Sonia Rouatbi

Oxidative stress and lung function profiles of male smokers free from COPD compared to those with COPD: a case-control study

Background The mechanisms of smoking tobacco leading to chronic obstructive pulmonary disease (COPD) are beginning to be understood. However, conclusions about the role of blood or lung oxidative stress markers were disparate. Aims To investigate the oxidative stress in blood or lung associated with tobacco smoke and to evaluate its effect on pulmonary function data and its relation with physical activity. Methods It is a case-control study. Fifty-four male-smokers of more than five pack-years (PY) and aged 40-60 years were included (29 Non-COPD, 16 COPD). Physical activity score was determined. Blood sample levels of malondialdehyde (MDA), protein-cys-SH (PSH), and Glutathione (GSH) were measured. Fractional exhaled nitric oxide (FeNO) and plethysmographic measurements were performed. Correlation coefficients (r) evaluated the association between oxidative stress markers and independent variables (plethysmographic data and physical activity score). Results Non-COPD (48±6 years) and COPD (49±5 years) groups had similar tobacco consumption patterns, that is, 27±14 PY versus 30±19 PY, respectively. Compared to the Non-COPD group, the COPD group had significantly lower levels of GSH and PSH, that is, mean±SE were 40±6 versus 25±5 µg/mL and 54±10 versus 26±5 µg/g of hemoglobin, respectively. However, MDA level and FeNO values were similar. In the COPD group, none of the oxidative stress markers was significantly correlated with plethysmographic data or physical activity score. In the Non-COPD group, GSH was significantly correlated with physical activity score (r=0.47) and PSH was significantly correlated with total lung capacity (TLC) (r=-0.50), residual volume (r=0.41), and physical activity score (r=0.62). FeNO was significantly correlated with TLC of the COPD group (r=-0.48). Conclusion Compared to the Non-COPD group, the COPD group had a marked decrease in blood antioxidant markers (GSH and PSH) but similar blood oxidant (MDA) or lung (FeNO) burden.Background The mechanisms of smoking tobacco leading to chronic obstructive pulmonary disease (COPD) are beginning to be understood. However, conclusions about the role of blood or lung oxidative stress markers were disparate. Aims To investigate the oxidative stress in blood or lung associated with tobacco smoke and to evaluate its effect on pulmonary function data and its relation with physical activity. Methods It is a case-control study. Fifty-four male-smokers of more than five pack-years (PY) and aged 40–60 years were included (29 Non-COPD, 16 COPD). Physical activity score was determined. Blood sample levels of malondialdehyde (MDA), protein-cys-SH (PSH), and Glutathione (GSH) were measured. Fractional exhaled nitric oxide (FeNO) and plethysmographic measurements were performed. Correlation coefficients (r) evaluated the association between oxidative stress markers and independent variables (plethysmographic data and physical activity score). Results Non-COPD (48±6 years) and COPD (49±5 years) groups had similar tobacco consumption patterns, that is, 27±14 PY versus 30±19 PY, respectively. Compared to the Non-COPD group, the COPD group had significantly lower levels of GSH and PSH, that is, mean±SE were 40±6 versus 25±5 µg/mL and 54±10 versus 26±5 µg/g of hemoglobin, respectively. However, MDA level and FeNO values were similar. In the COPD group, none of the oxidative stress markers was significantly correlated with plethysmographic data or physical activity score. In the Non-COPD group, GSH was significantly correlated with physical activity score (r=0.47) and PSH was significantly correlated with total lung capacity (TLC) (r=−0.50), residual volume (r=0.41), and physical activity score (r=0.62). FeNO was significantly correlated with TLC of the COPD group (r=−0.48). Conclusion Compared to the Non-COPD group, the COPD group had a marked decrease in blood antioxidant markers (GSH and PSH) but similar blood oxidant (MDA) or lung (FeNO) burden.

Investigation of Exclusive Narghile Smokers: Deficiency and Incapacity Measured by Spirometry and 6-Minute Walk Test

