects of postoperative pain management with an erector spinae plane block in patients undergoing percutaneous nephrolithotomy. Methods Sixty American Society of Anesthesiologists (ASA) I-II patients aged 18-65 years, scheduled to undergo percutaneous nephrolithotomy, were randomized either to the erector spinae plane block (ESPB) or control group. Fifteen mL 0.5% bupivacaine at the T11 level was administered preoperatively using the in-plane technique in the ESPB group. In both groups, 1 gr of intravenous paracetamol was administered intraoperatively. Postoperative pain and agitation were evaluated using the visual analog scale (VAS), dynamic VAS at zero, six, and 24 hours, and the Riker sedation-agitation scale at the 0th hour after surgery. Peak expiratory flow rate (PEFR) and oxygen saturation (SpO2) were measured in preoperative examination and at the 0th, 6th, and 24th hours postoperatively. The time and number of the analgesic requirement, mobilization, and discharge time were also recorded. Results A significantly lower VAS and dynamic VAS were observed at the 0th, 6th, and 24th hours in the ESPB group (p<0.05 for each timepoint). The postoperative/preoperative PEFR ratio was lower and there were more agitated patients in the control group (p<0.05). Conclusion An erector spinae plane block may have additional clinical advantages while providing effective analgesia in patients who underwent percutaneous nephrolithotomy compared to intravenous analgesia.
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  • 文章类型: Journal Article
    UNASSIGNED: Daily evaluation of peak expiratory flow rate (PEFR) is quite useful for monitoring and adjusting an asthmatic patient\'s treatment. Many factors including geography, ethnicity, socio-economic conditions, gender, and anthropometric play a role in lung function differences studies have found. The aim of this study is to present normal PEFR and to establish a PEFR equation for Thai children living in a suburban environment.
    UNASSIGNED: This study includes a cross-section of healthy children aged 6 to 18. It was conducted in Phitsanulok Province in the lower north of Thailand. The children were chosen to participate from five primary and secondary schools over the period from February 2014 to January 2015. The children were instructed on how to use the Wright peak flow meter (Clement Clarke International Ltd.). All of the participants performed PEFR 3 times and the highest value was recorded.
    UNASSIGNED: A total of 2,000 students were initially examined; 80 students were excluded from the study. A total of 1,920 healthy children were recruited between the ages of 6 and18 years. Among them, 719 (37.4%) were males and 1,201 (62.6%) were females. The median age was 18 [12-18] years old, mean height, weight, body mass index (BMI) and PEFR were 155.98±14.99 cm, 51.38±16.95 kg, 20.62±4.79 kg/m2 and 339.31±113.55 L/min, respectively. PEFR has a linear relationship in regards age, weight, height and BMI. For males, age was the strongest factor associated with PEFR (r=0.838, P<0.001). Females had a highly significant correlation between height and PEFR (r=0.532, P<0.001). The regression equations are PEFR = (1.34 × height) + (1.41 × weight) + (16.56 × age) - 137.88 for males (R2=0.751, P<0.001) and PEFR = (1.31 × height) + (0.94 × weight) + (7.30 × age) - 55.27 for females (R2=0.507, P<0.001).
    UNASSIGNED: This research study has provided the normal range of PEFR for Thai children aged from 6 to 18 years in Phitsanulok. The data was obtained using the Wright peak flow meter. Height, weight, and age were the significant determiners of the PEFR for each sex in the regression equation.
