Comparison of the effects of salmeterol and ipratropium bromide on exercise performance and breathlessness in patients with stable chronic obstructive pulmonary disease

AbstractTo compare the effects of salmeterol, an adrenergic drug, and ipratropium bromide, an anticholinergic drug, on breathlessness and gas exchange during exercise in patients with chronic obstructive lung disease (COPD), we performed a progressive treadmill exercise test on 15 patients on 3 days (24 h apart), after inhalation placebo, ipratropium bromide (120 μg) or salmeterol (50 μg) in a randomized fashion. Dyspnoea during exercise was evaluated from the regression slope between Borg scale (BS) scores and distance walked each minute on the treadmill. The regression was expressed as the distance walked at BS score 5, the threshold load of dyspnoea (TLD) and breakpoint load of dyspnoea. During and after the exercise, oxygen saturation was monitored by pulse oxymeter and we measured the lower SaO2 during exercise and the recovery time of SaO2 after exercise.In comparison to placebo inhalation we found the same small but significant improvement in airflow limitation after salmeterol or ipratropium inhalation, also the distance walked on treadmill increased after bronchodilators. After bronchodilators the magnitude of oxyhaemoglobin desaturation with exercise was similar to that observed after placebo but the duration of the recovery from sustained SaO2 desaturation after exercise was shorter to the same extent as after ipratropium or salmeterol. Dyspnoeic sensation, when assessed by the TLD and by the distance walked at BS score 5, was decreased after salmeterol and after ipratropium bromide to a similar extent.We conclude that the salmeterol, when given in conventional doses, produces significant improvement in the airway obstruction in the recovery of postexercise HbO2 desaturation and in dyspnoeic sensation in patients with COPD, effects which were similar to those observed after inhalation of the anticholinergic agent ipratropium bromide

The Surface Water and Ocean Topography Satellite Mission - An Assessment of Swath Altimetry Measurements of River Hydrodynamics

The Surface Water and Ocean Topography (SWOT) satellite mission, scheduled for launch in 2020 with development commencing in 2015, will provide a step-change improvement in the measurement of terrestrial surface water storage and dynamics. In particular, it will provide the first, routine two-dimensional measurements of water surface elevations, which will allow for the estimation of river and floodplain flows via the water surface slope. In this paper, we characterize the measurements which may be obtained from SWOT and illustrate how they may be used to derive estimates of river discharge. In particular, we show (i) the spatia-temporal sampling scheme of SWOT, (ii) the errors which maybe expected in swath altimetry measurements of the terrestrial surface water, and (iii) the impacts such errors may have on estimates of water surface slope and river discharge, We illustrate this through a "virtual mission" study for a approximately 300 km reach of the central Amazon river, using a hydraulic model to provide water surface elevations according to the SWOT spatia-temporal sampling scheme (orbit with 78 degree inclination, 22 day repeat and 140 km swath width) to which errors were added based on a two-dimension height error spectrum derived from the SWOT design requirements. Water surface elevation measurements for the Amazon mainstem as may be observed by SWOT were thereby obtained. Using these measurements, estimates of river slope and discharge were derived and compared to those which may be obtained without error, and those obtained directly from the hydraulic model. It was found that discharge can be reproduced highly accurately from the water height, without knowledge of the detailed channel bathymetry using a modified Manning's equation, if friction, depth, width and slope are known. Increasing reach length was found to be an effective method to reduce systematic height error in SWOT measurements

Risk factors for human infection with West Nile Virus in Connecticut: a multi-year analysis

<p>Abstract</p> <p>Background</p> <p>The optimal method for early prediction of human West Nile virus (WNV) infection risk remains controversial. We analyzed the predictive utility of risk factor data for human WNV over a six-year period in Connecticut.</p> <p>Results and Discussion</p> <p>Using only environmental variables or animal sentinel data was less predictive than a model that considered all variables. In the final parsimonious model, population density, growing degree-days, temperature, WNV positive mosquitoes, dead birds and WNV positive birds were significant predictors of human infection risk, with an ROC value of 0.75.</p> <p>Conclusion</p> <p>A real-time model using climate, land use, and animal surveillance data to predict WNV risk appears feasible. The dynamic patterns of WNV infection suggest a need to periodically refine such prediction systems.</p> <p>Methods</p> <p>Using multiple logistic regression, the 30-day risk of human WNV infection by town was modeled using environmental variables as well as mosquito and wild bird surveillance.</p

