bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuroimmune/Hematopoietic Axis with Distinct Regulation by the High-Mobility Group Box 1 in Association with Tachykinin Peptides
Authors: Gergues Marina , Nagula Vipul , Bliss Sarah A. , Eljarrah Adam , Ayer Seda , Gnanavel Nikhil , Sinha Garima , Wu Qunfeng , Yehia Ghassan , Greco Steven J. , Qian Jing , Rameshwar Pranela
Published: January 2020

Hematopoiesis is tightly regulated by the bone marrow (BM) niche. The niche is robust, allowing for the return of hematopoietic homeostasis after insults such as infection. Hematopoiesis is partly regulated by soluble factors, such as neuropeptides, substance P (SP), and neurokinin A (NK-A), which mediate hematopoietic stimulation and inhibition, respectively. SP and NK-A are derived from the Tac1 gene that is alternately spliced into four variants. The hematopoietic effects of SP and NK-A are mostly mediated via BM stroma. Array analyses with 2400 genes indicated distinct changes in SP-stimulated BM stroma. Computational analyses indicated networks of genes with hematopoietic regulation. Included among these networks is the high-mobility group box 1 gene (HMGB1), a nonhistone chromatin-associated protein. Validation studies indicated that NK-A could reverse SP-mediated HMGB1 decrease. Long-term culture-initiating cell assay, with or without NK-A receptor antagonist (NK2), showed a suppressive effect of HMGB1 on hematopoietic progenitors and increase in long-term culture-initiating cell assay cells (primitive hematopoietic cells). These effects occurred partly through NK-A. NSG mice with human hematopoietic system injected with the HMGB1 antagonist glycyrrhizin verified the in vitro effects of HMGB1. Although the effects on myeloid lineage were suppressed, the results suggested a more complex effect on the lymphoid lineage. Clonogenic assay for CFU– granulocyte-monocyte suggested that HMGB1 may be required to prevent hematopoietic stem cell exhaustion to ensure immune homeostasis. In summary, this study showed how HMGB1 is linked to SP and NK-A to protect the most primitive hematopoietic cell and also to maintain immune/hematopoietic homeostasis.
MUJERES METODISTAS EN LEÓN, GUANAJUATO-MÉXICO: LIDERAZGOS EN MOVIMIENTO
Authors: Mazariegos Herrera Hilda María Cristina
Published: January 2020

El objetivo de este trabajo es reflexionar en torno a los liderazgos femeninos metodistas en la ciudad de León, en el estado de Guanajuato, México, identificando los mecanismos que construyen las mujeres para desenvolverse y ganar mayores espacios de acción y reconocimiento al interior de su iglesia. Guanajuato es un estado ubicado en el centro-occidente de México, caracterizado por un fuerte conservadurismo católico, en el que las agrupaciones protestantes han tenido que adecuar sus formas de evangelización. Tal es el caso de las mujeres metodistas, quienes llevan a cabo “liderazgos femeninos en movimiento”, puesto que, independientemente del lugar que ocupan en la jerarquía eclesial, transcienden las normas y el discurso religioso sobre el “deber ser” femenino, estableciendo estrategias de evangelización vinculadas a la gestión emocional, a través de la cual ponen de manifiesto las desigualdades que viven, tanto dentro como fuera de la iglesia. La movilidad espacial fue importante para comprender su participación, para ello fue necesario recurrir a una metodología que me permitiera dar cuenta del alcance de la actividad femenil metodista: la etnografía multisituada. Esto posibilitó distintas dimensiones de observación, aportando al análisis una visión macro y micro del liderazgo femenino metodista en León.
Spontaneous pneumothorax and ozone levels: is there a relation?
Authors: Abul Yasin , Karakurt Sait , Bostanci Korkut , Yuksel Mustafa , Eryuksel Emel , Evman Serdar , Celikel Turgay
Published: January 2020

Study objectives: Although links between meteorological con- ditions and spontaneous pneumothorax (SP) have been pro- posed, the reports are controversial. In this study ozone lev- els, which are known to have some adverse effects on lung tissues, were investigated as a potential triggering factor of SP. At present there is not sufficient information about the effects of ozone on SP.

Methods: Of a total 79 pneumothorax patients recruited for the study, 21 secondary pneumothorax cases were excluded. In the remaining 58 SP patients, meteorological data at the time of SP occurrence were recorded.

Results: The number of SP patients was higher in spring than in the other seasons (p < 0.05). There was an association between the SP frequency and the average ozone level at dif- ferent seasons (F 3,52 = 19.45, p = 0.001). The average ozone level was higher in spring (363 ± 25 Dobson) than during the other seasons (autumn 296 ± 18 Dobson; summer 321 ± 26 Dobson; winter 324 ± 32 Dobson) (p = 0.001). There was a positive correlation between SP frequency and the average ozone values for each season (r = 0.301, p = 0.024). There was no significant correlation between the severity of SP and ozone level (r = 0.236, p = 0.16).