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    文章类型: Clinical Trial
    The asthma treatment and control might be associated with significant burden on family and community\' thus exploring other therapeutic plans could be desirable. The aim of this study was to investigate the effect of salt space on clinical findings and peak expiratory flow rate among children with asthma. In this randomized crossover trial, 34 patients aged 6-14 years old with mild to moderate asthma were selected and randomly divided into two groups. The first group went through a period of salt therapy by staying in the salt room for one hour, three times a week for 3 consecutive weeks and then was under observation for three weeks. This process was reversed for the second group (three weeks under observation followed by salt therapy). The wash-out period was one week. During the study, the morning and evening peak expiratory flow (PEF), the frequency of coughing, wheezing, dyspnea and use of rescue medications were measured. Salt therapy had a significant effect on raising the morning and evening PEF in the second week in both groups (p=0.028 and p=0.032, respectively). However, there was no significant effect on PEF variabilities\' cough\' wheezing, dyspnea, and the frequency of rescue medication (p>0.05). No side effect was observed during salt therapy. This study showed the significant effect of salt therapy on PEF rate of the patients in the second week. However, further studies with different frequency and time of salt therapy on respiratory disorders are recommended.
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  • 文章类型: Journal Article
    背景:印度的Brickfield工人进行手动物料搬运(MMH),结果,发生氧化应激的风险很高。这导致细胞水平上代谢氧化应激的各种标记物的改变。由于红细胞(RBC)是氧气的中心点,葡萄糖-6-磷酸脱氢酶(G-6-PD),谷胱甘肽(GSH)参与其中,表面粗糙度及其改变和建模关于工人暴露于MMH可以被认为是有帮助的决定因素,在预测早期损害的细胞和恢复更好的健康暴露人群。也就是说,暴露在压力下的工人。因此,RBC表面粗糙度的纳米分析可以作为这些个体中与应力相关的损伤的早期指标。
    目的:本研究的目的是根据各种生化参数相关的线性模型来确定早期红血球表面损伤特征。线性建模的目的是为了证明个体氧化应激标志物如丙二醛(MDA),G-6-PD,GSH的降低与红细胞表面粗糙度[均方根(RMS)]有关。
    方法:在MMH劳动者(年龄在18岁至21岁之间)和同年龄组的可比对照组(久坐的生活方式)中评估了这些生化反应的常规分析。在完成标准化运动(MMH)后,立即通过原子力显微镜(AFM)和相关扫描探针显微镜(SPM分析软件)进行峰值呼气流速(PEFR)和RBC表面分析,并进行相应的图像分析。
    结果:在MDA之间建立了许多相关显著性和回归线性模型,G-6-PD,GSH,和红细胞表面粗糙度。
    结论:看来这些线性模型可能有助于预测与特定职业危害相关的早期氧化损伤。
    BACKGROUND: Brickfield workers in India perform manual materials handling (MMH) and as a result, are at a high risk of developing oxidative stress. This results in an alteration of the various markers of metabolic oxidative stress at the cellular level. Since red blood cell (RBC) is the central point where oxygen, glucose-6-phosphate dehydrogenase (G-6-PD), and glutathione (GSH) are involved, the surface roughness and its alteration and modeling with respect to workers exposed to MMH may be considered as helpful determinants in predicting early damage to the cell and restoring better health to the exposed population, that is, the worker exposed to stress. Hence, nanometric analysis of the surface roughness of the RBC may serve as an early indicator of the stress-related damage in these individuals.
    OBJECTIVE: The purpose of the study was to identify early red blood corpuscular surface damage profile in terms of linear modeling correlating various biochemical parameters. Linear modeling has been aimed to be developed in order to demonstrate how individual oxidative stress markers such as malondialdehyde (MDA), G-6-PD, and reduced GSH are related to the RBC surface roughness [root mean square (RMS)].
    METHODS: Conventional analysis of these biochemical responses were evaluated in MMH laborers (age varying between 18 years and 21 years) and a comparable control group of the same age group (with sedentary lifestyles). Peak expiratory flow rate (PEFR) and RBC surface analysis by atomic-force microscopy (AFM) and correlated scanning probe microscopy (SPM-analytical software) with corresponding image analysis were performed immediately after completion of standardized exercise (MMH) at the brickfield.
    RESULTS: A number of correlated significances and regressive linear models were developed among MDA, G-6-PD, GSH, and RBC surface roughness.
    CONCLUSIONS: It appears that these linear models might be instrumental in predicting early oxidative damages related to specific occupational hazards.
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