Rozprawy doktorskie: „Exhaled nitric oxide”

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Kharitonov, Sergei Alexandrovich. "Exhaled nitric oxide in airway diseases." Thesis, Imperial College London, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266411.

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Hemmingsson, Tryggve. "Exhaled nitric oxide in extreme environments." Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-609-5/.

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Liu, Jia Clinical School Prince of Wales Hospital Faculty of Medicine UNSW. "Nitric oxide in airway inflammation." Publisher:University of New South Wales. Clinical School - Prince of Wales Hospital, 2009. http://handle.unsw.edu.au/1959.4/43678.

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Exhaled breath condensate (EBC) is a non-invasive method of investigating airway inflammation associated with nitric oxide (NO) and the metabolites nitrite/nitrates (NOx) in diseases such as chronic obstructive pulmonary disease (COPD), but some of the variables affecting the results are unknown. It was hypothesised that 1) EBC would be influenced by lung volumes and the type of EBC collection device; 2) fractional exhaled NO (FENO) and EBC NOx in COPD patients would be altered by smoking and glucocorticosteroids (GCS); 3) cigarette smoke could contribute to the EBC NOx concentration while it may also decrease FENO indirectly by converting airway NO to NOx. It was found that EBC volume was significantly correlated with both tidal volume and minute volume. Comparing four EBC collection devices demonstrated greater efficiency with the ECoScreen?? than siliconised glass tubes or RTube?? but it gave factitiously high NOx levels. Total EBC protein levels over a 10-minute collection were significantly higher using the ECoScreen?? than either glass or RTube?? devices. A cross-sectional study of 96 COPD patients and 80 age-matched control subjects demonstrated that FENO levels in COPD patients were significantly higher than normal subjects when comparing either the combined groups or appropriate two subgroups: ex-smokers and smokers. GCS treatment demonstrated no significant effect on either FENO levels or EBC NOx, but EBC NOx was elevated in smokers. In vitro, cigarette smoke extract (CSE) induced significantly higher NOx and asymmetric dimethylarginine (ADMA) levels in A549 cells when compared with control media. The anti-oxidant, NAC pre-treatment partially reversed the elevated NOx levels but not the ADMA levels. This thesis is the first to report FENO and EBC NOx in COPD patients in an appropriate sample size to be able to evaluate each subgroup, and the increased EBC NOx levels found in smokers in vivo was consistent with the elevated NOx level in response to CSE observed in vitro. These data indicate that smoking-related airway inflammation and activation of the NO pathway are complex with both an increase in ADMA, NO, NOx and may be regulated by oxidative stress rather than the nitric oxide synthase (NOS) pathway.

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Ratnawati, Ratnawati Prince of Wale Hospital Clinical School UNSW. "Exhaled nitric oxide in asthmatic airway inflammation." Awarded by:University of New South Wales. Prince of Wale Hospital Clinical School, 2006. http://handle.unsw.edu.au/1959.4/25729.

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Measuring the level of exhaled NO (eNO) in the breath is a new method to monitor airway inflammation in asthma and may have a role in the management of asthma. The hypotheses were that eNO will reflect the degree of inflammation in chronic asthma, and will indicate how anti- inflammatory therapy should be altered to improve asthma control. Three studies were performed to test the hypotheses. A cross sectional study was performed to define the normal range of eNO and to compare this range with those who have asthma or atopy. The second study was observational, to compare the level of eNO during and after an exacerbation of asthma. The third study was an interventional study to evaluate eNO in management of paediatric asthma. In this latter study the level of eNO was measured to monitor airway inflammation in asthmatic children with the intention of adjusting antiinflammatory drugs (inhaled glucocorticosteroids) according to the level of eNO. These studies have shown that the mean level of eNO was significantly higher in asthmatic compared with normal subjects, but not significantly different when compared with atopic non-asthmatic subjects. eNO was correlated with the number of positive skin prick tests in atopic subjects whether asthmatic or nonasthmatic. The eNO level was increased during acute exacerbations of asthma and decreased after two weeks with therapy of GCS. In a pilot study eNO appeared to be superior to FEV1 in adjusting the dose of iGCS to control asthmatic children, but this needs to be confirmed with a larger sample size. Another non-invasive method to detect inflammatory markers is the technique of exhaled breath condensate (EBC). Although NO is degraded to NOx, it was found that eNO had no significant correlation with EBC NOx but had a significant correlation with pH. Hypertonic saline challenge, an artificial model of an asthmatic exacerbation was associated with an increase in EBC volume and the release of histamine, implicating mast cell activation. These novel findings suggest that non-invasive markers can be used both for clinical and mechanistic proposes.

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Pedroletti, Christophe. "Exhaled nitric oxide in schoolchildren with asthma /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-164-4/.

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Marteus, Helena. "Oropharyngeal origin of markers in exhaled breath /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-274-8/.

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Mitchell, Colin. "The Association Between Exhaled Nitric Oxide in Exhaled Breath Condensate and Chronic Obstructive Pulmonary Disease." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/397.

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Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Detecting COPD early in the disease process will help in decreasing later stage COPD severity. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. Using the hypothetico-deductive theory as a guideline, this study used secondary data from the National Health and Nutrition Examination Survey 2007 to 2010 to test the association between exhaled nitric oxide (eNO), COPD, and COPD severity. In addition, this study explored whether occupation modifies the association between eNO and COPD. Descriptive statistics, chi-square analyses, and regression analyses were used to analyze data from a sample size of 10,214 individuals. The prevalence of COPD was 7.2%, based on self-reported physician diagnoses and 11.4% based on prebronchodilator spirometry analysis, strengthening the argument that COPD is often under- or misdiagnosed in clinical settings. This study found no statistically significant association between eNO, COPD, and COPD severity, and occupational status did not appear to modify the association between eNO and COPD. The findings of this study highlight the importance of using objective measures such as spirometry in clinical settings for early diagnosis and management of COPD. Early diagnosis helps to slow the progression of the disease, resulting in fewer related comorbidities and complications.

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Hazari, Mehdi Saeed. "Elevated exhaled nitric oxide (ENO) in non-asthmatic atopic adults." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ58853.pdf.

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Törnberg, Daniel C. F. "Exhaled nitric oxide : influence of mechanical ventilation and vasoactive agents /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-070-2/.

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Smith, Andrew D., and n/a. "Exhaled nitric oxide measurements in the diagnosis and management of asthma." University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20070924.133734.

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Introduction: The enzyme, inducible nitric oxide synthase (iNOS), is upregulated in the airway epithelium in patients with allergic asthma resulting increased nitric oxide production. The concentration of nitric oxide in exhaled air (FENO) correlates with the degree of eosinophilic airway inflammation and has been proposed as a new breath test to assist in the management of asthma. Key Aims: To determine the predictive accuracy of FENO compared with conventional testing in the diagnosis of asthma. To assess the performance characteristics of FENO to predict steroid responsiveness compared with the conventional approach in patients presenting with non-specific respiratory symptoms. To assess the role of FENO compared with conventional guidelines-based approach as a guide to adjusting inhaled corticosteroid therapy in patients with chronic persistent asthma. Methods: Consecutive patients referred with chronic undiagnosed respiratory symptoms were enrolled. Comparisons were made between FENO, induced sputum analysis and other conventional tests (including peak flow variation, spirometry, response to oral steroid challenge) for predicting the presence of asthma in the first study, and for predicting response to four weeks inhaled fluticasone treatment in the second study. In the third study, 110 subjects with chronic persistent asthma were enrolled into a single-blind placebo-controlled study during which subjects were randomly allocated to have their corticosteroid (fluticasone) dose adjusted on the basis of either FENO measurements or an algorithm based on conventional guidelines. The main outcomes were the frequency of asthma exacerbations and the mean daily dose of inhaled corticosteroid. Results: In the first study, 17 of 47 consecutive patients were diagnosed with asthma. Sensitivities for the conventional tests (0-47%) were lower than for FENO (88%) and sputum eosinophils (86%), with overall significantly greater diagnostic accuracy for FENO and sputum eosinophils. Fifty-two consecutive subjects completed the second study. When compared to the conventional tests, the predictive powers for FENO were consistently greater than for almost all other baseline measurements used to predict steroid responsiveness, with an optimum cut point of 47 ppb. In the third study, the exacerbation rates were 0.49 (95% C.I. 0.20, 0.78) per patient per year in the FENO group and 0.90 (95% C.I. 0.31, 1.49) in the control group, representing a nonsignificant reduction of 45.6 percent (95% C.I. -78.5, 54.5%) in the FENO group. The final mean daily doses of fluticasone were significantly lower in for the FENO group compared with the conventional group (370 [mu]g/day (95% C.I. 263, 477) vs 641 [mu]g/day (95% C.I. 526, 756) respectively; p=0.003). There were no significant differences in other markers of asthma control, use of oral prednisone, pulmonary function, or levels of airway inflammation (sputum eosinophils). Conclusions: FENO is comparable to induced sputum analysis and superior to the conventional methods currently used including peak flows and spirometry as a dignositic for asthma and as a predictor of steroid responsiveness in patients with chronic respiratory symptoms. FENO measurements as a guide to adjusting inhaled corticosteroid therapy compared to the conventional guidelines based approach results in significantly lower maintenance doses being achieved without compromising asthma control. The results of this thesis provide evidence to support the use of FENO measurements in routine clinical practice as a tool to improve the overall management and diagnosis of asthma.

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Sheel, Andrew William. "Relationship between exhaled and inhaled nitric oxide and exercise-induced hypoxemia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0015/NQ48711.pdf.

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Patel, Sunita I. "Exhaled breath nitric oxide is there a baseline difference due to ethnicity /." [Tampa, Fla.] : University of South Florida, 2005. http://purl.fcla.edu/fcla/etd/SFE0001156.

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Adisesh, Linganatha Anil. "Exhaled air nitric oxide and occupational exposure to organic dusts and endotoxin." Thesis, University of Manchester, 2003. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:86766.

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Gordon, Robert L. "A comparison of exhaled breath nitric oxide between old and young individuals." [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000346.

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Franklin, Peter James. "The effect of indoor pollutants on exhaled nitric oxide in healthy children." Thesis, Franklin, Peter James (2000) The effect of indoor pollutants on exhaled nitric oxide in healthy children. PhD thesis, Murdoch University, 2000. https://researchrepository.murdoch.edu.au/id/eprint/52150/.

