Severe asthma: One disease and multiple definitions

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem

SANI-Severe Asthma Network in Italy: a way forward to monitor severe asthma

Even if severe asthma (SA) accounts for 5-10% of all cases of the disease, it is currently a crucial unmet need, owing its difficult clinical management and its high social costs. For this reason several networks, focused on SA have been organized in some countries, in order to select these patients, to recognize their clinical features, to evaluate their adherence, to classify their biological/clinical phenotypes, to identify their eligibility to the new biologic therapies and to quantify the costs of the disease. Aim of the present paper is to describe the ongoing Italian Severe Asthma Network (SANI). Up today 49 centres have been selected, widespread on the national territory. Sharing the same diagnostic protocol, data regarding patients with SA will be collected and processed in a web platform. After their recruitment, SA patients will be followed in the long term in order to investigate the natural history of the disease. Besides clinical data, the cost/benefit evaluation of the new biologics will be verified as well as the search of peculiar biomarker(s) of the disease

Correlação linear e espsacial entre a produtividade de feijão e a porosidade de um Latossolo Vermelho de Selvíria (MS) Linear and spatial correlation between common bean yield and porosity of a Red Latosol in Selvíria (MS), Brazil

A porosidade do solo exerce grande influência sobre o crescimento e desenvolvimento vegetal, uma vez que o crescimento das raízes, tal como a produtividade das culturas, é limitado pela profundidade que atingem. Portanto, o objetivo deste trabalho foi estudar a variabilidade espacial e as correlações lineares entre a produtividade de feijão e a porosidade do solo. No ano de 2004/2005, no município de Selvíria, MS, foram analisadas a produtividade de grãos de feijão (PG), cultivar IAC Carioca, irrigado, a macroporosidade (MA), a microporosidade (MI) e a porosidade total (PT) do solo em quatro profundidades: 1 (0,0-0,10); 2(0,10-0,20); 3(0,20-0,30) e 4(0,30-0,40 m), num Latossolo Vermelho distroférrico. As amostras de solo e planta foram coletadas em uma malha geoestatística com 75 pontos espaçados de 10 x 10 m, mais 60 pontos de quatro malhas de refinamento numa área de 50 x 150 m. Os atributos estudados, além de não terem variado aleatoriamente, apresentaram média e baixa variabilidades. Seguiram padrões espaciais bem definidos, com alcances entre 11,70 e 104,40 m. A correlação linear entre o atributo da planta e os do solo, em função do elevado número de observações, foi baixa. As de melhor correlação linear com a PG foram a MA1, MI1 e a PT3. Entretanto, do ponto de vista espacial, houve excelente correlação inversa entre a PG e a #PT2. Assim, nos sítios onde a #PT2 diminuiu (0,030-0,045 m³ m-3 ), a PG variou entre 2.173 e 3.529 kg ha-1. Já naqueles onde aumentou (0,045-0,076 m³ m-3 ), a PG ficou entre 1.630-2.173 kg ha-1. Assim, a porosidade total do solo, quando avaliada na camada de 0,10-0,20 m (#PT2), indicou a importância do contato raiz/solo e, de modo inverso, apresentou satisfatório indicador da qualidade física do solo estudado, quando destinado à produtividade de grãos de feijão irrigado.<br>Soil porosity influences plant development since root growth and crop yield are determined by the root depth. The objective of this study was to investigate the linear and spatial variability and correlations between common bean yield and soil porosity. The bean grain yield of the irrigated cultivar Carioca IAC was analyzed in the growing season 2004/2005, in Selviria-MS, as well as macroporosity (MA), microporosity (MI) and total porosity (TP), in a Dystroferric Red Latosol, at four depths: 1 (0.0-0.10 m), 2 (0.10-0.20 m), 3 (0.20-0.30 m) and 4 (0.30-0.40 m). Soil and plant data were collected in a geostatistical grid with 135 points spaced 10 m apart, covering an area of 50 x 150 m. The data of the studied attributes did not vary randomly and the values were intermediate to low. They followed well-defined spatial standards, reaching between 11.70-104.40 m. On the other hand, the linear correlation between the plant and soil attributes was low, due to the high number of observations. Grain yield had the best linear correlations with MA1b, MI1 and TP3. From the spatial point of view, the inverse correlation between PG and #TP2 was outstanding. At the sites where #TP2 diminished (0.030-0.045 m³ m-3 ) the yield varied from 2,173 to 3,529 kg ha-1 and where it increased (0.045-0.076 m³ m-3 ), the yield was between 1,630 and 2,173 kg ha-1. Therefore, the total soil porosity, evaluated in the 0.10-0.20 m layer (#TP2), indicated the importance of the contact root/soil and was in turn a satisfactory indicator of soil physical quality, with a view to the grain yield of irrigated common bean

Occurrence of Aelurostrongylus abstrusus (Railliet, 1898) larvae (Nematoda: Metastrongylidae) infecting Achatina (Lissachatina) fulica Bowdich, 1822 (Mollusca: Gastropoda) in the Amazon region Ocorrência de Aelurostrongylus abstrusus (Railliet, 1898) (Nematoda: Metastrongylidae) infectando o Achatina (Lissachatina) fulica Bowdich, 1822 (Mollusca: Gastropoda) na região amazônica

Achatina fulica or "giant African snail" is an exotic species, considered to be one of the world's hundred most invasive species, causing serious environmental damages. In the present study we report, for the first time, the occurrence of Aelurostrongylus abstrusus infecting A.fulica in the Amazon region. This nematode is described parasitizing mainly the pulmonary system of felines, which causes "aelurostrongilose", also known as feline cardio-pulmonary strongyloidosis. New morphometric data of third stage larvae are presented herein. The present study demonstrated that 40% of all the snails were infected by A. abstrusus. Achatina fulica specimens were collected from three different areas in Manaus namely: rural; east and west areas. The east area presents the highest prevalence of 80%. The large number of A.fulica found in inhabited areas increases the chances of emergent zoonoses, which highlights the need of further studies so as to better control this disease.<br>Achatina fulica ou "caramujo africano" é uma espécie exótica, considerada uma das cem piores espécies invasoras do mundo, causando sérios danos ambientais. No presente estudo foi registrado, pela primeira vez, a ocorrência do Aelurostrongylus abstrusus infectando o A.fulica na região amazônica. Esse nematóide é descrito parasitando principalmente o sistema pulmonar de felinos, causando a "aelurostrongilose", também conhecida como estrongiloidose cardio-pulmonar felina. Novos dados morfométricos de larvas de terceiro estágio são apresentados. Dos 45 caramujos coletados, 40% estavam infectados por larvas de A. abstrusus. Especimens de Achatina fulica foram coletados em três áreas da cidade de Manaus: rural, leste e oeste. A zona leste apresentou a maior prevalência de 80%. O grande número de A.fulica encontrado em áreas habitadas aumenta as chances de ocorrência de zoonoses emergentes e destaca a necessidade de mais estudos para o melhor controle da doença