Diverging trends of chronic bronchitis and smoking habits between 1998 and 2010

Background

No study has been carried out on the time trend in the prevalence of chronic bronchitis (CB) in recent years, despite its clinical and epidemiological relevance. We evaluated the trend in CB prevalence during the past decade among young Italian adults.

Methods

A screening questionnaire was mailed to general population samples of 20–44 year-old subjects in two cross-sectional surveys: the Italian Study on Asthma in Young Adults (ISAYA) (1998/2000; n = 18,873, 9 centres) and the screening stage of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007/2010; n = 10,494, 7 centres). CB was defined as having cough and phlegm on most days for a minimum of 3 months a year and for at least 2 successive years. The prevalence rates and the risk ratios (RRs) for the association between CB and each potential predictor were adjusted for gender, age, season of response, type of contact, cumulative response rate, and centre.

Results

CB prevalence was 12.5% (95% CI: 12.1-12.9%) in 1998/2000 and 12.6% (95% CI: 11.7-13.7%) in 2007/2010; it increased among never smokers (from 7.6 to 9.1%, p = 0.003), current light smokers (<15 pack-years; from 15.1 to 18.6%, p < 0.001), and unemployed/retired subjects (from 14.3 to 19.1%, p = 0.001). In this decade, the prevalence of current smoking decreased (from 33.6 to 26.9%, p < 0.001), whereas the prevalence of unemployment/premature retirement (from 5.3 to 6.0%, p = 0.005), asthma (from 5.0 to 6.2%, p = 0.003), and allergic rhinitis (from 19.5 to 24.5%, p < 0.001) increased. In both 1998/2000 and 2007/2010, the likelihood of having CB was significantly higher for women, current smokers, asthmatic patients, and subjects with allergic rhinitis. During this period, the strength of the association between CB and current heavy smoking (≥15 pack-years) decreased (RR: from 4.82 to 3.57, p = 0.018), whereas it increased for unemployment/premature retirement (from 1.11 to 1.53, p = 0.019); no change was observed for gender, asthma, and allergic rhinitis.

Conclusions

Despite the significant reduction in current smoking, CB prevalence did not vary among young Italian adults. The temporal pattern of CB prevalence can only be partly explained by the increase of unemployment/premature retirement, asthma and allergic rhinitis, and suggests that other factors could have played a role.     

Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry

Background

Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients.

Methods

COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)).

Results

Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7).

Conclusions

COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.     

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Chronic kidney disease (CKD) is a global problem. Slowing CKD progression is a major health priority. Since CKD is characterized by complex derangements of homeostasis, integrative animal models are necessary to study development and progression of CKD. To study development of CKD and novel therapeutic interventions in CKD, we use the 5/6th nephrectomy ablation model, a well known experimental model of progressive renal disease, resembling several aspects of human CKD. The gross reduction in renal mass causes progressive glomerular and tubulo-interstitial injury, loss of remnant nephrons and development of systemic and glomerular hypertension. It is also associated with progressive intrarenal capillary loss, inflammation and glomerulosclerosis. Risk factors for CKD invariably impact on endothelial function. To mimic this, we combine removal of 5/6th of renal mass with nitric oxide (NO) depletion and a high salt diet. After arrival and acclimatization, animals receive a NO synthase inhibitor (NG-nitro-L-Arginine) (L-NNA) supplemented to drinking water (20 mg/L) for a period of 4 weeks, followed by right sided uninephrectomy. One week later, a subtotal nephrectomy (SNX) is performed on the left side. After SNX, animals are allowed to recover for two days followed by LNNA in drinking water (20 mg/L) for a further period of 4 weeks. A high salt diet (6%), supplemented in ground chow (see time line Figure 1), is continued throughout the experiment. Progression of renal failure is followed over time by measuring plasma urea, systolic blood pressure and proteinuria. By six weeks after SNX, renal failure has developed. Renal function is measured using ''gold standard'' inulin and para-amino hippuric acid (PAH) clearance technology. This model of CKD is characterized by a reduction in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), hypertension (systolic blood pressure>150 mmHg), proteinuria (> 50 mg/24 hr) and mild uremia (>10 mM). Histological features include tubulo-interstitial damage reflected by inflammation, tubular atrophy and fibrosis and focal glomerulosclerosis leading to massive reduction of healthy glomeruli within the remnant population (<10%). Follow-up until 12 weeks after SNX shows further progression of CKD.     

Identification of Annexin A1 interacting proteins in chronic myeloid leukemia KCL22 cells

In the present study, we used a functional proteomic approach to identify Annexin A1 (Anxa1) interacting proteins in the Philadelphia‐positive KCL22 cell line. We focused on Anxa1 because it is one of the major proteins upregulated in imatinib‐sensitive KCL22S cells versus imatinib‐resistant KCL22R. Our proteomic strategy revealed 21 interactors. Bioinformatic analysis showed that most of these proteins are involved in cell death processes. Among the proteins identified, we studied the interaction of Anxa1 with two phosphatases, Shp1 and Shp2, which were recently identified as biomarkers of imatinib sensitivity in patients affected by chronic myeloid leukemia. Our data open new perspectives in the search for annexin‐mediated signaling pathways and may shed light on mechanisms of resistance to imatinib that are unrelated to Bcr‐Abl activity. All mass spectrometry data have been deposited in the ProteomeXchange with identifier PXD000030.     