Conclusions: The number of SP patients increases in spring when ozone levels are highest. Ozone is known to affect alve- olar cells and cause interstitial edema. Ozone causes damage to the lung interstitium by way of oxidative stress. Rupture of unrecognized underlying blebs/bullae has been proposed as a cause of SP. Increased levels of ozone may be a triggering fac- tor for these ruptures.
Clinical trials in advanced stage lung cancer: a survey of patients’ opinion about their treatment
Authors: Zaric Bojan , Perin Branislav , Ilic Aleksandra , Kopitovic Ivan , Matijasevic Jovan , Andrijevic Ljiljana , Secen Nevena , Stanic Jelena , Bijelovic Milorad , Kosjerina Zdravko , Antonic Milan
Published: January 2020

Background: The major aim of this study was to investigate what patients with advanced stage lung cancer, enrolled in a clinical trial, thought about their treatment. We also wanted to investigate if there exist any characteristics that could influence patients’ opinion about the clinical trial.

Patients and methods: Over the period from June 2008 to June 2009, 59 eligible patients were enrolled in this study. The major inclusion criteria were: participation in a clinical trial, previously treated advanced stage lung cancer, and good per- formance status (ECOG 0-2). All patients were asked to answer a questionnaire designed to investigate their impres- sions about participation in a clinical trial. The questionnaire was deposited in a sealed box which was opened at the end of the study. We investigated a possible influence of age, gender, education, lung cancer stage, chemotherapy line and tumor type on the patients' opinion about some aspects of the clinical trial.

Results: The majority of the patients were aware they were participating in the clinical trial and a significant number of them were very satisfied with the treatment. Of the investi- gated factors, only the level of education had a statistically significant influence on some of the questions raised in the questionnaire.

Conclusions: Patients participating in clinical trials are satis- fied with their treatment, ready to proceed with it and would recommend it to other patients. It depends mainly on health professionals to maintain this level of confidence and justify their trust.
Prevalence of smoking and chronic obstructive pulmonary disease amongst teachers working in Kocaeli, Turkey
Authors: Barış Serap A. , Yıldız Füsun , Başyiğit İlknur , Boyacı Haşim , Ilgazlı Ahmet
Published: January 2020

Aim: To evaluate smoking and COPD prevalence amongst teachers working in the schools of Kocaeli City, Turkey.Method: In this cross-sectional study, a questionnaire focusing on respiratory symptoms and smoking habits was adminis- tered to all participants who accepted to join the study. All sub- jects also underwent a physical examination and a pulmonary function test performed with portable spirometer. According to GOLD criteria, subjects who had post-bronchodilator FEV1/FVC < 70% and negative reversibility test were classi- fied as COPD.

Results: A total of 685 teachers were included [female n = 307 (45%), male n = 378 (55%)] with mean age 38.9 ± 8.9 years. Smoking habit was evaluated in 660 subjects: 291 (44.1%) were smokers, 252 (38.2%) were non-smokers and 117 (17.7%) were ex-smokers. Pulmonary function test was available in 651 subjects and 510 (78.3%) were defined as normal on spirometric analysis. Small airway obstruction was found in 115 of the cases (17.7%) in whom FEF25-75 level was found to be lower than 70% predicted. FEV1/FVC level was lower than 70% in 16 subjects (2.5%). Five subjects who had positive reversibility test were excluded from the study. The remaining 11 subjects who were considered as COPD consisted of 2 (18%) females and 9 (82%) males. Six of these subjects were aged over 40 years.

Conclusion: Spirometry has an important role in early diagno- sis of COPD. Spirometric evaluation of cases with risk factors for COPD could be helpful in diagnosing patients before the progressive decline in lung function begins. Further studies are needed to evaluate whether the interventional strategies at this stage such as smoking cessation could prevent the progression of disease.
Round atelectasis in sarcoidosis
Authors: Tetikkurt Cuneyt , Tetikkurt Seza , Ozdemir Imran , Bayar Nihal
Published: January 2020

Round atelectasis is a benign inflammatory condition most frequently observed in patients with asbestos exposure but it can also result from a variety of chronic pleural diseases like infection. It has not previously been described in sarcoidosis. We report the occurrence of round atelectasis in four previ- ously diagnosed sarcoidosis patients who were under follow up at our outpatient clinic. Three patients had symptoms con- sisting of thoracic pain, dry cough and sensation of fullness at the posterior thorax, respectively. Chest roentgenogram showed subpleural or pleural based opacity with diameters ranging from 2 to 3 cm in each of the patients. Chest comput- erized tomography (CT) revealed features of round atelecta- sis. Fiberoptic bronchoscopy with transbronchial lung biopsy was performed. Diagnosis was confirmed by the histopatho- logic examination of the biopsy samples. The mechanical influence of a prior pleural effusion due to sarcoidosis may be the predominant mechanism underlying the onset of round atelectasis in these patients. Clinicians should bear in mind the possibility of sarcoidosis as an etiologic factor for round atelectasis.
Rituximab treatment in a case of anti- synthetase syndrome with severe interstitial lung disease and acute respiratory failure
Authors: Zappa Maria Cristina , Trequattrini Tiziana , Mattioli Francesco , Rivitti Rosario , Vigliarolo Rossana , Marcoccia Antonella , D’Arcangelo Giovanni
Published: January 2020

We present a case of severe interstitial pneumonitis, mild polyarthritis and polymyositis, and Raynaud's syndrome with the presence of anti-Jo-1 antibodies, which had been diag- nosed as anti-synthetase syndrome. The presence, however, of anti-Ro/SSA antibodies led us to understand that we were dealing here with a more severe form of interstitial lung dis- ease. The patient was treated for acute respiratory failure but he showed resistance to glucocorticoids and cyclosporine. Thus, he was treated with infusions of anti-CD20 therapy (rituximab): his clinical conditions improved very rapidly and a significant decrease in the activity of pulmonary disease was detected using high-resolution computerized tomogra- phy (HRCT) of the thorax and pulmonary function tests.
Systemic inflammation in COPD in relation to smoking status
Authors: Serapinas Danielius , Narbekovas Andrius , Juskevicius Jonas , Sakalauskas Raimundas
Published: January 2020

Background and aims: Smoking is the main risk factor for the development of chronic obstructive pulmonary disease (COPD) that has been recently defined as a systemic pul- monary inflammatory disease. However, the impact of smok- ing itself on systemic inflammation in COPD patients has not yet been well established. The aim of our study was to inves- tigate the association between inflammatory markers and smoking status.

