Displaying publications 1 - 20 of 73 in total

Abstract:
Sort:
  1. Fulltext Gastro-oesophageal reflux disease in 'difficult-to-control' asthma: prevalence and response to treatment with acid suppressive therapy
    Wong CH, Chua CJ, Liam CK, Goh KL
    Aliment Pharmacol Ther, 2006 May 1;23(9):1321-7.
    PMID: 16629937 DOI: 10.1111/j.1365-2036.2006.02888.x
    BACKGROUND: The causal association between gastro-oesophageal reflux disease (GERD) and difficult-to-control asthma is unclear.
    AIM: To determine the prevalence of GERD and response to proton pump inhibitor therapy in patients with difficult-to-control asthma.
    METHODS: Consecutive patients with difficult-to-control asthma as defined by persistent and recurrent symptoms despite on optimal asthmatic medications were recruited for the study. GERD was diagnosed by symptoms, gastroscopy and 24-h oesophageal pH monitoring. All patients were prescribed a course of lansoprazole 30 mg daily for 8 weeks. Improvement to treatment was assessed by a change in pulmonary symptom score and also by patient's subjective assessment of improvement.
    RESULTS: Seventeen of 30 (56.7%) patients with difficult-to-control asthma were diagnosed with GERD. Pulmonary symptom score improved significantly only in patients with GERD (35.0 to 21.0; P = 0.002). Twelve of 16 (75%) patients with GERD reported an improvement in asthma symptoms; 1 of 11 (9.1%) without GERD reported mild symptom improvement. There was no significant change in peak expiratory flow rate and forced expiratory volume.
    CONCLUSIONS: More than half of patients with difficult-to-control asthma were diagnosed with GERD. In these patients the severity of asthma improved significantly with potent acid suppression therapy. This underlines the critical role of acid reflux in this subset of patients with difficult-to-control asthma.
    Study site: Respiratory clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Forced Expiratory Volume/drug effects
  2. Fulltext Associations of Occupational, Socio-Demographic and Lifestyle Factors with Lung Functions in Malaysian Traffic Policemen
    Jamil PASM, Karuppiah K, Rasdi I, How V, Tamrin SBM, Mani KKC, et al.
    Ann Glob Health, 2020 07 28;86(1):84.
    PMID: 32775216 DOI: 10.5334/aogh.2895
    Background: Apart from being exposed to various hazards, there are several other factors that contribute to the deterioration of traffic police health.

    Objectives: A cross-sectional study was carried out to explore the association of occupational, socio-demographic, and lifestyle factors with lung functions in traffic policemen in Kuala Lumpur (KL) and Johor Bahru (JB).

    Methods: A spirometer was used to measure lung function of subjects, whereas a self-administered questionnaire was used to obtain their information on background data, lifestyle, and occupational factors. The statistical test used was Spearman rho's test and chi-square test; then, the factors were further tested using Logistic regressions.

    Findings: 134 male subjects were selected as respondents in this study with 83% response rate. Among all the factors tested, age (FVC: χ = 8.42(3), p = 0.04), (FEV: χ = 8.26(3), p = 0.04), rank (FVC: χ = 8.52(3), p = 0.04), (FEV: χ = 8.05(3), p = 0.04), duration of services (FVC: χ = 11.0(1), p = 0.04), (FEV: χ = 6.53(1), p = 0.01), and average working hours (with the Measured FVC (litre), r = -3.97, p < 0.001; Measured FEV1 (litre), r = -3.70, p < 0.001; Predicted FVC, r = -0.49, p < 0.001; Predicted FEV1, r = -0.47, p < 0.001; and %Ratio FEV1/FV, r = -0.47, p < 0.001) were significantly related to lung function among traffic police.

    Conclusions: Occupational factors play a crucial role, and hence, the authorities should take action in generating flexible working hours and the duration of services accordingly. The data from this study can help by serving as a reference to the top management of traffic police officers to develop occupational safety and health guideline for police officers to comply with the Occupational Safety and Health Act (OSHA, Act 514 1994).