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Air pollution in the home has been associated with asthma and asthma-like symptoms in children. To understand how they contribute to the initiation and/or exacerbation of asthma, the toxic effects of these pollutants on the human respiratory system have been studied under controlled laboratory conditions. In these clinical studies exposure is short and concentrations are generally higher than those encountered on a daily basis. Domestic levels of air pollutants are quite low and little is known about how chronic exposure to these low level pollutants can affect asthma prevalence and severity. Inflammatory changes in the airways are important for both the development of asthma and triggering of symptoms. The main aim of this thesis was to investigate the effects of selected indoor pollutants on exhaled nitric oxide, a marker of asthmatic airway inflammation, in healthy children. The primary objective was to improve our knowledge regarding a possible mechanism by which these pollutants can contribute to asthma in children. The research was divided into two parts. In the first part methodological and physiological factors that can affect measurements of exhaled nitric oxide in a healthy paediatric population were investigated. One hundred and fifty seven children aged between 6 and 13 years were recruited for this study. Children were recruited from local primary schools via a respiratory health questionnaire and only those children without current respiratory disease or a history of respiratory illness were included. The children underwent a respiratory assessment at the Respiratory Medicine Department of Princess Margaret Hospital for Children (Perth, Western Australia). This included spirometry, a skin prick test and measurement of exhaled nitric oxide. Methodological issues that were investigated included a suitable expiratory flow for children for eNO measurements and the repeatability of eNO measurements. Physiological factors studied included skin prick reactivity (atopy), age, height and spirometric variables (forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1)). Exhaled NO levels are flow dependent and if the flow is too high differences in eNO levels between subjects is reduced. Three expiratory flows were used (50, 75 and 100 mis'1) for measuring eNO levels in this study. A flow of 75ml.s'1 seemed to be the most comfortable for the children, while, at this flow, there remained good discrimination of eNO levels between subjects. The twenty-four hour repeatability of eNO levels for each expiratory flow was measured in 10 children. The coefficient of repeatability of measurements were 8.3 ppb, 5.2 ppb and 6.3 ppb, respectively, which represents 9.9%, 6.9% and 10.0% of the range of eNO levels at each flow. Two physiological factors were positively associated with eNO levels in healthy children. These were age (p < 0.05) and atopy (p < 0.001). These findings had not been reported previously and the mechanisms require further investigation. A possible mechanism for the relationship between atopy and raised eNO levels is subclinical inflammation caused by exposure to allergens. To investigate this house dust mite allergen levels were collected from the mattress of those children who had a positive skin prick reaction to house dust mite. Exhaled NO measurements were repeated in these children during the period allergen levels were collected. There was no association between current allergen exposure, as determined by mattress levels, and eNO in these children. The main part of this thesis was a cross sectional study to investigate the effect of indoor air pollution on eNO levels in healthy children. This study involved 224 children (6 to 13 years old) who were free of respiratory disease. The homes of the children were monitored for formaldehyde and nitrogen dioxide using passive sampling techniques, while their exposure to environmental tobacco smoke was determined by questionnaire. These three pollutants - formaldehyde, nitrogen dioxide and environmental tobacco smoke - were chosen for the study due to reported associations with asthma and evidence that they can induce inflammatory responses in human airways. During the week their homes where monitored the children underwent a respiratory assessment (as above). Neither measured N02 concentrations nor reported smoking in the home were associated with changes in eNO levels in the children. However, children living in homes with formaldehyde levels that were greater than or equal to 50 parts per billion had significantly higher levels of eNO than children exposed to levels less than 50 ppb in the home (15.5 ppb v 8.7 ppb, p < 0.002). The results of this study suggest that exposure to low levels of air pollution in the home can be associated with inflammatory changes in the airways. These results need to be confirmed and extended in future research. Future studies should include an investigation of how these indoor pollutants affect the developing lungs and immune system in infants, thereby improving our understanding of their role in the initiation of asthma.

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Patel, Sunita I. M. D. "Exhaled Breath Nitric Oxide: Is There A Baseline Difference Due To Ethnicity?" Scholar Commons, 2005. https://scholarcommons.usf.edu/etd/810.

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The air that humans exhale contains various chemical markers whose levels have been associated with various respiratory disorders. Therefore, measurement of these markers offers a potential method of examining airway disease status. Furthermore, exhaled breath offers the advantage of being easy to collect and non-invasive. Hence, these exhaled breath markers are potentially of significant clinical use in examining airways. Therefore, examination of exhaled breath has become the subject of intense study. Current research is targeting the development of methods and parameters for looking at these markers. The goal of this cross-sectional pilot study was to consider the variability in the measurement of these exhaled breath markers between members of different ethnic populations. Specifically, measurements of the exhaled breath marker Nitric Oxide (NO) were compared between two ethnic groups (Caucasian men versus men of African descent). Ten healthy men in each group were studied to examine whether baseline NO measurements differed between them. In this study, a cross-sectional design was used. The study sample consisted of young, healthy men with no history of environmental allergies, asthma, or lung diseases and no significant smoking history. A total of twenty-five men volunteered for the study, including fourteen men of Caucasian descent and eleven men of African descent. Because four men were excluded and one withdrew, ten men in each ethnic group were included in the final analysis. The source population from which the sample was drawn included students and workers. All participants were residing in Florida at the time of study. Ideally, the target population for this study was young, healthy, working men. Large inter-measurement variation was seen between the participants of each ethnic group. This was hypothesized to be attributed to a tri-modal distribution due to the existence of 3 populations of subjects: (1) asymptomatic with normal airways, where NO levels were under 30 parts per billion (ppb); (2) asymptomatic with airway pathology, where NO levels were over 30 ppb; and (3) asymptomatic just before the onset of an upper respiratory tract infection, where NO levels were over 60 ppb. This pilot study did not find statistically significant evidence that there is a difference in the baseline exhaled breath NO measurements between the two ethnic groups studied. Nonetheless, in participants with NO levels under 30 ppb the mean of the African group was found to be 7.6 ppb lower than the mean of the Caucasian group when attempts were made to exclude individuals with underlying airway pathology or imminent upper respiratory tract infection. In order to find statistical significance in the results, a power analysis using the standard deviation of 7.7 ppb that was found in this study indicates that at least thirty-two eligible participants with NO levels under 30 ppb would be required. Only 13 such participants were examined in this study, Thus, at least fifty eligible participants would be required to find significant results. The implication is that even though statistical significance was not achieved, the crude mean averages differed between the two groups in participants with NO levels under 30 ppb. This implies that a larger-scale well-designed study is warranted before NO is used in clinical settings in the diagnosis and monitoring of patients.

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Blake, Tamara Louise. "Spirometry and fractional exhaled nitric oxide (FeNO) reference values for Indigenous Australians." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/131824/1/Tamara%20Blake%20Thesis.pdf.

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This thesis is the first to demonstrate the most appropriate spirometry and FeNO reference values for use amongst Aboriginal and Torres Strait Islander children and young adults. Availability of this data will lead to improved accuracy of spirometry and FeNO interpretation which will aid in more timely diagnosis and management of respiratory conditions for this population. Results from this study also suggest that healthy Australian Indigenous lung function data may not be as low as previously reported in earlier studies.

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Keyser, Eric J. "Exhaled nitric oxide and the Systemic Inflammatory Response Syndrome (SIRS) after cardiac surgery." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31247.

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Background. Septic patients produce increased nitric oxide (NO). We postulated increased exhaled nitric oxide (exNO) in SIRS after cardiopulmonary bypass surgery (CPB). Methods. Forty-two intubated patients were studied postoperatively and at two-hour intervals for eight hours or until extubated. Hemodynamic indices, including indexed systemic vascular resistance (SVRi) and cardiac index (CI) were measured. ExNO was analyzed by ozone chemiluminescence. Results. Six patients (14%) Manifested SIRS, defined as SVRI <1800 dynes·sec/cm5/m2. ExNO indexed by expired volume of minute ventilation and body surface area (exNO· V&dot;Ei) was less in SIRS patients at each interval. Overall, normal exNO·V&dot;Ei was 4.3 +/- 0.4 nL/min/m2 with a Cl of 2.56 +/- 0.05 L/min/m 2 and an SVRI of 2488 +/- 62 dynes·sec/cm5/m 2, whereas in SIRS exNO·V&dot;Ei was 0.7 +/- 0.3 (p < 0.001) with a Cl of 2.97 +/- 0.09 (p < 0.001) and an SVRi of 1826 +/- 86 (p < 0.001). Conclusions. Pulmonary production of NO in post-CPB SIRS differs from sepsis and may not be reflective of systemic levels. Increased pulmonary blood flow may scavenge lung production of NO thereby decreasing exhaled levels.

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Spanier, Adam Jason. "The Relationship of Genes and Environment with Exhaled Nitric Oxide in Children with Asthma." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1204220355.

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Artlich, Andreas. "Nitric oxide in exhaled gas : studies on physiological regulation and measurements in infants and children /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3670-6/.

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Gallagher, Michael James. "Evaluation of pulmonary function cross-shift changes in dairy parlor workers using spirometry & exhaled nitric oxide." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/1600.

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Inhalation of organic dust, including endotoxin, has been associated with inflammatory response of the pulmonary system. Limited studies have evaluated the work shift effects of endotoxin on respiratory outcomes for workers in the dairy industry, such as spirometry changes. Measurement techniques for exhaled nitric oxide (eNO) have been standardized by the American Thoracic Society (ATS) and used as a biomarker to identify diseases marked with lung inflammation. Dairy parlor workers are known to work long hours in one location with little job variability. The objectives of this study were to quantify exposure concentrations of inhalable dust and endotoxin among dairy parlor workers, evaluate acute cross-shift changes in respiratory status using spirometry, and assess the effectiveness of exhaled nitric oxide for detecting cross-shift bronchial inflammation changes. The cross-sectional study recruited 62 dairy parlor workers from 10 large herd dairy farms across Iowa, Minnesota, Wisconsin, and South Dakota. Data collected before and after the work shifts included spirometry tests, eNO measurements, and pulmonary symptom questionnaires. Personal breathing zone exposure to inhalable dust was assessed during the shift using Button Aerosol Samplers. Gravimetric analysis was used to determine airborne concentrations of inhalable dust and endotoxin concentration was determined using the recombinant factor C assay. Inhalable dust concentrations ranged from 0.09 - 4.95 mg/m3 with a geometric mean of 0.58 mg/m3. Inhalable endotoxin concentrations ranged from 4-1968 EU/m3 with a geometric mean of 117 EU/m3. The study participants pre-shift forced expiratory volume in the first second (FEV1) as a percentage of predicted was an average of 93.4%. Study group cross-shift FEV1 decreased by -1.16%. Six participants with moderate post-shift concentrations of eNO had an average FEV1 cross-shift change of -3.19%. Dairy parlor workers are exposed to concentrations of organic dusts that may adversely impact health. Future studies should test interventions in milking parlors to reduce dust exposure among dairy workers.

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Vento, Daniella Alves. "Desenvolvimento de um aparato para a coleta do condensado do exalado pulmonar visando a análise do óxido nítrico em indivíduos hígidos." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-05082016-084941/.

