Asthma costs and social impact

In recent decades, both asthma prevalence and incidence have been increasing worldwide, not only due to the genetic background, but mainly because of the effect of a wide number of environmental and lifestyle risk factors. In many countries noncommunicable diseases, like asthma, are not yet considered a healthcare priority. This review will analyze and discuss disparities in asthma management in several countries and regions, such as access to healthcare human resources and medications, due to limited financial capacity to develop strategies to control and prevent this chronic disease. This review tries to explore the social and economic burden of asthma impact on society. Although asthma is generally accepted as a costly illness, the total costs to society (direct, indirect and intangible asthma costs) are difficult to estimate, mainly due to different disease definitions and characterizations but also to the use of different methodologies to assess the asthma socio-economic impact in different societies. The asthma costs are very variables from country to country, however we can estimate that a mean cost per patient per year, including all asthmatics (intermittent, mild, moderate and severe asthma) in Europe is $USD 1,900, which seems lower than USA, estimated mean$USD 3,100.info:eu-repo/semantics/publishedVersio

An Enhanced Visualization of DBT Imaging Using Blind Deconvolution and Total Variation Minimization Regularization

Digital Breast Tomosynthesis (DBT) presents out-of-plane artifacts caused by features of high intensity. Given observed data and knowledge about the point spread function (PSF), deconvolution techniques recover data from a blurred version. However, a correct PSF is difficult to achieve and these methods amplify noise. When no information is available about the PSF, blind deconvolution can be used. Additionally, Total Variation (TV) minimization algorithms have achieved great success due to its virtue of preserving edges while reducing image noise. This work presents a novel approach in DBT through the study of out-of-plane artifacts using blind deconvolution and noise regularization based on TV minimization. Gradient information was also included. The methodology was tested using real phantom data and one clinical data set. The results were investigated using conventional 2D slice-by-slice visualization and 3D volume rendering. For the 2D analysis, the artifact spread function (ASF) and Full Width at Half Maximum (FWHMMASF) of the ASF were considered. The 3D quantitative analysis was based on the FWHM of disks profiles at 90°, noise and signal to noise ratio (SNR) at 0° and 90°. A marked visual decrease of the artifact with reductions of FWHMASF (2D) and FWHM90° (volume rendering) of 23.8% and 23.6%, respectively, was observed. Although there was an expected increase in noise level, SNR values were preserved after deconvolution. Regardless of the methodology and visualization approach, the objective of reducing the out-of-plane artifact was accomplished. Both for the phantom and clinical case, the artifact reduction in the z was markedly visible

Development of a PCR-RFLP marker to genetically distinguish Prosorhynchus crucibulum and Prosorhynchus aculeatus

The cercariae stages of Prosorhynchus crucibulum and Prosorhynchus aculeatus are morphologically indistinguishable. However, the differentiation of these two species is crucial to understand the transmission dynamics between these primary hosts (mussels) and the secondary hosts (fish). In this way, the objective of this study is to develop an accurate molecular identification too] to differentiate the cercariae stage of P. crucibulum and P. aculeatus. We targeted the 18S nuclear ribosomal DNA region by PCR amplification and sequenced this amplicon. By generating these sequences, we developed a RFLP tool with the use of the enzymes Hincll and FokI that produced different restriction profiles between P. crucibulum and P. aculeatus. Each enzyme generated different-sized fragments specific to the species examined and no cross-reaction between the species was detected in their restriction pattern. By sequencing, no intraspecific-polymorphism was detected since there is 100% homology among A aculeatus or A crucibulum. These results indicate that PCR-linked restriction analysis of the 18S rDNA region provided us with rapid and reliable molecular tools for distinction of the cercariae of these species. The sequences generated were deposited in GenBank accession numbers for P. crucibulum cercariae (FJ463407, FJ463408 and FJ463409) and adult worm (FJ429096, FJ429097), and for A aculeatus adult (FJ429094 and FJ429095). (C) 2009 Elsevier Ireland Ltd. All rights reserved

Impact of total variation minimization in volume rendering visualization of breast tomosynthesis data

