Interrelationship between serum and sputum inflammatory mediators in chronic obstructive pulmonary disease

Little is known about airway inflammatory markers in chronic obstructive pulmonary disease (COPD). The objective of the present study was to identify and try to correlate pulmonary and peripheral blood inflammatory markers in COPD. In a cross-sectional study on patients with stable COPD, induced sputum and blood samples were collected for the determination of C-reactive protein, eosinophilic cationic protein, serum amyloid A protein, a-1 antitrypsin (a-1AT), and neutrophil elastase. Twenty-two patients were divided into two groups according to post-bronchodilator forced expiratory volume in the first second (%FEV1): group 1 (N = 12, FEV1 <40%) and group 2 (N = 10, FEV1 ³40%). An increase in serum elastase, eosinophilic cationic protein and a-1AT was observed in serum markers in both groups. Cytology revealed the same total number of cells in groups 1 and 2. There was a significantly higher number of neutrophils in group 1 compared to group 2 (P < 0.05). No difference in eosinophils or macrophages was observed between groups. Serum elastase was positively correlated with serum a-1AT (group 1, r = 0.81, P < 0.002 and group 2, r = 0.83, P < 0.17) and negatively correlated with FEV1 (r = -0.85, P < 0.03 and -0.14, P < 0.85, respectively). The results indicate the presence of chronic and persistent pulmonary inflammation in stable patients with COPD. Induced sputum permitted the demonstration of the existence of a subpopulation of cells in which neutrophils predominated. The serum concentration of all inflammatory markers did not correlate with the pulmonary functional impairment

Effects of an aerobic physical training program on psychosocial characteristics, quality-of-life, symptoms and exhaled nitric oxide in individuals with moderate or severe persistent asthma

OBJETIVO: Avaliar o papel de um programa de condicionamento físico aeróbio nos aspectos psicossociais, qualidade de vida, sintomas e óxido nítrico exalado (NOe) de adultos com asma persistente moderada ou grave. MATERIAIS E MÉTODOS: Vinte pacientes foram divididos aleatoriamente em Grupo Controle (GC, n= 10; programa de educação e exercícios respiratórios) e Grupo Treinado (GT, n= 10; programa de educação e exercícios respiratórios mais condicionamento aeróbio, 70% potência máxima obtida). A intervenção aconteceu duas vezes por semana durante três meses. Antes e após, foram avaliados a capacidade aeróbia máxima, a função pulmonar, a dispnéia ao esforço, os níveis de ansiedade e depressão e a qualidade de vida. Mensalmente, eram avaliados o NOe em repouso e o número de dias livres de sintomas. RESULTADOS: Apenas o GT apresentou redução dos sintomas (GT 24,8 [IC95%= 23-27] versus GC 15,7 [IC95%= 9-21] dias livres de sintomas, p< 0,05), dos níveis de NOe (GT 25,8 [IC95%= 15,3-44] versus GC 44,3 [IC95%= 24-60] ppb, p< 0,05), da ansiedade (GT 39,3 [IC95%= 37-50] versus GC 40,9 [IC95%= 37-50] escore, p< 0,001) e da depressão (GT 6,6 [IC95%= 1-21] versus GC 9 [IC95%= 1-20] escore, p< 0,001), melhora da qualidade de vida (GT 42,8 [IC95%= 34,3-71,7] versus GC 69,7 [IC95%= 45,1-87,9] %, p< 0,001), e incremento da aptidão aeróbia (GT 25,7 [IC95%= 16,2-31,3] versus GC 20,5 [IC95%= 17,3-24,1] mL/kg/min, p< 0,001). CONCLUSÕES: Os resultados sugerem que o treinamento físico reduz o NOe, os sintomas e melhora a qualidade de vida e os aspectos psicossociais de adultos com asma persistente moderada ou grave.OBJECTIVE: To evaluate the role of an aerobic physical training program on psychosocial characteristics, quality of life, symptoms and exhaled nitric oxide of adults with moderate or severe persistent asthma. METHODS: Twenty patients were randomly assigned to a Control Group (CG, n= 10, education program and respiratory exercises) and a Trained Group (TG, n= 10, education program and respiratory exercises plus aerobic training at 70% of the maximum power obtained). The intervention took place twice a week for three months. Maximum aerobic capacity, pulmonary function, effort dyspnea, anxiety levels, depression levels and quality of life were assessed before and after the treatment. Exhaled nitric oxide at rest and the number of days without asthma symptoms were evaluated every month. RESULTS: The TG presented increased numbers of symptom-free days (TG 24.8 days [95%CI= 23-27] versus CG 15.7 days [95%CI= 9-21]; p< 0.05), decreased exhaled nitric oxide levels (TG 25.8 ppb [95%CI= 15.3-44.0] versus CG 44.3 ppb [95%CI= 24-60]; p< 0.05), decreased anxiety scores (TG 39.3 [95%CI= 37-50] versus CG 40.9 [95%CI= 37-50]; p< 0.001), decreased depression scores (TG 6.6 [95%CI= 1-21] versus CG 9 [95%CI= 1-20]; p< 0.001), improved quality of life (TG 42.8% [95%CI= 34.3-71.7] versus CG 69.6% [95%CI= 45.1-87.9]; p< 0.001) and improved aerobic aptitude (TG 25.7 mL/kg/min [95%CI= 6.2-31.3] versus CG 20.5 mL/kg/min [95%CI= 17.3-24.1]; p< 0.001). CONCLUSIONS: Our results suggest that physical training reduces exhaled nitric oxide and symptoms and improves the quality of life and psychosocial characteristics of adults with moderate or severe persistent asthma.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Pesquisa (CNPq