    Matched MeSH terms: Forced Expiratory Volume
  3. Pulmonary function in healthy Chinese, Malay and Indian adults in Singapore
    Chia SE, Wang YT, Chan OY, Poh SC
    Ann Acad Med Singap, 1993 Nov;22(6):878-84.
    PMID: 8129348
    Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), single-breath diffusion capacity measurements (effective alveolar volume (VA), carbon monoxide transfer factor (DLCO) and transfer coefficient (KCO)) were determined in 452 healthy Singaporean adults (277 males and 175 females) aged 20-70 years. The ratio of Chinese, Malay and Indian subjects was 5:2:3 in both sexes. Age, height and weight in the males were all significantly correlated with FEV1, FVC, DLCO, VA and PEFR. However, for females, only age and height were significantly correlated with the studied lung function parameters. Significant ethnic differences were observed for most of the pulmonary functions (except KCO and PEFR) among the Chinese, Malays and Indians for both males and females. The predicted FEV1 and FVC values (specific age and height) for both sexes were highest among the Chinese followed by the Malays than Indians, in that order. Regression equations, with age and height as independent variables, were derived for males and females in each ethnic group to predict normal pulmonary function for the Singapore Chinese, Malay and Indian populations. The predicted values of various pulmonary function measurements obtained from these regression equations for subjects of specified age (30 years) and height (165 cm for men, 155 cm for women) were compared with those reported in other studies. Differences were observed among the different races.
    Matched MeSH terms: Forced Expiratory Volume
  4. An epidemiological study of lung functions and hearing acuity in Singapore firemen
    Phoon WO, Ong CN, Foo SC, Plueksawan W
    Ann Acad Med Singap, 1984 Apr;13(2 Suppl):408-16.
    PMID: 6497345
    This study was conducted on 506 firemen in Singapore. Interviews, pulmonary function tests and audiometry were conducted. With regard to pulmonary function, the results showed that forced vital capacity (FVC) increased up to the age of 25-30 years for both Chinese and Malays. Both FVC and forced expiratory volume in one second (FEV1.0) increased with standing height over the whole age range studied. The mean values of FVC and FEV1.0 were higher in Chinese. It was also found that the FEV1 of the subjects in the study showed a greater decline in rate with age than other workers studied by the authors previously. The hearing threshold of 83 fire fighters showed a prominent upward shift of 6-8 KHz at ages 20-30. This upward shift was more pronounced in the right ear. The implications of the findings are discussed and a comparison with results of other similar studies in other countries is made.
    Matched MeSH terms: Forced Expiratory Volume
  5. Predicting the risk of exacerbation in patients with chronic obstructive pulmonary disease using home telehealth measurement data
    Mohktar MS, Redmond SJ, Antoniades NC, Rochford PD, Pretto JJ, Basilakis J, et al.
    Artif Intell Med, 2015 Jan;63(1):51-9.
    PMID: 25704112 DOI: 10.1016/j.artmed.2014.12.003
    BACKGROUND: The use of telehealth technologies to remotely monitor patients suffering chronic diseases may enable preemptive treatment of worsening health conditions before a significant deterioration in the subject's health status occurs, requiring hospital admission.
    OBJECTIVE: The objective of this study was to develop and validate a classification algorithm for the early identification of patients, with a background of chronic obstructive pulmonary disease (COPD), who appear to be at high risk of an imminent exacerbation event. The algorithm attempts to predict the patient's condition one day in advance, based on a comparison of their current physiological measurements against the distribution of their measurements over the previous month.
    METHOD: The proposed algorithm, which uses a classification and regression tree (CART), has been validated using telehealth measurement data recorded from patients with moderate/severe COPD living at home. The data were collected from February 2007 to January 2008, using a telehealth home monitoring unit.
    RESULTS: The CART algorithm can classify home telehealth measurement data into either a 'low risk' or 'high risk' category with 71.8% accuracy, 80.4% specificity and 61.1% sensitivity. The algorithm was able to detect a 'high risk' condition one day prior to patients actually being observed as having a worsening in their COPD condition, as defined by symptom and medication records.
    CONCLUSION: The CART analyses have shown that features extracted from three types of physiological measurements; forced expiratory volume in 1s (FEV1), arterial oxygen saturation (SPO2) and weight have the most predictive power in stratifying the patients condition. This CART algorithm for early detection could trigger the initiation of timely treatment, thereby potentially reducing exacerbation severity and recovery time and improving the patient's health. This study highlights the potential usefulness of automated analysis of home telehealth data in the early detection of exacerbation events among COPD patients.
    Matched MeSH terms: Forced Expiratory Volume
  6. Fulltext Sputum induction in corticosteroid-dependant asthmatics: risks and airway cellular profile
    Loh LC, Kanabar V, D'Amato M, Barnes NC, O'Connor BJ
    Asian Pac J Allergy Immunol, 2005 Dec;23(4):189-96.
    PMID: 16572738
    Sputum induction with nebulized hypertonic saline is increasingly being used to evaluate airway inflammation. We investigated the procedure-associated risk in 16 asthmatics that were still symptomatic despite on high doses of regular corticosteroid (CS) therapy (7 on daily inhaled CS > or = 800 microg budesonide or equivalent; 9 on additional daily oral CS) and their sputum cellular profile. For comparison, 12 mild stable asthmatics and 10 normal healthy subjects were included. All subjects inhaled 3%, 4% and 5% hypertonic saline sequentially via ultrasonic nebulizer as a means to induce sputum. Maximal percentage fall of Forced Expiratory Volume on One Second (FEV1) during sputum induction was significantly greater in CS-dependent asthmatics (median % [IQR]: 16.0 [11.0-32.3]) than in mild asthmatics (5.3 [4.2-10.8], p = 0.002] and in normal subjects (4.6 [3.4-6.4]), p = 0.0001). The maximal percentage FEV1 fall was inversely correlated with baseline FEV1 (Rs= -0.69; p < 0.0001). Compared to mild asthmatics, induced sputum from CS-dependant asthmatics had proportionately fewer eosinophils (2.2 [0.8-7.0] versus 23.3% [10.7-46.3], p = 0.003) and greater neutrophils (64.2 [43.9-81.2] versus 28.7 [19.0-42.6], p = 0.009). Sputum neutrophils showed a significant inverse correlation to FEV1 (Rs = -0.51, p = 0.01). We concluded that sputum induction using nebulized hypertonic saline should be performed with caution in CS-dependant asthmatics. The airway cellular profile observed suggests that the immunopathology underlying CS-dependant asthmatics may be different or a consequence of CS therapy.
    Matched MeSH terms: Forced Expiratory Volume
  7. Fulltext Relationship between symptoms and objective measures of airway obstruction in asthmatic patients
    Liam CK, Goh CT, Isahak M, Lim KH, Wong CM
    Asian Pac J Allergy Immunol, 2001 Jun;19(2):79-83.
    PMID: 11699724
    The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214, p = 0.104, n = 59) and only correlated poorly with prebronchodilator FEV1 (total asthma symptom score vs FEV1: r = -0.256, p = 0.041, n = 64). These results lend support to the recommendation that airway obstruction should be measured objectively when assessing patients with chronic persistent asthma.
    Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Forced Expiratory Volume/drug effects; Forced Expiratory Volume/physiology
  8. Fulltext FEV1 and total Cardiovascular mortality and morbidity over an 18 years follow-up Population-Based Prospective EPIC-NORFOLK Study
    Ching SM, Chia YC, Lentjes MAH, Luben R, Wareham N, Khaw KT
    BMC Public Health, 2019 May 03;19(1):501.
    PMID: 31053065 DOI: 10.1186/s12889-019-6818-x
    BACKGROUND: Our study aimed to determine the association between forced expiratory volume in one second (FEV1) and subsequent fatal and non-fatal events in a general population.

