IMPORTANCE: Airway mucus plugs are common in patients with chronic obstructive pulmonary disease (COPD); however, the association of airway mucus plugging and mortality in patients with COPD is ...unknown. OBJECTIVE: To determine whether airway mucus plugs identified on chest computed tomography (CT) were associated with increased all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS: Observational retrospective analysis of prospectively collected data of patients with a diagnosis of COPD in the Genetic Epidemiology of COPD cohort. Participants were non-Hispanic Black or White individuals, aged 45 to 80 years, who smoked at least 10 pack-years. Participants were enrolled at 21 centers across the US between November 2007 and April 2011 and were followed up through August 31, 2022. EXPOSURES: Mucus plugs that completely occluded airways on chest CT scans, identified in medium- to large-sized airways (ie, approximately 2- to 10-mm lumen diameter) and categorized as affecting 0, 1 to 2, or 3 or more lung segments. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality, assessed with proportional hazard regression analysis. Models were adjusted for age, sex, race and ethnicity, body mass index, pack-years smoked, current smoking status, forced expiratory volume in the first second of expiration, and CT measures of emphysema and airway disease. RESULTS: Among the 4483 participants with COPD, 4363 were included in the primary analysis (median age, 63 years IQR, 57-70 years; 44% were women). A total of 2585 (59.3%), 953 (21.8%), and 825 (18.9%) participants had mucus plugs in 0, 1 to 2, and 3 or more lung segments, respectively. During a median 9.5-year follow-up, 1769 participants (40.6%) died. The mortality rates were 34.0% (95% CI, 32.2%-35.8%), 46.7% (95% CI, 43.5%-49.9%), and 54.1% (95% CI, 50.7%-57.4%) in participants who had mucus plugs in 0, 1 to 2, and 3 or more lung segments, respectively. The presence of mucus plugs in 1 to 2 vs 0 and 3 or more vs 0 lung segments was associated with an adjusted hazard ratio of death of 1.15 (95% CI, 1.02-1.29) and 1.24 (95% CI, 1.10-1.41), respectively. CONCLUSIONS AND RELEVANCE: In participants with COPD, the presence of mucus plugs that obstructed medium- to large-sized airways was associated with higher all-cause mortality compared with patients without mucus plugging on chest CT scans.
This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for ...cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH).
Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD).
REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death.
We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0 years), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 95% CI: 0.853-0.869). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 95% CI: 0.871-0.894 for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 95% CI: 0.779-0.818 for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%.
CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
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Plant-animal interactions are key to sustaining whole communities and ecosystem function. However, their complexity may limit our understanding of the underlying mechanisms and the species involved. ...The ecological effects of epizoochory remain little known compared to other seed dispersal mechanisms given the few vectors identified. In addition, epizoochory is mostly considered non-mutualistic since dispersers do not obtain nutritional rewards. Here, we show a widespread but unknown mutualistic interaction between parrots and plants through epizoochory. Combining our observations with photos from web-sources, we recorded nearly 2000 epizoochory events in 48 countries across five continents, involving 116 parrot species and nearly 100 plant species from 35 families, including both native and non-native species. The viscid pulp of fleshy fruits and anemochorous structures facilitate the adherence of tiny seeds (mean 3.7 × 2.56 mm) on the surface of parrots while feeding, allowing the dispersion of these seeds over long distances (mean = 118.5 m). This parrot-plant mutualism could be important in ecosystem functioning across a wide diversity of environments, also facilitating the spread of exotic plants. Future studies should include parrots for a better understanding of plant dispersal processes and for developing effective conservation actions against habitat loss and biological invasions.
The immune response plays a critical role in the pathophysiology of SARS‐CoV‐2 infection ranging from protection to tissue damage and all occur in the development of acute respiratory distress ...syndrome (ARDS). ARDS patients display elevated levels of inflammatory cytokines and innate immune cells, and T and B cell lymphocytes have been implicated in this dysregulated immune response. Mast cells are abundant resident cells of the respiratory tract and are able to release different inflammatory mediators rapidly following stimulation. Recently, mast cells have been associated with tissue damage during viral infections, but their role in SARS‐CoV‐2 infection remains unclear. In this study, we examined the profile of mast cell activation markers in the serum of COVID‐19 patients. We noticed that SARS‐CoV‐2‐infected patients showed increased carboxypeptidase A3 (CPA3) and decreased serotonin levels in their serum when compared with symptomatic SARS‐CoV‐2‐negative patients. CPA3 levels correlated with C‐reactive protein, the number of circulating neutrophils, and quick SOFA. CPA3 in serum was a good biomarker for identifying severe COVID‐19 patients, whereas serotonin was a good predictor of SARS‐CoV‐2 infection. In summary, our results show that serum CPA3 and serotonin levels are relevant biomarkers during SARS‐CoV‐2 infection. This suggests that mast cells and basophils are relevant players in the inflammatory response in COVID‐19 and may represent targets for therapeutic intervention.