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O óxido nítrico (NO) tem papel relevante nas diversas funções fisiológicas do organismo e nos mais variados sistemas que o compõe. Sabe-se que esta molécula é um constituinte normal do ar exalado na respiração de humanos e de animais. Tem como funções modular respostas inflamatórias e imunes bem como atuar na regulação do tônus vascular da musculatura lisa das vias aéreas. Esta molécula vem sendo reconhecida como importante marcador de lesão pulmonar, o que despertou a intensa investigação do NO no ar exalado. Uma metodologia não invasiva, de baixo custo e de fácil aplicação está sendo extensivamente estudada para a captação do ar exalado através do seu resfriamento e condensação, denominada Condensado do Exalado Pulmonar (CEP). É grande o interesse no estudo de doenças pulmonares inflamatórias, no entanto, observa-se uma considerável carência de evidências acerca dos níveis de concentração de mediadores inflamatórios, como o NO em amostras de indivíduos hígidos utilizando o CEP. Diante disso, decidiu-se elaborar um protótipo de aparato para coleta do condensado e empregar esta técnica para determinar valores de concentração de NO em uma amostra de voluntários hígidos. A metodologia de coleta utilizada foi baseada nas recomendações da força tarefa da American Thoracic Society/European Respiratory Society (ATS/ERS) para procedimentos de coleta de condensado, com o intuito de evitar erros metodológicos, padronizar e trazer mais evidências para auxiliar a inserção do método na rotina clínica, além de disponibilizá-lo para novas pesquisas. Para isto foram selecionados 116 indivíduos adultos hígidos de ambos os sexos, com idade entre 20 e 70 anos. O protótipo de aparato utilizado na pesquisa foi de fabricação artesanal e desenvolvido na Divisão de Cirurgia Torácica e Cardiovascular da Faculdade de Medicina da Universidade de São Paulo- FMRP/USP, visto que os aparatos comerciais são todos importados, de custo elevado e que ainda não forneceram evidências suficientes de que algum destes seria o padrão ouro para a coleta. O aparato foi eficiente para coletar o CEP e o NO foi detectável em todas as amostras. A média de NO foi de 13±14,4µM, e não houve correlação com o gênero (p=0,847) e idade (p=0,811). Não foi observado correlação entre o NO e o volume de CEP coletado (p=0,944). O volume de CEP coletado é dependente do volume exalado total (p<0,001). A partir destes resultados pode-se verificar que o aparato é viável e eficiente. Não foram encontradas correlações entre a concentração de NO no CEP, idade e o gênero. O presente estudo poderá contribuir com futuras pesquisas de caráter comparativo e fornecer mais uma opção de aparato para coleta do condensado do exalado pulmonar, provendo baixo custo, reprodutibilidade e reutilização do aparato Nitric oxide (NO) plays an important role in various physiological functions in the body and in various systems that compose it. It is known that this molecule is a normal constituent of exhaled breath in humans and animals. Its functions modulate inflammatory and immune responses as well as act in the regulation of vascular tone of smooth muscles of the airways. This molecule has been recognized as an important marker of lung injury, which sparked intense investigation of exhaled NO. A non-invasive method, low cost and easy application has been extensively studied to collect the exhaled air through its cooling and condensation, termed exhaled breath condensate. There is great interest in the study of inflammatory lung diseases, however, there is a considerable lack of evidence about the concentration levels of inflammatory mediators such NO in samples of healthy individuals using exhaled breath condensate. Given this, it was decided to develop a prototype apparatus for collecting exhaled breath condensate (EBC) and employ this technique to determine concentration values of nitric oxide in a sample of healthy volunteers. The sampling methodology based on the recommendations of the task force of the American Thoracic Society / European Respiratory Society (ATS / ERS) for procedures using for collection of condensate, in order to avoid methodological errors, standardize and bring more evidence to support the inclusion of the method in clinical routine, and make it available for further research. We selected 116 healthy adults of both gender, aged between 20 and 70. The prototype apparatus used in the research was designed, produced and developed in the Division of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of São Paulo-FMRP / USP. The commercial devices are all imported, expensive and not yet provided sufficient evidence that any of these would be the gold standard for collection. The apparatus was efficient to collect the EBC and NO was detectable in all samplesThe average NO was 14.4 ± 13 µM, and there was no correlation with gender (p = 0.847) and age (p = 0.811). There was no correlation between NO and the volume of collected EBC (p = 0.944). The volume of collected EBC is dependent on the total exhaled volume (p <0.001). From these results it can be seen that the apparatus is feasible and efficient. No correlation was found between the concentration of NO in the EBC, age and gender. The present study may contribute to future comparative studies of character and provide another option for apparatus for collecting condensate, providing low cost, reliability and reusability of the apparatus

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Malinovschi, Andrei. "Nitric Oxide Exchange in Central and Peripheral Airways : Determinants in Health and Respiratory Disease." Doctoral thesis, Uppsala universitet, Institutionen för medicinsk cellbiologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9416.

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Background: Exhaled nitric oxide (NO) is a marker of eosinophilic steroid-sensitive inflammation in the airways of patients with respiratory disease. Moreover, information about the localization of inflammation in the respiratory tree is obtained by estimates of bronchial and alveolar contributions to exhaled NO. Aims: The main aim of this thesis was to identify the determinants of exhaled NO, as well as determinants of bronchial and alveolar contributions to exhaled NO in health and disease. Smoking history, degree of IgE sensitization and effects of modulating the pharyngo-oral tract production of NO were specifically studied in this context. Other specific aims were to determine the association of exhaled NO with the presence of asthma and pulmonary hypertension (PH). Methods: Both population-based studies and experimental studies have been performed within the frame of the thesis. The population-based studies are based on data from the European Community Respiratory Health Survey II. NO measurements at several exhalation flow rates were performed in order to estimate alveolar and bronchial contributions to exhaled NO. Results: Both current and previous smoking were associated with decreased exhaled NO and bronchial NO flux levels. Alveolar NO concentrations were decreased in current smokers. The degree of IgE sensitization was positively related to the levels of exhaled NO and its bronchial contribution. Exhaled NO appeared to be a more specific marker of allergic inflammation than of rhinitis or asthma. Both allergic and non-allergic asthma were associated with increased exhaled NO levels, but only in never-smoking persons. The estimated alveolar NO increased after ingestion of nitrate in individuals with high nitrate turnover in the pharyngo-oral tract. Pulmonary arterial hypertension, but not other forms of PH, was associated with decreased bronchial NO flux, whereas PH of all etiologies was related to increased alveolar NO concentrations. Conclusion: Smoking history and IgE sensitization, that are known determinants of exhaled NO, affected the bronchial and alveolar contributions to exhaled NO differently. The limitations of the simple NO pulmonary exchange models were highlighted by the paradoxical effects on estimated alveolar NO when modulating the NO production proximally, in the pharyngo-oral tract. Predominance of non-eosinophilic inflammation in ever-smoking patients with asthma could explain the poor association between the presence of asthma and exhaled NO in these patients. Different pathophysiological changes in terms of bronchial NO production and exchange were related to the etiology of pulmonary hypertension.

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Roberts, Graham Colin. "The effects of allergic desensitisation on children with seasonal allergic asthma : symptom control and inflammation as measured by exhaled nitric oxide." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408813.

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Wilson, Emma Elizabeth. "Biomarkers of airway inflammation : the use of exhaled nitric oxide (FeNO) in the management of adult asthma in UK primary care." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/29710/.

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Rationale: Current asthma guidelines recommend reducing inhaled corticosteroid (ICS) therapy dose by 50% in patients with mild to moderate asthma who have demonstrated three months of good symptom control however there is evidence to suggest that this does not occur. Objectives: We tested whether exhaled nitric oxide (FeNO) measurements or other clinical indices could be utilised to predict a safe reduction of ICS dose, without provoking loss of symptom control or exacerbation within 3 months. We also investigated relationships between airway inflammation and asthma symptoms in the mild to moderate asthma cohort. Methods: 191 patients with stable asthma were recruited from primary care. Patients had their FeNO level measured at baseline and then had their inhaled corticosteroid (ICS) dose reduced by 50%. FeNO measurements were reassessed seven days later. The primary outcomes were whether baseline FeNO or a change in FeNO following ICS dose reduction could predict asthma stability at 3 months. Results: 128/191 patients (67%) completed the ICS dose reduction successfully at three months. 63/191 patients (33%) suffered from either a loss of control or an exacerbation. Baseline FeNO, or change in FeNO (post step-down minus pre step-down) were not statistically significantly different between the two groups. Conclusion: 67% of patients with well-controlled asthma can safely reduce their ICS dose by half without suffering from a loss of control or exacerbation within three months; however neither baseline nor change in FeNO measurements or routine clinical indices can be used to predict which patients can or cannot successfully tolerate a reduction in ICS dose.

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Barath, Stefan, Nicholas L. Mills, Ellinor Ädelroth, Anna-Carin Olin, and Anders Blomberg. "Diesel exhaust but not ozone increases fraction of exhaled nitric oxide in a randomized controlled experimental exposure study of healthy human subjects." Umeå universitet, Medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-71312.

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Background: Fraction of exhaled nitric oxide (FENO) is a promising non-invasive index of airway inflammation that may be used to assess respiratory effects of air pollution. We evaluated FENO as a measure of airway inflammation after controlled exposure to diesel exhaust or ozone. Methods: Healthy volunteers were exposed to either diesel exhaust (particle concentration 300 mu g/m(3)) and filtered air for one hour, or ozone (300 ppb) and filtered air for 75 minutes. FENO was measured in duplicate at expiratory flow rates of 10, 50, 100 and 270 mL/s before, 6 and 24 hours after each exposure. Results: Exposure to diesel exhaust increased FENO at 6 hours compared with air at expiratory flow rates of 10 mL/s (p = 0.01) and at 50 mL/s (p = 0.011), but FENO did not differ significantly at higher flow rates. Increases in FENO following diesel exhaust were attenuated at 24 hours. Ozone did not affect FENO at any flow rate or time point. Conclusions: Exposure to diesel exhaust, but not ozone, increased FENO concentrations in healthy subjects. Differences in the induction of airway inflammation may explain divergent responses to diesel exhaust and ozone, with implications for the use of FENO as an index of exposure to air pollution.

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Anderson, William James. "Personalising inhaled corticosteroid dose response in persistent asthma." Thesis, University of Dundee, 2016. https://discovery.dundee.ac.uk/en/studentTheses/0c7c79f5-91e8-4b47-96cd-69db4afc4cd8.

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This thesis examines the overarching theme of inhaled corticosteroid (ICS) dose response effects on a variety of asthma outcome measures; with further importance placed on the application of these findings to personalising ICS dosing for the individual asthmatic. The introduction provides a detailed summary of the current recommendations for the treatment of adult asthma, with particular reference to the mechanism of action and clinical utility of ICS for the treatment of asthma. Current methods of assessing ICS dose response are presented, as well as the common influences that affect these responses. Novel therapeutic theories and the identification of specific asthmatic phenotypes are also introduced, in order to demonstrate the shift towards personalising treatment for asthma. The first two studies examine the dose response of ICS on two specific factors that influence asthma. The third study presents an examination of pharmacological manipulation of the ICS dose response using an additional agent. The following two studies address: how asthma outcomes relate to each other in patients receiving ICS; in addition to an overall assessment of the ICS dose response across a broad range of both ICS moieties and outcome measures. The final study examines for any detrimental effect of an ICS dose ramp on bone metabolism, an important potential long-term adverse effect of higher ICS dosing. The discussion draws together all the results obtained in relation to ICS dose response in asthma, and how these apply to current clinical practice for the individual patient. Furthermore, hypotheses are generated for areas of future study based on the findings from this work.

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Al-Badri, Faisal. "Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29574.

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Aim: To assess the health impact of an intervention in supermarket bakeries using fractional exhaled nitric oxide and other clinical endpoints for baker’s allergy and asthma after a one-year follow-up period. Methods: A field randomised controlled trial of 31 bakeries initially assigned to one of two intervention groups (bakery mixer lid and training) (n=244) and a control group (n=93). Health data prior to and after the intervention included a modified ECRHS questionnaire; Phadiatop ® and serum specific IgE to cereal flours (wheat, rye, alpha-amylase); and FeNO performed during the work shift using NIOX MINO®. The data of the two intervention groups was combined into one intervention group for the analysis. Data was analysed using STATA (version 12). Results: The two groups were comparable with regard to age (32-33 years), proportion of females (55%-57%) and smoking status (38%-40%). The intervention group had a significantly higher prevalence of workers with atopy (42%, p=0.025), work-related chest symptoms (25%, p=0.044) and sensitisation to cereal flour allergens (35%, p=0.042) at baseline than the control group (25%, 15%, 23% respectively). At one year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO >25ppb) was similar in the two groups. The mean difference in FeNO was similar across the two groups (2.2ppb vs 1.7ppb, p=0.860). However, when stratifying according to baseline FeNO >25ppb, the FeNO decline was greater in the intervention group (16.9 ppb) than in the control group (7.7ppb), although not statistically significant (p=0.237). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO >25ppb) did not demonstrate an appreciable decline in FeNO (>10%) in the intervention compared to the control group. However, stratification according to the presence of work related ocular-nasal symptoms at baseline demonstrated a significant decline (>10%) in FeNO in the intervention group compared to the control group (OR=3.73, CI: 1.22-11.42). Conclusion: This study demonstrates some evidence of an intervention effect on exhaled nitric oxide (FeNO) one year after the intervention, particularly among bakers reporting work-related ocular-nasal symptoms at baseline. The lack of a demonstrably stronger effect on other clinical endpoints can be attributable to the short follow-up period.