BACKGROUND: Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group. METHODS: Seventy 20–60-y-old male ENS were included. Narghile use (narghile-years) and anthropometric, clinical, spirometric, and 6MWT data were collected. Univariate and multivariate analyses were used to identify factors influencing 6MWD. Data of a subgroup of 40–60-y-old ENS (n = 25) were compared with those of an age-matched HNS group (n = 53). RESULTS: The median (first to third quartile) for age and narghile use were 32 (26–43) and 17 (8–32) narghile-years, respectively. The profile of ENS performing the 6MWT was as follows: at the end of the 6MWT, 34% and 9% had a low heart rate (< 60% of maximum predicted) and high dyspnea scores (> 5/10, visual analog scale), respectively; 3% had an oxyhemoglobin saturation decrease of > 5 points during the test; and 20% had an abnormal 6MWD (less than the lower limit of the normal range). The factors that significantly influenced the 6MWD, explaining 38% of its variability, are included in the following equation: 6MWD (m) = 742.63 − 5.20 × body mass index (kg/m2) + 25.23 × FEV1 (L) − 0.44 × narghile use (narghile-years). Compared with HNS, the subgroup of ENS had a significantly lower 6MWD (98 ± 7 vs 87 ± 9% predicted, respectively). CONCLUSIONS: Narghile use may play a role in reducing submaximal aerobic capacity. The present study suggests that a program of pulmonary rehabilitation is an excellent axis to follow.

Pulmonary functions of narghile smokers compared to cigarette smokers: a case-control study

Background Studies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS). Methods Males aged 35–60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n = 36) or cigarettes exclusively for more than 10 pack-years (n = 106) were recruited to participate in this case–control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV1/FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ2 test were used to compare plethysmographic data and profiles of the two groups. Results The subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV1/FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%). Conclusion Chronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.Background Studies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS). Methods Males aged 35-60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n = 36) or cigarettes exclusively for more than 10 pack-years (n = 106) were recruited to participate in this case-control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV1/FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ2 test were used to compare plethysmographic data and profiles of the two groups. Results The subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV1/FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%). Conclusion Chronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.

Facteurs physiologiques influençant le volume capillaire pulmonaire et la diffusion membranaire.

Resume Introduction Le poumon subit plusieurs modifications physiologiques au cours de la vie. L’objectif de ce travail est d’identifier les facteurs qui peuvent influencer la fonction du poumon profond en etudiant la diffusion membranaire (Dm) et le volume sanguin capillaire pulmonaire (Vc). Methodes Une mesure de la Dm et du Vc a ete realisee au repos chez 135 sujets sains repartis en 3 groupes d’âges differents. Les memes mesures ont ete effectuees apres une epreuve d’exercice musculaire chez 22 enfants. La technique de mesure impliquait le transfert simultane de 2 gaz, le monoxyde d’azote (NO) et le monoxyde de carbone (CO). Resultats La Dm est correlee a la taille chez le groupe adulte et au poids chez les âges. Vc n’est pas correle au poids chez les trois groupes etudies, mais il l’est avec la taille chez les adultes jeunes. Dm et Vc diminuent significativement avec l’âge (p Conclusion La connaissance de toutes ces modifications physiologiques permettra une meilleure interpretation des variations pathologiques de la fonction du poumon profond.

Effects of Ramadan on physical capacities of North African boys fasting for the first time

Introduction Most of the literature related to the effects of Ramadan fasting on physical performance has focused on adults, and only three studies have examined its impact on childrens physical performance. Aims To examine the effects of Ramadan fasting on first-time fasting boys’ performance in short-term explosive exercises [vertical and horizontal jump tests (VJT and HJT), 20-m and 30-m sprints and medicine-ball throw (MBT)], as well as in sub-maximal endurance [6-min walking distance (6MWD) measured during the 6-min walk test (6MWT)]. Methods Eighteen Tunisian boys [mean±standard deviation (SD) of age and body mass (BM): 11.9±0.8 y and 55.4±18.2 kg, respectively] were included. The experimental design comprised four testing phases: 2-weeks before Ramadan (BR), the end of the second week (R2) and the fourth week (R4) of Ramadan, and 10–12 days after the end of Ramadan (AR). At each phase, boys performed two test sessions in the afternoon (15:00–17:00 h) interrupted by 48 h of recovery (first test session: BM, VJT, HJT, and 20-m and 30-m sprint tests; second session: MBT and 6MWT). The study was conducted during the summer of 2012 from July 5 to August 29. Results 6MWDs (m) were significantly shorter during R2 (652±101) and R4 (595±123) compared to BR (697±86) and came back to baseline values AR. BM (kg) mean±SD did not significantly change during R2 (52±15) and during R4 (53±15) compared to BR (55±17), and short-term explosive performances were unchanged throughout the study. Conclusion In non-athletic children, first-ever Ramadan fasting impairs sub-maximal aerobic capacity but has no effect on BM or short-term explosive performance.

North-African reference values of alveolar membrane diffusion capacity and pulmonary capillary blood volume.