Graphical
Serum levels of CPA3 and serotonin are affected during SARS‐CoV‐2 infection and can be considered as biomarkers during COVID‐19.
Aims
The purpose of this paper was to perform a bibliometric analysis of the production of qualitative research in scientific journals through aggregation by levels and to identify factors of ...diversity, such as types of designs, in qualitative research on the experience of having an intestinal stoma between 2002 and 2018.
Design
Descriptive bibliometric study focused on the production of qualitative research on the subject of study, on three levels: micro, meso and macro.
Methods
Databases such as PubMed, CINAHL, Web of Knowledge, Scopus, SciELO, CUIDEN, Lilacs and Google Scholar were used to collect the data, between August ‐ November 2018.
Results
Nursing was the main area of knowledge. Brazil was the predominant country of origin. The most productive journal was the Journal of Wound, Ostomy & Continence Nursing. English and Portuguese were the main languages of scientific communication. The number of authors was typically between 2 and 6. Authors conducted descriptive and phenomenological studies.
Conclusion
The present bibliometric study helps us to map the qualitative research on the experiences of individuals with an intestinal stoma and to understand patterns in the designs, methods, disciplines and journals involved in this area of research. This will allow nurses to have a leading contribution to stoma care at their disposal.
目的本文旨在通过分级汇总对科学期刊定性研究成果进行文献计量分析,从而确定2002年到2018年期间发表的有关肠造口术后患者的定性研究中设计类型等多样性因素。设计描述性文献计量研究侧重于在微观、中观和宏观三个层面上对研究对象展开定性研究。方法通过PubMed、CINAHL、Web of Knowledge、Scopus、SciELO、CUIDEN、Lilacs和谷歌学术搜索等数据库对2018年8月至11月间发表的文献数据进行检索。结果护理是一大主要知识领域。巴西是主要来源国。最有成效的期刊为《创面、造口及自制护理杂志》。英语和葡萄牙语是科学交流的两大主要用语。作者人数通常在2到6人之间。作者还开展了描述性和现象学研究。结论当前的文献计量研究有助于我们对肠造口术后患者展开定性研究,了解这一研究领域所涉及的设计、方法、学科和期刊模式。这将使护士在造口护理方面发挥主导作用。
Cetacean morbillivirus in Humpback whales’ exhaled breath Groch, Kátia R.; Blazquez, Diana N. H.; Marcondes, Milton C. C. ...
Transboundary and emerging diseases,
July 2021, 2021-07-00, 20210701, Letnik:
68, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The humpback whale (HW; Megaptera novaeangliae) population that seasonally resides along the Brazilian coast concentrates in the Abrolhos Bank (Bahia and Espírito Santo states) for breeding during ...austral winter and spring. Cetacean morbillivirus (CeMV, Paramyxoviridae family) is currently one of the most significant biological threats to cetaceans worldwide with high infection and mortality rates. CeMV is pleiotropic yet it has special tropism for the respiratory, lymphoid and nervous system and is primarily transmitted by the aerogenous route. A new lineage of CeMV, the Guiana dolphin morbillivirus (GDMV), is known to affect cetaceans off Brazil. GDMV was first detected in a Guiana dolphin (Sotalia guianensis) stranded in the Abrolhos Bank region, in 2010. In addition to pathologic examinations on stranded HW, pathogen survey of free‐ranging HW may provide valuable insight into the epidemiology of diseases. We hypothesized that HW in the Brazilian breeding ground could be exposed to CeMV. Thus, in the present study, we investigated the presence of CeMV in exhaled breath condensates (EBC) of HW in the Abrolhos Bank. Overall, 73 samples of EBC from 48 groups of HW were collected during the breeding seasons of 2011 (n = 16) and 2012 (n = 57). One sample failed to have the reference gene amplified and was excluded from the study. CeMV was detected by a RT‐qPCR method in 2 EBC samples, representing 2 whale groups. Phylogenetic analysis of partial morbillivirus phosphoprotein gene showed 100% homology to GDMV. Our results show that HW in Brazil are infected by CeMV with a relative prevalence of 4.3% (2/47) and demonstrate the suitability of using EBC and RT‐qPCR as a non‐invasive tool for CeMV survey in free‐ranging whales. This pioneer study provides scientific basis for non‐invasive CeMV monitoring of HW, suggests HW may play a role in the dynamics of CeMV and raises concern for potential conservation implications for this species.
Zoonoses constitute a major risk to human health. Comprehensive assessments on the potential emergence of novel disease outbreaks are essential to ensure the effectiveness of sanitary controls and to ...establish mitigating actions.
