Low-dose CT measurements of airway dimensions and emphysema associated with airflow limitation in heavy smokers: a cross sectional study

Background

Increased airway wall thickness (AWT) and parenchymal lung destruction both contribute to airflow limitation. Advances in computed tomography (CT) post-processing imaging allow to quantify these features. The aim of this Dutch population study is to assess the relationships between AWT, lung function, emphysema and respiratory symptoms.

Methods

AWT and emphysema were assessed by low-dose CT in 500 male heavy smokers, randomly selected from a lung cancer screening population. AWT was measured in each lung lobe in cross-sectionally reformatted images with an automated imaging program at locations with an internal diameter of 3.5 mm, and validated in smaller cohorts of patients. The 15^th percentile method (Perc15) was used to assess the severity of emphysema. Information about respiratory symptoms and smoking behavior was collected by questionnaires and lung function by spirometry.

Results

Median AWT in airways with an internal diameter of 3.5 mm (AWT_3.5) was 0.57 (0.44 - 0.74) mm. Median AWT in subjects without symptoms was 0.52 (0.41-0.66) and in those with dyspnea and/or wheezing 0.65 (0.52-0.81) mm (p<0.001). In the multivariate analysis only AWT_3.5 and emphysema independently explained 31.1%and 9.5%of the variance in FEV₁%predicted, respectively, after adjustment for smoking behavior.

Conclusions

Post processing standardization of airway wall measurements provides a reliable and useful method to assess airway wall thickness. Increased airway wall thickness contributes more to airflow limitation than emphysema in a smoking male population even after adjustment for smoking behavior.     

COPD symptoms in the morning: impact,evaluation and management

Chronic obstructive pulmonary disease (COPD) symptoms in the morning, including dyspnea and sputum production, affect patients’ quality of life and limit their ability to carry out even simple morning activities. It is now emerging that these symptoms are associated with increased risk of exacerbations and work absenteeism, suggesting that they have a more profound impact on patients than previously thought. The development of validated patient-reported outcome (PRO) questionnaires to capture patients’ experience of COPD symptoms in the morning is, therefore, vital for establishing effective and comprehensive management strategies. Although it is well established that long-acting bronchodilators are effective in improving COPD symptoms, the limited available data on their impact on morning symptoms and activities have been obtained with non-validated PRO questionnaires. In this review, we discuss the impact of COPD symptoms in the morning and available tools used to evaluate them, and highlight specific gaps that need to be addressed to develop standardized instruments able to meet regulatory requirement. We also present available evidence on the effect of pharmacological therapies on morning symptoms.     

遂宁地区良性前列腺增生术后LUTS相关危险因素分析

目的:调查与分析遂宁地区良性前列腺增生术后下尿路症状(Lower Urinary Tract Symptoms,LUTS)发生的相关危险因素。方法:2014年9月到2019年10月选择在遂宁市中心医院诊治的遂宁地区良性前列腺增生症患者172例,所有患者都给予手术治疗,记录术后LUTS发生情况,调查患者的临床资料并进行影响因素分析。结果:在172例患者中,术后平均国际前列腺症状评分量表(International prostate symptom scores,IPSS)评分为5.67±0.13分,其中储尿期症状评分3.01±0.11分,排尿期症状评分为1.76±0.22分,排尿后症状评分0.89±0.14分,发生LUTS 18例(LUTS组),发生率为10.5%。LUTS组的生活质量评分高于非LUTS组(P<0.05);LUTS组的年龄、体重指数、低密度脂蛋白、总胆固醇、前列腺体积与非LUTS组对比差异有统计学意义(P<0.05);Pearson分析显示年龄、体重指数、低密度脂蛋白、总胆固醇、前列腺体积都与LUTS存在相关性(P<0.05);二元Logistic回归分析显示年龄、体重指数、低密度脂蛋白、总胆固醇、前列腺体积都为导致LUTS发生的主要因素(P<0.05)。结论:遂宁地区良性前列腺增生术后LUTS的发生比较常见,可严重影响患者的生活质量,年龄、体重指数、低密度脂蛋白、总胆固醇、前列腺体积都为导致LUTS发生的主要因素。     

