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Spirometry in the ambulatory setting

Hassan Aqeel Khan, Amit Gore, Jeffrey Ashe, Shantanu Chakrabartty
Continuous monitoring of respiratory patterns and physical activity levels can be useful for remote health management of patients with conditions such as heart disease and chronic obstructive pulmonary disease. In a clinical setting, spirometers serve as the gold standard for monitoring respiratory patterns such as breathing rate and changes in lung volume. However, direct measurements using a spirometer requires placement of a sensor in the patient's airway and is thus infeasible for continuous monitoring in nonclinical, ambulatory settings...
August 2017: IEEE Transactions on Biomedical Circuits and Systems
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
December 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
M Patout, M Zysman, C Raherison Semjen, T Perez, A Cuvelier, N Roche
INTRODUCTION: A workshop has been organized in April 2013 by the Société de Pneumologie de Langue Française about COPD epidemiology and COPD screening in France and other European countries. This article deals with epidemiological data and their consequences on the French screening strategy. STATE-OF-THE-ART: According to the most recent data, spirometric prevalence of COPD in France is 7.5% in individuals over 45 years old. During 2000-2002, COPD was responsible for 1...
October 2014: Revue des Maladies Respiratoires
Claudia Halaby, Martin Feuerman, Dan Barlev, Melodi Pirzada
OBJECTIVE: To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. METHODS: 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms...
March 2014: Postgraduate Medicine
Michael J Cawley, Richard Pacitti, William Warning
OBJECTIVE: To assess value-added service of a pharmacist-driven point-of-care spirometry clinic to quantify respiratory disease abnormalities within a primary care physicians office. METHODS: This retrospective, cohort study was an analysis of physician referred patients who attended our spirometry clinic during 2008-2010 due to pulmonary symptoms or disease. After spirometry testing, data was collected retrospectively to include patient demographics, spirometry results, and pulmonary pharmaceutical interventions...
October 2011: Pharmacy Practice
Christopher Voscopoulos, Jordan Brayanov, Diane Ladd, Michael Lalli, Alexander Panasyuk, Jenny Freeman
BACKGROUND: Currently there is no technology that noninvasively measures the adequacy of ventilation in nonintubated patients. A novel, noninvasive Respiratory Volume Monitor (RVM) has been developed to continuously measure and display minute ventilation (MV), tidal volume (TV), and respiratory rate (RR) in a variety of clinical settings. We demonstrate the RVM's accuracy and precision as compared with a standard spirometer under a variety of clinically relevant breathing patterns in nonintubated subjects...
July 2013: Anesthesia and Analgesia
Francisco García-Río, Myriam Calle, Felip Burgos, Pere Casan, Félix Del Campo, Juan B Galdiz, Jordi Giner, Nicolás González-Mangado, Francisco Ortega, Luis Puente Maestu
Spirometry is the main pulmonary function test and is essential for the evaluation and monitoring of respiratory diseases. Its utility transcends the field of Respiratory Medicine, is becoming increasingly important in primary care and applications have even been described outside the field of respiratory diseases. This document is therefore intended to serve as support for all health professionals who use spirometry, providing recommendations based on the best scientific evidence available. An update of the indications and contraindications of the test is proposed...
September 2013: Archivos de Bronconeumología
Rhonda Cady, Stanley Finkelstein, Bruce Lindgren, William Robiner, Ruth Lindquist, Arin VanWormer, Kathleen Harrington
OBJECTIVE: Home telemonitoring improves clinical outcomes but can generate large amounts of data. Automating data surveillance with clinical decision support could reduce the impact of translating these systems to clinical settings. We utilized time-motion methodology to measure the time spent on activities monitoring subjects in the two groups of a home spirometry telemonitoring randomized controlled trial: the manual nurse review (control) group and the automated review (intervention) group...
June 2010: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
A F J Brouwer, P L P Brand, R J Roorda, E J Duiverman
BACKGROUND: In asthma treatment, doses of inhaled corticosteroids are often adapted to symptoms and need for bronchodilators. However, in cross-sectional studies in emergency room settings, lung function and respiratory symptoms are not always concordant. Available longitudinal data are based on written peak flow diaries, which are unreliable. Using home spirometry, we studied prospectively whether mild respiratory symptoms, prompting reliever therapy are accompanied by a clinically relevant drop in lung function in children with asthma...
June 2010: Acta Paediatrica
Joel J Bechtel, William A Kelley, Teresa A Coons, Philip Mohler, Andrew Mohler, David James, Thomas L Petty
INTRODUCTION: We have previously published the outcome of a community-based lung cancer screening program. We now report on the 5-year follow-up of this study and include both patients with and without airflow obstruction. MATERIALS AND METHODS: One thousand two hundred fifty-six patients completed questionnaires in the office of their primary care physicians, and 430 of this group were assessed to be at high risk for lung cancer. These patients then underwent spirometry, and 88 of 126 patients with airflow obstruction consented to lung cancer screening test...
November 2009: Journal of Thoracic Oncology
Martin Zoremba, Frank Dette, Laura Gerlach, Udo Wolf, Hinnerk Wulf
BACKGROUND: Even several days after surgery, obese patients exhibit a measureable amount of atelectasis and thus are predisposed to postoperative pulmonary complications. Particularly in ambulatory surgery, rapid recovery of pulmonary function is desired to ensure early discharge of the obese patient. In this study, we wanted to evaluate intensive short-term respiratory physical therapy treatment (incentive spirometry) in the postanesthesia care unit (PACU) and its impact on pulmonary function in the obese...
