Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review

COPD is characterized by a pulmonary and systemic inflammatory process. Several authors have reported the elevation of multiple inflammatory markers in patients with COPD; however, their use in routine clinical practice has limitations. The neutrophil-to-lymphocyte ratio (NLR) is a useful and cost-effective inflammatory marker derived from routine complete blood count. We performed a systematic literature review using the PRISMA statement. Twenty-two articles were included, recruiting 7,601 COPD patients and 784 healthy controls. Compared with controls, COPD patients had significantly higher NLR values. We found a significant correlation between the NLR and clinical/functional parameters (FEV1, mMRC, and BODE index) in COPD patients. Elevation of the NLR is associated with the diagnosis of acute exacerbation of COPD (pooled data propose a cut-off value of 3.34 with a median sensitivity, specificity, and area under the curve of 80%, 86%, and 0.86, respectively). Additionally, increased NLR is also associated with the diagnosis of a bacterial infection in exacerbated patients, with a cut-off value of 7.30, although with a low sensitivity and specificity. The NLR is an independent predictor of in-hospital and late mortality after exacerbation. In conclusion, the NLR could be a useful marker in COPD patients; however, further studies are needed to better identify the clinical value of the NLR

Chronic Obstructive Pulmonary Disease and Apical Periodontitis and Other Oral Health Variables: A Case-Control Study

Background: The relationship between chronic inflammatory diseases and their comorbidities and correlation with periodontal diseases has become an increasing focus of research. Objectives: The aim of this case-control study was to conclude if patients suffering from COPD (Chronic Obstructive Pulmonary Disease) tend to have more AP (Apical Periodontitis) than non-COPD patients. Materials and Methods: The study was conducted on 30 patients assigned as cases, associated with 30 control patients linked by age (+/-5 years) and sex. Results: A total of 60 patients were recorded, and a total of 12 radiographic variables were analyzed. A total of 43 (71.7%) patients were registered with PAI (Periapical Index) >= 3, and there was a slightly tendency in the patients from the control group 22 (73.3%) compared to those from the cases 21 (70%), respectively (p > 0.05). Conclusions: It was concluded that there was not a significant association between the levels of PAI (Periapical Index) >= 3 per patient in those suffering from COPD. In fact, it could be concluded that patients diagnosed with COPD tend to have more teeth with PAI >= 3, more endodontic treatments and their periodontitis tended to accumulate more caries. Clinical Significance: This study establishes, in a case-control study, some specific aspects of oral health in patients with COPD, as well as analyzing the importance of oral health in this disease

Imbalance in the expression of genes associated with purinergic signalling in the lung and systemic arteries of COPDpatients.

Growing evidence indicates that purinergic signalling is involved in the pathogenesis of chronic obstructive pulmonary disease (COPD) and in the vascular remodelling that occurs in other disorders; however, its role in initial vascular changes of COPD is not entirely known. We hypothesised that expression of genes regulating extracellular ATP and adenosine levels would be altered in the lung and systemic arteries of COPD patients. Quantitative real-time PCR was performed to analyse the relative expression of 17 genes associated with purinergic signalling and inflammation in lungs and intercostal arteries of never smokers (NS) (n = 16), non-obstructed smokers (NOS) (n = 17) and COPD patients (n = 21). Gene expression of ATP-degrading enzymes was decreased in both tissues of NOS and COPD patients compared to NS. NT5E expression (gene transcribing for an AMP hydrolyzing ectonucleotidase) was increased in both tissues in NOS compared to the other groups. P1 and P2 receptors did not show changes in expression. Expression of genes associated with inflammation (interleukin-13) was upregulated only in lung tissues of COPD. These findings suggest that the expression of different extracellular ATP-degrading enzymes is altered in smokers (NOS and COPD patients), promoting inflammation. However, the high NT5E expression found only in NOS could compensate this inflammatory environment

Gastrointestinal metastasis from primary lung cancer. Case series and systematic literature review

Aim of the present study is to report clinical characteristics and outcomes of patients treated in authors’ hospital for GI metastasis from primary lung cancer, and to report and analyse the same data concerning patients retrieved from a systematic literature review. We performed a retrospective analysis of prospectively collected data, and a systematic review using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Ninety-one patients were included, 5 patients from the authors’ hospital and 86 through PubMed database using the keywords “intestinal metastasis” AND “lung cancer”. The median time between primary lung cancer diagnosis and GI metastasis diagnosis was 2 months and the median overall survival was 4 months. This group of patients present a poor prognosis and the gold standard treatment is not defined. None of the reported treatments had a significant impact on survival

Association between cutaneous leishmaniosis incidence and the human development index and its components in four endemic states of Venezuela

