Forced expiratory volume in one second
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Základním problémem nemocných s CHOPN je zvýšený roční pokles objemu usilovně vydechnutého vzduchu za 1 vteřinu (FEV1). Zajímalo nás, zda tento pokles závisí na počtu exacerbací nemoci. Retrospektivně bylo vybráno 50 nemocných s CHOPN (33 mužů, 27 žen), kteří byli sledováni minimálně 24 ± 2 měsíců. Průměrný věk byl 62,8 ± 9,2 let. Průměrný roční pokles FEV1 činil 116 ± 92 ml. Průměrný počet exacerbací u jednoho nemocného zajeden rok byl 2 ± 1,5. Spearmemův korelační koeficient mezi počtem exacerbací a poklesem FEV1 byl 0,17 (p = 0,25, N.S.). Autoři neprokázali signifikantní vztah mezi počtem exacerbací CHOPN a ročním poklesem FEV1.
An essential problem of patients presenting COPD is the higher annual drop in the volume of forced expiratory volume per second (FEV1). We wanted to investigate whether this drop related to the number disease exacerbations. The authors selected retrospectively 50 COPD patients (33 men, 27 women), who were under observation for at least 24 ± 2 months. The mean age of the patients was 62.8 ±9.2 years. The mean annual drop in FEV1 was 116 ± 92 ml. The average number of exacerbations in one patient per year was 2 ± 1.5. Spearman' correlation coefficient of the number of excerbations and the drop in FEV1 was 0.17 (p = 0.25, N.S.). The authors could not demonstrate a significant correlation between the number of COPD exacerbations and the annual drop in FEV1.
RATIONALE: Forced expiratory volume in one second (FEV1), an important measure of pulmonary disease severity in patients with cystic fibrosis (CF), is frequently expressed as a percentage of a predicted value derived from a healthy reference population. There are limitations to comparing the lung function of a patient with CF to that of healthy control subjects, and potential advantages to comparing it to that of other patients with CF. OBJECTIVE: To estimate CF-specific percentiles of FEV1 as functions of height, age, and sex. METHODS: We used 287,108 FEV1 observations among more than 21,000 patients with CF in the CF Foundation National Patient Registry between 1994 and 2001. The percentiles were estimated using quantile regression methods. RESULTS: FEV1 percentile "growth grids" are presented, allowing comparison of an individual's FEV1 to that of patients with CF of the same sex, age, and height. Their potential uses in clinical practice and research are illustrated. CONCLUSIONS: CF-specific reference equations allow individual patients' FEV1 to be placed in the context of the distribution of lung function of their peers with CF, and should improve generalizability of CF clinical trials by setting entry criteria that are equitable across sex and age ranges. They may serve as a useful adjunct to conventional reference equations.
Nebulization with saline solution, although commonly used to alleviate respiratory symptoms, particularly in children, is often questioned concerning its effectiveness. In this study, we investigated the effects of isotonic saline nebulization on lung function in 40 children (mean age of 14±1 years) suffering from different types of airway disorders. Measurements were carried out directly before and up to 15 min after nebulization, for six days in a row, always on the same day time in the morning. The children were divided into two study groups according to the baseline ratio of forced expired volume in one second/forced vital capacity (FEV1/FVC), below and above 80 %. We found significant improvements after saline nebulization in FEV1, mid-expiratory flow at 50 % and 75 % of FVC (MEF50 and MEF75), and peak expiratory flow (PEF) in the group with the baseline FEV1/FVC less than 80 %. In contradistinction, children with an index greater than 80 % displayed no appreciable changes in the lung function variables when compared with the baseline level before saline nebulization. We conclude that isotonic saline nebulization might mitigate the functional signs of threatening pulmonary obstruction and as such may be clinically useful in pediatric patients with mild respiratory problems.
