Ultrasonographic and radiologic images of the kidneys.

<p>(A, B) healthy lynx, (C, D) lynx with renal disease. Diseased kidneys are smaller, have irregular contour, show loss of normal architecture and mineralization.</p

Von Kossa stained sections of the kidney, stomach, lung, heart and aorta from Iberian lynx.

<p>(A-E) Healthy controls that died in car accidents; (F-J) Animals that died as a consequence of vitamin D toxicosis and renal failure. Foci of calcification (arrows) are stained brown. Magnification = x200.</p

Blood and urine parameters in healthy free ranging lynx, healthy captive lynx and captive lynx with renal disease.

<p>Blood and urine parameters in healthy free ranging lynx, healthy captive lynx and captive lynx with renal disease.</p

Impact of Obesity on the Clinical Profile of a Population-Based Sample with Chronic Obstructive Pulmonary Disease

<div><p>Aims</p><p>To characterize the distribution of BMI in a population-based sample of COPD patients and to evaluate the impact of obesity on their health status, exercise tolerance, systemic inflammation and comorbidity.</p><p>Methods</p><p>A population-based sample of 3,797 subjects aged 40–80 years from the EPI-SCAN study was selected. Subjects were categorized according their body mass index (BMI) as underweight (<18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²) or obese (BMI≥30.0 kg/m²). Subjects were evaluated with post-bronchodilator spirometry and 6-minute walk tests. Smoking habits, respiratory symptoms, generic and specific quality of life, daily physical activities, comorbidities and systemic inflammatory biomarkers were recorded.</p><p>Results</p><p>The prevalence of obesity or being overweight was higher in the 382 COPD patients than in the subjects without airflow limitation (29.4%, 95%CI 24.8–33.9% vs. 24.3, 95%CI 22.9–25.8; and 44.7%, 95%CI 39.7–49.6% vs. 43.0%, 95%CI 41.3–44.6, respectively; p = 0.020). In the COPD subgroup, obese subjects presented more dyspnea and less chronic cough, chronic bronchitis or chronic phlegm than normal-weight patients, as well as a worse health status. Moreover, reduced exercise tolerance and higher plasmatic C-reactive protein levels were found in the obese patients, who also presented a greater prevalence of cardiovascular disease (adjusted odds ratio 4.796, 95%CI 1.806–12.736, p = 0.002).</p><p>Conclusions</p><p>In a population-based sample, obesity is more prevalent in COPD patients than in subjects without airflow limitation. Furthermore, obesity affects the clinical manifestations, quality of life and exercise tolerance of COPD patients, and it may contribute to a phenotype characterized by increased systemic inflammation and greater frequency of cardiovascular comorbidity.</p></div

Comparison of symptoms, previous exacerbations, health status and systemic biomarker levels between the study groups.

<p>Values are mean ± SD or frequency. Abbreviations: BMI = body mass index; mMRC = modified Medical Research Council dyspnea scale; SGRQ = St. George's Respiratory Questionnaire; EQ-5D = EuroQol 5 Dimensions questionnaire; VAS = Visual analogue scale; LCADL = London Chest Activities of Daily Living; CRP = C-reactive protein; TNF = tumor necrosis factor; IL = interleukin; NOx = nitrites/nitrates.</p><p>Comparisons between groups by ANOVA with Bonferroni post-hoc comparisons: ^†p<0.01 vs. normal weight group; ^‡p<0.05 vs. normal weight group; ^¶p<0.01 vs. overweight group; ^§p<0.05 vs. overweight group.</p

Adjusted comparisons of multidimensional indices and comorbidity between the three groups of COPD patients.

<p>Mean values are adjusted for gender, age, packs-year and FEV₁ (% pred.). Error bars represent SEM.</p

Distribution of BMI classifications according to age group in COPD and non-COPD subjects.

<p>Distribution of BMI classifications according to age group in COPD and non-COPD subjects.</p

Adjusted comparisons of health status, exercise tolerance and systemic inflammatory biomarkers between the study groups.

<p>Values are mean ± SEM. Comparisons adjusted by gender, age, pack-year and FEV₁ (% pred). Abbreviations: mMRC = modified Medical Research Council dyspnea scale; SGRQ = St. George's Respiratory Questionnaire; EQ-5D = EuroQol 5 Dimensions questionnaire; VAS = Visual analogue scale; LCADL = London Chest Activities of Daily Living; CRP = C-reactive protein; TNF = tumor necrosis factor; IL = interleukin; NOx = nitrites/nitrates.</p><p>Post-hoc comparisons between groups by Bonferroni test: ^†p<0.001 vs. normal weight group; ^‡p<0.05 vs. normal weight group; ^¶p<0.01 vs. overweight group; ^§p<0.05 vs. overweight group.</p