    METHODS: The Norfolk (UK) based European Prospective Investigation into Cancer (EPIC-Norfolk) recruited 25,639 participants between 1993 and 1997. FEV1 measured by portable spirometry, was categorized into sex-specific quintiles. Mortality and morbidity from all causes, cardiovascular disease (CVD) and respiratory disease were collected from 1997 up to 2015. Cox proportional hazard regression analysis was used with adjustment for socio-economic factors, physical activity and co-morbidities.

    RESULTS: Mean age of the population was 58.7 ± 9.3 years, mean FEV1 for men was 294± 74 cL/s and 214± 52 cL/s for women. The adjusted hazard ratios for all-cause mortality for participants in the highest fifth of the FEV1 category was 0.63 (0.52, 0.76) for men and 0.62 (0.51, 0.76) for women compared to the lowest quintile. Adjusted HRs for every 70 cL/s increase in FEV1 among men and women were 0.77 (p < 0.001) and 0.68 (p < 0.001) for total mortality, 0.85 (p<0.001) and 0.77 (p<0.001) for CVD and 0.52 (p <0.001) and 0.42 (p <0.001) for respiratory disease.

    CONCLUSIONS: Participants with higher FEV1 levels had a lower risk of CVD and all-cause mortality. Measuring the FEV1 with a portable handheld spirometry measurement may be used as a surrogate marker for cardiovascular risk. Every effort should be made to identify those with poorer lung function even in the absence of cardiovascular disease as they are at greater risk of total and CV mortality.

