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The FEV1/FVC ratio, also called Tiffeneau index, is a calculated ratio used in the diagnosis of obstructive and

restrictive lung disease.[1][2] It represents the proportion of the forced vital capacity exhaled in the first second.[3] Normal values are approximately 80%.[4]. Predicted normal values can be calculated online and depend on age, sex, height, weight and ethnicity as well as the research study that they are based upon. A derived value of FEV1% is FEV1% predicted, which is defined as FEV1% of the patient divided by the average FEV1% in the population for any person of similar age, sex and body composition.

[edit] Disease states
In obstructive lung disease, the FEV1 is reduced due to obstruction to air escape. Thus, the FEV1/FVC ratio will be reduced.[3] More specifically, the diagnosis of COPD is made when the FEV1/FVC ratio is less than 70%.[5] The Global Initiative for Obstructive Lung Disease (GOLD) criteria also require that values are after bronchodilator medication has been given to make the diagnosis, and the British National Institute for Health and Clinical Excellence (NICE) criteria also require FEV1% to be less than 80% of predicted.[5] According to the European Respiratory Society (ERS) criteria, it is FEV1% predicted that defines when a patient has COPD--that is, when the patient's FEV1% is less than 88% of the predicted value for men, or less than 89% for women.[5]. In restrictive lung disease, the FEV1 and FVC are equally reduced due to fibrosis or other lung pathology (not obstructive pathology). Thus, the FEV1/FVC ratio should be approximately normal.[3]

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Back to Top . Necrotizing fasciitis (occasionally described by the media as "the flesh-eating bacteria") is a rapidly progressive disease which destroys muscles. STSS is not the same as the "toxic shock syndrome" due to the bacteria Staphylococcus aureus which has been associated with tampon usage. Streptococcal toxic shock syndrome (STSS) results in a rapid drop in blood pressure and organs (e." Two of the most severe. impetigo) Programs Disease Listing | General Information | Technical Information | Additional Information Frequently Asked Questions What is group A Streptococcus (GAS)? English and Spanish (800) CDC-INFO begin_of_the_skype_highlighting (800) CDC-INFO end_of_the_skype_highlighting (800) 232-4636 begin_of_the_skype_highlighting (800) 232-4636 end_of_the_skype_highlighting TTY: (888) 232-6348 FAX: (770) 488-4760 International Travel Phone: 1-887-394-8747 email: cdcinfo@cdc. People may carry group A streptococci in the throat or on the skin and have no symptoms of illness. forms of invasive GAS disease are necrotizing fasciitis and streptococcal toxic shock syndrome. Severe. While 10%-15% of patients with invasive group A streptococcal disease die from their infection. sometimes life-threatening. These infections are termed "invasive GAS disease. and skin tissue. muscle.g. lungs) to fail. such as the blood. necrotizing fasciitis. GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found." or impetigo. kidney. or the lungs.gov How are group A streptococci spread? What kind of illnesses are caused by group A streptococcal infection? How common is invasive group A streptococcal disease? Why does invasive group A streptococcal disease occur? Who is most at risk for getting invasive group A streptococcal disease? What are the early signs and symptoms of necrotizing fasciitis and streptococcal toxic shock syndrome? How is invasive group A streptococcal disease treated? What can be done to help prevent group A streptococcal infections? What is group A streptococcus (GAS)? Group A Streptococcus is a bacterium often found in the throat and on the skin.Home > Disease Listing > Group A Streptococcal Group A Streptococcal (GAS) Disease (strep throat. liver.. but least common. Most GAS infections are relatively mild illnesses such as "strep throat. approximately 25% of patients with necrotizing fasciitis and more than 35% with STSS die. Occasionally these bacteria can cause severe and even life-threatening diseases. fat.

