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

Aspectos epidemiológicos, clínicos e anatomopatológicos do linfoma em bovinos: 128 casos (1965-2013)

Por meio de um estudo retrospectivo, os aspectos epidemiológicos, clínicos e anatomopatológicos de 128 casos de linfoma bovino são descritos. Dos protocolos que informavam o sexo (n=111), 84,7% correspondiam a fêmeas e 15,3% a machos. Dos protocolos em que constava a raça (n=108), a mais prevalente foi a holandesa (63%). Em relação à idade (n=107), houve uma variação entre um e 14 anos. A maioria dos bovinos era adulta (89,7%) e a maior concentração dos casos ocorreu ao redor de 5-8 anos (57,9%). Em relação aos sinais clínicos (n=89), linfadenomegalia foi o achado mais frequentemente observado (74,1%). Outros sinais clínicos, principalmente aqueles relacionados com os sistemas respiratório (dispneia, estertoração pulmonar e taquipneia), cardiovascular (taquicardia, edema subcutâneo e pulso venoso positivo), digestório (atonia ruminal, timpanismo e diarreia) e nervoso (paresia dos membros pélvicos e andar cambaleante), foram pouco prevalentes. Na necropsia (n=125), 71,2% dos bovinos apresentavam aumento de volume dos linfonodos; essa linfadenomegalia foi classificada como localizada em 89,6% dos casos e generalizada em 10,3% dos casos. Dos protocolos que informavam os linfonodos acometidos (n=58), a distribuição foi a seguinte: mesentéricos (51,7%), mediastínicos (37,9%), pré-escapulares (29,3%), ilíacos internos (27,6%), inguinais superficiais (25,8%) e traqueobrônquicos (18,9%). Além dos linfonodos, outros órgãos comumente afetados pelo linfoma neste estudo incluíram: coração (40%), fígado (15,2%), rim (14,4%), abomaso (12,8%), útero (11,2%), intestino (10,4%) e pulmão (7,2%). A presença de massas tumorais no canal vertebral foi observada em poucos casos (3,2%). Com base na epidemiologia e na localização das lesões, a maioria dos casos (96%) foi classificada como linfoma enzoótico e o restante (4%) como linfoma esporádico. Os resultados encontrados neste estudo irão auxiliar clínicos de grandes animais e patologistas veterinários na suspeita e no diagnóstico definitivo do linfoma na espécie bovina

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

Long-range Angular Correlations On The Near And Away Side In P-pb Collisions At √snn=5.02 Tev

7191/Mar294

Allergy to fungal allergens in Northern Italy

IgE-mediated allergy to fungal allergens was found in 8.1% out of 4174 patients undergoing skin prick test with commercial extracts. The most frequently involved fungi were A. Alternata (which accounted for 67% skin prick test positivities) and C. herbarum (14%). Monosensitization to fungi was very rare (6% of sensitized subjects) and was less frequently associated with asthma (38%) as compared to polysensitization (52% of subjects also sensitized to other inhalant allergens)

Contribution of sexual desire and motives to the compulsive use of cybersex.

Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex. The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire). For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men. The study showed gender differences in the contributors to sex-related CIUS scores

Anti tissue transglutaminase antibodies as predictors of silent coeliac disease in patients with hypertransaminasaemia of unknown origin

Background. Unexplained hypertransaminasaemia can be regarded as an extraintestinal presentation of coeliac disease.Aim, To evaluate the reliability of immunoglobulin A anti tissue transglutaminase antibodies for identifying coeliac disease in those patients. with raised transaminases of unknown origin.Patients. Of 1120 consecutive patients referred to the outpatient clinic for, liver disease due to raised transaminases from September 1995 to December 1999, 110 were classified as having cryptogenic hypertransaminasaemia after the exclusion of every known cause of liver disease.Methods. These 110 patients were tested for immunoglobulin A anti tissue transglutaminase and antiendomysial antibodies by enzyme-linked immunosorbent assay and indirect immunofluorescence, respectively.Results. Ten patients resulted positive fop both antibodies; in all of them duodenal biopsy showed a subtotal villous atrophy consistent with coeliac disease. They did not complain of any gastrointestinal symptom. Liver biopsy, performed in five, showed a histological picture of non-specific reactive hepatitis.Conclusions. Due to the high proportion (9.1%) of patients with cryptogenic hypertransaminasaemia affected by symptomless coeliac disease, serological screening for gluten-sensitive enteropathy must be included in the work-up of these patients. In this respect, anti tissue transglutaminase antibodies represent a valid alternative to antiendomysial antibodies with the advantage of being feasible everywhere thanks to the worldwide availability of enzyme-linked immunosorbent assay

Prevalence and severity of the oral allergy syndrome in pollen monosensitized subjects living in an area of Northen Italy

Background: The term “oral allergy syndrome” (OAS) is currently used to report immediate reactions following the ingestion of raw fruit and vegetables. It is believed to be due to cross-reactivity between inhalant and food allergens. The exact prevalence and severity of OAS is still not clarified. Objective: To evaluate the prevalence and severity of OAS in two groups of pollen (grass and birch/hazel) monosensitized subjects. Materials and Methods: 141 subjects skin prick test (SPT) positive only to birch/hazel (group I) and 809 only to grass (group II) were interviewed about the occurence and the severity of any adverse reaction to fruit and vegetables. Latex- and poly-sensitized subjects were excluded. Results: The overall prevalence of OAS was 21% and was mild/moderate in 93%. In both groups OAS was more frequent in women (38% and 22%, p<0.05 and p<0.001, respectively) than men (22% and 15%) and less frequent in group II overall (18% vs 31%, p<0.001). Severe reactions were more prevalent in group I (overall prevalence 3.5% vs 0.7%, p<0.02). Reactions to apple (p<0.0001), vegetables of the Umbelliferae family (p<0.0001) and nuts (p<0.03) were more frequent in group I, whereas those to Cucurbitaceae (p<0.0005) and to vegetables of the Solanaceae family in group II (p<0.03). Conclusion: Although generally benign, SOA is a relevant phenomenon, affecting 18%-31% pollen monosensitized individuals and even more frequently women. Our data support the implementation of both clinical and laboratory studies to better define it and to draw guidelines for its management