- MeSH
- lidé MeSH
- mechanika dýchání účinky léků fyziologie MeSH
- mladiství MeSH
- nebulizátory a vaporizátory * MeSH
- plíce účinky léků fyziologie MeSH
- poruchy dýchání diagnóza patofyziologie MeSH
- respirační funkční testy metody MeSH
- solný roztok aplikace a dávkování MeSH
- usilovný výdechový objem účinky léků fyziologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The Phenotypes of COPD in Central and Eastern Europe (POPE) study assessed the prevalence and clinical characteristics of four clinical COPD phenotypes, but not mortality. This retrospective analysis of the POPE study (RETRO-POPE) investigated the relationship between all-cause mortality and patient characteristics using two grouping methods: clinical phenotyping (as in POPE) and Burgel clustering, to better identify high-risk patients. PATIENTS AND METHODS: The two largest POPE study patient cohorts (Czech Republic and Serbia) were categorized into one of four clinical phenotypes (acute exacerbators [with/without chronic bronchitis], non-exacerbators, asthma-COPD overlap), and one of five Burgel clusters based on comorbidities, lung function, age, body mass index (BMI) and dyspnea (very severe comorbid, very severe respiratory, moderate-to-severe respiratory, moderate-to-severe comorbid/obese, and mild respiratory). Patients were followed-up for approximately 7 years for survival status. RESULTS: Overall, 801 of 1,003 screened patients had sufficient data for analysis. Of these, 440 patients (54.9%) were alive and 361 (45.1%) had died at the end of follow-up. Analysis of survival by clinical phenotype showed no significant differences between the phenotypes (P=0.211). However, Burgel clustering demonstrated significant differences in survival between clusters (P<0.001), with patients in the "very severe comorbid" and "very severe respiratory" clusters most likely to die. Overall survival was not significantly different between Serbia and the Czech Republic after adjustment for age, BMI, comorbidities and forced expiratory volume in 1 second (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.65-0.99; P=0.036 [unadjusted]; HR 0.88, 95% CI 0.7-1.1; P=0.257 [adjusted]). The most common causes of death were respiratory-related (36.8%), followed by cardiovascular (25.2%) then neoplasm (15.2%). CONCLUSION: Patient clusters based on comorbidities, lung function, age, BMI and dyspnea were more likely to show differences in COPD mortality risk than phenotypes defined by exacerbation history and presence/absence of chronic bronchitis and/or asthmatic features.
- MeSH
- chronická bronchitida * MeSH
- chronická obstrukční plicní nemoc * epidemiologie MeSH
- dyspnoe epidemiologie MeSH
- fenotyp MeSH
- lidé MeSH
- progrese nemoci MeSH
- retrospektivní studie MeSH
- usilovný výdechový objem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: The evaluation of chronic obstructive pulmonary disease (COPD) has been shifting from spirometry to focus on the patients' overall health. Despite the existence of many COPD prognostic scales, there remains a large gap for improvement, in particular a scale that incorporates the current focus on overall health. METHODS: We proposed a new prognostic scale (the COPD Prognostic Score) through discussion among the authors based on published studies. Validation was retrospective, using data from the National Emphysema Treatment Trial. RESULTS: The scores ranged from 0-16, where 16 indicated the poorest prognosis. We assigned 4 points each for forced expiratory volume in one second (%predicted), the modified Medical Research Council dyspnea scale, and age; 2 points for the hemoglobin level; and one point each for decreased activity and respiratory emergency admission in the last two years. The validation cohort included 607 patients and consisted of 388 men (73.9%) and 219 women (36.1%), mean age 67 ± 6 years and an average forced expiratory volume in one second (% predicted) of 27 ± 7%. A one-point increase in the score was associated with increased all-cause death, with a hazard ratio of 1.28 (95%CI: 1.21-1.36. P < 0.001). The areas under the receiver operating characteristic curves for two-year and five-year all-cause death for the new scale were 0.72 and 0.66, respectively. These values were higher than those given by the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index and age, dyspnea, airway obstruction (ADO) index. CONCLUSION: The preliminary validation for a new COPD prognostic scale: the COPD Prognostic Score was developed with promising results thus far. Above mentioned 16-point score accurately predicted 2-year and 5-year all-cause mortality among subjects who suffered from severe and very severe COPD.