Quantum Stephani Universe in vicinity of the symmetry center

We study a class of spherically symmetric Stephani cosmological models in the presence of a self-interacting scalar field in both classical and quantum domains. We discuss the construction of `canonical' wave packets resulting from the solutions of a class of Wheeler-DeWitt equations in the Stephani Universe. We suggest appropriate initial conditions which result in wave packets containing some desirable properties, most importantly good classical and quantum correspondence. We also study the situation from de-Broglie Bohm interpretation of quantum mechanics to recover the notion of time and compare the classical and Bohmian results. We exhibit that the usage of the canonical prescription and appropriate choices of expansion coefficients result in the suppression of the quantum potential and coincidence between classical and Bohmian results. We show that, in some cases, contrary to Friedmann-Robertson-Walker case, the bound state solutions also exist for all positive values of the cosmological constant.Comment: 22 pages, 19 figures, to appear in JCA

An Einstein-Hilbert Action for Axi-Dilaton Gravity in 4-Dimensions

We examine the axi-dilatonic sector of low energy string theory and demonstrate how the gravitational interactions involving the axion and dilaton fields may be derived from a geometrical action principle involving the curvature scalar associated with a non-Riemannian connection. In this geometry the antisymmetric tensor 3-form field determines the torsion of the connection on the frame bundle while the gradient of the metric is determined by the dilaton field. By expressing the theory in terms of the Levi-Civita connection associated with the metric in the ``Einstein frame'' we confirm that the field equations derived from the non-Riemannian Einstein-Hilbert action coincide with the axi-dilaton sector of the low energy effective action derived from string theory.Comment: 6 pages Plain Tex (No Figures), Letter to Editor Classical and Quantum Gravit

Quantum Stephani exact cosmological solutions and the selection of time variable

We study perfect fluid Stephani quantum cosmological model. In the present work the Schutz's variational formalism which recovers the notion of time is applied. This gives rise to Wheeler-DeWitt equation for the scale factor. We use the eigenfunctions in order to construct wave packets for each case. We study the time-dependent behavior of the expectation value of the scale factor, using many-worlds and deBroglie-Bohm interpretations of quantum mechanics.Comment: 19 pages, 7 figure

An analysis of cosmological perturbations in hydrodynamical and field representations