. and those who use medications such as steroids have a higher risk. fat. and . cups. muscle. and chronic heart or lung disease. Also.000-1. However. streptococcal toxic shock syndrome) Severe. Back to Top How common is invasive group A streptococcal disease? About 9. resulting in 1. and skin tissue. It is not likely that household items like plates.800 deaths annually. STSS is not the same as the "toxic shock syndrome" frequently associated with tampon usage. such as the blood. forms of invasive GAS disease are necrotizing fasciitis and Streptococcal Toxic Shock Syndrome." Two of the most severe. Back to Top What kind of illnesses are caused by group A streptococcal infection? Infection with GAS can result in a range of symptoms: No illness Mild illness (strep throat or a skin infection such as impetigo) Severe illness (necrotizing faciitis. diabetes. and some may have no symptoms at all. Streptococcal toxic shock syndrome (STSS). it is important to complete the entire course of antibiotics as prescribed. or toys spread these bacteria. In contrast. These infections are termed "invasive GAS disease.g. people with chronic illnesses like cancer. such as those who have strep throat or skin infections. or the lungs. This may occur when a person has sores or other breaks in the skin that allow the bacteria to get into the tissue. Persons with skin lesions (such as cuts. causes blood pressure to drop rapidly and organs (e. Although healthy people can get invasive GAS disease.How are group A streptococci spread? These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin. kidney. surgical wounds).500 cases of invasive GAS disease occur each year in the United States. sometimes life-threatening. GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found. there are several million cases of strep throat and impetigo each year. Treating an infected person with an antibiotic for 24 hours or longer generally eliminates their ability to spread the bacteria. About 10%-15% of patients with other forms of invasive group A streptococcal disease die. STSS and necrotizing fasciitis each comprise an average of about 6%-7% of these invasive cases. liver. Back to Top Who is most at risk of getting invasive group A streptococcal disease? Few people who come in contact with GAS will develop invasive GAS disease. or when the person’s ability to fight off the infection is decreased because of chronic illness or an illness that affects the immune system. Persons who carry the bacteria but have no symptoms are much less contagious. the elderly. Ill persons. About 20% of patients with necrotizing fasciitis and more than half with STSS die. lungs) to fail. Most people will have a throat or skin infection. some virulent strains of GAS are more likely to cause severe disease than others.000-11. are most likely to spread the infection. but least common. Necrotizing fasciitis (occasionally described by the media as "the flesh-eating bacteria") destroys muscles. Why does invasive group A streptococcal disease occur? Invasive GAS infections occur when the bacteria get past the defenses of the person who is infected. chicken pox.

A person with signs of an infected wound. For STSS and necrotizing fasciitis. Persons with sore throats should be seen by a doctor who can perform tests to find out whether the illness is strep throat. early and aggressive surgery is often needed to remove damaged tissue and stop disease spread. especially if fever occurs. However. antibiotic therapy may be . If the test result shows strep throat. should immediately seek medical care. and pain at the wound site. Back to Top What can be done to help prevent group A streptococcal infections? The spread of all types of GAS infection can be reduced by good hand washing. Early treatment may reduce the risk of death from invasive group A streptococcal disease. All wounds should be kept clean and watched for possible signs of infection such as redness. high dose penicillin and clindamycin are recommended. even the best medical care does not prevent death in every case. often rapidly increasing Fever Redness at a wound site Early signs and symptoms of STSS. It is not necessary for all persons exposed to someone with an invasive group A strep infection (i. For persons with necrotizing fasciitis. Fever Abrupt onset of generalized or locallized severe pain. Severe pain and swelling.e. supportive care in an intensive care unit may also be needed. swelling. or day care until 24 hours after taking an antibiotic. especially after coughing and sneezing and before preparing foods or eating. However. the person should stay home from work. often in an arm or leg Dizziness Influenza-like syndrome Confusion A flat red rash over large areas of the body (only occurs in 10% of cases) Back to Top How is invasive group A streptococcal disease treated? GAS infections can be treated with many different antibiotics. Back to Top What are the early signs and symptoms of necrotizing fasciitis and streptococcal toxic shock syndrome? Early signs and symptoms of necrotizing fasciitis. drainage.adults with a history of alcohol abuse or injection drug use also have a higher risk for disease. For those with very severe illness. school. in certain circumstances. necrotizing fasciitis or strep toxic shock syndrome) to receive antibiotic therapy to prevent infection.

A English and Spanish: (800) CDC-INFO begin_of_the_skype_highlighting (800) CDC-INFO end_of_the_skype_highlighting / (800) 232-4636 begin_of_the_skype_highlighting (800) 232-4636 end_of_the_skype_highlighting TTY: (888) 232-6348 / FAX: (770) 488-4760 Dep Hea and Serv . GA 30333. 2008 Content source: National Center for Immunization and Respiratory Diseases: Division of Bacterial Home | Policies and Regulations | Disclaimer | e-Government | FOIA | Contact Us Centers for Disease Control and Prevention.appropriate.1600 Clifton Rd.S. Back to Top Date: April 3. U. Atlanta. That decision should be made after consulting with your doctor.