    Matched MeSH terms: Forced Expiratory Volume/physiology*
  9. Fulltext Indoor air quality and respiratory health among malay preschool children in Selangor
    Rawi NA, Jalaludin J, Chua PC
    Biomed Res Int, 2015;2015:248178.
    PMID: 25984527 DOI: 10.1155/2015/248178
    Indoor air quality (IAQ) has been the object of several studies due to its adverse health effects on children. Methods. A cross-sectional comparative study was carried out among Malay children in Balakong (2 studied preschools) and Bangi (2 comparative preschools), Selangor, with the aims of determining IAQ and its association with respiratory health. 61 and 50 children aged 5-6 years were selected as studied and comparative groups. A questionnaire was used to obtain an exposure history and respiratory symptoms. Lung function test was carried out. IAQ parameters obtained include indoor concentration of particulate matter (PM), volatile organic compounds (VOCs), carbon monoxide (CO), carbon dioxide (CO2), temperature, air velocity (AV), and relative humidity. Results. There was a significant difference between IAQ in studied and comparative preschools for all parameters measured (P < 0.001) except for CO2 and AV. Studied preschools had higher PM and CO concentration. FVC, FEV1, FVC% and FEV1% predicted values were significantly lower among studied group. Exposures to PM, VOCs, and CO were associated with wheezing. Conclusion. The finding concluded that exposures to poor IAQ might increase the risk of getting lung function abnormality and respiratory problems among study respondents.
    Matched MeSH terms: Forced Expiratory Volume
  10. A Randomized, Placebo-Controlled Phase 2 Trial of CNTO 6785 in Chronic Obstructive Pulmonary Disease
    Eich A, Urban V, Jutel M, Vlcek J, Shim JJ, Trofimov VI, et al.
    COPD, 2017 Oct;14(5):476-483.
    PMID: 28753067 DOI: 10.1080/15412555.2017.1335697
    Interleukin (IL)-17A may be an underlying factor in the pathophysiology of chronic obstructive pulmonary disease (COPD). Anti-IL-17 monoclonal antibodies have been used successfully in treating several immune-mediated inflammatory diseases. This phase 2, randomized, placebo-controlled, double-blind, parallel-group, proof-of-concept study is the first clinical study evaluating the efficacy and safety of the anti-IL-17A monoclonal antibody CNTO 6785 in patients with symptomatic moderate-to-severe COPD. Patients were treated with CNTO 6785 (n = 93) or placebo (n = 94) intravenously at Weeks 0, 2, and 4 (induction), then Weeks 8 and 12, and followed till Week 24. The primary efficacy endpoint was the change from baseline in pre-bronchodilator percent-predicted forced expiratory volume in 1 second at Week 16. Samples were collected at all visits for pharmacokinetic (PK) evaluation, and standard safety assessments were performed. The mean difference in the primary efficacy endpoint between CNTO 6785 and placebo was not statistically significant (-0.49%; p = 0.599). No other efficacy endpoints demonstrated clinically or statistically significant differences with CNTO 6785 compared with placebo. CNTO 6785 was generally well tolerated; no major safety signals were detected. The most frequently reported treatment-emergent adverse events were infections and infestations; however, no notable differences were observed between CNTO 6785 and placebo in terms of rates of infections. PK results suggested that the steady state of serum CNTO 6785 concentration was reached within 16 weeks. These results suggest that IL-17A is unlikely to be a dominant driver in the pathology of, or a viable therapeutic target for, COPD. ClinicalTrials.gov Identifier: NCT01966549; EudraCT Identifier: 2012-003607-36.
    Matched MeSH terms: Forced Expiratory Volume
  11. Objective cough frequency, airway inflammation, and disease control in asthma
    Marsden PA, Satia I, Ibrahim B, Woodcock A, Yates L, Donnelly I, et al.
    Chest, 2016 06;149(6):1460-6.
    PMID: 26973014 DOI: 10.1016/j.chest.2016.02.676
    BACKGROUND: Cough is recognized as an important troublesome symptom in the diagnosis and monitoring of asthma. Asthma control is thought to be determined by the degree of airway inflammation and hyperresponsiveness but how these factors relate to cough frequency is unclear. The goal of this study was to investigate the relationships between objective cough frequency, disease control, airflow obstruction, and airway inflammation in asthma.

    METHODS: Participants with asthma underwent 24-h ambulatory cough monitoring and assessment of exhaled nitric oxide, spirometry, methacholine challenge, and sputum induction (cell counts and inflammatory mediator levels). Asthma control was assessed by using the Global Initiative for Asthma (GINA) classification and the Asthma Control Questionnaire (ACQ). The number of cough sounds was manually counted and expressed as coughs per hour (c/h).

