Differences in symptoms and cardiopulmonary responses to Treadmill versus Cycle cardiopulmonary exercise testing and comparison with the 6MWT in ILD

Aims: Cardiopulmonary exercise testing (CPET) is used for diagnostic and prognostic reasons in Interstitial Lung Disease (ILD). Our aims were to compare symptoms and cardiopulmonary responses between a) cycle and treadmill walking and b) between CPET and the 6MWT. Methods: 18 ILD patients (6 IPF; 12M), mean (SD) age 65.4 (12.6), FVC% pred. 72.7 (20.7), DLCO% pred. 42.2 (13.4) underwent CPET by cycle ergometry (C-CPET) and treadmill walking (T-CPET) in random order, with 30-45 min rest between tests, on a single session. On a second session 3-7 days apart, patients performed the 6MWT. Oxygen saturation (SpO2), heart rate (HR), breathlessness (BORG score) and leg fatigue/exertion (RPE scale) were recorded at rest, peak and at each minute of the 3-min recovery. We used the sign rank test with the null hypothesis of no difference between responses to the 3 tests of multiple CPET and symptom parameters. Results: Data were consistent with no differences between C-CPET and T-CPET in cardiopulmonary parameters (PeakVO2 p value=0.4, AT_VO2 p= 0.5, Peak VE/VCO2 p= 0.5, Peak VE/VO2 = 0.8). Desaturation (∆SpO2) was similar between T- CPET and C-CPET (p= 0.4) or 6MWT (0.7) but differed between C-CPET and 6MWT (p=0.03). The 3-minute SpO2 recovery was slower in T-CPET than the other tests. Change in HR (∆HR) and 3-min recovery was similar between CPET modes (p=0.1) but statistically lower in the 6MWT (p= 0.001). Breathlessness was greater in T-CPET than C-CPET (∆BORG p= 0.04) and recovery slower than the other two tests. Patients with CTD-ILD reported a preference for T-CPET. Summary/Conclusions: Cardiopulmonary parameters can be derived accurately from both types of CPET. The drop in oxygen saturation at the 6MWT was similar to that of the maximal T-CPET so, it can be used in ILD patients to estimate level of desaturation, even though the 6MWT underestimates the delay in SpO2 recovery. Funding source: This abstract presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-1112-29067). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health, UK

Isolation and purification of a squamous cell carcinoma of the head and neck-associated antigen identified by autologous antibody

We have previously shown that detection of autologous antibody activity to squamous cell carninoma of the head and neck many be augmented by dissociation in immune complexes. Western blot analysis with autologous antibody has identified a 60 kDa squamous cell carcinoma of the head and neck-associated antigen in spent media and immune complex-dissociated serum ultrafiltrate not recognized by normal human area. Antigen-containing fractions of spent media were eluted from anion exchange columns immediately after serum albumin indicating that the antigen has an acidic PI Triticum vulgaris column. A single 60 kDa band was detected by silver stain and Western blot in antigen-containing fractions eluted following lectin affinity chromotography and SDS-PAGE. Final concentration of the antigen was determined to be 1 [mu]m/ml of protein with relative activity increased 1600 x over unfractionated spent media. We conclude that a squamous cell carcinoma of the head and neck-associated antigen, detected by autologous antibody, is an acidic kDa glycoprotein.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30831/1/0000493.pd

Platelet counts and haemorrhagic diathesis in patients with myelodysplastic syndromes.