Material and methods: We compared 202 current smokers, 61 ex-smokers and 57 never-smokers, all COPD patients. Assessments included medical history, spirometry, alpha-1 antitrypsin (AAT) genotyping, serum AAT, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and soluble tumor necrosis factor receptor (sTNFR)-1 and sTNFR-2 concentra- tions.

Results: AAT and CRP concentrations in smokers (1.75 ± 0.51 g/L and 14.4 [9.5–20.5] mg/L) and ex-smokers (1.69 ± 0.43 g/L and 12.3 [8.7–16.3] mg/L) were higher than in never-smokers (1.49 ± 0.38 g/L and 5.1 [2.5–8.7] mg/L; p < 0.05). sTNFR-1 level was higher in smokers than ex-smokers or never-smok- ers (241.2 pg/mL [145.3–349.4] vs. 213.7 pg/mL [147.1– 280.3] and 205.2 pg/mL [125–275]; p < 0.05).

Conclusions: Our data confirm that smoking is associated with increased levels of AAT, CRP, and sTNFR-1 in COPD patients, an array of systemic inflammation markers that continue to be active even after smoking cessation.
Anxiety and depression in COPD patients and correlation with sputum and BAL cytology
Authors: Tetikkurt Cuneyt , Ozdemir Imran , Tetikkurt Seza , Yılmaz Nail , Ertan Turan , Bayar Nihal
Published: January 2020

Background and aims: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psycholog- ical aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capac- ity), and to evaluate the association between atypical cyto- logic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease.

Methods: COPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were per- formed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia.

Results: The overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD.

Conclusions: We conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.
The European Respiratory Roadmap
Authors: Decramer Marc
Published: January 2020

It is clear by now that health policy makers did not devote the deserved attention to respiratory diseases in the last decades. The five most important respiratory diseases (COPD, asthma, lung cancer, pneumonia and tuberculosis) are now responsible for 20% of the mortality worldwide [1,2]. The annual cost associated with these diseases amounts to €100 billion in Europe. Worldwide there are [...]
Epidemiology and costs of hospital care for COPD in Puglia
Authors: Moretti Anna Maria , Tafuri Silvio , Parisi Davide , Germinario Cinzia
Published: January 2020

Background and aims: Chronic obstructive pulmonary disease (COPD) is currently the 5th cause of morbidity and mortality in the developed world and represents a substantial economic and social burden. The aim of this study is to report on hospital admissions and related costs of hospital treatment for COPD in the Puglia Region of Italy in the years 2005-2007.

Materials and methods: Patients were selected who were hospitalized between 01/01/2005 and 31/12/2007 with ICD-9-CM code: 490.xx: bronchitis not specified as acute or chronic; 491.xx: chronic bronchitis; 492.xx: emphysema; 493.xx: asthma; 494.xx: bronchiectasis; 496.xx: chronic airway obstruction not elsewhere classified; 518.81: acute respiratory failure as principal or secondary diagnosis.

Results: In the period 2005-2007, there were 73,721 hospital admissions for COPD registered in Puglia (25,690 in 2005; 24,153 in 2006 and 23,878 in 2007) of which 34.3% were women, with no significant variation in the three years. There appears to be a negative trend in hospitalisations in Puglia for chronic bronchitis with ratios decreasing from 359.4 per 100,000 population in 2005 to 307.9 per 100,000 in 2007. The overall cost of COPD for Apulian hospital trusts was €272,293,182.85 over the 3-year period.

Conclusions: Analysis of the data for hospital care, its costs and performance may be an important indicator of the efficacy of community care. In particular, the lack of reduction in admissions for COPD should lead decision makers to question both the appropriateness and quality of the care given.
Frequency of pleural effusion in acute bronchiolitis and its effect on prognosis
Authors: Yilmaz Ayse E. , Koktener Aslı , Celik Nurullah , Akca Halise , Bilici Meki , Mete Emit
Published: January 2020

Aim: To analyze the frequency of pleural effusion and theeffect on prognosis in children with acute bronchiolitis.

Methods: A total of 69 infants aged 1-24 months with acute bronchiolitis were studied between September 2009 and December 2010. All patients’age, sex, breastfeeding duration, exposure to smoking, history of using vitamin D, symptoms duration, physical examination and laboratory findings were recorded. Bronchiolitis score and predisposing factors that influence the disease process were determined. Thorax ultrasonography was carried out in all patients, who were evaluated on the 3rd and 7th day of the treatment.

