Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus

Background: Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. Methods: Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had chest computed tomography (CT) scans with quantitative image analysis. Emphysema-predominant COPD was defined by low attenuation area at -950 Hounsfield Units (LAA-950) ≥10%. Non-emphysematous COPD was defined by airflow obstruction with minimal to no emphysema (LAA-950 < 5%). Results: Out of 4197 COPD subjects, 1687 were classified as emphysema-predominant and 1817 as non-emphysematous; 693 had LAA-950 between 5-10% and were not categorized. Subjects with emphysema-predominant COPD were older (65.6 vs 60.6 years, p < 0.0001) with more severe COPD based on airflow obstruction (FEV1 44.5 vs 68.4%, p < 0.0001), greater exercise limitation (6-minute walk distance 1138 vs 1331 ft, p < 0.0001) and reduced quality of life (St. George's Respiratory Questionnaire score 43 vs 31, p < 0.0001). Self-reported diabetes was more frequent in non-emphysematous COPD (OR 2.13, p < 0.001), which was also confirmed using a strict definition of diabetes based on medication use. The association between diabetes and non-emphysematous COPD was replicated in the ECLIPSE study. Conclusions: Non-emphysematous COPD, defined by airflow obstruction with a paucity of emphysema on chest CT scan, is associated with an increased risk of diabetes. COPD patients without emphysema may warrant closer monitoring for diabetes, hypertension, and hyperlipidemia and vice versa

Prediction of climatic changes on the ecological niche of Myracrodruon urundeuva in Brazil

Myracrodruon urundeuva is a native timber species and has great potential for commercial use in Brazil, especially in the Pantanal, Savannah and Caatinga regions, where native species are explored. In this study, distribution of M. urundeuva was predicted, based on the region of natural occurrence of the species. Coordinates of the species were obtained from online databases - CRIA and SpecialLinks, as well as from scientific articles and fieldwork conducted by UNESP located in Ilha Solteira. Therefore, ecological niche modeling was used, with current layers of climatic variables and layers prepared for future climate scenarios, according to the 4th Report of the Intergovernmental Panel on Climate Change (AR4 / IPCC), using Worldclim data on Brazil. Using Open Modeller and ArcGIS programs, prediction maps of their occurrence were generated for the current period and for future climate scenarios according to global climate change projects. With projected increases in temperature and rainfall in the area where the species occurs, M. urundeuva tends to migrate to areas of Brazil where the climate is currently milder in the south and southeast. Due to climate change, the species tends to undergo changes in area distribution and size by 2080. In both periods Caatinga and Pantanal were projected to increase in area, while for the Cerrado in the first period the area increased and for the second, it decreased. In scenario B1, large population size loss is projected in Caatinga and Pantanal