    RESULTS: Eighty-nine subjects with asthma (mean ± SD age, 57 ± 12 years; 57% female) were recruited. According to GINA criteria, 18 (20.2%) patients were classified as controlled, 39 (43.8%) partly controlled, and 32 (36%) uncontrolled; the median ACQ score was 1 (range, 0.0-4.4). The 6-item ACQ correlated with 24-h cough frequency (r = 0.40; P < .001), and patients with uncontrolled asthma (per GINA criteria) had higher median 24-h cough frequency (4.2 c/h; range, 0.3-27.6) compared with partially controlled asthma (1.8 c/h; range, 0.2-25.3; P = .01) and controlled asthma (1.7 c/h; range, 0.3-6.7; P = .002). Measures of airway inflammation were not significantly different between GINA categories and were not correlated with ACQ. In multivariate analyses, increasing cough frequency and worsening FEV1 independently predicted measures of asthma control.

    CONCLUSIONS: Ambulatory cough frequency monitoring provides an objective assessment of asthma symptoms that correlates with standard measures of asthma control but not airflow obstruction or airway inflammation. Moreover, cough frequency and airflow obstruction represent independent dimensions of asthma control.
    Matched MeSH terms: Forced Expiratory Volume
  12. Fulltext Clinical outcomes of theophylline use as add-on therapy in patients with chronic obstructive pulmonary disease: A propensity score matching analysis
    Wilairat P, Kengkla K, Thayawiwat C, Phlaisaithong P, Somboonmee S, Saokaew S
    Chron Respir Dis, 2018 12 19;16:1479973118815694.
    PMID: 30558448 DOI: 10.1177/1479973118815694
    To examine clinical outcomes of theophylline use in patients with chronic obstructive pulmonary disease (COPD) receiving inhaled corticosteroids (ICS) and long-acting beta-2 agonists (LABA). Electronic data from five hospitals located in Northern Thailand between January 2011 and December 2015 were retrospectively collected. Propensity score (PS) matching (2:1 ratio) technique was used to minimize confounding factors. The primary outcome was overall exacerbations. Secondary outcomes were exacerbation not leading to hospital admission, hospitalization for exacerbation, hospitalization for pneumonia, and all-cause hospitalizations. Cox's proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI). After PS matching, of 711 patients with COPD (mean age: 70.1 years; 74.4% male; 60.8% severe airflow obstruction), 474 theophylline users and 237 non-theophylline users were included. Mean follow-up time was 2.26 years. Theophylline significantly increased the risk of overall exacerbation (aHR: 1.48, 95% CI: 1.11-1.96; p = 0.008) and exacerbation not leading to hospital admission (aHR: 1.47, 95% CI: 1.06-2.03; p = 0.020). Theophylline use did not significantly increase the risk of hospitalization for exacerbation (aHR: 1.11, 95% CI: 0.79-1.58; p = 0.548), hospitalization for pneumonia (aHR: 1.28, 95% CI: 0.89-1.84; p = 0.185), and all-cause hospitalizations (aHR: 1.03, 95% CI: 0.80-1.33; p = 0.795). Theophylline use as add-on therapy to ICS and LABA might be associated with an increased risk for overall exacerbation in patients with COPD. A large-scale prospective study of theophylline use investigating both safety and efficacy is warranted.
    Matched MeSH terms: Forced Expiratory Volume/physiology
  13. Fulltext Effect of intercostal stretch on pulmonary function parameters among healthy males
    Mohan V, Aziz KB, Kamaruddin K, Leonard JH, Das S, Jagannathan MG
    EXCLI J, 2012;11:284-90.
    PMID: 27418905
    The use of manual stretching procedures has become more prevalent in cardiorespiratory physiotherapy to improve pulmonary functions. However, limited evidence exists regarding evaluation of their effectiveness. The study aimed to determine the impact of Intercostal (IC) stretch in improving the dynamic pulmonary function parameters (Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC) and FEV1/FVC % and respiratory rate among healthy adults. Thirty healthy male subjects were recruited based on inclusion and exclusion criteria. Subjects were assigned to the experimental group and the control group through random sampling method. In the experimental group, subjects underwent IC stretch for ten breaths on the inspiratory phase of the respiratory cycle with breathing control exercises in semi recumbent position, while in the control group, breathing control exercises alone were performed in the semi recumbent position. The results of the study showed, FEV1/FVC % in the experimental group significantly improved with P=0.017 (p<0.05) than the control group, which means IC stretch increased lung volume and lead to improved lung function. This study suggested the IC stretching with breathing control may be more effective in improving dynamic lung parameters especially FEV1/FVC % than breathing control alone.
    Matched MeSH terms: Forced Expiratory Volume
  14. Impact of long-term exposure wildfire smog on respiratory health outcomes
    Ontawong A, Saokaew S, Jamroendararasame B, Duangjai A
    Expert Rev Respir Med, 2020 05;14(5):527-531.
    PMID: 32156169 DOI: 10.1080/17476348.2020.1740089