Background and objective: Total Variation (TV) minimization algorithms have achieved great attention due to the virtue of decreasing noise while preserving edges. The purpose of this work is to implement and evaluate two TV minimization methods in 3D. Their performance is analyzed through 3D visualization of digital breast tomosynthesis (DBT) data with volume rendering. Methods: Both filters were studied with real phantom and one clinical DBT data. One algorithm was applied sequentially to all slices and the other was applied to the entire volume at once. The suitable Lagrange multiplier used in each filter equation was studied to reach the minimum 3D TV and the maximum contrast-to-noise ratio (CNR). Imaging blur was measured at 0° and 90° using two disks with different diameters (0.5 mm and 5.0 mm) and equal thickness. The quality of unfiltered and filtered data was analyzed with volume rendering at 0° and 90°. Results: For phantom data, with the sequential filter, a decrease of 25% in 3D TV value and an increase of 19% and 30% in CNR at 0° and 90°, respectively, were observed. When the filter is applied directly in 3D, TV value was reduced by 35% and an increase of 36% was achieved both for CNR at 0° and 90°. For the smaller disk, variations of 0% in width at half maximum (FWHM) at 0° and a decrease of about 2.5% for FWHM at 90° were observed for both filters. For the larger disk, there was a 2.5% increase in FWHM at 0° for both filters and a decrease of 6.28% and 1.69% in FWHM at 90° with the sequential filter and the 3D filter, respectively. When applied to clinical data, the performance of each filter was consistent with that obtained with the phantom. Conclusions: Data analysis confirmed the relevance of these methods in improving quality of DBT images. Additionally, this type of 3D visualization showed that it may play an important complementary role in DBT imaging. It allows to visualize all DBT data at once and to analyze properly filters applied to all the three dimensions

Plasma free amino acid profiles of Boer goat bucks as influenced by two feeding regimens

The aim of the study was to monitor the physiological changes in plasma free amino acid profiles in Boer goats under nutritional restriction. Fifteen Boer goat bucks were allocated to two experimental groups: CG (control), fed Themeda trianda hay, supplemented with maize, molasses and urea ad libitum; and RG (restricted feeding) fed the same hay (80 and 86% of the daily NRC energy and protein requirements, respectively) for 29 days. Animals were weighed and blood collected weekly for determination of plasma free amino acid profiles and the results compared between experimental groups. At the end of the experimental period the CG animals had higher concentrations of alanine, tyrosine and citrulline amino acids. The RG group had higher concentrations of valine, isoleucine, leucine, threonine, methionine, lysine, taurine, ornithine, hydroxyproline and tri-methyl-histidine, while glycine, serine, aspartic acid, glutamic acid, arginine, histidine and proline levels were similar in both groups. From the results it can be concluded that plasma amino acid profiles in the Boer goat were significantly affected by nutritional restriction. The degradation of short carbon chain amino acids is preferred to long carbon chain amino acids for gluconeogenesis in the physiological mechanisms of response to nutritional restriction in Boer goats. Keywords: Boer goat; nutrition; restricted feeding; amino acids South African Journal of Animal Science Vol. 36 (5) 2006: pp.14-1

Long noncoding RNAs: a missing link in osteoporosis

Osteoporosis is a systemic disease that results in loss of bone density and increased fracture risk, particularly in the vertebrae and the hip. This condition and associated morbidity and mortality increase with population ageing. Long noncoding (lnc) RNAs are transcripts longer than 200 nucleotides that are not translated into proteins, but play important regulatory roles in transcriptional and post-transcriptional regulation. Their contribution to disease onset and development is increasingly recognized. Herein, we present an integrative revision on the studies that implicate lncRNAs in osteoporosis and that support their potential use as therapeutic tools. Firstly, current evidence on lncRNAs involvement in cellular and molecular mechanisms linked to osteoporosis and its major complication, fragility fractures, is reviewed. We analyze evidence of their roles in osteogenesis, osteoclastogenesis, and bone fracture healing events from human and animal model studies. Secondly, the potential of lncRNAs alterations at genetic and transcriptomic level are discussed as osteoporosis risk factors and as new circulating biomarkers for diagnosis. Finally, we conclude debating the possibilities, persisting difficulties, and future prospects of using lncRNAs in the treatment of osteoporosis.This project has been supported by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project POCI-01-0145-FEDER-031402—R2Bone, under the PORTUGAL 2020 Partnership Agreement, through ERDF. Authors would like to thank to FCT DL 57/2016/CP1360/CT0008 (M.I.A.) and SFRH/BD/112832/2015 (J.H.T)

Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headaches

Objective: To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology: Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8-12 weeks after the end of the intervention (A2). Results: At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven't change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion: The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.info:eu-repo/semantics/publishedVersio

