Opposite behavior of plasma levels surfactant protein type B and receptor for advanced glycation end products in pulmonary sarcoidosis

Background: No biological marker is currently available for evaluating pulmonary involvement and/or for monitoring the clinical course of sarcoidosis. The present pilot study focused on possible relationships between circulating plasma levels of surfactant protein type B (SP-B) and plasma receptor for advanced glycation end products (RAGE) and lung function abnormalities in patients with pulmonary sarcoidosis, since both SP-B and RAGE have been previously suggested as lung injury markers. The plasmatic levels of these two proteins were also investigated with respect to functional capacity, as assessed by a cardiopulmonary exercise test (CPET). Methods: Thirty pulmonary sarcoidosis outpatients and fifteen volunteers (Control Group) underwent lung function tests and CPET. Resting SP-B and RAGE plasma levels were also determined. Patients were then categorized according to the severity of their pulmonary involvement, as assessed in terms of lung diffusion for carbon monoxide (DLCO) values. Results: Group B showed SP-B levels higher and RAGE levels lower than Group A and Control Group (p < 0.01). Group A showed lower RAGE levels than Control Group (p < 0.01), whereas SP-B levels did not differ between these two groups. A significant univariate relationship was found between both SP-B and RAGE and several lung function data, particularly with DLCO (SP-B Vs DLCO: r: -0.437, p = 0.016; RAGE Vs DLCO: r: -0.451, p = 0.012). Conclusions: Circulating plasma levels of SP-B and RAGE showed an opposite behavior in patients with pulmonary sarcoidosis. SP-B values are directly related to alveolar unit damage, supporting a possible role of SP-B as a marker of disease severity in these patients. Differently, RAGE decreases in severe sarcoidosis, suggesting more complex underlying mechanisms. (C) 2013 Elsevier Ltd. All rights reserved

Evidence-based search strings for the study of farmers' occupational diseases

Objective The aim of the study was to identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of farmers’ diseases. Methods Based on Medical Subject Heading (MeSH) definitions and expert knowledge, we selected the MeSH term agricultural workers’ disease and, as candidate search terms, five MeSH terms describing farm work (pesticides, agriculture, rural population, rural health, agrochemicals NOT pesticides) alongside 25 other promising terms. Using random samples of abstracts retrieved by each term, we estimated propor- tions of articles containing potentially pertinent information regarding occupational aetiology in order to formulate two search strategies (one more ‘‘specific’’, one more ‘‘sen- sitive’’). We applied these strategies to retrieve information on possible occupational aetiology among farmers of knee osteoarthritis, multiple sclerosis and kidney cancer. We evaluated the number of abstracts needed to read (NNR) to identify one potentially pertinent article in the context of these pathologies. Results The more ‘‘specific’’ search string was based on the combina- tion of terms that yielded the highest proportion (40%) of potentially pertinent abstracts. The more ‘‘sensitive’’ string was based on use of broader search fields and additional coverage provided by other search terms under study. Using the specific string, the NNR to find one potentially pertinent article were: 1.3 for knee osteoarthritis; 1.3 for multiple sclerosis; 1.1 for kidney cancer. Using the sensitive strategy, the NNR were 1.8, 2.4 and 1.4, respectively. Conclusions The proposed strings could help health care professionals explore putative occupational aetiology for farmers’ diseases (even if not generally thought to be work-related)