Through a continental‐scale survey of rural human settlements conducted over 13 years in 15 Neotropical countries, we document the vast extent of poaching to meet the local demand for pets, resulting in thousands of families living with ca. 275 species of wild animals without any sanitary controls. Parrots account for ca. 80% of wild pets, dying mostly from diseases at an average age of 1 year.
This culturally rooted tradition, which dates back to pre‐Columbian times, may lead to health risks by bringing wild animals prone to carrying parasites and pathogens into close contact with humans and their exotic pets and livestock.
Although animal pathogens and parasites have been transmitted to humans for centuries, the current trend of human population growth and connectivity can increase the risk of zoonotic outbreaks spreading at an unprecedented pace. Similarly, disease transmission from humans and poultry to wild animals is also expected to be facilitated via wild pets, leading to conservation problems.
Several studies have highlighted the risk posed by wildlife city markets for cross‐species disease transmission, ignoring the risk associated with widespread pet ownership of wild animals poached locally in rural areas. Given its geographic and social dimensions, a holistic approach is required to reduce this illegal activity as well as to strengthen health surveillance of seized individuals and people in close contact with poached pets, which would benefit both people and wildlife.
Read the free Plain Language Summary for this article on the Journal blog.
Resumen
Las zoonosis constituyen un riesgo importante para la salud humana. Las evaluaciones exhaustivas sobre la posible aparición de nuevos brotes de enfermedades son esenciales para garantizar la eficacia de los controles sanitarios y establecer medidas paliativas.
Mediante un estudio a escala continental realizado en asentamientos rurales, llevado a cabo a lo largo de 13 años en 15 países neotropicales, documentamos el enorme alcance que tiene la captura ilegal para satisfacer la demanda local de mascotas, dando lugar a que miles de familias convivan con unas 275 especies de animales salvajes sin ningún tipo de control sanitario. Los loros representan aprox. 80% de las mascotas silvestres, muriendo la mayoría por enfermedades alrededor del primer año de vida.
Esta tradición, que se encuentra culturalmente muy arraigada y se remonta a la época precolombina, puede conllevar riesgos para la salud al poner en contacto estrecho animales salvajes propensos a portar parásitos y patógenos con seres humanos y sus mascotas exóticas y ganado.
Aunque los patógenos y parásitos animales llevan transmitiéndose a humanos durante siglos, la actual tendencia de crecimiento y conectividad de la población humana puede aumentar el riesgo de que los brotes zoonóticos se propaguen a un ritmo sin precedentes. Del mismo modo, también es de esperar que la transmisión de enfermedades de seres humanos y las aves de corral a animales salvajes se vea facilitada a través de animales de compañía de origen salvaje, lo que provocaría problemas de conservación.
Varios estudios han destacado el riesgo que suponen los mercados en los que se vende fauna salvaje como vía de transmisión de enfermedades entre especies, ignorando el riesgo asociado a la tenencia generalizada como mascotas de origen salvaje capturadas ilegalmente en zonas rurales. Dada la dimensión geográfica y social de este fenómeno, se requiere un enfoque holístico para reducir esta actividad ilegal, así como para reforzar la vigilancia sanitaria de los individuos incautados y de las personas en estrecho contacto con animales de compañía capturados furtivamente, beneficiando tanto a personas como a fauna silvestre.
Read the free Plain Language Summary for this article on the Journal blog.
The attempts to clarify the origin of eating disorders (ED) have not been completely successful and their etiopathogenesis remains unknown. Current research shows an activation of the immune response ...in neuropsychiatric diseases, including ED. We aimed to investigate immune response parameters in patients with ED and to identify psychological factors influencing the inflammatory response. The relationship between inflammation markers and impulsivity and affective symptomatology was explored as well. Thirty-four adult female patients with current diagnosis of ED, none of them under psychopharmacological treatment (excluding benzodiazepines), were included in this study. Patients were compared with a healthy control group of fifteen adult females. The levels of inflammatory markers and indicators of oxidative/nitrosative stress were evaluated in plasma and/or in peripheral blood mononuclear cells (PBMCs). Subjects were assessed by means of different ED evaluation tools. Additionally, the Barratt Impulsiveness Scale, the Montgomery-Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale were also employed. Patients with ED shown increased plasma levels of the pro-inflammatory nuclear factor
B (NFκB) and the cytokine tumor necrosis factor-
(TNF-α), among other factors and an increment in the oxidative/nitrosative stress as well as increased glucocorticoid receptor (GR) expression levels in their PBMCs. Moreover, the inflammatory prostaglandin E
(PGE
) correlated with impulsiveness and the anti-inflammatory prostaglandin J
(15d-PGJ
) correlated with depressive symptomatology. Our results point towards a relationship between the immune response and impulsiveness and between the immune response and depressive symptomatology in female adult patients with ED.
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