Reflection on Risk Factors, Ashtma and Tobacco Smoke Exposure

O impacto da asma brônquica nas últimas décadas, nomeadamente em idade pediátrica, associando prevalências significativas a uma tendência, gravidade e custos crescentes, tem levado a que se efectuem múltiplos estudos para esclarecer causas, avaliando riscos, permitindo a elaboração de programas de prevenção. Estudos epidemiológicos bem desenhados, aplicados a amostras populacionais significativas, permitem identificar determinantes independentes da asma, viabilizando a actuação. Se muito se tem avançado no conhecimento das bases fisiopatológicas da doença alérgica, é com alguma preocupação que sentimos que a comunidade médica, mesmo a especializada, não sente as evidências epidemiológicas como aplicáveis à sua população de asmáticos. “Precisamos de mais estudos”, é declaração comum. Com este trabalho, centrado em três rastreios efectuados com a coordenação dos autores, pretendemos demonstrar que existem factores preveníveis, moduláveis, que podem permitir reduzir a morbilidade da doença asmática. Entre estes, o tabagismo passivo assume uma relevância ímpar, por ser o principal factor de risco para a gravidade da asma pediátrica em Portugal

Development Process and Cognitive Testing of CARATkids - Control of Allergic Rhinitis and Asthma Test for Children

Background: Allergic rhinitis and asthma (ARA) are chronic inflammatory diseases of the airways that often coexist in children. The only tool to assess the ARA control, the Control of Allergic Rhinitis and Asthma Test (CARAT) is to be used by adults. We aimed to develop the Pediatric version of Control of Allergic Rhinitis and Asthma Test (CARATkids) and to test its comprehensibility in children with 4 to 12 years of age. Methods: The questionnaire development included a literature review of pediatric questionnaires on asthma and/or rhinitis control and two consensus meetings of a multidisciplinary group. Cognitive testing was carried out in a cross-sectional qualitative study using cognitive interviews. Results: Four questionnaires to assess asthma and none to assess rhinitis control in children were identified. The multidisciplinary group produced a questionnaire version for children with 17 questions with illustrations and dichotomous (yes/no) response format. The version for caregivers had 4-points and dichotomous scales. Twenty-nine children, 4 to 12 years old, and their caregivers were interviewed. Only children over 6 years old could adequately answer the questionnaire. A few words/expressions were not fully understood by children of 6 to 8 years old. The drawings illustrating the questions were considered helpful by children and caregivers. Caregivers considered the questionnaire complete and clear and preferred dichotomous over the 4-points scales. The proportion of agreement between children and their caregivers was 61%. The words/expressions that were difficult to understand were amended. Conclusion: CARATkids, the first questionnaire to assess a child’s asthma and rhinitis control was developed and its content validity was assured. Cognitive testing showed that CARATKids is well-understood by children 6 to 12 years old. The questionnaire’s measurement properties can now be assessed in a validation study

Allergic conjunctivitis and conjunctival provocation tests in atopic dogs.

INTRODUCTION: Canine atopic dermatitis (cAD) is a very common disease, but little is known about eye involvement. The conjunctival provocation test (CPT) is used in human to study the ocular response to allergenic stimuli and to evaluate anti-allergic therapy. To our knowledge it has not been used in dogs. OBJECTIVES: To evaluate the prevalence of ocular signs in a population of atopic dogs and relate these with clinical cAD scores; and the usefulness of CPT for dust mites in atopic dogs with itchy eyes. PROCEDURES: Sixty cAD patients were evaluated for (i) ocular signs of allergic conjunctivitis including conjunctival hyperemia, chemosis, epiphora, ocular discharge, pruritus and corneal involvement, graded 0 to 3 according to severity, and (2) cAD Extent and Severity Index (CADESI-03). Additionally, CPTs for Dermatophagoides farinae (n = 12) and Dermatophagoides pteronyssinus (n = 12) were performed in sensitized atopic dogs and 24 control dogs. RESULTS: Periocular and ocular signs of allergy were present in 60% (36/60) of cases. Conjunctival hyperemia (90%) was the most common sign. Severity of ocular signs was significantly correlated with eye pruritus (r(s)  = 0.690, P = <0.001) and skin lesions score for head region (r(s) = 0.261, P = 0.04). A highly significant difference (P < 0.001, Fisher test) was found in CPTs between the test and the control groups. CONCLUSION:  Allergic conjunctivitis signs associated with cAD seem under valuated so these patients would benefit from an ophthalmologic evaluation. Furthermore, we found CPT to be a reliable, easy to perform and safe test for the etiologic diagnosis of allergic conjunctivitis in the dog