Results: Mean age of patients (43 boys, 26 girls) was 11.97 ± 0.69 months (median 11 months). Breastfeeding duration was 8.26 ± 0.56 months (median 8 months). According to bronchiolitis score, 52 patients (75.4%) had mild and moderate bronchiolitis and 17 (24.6%) had severe bronchiolitis; 34 patients (49.2%) had pleural effusion. There was no relation between pleural effusion and symptoms. Frequency of pleural effusion was significantly higher in patients with risk factors.

Conclusions: This study demonstrated that most of the acute bronchiolitis cases in the infants studied were accompanied by pleural effusion. Pleural effusion in acute bronchiolitis had no effects on prognosis.
Clinical findings in 19 cases of invasive pulmonary aspergillosis with liver cirrhosis
Authors: Chen Jiajia , Yang Qing , Huang Jianrong , Li Lanjuan
Published: January 2020

Background: Aspergillus infection was mostly reported with high mortality rates and a bad prognosis in immunocompromised patients, but data were lacking on the clinical characteristics of aspergillus infection in liver cirrhosis. The aim of this study was to retrospectively assess the morbidity and mortality rate, clinical manifestation, risk factors, and medication of invasive pulmonary aspergillosis (IPA) in liver cirrhosis in The First Affiliated Hospital, College of Medicine, Zhejiang University.

Methods: Patients with liver cirrhosis who had been diagnosed with proven or probable IPA by clinical and laboratory parameters from 1st December 2008 to 1st May2012 were retrospectively evaluated for predisposing factors for IPA and clinical outcome. The follow up ended on 30th July2012. IPA was defined according to European Organization for Research and Treatment of Cancer/Mysoses Study group criteria.

Results: In total, 6,600 patients with liver cirrhosis were enrolled, and 19 out of these developed IPA. Seventeen out of 19 patients died. Imaging findings such as the halo sign and lower respiratory tract infection symptoms contributed to the early diagnosis of IPA. Possible risk factors for IPA included a high Child-Turcotte-Pugh (CTP) score, broad antibiotic usage and steroid exposure. The use of antifungal compounds may prolong a patient’s life.

Conclusions: The mortality of liver cirrhosis with IPA is high. Liver cirrhosis should be considered a risk factor of  IPA. Once patients with high CTP scores and steroid and broad spectrum antibiotics exposure present cough and fever, IPA should be taken into consideration and antifungal agents should be used as soon as possible.
Increased circulating obestatin in patients with chronic obstructive pulmonary disease
Authors: Lei Yi , Liang Yasha , Liu Xiaojing , Liao Xiaoyang , Luo Fengming
Published: January 2020

Background: Some peptides, which regulate the metabolic balance, are thought to play important roles in nutritional disorders and systemic inflammation in COPD. Treatment of rats with obestatin decreased body-weight gain. Obestatin was also found to be correlated with inflammation in rheumatoid arthritis. The aims of this study were to investigate the level of circulating obestatin in COPD and to analyze the relationship among obestatin and nutritional status, and systemic inflammation.

Methods: 32 COPD patients with BMI less than 20 kg/m2 and 22 normal controls were included. Body composition was estimated using “foot-to-foot” BIA technology. Circulating obestatin was determined with enzyme-linked immunosorbent assay. Pulmonary function, TNF-α and C reactive protein were also measured.

Results: The level of circulating obestatin was higher in COPD with underweight than that in normal control (5562.75 ± 3435.43 pg/ml in COPD, 3663.90 ± 2313.95 pg/ml in controls, p = 0.028). BMI, Waist circumference, hip circumference, bodyFAT and FAT% in COPD group were lower than those in normal control. Positive correlation was found among circulating C reactive protein, TNF-α and obestatin. There was no significant correlation among BMI, pulmonary function and obestatin.

Conclusions: This study shows that circulating obestatin is higher in underweight COPD patients, and positively correlated to systemic inflammation, but not to nutritional status.
The safety of beta-blocker use in chronic obstructive pulmonary disease patients with respiratory failure in the intensive care unit
Authors: Kargin Feyza , Takir Huriye Berk , Salturk Cuneyt , Goksenoglu Nezihe Ciftaslan , Karabay Can Yucel , Mocin Ozlem Yazicioglu , Adiguzel Nalal , Gungor Gokay , Balci Merih Kalamanoglu , Yalcinsoy Murat , Kargin Ramazan , Karakurt Zuhal
Published: January 2020

Background: The safety of beta-blockers as a heart rate-limiting drug (HRLD) in patients with acute respiratory failure (ARF) due to chronic obstructive lung disease (COPD) has not been properly assessed in the intensive care unit (ICU) setting. This study aims to compare the use of beta-blocker drugs relative to non-beta-blocker ones in COPD patients with ARF due to heart rate-limiting with respect to length of ICU stay and mortality.

Methods: We performed a retrospective (January 2011-December 2012) case-control study in a level III ICU in a teaching hospital. It was carried out in a closed ICU by the same intensivists. All COPD patients with ARF who were treated with beta-blockers (case group) and non-beta-blocker HRLDs (control group) were included. Their demographics, reason for HRLD, cause of ARF, comorbidities, ICU data including acute physiology and chronic health evaluation (APACHE II) score, type of ventilation, heart rate, and lengths of ICU and hospital stays were collected. The mortality rates in the ICU, the hospital, and over 30 days were also recorded.

