MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

<p>Abstract</p> <p>Background</p> <p>Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease.</p> <p>Methods</p> <p>We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients</p> <p>Results</p> <p>Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p < 0.001), the SPO₂at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p < 0.001 respectively) and the desaturation index (r = .634, p = 0.001) for the 6MWT; the MRC score and <it>V</it>O₂peak/kg (r = -.731, p < 0.001), SPO₂at peak exercise (r = -. 682, p < 0.001), VE/VCO₂slope (r = .731, p < 0.001), VE/VCO₂at AT (r = .630, p = 0.002) and the Borg scale at peak exercise (r = .50, p = 0.01) for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT.</p> <p>Conclusion</p> <p>In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.</p

Oral manifestations of systemic disease

While the majority of disorders of the mouth are centred upon the direct action of plaque, the oral tissues can be subject to change or damage as a consequence of disease that predominantly affects other body systems. Such oral manifestations of systemic disease can be highly variable in both frequency and presentation. As lifespan increases and medical care becomes ever more complex and effective it is likely that the numbers of individuals with oral manifestations of systemic disease will continue to rise. The present article provides a succinct review of oral manifestations of systemic disease. In view of this article being part of a wider BDJ themed issue on the subject of oral medicine, this review focuses upon oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease

Museums Brand Equity and Social Media: Looking into Current Research Insights and Future Research Propositions

Abstract. Extensive research has repeatedly acknowledged the link between traditional and digital marketing communication tools and branding performance. Particularly, both within For Profit Organizations (henceforth, FPOs) and Non-Profit Organizations (henceforth NPOs), social media as the milestone of the digital era has rebutted the foundations of corporate and personal communication through the emergence of new participatory communication terms, such as ''prod-user'' and “co-creation”. Consequently, a growing research trend has emerged towards e-e marketing tools and social media impact on destination branding, as well. Simultaneously, thanks to its multidimensional benefits both at the communicational, educational, and promotional levels, social media are emerging as an essential feature in the branding of the new museum era. To date, within the NPOs sector, few studies have investigated the effect of social media on brand equity. Moreover, far too little attention has been paid to the link between social media and museums' brand equity. Based on the systematic qualitative critical review methodology, this paper attempts to identify the basic trends and research status by 2018. Drawing on a review of 78 papers that are the result of systematic desk research, this study categorizes and presents, for the first time, the effects of social media use on museums’ brand components. The study offers new and valuable insights into the multidisciplinary research interests of the research and industry community relating to communication and marketing, NPOs, tourism, and museums context. Keywords: Social Media, Museums, Brand Equity, NPOs, Cultural Tourism

Pilgrimages: the “promised land” for travel age

&lt;p&gt;&lt;b&gt;Purpose:&lt;/b&gt; The purpose of this paper is to investigate the most important characteristics of the religious package tour as perceived by consumers who travel to the Holy Land and to examine the marketing components that play an important role for pilgrims.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Design/methodology/approach:&lt;/b&gt; In-depth interviews were conducted with Greek Orthodox travellers who were about to leave for a pilgrimage to Jerusalem. Content analysis was used in order to analyse the transcribed interviews.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Findings:&lt;/b&gt; Results show that regarding the product mix, hotel ratings and extra benefits are considered of minor importance by the interviewed travellers. However, the tour guide and the trip's schedule and program are the most important factors that influence consumer decisions regarding the purchase of a specific tourism product. In addition, the travel agent's reputation for organising religious trips plays a crucial role. Alternatively, price does not seem to influence travellers to sacred places.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Practical implications:&lt;/b&gt; Travel agents that offer tour packages to pilgrims, as well as tourism companies wishing to promote pilgrimages can take into consideration these findings in order to design effective marketing plans.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Originality/value:&lt;/b&gt; Although tour packages for pilgrims are profitable, only few studies have focused on this type of traveller. As travel for religious purposes increases, the design of an effective marketing plan may help to further develop the market for pilgrimages.&lt;/p&gt

Non CF-bronchiectasis: Aetiologic approach, clinical, radiological, microbiological and functional profile in 277 patients