Most patients with myelodysplastic syndromes (MDS) present with single or multiple lineage cytopenias in peripheral blood despite a hypercellular bone marrow. Thrombocytopenia, attributable to ineffective platelet production by dysfunctional megakaryocytes, has been estimated to occur in 40-65% of patients. However, there are hardly any studies on the clinical relevance of low platelet counts in MDS. We retrospectively analysed data from 2900 patients in the Duesseldorf MDS Registry who were diagnosed at our laboratory between 1982 and 2007. At the time of diagnosis, 43% of the patients had a platelet count lower than 100 000/microL. Platelets were lower than 20 000/microL in 7% of the patients, especially in those with advanced stages of MDS, who showed a higher frequency of thrombocytopenia and platelet transfusion dependency. On multivariate analysis, platelet anisometry, hypocellularity of megakaryopoiesis, maturational defects of megakaryocytes and platelets <20 000/microL were independent variables showing a statistically significant correlation (P < 0.05) with clinical signs of bleeding. Platelets lower than 100 000/microL were associated with significantly shortened survival (P < 0.00005), because of an increased risk of progression to acute myeloid leukaemia (AML) (30% vs. 21%) (P < 0.02) and bleeding (16% vs. 8%) (P = 0.0005). Thrombocytopenia is a strong predictor of short survival, with or without haemorrhagic complications

Long-term outcome of patients with newly diagnosed chronic myeloid leukemia: a randomized comparison of stem cell transplantation with drug treatment.

Tyrosine kinase inhibitors represent today's treatment of choice in chronic myeloid leukemia (CML). Allogeneic hematopoietic stem cell transplantation (HSCT) is regarded as salvage therapy. This prospective randomized CML-study IIIA recruited 669 patients with newly diagnosed CML between July 1997 and January 2004 from 143 centers. Of these, 427 patients were considered eligible for HSCT and were randomized by availability of a matched family donor between primary HSCT (group A; N=166 patients) and best available drug treatment (group B; N=261). Primary end point was long-term survival. Survival probabilities were not different between groups A and B (10-year survival: 0.76 (95% confidence interval (CI): 0.69-0.82) vs 0.69 (95% CI: 0.61-0.76)), but influenced by disease and transplant risk. Patients with a low transplant risk showed superior survival compared with patients with high- (P<0.001) and non-high-risk disease (P=0.047) in group B; after entering blast crisis, survival was not different with or without HSCT. Significantly more patients in group A were in molecular remission (56% vs 39%; P=0.005) and free of drug treatment (56% vs 6%; P<0.001). Differences in symptoms and Karnofsky score were not significant. In the era of tyrosine kinase inhibitors, HSCT remains a valid option when both disease and transplant risk are considered

Understanding the burden of interstitial lung disease post-COVID-19: the UK Interstitial Lung Disease-Long COVID Study (UKILD-Long COVID)

Introduction The COVID-19 pandemic has led to over 100 million cases worldwide. The UK has had over 4 million cases, 400 000 hospital admissions and 100 000 deaths. Many patients with COVID-19 suffer long-term symptoms, predominantly breathlessness and fatigue whether hospitalised or not. Early data suggest potentially severe long-term consequence of COVID-19 is development of long COVID-19-related interstitial lung disease (LC-ILD). Methods and analysis The UK Interstitial Lung Disease Consortium (UKILD) will undertake longitudinal observational studies of patients with suspected ILD following COVID-19. The primary objective is to determine ILD prevalence at 12 months following infection and whether clinically severe infection correlates with severity of ILD. Secondary objectives will determine the clinical, genetic, epigenetic and biochemical factors that determine the trajectory of recovery or progression of ILD. Data will be obtained through linkage to the Post-Hospitalisation COVID platform study and community studies. Additional substudies will conduct deep phenotyping. The Xenon MRI investigation of Alveolar dysfunction Substudy will conduct longitudinal xenon alveolar gas transfer and proton perfusion MRI. The POST COVID-19 interstitial lung DiseasE substudy will conduct clinically indicated bronchoalveolar lavage with matched whole blood sampling. Assessments include exploratory single cell RNA and lung microbiomics analysis, gene expression and epigenetic assessment. Ethics and dissemination All contributing studies have been granted appropriate ethical approvals. Results from this study will be disseminated through peer-reviewed journals. Conclusion This study will ensure the extent and consequences of LC-ILD are established and enable strategies to mitigate progression of LC-ILD

Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen

Otitis media is endemic in remote Indigenous communities of Australia’s Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM) in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation.Financial support for this study was provided by the Channel 7 Children’s Research Foundation; The Trust Foundation; and the National Health and Medical Research Council (Australia)

CHEMICAL CONTROL OF THE REDBAY AMBROSIA BEETLE, XYLEBORUS GLABRATUS, AND OTHER SCOLYTINAE (COLEOPTERA: CURCULIONIDAE)

A BSTRACT The redbay ambrosia beetle (RAB), Xyleborus glabratus Eichhoff (Coleoptera: Curculionidae: Scolytinae), is an adventive pest of Lauraceae in the southeastern U.S. This wood-boring insect vectors a lethal fungus, Raffaelea lauricola T. C. Harr., Fraedrich & Aghayeva , the causal agent of laurel wilt (LW) disease. The vector-pathogen complex is responsible for extensive mortality of native Persea trees in South Carolina, Georgia, and northern Florida, and now poses an imminent threat to the avocado ( Persea americana Mill.) industry in south Florida. While chemical control of the vector is not viewed as the primary solution, control tactics should be made available to Florida avocado growers. Field and laboratory tests were conducted using avocado bolts, potted avocado trees, and field grown swampbay trees ( Persea palustris (Raf.) Sarg.) treated with contact and systemic insecticides. Zeta-cypermethrin + bifenthrin and lambda-cyhalothrin + thiamethoxam provided the most consistent control of Scolytinae as contact insecticides, while methomyl, malathion, bifenthrin, and endosulfan were more variable in effectiveness. Avocado trees treated with fenpropathrin, cryolite Na Al fluoride, and lambda-cyhalothrin+thiametoxam had similar numbers of beetle entrance holes on treated trees as on the untreated control trees. No statistical differences were observed in disease severity on treated versus non-treated avocados or swampbay. Linear regressions between the number of RAB entrance holes per tree ( x) and LW disease severity ( y a ) and between RAB entrance holes per tree ( x) and recovery of R. lauricola ( y b ) were both significant. Key Words: Redbay ambrosia beetle, avocado, Persea , Xyleborus , Xylosandrus , Hypothenemus , chemical control R ESUMEN El cucarroncito de ambrosia del laurel, Xyleborus glabratus Eichhoff (Coleoptera: Curculionidae), es una plaga exótica de la familia Lauraceae que ha invadido el suroriente de los Estados Unidos. Este insecto barrenador es el vector del hongo, Raffaelea lauricola T.C. Harr., Fraedrich & Aghayeva, agente causal de la enfermedad del secamiento del laurel. El complejo vector-patógeno es responsable de una extensa mortalidad de arboles nativos del genero Persea en Carolina del Sur, Georgia y en el norte de Florida y representa una amenaza inminente para la industria del aguacate ( Persea americana Mill.) de Florida. Aunque el control químico no es la única solución a este problema, se estima que este tipo de opción de tác-ticas se debe ofrecer a los productores de aguacate. Se condujeron experimentos tanto en campo como en laboratorio utilizando troncos de aguacate, arboles de aguacate y arboles del laurel de la ciénaga ( P. palustris (Raf.) Sarg.), los cuales se trataron con insecticidas de contacto y sistémicos. En general, zetaciypermetrina + bifenthrina y lambda-cyalotrina + tiametoxam dieron un control consistente de los Scolytinae como insecticidas de contacto, mientras que metomíl, malatión y bifentrina y endosulfan dieron resultados variables. No hubo diferencias significativas en los orificios de entrada de los cucarroncitos cuando se trataron los arboles de aguacate con fenpropatrina, floruro de cryolita NA Al y lambda-cyalotrina-tiametoxam comparado con los arboles testigo. No se observaron diferencias estadísticas en cuanto a la severidad de la enfermedad entre árboles tratados y aquellos no tratados. Sin embargo, modelos de regresión lineal entre el número de orificios por árbol ( x