    Background: Air pollution is a global problem and also linked to respiratory diseases. Wildfire smog is a major cause of air pollution in the upper northern area of Thailand. Thus, in the current study, we examined whether long-term exposure to wildfire smog induces lung function changes in a population from the upper northern area of Thailand.Methods: The lung function of 115 participants with long-term exposure smog was determined using peak flow meter.Results: Long-term smoke exposure participants decreased FEV1 (forced expiratory volume in 1 second)/FVC (forced vital capacity) ratio (56.49 ± 23.88 in males and 56.29 ± 28.23 in females) compared with general Thai population. Moreover, the reduction of FVC, FEV1, and peak expiratory flow rate (PEFR) values also showed in both male and female subjects. These results suggest that long-term smoke exposure induces obstructive lung abnormality. Moreover, itchy/watery nose, cough, phlegm, and chest pain also reported in these subjects.Conclusion: Wildfire smog could be induced respiratory pathway inflammation and easily collapsible respiratory airways.
    Matched MeSH terms: Forced Expiratory Volume
  15. Fulltext Impact of objective airflow measurement on assessment of asthma severity and treatment appropriateness.
    Loh LC, Koh CN
    Family Physician, 2005;13(3):10-14.
    MyJurnal
    Current asthma treatment is directed by severity of symptoms and lung function. In Malaysia, spirometry is not widely available and therefore not used in most medical consultations. In 163 asthmatic patients [mean (95% CI) age: 41 (38-44) yrs; 29% male; 32% Malays, 32% Chinese, 34% Indians] who were being followed up in a State Hospital medical outpatient clinic and a large urban-based health clinic, we studied the effect on Global Initiative for Asthma (GINA) disease severity classification and the appropriateness of currently prescribed treatment when forced expiratory volume in one second (FEV1) was considered together with symptom severity. We showed that 52% of the patients were upgraded to a higher severity classification and 71% of the patients were under-treated. If based on symptoms alone to assess severity, 39% of the patients were still under-treated. We concluded that the disease severity in many asthmatic patients might have been underestimated and therefore not adequately treated, because spirometry was not available or used to assess asthma severity. The use of spirometry should be advocated more widely among clinicians treating asthma in Malaysia.
    Study site: Hospital Tuanku Jaafar, Seremban, Negeri Sembilan; Klinik Kesihatan Seremban, Malaysia
    Matched MeSH terms: Forced Expiratory Volume
  16. Fulltext What are the antioxidant status predictors' factors among male chronic obstructive pulmonary disease (COPD) patients?
    Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Abdul Manaf Z, Rajab N, et al.
    Glob J Health Sci, 2013 Jan;5(1):70-8.
    PMID: 23283038 DOI: 10.5539/gjhs.v5n1p70
    Imbalance between antioxidant and oxidative stress is a major risk factor for pathogenesis of some chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to determine antioxidant and oxidative stress status, and also theirs association with respiratory function of male COPD patients to find the antioxidant predictors' factors. A total of 149 subjects were involved in a cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. Results of the study showed that plasma vitamin C was low in most of the subjects (86.6%). Total antioxidant capacity was the lowest in COPD stage IV compare to other stages (p < 0.05). Level of plasma vitamin A (p= 0.012) and vitamin C (p= 0.007) were low in malnourished subjects. The predictors for total antioxidant capacity were forced vital capacity (FVC) % predicted and intake of ?-carotene (R2= 0.104, p= 0.002). Number of cigarette (pack/ year) and smoking index (number/ year) were not associated with total antioxidant capacity of this COPD population. Plasma oxidative stress as assessed plasma lipid peroxidation (LPO) was only positively correlated with plasma glutathione (p= 0.002). It might be a need to evaluate antioxidant status especially in older COPD patients to treat antioxidant deficiency which is leading to prevent COPD progression.
    Study site: Outpatient clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Institute of Respiratory Medicine, Kuala Lumpur, Malaysia
    Matched MeSH terms: Forced Expiratory Volume
  17. Fulltext Validation and clinical interpretation of the St George's respiratory questionnaire for COPD (SGRQ-C) after adaptation to Malaysian language and culture, in patients with COPD
    Rehman AU, Hassali MAA, Harun SN, Abbas S, Muneswarao J, Ali IABH, et al.
    Health Qual Life Outcomes, 2020 May 13;18(1):138.
    PMID: 32404113 DOI: 10.1186/s12955-020-01393-1
    BACKGROUND: Cultural differences affect the administration and results of health status questionnaires. "Cross cultural adaptation" ensures retention of psychometric properties such as validity and reliability at an item and/or scale level.

