Health status perception and airflow obstruction in five Latin American cities: the PLATINO study

Background: COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general, health status perception, degree of breathlessness and physical activity limitation with the severity of their respiratory condition measured by airway obstruction, in a population-based sample.Methods: We used postbronchodilator FEV(1)/FVC < 0.70 to define COPD. Patients' perception of their general. health status was derived from the question in general, you would say that your health is: excellent, very good, good, fair or poor?Results: Spirometry was performed in 5314 subjects: an FEV(1)/FVC ratio below 0.70 was found in 759 subjects. in persons with COPD, general. health status decreased with increasing GOLD stages. Over one-half of subjects with stage 2 and one third of those with stages 3 and 4 reported their health status as good to excellent. There was also a disparity between airway obstruction severity and breathlessness intensity. Although the more severe COPD stages were frequently associated with significant compromise of work and everyday activities, patients often tended to provide an optimistic self evaluation of their health status.Conclusions: the discrepancy observed between general health status, dyspnea severity, physical activity limitation and airway obstruction most likely reflect patients' underperception of disease severity, emphasizing the need for improving case-finding measures and multi-component evaluation of COPD subjects. (C) 2009 Elsevier B.V. All rights reserved.Boehringer Ingelheim GmbHCent Univ Venezuela, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAInst Resp Dis, Mexico City 14080, DF, MexicoUniv Republica, Hosp Maciel, Montevideo, UruguayUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilPontificia Univ Catolica Chile, Dept Salud Publ, Santiago, ChilePontificia Univ Catolica Chile, Catedra Neumol, Santiago, ChileUniv Fed Pelotas, Fac Med, BR-96030002 Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc

Chronic obstructive pulmonary disease and body mass index in five Latin America cities: the PLATINO study

Background: the body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD.Methods: COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV(1)/FVC)= 30.0 kg/m(2)).Results: Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m(2). No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in mates with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III - IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. in females with COPD, current smoking, lower education, and GOLD stages II - IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI.Conclusions: BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD. (c) 2008 Elsevier B.V. All rights reserved.Cent Univ Venezuela, Fac Med, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaInst Resp Dis, Mexico City 14080, DF, MexicoUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilUniv Republica, Hosp Maciel, Fac Med, Montevideo 2610, UruguayPontificia Univ Catolica Chile, Fac Med, Dept Salud Publ, Santiago, ChileUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAUniv Fed Pelotas Duque Caxias, Fac Med, Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Increased Risk of Exacerbation and Hospitalization in Subjects With an Overlap Phenotype COPD-Asthma

Background: Several COPD phenotypes have been described; the COPD-asthma overlap is one of the most recognized. the aim of this study was to evaluate the prevalence of three subgroups (asthma, COPD, and COPD-asthma overlap) in the Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) study population, to describe their main characteristics, and to determine the association of the COPD-asthma overlap group with exacerbations, hospitalizations, limitations due to physical health, and perception of general health status (GHS).Methods: the PLATINO study is a multicenter population-based survey carried out in five Latin American cities. Outcomes were self-reported exacerbations (defined by deterioration of breathing symptoms that affected usual daily activities or caused missed work), hospitalizations due to exacerbations, physical health limitations, and patients' perception of their GHS obtained by questionnaire. Subjects were classified in three specific groups: COPD-a postbronchodilator (post-BD) FEV1/FVC ratio of < 0.70; asthma-presence of wheezing in the last year and a minimum post-BD increase in FEV1 or FVC of 12% and 200 mL; and overlap COPD-asthma-the combination of the two.Results: Out of 5,044 subjects, 767 were classified as having COPD (12%), asthma (1.7%), and COPD-asthma overlap (1.8%). Subjects with COPD-asthma overlap had more respiratory symptoms, had worse lung function, used more respiratory medication, had more hospitalization and exacerbations, and had worse GHS. After adjusting for confounders, the COPD-asthma overlap was associated with higher risks for exacerbations (prevalence ratio [PR], 2.11; 95% CI, 1.08-4.12), hospitalizations (PR, 4.11; 95% CI, 1.45-11.67), and worse GHS (PR, 1.47; 95% CI, 1.18-1.85) compared with those with COPD.Conclusions: the coexisting COPD-asthma phenotype is possibly associated with increased disease severity.Boehringer Ingelheim GmbHGlaxoSmithKlineUniv Fed Pelotas, Postgrad Program Epidemiol, BR-96020220 Pelotas, RS, BrazilCent Univ Venezuela, Fac Med, Caracas, VenezuelaNatl Inst Resp Dis, Sleep Clin & Pulm Physiol, Mexico City, DF, MexicoGlaxoSmithKline, London, EnglandUniv Republica, Fac Med, Montevideo, UruguayCtr Hosp Pereira Rossell, Montevideo, UruguayUniversidade Federal de São Paulo, São Paulo, BrazilPontificia Univ Catolica Chile, Santiago, ChileUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Diagnostic Labeling of COPD in five Latin American cities