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Arcêncio, Livia. "Estudo do nitrito/nitrato no condensado do exalado pulmonar e no plasma de pacientes valvopatas e coronariopatas submetidos à cirurgia cardíaca com circulação extracorpórea." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-28052018-154842/.

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Pacientes submetidos à cirurgia cardiotorácica com circulação extracorpórea (CEC) apresentam reações inflamatórias, desencadeadas por este procedimento e pela isquemiareperfusão, que acarretam disfunção pulmonar e lesão do endotélio vascular no pósoperatório. Estes processos relativos à cirurgia cardíaca podem afetar a produção e o consumo do óxido nítrico (NO) no pulmão e no endotélio vascular, principalmente na sua participação no processo inflamatório. No pulmão, o NO se difunde com facilidade sendo detectado na via aérea na fase gasosa ou no fluído pulmonar como nitrito e o nitrato. A presença do NO na via aérea pode em algumas situações refletir a sua produção pelo epitélio da via aérea e pelo endotélio microvascular pulmonar. No entanto, os processos que envolvem a produção e o consumo do NO na via aérea ainda não estão totalmente esclarecidos. O condensado do exalado pulmonar (CEP) é um fluido obtido através do resfriamento do ar exalado através de um método totalmente não invasivo e que pode ser utilizado para a investigação do NO nas vias aéreas distais. No desenvolvimento deste estudo foi utilizado um aparato de coleta artesanal e de baixo custo para obtenção do CEP. Assim, foi coletado o CEP de pacientes coronariopatas e valvopatas submetidos à cirurgia cardíaca com CEC nos períodos pré- operatório e pós-operatório (4 horas após a CEC e 12, 24, 48 e 72 horas após a extubação). As concentrações plasmáticas de nitrito/nitrato destes pacientes também foram avaliadas através de amostras de sangue colhidas imediatamente após cada coleta do CEP. O CEP e o plasma foram analisados pela técnica de quimioluminescência para obter as concentrações de nitrito/nitrato. O aparato utilizado obteve utilização reprodutível na rotina clínica da cirurgia cardíaca nesta pesquisa em pacientes sob ventilação espontânea e ventilação mecânica. Não foram encontradas diferenças significativas (p>0,05) nas concentrações de nitrito/nitrato no CEP e plasma entre os pacientes coronariopatas e valvopatas no período pré-operatório. Concentrações significativamente maiores de nitrito/nitrato (p=0,017) foram encontradas no CEP, mas não no plasma, de pacientes que utilizaram nitrato por via oral (dinitrato de isossorbida) no período pré-operatório. Em pacientes que não utilizaram medicação contendo doador de NO (nitroglicerina ou nitroprussiato de sódio) por via endovenosa no pósoperatório ocorreu uma tendência à elevação das concentrações de nitrito/nitrato no CEP que foi numericamente significativa no período de 48 horas do pós-operatório (p=0,008). Em pacientes que receberam ou não doador de NO no pós-operatório as concentrações de nitrito/nitrato foram significativamente maiores nos períodos de 48 horas (p=0,005) e 72 horas (p=0,037) do pós-operatório. A utilização de nitroglicerina (NTG) no período pósoperatório elevou significativamente as concentrações de nitrito/nitrato no CEP nos períodos de 12 horas (p=0,022), 48 horas (p=0,015) e 72 horas (0,048) e no plasma nos períodos de 12 horas (p=0,045). As concentrações de nitrito/nitrato plasmáticos foram significativamente reduzidas (p=0,045) no pós-operatório imediato 4 horas após a CEC em pacientes que receberam ou não doador de NO. A partir destes resultados pode se observar que não houve diferenças significativas nas concentrações de nitrito/nitrato no CEP dos pacientes coronariopatas e valvopatas no período pré-operatório, exceto elevação significativa encontrada em pacientes que utilizaram dinitrato de isossorbida por via oral. As concentrações de nitrito/nitrato no CEP tendem a elevar-se no período pós-operatório principalmente com a utilização de NTG. As concentrações de nitrito/nitrato no plasma foram significativamente reduzidas após 4 horas da CEC no pós-operatório imediato. No entanto foi observado elevação nas concentrações de nitrito/nitrato no plasma de pacientes que usaram NTG. Os achados deste estudo poderão contribuir em futuras pesquisas fornecendo dados comparativos a respeito da participação do NO na via aérea e no plasma nos processos que envolvem a cirurgia cardíaca nos períodos pré e pós-operatório. Patients undergoing cardiothoracic surgery with cardiopulmonary bypass (CPB) have inflammatory reactions triggered by this procedure and by ischemia-reperfusion, which cause lung dysfunction and injury of vascular endothelium in the postoperative period. These processes related to cardiac surgery may affect the production and consumption of nitric oxide (NO) in the lung and vascular endothelium, especially in their participation in the inflammatory process. In the lung, NO diffuses easily and can be detected in the airway in the gas phase or in the lung fluid as nitrite and nitrate. The presence of NO in exhaled air may reflect the airway epithelium and lung microvascular endothelium in some situations. However, processes involving the production and consumption of NO in the airway are not totally understood. The exhaled breath condensate (EBC) is a fluid obtained by cooling exhaled air wich can be used for the investigation of NO in the distal airways. For this study we used an apparatus homemade and with low cost for collecting and obtain the EBC. The EBC was collected from patients with coronary artery disease and heart valve disease undergoing cardiac surgery with CPB in the preoperative and postoperative period (4 hours after CPB and 12, 24, 48 and 72 hours after extubation). Plasma concentrations of nitrite/nitrate in these patients were also evaluated using blood samples taken immediately after each collection of the EBC. The EBC and plasma were analyzed by chemiluminescence method to obtain the concentrations of nitrite/nitrate. The apparatus used was reproducible in clinical routine of cardiac surgery in patients under spontaneous ventilation or mechanical ventilation. There were no significant differences (p> 0.05) in concentrations of nitrite/nitrate in EBC and plasma in patients with coronary artery disease and heart valve disease in the preoperative period. Significantly higher concentrations of nitrite/nitrate (p=0.017) were found in EBC, but not in plasma of patients who used oral nitrate (isosorbide dinitrate) in the preoperative period. In patients who did not use medication containing NO donor (nitroglycerin or sodium nitroprusside) intravenously in the postoperative period there was a tendency to high concentrations of nitrite/nitrate in EBC that was numerically significant in the period of 48 hours postoperative (p=0.008). In patients who received or not NO donor in postoperative period the concentrations of nitrite/nitrate were significantly higher in periods of 48 hours (p=0.005) and 72 hours (p=0.037) after surgery. The use of nitroglycerin (GTN) in the postoperative period significantly elevated concentrations of nitrite/nitrate in the EBC in periods of 12 hours (p=0.022), 48 hours (p=0.015) and 72 hours (0.048) and plasma in period of 12 hours (p=0.045). The concentrations of nitrite/nitrate were significantly reduced (p=0.045) in the immediate postoperative period 4 hours after CPB in patients who received or not NO donor. From these results we could observe that there were no significant differences in concentrations of nitrite/nitrate in the EBC of patients with heart valve disease and coronary artery disease in the preoperative period, but we found a significant increase in these concentrations in patients who used isosorbide dinitrate orally. The concentrations of nitrite/nitrate in EBC presented a tendency to increase in postoperative period especially in patients who used GTN. The concentrations of nitrite/nitrate in plasma were significantly reduced after 4 hours of CPB in the immediate postoperative period. However, was observed that GTN tended to increase the concentration of nitrite/nitrate in plasma. These findings could help in future research providing comparative data about the role of NO in the airway and plasma in processes involving cardiac surgery in the pre and postoperative periods.

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Sothirajah, Shobana. "Clinical Algorithms for Maintaining Asthma Control." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3546.

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Rationale: Asthma management aims to achieve optimal control on the minimal effective dose of medication. We assessed the effectiveness of two algorithms to guide ICS dose in well-controlled patients on ICS+LABA in a double-blind study, comparing dose adjustment guided by exhaled nitric oxide (eNO) to clinical care algorithm(CCA) based on symptoms and lung function. Methods: We randomised non-smoking adult asthmatics on minimum FP dose 100μgs daily +LABA to ICS adjustment using eNO or CCA, assessed over 5 visits during 8 months treatment. Primary endpoints were asthma-free days and asthma related quality of life (QOL). Analysis was by mixed model regression and generalised estimating equations with log link. Results: 69 subjects were randomised (eNO:34, CCA:35) and 58 completed the study. At baseline mean FEV1 was 94% pred., mean eNO (200ml/sec) 7.1 ppb, median ACQ6 score 0.33. Median ICS dose was 500 μg (IQR 100-500) at baseline and 100 μg on both eNO (IQR 100-200) and CCA arms (IQR 100–100) at end of study. There were no significant differences between eNO and CCA groups in asthma-free days (RR=0.92, 95% CI 0.8–1.01), AQL (RRAQL<median = 0.95, 95% CI 0.8–1.1) or exacerbation-free days (HR = 1.03, 95%CI 0.6–1.7). Neither clinic FEV1 (overall mean difference FEV1 % pred. -0.24%, 95% CI -2.2–1.7) nor a.m. PEF (mean difference 1.94 L/min (95% CI -2.9–6.8) were significantly different. Similar proportions of subjects were treated for ≥1 exacerbation (eNO: 50%, 95% CI 32.1–67.9; CCA: 60%, 95% CI 43.9–76.2). Conclusion: Substantial reductions in ICS doses were achieved in well controlled asthmatics on ICS+LABA, with no significant differences in outcomes between eNO or clinically based algorithms.

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Sothirajah, Shobana. "Clinical Algorithms for Maintaining Asthma Control." University of Sydney, 2008. http://hdl.handle.net/2123/3546.

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Master of Science in Medicine Rationale: Asthma management aims to achieve optimal control on the minimal effective dose of medication. We assessed the effectiveness of two algorithms to guide ICS dose in well-controlled patients on ICS+LABA in a double-blind study, comparing dose adjustment guided by exhaled nitric oxide (eNO) to clinical care algorithm(CCA) based on symptoms and lung function. Methods: We randomised non-smoking adult asthmatics on minimum FP dose 100μgs daily +LABA to ICS adjustment using eNO or CCA, assessed over 5 visits during 8 months treatment. Primary endpoints were asthma-free days and asthma related quality of life (QOL). Analysis was by mixed model regression and generalised estimating equations with log link. Results: 69 subjects were randomised (eNO:34, CCA:35) and 58 completed the study. At baseline mean FEV1 was 94% pred., mean eNO (200ml/sec) 7.1 ppb, median ACQ6 score 0.33. Median ICS dose was 500 μg (IQR 100-500) at baseline and 100 μg on both eNO (IQR 100-200) and CCA arms (IQR 100–100) at end of study. There were no significant differences between eNO and CCA groups in asthma-free days (RR=0.92, 95% CI 0.8–1.01), AQL (RRAQL<median = 0.95, 95% CI 0.8–1.1) or exacerbation-free days (HR = 1.03, 95%CI 0.6–1.7). Neither clinic FEV1 (overall mean difference FEV1 % pred. -0.24%, 95% CI -2.2–1.7) nor a.m. PEF (mean difference 1.94 L/min (95% CI -2.9–6.8) were significantly different. Similar proportions of subjects were treated for ≥1 exacerbation (eNO: 50%, 95% CI 32.1–67.9; CCA: 60%, 95% CI 43.9–76.2). Conclusion: Substantial reductions in ICS doses were achieved in well controlled asthmatics on ICS+LABA, with no significant differences in outcomes between eNO or clinically based algorithms.

