Chest
Clinical InvestigationsSensitivity and Specificity of Bronchial Provocation Testing: An Evaluation of Four Techniques in Exercise-Induced Bronchospasm
Section snippets
Subjects
Forty subjects were enrolled in a randomized, crossover study of four different BPC tests. Twenty patients were recruited from the Pulmonary Disease Clinic when they presented for evaluation of symptoms of postexertional dyspnea. Symptoms included wheezing, the feeling of tightness in the chest with exercise, dyspnea out of proportion to the level of exertion, or unexplained cough occurring during or soon after exercise. Exclusion criteria included the following: age younger than 20 years or
RESULTS
The EIB subject group was composed of 17 men and three women, aged 22 to 40 years. Fifteen were lifelong nonsmokers, and all former smokers had not smoked within six months. The control group consisted of 16 men and four women, aged 25 to 42 years. Sixteen of the control subjects were lifelong nonsmokers, and none of the remaining four subjects had smoked within four years. None of the EIB subjects or controls had received steroids and none had taken nonsteroidal anti-inflammatory drugs within
DISCUSSION
For practitioners dealing with the spectrum of bronchospastic disorders, a number of BPC techniques are available for use in diagnostic and management decision-making. Selecting a challenge test and interpreting the results can be perplexing. In essence, the goal of a BPC is to differentiate between subjects who have AHR and those who do not. A BPC should provide the physician with an assessment of the patient’s bronchial reactivity thereby confirming or ruling out the presence of inducible
ACKNOWLEDGMENTS
The authors thank SSG James Godville, SSG Thomas McCumber, and SFC William Slivka for their technical assistance and the performance of bronchoprovocation studies.
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Exercise-induced bronchoconstriction update—2016
2016, Journal of Allergy and Clinical ImmunologyExercise-Induced Asthma: Strategies to Improve Performance
2016, Pediatric Allergy: Principles and Practice: Third EditionExercise-induced bronchoconstriction
2014, Otolaryngologic Clinics of North AmericaDevelopment, Structure, and Physiology in Normal Lung and in Asthma
2014, Middleton's Allergy: Principles and Practice: Eighth EditionGuidelines for the Study of Nonspecific Bronchial Hyperresponsiveness in Asthma
2013, Archivos de BronconeumologiaTreatment of Exercise-Induced Bronchoconstriction
2013, Immunology and Allergy Clinics of North AmericaCitation Excerpt :The symptoms of EIB range from a slight feeling of chest tightness with a small reduction in lung function to severe bronchospasm and a large reduction in FEV1 after exercise. Documenting EIB with a reduction in FEV1 of at least 10% from the pre-exercise values is considered to be specific for asthma, but exercise itself is not a sensitive means of diagnosing asthma.7,8 Individuals with asthma who develop EIB generally report symptoms such as cough, wheeze, chest tightness, dyspnoea, and fatigue.6
Manuscript received July 22; revision accepted November 19
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.