October 2009: Obesity Surgery
Z M Sund, T Powell, R Greenwood, N A Jarad
New technologies have allowed remote real-time electronic recording of symptoms and spirometry. The feasibility of utilising this technology in COPD patients has not been investigated. This is a feasibility study. The primary objective is to determine whether the use of an electronic diary with a portable spirometer can be performed by COPD patients with a moderate to severe disease. Secondary objectives are to investigate the value of this method in early detection of acute exacerbations of COPD (AECOPD). In this 6-month study, 18 patients recorded daily their symptom score and spirometry...
September 2009: Respiratory Medicine
Iain L O Buxton, John Q Adams, Mark Gore, Charles R Sullivan
Established in 1978, Computerized Screening Inc. (CSI) is the manufacturer of medical kiosks that combine non-invasive & invasive preventive health-screening technology and services in the U.S. The centerpiece of CSl's health complement is the CSI Health Station, one-stop health information and screening using patented technology. The CSI Health Station (Model 6K) represents the corporation's evolution from its self-administered automated blood pressure monitors (Model 3K). CSI Health Stations also offer touch screen activated heart rate testing, patented, seated weight measurement and fitness evaluations plus other non-invasive features like BMI, resting metabolic rate, spirometry, pulse oximetry and customized health risk assessments or triage guidelines...
2007: Proceedings of the Western Pharmacology Society
H O Koskela, M K Purokivi, K M Kontra, A H Taivainen, H O Tukiainen
BACKGROUND: Cough is one of the most common symptoms of asthma. However, studies using capsaicin, citric acid, or tartaric acid to document cough threshold have repeatedly failed to show statistically significant differences between asthmatic and healthy subjects. The studies using hypertonic aerosols as the cough stimulant have suggested an enhanced sensitivity in asthmatic subjects but the induced bronchoconstriction has made the interpretation of the results difficult. OBJECTIVE: To determine the cough sensitivity to hypertonicity in healthy subjects, patients with chronic cough, and patients with asthma in a setting where the induction of bronchoconstriction is prevented...
July 2008: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Timothy J Wilt, Dennis Niewoehner, Roderick MacDonald, Robert L Kane
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common and disabling condition in adults. Information about therapeutic effectiveness and adverse effects of common treatment options and how clinical and spirometric characteristics affect outcomes is not well known but is important for clinicians caring for patients with stable COPD. PURPOSE: To evaluate the effectiveness of COPD management strategies. DATA SOURCES: English-language publications in MEDLINE and the Cochrane Library through March 2007...
November 6, 2007: Annals of Internal Medicine
T Kim Callahan Rodehorst, Susan L Wilhelm, Mary Beth Stepans
BACKGROUND: Asthma, the leading cause of chronic illness in children, must be managed in both the home and school environments. Identification of children who have risk factors associated with asthma is the first step toward achieving one of the Healthy People 2010 (2000) objectives, which identifies that 25 states will establish a system of surveillance to track asthma mortality, morbidity, access to care, and asthma management. PURPOSE: The purposes of this research were to: a) identify rural children who are at risk for asthma through written screening; b) assess parameters of respiratory health status of rural school-aged children as indicated by forced expiratory volume at l second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), mean mid-expiratory flow (FEF(25-75)); and c) identify the number of rural school-aged children who sought and obtained follow-up from their primary health care provider and were given a definitive diagnosis of asthma...
October 2006: Issues in Comprehensive Pediatric Nursing
G Huchon
The follow-up of Community Acquired Pneumonias (CAP) and Acute Exacerbations of Chronic Obstructive Pulmonary Diseases (AECOPD) differs with the setting of care, but overall calls upon the same investigations as the initial evaluations. In the event of initial ambulatory care, the evaluation is carried out primarily on clinical data, at the 2 or 3rd day for the CAP, at the 2nd to 5th day for the AECOPD. In the event of unfavourable evolution, or from the start in the most severe cases, the follow-up is carried out in hospital; clinical evaluation is readily daily, and all the more frequent that the clinical condition is worrying because of the severity or risk factors...
November 2006: Médecine et Maladies Infectieuses
Daryl Freeman, Robert J Nordyke, Sharon Isonaka, Dmitry V Nonikov, Jaman M Maroni, David Price, R J Halbert
OBJECTIVES: To test questions usable in an ambulatory clinic to identify persons likely to have chronic obstructive pulmonary disease (COPD). METHODS: Analyses were performed as part of a study to identify patients with likely COPD in the Glenfield UK primary care clinic. Patients age 40 and older were recruited based on one of the following criteria: (1) respiratory medications in previous 2 years; (2) history of smoking or (3) history of asthma with no current medications based on case notes...
October 2005: Respiratory Medicine
Stanley M Finkelstein, Anthony Scudiero, Bruce Lindgren, Mariah Snyder, Marshall I Hertz
Purpose The objective of this study was to develop and evaluate a computerized rule-based decision support algorithm for nursing triage of potential acute bronchopulmonary events in lung transplant recipients on the basis of home monitoring of spirometry and symptoms. Methods The algorithm automatically separates recipients into 2 groups: those who are stable or improving and those who should be "watched" further because of their potential for developing bronchopulmonary events according to their weekly home-monitoring measurements...
May 2005: Heart & Lung: the Journal of Critical Care
Luis García-Marcos, José A Castro-Rodríguez, Amparo Escribano Montaner, Jesús Garde Garde, Juan José Morell Bernabé, Javier Pellegrini Belinchón et al.
The objective of this study was to determine the level of adherence of pediatricians in Spain to the Spanish National Guidelines for Asthma Treatment with regard to the use of a peak flow meter (PEFR) or a spirometer in the diagnosis and management of asthma in childhood and to analyze sources of variations in these practices. A prospective survey (consisting of demographic and asthma knowledge sections) was conducted over a 2-wk time interval of 3000 pediatricians throughout the country. At least one part of the questionnaire was completed and returned by 2773 individuals (92...
August 2004: Pediatric Allergy and Immunology
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