Results: We enrolled 188 patients (46 female, n = 74 and n = 114 for the case and control groups, respectively). Reasons for HRLD (case and control group, respectively) were atrial fibrillation (AF, 23% and 50%), and supraventricular tachycardia (SVT, 41.9% and 54.4%). Patients’ characteristics, APACHE II score, heart rate, duration and type of ventilation, and median length of ICU-hospital stay were similar between the groups. The mortality outcomes in the ICU, hospital, and 30 days after discharge in the case and control groups were 17.6% versus 15.8% (p > 0.75); 18.9% versus 19.3% (p > 0.95) and 20% versus 11% (p > 0.47), respectively.

Conclusions: Our results suggest that beta-blocker use for heart rate control in COPD patients with ARF is associated with similar ICU stay length and mortality compared with COPD patients treated with other HRLDs.
Association between peripheral muscle strength, exercise performance, and physical activity in daily life in patients with Chronic Obstructive Pulmonary Disease
Authors: Rausch-Osthoff Anne-Kathrin , Kohler Malcolm , Sievi Noriane A. , Clarenbach Christian F. , Van Gestel Arnoldus J.R.
Published: January 2020

Background: Resistance training of peripheral muscles has been recommended in order to increase muscle strength in patients with Chronic Obstructive Pulmonary Disease (COPD). However, whether peripheral muscle strength is associated with exercise performance (EP) and physical activity in daily life (PADL) in these patients needs to be investigated. The aim of this study is to evaluate whether strength of the quadriceps muscle (QS) is associated with EP and daily PADL in patients with COPD.

Methods: We studied patients with COPD (GOLD A-D) and measured maximal isometric strength of the left QS. PADL was measured for 7 days with a SenseWear-Pro® accelerometer. EP was quantified by the 6-minute walk distance (6MWD), the number of stands in the Sit-to-Stand Test (STST), and the handgrip-strength. Univariate and multivariate analyses were used to examine possible associations between QS, PADL and EP.

Results: In 27 patients with COPD with a mean (SD) FEV1 of 37.6 (17.6)% predicted, QS was associated with 6MWD, STST, and handgrip-strength but not with PADL. Multiple linear regression analyses showed that QS was independently associated with the 6MWD (β = 0.42, 95% CI 0.09 to 0.84, p = 0.019), STST (β = 0.50, 95% CI 0.11 to 0.86, p = 0.014) and with handgrip-strength (β = 0.45, 95% CI 0.05 to 0.84, p = 0.038).

Conclusions: Peripheral muscle strength may be associated with exercise performance but not with physical activity in daily life. This may be due to the fact that EP tests evaluate patients’ true abilities while PADL accelerometers may not.
Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries
Authors: Sweileh Waleed M. , Al-Jabi Samah W. , Zyoud Sa’ed H. , Sawalha Ansam F.
Published: January 2020

Background: Chronic respiratory diseases, like bronchial asthma and chronic obstructive pulmonary disease (COPD), are a worldwide health problem. Quantitative and qualitative assessment of asthma and COPD-related research from Arab countries has not been explored and there are few internationally published reports on such field. The main objectives of this study were to analyze research output originating from Arab countries in the field of bronchial asthma and COPD.

Methods: Original scientific articles or reviews published from the 22 Arab countries were screened using specific words pertaining to asthma and COPD using Scopus database and search engine. Research productivity was evaluated based on: (a) total and trends of contribution of each Arab country to asthma and COPD research and (b) journals in which researchers from Arab countries published their research.

Results: The total number of original research and review articles published globally about bronchial asthma and COPD was 163,964. The leading country in bronchial asthma and COPD research was United States of America (38,632; 23.56%). Worldwide, Turkey ranked 19th while Israel and Iran ranked 25th and 29th respectively. Among Arab countries, Egypt and Kingdom of Saudi Arabia came on positions 39th and 43rd, respectively. A total of 1,304 documents about bronchial asthma and COPD were published from Arab countries which represents 0.8% of the global research output. Research in bronchial asthma was almost double that in COPD. Research from Arab countries was low and showed a significant increase after 2000. Approximately 12% of research activity in asthma and COPD from Arab countries was published in Saudi Medical Journal, Annals of Saudi Medicine, Eastern Mediterranean Health Journal and Tunisie Medicale. Kingdom of Saudi Arabia, with a total publication of 353 (27.07%) ranked first among the Arab countries while University of Kuwait was the most productive institution with a total of 123 (9.43%) documents.

Conclusions: The present data showed relatively low research productivity about bronchial asthma and COPD in Arab countries. Research output can be improved by investing more in international and national collaborative research projects in the field of asthma and COPD.
Correction: Evaluation of pulmonary dysfunctions and acid–base imbalances induced by Chlamydia psittaci in a bovine model of respiratory infection
Authors: Ostermann Carola , Linde Susanna , Siegling-Vlitakis Christiane , Reinhold Petra
Published: January 2020

Correction about the publication of our article by Ostermann C, Linde S, Siegling-Vlitakis C, Reinhold P: Evaluation of pulmonary dysfunctions and acid–base imbalances induced by Chlamydia psittaci in a bovine model of respiratory infection. Multidiscip Respir Med 2014, 9:10.
Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial
Authors: Aguiar Isabella C. , Freitas jr. Wilson R. , Santos Israel R. , Apostolico Nadua , Nacif Sergio R. , Urbano Jéssica Julioti , Teixeira Fonsêca Nina , Rodrigues Thuler Fabio , Jirjoss Ilias Elias , Kassab Paulo , Leitão Filho Fernando S.S. , Laurino Neto Rafael M. , Malheiros Carlos A. , Insalaco Giuseppe , Donner Claudio F. , Oliveira Luis Vicente F.
Published: January 2020