Background: COPD is a major worldwide problem with a rising prevalence. Despite its importance, there is a lack of information regarding underdiagnosis and misdiagnosis of COPD in different countries. As part of the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study, we examined the relationship between prior diagnostic label and airway obstruction in the metropolitan areas of five Latin American cities (S (a) over tildeo Paulo, Santiago, Mexico City, Montevideo, and Caracas).Methods: A two-stage sampling strategy was used in each of the five areas to obtain probability samples of adults aged 40 years. Participants completed a questionnaire that included questions on prior diagnoses, and prebronchodilator and postbronchodilator spirometry. A study diagnosis of COPD was based on airway obstruction, defined as a postbronchodilator FEV1/FVC < 0.70.Results: Valid spirometry and prior diagnosis information was obtained for 5,303 participants; 758 subjects had a study diagnosis of COPD, of which 672 cases (88.7%) had not been previously diagnosed. the prevalence of undiagnosed COPD was 12.7%, ranging from 6.9% in Mexico City to 18.2% in Montevideo. Among 237 subjects with a prior COPD diagnosis, only 86 subjects (36.3%) had postbronchodilator FEV1/FVC < 0.7, while 151 subjects (63.7%) had normal spirometric values. in the same group of 237 subjects, only 34% reported ever undergoing spirometry prior to our study.Conclusions: Inaccurate diagnostic labeling of COPD represents an important health problem in Latin America. One possible explanation is the low rate of spirometry for COPD diagnosis.Hosp Univ Caracas, Univ Cent Venezuela, Fac Med, Catedra Neumonol, Caracas 1040, VenezuelaUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USAInst Resp Dis, Mexico City, DF, MexicoUniversidade Federal de São Paulo, São Paulo, BrazilUniv Republica, Fac Med, Montevideo, UruguayPontificia Univ Catolica Chile, Santiago, ChileFed Univ Pelotas, Post Grad Program Epidemiol, Pelotas, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Worldwide burden of COPD in high- and low-income countries. Part II. Burden of chronic obstructive lung disease in Latin America: the PLATINO study

SETTING: Five Latin American cities: Sao Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; Caracas, Venezuela.OBJECTIVE: To describe the burden of chronic obstructive pulmonary disease (COPD) in Latin America.DESIGN: This is a multi Centre study. Post-bronchodilator spirometry was used and the main outcome measure was FEV(1)/FVC = 40 years in the five countries included in the study was approximately 85.3 million. Of these, it was estimated that 12.2 million have airflow obstruction, which corresponds to our prevalence estimate of 14.3%. The proportion of subjects in Stages II-IV of the GOLD classification was 5.6%. Risk factors presenting the highest actiological fractions for COPD were age, current smoking, indoor exposure to coal and exposure to dust in the workplace. Smoking, the modifiable factor with the strongest aetiological fraction for COPD, affects 29.2% of adults aged >= 40 years in these cities, corresponding to approximately 25 million smokers in this age group.CONCLUSION: Prevention of smoking and exposure to pollutants, such as coal and dust, are the interventions most likely to succeed against COPD in Latin America. The information obtained by a collaborative study has been vast and encouraging for other similar studies.Univ Fed Pelotas, Programa Posgrad Epidemiol, Pelotas, RS, BrazilInst Nacl Enfermedades Resp, Tialpan, MexicoUniv Fed Sao Paulo, Sao Paulo, BrazilUniv Republica, Montevideo, UruguayPontificia Univ Catolica Chile, Santiago, ChileCent Univ Venezuela, Caracas, VenezuelaUniv Fed Sao Paulo, Sao Paulo, BrazilWeb of Scienc

Paid employment in subjects with and without chronic obstructive pulmonary disease in five Latin American cities: the PLATINO study

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a costly condition that frequently causes permanent work disabilities. Little information exists regarding the impact of COPD on work force participation and the indirect costs of the disease in developing countries.OBJECTIVE: To examine the frequency of paid employment and factors influencing it in a Latin-American population-based study.METHODS: Post-bronchodilator FEV(1)/FVC < 0.70 (forced expiratory volume in 1 s/forced vital capacity) was used to define COPD. Information regarding paid work was assessed by the question 'At any time in the past year, have you worked for payment?'RESULTS: Interviews were conducted with 5571 subjects; 5314 (759 COPD and 4554 non-COPD) subjects underwent spirometry. Among the COPD subjects, 41.8% reported having paid work vs. 57.1% of non-COPD (P < 0.0001). the number of months with paid work was reduced in COPD patients (10.5 +/- 0.17 vs. 10.9 +/- 0.06, P < 0.05). the main factors associated with having paid work in COPD patients were male sex (OR 0.33, 95% CI 0.23-0.47), higher education level (OR 1.05, 95% CI 1.01-1.09) and younger age (OR 0.90, 95% CI 0.88-0.92). COPD was not a significant contributor to employment (OR 0.83, 95% CI 0.69-1.00, P = 0.054) in the entire population.CONCLUSIONS: Although the proportion of persons with paid work is lower in COPD, having COPD appears not to have a significant impact on obtaining paid employment in the overall population of developing countries.Boehringer Ingelheim GmbHCent Univ Venezuela, Hosp Univ Caracas, Serv Neumonol, Fac Med, Caracas 1030, VenezuelaUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USAInst Resp Dis, Mexico City, DF, MexicoUniv Republica, Hosp Maciel, Fac Med, Montevideo, UruguayUniversidade Federal de São Paulo, São Paulo, BrazilPontificia Univ Catolica Chile, Fac Med, Catedra Neumol, Santiago, ChileUniv Fed Pelotas, Fac Med, Pelotas, RS, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

www.elsevier.comrlocatercatena Book review Soil Analysis — An Interpretation Manual

standardise methods of soil analysis as in different countries different procedures were used which hampered exchange of data and ideas. More than 75 years have lapsed but the call for uniform methods of soil analysis can still occasionally be heard, like for example at the 16th Worlds Congress of Soil Science in 1998. In general, however, consistency and standardisation of procedures has occurred which — not in the last place — facilitated the development of international soil classification systems. There is an analogy between developments in soil science at the global level and those in Australia. In the various Australian State and Territory organizations, soils were analyzed in a different way despite the fact that a number of States had soils with similar pedofeatures. The problem was recognised for many decades but in 1992 the ‘‘Australia