Impulse oscillometry (IOS) is a variant of forced oscillation technique described by Dubois 50 years ago, which allows us to measure the reactance of the airways and the resistance of the small and large airways during tidal breathing. It requires minimal patient cooperation from subjects who are unable to perform spirometry, like elders, children and patients with neurologic disorders. IOS can outline the diagnosis of obstructive airway disease, differentiate small airway obstruction from large airway obstruction. It is more sensitive than spirometry for peripheral airway disease in determining the severity of the disease, the exacerbations and evaluate the therapeutic response. Other applications include early evaluation of transplant rejection, cystic fibrosis, vocal cord disorder, bronchiectasis, hypersensitivity pneumonitis, obstructive sleep apnea.
The Metabolic syndrome (MetS) is considered as an association of the abdominal obesity, abnormal metabolism of the lipids and glucose (high level of triglycerides, low level of HDL-cholesterol and high level of glycemia) and high values of blood pressure, determined by an underlying mechanism of insulin resistance. As a result of environmental-gene interaction, MetS is associated with unhealthy nutrition, smoking, alcohol abuse, lack of physical activity, shorter sleep duration and desynchronization of the circadian rhytm caused by working in shifts. The aim of this article is to review the effects of working in shifts on the MetS through the epidemiological evidence and the perspective of the physiopathological mechanisms.
Occupational asthma, the most common occupational respiratory disease in industrialized societies, accounts for 5-10% of all cases of asthma diagnosed in the world. The number of cases is increasing given the development of the “consumer society”. We aim to discuss a case of occupational asthma that we have confirmed using internationally validated methods.
Viral respiratory infections in patients with asthma or chronic obstructive pulmonary disease (COPD) can cause severe exacerbations, increasing the risk of secondary bacterial infections and having a significant impact on disease-related morbidity and mortality. Several antivirals such as oseltamivir and zanamivir evaluated in influenza and other virus-induced respiratory infections are discussed in this review as a starting point of their potential use in improving the outcome of asthma and COPD exacerbations. However, the efficacy of antiviral therapy for asthma/COPD exacerbations needs a further evaluation.