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Alyousif, Zakaria A. "The Effects of High Intensity Interval Training (HIIT) on Asthmatic Adult Males." University of Toledo / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1403969461.

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Gonçalves, Raquel Calvo. "Efeito do treinamento aeróbio na capacidade funcional, qualidade de vida, ansiedade, depressão e óxido nítrico exalado de adultos com asma persistente moderada ou grave." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-16102014-101836/.

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O objetivo do presente estudo foi avaliar o papel de um programa de condicionamento físico nos aspectos relacionados à qualidade de vida, níveis de ansiedade e depressão, sintomas e óxido nítrico exalado de pacientes com asma persistente moderada ou grave. Foram avaliados 39 pacientes divididos aleatoriamente em grupo controle (GC; N=20) e grupo treinado (GT; N=19). Foram avaliados a capacidade aeróbica máxima (VO2max), função pulmonar, qualidade de vida, sintomas, ansiedade, depressão e percepção subjetiva de esforço e óxido nítrico exalado com um intervalo de 3 meses. Não houve diferença entre os grupos antes do tratamento. O treinamento físico melhorou as capacidades máximas e submáximas ao esforço e os níveis de depressão (p < 0,05). O treinamento físico reduziu os níveis de ansiedade-traço (p < 0,05), mas não a ansiedade-estado. O treinamento físico também melhorou os domínios limitação física, freqüência de sintomas, psicossocial e escore total dos HRQL (p < 0,001). Houve aumento no número de dias livres de sintomas (p < 0,001) e nos valores de óxido nítrico exalado (p < 0,001) no grupo treinado. Nossos resultados sugerem que o condicionamento físico para pacientes asmáticos pode ser benéfico para reduzir sintomas e melhorar os escores de qualidade de vida e a co-morbidade psicossocial. Estes dados sugerem que o treinamento físico pode ter um papel adjuvante importante no controle clínico de pacientes com asma persistente moderada ou grave The aim of the present study was to evaluate the effect of aerobic training on quality of life, functional capacity and exhaled nitric oxide (NOex) in patients with moderate and severe asthma. Twenty nine subjects were randomly divided in control group (n 20) (educational program + breathing exercises) and training group (n 19) (control + aerobic training, 70% maximal VO2peak) and followed during 3 months, twice a week. Aerobic capacity (VO2peak), quality of life, anxiety, depression, and pulmonary function were evaluated before and after treatment. FENO and symptoms were evaluated monthly. There was no change in inhaled glucocortiscosteroid during treatment. Our results show that patients submitted to an aerobic training presented a decrease on physical limitation (p < 0.05), frequency and gravity score, decrease in psychosocial limitation an increse in global score of quality of life (p < 0.05) as well as an improvement on VO2peak (p=0,001) when compared with control group. Compared with control group, training group also presented a increase in number of days without symptoms (p < 0,001). FENO it was also decreased (p < 0,001) after training in training group. No change was observed in lung function in both groups after treatment. Our results suggest that aerobic improves quality of life and decreases symptoms and exhaled nitric oxide on asthmatic patients reinforcing its importance on asthma treatment

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Correia, Iolanda Baptista Gonçalves Caires. "Influência do ciclo menstrual na fracção exalada de óxido nítrico." Master's thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2011. http://hdl.handle.net/10362/6987.

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RESUMO:A determinação da fracção exalada de óxido nítrico (FENO) é amplamente utilizada como um biomarcador da inflamação eosinofílica das vias aéreas. Alguns estudos sugerem que a produção de óxido nítrico (NO) é influenciada pelas variações cíclicas hormonais na mulher,porém os dados não são consensuais. Deste modo, o objectivo do nosso estudo foi avaliar como varia a FENO ao longo do ciclo menstrual. Com esta finalidade, avaliamos um grupo de 20 voluntárias, em idade fértil, com ciclo menstrual regular, não fumadoras, que não utilizavam contraceptivos hormonais, nem suplementos alimentares e/ou medicamentosos e que não se encontravam grávidas, nem a amamentar. Todas referiram não ter conhecimento de qualquer patologia que afecte a FENO. A existência de atopia foi controlada através de testes cutâneos por prick, tendo-se excluído as participantes que apresentaram testes positivos. Realizamos quatro visitas de estudo, com base na periodicidade do ciclo de cada participante, nas quais, efectuamos a determinação da FENO, a quantificação dos níveis plasmáticos de óxido nítrico e nitratos (NO/NO3 -) e o doseamento hormonal de 17 -estradiol e progesterona. As avaliações realizaram-se no período da manhã, em jejum absoluto, tendo respeitado uma dieta pobre em nitratos no dia anterior e abstido da prática de exercício vigoroso uma hora antes da avaliação. Com este trabalho, verificamos um aumento significativo da FENO na fase secretora (17.97 ppb ± 5.8) comparativamente com a fase menstrual e proliferativa (16.48 ppb ± 3.6 e 15.95 ppb ±2.8, respectivamente). Não observamos variações significativas dos níveis plasmáticos de NO/NO3 - ao longo do ciclo. Constatamos uma correlação positiva entre a FENO e os níveis plasmáticos de NO/NO3 - durante a ovulação e verificamos que, para a nossa amostra, os níveis hormonais de estradiol e progesterona não são preditores do valor da FENO, nem dos níveis plasmáticos de NO/NO3-. Os resultados deste trabalho mostram uma variação da FENO ao longo do ciclo, ainda assim, mantendo-se os seus valores dentro do intervalo de referência, reforçando a fiabilidade deste biomarcador.--ABSTRACT:The determination of fractional exhaled nitric oxide (FENO) is widely used as a biomarker of eosinophilic airway inflammation. Some studies suggest that nitric oxide (NO) is influenced by cyclical hormonal changes in women, but those are not consensual. The aim of our study was to assess how FENO varies throughout the menstrual cycle. With this purpose, we studied a group of 20 volunteers within childbearing age, with regular menstrual cycle, non-smokers, who were not taking any medications including hormonal contraception and food supplements and who were not pregnant or breast-feeding. All participants reported not being aware of any condition that could affect the FENO. The presence of atopy was controlled by a skin prick test, having been excluded participants with positive test. We conducted four study visits, based on the periodicity of the cycle of each participant. In each visit, we made the determination of the FENO, the quantification of plasmatic levels of nitric oxide and nitrates (NO/NO3 -) and the blood levels of hormone estradiol-17 and progesterone. The evaluations occurred at morning, after overnight fasting. The participants were request to follow a low-nitrate diet in the previous day and refrained from vigorous exercise, for at least one hour before the visit We found a significant increase of FENO on secretory phase (17.97 ppb ± 5.8) compared with the menstrual and proliferative phase (16.48 ppb ± 3.6 and 15.95 ppb ± 2.8, espectively). No significant variations were found throughout the menstrual cycle in plasmatic levels of NO/NO3 -. We found a positive correlation between FENO and plasmatic levels of NO/NO3 - during ovulation. Finally, in our sample, the levels of oestradiol and progesterone are not predictors of FENO value nor of plasmatic levels of NO/NO3-. This study shows a variation of FENO over the menstrual cycle, nevertheless, the values remain within the reference range, reinforcing the reliability of this biomarker.

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Singh, Umesh M. D. "Environmental Exposures to Airborne Microbial Sub-micrometer Particles and Airway Inflammation in Children." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1318607732.

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Ronkainen, E. (Eveliina). "Early risk factors influencing lung function in schoolchildren born preterm in the era of new bronchopulmonary dysplasia." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526213477.

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Abstract Advances in perinatal treatment practices—such as antenatal corticosteroids, surfactant replacement therapy, and gentler ventilator modalities—have improved the survival of infants born preterm. Consequently, later morbidity and pulmonary outcome for survivors has attracted increasing interest. The incidence of bronchopulmonary dysplasia (BPD) remains high and the condition is manifesting in infants born at earlier gestational weeks than before. This so-called new BPD results from the arrest of alveolar development and is associated with less structural airway injury and interstitial fibrosis than previously. Long-term follow-up data on lung function, lung structure and respiratory morbidity of children treated with modern methods is insufficiently known. We performed a follow-up study of 88 preterm-born children and 88 matched term-born controls at school age. Children born preterm had lower values in lung function measurements than term-born peers. Reductions were most marked in those with a history of BPD. In accordance with the foetal origins hypothesis, children with intrauterine growth restriction (IUGR) had lower lung function than gestation-controls. This indicates that poor growth in utero is an additional burden on pulmonary health. Both IUGR and BPD predicted lower lung function independently. High-resolution computed tomography of the lung was obtained from 21 children with a history of BPD. Structural abnormalities were common, children with severe BPD being most affected. Preterm children were hospitalised more often than controls, mainly because of wheezing disorders. However, BPD did not influence the hospitalisations. According to the meta-analysis of the contemporary data available, the respiratory outcome of children who had only mild BPD may have improved in comparison to old follow-up data, whereas the results for those without BPD or moderate-to-severe BPD have remained remarkably stable despite progress in treatment practices during early life. In conclusion, preterm children had subtle impairments in lung function at school age. Although they were fairly asymptomatic, concern about the possible long-term effects of preterm birth on pulmonary health is justified. It has been proposed that BPD may predispose individuals to an early COPD-like disorder. Preterm children must be protected from any additional burden on respiratory health and should be monitored appropriately for early detection of lung disease Tiivistelmä Keskosten tehohoito on kehittynyt viime vuosikymmeninä merkittävästi, ja yhä epäkypsempänä syntyvät keskoset selviävät hengissä syntymän jälkeen. Keskosten pitkäaikainen keuhkosairaus, bronkopulmonaalinen dysplasia (BPD), on perinteisesti johtunut hengityskonehoidon ja happikaasun aiheuttamasta keuhkovauriosta ja johtanut keuhkokudoksen arpeutumiseen. Aiempaa ennenaikaisemmilla keskosilla esiintyy kuitenkin nykyään niin sanottua uutta BPD:tä, jonka ajatellaan johtuvan enemmän keuhkorakkuloiden kehityshäiriöstä kuin hoitojen aiheuttamasta keuhkovauriosta. Selvitimme, miten nykyaikaisilla menetelmillä hoidettujen keskosten keuhkojen rakenne ja toiminta kehittyvät kouluikään mennessä. Seurantatutkimukseemme osallistui 88 ennenaikaisena syntynyttä, kouluikään ehtinyttä lasta ja 88 täysiaikaisena syntynyttä, kaltaistettua verrokkia. Keskosena syntyneiden lasten keuhkofunktio oli kouluiässä huonompi kuin täysiaikaisena syntyneiden verrokkien. Alhaisin keuhkofunktio oli niillä keskosena syntyneillä lapsilla, jotka olivat sairastaneet vastasyntyneenä BPD:n. Myös kohdunsisäiseen kasvuhäiriöön (intrauterine growth restriction, IUGR) liittyi alentunut keuhkofunktio. BPD ja IUGR ennustivat alentunutta keuhkofunktiota toisistaan riippumatta. Tutkimuksessa tehtiin myös keuhkojen ohutleiketietokonekuvaus 21 keskoselle, jotka olivat sairastaneet BPD:n. Lähes kaikilla havaittiin poikkeavia löydöksiä – eniten niillä, joilla oli ollut vastasyntyneenä BPD:n vaikea tautimuoto. Keskosina syntyneet joutuivat kahden ensimmäisen vuoden aikana verrokkeja useammin sairaalahoitoon. Yleisimpiä syitä olivat hengityksen vinkumista aiheuttavat taudit kuten ilmatiehyttulehdus, ahtauttava keuhkoputkitulehdus tai akuutti astmakohtaus. Vastasyntyneenä sairastettu BPD ei kuitenkaan lisännyt todennäköisyyttä joutua sairaalahoitoon. Tutkimuksessa tehtiin myös meta-analyysi nykyaikaisilla menetelmillä hoidettujen keskosten keuhkofunktiosta: lievää BPD:tä sairastavien tulokset näyttävät parantuneen, kun taas keskivaikeaa tai vaikeaa tautimuotoa sairastavien ja ilman BPD:tä selvinneiden keuhkofunktio ei ole muuttunut uusien hoitojen myötä. Yhteenvetona voidaan todeta, että keskosten keuhkojen toimintakyky on jonkin verran alentunut täysiaikaisiin verrattuna. Lievästi alentunut keuhkofunktio ei kuitenkaan yleensä aiheuttanut koululaisille oireita. Keskosena syntyneiden lasten hengityselinten toimintaa on syytä seurata, sillä niin sanotun uuden BPD:n pitkäaikaisesta ennusteesta ei ole vielä tietoa

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"Exhaled nitric oxide in Chinese schoolchildren." 2005. http://library.cuhk.edu.hk/record=b5896396.

