Vasiliki Avramidou

Exercise responses are related to structural lung damage in CF pulmonary disease

Early detection of lung disease is a primary objective in monitoring patients with Cystic Fibrosis (CF); High‐Resolution‐Computed‐Tomography (HRCT) assesses structural damage. Spirometry and cardiopulmonary exercise testing are used for functional evaluation of CF lung disease.

Lung clearance index (LCI) as a predictor of exercise limitation among CF patients

FEV1 is often considered the gold standard to monitor lung disease in cystic fibrosis (CF). Recently, there has been increasing interest in multiple breath washout (MBW) and cardiopulmonary exercise testing (CPET) as alternative or even more sensitive techniques. However, limited data exist on associations among the above methods.

A “real-life” study on height in prepubertal asthmatic children receiving inhaled steroids

ABSTRACT Introduction: Asthma is the most common chronic respiratory disease in children and inhaled corticosteroids (ICS) constitute the first line of treatment for these patients. However, the potential growth-inhibiting effect of ICS has often been a cause of concern for both caregivers as well as physicians, and there still remains conflict regarding their safety profile. Objective: To assess whether the administration of ICS in low or medium doses is associated with height reduction in prepubertal children. Methods: We performed a retrospective study to examine the association between ICS treatment and growth deceleration in children with mild persistent asthma. The comparison of height measurements every 6 months from 3 to 8 years of age was conducted among three groups of patients: patients not receiving ICS, patients being treated with low dose of ICS and patients being treated with medium dose of ICS (GINA Guidelines 2015). Results: This study included 284 patients (198 male, 86 female) aged 3–8 years; 75 patients were not receiving ICS, 63 patients were on low-dose ICS and 146 patients were on medium-dose ICS. The measured height every 6 months did not differ significantly (p > 0.05) among the three groups while the difference remained stable (p > 0.05), even when we evaluated males and females separately. Conclusions: In this “real-life” study we found that long-term treatment with ICS in low or medium doses is not associated with height reduction in prepubertal children with asthma.

Is Lung Clearance Index (LCI) Affected by the Severity of Lung Disease in CF

Background: LCI has been proven an effective tool in the detection of lung disease in CF. Objectives: a) To assess the correlation of ventilation inhomogeneity indices with structural damages of the lung, among different groups of disease severity and b) To compare the associations among MBW parameters with spirometry and CT. Method: Forty-four children and adolescents with CF participated in the study. Spirometry and multiple breath washout tests were performed. All children had a HRCT scan. The study population was divided into two groups, according to FEV1% predicted values: Group A: ≥ 85% predicted (normal) and Group B: 40-84% predicted (mild-moderate disease). Results: The patients’ mean age was 12.9 (5.67; 23.25) years, mean FEV1: 91.22 ± 24.22% and mean LCI: 10.72 ± 3.51. Children of Group A had significantly lower LCI, compared to Group B (p<0.001). Among the whole study group all the ventilation inhomogeneity indices were correlated with FVC%, FEV1% and FEF50% and the severity and extent of bronchiectasis, the generation of bronchial division and the presence of emphysema (p<0.05). Among patients with normal FEV1, MBW parameters showed stronger correlation with the structural changes of HRCT, while among patients with mild-moderate lung disease, they showed stronger correlation with spirometry. Conclusion: MBW is a reliable method to assess the structural and functional lung disease in CF. However in mild disease ventilation inhomogeneity outcomes were better associated with CT changes, while in mild - moderate disease MBW outcomes were better associated with spirometry.