IL-10 and TGF-β1 gene polymorphisms in Greek patients with recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) is one of the most frequent inflammatory disorders of the oral mucosa. Cytokines, which play an important role in RAS pathogenesis, participate directly or indirectly in normal, immunological and inflammatory processes and are secreted from cells belonging to innate and adaptive immunity as a consequence of microbial and antigenic stimuli. Gene polymorphisms in specific cytokines may predispose to RAS development. The aim of this study was the investigation and association of IL-10 and TGF-β1 gene polymorphisms with RAS

Behavioural response of the house mosquitoes Culex quinquefasciatus and Culex pipiens molestus to avian odours and its reliance on carbon dioxide

How Culex (Diptera: Culicidae) mosquitoes select and discriminate between potential avian hosts is critical for understanding the epidemiology of West Nile virus. Therefore, the present authors studied the behavioural responses of Culex quinquefasciatus (Say) and Culex pipiens molestus (Forsskål) to headspace volatiles of three avian species [chicken and pigeon (sexes analysed separately), and magpie], presented either alone or in combination with 600 p.p.m. carbon dioxide (CO2). The attraction of Cx. quinquefasciatus to the headspace volatiles of both sexes of chicken, and of female pigeon, in combination with CO2 was significantly higher than that achieved by the CO2 and solvent control. Although Cx. p. molestus was attracted to headspace volatiles of chickens and magpies, it was repelled by those of female pigeons when combined with CO2. An increased effect between the avian volatiles and CO2 was observed for Cx. quinquefasciatus, whereas the addition of CO2 had no effect on the attraction of Cx. p. molestus females. The results of this study demonstrate that Cx. quinquefasciatus and Cx. p. molestus are attracted to the odour of potential avian hosts. Future studies aimed at identifying the bioactive volatile compounds in the headspace of chickens may contribute to the potential development of effective surveillance and control tools against Culex species

Analysis on the clinical features of 22 basaloid squamous cell carcinoma of the lung

<p>Abstract</p> <p>Background</p> <p>Basaloid squamous cell carcinoma of the lung is a rare and highly malignant tumor mostly observed in the proximal bronchi. Basaloid squamous cell carcinoma of the lung cases typically show rapid clinical progression, very poor prognosis and special pathological morphology. This project aimed to examine the clinical features of basaloid squamous cell carcinoma of the lung and the factors related to its prognosis; and to compare survival outcomes between basaloid squamous cell carcinoma and poorly differentiated squamous cell carcinomas (PDSC).</p> <p>Methods</p> <p>Between January 2004 and December 2008, pathological sections from basaloid squamous cell carcinoma and PDSC of the lung were collected and retrospectively analyzed at Tianjin Medical University Cancer Institute and Hospital. Data analysis was performed using Statistical Package for the Social Sciences (SPSS11.0). The Kaplan-Meier method was used to calculate the survival rate. Log-rank test was used to compare the differences in survival rate between the two groups. The factors influencing prognosis were analyzed using the Cox proportional hazard model.</p> <p>Results</p> <p>A total of 120 pathological sections were used in the analysis of this study-22 from basaloid squamous cell carcinoma cases and 98 from PDSC cases. Compared to the PDSC group, the basaloid squamous cell carcinoma group had a larger proportion of female patients (p = 0.001); however it had higher proportion of male smokers (p = 0.003). There were no statistically significant differences in survival rate between the two groups (χ²= 1.200, p = 0.273). Additionally, prognosis of basaloid squamous cell carcinoma is significantly influenced by treatment mode and clinical stages of the tumor. The post-operation mortality hazard of patients treated with a combination chemotherapy and radiotherapy was 1.296 times higher than other treatment modes (<it>p </it>= 0.025). Increases in post-operation mortality hazard ratio were also associated with more advanced clinical stage of tumors (χ²trend = 11.907, <it>p </it>= 0.000).</p> <p>Conclusions</p> <p>This study demonstrated that basaloid squamous cell carcinoma and PDSC have very similar clinical features, and there are no significant differences in survival rates between the two groups. Hence, we conclude that in the short term, the same clinical treatments and therapeutic modes can be administered to patients with basaloid squamous cell carcinoma and PDSC of the lung.</p