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Liu Kin Hang. Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. Includes bibliographical references (leaves 88-98). Abstracts in English and Chinese. Abstract (in English) --- p.i Abstract (in Chinese) --- p.iii Acknowledgement --- p.v Table of Contents --- p.vi List of Tables --- p.ix List of Figures --- p.x Glossary of Terms and Abbreviations --- p.xi Chapter Section I: --- Overview --- p.1 Chapter Chapter 1: --- Introduction --- p.2 Chapter 1.1 --- Asthma and Assessment of A irway Inflammation --- p.2 Chapter 1.1.1 --- Assessment of A irway Inflammation --- p.4 Chapter 1.1.2 --- Invasive and Noninvasive Methods --- p.4 Chapter 1.1.3 --- Exhaled Nitric Oxide as a Diagnostic Marker and Its Correlation with Other Markers of Inflammation --- p.6 Chapter 1.1.4 --- Normal Reference Studies of Exhaled Nitric Oxide --- p.8 Chapter 1.2 --- Aim of Study --- p.10 Chapter Chapter 2: --- Plan of Study --- p.11 Chapter Section II: --- Literature Review --- p.13 Chapter Chapter 3: --- Nitric Oxide Biology --- p.15 Chapter 3.1 --- Exhaled Nitric Oxide Production in Airway --- p.15 Chapter 3.2 --- Nitric Oxide Production and Function --- p.16 Chapter 3.3 --- Nitric Oxide Synthase Pathway --- p.18 Chapter 3.4 --- Factors Affecting Exhaled Nitric Oxide Level --- p.21 Chapter 3.4.1 --- Procedure-related Factors --- p.22 Chapter 3.4.1.1 --- Nasal Nitric Oxide Contamination --- p.22 Chapter 3.4.1.2 --- Exhalation Procedure 226}0´ؤؤStarting Lung Volumes --- p.23 Chapter 3.4.1.3 --- Exhalation Procedure 226}0ؤ Flow --- p.23 Chapter 3.4.1.4 --- Circadian Rhythm --- p.25 Chapter 3.4.2 --- Patient Factors --- p.26 Chapter 3.4.2.1 --- Sex --- p.26 Chapter 3.4.2.2 --- Upper Respiratory Tract Infection --- p.26 Chapter 3.4.2.3 --- Diet and Exhaled Nitric Oxide --- p.27 Chapter 3.4.2.4 --- Effect of Spirometry and Exercise --- p.28 Chapter 3.4.3 --- Environmental Factors --- p.28 Chapter Chapter 4: --- Exhaled Nitric Oxide in Asthmatics and Its Relationship to Anti-inflammatory Treatment --- p.31 Chapter Chapter 5: --- Relationship of Exhaled Nitric Oxide with Other Inflammatory Markers --- p.33 Chapter 5.1 --- Correlation of Findings from Biopsy and Bronchoalveolar Lavage with Exhaled Nitric Oxide --- p.33 Chapter 5.2 --- "Exhaled Nitric Oxide, Induced Sputum Analysis and Sputum Eosinophil Cationic Protein" --- p.35 Chapter Section III: --- Original Study --- p.37 Chapter Chapter 6: --- Methodology --- p.38 Chapter 6.1 --- Study Population --- p.38 Chapter 6.2 --- The International Study of Asthma and Allergies in Childhood --- p.40 Chapter 6.3 --- ISAAC Questionnaires --- p.42 Chapter 6.4 --- Standardized Approach for Answering Questions in the Field --- p.44 Chapter 6.5 --- Anthropometric Measurements --- p.45 Chapter 6.6 --- Exhaled Nitric Oxide Measurement --- p.46 Chapter 6.6.1 --- "NIOY® (Aerocrine AB, Stockholm, Sweden)" --- p.46 Chapter 6.6.2 --- Calibration Procedures --- p.47 Chapter 6.6.3 --- Exhaled Nitric Oxide Measurement --- p.48 Chapter 6.7 --- Classification of Subjects --- p.51 Chapter 6.8 --- Statistical Analysis --- p.53 Chapter Chapter 7: --- Results --- p.54 Chapter 7.1 --- Subjects and Demography --- p.54 Chapter 7.2 --- Exhaled Nitric Oxide in Chinese Children --- p.58 Chapter 7.3 --- Exhaled Nitric Oxide in Caucasians and Other Ethnic Groups --- p.66 Chapter Chapter 8: --- Discussion --- p.69 Chapter Chapter 9: --- Conclusion and Further Studies --- p.76 Appendix 1 Questionnaires (Chinese Version) --- p.80 Appendix 2 Questionnaires (English Version) --- p.84 References --- p.88

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Paz, Miguel Ángel. "Fractional exhaled nitric oxide in pulmonary hypertension." Thesis, 2018. https://hdl.handle.net/2144/31263.

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BACKGROUND: Pulmonary Hypertension (PH) is a common form of high blood pressure in the lungs. It affects the pulmonary arteries, which normally allow blood to flow from the right heart to the lungs. Nitric Oxide (NO) is a potential mediator for establishing PH and decreasing its availability is implicated in the pathogenesis of PH. HYPOTHESIS: We tested the hypothesis that Fractional Exhaled Nitric Oxide (FeNO) is a good indicator to assess disease severity that may add to understanding the disease. METHODS: The aim of the study was to measure FeNO levels in consecutive PH patients and seek correlations with the 6 Minute walk distance (6MWD) within different World Health Organization (WHO) groups and New York Health Association Function Class (NYHA FC). Assignment to groups I or IV was done respecting the current guidelines. All values were taken at Tufts Medical Center PAH clinic visits. FeNO levels were measured utilizing the NIOX device. RESULTS: FeNO levels were highest in WHO Group 1 and lowest in WHO Group 5 patients. There was a strong inverse correlation between FeNO and 6MWD for each NYHA FC. (Pearson correlation of -0.986, p = 0.014). Within WHO Groups, we found significantly inverse correlations between FeNO and 6MWD in PH Group 4 (p= 0.012) and PH Group 5 (p=0.001). NYHA FC correlated with 6MWD across all WHO Groups (P=0.001). CONCLUSION: We report for the first time FeNO levels in all WHO Groups of PH. FeNO levels are low in early disease. FeNO levels correlate inversely with the severity of PH in WHO Group 4 and 5 patients. The increase in FeNO in more severe patients may reflect the degree of oxidative stress and inflammation in severe PH. Further studies to determine whether FeNO may be a biomarker in early disease, especially in PH Group 4 and 5 warrants further investigation.

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Jacinto, Tiago António Queirós. "Important determinants and reference values for exhaled nitric oxide." Doctoral thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/104198.

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Jacinto, Tiago António Queirós. "Important determinants and reference values for exhaled nitric oxide." Tese, 2017. https://repositorio-aberto.up.pt/handle/10216/104198.

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Byrnes, Catherine Ann. "Non-invasive method of measuring airway inflammation : exhaled nitric oxide." 2008. http://hdl.handle.net/2292/5558.