- MeSH
- chronická obstrukční plicní nemoc mortalita patofyziologie MeSH
- chůze fyziologie MeSH
- dyspnoe mortalita patofyziologie MeSH
- hemoglobiny metabolismus MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- prognóza MeSH
- průzkumy a dotazníky MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spirometrie metody MeSH
- stupeň závažnosti nemoci * MeSH
- usilovný výdechový objem fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
OBJECTIVES: To search for optimal markers in the exhaled breath condensate (EBC), plasma and urine that would reflect the activity/severity of occupational asthma (OA) after the withdrawal from the exposure to the allergen. MATERIAL AND METHODS: Markers of oxidative stress: 8-iso-prostaglandin F2α (8-isoprostane, 8-ISO), malondialdehyde (MDA), 4-hydroxy-trans-2-nonenale (HNE), cysteinyl leukotrienes (LT) and LTB4 were determined using liquid chromatography and mass spectrometry in 43 subjects with immunological OA (49.3 ± 11.8 years), removed from the exposure to the sensitizing agent 10.5 ± 6.5 years ago; and in 20 healthy subjects (49.0 ± 14.9 years). EBC was harvested both before and after the methacholine challenge test. In parallel, identical markers were collected in plasma and urine. The results were analyzed together with forced expiratory volume in one second (FEV1), blood eosinophils, immunoglobulin E (IgE) and eosinophilic cationic protein (ECP) and statistically evaluated (Spearman rank correlation rS, two- or one-sample t tests and alternatively Kruskal Wallis or pair Wilcoxon tests). RESULTS: Several parameters of lung functions were lower in the patients (FEV1% predicted, MEF25% and MEF50%, Rtot%, p < 0.001). Shorter time interval since the removal from the allergen exposure correlated with higher ECP (rS = 0.375) and lower FEV1%, MEF25% and MEF50% after methacholine challenge (rS = -0.404, -0.425 and -0.532, respectively). In the patients, IgE (p < 0.001) and ECP (p = 0.009) was increased compared to controls. In EBC, 8-ISO and cysteinyl LTs were elevated in the asthmatics initially and after the challenge. Initial 8-ISO in plasma correlated negatively with FEV1 (rS = -0.409) and with methacholine PD20 (rS = -0.474). 8-ISO in plasma after the challenge correlated with IgE (rS = 0.396). CONCLUSIONS: The improvement in OA is very slow and objective impairments persist years after removal from the exposure. Cysteinyl LTs and 8-ISO in EBC and 8-ISO in plasma might enrich the spectrum of useful objective tests for the follow-up of OA.
- MeSH
- biologické markery analýza metabolismus MeSH
- cystein analýza MeSH
- dechové testy MeSH
- dinoprost analogy a deriváty analýza krev MeSH
- dospělí MeSH
- eozinofilní kationtový protein krev MeSH
- leukotrieny analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- maximální exspirační průtok ve střední části MeSH
- následné studie MeSH
- profesionální astma metabolismus patofyziologie MeSH
- studie případů a kontrol MeSH
- stupeň závažnosti nemoci MeSH
- usilovný výdechový objem MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF). METHODS: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021. Forced expiratory volume in one second percent predicted (ppFEV1) and body mass index (BMI) twelve months prior to and following a diagnosis of COVID-19 were recorded. Change in mean ppFEV1 and BMI were compared using a t-test. A linear mixed-effects model was used to estimate change over time and to compare the rate of change before and after infection. RESULTS: A total of 6,500 cases of COVID-19 in pwCF from 33 countries were included for analysis. The mean difference in ppFEV1 pre- and post-infection was 1.4 %, (95 % CI 1.1, 1.7). In those not on modulators, the difference in rate of change pre- and post-infection was 1.34 %, (95 % CI -0.88, 3.56) per year (p = 0.24) and -0.74 % (-1.89, 0.41) per year (p = 0.21) for those on elexacaftor/tezacaftor/ivacaftor. No clinically significant change was noted in BMI or BMI percentile before and after COVID-19 infection. CONCLUSIONS: No clinically meaningful impact on lung function and BMI trajectory in the year following infection with COVID-19 was identified. This work highlights the ability of the global CF community to unify and address critical issues facing pwCF.
- MeSH
- COVID-19 * patofyziologie komplikace epidemiologie MeSH
- cystická fibróza * patofyziologie komplikace MeSH
- dospělí MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- nutriční stav * MeSH
- respirační funkční testy metody MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 MeSH
- usilovný výdechový objem MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Z klinické praxe i výzkumných prací je známo, že dechová cvičení mají pozitivní význam pro osoby s poraněním míchy (PM). Účelem této práce bylo provedení speciálních dechových cvičení u osob s PM a hodnocení jejich účinnosti za pomoci RTG snímku plic a dalších testů. Soubor sestával z 15 respondentů s PM, 8 mužů a 7 žen, převážně středního a vyššího věku. Intervenční program trval šest měsíců, s frekvencí cvičení pětkrát týdně, v rozmezí 20 až 30 minut. V této studii byly vyšetřovány následující parametry: 1. RTG plic vsedě při nádechu a při výdechu; 2. exkurze hrudníku; 3. stanovení usilovné vitální kapacity plic (FVC) a jednosekundové vitální kapacity (FEV1); 4. měření dechové frekvence. Pretestové RTG vyšetření ukázalo, že rozdíl pohybu dolních žeber při nádechu a výdechu byl 2 až 35 mm. Pretestové hodnoty ukázaly, že měření obvodu hrudníku vykazovalo omezení expanze hrudníku vzhledem k normálním hodnotám daným věkem a pohlavím. V porovnání s hodnotami zdravé populace se u tetraplegiků snížila hodnota FVC na 30 %–50 % a u paraplegiků asi o 80 %. Dechová frekvence u všech respondentů s PM byla 13 až 22 vdechů/min. Po uplynutí šesti měsíců jsme opakovali testy. RTG vyšetření ukázalo, že rozdíl pohybu dolních žeber při nádechu a výdechu se zvýšil o 49 % (o 6 až 45 mm). Obvod hrudníku při nádechu se zvýšil o 3,5 % a obvod hrudníku při výdechu se snížil o 1,27 %. Jednosekundová vitální kapacita se zvýšila o 5,68 % a usilovná vitální kapacita plic o 7,61 %. Dechová frekvence se průměrně snížila o 16,22 %. V této studii jsme pomocí RTG vyšetření a dalších testů zaznamenali objektivní vliv dechových cvičení na dechové svaly u osob s PM.