    OBJECTIVE: To develop a Malaysian version of St George's respiratory COPD specific questionnaire (SGRQ-CM), to evaluate the full spectrum of psychometric properties (reliability, validity and responsiveness), to test the factor structure and to assess minimum clinically important difference for the SGRQ-CM, to be used in population of Malaysia.

    METHODOLOGY: SGRQ-C was translated to Bahasa Malaysia using a standard protocol. 240 COPD patients were included in the study. All patients were followed-up for six months. Construct validity, internal consistency, item convergent validity, test-retest ability, responsiveness, factor analysis and MCID of the Malaysian version of SGRQ-C to be used in population of Malaysia were evaluated.

    RESULTS: The Cronbach alpha coefficient and intraclass correlation coefficients (ICC) for SGRQ-CM were reported as 0.87, and 0.88 respectively. Correlation of SGRQ-CM with CAT, EQ-5D-5 L, mMRC dyspnea scales and FEV1%predicted were reported as 0.86, - 0.82, 0.72 and - 0.42 respectively. Correlation coefficient between the subscales and other clinical and health status measures ranged from r = - 0.35 to r = - 0.87. The MCID was reported as 5.07 (- 2.54-12.67).

    CONCLUSION: The Malaysian version of SGRQ-C has a good psychometric property comparable to those of the original version and has a strong evidence of validity, reliability and responsiveness towards disease severity in Malaysian COPD patients. It can be recommended as a reliable quality of life measure for future research.

    Matched MeSH terms: Forced Expiratory Volume
  18. Fulltext VitalQPlus: a potential screening tool for early diagnosis of COPD
    Sui CF, Ming LC, Neoh CF, Ibrahim B
    Int J Chron Obstruct Pulmon Dis, 2015;10:1613-22.
    PMID: 26316735 DOI: 10.2147/COPD.S84618
    Background: This study utilized a validated combination of a COPD Population Screener
    (COPD-PS) questionnaire and a handheld spirometric device as a screening tool for patients at high risk of COPD, such as smokers. The study aimed to investigate and pilot the feasibility and application of this combined assessment, which we termed the “VitalQPlus”, as a screening tool for the early detection of COPD, especially in primary care settings.
    Methods: This was a cross-sectional study screening potentially undiagnosed COPD patients using a validated five-item COPD-PS questionnaire together with a handheld spirometric device. Patients were recruited from selected Malaysian government primary care health centers.
    Results: Of the total of 83 final participants, only 24.1% (20/83) were recruited from Perak and Penang (peninsular Malaysia) compared to 75.9% (63/83) from Sabah (Borneo region). Our dual assessment approach identified 8.4% of the surveyed patients as having potentially undiagnosed COPD. When only the Vitalograph COPD-6 screening tool was used, 15.8% of patients were detected with a forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) ratio at <0.75, while 35.9% of patients were detected with the COPD-PS questionnaire. These findings suggested that this dual assessment approach has a greater chance of identifying potentially undiagnosed COPD patients compared to the Vitalograph COPD-6 or COPD-PS questionnaire when used alone. Our findings show that patients with more symptoms (scores of >=5) yielded twice the percentage of outcomes of FEV1/FEV6 <0.75 compared to patients with fewer COPD symptoms (scores <5).
    Conclusion: With the availability of a simple screening questionnaire and the COPD-6, there is an opportunity easily to make patients more aware of their lung symptoms and to encourage the provision of early treatment. The proposed dual assessment approach, which we termed the VitalQPlus, may play a profound role in the early diagnosis of COPD, which is crucial in improving the clinical management of the disease.
    Keywords: spirometry, pulmonary function test, chronic obstructive pulmonary disease,
    airway obstruction
    Matched MeSH terms: Forced Expiratory Volume
  19. Fulltext A novel CT-emphysema index/FEV1 approach of phenotyping COPD to predict mortality
    Loh LC, Ong CK, Koo HJ, Lee SM, Lee JS, Oh YM, et al.
    Int J Chron Obstruct Pulmon Dis, 2018;13:2543-2550.
    PMID: 30174423 DOI: 10.2147/COPD.S165898
    Background: COPD-associated mortality was examined using a novel approach of phenotyping COPD based on computed tomography (CT)-emphysema index from quantitative CT (QCT) and post-bronchodilator (BD) forced expiratory volume in 1 second (FEV1) in a local Malaysian cohort.

