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The 6-min walking distance (6MWD) is often used to assess prognosis in pulmonary arterial hypertension (PAH) patients. Whether or not changes in arterial oxygen saturation (SpOAmbispective study that includes 137 patients with PAH: 38 idiopathic/heritable (i/h PAH), 42 with connective tissue disease (CTD-PAH), 34 with porto-pulmonary hypertension (PoPH), 21 with HIV-associated PAH and 2 with pulmonary venous occlusive disease (PVOD). Patients were characterized and, treated according to international recommendations, and were followed-up for 5 years. To integrate SpO(1) during follow-up, 40 patients died (29.2%); (2) results confirmed the prognostic value of the 6MWD (AUC 0.913 [IQR 0.868-0.958]; p 0.0001), original DDR (AUC 0.923 [0.881-0.966]; p 0.001), New DDR (AUC 0.917 [0.872-0.961], p 0.001), and DSP (AUC 0.914 [0.869-0.959], p 0.001); and, (3) neither the original or new DDR or DSP added significant prognostic value to 6MWD in these patients.Consideration of three different composite indices of arterial oxygenation changes during exercise does not add prognostic value to that of the 6MWD in patients with PAH.

Background: Community pharmacies (CP) have access to subjects at high-risk of suffering Chronic Obstructive Pulmonary Disease (COPD). We investigated if a COPD case finding program in CP could be a new strategy to reduce COPD underdiagnosis. Methods: Prospective, cross-sectional, descriptive, uncontrolled, remotely supported study in 100 CP in Barcelona, Spain. Pharmacists were trained in a four-day workshop on spirometry and COPD, and each was provided with a spirometer for 12 weeks. The program included questionnaires and forced spirometry measurements, whose quality was controlled and monitored by web-assistance. Findings: Overall 2295 (73.5%), of 3121 CP customers invited to participate in the program accepted, and 1.456 (63.4%) were identified as "high risk" for COPD using the GOLD questionnaire. Only 33 could not conduct spirometry, and a pre-bronchodilator airflow limitation (FEV1/FVC ratio

Summary Objectives Cleaning workers have an increased risk of asthma but the underlying mechanisms are largely unknown. We studied functional and biological characteristics in asthmatic cleaners and compared these to healthy cleaners. Methods Forty-two cleaners with a history of asthma and/or recent respiratory symptoms and 53 symptom-free controls were identified. Fractional exhaled nitric oxide (FeNO) was measured and forced spirometry with reversibility testing was performed. Total IgE, pulmonary surfactant protein D and the 16 kDa Clara Cell secretory protein were measured in blood serum. Interleukins and other cytokines, growth factors, cys-leukotrienes and 8-isoprostane were measured in exhaled breath condensate. Information on occupational and domestic use of cleaning products was obtained in an interview. Associations between asthma status, specific characteristics and the use of cleaning products were evaluated using multivariable linear and logistic regression analyses. Results Asthma was associated with an 8% (95% confidence interval (CI) 1–15%) lower postbronchodilator FEV1, a higher prevalence of atopy (42% vs. 10%) and a 2.9 (CI 1.5–5.6) times higher level of total IgE. Asthma status was not associated with the other respiratory biomarkers. Most irritant products and sprays were more often used by asthmatic cleaners. The use of multiuse products, glass cleaners and polishes at work was associated with higher FeNO, particularly in controls. Conclusions Asthma in cleaning workers is characterised by non-reversible lung function decrement and increased total IgE. Oxidative stress, altered lung permeability and eosinophilic inflammation are unlikely to play an important underlying role, although the latter may be affected by certain irritant cleaning exposures.

The objective of this study was the analysis of five sets of reference equations for forced spirometry (Crapo et al., ECSC, Knudson et al., Paoletti et al. and Roca et al.) using measurements of FVC and FEV1 obtained in the European Community Respiratory Health Survey (ECRHS) in Spain. Standardized forced spirometry was measured in 998 non-asthmatic subjects (20-44 years), randomly selected from the general population, participating in the ECRHS in four different Spanish cities. Observed minus predicted values for both FVC and FEV1 were examined for each set of predicted equations. Observed FVC (4448 +/- 980 ml) and FEV1 (3715 +/- 813 ml) showed a good agreement with values predicted by Roca et al. (99% and 101%, respectively). The mean observed minus predicted difference (residual) for FVC and FEV1 were -34 +/- 527 ml and 30 +/- 455 ml, respectively. The regression line between observed and predicted values was not different from the identity line for both FVC and FEV1. These results indicate that reference values obtained by Roca et al. are useful for the assessment of the ventilatory capacity in the general population of Spain. In addition, the study indicates that discrepancies among the reference equations from different authors compared in the present study are unlikely to be due to ethnic differences within European origin populations.

Due to the lack of information on reference values for plethysmographic lung volumes, standardized measurements were carried out on a selected sample of 482 healthy non-smoking volunteers (300 men and 182 women), aged 20–70 years, living in the Barcelona area (Spain).Prediction equations using age, height and body surface area (BSA) as covariates were calculated for the subdivisions of lung volumes [TLC, IC, EVC, FRC, RV and RVTLC (%)], separately for both sexes.Simple linear equations predicted lung volumes as well as more complex equational models. BSA correction was useful for FRC but not for the other parameters. Our predicted FRC was up to 10% higher (mean 256 ml) than the FRC estimated by other studies using gas dilution techniques, but showed an acceptable agreement with the plethysmographic measurements carried out in an independent sample of 94 healthy non-smokers (42 men and 52 women) from Barcelona using different equipment.The present study provides an internally consistent set of prediction equations for static lung volumes. Differences in predicted FRC between the present study and other reference values obtained using gas dilution measurements should be attributed to the method of measurement.