Human epididymis protein 4 (HE4) levels inversely correlate with lung function improvement (delta FEV1) in cystic fibrosis patients receiving ivacaftor treatment

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Pulmonary Exacerbations

Pulmonary exacerbations (PEx) are a frequent occurrence in the lives of individuals with cystic fibrosis (CF) and are associated with worsened morbidity, mortality, and quality of life. Approximately 25–35% individuals with CF don’t recover to 90% of baseline lung function after treatment for a PEx. Currently, there is scant evidence upon which to base guidelines for detection and management of PEx; therefore, the CF Foundation convened a working group to design and conduct clinical trials in order to establish evidence for best practices (Standardized Treatment of Pulmonary Exacerbations, STOP). The STOP program has conducted an observational study which has helped define the phenotype of PEx, characterize physician treatment practices, and evaluate clinical endpoints to use in future clinical trials. STOP-2 is an ongoing clinical trial of duration of antibiotics, which should guide establishment of best practices on duration. This chapter reviews the definition, epidemiology, current treatment practices, prognosis, and associated outcomes related to CF PEx. A patient perspective highlights the burden of PEx on the lives of individuals with CF. Current research is reviewed to clarify future directions in PEx. Upcoming clinical trials of PEx should provide robust clinical data in order to provide clear guidelines on detection and treatment of PEx

Species–area relationships in the Hantam-Tanqua-Roggeveld, Succulent Karoo, South Africa

The Hantam-Tanqua-Roggeveld subregion is part of the Succulent Karoo hotspot of biodiversity which stretches along the southwestern side of South Africa and Namibia. Forty Whittaker plots were surveyed in the spring of 2005, in eight vegetation associations, to gather diversity data for the Hantam, Tanqua Karoo and Roggeveld areas. Seven plot sizes were used to construct species–area curves using three different models namely: the untransformed linear function, the power function and the exponential function. In general, the power and exponential functions produced a more significant fit to the data than the untransformed linear function. Linear regressions using environmental parameters indicated that altitude, mean annual precipitation and mean annual temperature were significant predictors of species richness at the 1, 10, 100 and 1000 m2 scales. To illustrate the variation in species–area curves and species richness across the landscape, a transect through the study area is discussed. The transect stretches eastwards from the Tanqua Karoo across the escarpment into the Roggeveld and crosses five different vegetation associations. Differences between associations were found in species richness in the 1000 m2 plots. Each association also produced species–area curves with their own characteristics. Slope values for the samples within an association did not differ significantly, although the intercept value often did. Comparisons between associations along the transect revealed significant differences in the slope value between the associations, except for the Dicerothamnus rhinocerotis Mountain Renosterveld which did not differ significantly from the associations bordering it on either side.The Critical Ecosystem Partnership Fund (CEPF) through the Succulent Karoo Ecosystem Plan/Program (SKEP) initiative and the National Research Foundation under grant number 61277.http://www.springerlink.com/content/0960-3115/nf201