Background: The increasing prevalence of obesity in both developed and developing countries is one of the most serious public health problems and has led to a global epidemic. Obesity is one of the greatest risk factors of obstructive sleep apnea (OSA), which is found in 60 to 70% of obese patients mainly due to the buildup of fat tissue in the upper portion of the thorax and neck. The aim of the present randomized clinical trial is to assess daytime sleepiness, sleep architecture and pulmonary function in patients with severe obesity before and after bariatric surgery.

Methods: This randomized, controlled trial, was designed, conducted, and reported in accordance with the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. Patients were divided into a bariatric surgery group and control group. The clinical evaluation was performed at the Sleep Laboratory of the Nove de JulhoUniversity (Sao Paulo, Brazil) and consisted of the collection of clinical data, weight, height, body mass index (BMI), measurements of neck and abdomen circumferences, spirometry, maximum ventilatory pressure measurements, standard overnight polysomnography (PSG) and the administration of the Berlin Questionnaire and Epworth Sleepiness Scale.

Results: Fifty-two patients participated in the present study and performed PSG. Out of these, 16 underwent bariatric surgery. After surgery, mean BMI decreased from 48.15 ± 8.58 to 36.91 ± 6.67 Kg/m2. Significant differences were found between the preoperative and postoperative periods regarding neck (p < 0.001) and waist circumference (p < 0.001), maximum inspiratory pressure (p = 0.002 and p = 0.004) and maximum expiratory pressure (p = 0.001 and p = 0.002) for women and men, respectively, as well as sleep stage N3 (p < 0.001), REM sleep (p = 0.049) and the apnea-hypopnea index (p = 0.008).

Conclusions: Bariatric surgery effectively reduces neck and waist circumference, increases maximum ventilatory pressures, enhances sleep architecture and reduces respiratory sleep disorders, specifically obstructive sleep apnea, in patients with severe obesity.

Trial registration: The protocol for this study was registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and Brazilian Registry of Clinical Trials – ReBEC (RBR-9k9hhv).
Evaluation of reactive oxygen metabolites in patients with non-small cell lung cancer after chemotherapy
Authors: Wakabayashi Toru , Kawashima Tatsuo , Matsuzawa Yasuo
Published: January 2020

Background: The aim of this study was to evaluate the level of reactive oxygen metabolites (ROMs) after chemotherapy in patients with non-small cell lung cancer (NSCLC) and its association with response to treatment.

Methods: Fifty-eight untreated NSCLC patients and twenty-three healthy subjects were selected for the study. Patients received two courses of platinum-based chemotherapy and were evaluated for oxidative stress and treatment response. As a marker of reactive oxygen species, ROMs levels were measured using the d-ROMs test.

Results: ROMs level (mean ± standard deviation) before chemotherapy in NSCLC patients (416 ± 135 U.CARR) was significantly elevated (p = 0.016) compared to normal healthy subjects (320 ± 59 U.CARR). Patients who responded to chemotherapy showed significantly decreased (p = 0.014) ROMs levels after chemotherapy, whereas patients who had stable disease or progressive disease showed no change in ROMs level (p = 0.387).

Conclusions: NSCLC patients had significantly elevated ROMs levels before chemotherapy compared with normal healthy subjects. Chemotherapy may suppress ROMs production in responders but not in non-responders. ROMs level may be a predictor of clinical outcome in patients receiving chemotherapy for NSCLC.
Diagnostic delay of pulmonary nontuberculous mycobacterial infection in China
Authors: Jing Hui , Tan Wanming , Deng Yunfeng , Gao Dachuan , Li Liang , Lu Zhiming , Graviss Edward A. , Ma Xin
Published: January 2020

Background: Nontuberculous mycobacteria (NTM) infection is an emerging, but neglected public health concern in China.

Findings: To investigate diagnostic delay of NTM diseases in China, we analyzed 91 patients with pulmonary NTM infection in Shandong Province. The median diagnostic delay time of the analyzed patients was 84 days, which was significantly associated with rural inhabitance (135 days vs. 73 days of urban inhabitance, p < 0.01) and lower level of first visiting hospitals/clinics (70 and 82 days of tertiary and secondary hospitals/clinics respectively vs. 120 days of primary hospitals/clinics, p < 0.05). M. farcinogenes was isolated from a 79-year-old male patient, which is the first report of pulmonary infection in humans.

Conclusions: Our results indicate a significant diagnostic delay of NTM diseases in China, especially for rural patients with limited access to higher-level healthcare services.
Experience with exercise right heart catheterization in the diagnosis of pulmonary hypertension: a retrospective study
Authors: Keusch Stephan , Bucher Anina , Müller-Mottet Séverine , Hasler Elisabeth , Maggiorini Marco , Speich Rudolf , Ulrich Silvia
Published: January 2020

Background: Data on exercise pulmonary hemodynamics in healthy people and patients with pulmonary hypertension (PH) are rare. We analyzed exercise right heart catheterization (RHC) data in a symptomatic collective referred with suspected PH to characterize the differential response by diagnostic groups, to correlate resting with exercise hemodynamics, and to evaluate safety.