Background: In North-African adults, location-specific reference values for membrane diffusion capacity (D_m) and pulmonary capillary blood volume (V_c) were needed. Objectives: To verify the applicability of previously published reference equations for D_m and V_c in North-African healthy adults (age >18 years) and to determine specific reference equations for North Africa. Methods: The study was designed as a prospective cross-sectional study. Anthropometric data (age, height, weight and body mass index) and D_m and V_c were assessed in 85 healthy Tunisian adults. Univariate and multiple linear regression analyses were used to determine reference equations and to calculate the lower limit of the normal range (LLN). Results: The mean ages ± SD (minimum – maximum) for male and female adults were 53 ± 21 (21–85) and 42 ± 16 (18–72) years, respectively. Previously published reference equations did not reliably predict measured D_m and V_c. The reference equation (r² = 47%) for D_m was –36.16 + 45.37 × height – 0.34 × age + 0.39 × weight + 7.41 × gender (0 = female and 1 = male). To calculate the D_m LLN subtract 24.36 from the reference value. The reference equation (r² = 30%) for female V_c was 94.70 – 0.57 × age, and the reference equation (r² = 52%) for male V_c was 0.82 – 0.48 × age + 52.47 × height + 0.16 × weight. To calculate the V_c LLN subtract 28.52 and 26.54 from these reference values for females and males, respectively. Conclusion: These V_c and D_m reference equations supplement the international World Bank of reference equations.

Quelle définition faut-il choisir pour le déficit ventilatoire obstructif ?

Resume Introduction Il n’existe pas de consensus clair en ce qui constitue un deficit ventilatoire obstructif (DVO). Selon l’ American Thoracic Society et l’ European Respiratory Society , c’est un rapport entre le volume expiratoire force seconde (VEMS) et la capacite vitale lente (CV) Global initiative for chronic Obstructive Lung Disease ou le British Thoracic Society, c’est un rapport VEMS/capacite vitale expiratoire forcee (CVF) Methodes Un questionnaire medical est realise. Les donnees anthropometriques sont determinees. Les debits expiratoires et les volumes pulmonaires sont mesures a l’aide d’un plethysmographe. Resultats Cent vingt et un (81 %) hommes parmi les 150 adresses sont inclus. Le pourcentage des hommes ayant un DVO est de 56,1 % (VEMS/CV Conclusion Le deficit ventilatoire obstructif est recommandation dependant.

Inhaled sodium fluoride decreases airway responsiveness to acetylcholine analogs in vivo

The study was conducted to characterize the action of NaF, which had relaxing property in carbachol precontracted isolated bovine bronchus, on airway responsiveness challenged by acetylcholine receptor agonists in rats and asthmatic humans. Tracheal flow rate and airway resistance were measured in anaesthetized rats. NaF was delivered either before carbachol challenge or together with carbachol. Patients with mild asthma were challenged with methacholine aerosol, and NaF was delivered when FEV1 fell by more than 20%. The results indicated that: (1) in rats NaF significantly inhibited carbachol-induced bronchial constriction when inhaled prior to carbachol challenge as airway resistances in the NaF and NaF+verapamil groups were significantly lower than those in the control group; (2) NaF significantly reversed carbachol or methacholine-induced bronchial constriction in asthmatic patients. In conclusion, NaF, delivered in form of aerosol, reduced bronchial responsiveness to carbachol in rats and had a bronchodilating effect on rat and human airways precontracted by inhalation of acetylcholine analogs.

Critical analysis of the published literature about the effects of Ramadan intermittent fasting on healthy children’s physical capacities

No abstract available. (Published: 8 June 2015) Citation: Libyan J Med 2015, 10 : 28351 -http://dx.doi.org/10.3402/ljm.v10.28351

Fraction of exhaled nitric oxide (FeNO ) norms in healthy Tunisian adults.

Aims. To establish FeNO norms for healthy Tunisian adults aged 18–60 years and to prospectively assess their reliability. Methods. This was a cross-sectional analytical study. A convenience sample of healthy Tunisian adults was recruited. Subjects responded to a medical questionnaire, and then FeNO levels were measured by an online method (Medisoft, Sorinnes (Dinant), Belgium). Clinical, anthropometric, and plethysmographic data were collected. All analyses were performed on natural logarithm values of FeNO. Results. 257 adults (145 males) were retained. The proposed reference equation to predict FeNO value is lnFeNO (ppb) = 3.47−0.56× height (m). After the predicted FeNO value for a given adult was computed, the upper limit of normal could be obtained by adding 0.60 ppb. The mean ± SD (minimum-maximum) of FeNO (ppb) for the total sample was 13.54 ± 4.87 (5.00–26.00). For Tunisian and Arab adults of any age and height, any FeNO value greater than 26.00 ppb may be considered abnormal. Finally, in an additional group of adults prospectively assessed, we found no adult with a FeNO higher than 26.00 ppb. Conclusion. The present FeNO norms enrich the global repository of FeNO norms that the clinician can use to choose the most appropriate norms.