It is known, from clinical practice and research, that breathing exercises have a positive effect on people with spinal cord injury (SCI). The purpose of this study was to perform special breathing exercises in persons with SCI and evaluate their effectiveness by using X-ray of lungs and other tests. Sample consisted of 15 respondents with SCI, 8 men and 7 women, mostly middle-aged and elderly. Intervention program took 6 months, with the frequency of exercise five times a week, in the range of 20-30 minutes. The study has included: 1 ) Chest X-Ray in a sitting position during inhalation and exhalation; 2) chest excursion; 3) determination of forced vital capacity (FVC) and forced expiratory volume during the first second (FEV1 ); 4) measurement of respiratory rate. Pretest X-ray showed that the difference between the movement of the lower ribs during inhalation and exhalation was 2-35 mm. Measurement of chest circumference showed a limitation of chest expansion related to normal values corrected with age and sex. Tetraplegic patient’s FVC decreased by 30-50 % compared with the values of healthy population and paraplegics FVC reduced about 80 %. Respiratory rate was 13 to 22 breaths/ min. for all respondents with SCI. We have repeated the tests after six months. X-ray examination showed that the difference between the movement of the lower ribs during inhalation and exhalation has increased by 49% (6 to 45 mm). It has become obvious that circumference of the chest during inspiration increased by 3.5 % and chest circumference during exhalation decreased by 1.27%. One-second vital capacity increased by 5.68% and forced vital lung capacity by 7.61 %. Respiratory rate decreased on average by 16.22 %. In this study, by using X-ray and other tests, we have noticed the objective influence of breathing exercises on the respiratory muscles in persons with SCI.
- MeSH
- dechová cvičení * metody MeSH
- dechová frekvence fyziologie MeSH
- dospělí MeSH
- hrudník * anatomie a histologie MeSH
- kvadruplegie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- paraplegie MeSH
- pilotní projekty MeSH
- plíce radiografie MeSH
- poranění míchy * komplikace MeSH
- poruchy dýchání * rehabilitace MeSH
- reprodukovatelnost výsledků MeSH
- respirační funkční testy * MeSH
- usilovný výdechový objem fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Ivacaftor, a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator, is approved for the treatment of patients with cystic fibrosis aged 6 years or older with Gly551Asp-CFTR. We assessed the safety and efficacy of ivacaftor during 96 weeks of PERSIST in patients with cystic fibrosis who completed a previous 48-week, placebo-controlled trial of the drug (STRIVE or ENVISION). METHODS: In this phase 3, open-label extension study, patients received ivacaftor 150 mg every 12 h in addition to their prescribed cystic fibrosis therapies. Patients who received placebo in their previous study initiated ivacaftor in this extension study. Patients were eligible if they had a Gly551Asp-CFTR mutation on at least one allele. The primary objective was to assess the long-term safety profile of ivacaftor as assessed by adverse events, clinical laboratory assessments, electrocardiograms, vital signs, and physical examination; secondary measures included change in forced expiratory volume in one second (FEV1), weight, and pulmonary exacerbations. This study is registered with ClinicalTrials.gov, number NCT01117012 and EudraCT, number 2009-012997-11. FINDINGS: Between July 8, 2010, and April 8, 2013, 144 adolescents/adults (≥12 years) from STRIVE and 48 children (6-11 years) from ENVISION were enrolled. Across both trials, 38 (20%) patients had a serious adverse event during the first 48 weeks and 44 (23%) during the subsequent 48 weeks. Two adults (1%) and one child (<1%) discontinued because of adverse events. The most common adverse events were pulmonary exacerbation, cough, and upper respiratory tract infection. Patients previously treated with ivacaftor had sustained improvements in FEV1, weight, and rate of pulmonary exacerbations for up to 144 weeks of treatment. Among adolescents/adults and children who previously received ivacaftor, absolute change in FEV1 at week 96 (144 weeks ivacaftor) was 9·4 and 10·3 % points and absolute increase in weight was 4·1 kg and 14·8 kg, respectively. For adolescents/adults only, the pulmonary exacerbation rate remained suppressed compared with that of patients who received placebo in the placebo-controlled study. INTERPRETATION: At 144 weeks of treatment, ivacaftor was well tolerated, with no new safety concerns. Ivacaftor also provided durable effects for 144 weeks in patients who had received active treatment in the placebo-controlled study. Those patients who previously received placebo had improvements comparable to those of patients treated with ivacaftor in the placebo-controlled study. FUNDING: Vertex Pharmaceuticals Inc.