Methods: This is a retrospective single-center study reviewing data from patients in whom an exercise RHC was performed between January 2006 and January 2013. Patients with follow-up RHC under PH -therapy were excluded.

Results: Data from 101 patients were analyzed, none of them had an adverse event. In 35% we detected a resting PH (27.8% precapillary, 6.9% postcapillary). Exercise PH (mean pulmonary arterial pressure (mPAP) >30 mmHg at exercise) was found in 38.6%, whereas in 25.7% PH was excluded. We found a remarkable number of exercise PH in scleroderma patients, the majority being postcapillary. 83% of patients with mPAP-values between 20 and 24.9 mmHg at rest had exercise PH. Patients with resting PH had worse hemodynamics and were older compared with exercise PH ones.

Conclusion: In this real-life experience in symptomatic patients undergoing exercise RHC for suspected PH, we found that exercise RHC is safe. The facts that the vast majority of patients with mPAP-values between 20 and 24.9 mmHg at rest had exercise PH and the older age of patients with resting PH may indicate that exercise PH is a precursor of resting PH. Whether earlier treatment start in patients with exercise PH would stabilize the disease should be addressed in future studies.
Metabolomic profile of amniotic fluid to evaluate lung maturity: the diaphragmatic hernia lamb model
Authors: Pelizzo Gloria , Ballico Maurizio , Mimmi Maria Chiara , Peirò José Louis , Marotta Mario , Federico Costanzo , Andreatta Erika , Nakib Ghassan , Sampaolesi Maurilio , Zambaiti Elisa , Calcaterra Valeria
Published: January 2020

Background: Tracheal occlusion (TO) stimulates lung growth in fetuses affected with congenital diaphragmatic hernia (CDH) although the processes involved in lung maturation still remain unknown. The objective of this study was to evaluate the metabolomic profile of amniotic fluid (AF) following TO in fetal lamb model in order to obtain an indirect view of mechanisms involved in pulmonary reversal hypoplasia and biochemical maturity in response to fetal TO.

Methods: Liquid Chromatography Mass Spectrometry was performed on lamb AF samples at: age I (70 days’gestation); age II (102 days’ gestation); age III (136 days’ gestation). CDH was induced at age I and TO at age II.

Results: Betaine, choline, creatinine were found significantly increased during gestation in the control group. The CDH group showed choline (p =0.007) and creatinine (p =0.004) decreases during pregnancy. In the TO group choline and creatinine profiles were restored.

Conclusions: Alveolar tissue and fetal global growth ameliorated after TO. Metabolomics provided useful information on biochemical details during lung maturation. Metabolomic profiling would help to identify the best time to perform TO, in order to increase survival of CDH affected patients.
Acute pneumonitis consequent on pleurodesis with Viscum album extract: severe chest images but benign clinical course
Authors: Cho Suk Ju , Kim Su Wan , Chang Jee Wo
Published: January 2020

Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of such chemical pleurodesis in the treatment of malignant pleural effusion. Moreover, the complications resulting from pleurodesis using Viscum album extract are very rare, and acute pneumonitis has not been reported. in this paper we report the first case of acute pneumonitis after pleurodesis using Viscum album extract in a 58-year-old man who had prolonged air leaks after a left upper lingularsegmentectomy for metastatic lung cancer. We performed repeated pleurodesis four times with 2 to 4 days intervals. While the patient had no symptoms of pneumonia, such as cough, sputum, chilling, and fatigue, a follow-up chest X-ray revealed increasing peribronchial consolidations and infiltrations in the left upper lobe. A chest tomography showed extensive parenchymal consolidations and ground-glass appearances in the left lungs, representing pneumonia with acute lung injury. The acute pneumonitis was spontaneously resolved with supportive care, and the patient was discharged ten days after the development of pneumonitis. We think that pleurodesis with Viscum album extract is effective, but repeated pleurodesis should be avoided for possible onset of acute pneumonitis.
Pharmacologic rationale, efficacy and safety of the fixed-dose co-formulation of indacaterol and glycopyrronium
Authors: Pelaia Girolamo , Maselli Rosario , Gallelli Luca
Published: January 2020

Chronic obstructive pulmonary disease (COPD) is a widespread respiratory disorder, usually characterized by progressive and poorly reversible airflow limitation. Inhaled long-acting bronchodilators, namely LABA (long-acting β2-adrenergic agonists) and LAMA (long-acting muscarinic receptor antagonists) are the mainstay of COPD treatment. Because the symptoms of many patients with COPD do not satisfactorily improve by using a single, either LABA or LAMA bronchodilator, the synergism of action resulting from the combination of the different bronchodilating mechanisms activated by LABA and LAMA, respectively, can significantly contribute to a better disease control. Based on these clinical and pharmacological considerations, several LABA/LAMA fixed-dose combinations have been developed and experimentally evaluated. Within such a context, the drug co-formulation containing indacaterol and glycopyrronium is probably the LABA/LAMA association which has been most extensively studied during the last few years.
Integrating COPD care in Italy
Authors: Calverley Peter M.A.
Published: January 2020