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Background Nitric oxide (NO) was well known to be a component of air pollution, often in the form of nitrogen dioxide (NO2). However its importance in biological systems altered dramatically with the discovery in 1987 that it was the 'endothelial-derived relaxing factor'. Since then there has been an explosion of research on NO demonstrating that this gaseous molecule was a widespread physiological mediator and was simultaneously recognised as a vital component of immune function contributing to macrophage-mediated cytotoxicity. NO was therefore a key molecule in modulating inflammation, including airway inflammation. The aim of this thesis was: 1. To adapt a NO chemiluminscence analyser from measuring airway pollution to measuring exhaled air in human subjects. 2. To measure NO levels in exhaled air in adult subjects. 3. To evaluate whether altering measurement parameters altered the levels of NO obtained. 4. To adapt this technique from adults to measure exhaled NO in children. 5. To compare levels of NO from healthy children to groups of asthmatic children on either bronchodilator therapy only, or on regular inhaled corticosteroids. 6. To compare the levels of NO in a pilot group of asthmatic children before and after commencement of inhaled corticosteroids. Methods A Dasibi Environmental Corporation Model 2107 chemiluminescence analyser was adapted specifically requiring a reduction in response time, which was achieved by modification of the circuitry and re-routing of the analogue signal directly to a chart recorder, achieving a reduction of the response time by 80%. Addition of a number of analysers allowed the measurement of exhaled NO, carbon dioxide (CO2), mouth pressure and flow for each exhalation from total lung capacity. Twenty adult subjects (in total) were then studied looking at direct (NO, CO2, mouth pressure) versus t-piece (with the addition of flow) measurements making five exhalations from total lung capacity, at 3-minute intervals (direct/t-piece/direct or t-piece/direct/t-piece in series). The area of NO under the curve versus the peak of the NO trace was compared and the exhalation pattern of NO versus CO2 was compared. Measurement conditions were altered to evaluate the effect of individual parameters on the exhaled NO result. This included separately assessing different expiratory flows, different expiratory mouth pressures, the effect of a high versus a low background NO level and the effect of drinking water (of varying temperatures) prior to exhalation. Healthy control children were then enrolled to the study from a local school (Park Walk Primary School) and compared with asthmatic children enrolled from outpatient clinics at the Royal Brompton Hospital. The asthmatic children were further divided into those on bronchodilator treatment only and those on regular inhaled corticosteroid therapy. NO was also measured before and two weeks after commencing inhaled corticosteroid therapy in previously steroid-naive asthmatics. Results It was possible to modify a chemiluminescence analyser to enable measurement of exhaled NO. In 12 healthy subjects (mean age 32 years, 6 males) peak direct NO levels were 84.8 parts per billion (ppb) (standard error of the mean (SEM) 14.0ppb), significantly higher than 41.2ppb (SEM 10.8ppb) measured via the t-piece system. The exhaled NO rose to an early peak and plateau while the CO2 levels continued to rise to peak late in the exhalation. The mean times to peak NO levels were 32.2 seconds (s) (direct) and 23.1s (t-piece), which was significantly different from the mean times to peak CO2 levels at 50.5s (direct) and 51.4s (t-piece, p<0.001). At peak NO level, the simultaneous CO2 level of 4.9% (SEM 0.47%, direct) and 5.2% (SEM 0.18, t-piece) were significantly lower than the peak CO2 achieved of 5.8% (SEM 0.21%, direct, p<0.001) and, 6.2% (SEM 0.28, t-piece, p<0.001). There was no difference between repeat direct or t-piece measurements. With regard to varying measurement conditions, the mean peak concentrations of NO decreased by 35ppb (95% confidence intervals 25.7-43.4) from a mean of 79ppb (SEM 15.4ppb) at an expiratory flow rate of 250mls/min to 54.1ppb (SEM 10.7ppb) at 1100mls/min. The mean peak concentration of NO did not change significantly when mouth pressure was increased in eight of ten subjects, although in two it did decrease in the highest pressure. The mean NO concentration with machine and subjects sampling from a low NO reservoir was 123ppb (SEM 19.4), which was an increase from results obtained before at 81.9ppb, SEM 10.2ppb, p=0.001 95%, CI -19.9 to -62.7) and after at 94.2ppb(SEM 18.3ppb, p=0.017, 95% CI 6.0-5.18) sampling with high ambient NO levels. The mean peak NO concentration decreased from 94.4ppb (SEM 20.8) to 70.8ppb (SEM 16.5, p=0.002 95% CI 12.9 -33.1) with water consumption. In 39 healthy pre-pubertal children with a mean age of 9.9 years (range 9-11 years, 23 girls) the mean direct exhaled No level was 49.6ppb (SD 37.8ppb, range 11.5-197.2ppb) compared with mean exhaled No via t-piece sampling of 29.2ppb (SD 27.1ppb, range 5.1-141.2ppb). There was no significant difference between boys and girls for either the direct or the t-piece recordings. In comparison with normal children, 15 asthmatic children on bronchodilator therapy only had much higher levels of exhaled NO at 126.1ppb via the direct system (SD 77.1ppb, p<0.001) and 109.5ppb via the t-piece system (SD 106.8ppb, p<0.001). In 16 asthmatics on regular inhaled corticosteroids the mean peak exhaled levels were significantly lower at 48.7ppb via the direct method (SD 43.3ppb, p<0.001) and via the t-piece system at 45.2ppb (SD 45.9ppb, p<0.01). There was no difference between the normal children and the asthmatic children who were on regular inhaled corticosteroids (p=0.9 direct, p=0.2 t-piece).There was no significant difference in CO2, mouth pressure, duration of expiration and expiratory flows between the three groups or between the two methods (direct and t-piece). In six asthmatic children the mean peak exhaled NO levels fell from a medium peak level of 124.5ppb to 48.6ppb when measured before and two weeks after commencement of inhaled corticosteroids on treatment. Discussion This research showed it was possible to modify an NO chemiluminescence analyser to enable measurement of exhaled NO in adult and paediatric subjects. Furthermore, it was possible to measure both healthy and asthmatic children. There were significant differences between the exhalation pattern of NO and CO2 suggesting that NO was produced in the airways, not at alveolar level, unlike CO2. The measurement of exhaled NO required a standardised approach as exhaled NO levels decreased with increasing expiratory flow, when measuring at a time of high ambient NO concentration, and with consumption of either hot or cold water immediately preceding exhalation (such as might be given if a subject was coughing). The findings with expiratory mouth pressure were less certain, with a difference seen in only two of ten subjects. The levels of exhaled NO measured in children aged 9-11 years were lower than that measured in the adult subjects. There was no difference between boys and girls, or with other parameters such as having a personal history of atopy, a family history of atopy, or the presence of a smoker or furry pets within the house-hold. These findings may have altered with increased numbers in this group and could possibly be a type two statistical error. The results of exhaled NO in asthmatic children on bronchodilator therapy only were significantly elevated compared to both normal children and asthmatic children treated with regular inhaled corticosteroids. The exhaled NO level also fell significantly by two weeks following the commencement of inhaled corticosteroid treatment in steroid-naive asthmatic children. These results suggested that the methods of measuring exhaled NO required standardization and that it could potentially be a non-invasive measure of airway inflammation to follow - particularly in children with asthma who were commencing inhaled steroid treatment.

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Hsieh, Chun-Fa, and 謝泉發. "Effect of Air Pollution on Exhaled Nitric Oxide Levels in Schoolchildren." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/27888139108348174361.

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碩士 國立陽明大學 公共衛生研究所 87 Asthma is a chronic inflammatory disease of the airway. Recently, studies have found that exhaled nitric oxide (eNO) was correlated with airway inflammation. We used eNO measurement and questionnaire to clarify the effect of air pollution on asthma and airway disease in schoolchildren. Our study subjects were third grade students from 石牌國小 in Taipei and 淡水國小 in Tamshui. We recruited 256 students (male: 133, female: 123) from the two schools. Study was performed between October 1998 and Apr 1999. The effect of children''s atopy or airway disease on eNO, and the effect of air pollutants and children''s eNO were analyzed. Finally, We compared the effect of air pollutants on children with or without atopic airway disease. In the study subjects, 10.2% children had physician-diagnosed asthma, 19.1% children had wheezing, 24.6% children had physician-diagnosed allergic rhinitis, and 5.4% children had physician-diagnosed dermatitis. Family factors that influenced eNO: children''s father with higher education, mother with allergic rhinitis, and sibling with allergic rhinitis would increase children''s eNO level. Children''s factors affecting eNO included: physician-diagnosed asthma, wheeze, allergic rhinitis, dermatitis, cough in the past year, and upper airway infection (at the time of examination) would increase children''s eNO level. Air pollution: Ozone concentration, ambient temperature, and particulate matter would decrease eNO level, but ambient nitric oxide concentration would increase eNO level. We also found that eNO level was continually increasing from October 1998 to Mar 1999. And it was decreased from Mar 1999 to Apr 1999. URI, sulfur dioxide, and particulate matter had more pronounced effect on nonatopic students. We also found that atopic students were more sensitive to ambient temperature. We concluded that atopy, airway disease and air pollution were correlated with eNO. The most important factor in air pollution that influenced children''s eNO was ambient temperature. We also found that eNO had a time-dependent trend. In conclusion, ozone concentration, ambient temperature, ambient nitric oxide, URI, and allergic rhinitis were important on eNO level.

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Sheel, Andrew William. "Relationship between exhaled and inhaled nitric oxide and exercise-induced hypoxemia." Thesis, 1999. http://hdl.handle.net/2429/10904.

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The consensus in the literature is that exercise-induced hypoxemia (EIH) occurs secondary to ventilation-perfusion (VA/Q) inequalities and diffusion limitations resulting from elevated pulmonary pressures causing the development of interstitial pulmonary edema, or decreased pulmonary transit time in the pulmonary vasculature. Endogenously produced pulmonary nitric oxide (NO) has been hypothesized to have several physiological functions including VA/Q matching and maintenance of low pulmonary vascular resistance. Respiratory derived NO is detectable in exhaled gases. Inhaled NO, a selective pulmonary vasodilator is used in the treatment of diseases characterized by pulmonary hypertension and hypoxemia. Short-term inhalation of NO causes selective pulmonary vasodilation without any systemic effects. Given that athletes with EIH are thought to have altered pulmonary hemodynamics during exercise, the relationship between endogenously produced and exogenously delivered NO and EIH was examined in two separate studies. It was hypothesized that subjects with EIH would have a decreased production rate of NO (VNO) compared to subjects who maintained normal oxyhemoglobin saturation (SaO2) and that SaO2 would be correlated with VNO. A group of highly-trained male cyclists (n = 18), some of whom develop EIH performed a maximal cycle test. VNO was determined during the cycle test. No significant differences were observed between those with and those without EIH. There was also no observed linear relationship between delta SaO2 and delta VNO. It can be concluded that NO present in exhaled air is not related to the etiology o f EIH. In a subsequent study, delivery of NO was accomplished using highly trained male cyclists (n = 7) with EIH who performed four 5-min cycle tests at VO2max under conditions of normoxia (N), normoxia + 20 ppm nitric oxide (N/NO), hypoxia (H), and hypoxia + 20 ppm nitric oxide (H/NO). It was hypothesized that: (i) inhaled NO would reverse EIH during normoxia, and (ii) inhaled NO would improve arterial oxygenation during hypoxia. Inhalation of NO during normoxic or hypoxic conditions did not significantly affect gas exchange, cardiorespiratory variables, or power output. These findings imply that pulmonary capillary blood volume reaches a maximal morphological limit during exercise and further dilation is not possible.

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HUANG, SHIH-TING, and 黃詩婷. "Association of exposure to welding fume particulates with plasma nitric oxide and fractional exhaled nitric oxide among shipyard workers." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/jpcq9t.

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碩士 國防醫學院 公共衛生學研究所 106 Aim: We assessed the relations between heavy metals, polycyclic aromatic hydrocarbons exposure and plasma nitric oxide, fractional exhaled nitric oxide, and lung function among shipyard workers. Methods: This study was a longitudinal study. All of 354 workers were recruited from the shipyard in Taiwan from 2014 to 2016. After excluded female workers, there were 333 workers include in this study finally. Personal air sampling was collected at the first day; FeNO and lung function test were collected at the second day. In order to analyze urine heavy metals and plasma NO, we also collected blood and urine from workers in both days. Results: In generalized estimating equation analysis, adjusting for age, waist, smoking status, time, and urinary creatinine, negative significant were found between log urinary nickel and log plasma NO (β=-0.079, 95%CI: -0.149 to -0.009, p=0.026). After adjusting for age, waist, smoking status, and time, negative significant were found between log PM2.5 and log FeNO (β=-0.051, 95%CI: -0.087 to -0.016, p=0.004). After adjusting for age, waist, smoking status, time, and urinary creatinine, negative significant were found between log urinary manganese and log FeNO (β=-0.068, 95%CI: -0.13 to -0.006, p=0.032); negative significant were found between log urinary cadmium and log plasma NO (β=-0.133, 95%CI: -0.221 to -0.045, p=0.003); negative significant were found between log urinary 1-OHP and log FeNO (β=-0.123, 95%CI: -0.233 to -0.014, p=0.028); negative significant were found between log urinary nickel and FVC% (β=-20.015, 95%CI: -34.836 to -5.194, p=0.008); FEV1 % (β=-19.159, 95%CI: -32.079 to -6.239, p=0.004); FEV1/FVC % (β=-1.983, 95%CI: -3.898 to -0.067, p=0.043). Conclusion: In conclusion, this study showed biomarkers of exposure to Mn, Cd, Ni, and PAH are associated with decreased plasma NO, FeNO, and lung function indicators. We suggest to wearing personal protective equipment may decrease adverse health effects from occupational exposure.

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KUO, Yi-Chieh, and 郭怡潔. "Effect of Betel (Areca) Nut Chewing on Fractional Exhaled Nitric Oxide Levels." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/08624855852381512931.