伴与不伴边缘性人格障碍的首发中青年抑郁症患者认知功能、临床症状的差异及其相关性分析

目的:比较伴与不伴有边缘性人格障碍(BPD)的首发中青年抑郁症患者认知功能及临床症状的差异,并分析相关性。方法:选取自2017年3月至2020年1月于我院就诊的首发中青年抑郁症患者167例,按照纳入标椎及排除标椎,剔除21例不符合者,最终入组146例。将伴有BPD的抑郁症患者归为研究组(72例),不伴有BPD的抑郁症患者归为对照组(74例)。采用韦氏记忆量表(WMS-RC)、韦氏智能量表(WAIS-RC)、威斯康星卡片分类测验(WCST)对两组患者进行认知功能的对照性评估,采用症状自评量表(SCL-90)评估患者临床症状,Pearson相关性分析患者认知功能与临床症状的关系。结果:研究组的人际关系敏感因子评分较对照组升高(P<0.05)。研究组即刻记忆、语言智商数、操作智商数评分均低于对照组,而持续错误数多于对照组(P<0.05)。经Pearson相关性分析可得:伴有BPD的首发中青年抑郁症患者人际关系敏感因子评分与即刻记忆、语言智商数、操作智商数均呈负相关关系(P<0.05),而与持续错误数呈正相关关系(P<0.05)。结论:伴有BPD的首发中青年抑郁症患者较不伴有BPD的抑郁症患者认知功能受损更为严重,人际关系敏感性更高,且患者的认知功能与临床症状存在一定的关联。     

Reduced noradrenaline,but not dopamine and serotonin in motor thalamus of the MPTP primate: relation to severity of Parkinsonism

We recently found severe noradrenaline deficits throughout the thalamus of patients with Parkinson's disease [C. Pifl, S. J. Kish and O. Hornykiewicz Mov Disord. 27, 2012, 1618.]. As this noradrenaline loss was especially severe in nuclei of the motor thalamus normally transmitting basal ganglia motor output to the cortex, we hypothesized that this noradrenaline loss aggravates the motor disorder of Parkinson's disease. Here, we analysed noradrenaline, dopamine and serotonin in motor (ventrolateral and ventroanterior) and non‐motor (mediodorsal, centromedian, ventroposterior lateral and reticular) thalamic nuclei in MPTP‐treated monkeys who were always asymptomatic; who recovered from mild parkinsonism; and monkeys with stable, either moderate or severe parkinsonism. We found that only the symptomatic parkinsonian animals had significant noradrenaline losses specifically in the motor thalamus, with the ventroanterior motor nucleus being affected only in the severe parkinsonian animals. In contrast, the striatal dopamine loss was identical in both the mild and severe symptom groups. MPTP‐treatment had no significant effect on noradrenaline in non‐motor thalamic nuclei or dopamine and serotonin in any thalamic subregion. We conclude that in the MPTP primate model, loss of noradrenaline in the motor thalamus may also contribute to the clinical expression of the parkinsonian motor disorder, corroborating experimentally our hypothesis on the role of thalamic noradrenaline deficit in Parkinson's disease.     

Diagnosis and management of Sclerotinia stem rot (white mould) of lentils in Greece

The paper describes the field-level symptoms, the identification and management of Sclerotinia stem rot of lentil caused by the soilborne plant pathogen Sclerotinia sclerotiorum in Greece. Regarding symptoms at a field level, initially plants before flowering turn yellow with roots and the base of the plants become brown; then rotten plants exhibit a dry stem and die. On the diseased tissue, at the base of the stem, the typical white mycelium and the resting bodies (sclerotia) were observed. According to our pathogenicity studies in vitro, on the infected plant tissues the fungus first develop a characteristic fluffy white mycelium which will give rise to large black sclerotia, the most obvious evidence of plants infected with S. sclerotiorum. Finally, concerning evaluation of fungicides, isolates of S. sclerotiorum were sensitive to thiophanate-methyl and to triazole fungicides. Thiophanate-methyl and triazole fungicides proved to be most effective in controlling the disease emerged from mycelium or sclerotia.     

Heavy metal soil contamination delays the appearance of virus-induced symptoms on potato but favours virus accumulation

Abstract

Here we report on the investigation of virus infection development in plants undergoing simultaneous heavy metal stress. We carried out small-scale field experiments using model system Potato virus X (PVX) – Solanum tuberosum cv. Povin' (potato) plants. Heavy metals zinc (Zn), copper (Cu) and lead (Pb) were added to the soil separately (monometal contamination) at a range of concentrations. Our results show that heavy metal stress significantly delays the appearance and potentiates severity of virus-specific symptoms on infected potato plants. We also demonstrate that PVX content in plants may increase tremendously in response to this abiotic stressor. Finally, we provide links to the possible consequences in the context of virus epidemiology.     