    Patients and methods: Prospectively collected data of 112 eligible COPD subjects (mean age, 67 years; male, 93%; mean post-BD FEV1, 45.7%) was available for mortality analysis. Median follow-up time was 1,000 days (range, 60-1,400). QCT and clinicodemographic data were collected at study entry. Based on CT-emphysema index and post-BD FEV1% predicted, subjects were categorized into "emphysema-dominant," "airway-dominant," "mild mixed airway-emphysema," and "severe mixed airway-emphysema" diseases.

    Results: Sixteen patients (14.2%) died of COPD-associated causes. There were 29 (25.9%) "mild mixed," 23 (20.5%) "airway-dominant," 15 (13.4%) "emphysema-dominant," and 45 (40.2%) "severe mixed" cases. "Mild mixed" disease was proportionately more in Global Initiative for Chronic Obstructive Lung Disease (GOLD) Group A, while "severe mixed" disease was proportionately more in GOLD Groups B and D. Kaplan-Meier survival estimates showed increased mortality risk with "severe mixed" disease (log rank test, p=0.03) but not with GOLD groups (p=0.08). Univariate Cox proportionate hazard analysis showed that age, body mass index, long-term oxygen therapy, FEV1, forced volume capacity, COPD Assessment Test score, modified Medical Research Council score, St Georges' Respiratory Questionnaire score, CT-emphysema index, and "severe mixed" disease (vs "mild mixed" disease) were associated with mortality. Multivariate Cox analysis showed that age, body mass index, and COPD Assessment Test score remain independently associated with mortality.

    Conclusion: "Severe mixed airway-emphysema" disease may predict COPD-associated mortality. Age, body mass index, and COPD Assessment Test score remain as key mortality risk factors in our cohort.
    Matched MeSH terms: Forced Expiratory Volume*
  20. Fulltext Clinical phenotypes of COPD and health-related quality of life: a cross-sectional study
    Chai CS, Liam CK, Pang YK, Ng DL, Tan SB, Wong TS, et al.
    Int J Chron Obstruct Pulmon Dis, 2019 03 01;14:565-573.
    PMID: 30880946 DOI: 10.2147/COPD.S196109
    Introduction: The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes.

    Methods: This was a cross-sectional study of patients with COPD attending the respiratory medicine clinic of University of Malaya Medical Centre from 1 June 2017 to 31 May 2018. Disease-specific HRQoL was assessed by using the COPD Assessment Test (CAT) and St George's Respiratory Questionnaire for COPD (SGRQ-c).

    Results: Of 189 patients, 28.6% were of non-exacerbator phenotype (NON-AE), 18.5% were of exacerbator with emphysema phenotype (AE NON-CB), 39.7% were of exacerbator with chronic bronchitis phenotype (AE CB), and 13.2% had asthma-COPD overlap syndrome phenotype (ACOS). The total CAT and SGRQ-c scores were significantly different between the clinical phenotypes (P<0.001). Patients who were AE CB had significantly higher total CAT score than those with ACOS (P=0.033), AE NON-CB (P=0.001), and NON-AE (P<0.001). Concerning SGRQ-c, patients who were AE CB also had a significantly higher total score than those with AE NON-CB (P=0.001) and NON-AE (P<0.001). However, the total SGRQ-c score of AE CB patients was only marginally higher than those who had ACOS (P=0.187). There was a significant difference in the score of each CAT item (except CAT 7) and SGRQ-c components between clinical phenotypes, with AE CB patients recording the highest score in each of them.

    Conclusion: Patients who were AE CB had significantly poorer HRQoL than other clinical phenotypes and recorded the worst score in each of the CAT items and SGRQ-c components. Therefore, AE CB patients may warrant a different treatment approach that focuses on the exacerbation and chronic bronchitis components.

    Matched MeSH terms: Forced Expiratory Volume
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links