63 research outputs found
Treatable Traits in COPD - A Proposed Approach
The well-recognized individual heterogeneity within COPD patients has led to a growing interest in greater personalization in the approach of these patients. Thus, the treatable traits strategy has been proposed as a further step towards precision medicine in the management of chronic airway disease, both in stable phase and acute exacerbations. The aim of this paper is to perform a critical review on the treatable traits strategy and propose a guide to approach COPD patients in the light of this new concept. An innovative stepwise approach is proposed - a multidisciplinary model based on two distinct phases, with the potential to be implemented in both primary care and hospital settings. The first phase is the initial and focused assessment of a selected subset of treatable traits, which should be addressed in all COPD patients in both settings (primary care and hospital). As some patients may present with advanced disease at diagnosis or may progress despite this initial treatment requiring a more specialized assessment, they should progress to a second phase, in which a broader approach is recommended. Beyond stable COPD, we explore how the treatable traits strategy may be applied to reduce the risk of future exacerbations and improve the management of COPD exacerbations. Since many treatable traits have already been related to exacerbation risk, the strategy proposed here represents an opportunity to be proactive. Although it still lacks prospective validation, we believe this is the way forward for the future of the COPD approach.info:eu-repo/semantics/publishedVersio
Purification of mercury-contaminated water using new AM-11 and AM-14 microporous silicates
Water is an essential resource on Earth and the maintenance of its quality led to the incentive of water reuse
programmes. Among the most relevant contaminants, mercury is recognized for its toxicity and biomagnifica-
tions along the food chain, reason why its removal from aqueous solutions was studied in this essay using two
microporous materials for the first time. The ability of a niobium silicate, called AM-11 (Aveiro-Manchester No
11), and of a vanadium silicate, AM-14 (Aveiro-Manchester No 14), were assessed under batch conditions, at
fixed temperature and pH. These microporous materials were synthesized and characterized by SEM, PXRD, ICP-
OES, TGA and elemental analysis. Because of their excellent ion exchange properties, equilibrium and kinetics
assays were performed using only a few mg dm−3 of material. The most relevant two- and three-parameter
isotherms were used to fit the experimental data. Langmuir isotherm adjusted better the AM-11 data (deviation
of 3.58 %, Radj
2 =0.980, AIC=52.8), predicting a maximum uptake of 161 mg g−1, while the AM-14 data were
better fitted by the Temkin model (deviation of 3.92 %, Radj
2 =0.985, AIC=54.2). The kinetic study was per-
formed using Elovich, pseudo-first order and pseudo-second order models. The pseudo–second order and Elovich
equations provided the best fits for both materials. The Elovich equation achieved a better correlation in the
initial branch while the pseudo-second order expression was more efficient for the horizontal branch. The in-
traparticle diffusivities of counter ions were also assessed using a kinetic model based on the Nernst-Plank
equations. Performance of these two microporous materials to remove mercury has been compared with other
sorbents, highlighting their potential as ion exchangerspublishe
Prevalência de Obstrução numa População Exposta ao Fumo do Tabaco - Projecto PNEUMOBIL
A espirometria não atingiu ainda a divulgação que se
justificaria em patologia respiratória, ou indivíduos
que se encontram em risco relativamente a esta patologia,
cujo diagnóstico é insuficiente, havendo um
escasso conhecimento, e consequente controlo, dos
custos atribuíveis a estas doenças, com destaque para
a doença pulmonar obstrutiva crónica (DPOC).
O PNEUMOBIL, iniciativa que visa esta divulgação entre
fumadores e ex -fumadores, foi reactivado, após 10
anos de aplicação em Portugal, revelando agora, numa
amostra de 5324 indivíduos, em que cerca de 50% ainda mantêm os hábitos tabágicos, sejam do sexo masculino
ou feminino, que houve uma elevada prevalência de obstrução
detectada por espirometria (30% e 25%, respectivamente)
nas pessoas rastreadas perto de centros de saúde
(grupo público) e em empresas (grupo privado).
Este risco não se explica em regra por exposição ocupacional,
nem se relaciona com a maioria dos sintomas
respiratórios, muito frequentes nos rastreados.
Apenas a dispneia (OR=1,28; p=0,02) e os episódios
frequentes de expectoração (OR=1,21; p=0,008) ou
de bronquite aguda (OR=1,31; p=0,05) revelam alguma
relação com a obstrução.
O reconhecimento prévio da DPOC é muito reduzido
e a presença de obstrução não se correlaciona
(p=0,204) com o assumir da condição de portador
Myocardial Work Brings New Insights into Left Ventricular Remodelling in Cardio-Oncology Patients
Serial transthoracic echocardiographic (TTE) assessment of 2D left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) are the gold standard screening methods for cancer therapeutics-related cardiac dysfunction (CTRCD). Non-invasive left ventricular (LV) pressure-strain loop (PSL) provides a novel method of quantifying myocardial work (MW) with potential advantages to evaluate the impact of cardiotoxic treatments on heart function. We prospectively assessed breast cancer female patients undergoing cancer therapy through serial monitoring by 2D and 3D TTE. Patients were evaluated at T0, T1 and T2 (before, 4-6 and 12-14 months after starting therapy, respectively). Through PSL analysis, MW indices were calculated. A total of 122 patients, with a mean age of 54.7 years, who received treatment with anthracyclines (77.0%) and anti-HER2 (75.4%) were included. During a mean follow-up of 14.9 ± 9.3 months, LVEF and GLS were significantly diminished, and 29.5% developed CTRCD. All MW indices were significantly reduced at T1 compared with baseline and tended to return to baseline values at T2. Global work index and global work efficiency showed a more pronounced variation in patients with CTRCD. The presence of more than one cardiovascular risk factor, obesity and baseline left atrium volume were predictors of changes in MW parameters. In conclusion, breast cancer treatment was associated with LV systolic dysfunction as assessed by MW, with its peak at 4-6 months and a partial recovery afterwards. Assessment of myocardial deformation parameters allows a more detailed characterization of cardiac remodelling and could enhance patient screening and selection for cardioprotective therapeutics.info:eu-repo/semantics/publishedVersio
Does thermal time for germination vary among populations of a tree legume (Peltophorum dubium)?
Uma utopia brasileira: Vargas e a construção do estado de bem-estar numa sociedade estruturalmente desigual
De novo assembly, functional annotation, and analysis of the giant reed (Arundo donax L.) leaf transcriptome provide tools for the development of a biofuel feedstock
Produção de porta-enxertos em tubetes e enxertia precoce da pinheira (Annona squamosa L.)
Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study
Background
Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study.
Methods
We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income.
Results
Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income.
Conclusion
At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio
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