Symptomatic expression of tristeza-infected citrus plants in Pakistan

Variable symptoms were recorded during a survey in the citrus trees infected or suspected to be infected with citrus tristeza virus based on ELISA tests. Sweet orange manifested main symptoms like bud union crease, pin holing, bark cracking, incompatibility, yellowing and dropping of leaves. Pin holing was particularly prevalent in Sweet orange (Citrus sinensis Osbeck), Kinnow (Citrus reticulata Blanco) and Grapefruit (Citrus paradisii Mcaf.), while incompatibility was only in Sweet orange and Grapefruit.     

Serological diagnosis and host range studies of important viral diseases of a few cucurbitaceous crops in Maharashtra,India

Around 39 well characterised viruses affect cucurbits crops in developing countries and their viral diversity may be the consequence for genetic and ecological diversity of their hosts. Indeed, cucurbits are grown in variety of climatic, environmental and agricultural conditions, and this may provide more or less favourable conditions for the specific viruses or their hosts. The presence of various viral diseases caused by different viruses in Maharashtra was studied from the infected samples collected from cucurbits and melons during the survey conducted in 2009–2010 in different locations. The virus isolates collected from various cucurbitaceous crops were established and their host ranges were studied by sap transmission. The study revealed Cucumber Mosaic Virus (CMV), Zucchini yellow mosaic virus (ZYMV), Watermelon mosaic virus (WMV) and Cucumber green mottle mosaic virus infections predominately found in Nashik region, and Watermelon bud necrosis virus (WBNV), CMV, ZYMV, WMV and Watermelon silver mottle virus (WSMoV) infections in Aurangabad and Paithan regions. In Sangamner region, the crop was mostly affected by WBNV, ZYMV and WSMoV, and CMV was found only in Sillod region. The protocols for performing sap transmission tests in assay hosts were standardised for ZYMV, CMV and WBNV. Using direct antigen-coating enzyme-linked immunosorbent assay, of all the plant parts, young leaves were found to have high concentration of virus and suitable for virus detection in screening programmes. CMV and ZYMV was found to have high concentration of virus and suitable for virus detection in screening programmes.     

The association between circadian rest-activity patterns and the behavioral and psychological symptoms depending on the cognitive status in Japanese nursing-home residents

ABSTRACT

Background: Limited information is available on the relationship between sleep disturbances during nighttime and the behavioral and psychological symptoms of dementia in older nursing-home residents. However, a few reports on the association between the circadian rest-activity rhythm and the behavioral and psychological symptoms of dementia in older residents have been published. The main objective of the present study was to examine the association among the circadian rest-activity rhythm, behavioral and psychological symptoms, and the cognitive function status among older individuals living in facilities. Method: The investigation was conducted from September 2017 to February 2018, and participants were recruited from five nursing homes in Akita prefecture, Japan, after obtaining patient agreement to participate in the study. To measure nonparametric circadian rest-activity parameters such as interdaily stability, intradaily variability, relative amplitude, mean of the least active 5-h period, and mean of the most active 10-h period, Actigraph devices were worn on the participants’ nondominant wrists continuously for seven days. The score or classification of the cognitive status and the severity of the behavioral and psychological symptoms of dementia (BPSD) were assessed using the clinical dementia rating (CDR) and the dementia behavior disturbance scale (DBD), respectively. The binomial logistic regression model was applied to clarify which kinds of circadian rest-activity parameters predicted the cognitive status in nursing home residents as well as the BPSD outcome. A multi-level model was also used to examine the association between the nonparametric rest-activity parameters and the BPSD outcome explained by the cognitive status among older individuals in facilities. Results: Seventy-seven participants (49 residents with dementia, and 28 residents without dementia) were included in this study. According to the binomial logistic regression analysis after adjusting for covariates, the classification of the cognitive status for older residents was associated with the DBD score (odds ratio, 1.22; 95% confidence interval [CI], 1.08, 1.38; p < 0.001), the IS (odds ratio, 0.01; 95% CI, 0.00, 1.00; p = 0.05) and the L5 (odds ratio, 0.99; 95% CI, 0.99, 1.00; p = 0.05). The results of a multi-level model also indicated that the IV at individual-level was significantly associated with the DBD score for nursing home residents, with the CDR score at cluster-level as an explanatory variable. As well, a significant association between the RA at individual level and the DBD score was observed in a multi-level model explained by the CDR score at cluster-level. Conclusion: Of these models, the multi-level model provided grounds for our proposal that the fragmentation or the amplitude of rest-activity parameters might be associated with the outcome of BPSD, considering the cognitive status of older individuals in different facilities. The findings offer practical insight into the prevention of BPSD and the improvement of rest-activity rhythms in rehabilitative care in nursing homes.