Density fluctuations of fluids with negative pressure exhibit decreasing time behaviour in the long wavelength limit, but are strongly unstable in the small wavelength limit when a hydrodynamical approach is used. On the other hand, the corresponding gravitational waves are well behaved. We verify that the instabilities present in density fluctuations are due essentially to the hydrodynamical representation; if we turn to a field representation that lead to the same background behaviour, the instabilities are no more present. In the long wavelength limit, both approachs give the same results. We show also that this inequivalence between background and perturbative level is a feature of negative pressure fluid. When the fluid has positive pressure, the hydrodynamical representation leads to the same behaviour as the field representation both at the background and perturbative levels.Comment: Latex file, 18 page

Moving beyond narrow definitions of gene drive: Diverse perspectives and frames enable substantive dialogue among science and humanities teachers in the United States and United Kingdom

This is the final version. Available on open access from SAGE Publications via the DOI in this recordGene drive is an emerging biotechnology with applications in global health, conservation and agriculture. Scientists are preparing for field trials, triggering debate about when and how to release gene-drive organisms. These decisions depend on public understandings of gene drive, which are shaped by language. While some studies on gene drive communication assume the need to persuade publics of expert definitions of gene drive, we highlight the importance of meaning-making in communication and engagement. We conducted focus groups with humanities and science teachers in the United Kingdom and United States to explore how different media framings stimulated discussions of gene drive. We found diversity in the value of these framings for public debate. Interestingly, the definition favoured by gene drive scientists was the least popular among participants. Rather than carefully curating language, we need opportunities for publics to make sense and negotiate the meanings of a technology on their own terms.Wellcome Trus

Black Holes with Weyl Charge and Non-Riemannian Waves

A simple modification to Einstein's theory of gravity in terms of a non-Riemannian connection is examined. A new tensor-variational approach yields field equations that possess a covariance similar to the gauge covariance of electromagnetism. These equations are shown to possess solutions analogous to those found in the Einstein-Maxwell system. In particular one finds gravi-electric and gravi-magnetic charges contributing to a spherically symmetric static Reissner-Nordstr\"om metric. Such Weyl ``charges'' provide a source for the non-Riemannian torsion and metric gradient fields instead of the electromagnetic field. The theory suggests that matter may be endowed with gravitational charges that couple to gravity in a manner analogous to electromagnetic couplings in an electromagnetic field. The nature of gravitational coupling to spinor matter in this theory is also investigated and a solution exhibiting a plane-symmetric gravitational metric wave coupled via non-Riemannian waves to a propagating spinor field is presented.Comment: 18 pages Plain Tex (No Figures), Classical and Quantum Gravit

Home parenteral nutrition a life-saving therapy in a primary intestinal lymphangiectasia patient affecting the entire GI tract - 3 year follow-up case report

Introduction and Importance: Primary intestinal lymphangiectasia (PIL) is a rare protein-losing gastroenteropathy of unknown etiology, characterized by impaired lymphatic vessels drainage. The pathological changes in PIL result in usually localized or diffuse dilatation of intestinal lacteals, leading to leakage of lymphatic fluid rich of proteins, lymphocytes, and immunoglobulins into the intestinal lumen. PIL may be asymptomatic or mildly symptomatic in moderate forms of the disease. In some patients, though, the outcome may be poor or even life-threatening. This case report demonstrates the severity of protein malnutrition, in some cases, and the extent of GI tract affected, requiring to start PN early and the need for its continuation as home parenteral nutrition (HPN). Case presentation: We present a case of 39-year-old male with Factor V Leiden deficiency, who presented initially with symptoms of malnutrition and anasarca. The diagnosis was confirmed by histopathological findings pathognomonic for PIL from biopsies of the stomach, small intestine and colon. Clinical discussion: The patient was started on low fat, high protein parenteral nutrition from the beginning of the treatment and required a long-term HPN for 3 years, because trials of tapering off and discontinuation of PN led to worsening of the biochemical results and recurrence of symptoms. Patient gradually improved and stabilized with persistent nutritional support. Conclusions: The presented case report shows the magnitude of nutritional support (HPN) needed for severe PIL patients. HPN offers PIL patients with poor outcome and life-threatening complications a chance to improve and lead a normal life