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碩士 中州科技大學 保健食品系 103 Background：Betel nut chewing is common in Taiwan and exhaled nitric oxide (eNO) is most important in our heath. It is make vessel dilatation to adjust blood pressure in cardiac vascular system. To control coagulation and cardiac contraction function. The peripheral nerve system can adjust vessel dilatation, respiratory, digestive and urological function with penis erection. In the immune system against bacteria, cancer cells and other pathogens, kill a variety of pathogens and protection mechanisms, and can provide a powerful defense system in vivo. Studies published in a patient suffering from asthma increased exhaled nitric oxide concentrations in the air in 1993, but if the patient has to take steroid drugs to reduce the concentration of exhaled nitric oxide. With so many articles when studies show respiratory irritation detect exhaled nitric oxide concentration, the concentration was found to increase nitric oxide can induce inflammatory inference eosinophil activity sphere. It is not known whether betel nut chewing affects eNO with contains constituents known to inhibit inducible NO synthase which releases exhaled. May be associated with respiratory inflammation related to this study will help to understand the impact of chewing betel nut of the human immune defense mechanism. Objective：To assess the effects of betel nut chewing on eNO levels. Methods：Nineteen regular betel nut chewers were studied. eNO levels were measured using a portable analyser (MiniNIOX) prior to and immediately after chewing a betel nut preparation, and at 30 min intervals up to 3 hr. Results：Data analysis and display chew whether fractional exhaled nitric oxide concentration (FeNO Value) will cause respiratory irritation reaction before and after the betel nut, exhaled nitric oxide in each group, are no significant differences. Whether the instrument detects lung function FEV1 (L) can cause airway contractile response in each group, are no significant differences. The possible reasons: 1. regional betel different contents of its relevance. 2. Oral cancer is not through this oncogenic pathway for inflammation. 3. Cha Ye component having polyphenolic compounds with antioxidant activity activity, further inhibit inflammation. Conclusions and Clinical Relevance：In this study, chewing betel nut, after their respiratory exhaled nitric oxide concentration FEV1 testing and data analysis, the results showed no statistical significance, followed by studies can then be blood test specific immunoglobulin E (Allergen Specific -IgE) data, the relative analysis of betel nut chewing further estimate whether the subjects of their respiratory inflammation, in order to facilitate the clinical diagnosis as the reference data.

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Holland, Ben Patrick. "Measurement of exhaled nitric oxide and carbon dioxide in the breath of beef calves." 2006. http://digital.library.okstate.edu/etd/umi-okstate-1956.pdf.

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Fang, Chun-Yu, and 方俊淯. "A Study of the Associations Between Air Pollutants Exposure and Exhaled Nitric Oxide / Exhaled Breath Condensate pH in Schoolchildren with Asthma." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/8236x7.

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碩士 輔仁大學 公共衛生學系碩士班 96 Background： According to the epidemiological studies, it demonstrated that the prevalence and incidence rate of asthma were increasing gradually every year. People spent over 80 % of their time indoors. Indoor and outdoor air pollutants such as particular matter（PM）, volatile organic compounds（VOCs）, sulfur dioxide（SO2）, ozone（O3）had been proved to be significantly correlated with the increased incidence of respiratory symptoms in asthmatic children. Collection of exhaled gas was a simple and noninvasive technique for sampling of nitric oxide（NO）and airway lining fluid that can be used as indicators of exacerbation of respiratory diseases. This study was to evaluate the impaction of indoor and outdoor air pollutants on pulmonary function by measuring NO levels and exhaled breath condensate（EBC）pH in exhaled gas. Methods： This panel study recruited 15 asthmatics and 15 healthy children, aged between 7 and 12 years old, from outpatient department of Chang Gung Memorial Hospital in 2006. Self-reported questionnaires included personal information, family allergic history, blood allergy index, and home/life characteristics. Air quality in domestic environment was measured with the dust monitor（GRIMM particle size analyzer model l.108, Germany）, air quality monitor（I.A.Q, KD Engineerings AirBoxx, USA）, and VOCs monitor（ppbRAE, RAE Systems model PGM-7600, USA）. Exhaled NO levels in schoolchildren were monitored by a chemiluminescence analyzer （CLD 77 AM, ECO Physics, Dürnten, Switzerland）. EBC pH was analyzed after collecting EBC from subjects using an exhaled breath condensate collector（ECoScreen, Jaeger-Toennies, Germany）. Pulmonary function tests were performed every three months to evaluate the variation of lung functions. The concentrations of outdoor air pollutants measured at the ambient air monitoring site operated by Taiwan Environmental Protection Agency（EPA）that located in district of Songshan were also collected. All the data were analyzed by SPSS software. Result： This study was to monitor indoor air quality of domestic environment in schoolchildren with asthma and healthy controls in autumn and winter. Air temperature in domestic environment of asthmatics was higher than the recommended value of indoor air quality guideline. Our results demonstrated that mean eNO concentrations in asthmatics（41.62 ppb in autumn and 48.75 ppb in winter）were significantly higher than those in healthy individuals（14.90 ppb in autumn and 14.94 ppb in winter）（ p＝0.001 in autumn and p＜0.001 in winter）. There was not a statistically significant difference in EBC pH between asthmatics（pH=6.76 in autumn and 6.61 in winter）and healthy children （pH=7.12 in autumn and 6.82 in winter）（ p＝0.112 in autumn and p＝0.412 in winter）, but EBC pH had a lower tendency found in children with asthma than normal controls in this study. In addition, forced expiratory volume time on one second (FEV1), peak expiratory flow (PEF) and forced expiratory flow25% ~ 75%, (FEF25% ~ 75%) in asthmatics had a decreased trend compared to healthy controls in both autumn and winter. From our findings, it was indicated that air pollutants were associated with eNO level, EBC pH and pulmonary function test. NO association was found between eNO level and EBC pH in schoolchildren. Conclusion： Exhaled gas analysis is a noninvasive, duplicated, and safety monitoring technique. Measurements of exhaled NO and EBC pH would react with airway inflammation correlated to indoor and outdoor air pollutants exposure.

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Chu, Chia-Chen, and 朱家成. "The Clinical Application of Chemiluminesce method - The Measurement of the Asthmatic Patients'' Exhaled Nitric Oxide Concentration." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/27858948097004613452.

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碩士 中國文化大學 應用化學研究所 87 Nitric oxide (NO) can be detected in the exhaled air of humans. Several recent studies have demonstrated that the concentration of exhaled NO is increased in patients with asthma, but reduced after patients were treated with inhaled glucocorticoids. In this thesis, we would like to build up a data bank and a method for measurement of exhaled NO concentrations of asthmatic patients in Taiwan. Exhaled NO determinations were performed via a on-line restricted exhaled breath method in 57 normal and 82 asthmatic subjects by a chemiluminescence analyzer. The exhaled NO level in the normals was 16.4 * 6.7 ppb, while the levels in the asthmatics, before and after treated with an inhaled bronchodilator, were 32.1 * 27.6 and 30.3 * 11.4 ppb, respectively. Obviously, the exhaled NO concentrations determined in patients with asthma were significantly elevated above those of normal subjects. However, there was no statistically significant change ( p > 0.05 ) in NO contents of asthmatic paitents, before and right after treated with a bronchodilator, no matter what age, sex, or level of exhaled NO. It is known that the difference in exhaled NO of normal subjects and asthmatics derives from a difference in NO concentration present in the lower airway, and reflects the inflammatory microenvironment of the asthmatic airway wall. Thus, the measurement of nitric oxide concentrations in exhaled air may represent a noninvasive measure of lower airway inflammation. And, it will be a useful way of monitoring the anti-inflammatory effects of glucocorticoids and other anti-inflammatory treatments in asthma.

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Hsu, Jeng-Yuan, and 許正園. "Non-invasive Monitoring of Airway Inflammation Evaluation by Exhaled Nitric Oxide in Patients with Chronic Airway Disease." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/10667325543853123359.

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博士 中山醫學大學 醫學研究所 101 Objective: To evaluation the usefulness of FeNO measurement in patients with eosinophilic inflammatory airway disease, such as bronchial asthma and chronic cough. Material and Method: A nitric oxide analyzer (NOA 280i) was used to conduct five experiments. In the first experiment, 249 Taiwanese non-smoking healthy adults were enrolled to determine the reference values of FeNO in Taiwan. In the second experiment, the correlations between offline and online FeNO data of 56 patients were evaluated. In the third experiment, the correlations between FeNO level and % of major basic protein (MBP) positive sputum cells (eosinophils) were compared. In the fourth experiment, we investigated possible correlations between ACT scores and FeNO values in 73 outpatient visits made by 60 asthmatic patients. In the fifth experiment we reviewed the medical records of 81 patients with chronic cough, to compare the FeNO level and the response to inhaled corticosteroid treatment in these patients. Results: The result of the first experiment showed that the mean FeNO in 249 Taiwanese non-smoking healthy adults was 27.9ppb. In multivariate regression analyses, age and lung function (FVC or FEV1) were positively associated with the FeNO values. In the second experiment, a high correlation between online and offline FeNO levels (r = 0.908, p < 0.001) were observed. The predicted online FeNO level (ppb) = 2.233 × offline FeNO level (ppb) - 6.236. In the third experiment, no correlation between FeNO level and percentage of major basic protein (MBP) positive sputum cells (eosinophils) were seen, but in 19 and 16 patients, the % of MBP positive cells was higher than 3% and 5% respectively. The result of the fourth experiment showed the mean FeNO value was higher in patients reported their ACT scores were≧20 than those who reported the ACT scores were＜20. There was a negative correlation between ACT scores and FeNO values (r = -0.596). In the fifth experiment, significant difference in FeNO value was seen in patients whose cough responded good to ICS treatment.ROC analysis showed that a FeNO of 33.9 ppb was the best cut-off value for using ICS (sensitivity 94.7%, specificity 76.3%). Conclusions: After conducting these five experiments, we found that FeNO measurement is a versatile, easy-to-use, non-invasive diagnostic tool for assessing inflammatory airway diseases. By using the reference FeNO value and the formula for predicting online data that we have devised, FeNO measurement can be applied to patients for evaluating eosinophilic inflammation of the airways.

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"The acute effects of high intensity interval exercise on pulmonary function and exhaled nitric oxide in adults with asthma." Thesis, 2014. http://hdl.handle.net/10388/ETD-2014-08-1707.

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Introduction: People with asthma suffer from lower fitness levels when compared to their peers. The abnormal respiratory response to exercise, known as exercise induced bronchoconstriction (EIB), in the majority of people with asthma is a barrier to improving fitness levels. EIB severity can be increased with airway inflammation, which can be measured by exhaled nitric oxide (eNO). One exercise protocol, high intensity interval exercise (HIIE), may decrease the risk of developing EIB in people with asthma. HIIE warm up studies have demonstrated that HIIE is feasible and reduces the incidence of EIB in subsequent exercise bouts. HIIE may be ideal for people with asthma because it can decrease the duration of high ventilation that can trigger EIB, and improve their fitness levels. The purpose of this study is to compare the acute respiratory effects of traditional constant workrate exercise to a novel HIIE protocol in adults with asthma. Methods: 5 females and 2 males with asthma were recruited to perform two randomly assigned exercise protocols: HIIE (30 seconds of 140% the peak workrate and 90 seconds at 20%) and constant workrate exercise (CWR) (60% peak workrate). Workrates were determined by a peak cardiopulmonary exercise test. Measures of pulmonary function and airway inflammation were done pre and post exercise protocols. During exercise protocols, operational lung volumes, heart rate, rating of perceived exertion (RPE) was obtained. Results: FEV1 decreased significantly in both exercise protocols (HIIE 3.91± 0.65 to 3.33 ± 0.61 vs. CWR 3.90 ±0.50 to 3.09 ± 0.63). eNO measurements decreased after both exercise protocols (HIIE 40.4± 34.8 vs. CWR 42.1 ± 36.3. Conclusion: FEV1 and eNO findings are similar in HIIE and CWR exercise in adults with asthma, therefore, the novel HIIE is a feasible exercise protocol to help improve fitness levels of adults with asthma.

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