Doctors are not short of advice about how to manage their patients. In the case of COPD (Chronic Obstruct- ive Pulmonary Disease) there are a wealth of guidelines, strategies and position papers synthesising an increasing body of data from observational studies and clinical tri- als into schemes that should help the doctor care for their COPD patients more effectively. [...]
Ambulatory pulse oximetry monitoring in Japanese COPD outpatients not receiving oxygen therapy
Authors: Minami Seigo , Yamamoto Suguru , Ogata Yoshitaka , Nakatani Takeshi , Takeuchi Yoshiko , Hamaguchi Masanari , Koba Taro , Komuta Kiyoshi
Published: January 2020

Background: It remains unknown whether desaturation profiles during daily living are associated with prognosis in patients with chronic obstructive pulmonary disease (COPD). Point measurements of resting oxygen saturation by pulse oximetry (SpO2) and partial pressure of arterial oxygen (PaO2) are not sufficient for assessment of desaturation during activities of daily living. A small number of studies continuously monitored oxygen saturation throughout the day during activities of daily living in stable COPD patients. This study aims to analyse the frequency of desaturation in COPD outpatients, and investigate whether the desaturation profile predicts the risk of exacerbation.

Methods: We studied stable COPD outpatients not receiving supplemental oxygen therapy. Baseline assessments included clinical assessment, respiratory function testing, arterial blood gas analysis, body mass index, and the COPD Assessment Test (CAT). Patients underwent 24-hour ambulatory monitoring of SpO2 during activities of daily living. Exacerbations of COPD and death from any cause were recorded.

Results: Fifty-one patients were enrolled in the study, including 12 current smokers who were excluded from the analyses in case high serum carboxyhaemoglobin concentrations resulted in inaccurately high SpO2 readings. The mean percent predicted forced expiratory volume in one second (%FEV1) was 50.9%. The mean proportion of SpO2values below 90% was 3.0% during the day and 7.4% during the night. There were no daytime desaturators, defined as ≥ 30% of daytime SpO2 values below 90%. Twenty-one exacerbations occurred in 13 patients during the mean follow-up period of 26.4 months. Univariate and multivariate Cox proportional hazards analyses did not detect any significant factors associated with exacerbation.

Conclusions: Our 24-hour ambulatory oximetry monitoring provided precise data regarding the desaturation profiles of COPD outpatients. Both daytime and nighttime desaturations were infrequent. The proportion of ambulatory SpO2 values below 90% was not a significant predictor of exacerbation.
Effect of β2 -adrenergic receptor gene Arg16Gly polymorphisms on response to long-acting β2-agonist in Chinese Han asthmatic patients
Authors: Qiu Yuying , Zhang Deping , Qin Yu , Yin Kai-Sheng
Published: January 2020

Background: To evaluate the effect of variation of the Arg16Gly polymorphism of the β2-adrenergic receptor gene on clinical response to salmeterol administered with fluticasone propionate in Chinese Han asthmatic patients.

Methods: Moderate persistent asthmatic patients (n = 62) currently receiving short-acting β2-agonists were administered twice-daily therapy with salmeterol/fluticasone propionate 50/250 μg in a single inhaler for 12 weeks, followed by a 2-to-4-day run-out period. Using direct DNA sequencing, five single nucleotide polymorphisms (SNPs) in the promoter and coding block regions of β2-adrenergic receptor gene were determined in 62 subjects and haplotypes were combined.

Results: There was sustained and significant improvement (p < 0.001) over baseline in all measures of asthma control in subjects receiving salmeterol and fluticasone, regardless of Arg16Gly genotype. However, there was no significant difference in the improvement among three genotypes (p > 0.05). Responses to salmeterol did not appear to be modified by haplotype pairs (p > 0.05). During the run-out period, all subjects had similar decreases in measures of asthma control, with no differences between genotypes (p > 0.05).

Conclusions: Response to salmeterol does not vary with Arg16Gly polymorphisms after chronic dosing with inhaled corticosteroids in Chinese Han asthmatic patients.
Lung, not only heart
Authors: Cogo Annalisa
Published: January 2020

It is well known that physical exercise requires the coor- dinated function of the heart, lungs and peripheral and pulmonary circulation to support the increased demands of contracting muscles. This evidence is well represented by the so-called Wasserman’s gears [...]
Ventilatory response to exercise of elite soccer players
Authors: Di Paco Adriano , Catapano Giosuè A. , Vagheggini Guido , Mazzoleni Stefano , Levi Micheli Matteo , Ambrosino Nicolino
Published: January 2020

Background: The purpose of this study was to evaluate the role of ventilatory parameters in maximal exercise performance in elite soccer players.

Methods: From September 2009 to December 2012, 90 elite soccer players underwent evaluation of lung function test and ergospirometry by means of an incremental symptom-limited treadmill test. Results were analyzed according to i) maximal exercise velocity performed (Hi-M: high-performers, >18.65 km/h; Lo-M: low-performers, <18.65 km/h) and ii) usual role in the team.

Results: Hi-M showed higher peak minute ventilation (V_ Epeak: 158.3 ± 19.5 vs 148.0 ± 18.54 L/min, p = 0.0203), and forced expiratory volume at first second (5.28 ± 0.50 vs 4.89 ± 0.52 liters, p < 0.001) than Lo-M, independently of playing role. Moreover, a significant correlation between peak oxygen uptake and V_ E (r = 0.57, p < 0.001) was found.

Conclusions: Ventilatory response plays a role in the assessment of exercise capacity in elite soccer players.