应用基因芯片筛选慢性乙型肝炎相关差异性基因

目的：应用基因芯片技术筛选不同病毒载量的慢乙肝病人及健康人差异性表达的基因。方法：选用含有48000位点的人类表达谱cDNA基因芯片,筛选4例慢乙肝病人与2例健康人外周血差异性表达的基因。结果：与健康人相比,慢乙肝患者有838个差异表达的基因,其中高表达的基因有150个,低表达的基因有688个。结论：用表达谱基因芯片可有效地研究高、低病毒载量的慢乙肝患者间,以及它们与健康人之间基因表达的差异,通过进一步分析有望筛选出与慢性乙型肝炎相关的新基因靶点。     

Stem cells: Insights into the secretome

Stem cells have been considered as possible therapeutic vehicles for different health related problems such as cardiovascular and neurodegenerative diseases and cancer. Secreted molecules are key mediators in cell–cell interactions and influence the cross talk with the surrounding tissues. There is strong evidence supporting that crucial cellular functions such as proliferation, differentiation, communication and migration are strictly regulated from the cell secretome. The investigation of stem cell secretome is accumulating continuously increasing interest given the potential use of these cells in regenerative medicine. The scope of the review is to report the main findings from the investigation of stem cell secretome by the use of contemporary proteomics methods and discuss the current status of research in the field. This article is part of a Special Issue entitled: An Updated Secretome.     

Development of the Attitudes Toward Vegetarians Scale

Abstract

Studies have explored the motivations behind the decision to become vegetarian, and have explored the well being of vegetarians. However, little research has focused on the social psychological and interpersonal aspects of vegetarianism. The focus of this study was to develop a scale designed to measure attitudes toward vegetarians (ATVS). This scale measures a one-factor construct with adequate internal consistency. The ATVS correlated significantly with the construct of authoritarianism, and, as expected, the ATVS did not correlate significantly with social desirability. In addition, attitudes toward vegetarians were found to be generally positive. The positive attitudes toward vegetarians may be the result of using a college student population that was overwhelmingly female.     

Assessment of the potential iridology for diagnosing kidney disease using wavelet analysis and neural networks

Alternative or complementary medicine emphasizes therapies that are claimed to improve quality of life, prevent disease, and address conditions that conventional medicine has limited success in curing. There are many techniques which are prevalent in many countries and these can cause harm if not scientifically evaluated. The objective of this paper is to validate the use of iridology to diagnose kidney abnormalities. Two subject groups were evaluated: one was 168 subjects free from kidney disease and the other was 172 subjects with chronic renal failure. The procedure to acquire, process and classify the iris images was designed in such a way that avoids any dependency on the iridologists by using wavelet analysis and Adaptive Neuro-Fuzzy Inference System. The results show a correct classification for both subjects with kidney problems and normal subjects of 82% and 93%, respectively. The proposed technique conducted on a systemic disease with ocular manifestations showed encouraging results. However, it is necessary to perform extensive studies with diseases that do not have ocular manifestations according to conventional medicine in order to validate iridology as a valid scientific technique.     

葶苈大枣泻肺汤加减对慢性心力衰竭患者尿液白蛋白/肌酐比值及炎症因子的影响

目的：探索葶苈大枣汤对慢性心力衰竭患者微量尿白蛋白及血浆炎症因子IL-6,C反应蛋白的影响。方法：70例诊断为慢性心力衰竭的患者（心功能Ⅱ~Ⅳ级）按心功能分级并随机分为中药＋心衰基础治疗组（治疗组）和心衰基础治疗对照组（对照组）,每组35例;在进行积极控制感染,改善心功能的基础上,对照组患者给予心衰的基础治疗（利尿剂＋β受体阻断剂＋ARB或ACEI）;治疗组在心衰基础治疗的基础上给予葶苈大枣汤加减进行治疗,每2周随访1次,观察周期为3月。治疗前后观察患者的心功能变化,尿微量白蛋白的变化,炎症因子IL-6,CRP的变化。结果：基线资料比较,两组患者无显著性差异;经3月的治疗后,治疗组患者心功能改善情况要好于对照组患者,P〈0.05;与对照组比较,葶苈大枣汤加减可显著降低慢性心力衰竭患者血浆IL-6,CRP水平,降低尿微量白蛋白水平,P均〈0.05,且与对照组比较,不良反应事件未见显著增加,P〉0.05。结论：对于慢性心力衰竭患者,在心衰基础治疗的基础上结合葶苈大枣汤加减治疗可显著提高对慢性心力衰竭患者的临床疗效,且安全性良好,值得临床推广。     

芪苈强心胶囊辅助治疗老年慢性心力衰竭的临床研究

目的：探讨芪苈强心胶囊辅助治疗老年慢性心力衰竭的临床疗效及其安全性。方法：选择我科2012年1月．6月收治的102例老年慢性心力衰竭患者为研究对象,并将其随机分为两组,对照组42例,给予西医常规治疗及地高辛0．125mg／d;观察组60例,在对照组基础上将地高辛用量改为O．0625mg／d,并予芪苈强心胶囊,每次4粒,每日3次12服,2个月为1个疗程,治疗3个疗程后观察和比较两组心功能的变化。结果：观察组和对照组的治疗总有效率分别为95．0．％和78．6％,观察组显著高于对照组,两组比较差异有统计学意义（P〈0．05）;观察组的平均住院时间明显短于对照组（P〈0．05）。治疗后,两组心输出量（cO）、每搏输出量（SV）、左室射血分数（LVEF）舒张晚期与舒张早期充盈速度比（～E）均较治疗前明显升高（P〈0．05）,而脑钠肽（BNP）水平较治疗前显著降低（P〈O．05）,且观察组CO、SV水平均明显高于对照组（P〈0．05）,BNP水平明显低于对照组（P〈0．05）。治疗过程中,对照组发生洋地黄中毒3例,观察组无不良事件发生。结论：芪苈强心胶囊辅助治疗老年慢性心力衰竭可有效改善其心功能,并减少地高辛用量和洋地黄中毒的发生,值得临床推广应用。