Submitted by Sandra Infurna ([email protected]) on 2017-09-29T19:11:26Z No. of bitstreams: 1 rosane3_griep_etal_IOC_2010.pdf: 1065385 bytes, checksum: 6a190221c9eae0cb1df1c0dcc3792155 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-09-29T19:29:08Z (GMT) No. of bitstreams: 1 rosane3_griep_etal_IOC_2010.pdf: 1065385 bytes, checksum: 6a190221c9eae0cb1df1c0dcc3792155 (MD5)Made available in DSpace on 2017-09-29T19:29:08Z (GMT). No. of bitstreams: 1 rosane3_griep_etal_IOC_2010.pdf: 1065385 bytes, checksum: 6a190221c9eae0cb1df1c0dcc3792155 (MD5) Previous issue date: 2010Universidad Central de Venezuela. Instituto de Medicina Tropical Felix Pifano. Sección de Inmunoparasitología. Caracas, Venezuela / Universidad de Los Andes. Instituto Experimental José Witremundo Torrealba. Núcleo Universitario Rafael Rangel. Trujillo, Venesuela / Universidad Central de Venezuela. Esculea de Medicina Luis Razetti. Departamento de Medicina Preventiva y Social. Cátedra de Salud Pública. Caracas, Venezuela / Dirección de Estudios Poblacionales, Fundación Centro de Estudios sobre Crecimiento y Desarrollo de la Población Venezolana (fUNDACREDESA), Ministerio del Poder Popular para las Comunas. Caracas, Venezuela.Universidad Central de Venezuela. Instituto de Medicina Tropical Felix Pifano. Sección de Inmunoparasitología. Caracas, Venezuela / Universidad Central de Venezuela. Esculea de Medicina Luis Razetti. Departamento de Medicina Preventiva y Social. Cátedra de Salud Pública. Caracas, Venezuela.Ministerio del Poder Popular para la Salud. Dirección General de Salud Ambiental y Contraloría Sanitaria. Maracay, Venezuela.Universidad Simón Bolívar. Unidad de Políticas Pública. Caracas, Venezuela.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Universidad Nacional Mayor de San Marcos. Sociedad Científica de San Fernando, Facultad de Medicina. Lima, Peru / , Hospital Universitario Vall d´Hebron. Servicio de Medicina Preventiva y Salud Pública. Barcelona, Spain.Universidad de Los Andes. Instituto Experimental José Witremundo Torrealba. Núcleo Universitario Rafael Rangel. Trujillo, Venesuela / Instituto Departamental de Salud de Norte de Santander. Cúcuta, Colombia.Objetivos. Evaluar las posibles asociaciones entre el índice de desarrollo humano (IDH) y sus componentes, y la incidencia de Leishmaniosis cutánea (LC) en cuatro estados endémicos de Venezuela (Mérida, Trujillo, Lara y Sucre) en el período 1994 al 2003. Materiales y métodos. La data socioeconómica (clasificada de acuerdo al Banco Mundial) se obtuvo del Instituto Nacional de Estadística y la epidemiológica del Ministerio de Salud, ambos de Venezuela. Para este estudio ecológico se evaluó la variación anual de las variables y se realizó modelos de regresión. Resultados. El IDH varió en el período, de 0,6746 en 1994 a 0,8144 en 2003 (p=0,90), asimismo, se observó un aumento de la incidencia acumulada de Leishmaniosis, en especial del año 1998 (7,3 casos/100 000 hab) a 1999 (11,3 casos/100 000 hab). Al analizar con los modelos de regresión lineal, se observó que la relación entre las variables epidemiológicas y sociales era diferente a nivel de los Estados evaluados. Para Mérida y Trujillo se observó un descenso significativo de la incidencia de LC con relación al aumento del porcentaje de alfabetización (p<0,05), de estudiantes matriculados (p<0,05), la esperanza de vida (p<0,05), su ingreso en USD per cápita por año (p<0,05) e IDH (p<0,05). Conclusión. Esta información refleja la influencia significativa de los indicadores socioeconómicos sobre la incidencia de la LC en los Estados Trujillo y Mérida, siendo inversa entre ambos tipos de variables; con el incremento o mejoría de los indicadores socioeconómicos, la incidencia acumulada de la enfermedad disminuyó.Objectives. Assess potential relationships between the Human Development Index (HDI) and its components and the incidence of cutaneous leishmaniasis (CL) in four endemic States of Venezuela (Mérida, Trujillo, Lara and Sucre) in the period 1994-2003. Material and methods. Socioeconomical data (classified according the World Bank) was obtained from the National Institute of Statistics, and the epidemiological data from the Ministry of Health, both from Venezuela. for this ecological study the annual variation of the variables was assessed and also regression models were done. Results. The HDI varied in the period from 0.6746 in 1994 to 0.8144 in 2003 (p=0.90). During this time an increase in the cumulative incidence of Leishmaniasis was observed, particularly from 1998 (7.3 cases/100,000 pop) to 1999 (11.3 cases/100,000 pop). Analyzing the linear regression models, it was observed that the relationship between epidemiological and social variables was different at States levels. for Mérida and Trujillo it was observed a significant decrease in the CL regard to the increase of literacy (p<0.05), of the gross combined enrollment (p<0.05), life expectancy (p<0.05), money income (p<0.05) and the HDI (p<0.05). Conclusion. This information reflects the significant influence of socioeconomical indicators on the CL incidence at Trujillo and Merida, being an inverse relationship between both types of variables; with an increase or improvement in the socioeconomical indicators, the disease incidence rate decreased