Background and objectives Non-Cystic Fibrosis (CF) bronchiectasis is common in Greece but little attention has been paid to the investigation of its aetiology, clinical, radiological, microbiological and lung function profile. Methods We prospectively evaluated patients with non-CF bronchiectasis confirmed by high resolution computed tomography (HRCT) of the chest. Aetiology, clinical data, radiology score, microbiological profile and lung function were investigated. Results We evaluated 277 patients (170 women) with bronchiectasis (mean age: 60.5 ± 16 years), 64% of them being non-smokers. Post-infectious (25.2%) and past tuberculosis (TB) (22.3%) were the most commonly identified underlying conditions, while no cause was found in 34% of the patients. The main symptoms were cough (82%), mucopurulent sputum (80%), dyspnea (60%) and haemoptysis (37%). Mean duration of symptoms was 9.7 (SD 10.7) years. Infectious exacerbations were observed in 67.5% of the patients with a mean frequency of 2.3 (SD 1.4) per year. The most frequent lung function pattern was the obstructive (43.1%) while 38% of the patients had normal spirometry. Pseudomonas aeruginosa was the most common pathogen yielded in sputum cultures (43%) followed by Haemophilus influenzae (12.6%). Patients with P. aeruginosa had a more long-standing disease and worse lung function. Radiological severity of the disease was mainly related to impaired lung function, P. aeruginosa isolation in sputum and frequent exacerbations. Conclusion Data indicate that in Greece, &quot;past&quot; tuberculosis remains an important cause of bronchiectasis. P. aeruginosa was the predominant pathogen in the airways, associated with disease severity, while the most common lung function impairment was obstruction. © 2016 Elsevier Ltd. All rights reserved

Combined pulmonary fibrosis and emphysema

The advent of computed tomography permitted recognition of the coexistence of pulmonary fibrosis and emphysema (CPFE). Emphysema is usually encountered in the upper lobes preceding fibrosis of the lower lobes, and patients are smokers, predominantly male, with distinct physiologic profile characterized by preserved lung volumes and markedly reduced diffusion capacity. Actually, the term CPFE is reserved for the coexistence of any type and grade of radiological pulmonary emphysema and the idiopathic usual interstitial pneumonia computed tomography pattern as well as any pathologically confirmed case. CPFE is complicated by pulmonary hypertension, lung cancer and acute lung injury and may present different outcome than that of its components. © 2013 2013 Expert Reviews Ltd

Bronchiolitis: Adopting a unifying definition and a comprehensive etiological classification

Bronchiolitis is an inflammatory and potentially fibrosing condition affecting mainly the intralobular conducting and transitional small airways. Secondary bronchiolitis participates in disease process of the airways and/or the surrounding lobular structures in the setting of several already defined clinical entities, mostly of known etiology, and occurs commonly. Primary or idiopathic bronchiolitis dominates and characterizes distinct clinical entities, all of unknown etiology, and occurs rarely. Secondary bronchiolitis regards infections, hypersensitivity disorders, the whole spectrum of smoking-related disorders, toxic fumes and gas inhalation, chronic aspiration, particle inhalation, drug-induced bronchiolar toxicities, sarcoidosis and neoplasms. Idiopathic or primary bronchiolitis defines clinicopathologic entities sufficiently different to be designated as separate disease entities and include cryptogenic constrictive bronchiolitis, diffuse panbronchiolitis, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, neuroendocrine hyperplasia in infants, bronchiolitis obliterans syndrome in lung and allogeneic hematopoietic cell transplantation, connective tissue disorders, inflammatory bowel disease and bronchiolitis obliterans organizing pneumonia. Most of the above are pathological descriptions used as clinical diagnosis. Acute bronchiolitis, though potentially life threatening, usually regresses. Any etiology chronic bronchiolitis contributes to morbidity and/or mortality if it persists and/or progresses to diffuse airway narrowing and distortion or complete obliteration. Bronchiolitis in specific settings leads to bronchiolectasis, resulting in bronchiectasis. © 2013 2013 Expert Reviews Ltd