Background: The choice between lower limit of normal or fixed value of forced expiratory volume in one second/forced vital capacity ratio (FEV(1)/FVC) < 0.70 as the criterion for confirming airway obstruction is an open issue. In this study, we compared the criteria of lower limit of normal and fixed FEV(1)/FVC for diagnosis of airway obstruction, with a focus on healthy elderly people.
Methods: We selected 367 healthy nonsmoking subjects aged 65-93 years from 1971 participants in the population-based SARA (Salute Respiratoria nell'Anziano, Italian for "Respiratory Health in the Elderly") study, analyzed their spirometric data, and tested the relationship between spirometric indices and anthropometric variables. The lower limit of normal for FEV(1)/FVC was calculated as the fifth percentile of the normal distribution for selected subjects.
Results: While FEV(1) and FVC decreased significantly with aging, the relationship between FEV(1)/FVC and age was not statistically significant in men or women. The lower limit of normal for FEV(1)/FVC was 0.65 in men and 0.67 in women. Fifty-five participants (15%) had FEV(1)/FVC < 0.70 and would have been inappropriately classified as obstructed according to the Global Initiative for Obstructive Lung Disease, American Thoracic Society/European Respiratory Society, and Canadian guidelines on chronic obstructive pulmonary disease. By applying different FEV(1)/FVC thresholds for the different age groups, as previously proposed in the literature, (0.70 for <70 years, 0.65 for 70-80 years, and 0.60 for >80 years) the percentage of patients classified as obstructed decreased to 6%. No subjects older than 80 years had an FEV(1)/FVC < 0.60.
Conclusion: The present results confirm the inadequacy of FEV(1)/FVC < 0.70 as a diagnostic criterion for airway obstruction after the age of 65 years. FEV(1)/FVC < 0.65 and <0.67 (for men and women, respectively) could identify subjects with airway obstruction in such a population. Further reduction of the threshold after 80 years is not justified.
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http://dx.doi.org/10.2147/COPD.S31630 | DOI Listing |
Cells
December 2024
School of Life Science, University of Technology Sydney, Ultimo, NSW 2007, Australia.
Chronic obstructive pulmonary disease (COPD) is characterized by progressive and incurable airflow obstruction and chronic inflammation. Both TGF-β1 and CXCL8 have been well described as fundamental to COPD progression. DNA methylation and histone acetylation, which are well-understood epigenetic mechanisms regulating gene expression, are associated with COPD progression.
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View Article and Find Full Text PDFJ Craniofac Surg
December 2024
Member of Sociedad Argentina de Ortodoncia, Member of International Society of Craneofacial Surgery, Member of Asociación Latinoamericana de Ortodoncia, Buenos Aires, Argentina.
Craniofacial syndromes present with exorbitism and airway obstruction as a result of upper and middle facial hypoplasia. Classical subcranial Lefort III (LF III) or monobloc distraction osteogenesis (DO) using an external craniofacial device is used to treat these deformities. These procedures are done during mixed dentition, in most cases, advancing an abnormal face, to a more normal position.
View Article and Find Full Text PDFPLoS One
January 2025
Faculty of Health Sciences, Postgraduation Program in Health Sciences, University of Brasilia, Brasilia, Brazil.
Unplanned extubation (UPE), defined as accidental removal of the endotracheal tube during mechanical ventilation or its replacement due to suspected obstruction or inadequate diameter, is considered the fourth most common adverse event in neonatal intensive care units (NICU). This study aimed to describe a systematic review and meta-analysis protocol that will identify and assess the effect of primary intervention measures designed to prevent UPE in NICU. A search will be carried out in the following databases: PubMed/Medline, EMBASE, Scopus, CINAHL, Cochrane Library, SciELO, and LILACS.
View Article and Find Full Text PDFAllergol Immunopathol (Madr)
January 2025
Geriatric Department, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou City, Jiangsu Province, China;
Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation, airway obstruction, and lung damage, often triggered by cigarette smoke. Dysregulated autophagy and inflammation are key contributors to its progression. Although double-stranded RNA-binding protein Staufen homolog 1 (STAU1), a multifunctional protein primarily involved in mRNA transport and localization, is identified as a potential biomarker, its role in COPD pathogenesis remains unclear.
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