- MeSH
- aminofenoly škodlivé účinky terapeutické užití MeSH
- časové faktory MeSH
- chinolony škodlivé účinky terapeutické užití MeSH
- cystická fibróza farmakoterapie genetika patofyziologie MeSH
- dítě MeSH
- dospělí MeSH
- hmotnostní přírůstek účinky léků MeSH
- infekce dýchací soustavy chemicky indukované MeSH
- kašel chemicky indukované MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace MeSH
- progrese nemoci MeSH
- protein CFTR genetika MeSH
- usilovný výdechový objem účinky léků MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- práce podpořená grantem MeSH
BACKGROUND: Cystic fibrosis is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein, and nearly 90% of patients have at least one copy of the Phe508del CFTR mutation. In a phase 2 trial involving patients who were heterozygous for the Phe508del CFTR mutation and a minimal-function mutation (Phe508del-minimal function genotype), the next-generation CFTR corrector elexacaftor, in combination with tezacaftor and ivacaftor, improved Phe508del CFTR function and clinical outcomes. METHODS: We conducted a phase 3, randomized, double-blind, placebo-controlled trial to confirm the efficacy and safety of elexacaftor-tezacaftor-ivacaftor in patients 12 years of age or older with cystic fibrosis with Phe508del-minimal function genotypes. Patients were randomly assigned to receive elexacaftor-tezacaftor-ivacaftor or placebo for 24 weeks. The primary end point was absolute change from baseline in percentage of predicted forced expiratory volume in 1 second (FEV1) at week 4. RESULTS: A total of 403 patients underwent randomization and received at least one dose of active treatment or placebo. Elexacaftor-tezacaftor-ivacaftor, relative to placebo, resulted in a percentage of predicted FEV1 that was 13.8 points higher at 4 weeks and 14.3 points higher through 24 weeks, a rate of pulmonary exacerbations that was 63% lower, a respiratory domain score on the Cystic Fibrosis Questionnaire-Revised (range, 0 to 100, with higher scores indicating a higher patient-reported quality of life with regard to respiratory symptoms; minimum clinically important difference, 4 points) that was 20.2 points higher, and a sweat chloride concentration that was 41.8 mmol per liter lower (P<0.001 for all comparisons). Elexacaftor-tezacaftor-ivacaftor was generally safe and had an acceptable side-effect profile. Most patients had adverse events that were mild or moderate. Adverse events leading to discontinuation of the trial regimen occurred in 1% of the patients in the elexacaftor-tezacaftor-ivacaftor group. CONCLUSIONS: Elexacaftor-tezacaftor-ivacaftor was efficacious in patients with cystic fibrosis with Phe508del-minimal function genotypes, in whom previous CFTR modulator regimens were ineffective. (Funded by Vertex Pharmaceuticals; VX17-445-102 ClinicalTrials.gov number, NCT03525444.).
- MeSH
- aktivátory chloridových kanálů aplikace a dávkování škodlivé účinky MeSH
- aminofenoly aplikace a dávkování škodlivé účinky MeSH
- benzodioxoly aplikace a dávkování škodlivé účinky MeSH
- chinolony aplikace a dávkování škodlivé účinky MeSH
- chloridy analýza MeSH
- cystická fibróza farmakoterapie genetika patofyziologie MeSH
- dítě MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- fixní kombinace léků MeSH
- genotyp MeSH
- indoly aplikace a dávkování škodlivé účinky MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace * MeSH
- pot chemie MeSH
- protein CFTR genetika MeSH
- pyrazoly aplikace a dávkování škodlivé účinky MeSH
- pyridiny aplikace a dávkování škodlivé účinky MeSH
- pyrrolidiny aplikace a dávkování škodlivé účinky MeSH
- usilovný výdechový objem MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Research Support, N.I.H., Extramural MeSH
