2,850 research outputs found
Prevalence of asthma and its association with rhinitis in the elderly
BACKGROUND:
Asthma and rhinitis are frequent respiratory diseases in children and adults. Despite the increase in the aging population, there are few epidemiologic data on both diseases in the elderly. So far, no population-based study has analyzed the association between asthma and rhinitis symptoms and severity in this age group. This study aimed to estimate the prevalence of physician-diagnosed asthma in the population aged â„65 years in mainland Portugal and to evaluate its association with the presence and classification of rhinitis according to ARIA recommendations, in this age group.
METHODS:
A cross-sectional, nationwide, population-based survey of individuals aged â„65 years, living in mainland Portugal was performed.
RESULTS:
Data were obtained from 3678 respondents. The prevalence of physician-diagnosed asthma was 10.9% (95% confidence interval (95%CI) 9.9-11.9). The frequency of asthma diagnosis increased with the number of nasal symptoms (p < 0.001). A strong association between asthma and rhinitis was found (odds ratio (OR) 13.86 (95%CI 10.66-18.02)). The strength of this association increased with the persistence and severity of rhinitis, being particularly high in elderly subjects with moderate-severe persistent rhinitis (OR 39.9 (95%CI 27.5-58.0)).
CONCLUSIONS:
Asthma is common in the elderly and strongly associated with rhinitis. The OR for asthma is especially high in persistent and severe ARIA classification rhinitis types. This study strengthens the need for an integrated assessment of asthma together with rhinitis in the elderl
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 childâs 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 questionnaireâs measurement properties can now be assessed in a validation study
Epigallocathechin-O-3-Gallate Inhibits Trypanothione Reductase of Leishmania infantum, Causing Alterations in Redox Balance and Leading to Parasite Death
Leishmania infantum is a protozoan parasite that causes a vector borne infectious disease in humans known as visceral leishmaniasis (VL). This pathology, also caused by L. donovani, presently impacts the health of 500,000 people worldwide, and is treated with outdated anti-parasitic drugs that suffer from poor treatment regimens, severe side effects, high cost and/or emergence of resistant parasites. In previous works we have disclosed the anti-Leishmania activity of (-)-Epigallocatechin 3-O-gallate (EGCG), a flavonoid compound present in green tea leaves. To date, the mechanism of action of EGCG against Leishmania remains unknown. This work aims to shed new light into the leishmanicidal mode of action of EGCG. Towards this goal, we first confirmed that EGCG inhibits L. infantum promastigote proliferation in a concentration-dependent manner. Second, we established that the leishmanicidal effect of EGCG was associated with i) mitochondria depolarization and ii) decreased concentration of intracellular ATP, and iii) increased concentration of intracellular H2O2. Third, we found that the leishmanicidal effect and the elevated H2O2 levels induced by of EGCG can be abolished by PEG-catalase, strongly suggesting that this flavonoid kills L. infantum promastigotes by disturbing their intracellular redox balance. Finally, we gathered in silico and in vitro evidence that EGCG binds to trypanothione reductase (TR), a central enzyme of the redox homeostasis of Leishmania, acting as a competitive inhibitor of its trypanothione substrate.This work was supported by FundacÌ§ĂŁo Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento CientıÌfico e TecnoloÌgico (CNPq), Programa EstrateÌgico de Apoio a Pesquisa em SauÌde (PAPES/FIOCRUZ);, and FundacÌ§ĂŁo Oswaldo Cruz (FIOCRUZ). EA-A is the ecipient of a research scholarship from Conselho Nacional de Desenvolvimento CientıÌfico e TecnoloÌgico (CNPq). JI was supported by a postdoctoral fellowship from Conselho Nacional de Desenvolvimento CientıÌfico e TecnoloÌgico (CNPq). JI is a recipient of a postdoctoral fellowship from FundacÌ§ĂŁo Oswaldo Cruz (FIOCRUZ). HC is funded by FundacÌ§ĂŁo para a CieÌncia e Tecnologia (FCT, Portugal) through the âInvestigador FCTâ contract IF/01244/2015
Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituximab, a case-based review
Primary biliary cirrhosis (PBC) is an autoimmune disease in which intrahepatic bile ducts are targeted by an immune-mediated injury. This disease tends to progress to fibrosis and cirrhosis with hepatic failure. The authors report a case of a 50-year-old rheumatoid arthritis (RA) patient, with erosions and seropositive for rheumatoid factor and anti-citrullinated peptide antibodies, with 18 years disease duration refractory to prednisolone and several disease-modifying antirheumatic drugs, either conventional or biological (adalimumab and etanercept). In April 2007, she started therapy with rituximab (RTX) with good European League Against Rheumatism response achieved 9 months later. In June 2008, she was admitted with intrahepatic cholestasis, steatorrhea, and spontaneous fractures of various ribs. After excluding cholelitiasis, as well as infectious and neoplastic diseases a liver biopsy was performed that was compatible with the diagnosis of PBC. The antinuclear antibodies (1/160) were positive as well as the antimitochondrial antibodies (1/640). Other antibodies were negative such as anti-SSA and anti-SSB. Afterwards, the patient started ursodesoxycholic acid 15 mg kg(-1) day(-1) with progressive improvement of cholestatic markers. A labial salivary gland biopsy was performed and showed findings compatible with the concomitant diagnosis of Sjögren's syndrome. Based on this clinical report, a detailed review of the clinical aspects of PBC is presented as well as its association with other immune-mediated inflammatory diseases, particularly, with RA
Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal
BACKGROUND:
Nationwide epidemiologic data on rhinitis in the elderly do not exist. This study aimed to estimate the prevalence of rhinitis in the population aged 65 years or above in mainland Portugal and to characterize and classify rhinitis in this age group.
METHODS:
Cross-sectional, nationwide, population-based survey of citizens aged 65 years or above, living in mainland Portugal. Current rhinitis (CR) was defined as the presence of at least two symptoms: 'repeated sneezing and itchy nose', 'blocked nose for more than one whole hour', or 'runny nose when not having a cold or flu', either usually or in the last 12 months. Rhinitis severity was assessed using a visual analogue scale; rhinitis was classified according to ARIA.
RESULTS:
Data were obtained from 3678 responders (92.5% response rate). The prevalence of CR was 29.8% (95% confidence interval (CI): 28.4%-31.3%): 49.1% had mild intermittent, 7.0% mild persistent, 27.5% moderate-severe intermittent, and 16.4% moderate-severe persistent rhinitis. Only 38.6% of patients with CR had been physician diagnosed and 38.7% were under treatment for this disease in the previous year. Allergic conjunctivitis symptoms were referred by 68.6% of subjects with CR (rhinoconjunctivitis population prevalence, 20.5% (95% CI: 19.2%-21.8%)).
CONCLUSIONS:
Rhinitis and rhinoconjunctivitis are common but underdiagnosed and undertreated diseases in the geriatric population. This was the first nationwide epidemiological survey classifying rhinitis according to ARIA guidelines in this age group. More than 40% of old-age patients presented moderate-severe disease
Quantum enhanced positioning and clock synchronization
A wide variety of positioning and ranging procedures are based on repeatedly
sending electromagnetic pulses through space and measuring their time of
arrival. This paper shows that quantum entanglement and squeezing can be
employed to overcome the classical power/bandwidth limits on these procedures,
enhancing their accuracy. Frequency entangled pulses could be used to construct
quantum positioning systems (QPS), to perform clock synchronization, or to do
ranging (quantum radar): all of these techniques exhibit a similar enhancement
compared with analogous protocols that use classical light. Quantum
entanglement and squeezing have been exploited in the context of
interferometry, frequency measurements, lithography, and algorithms. Here, the
problem of positioning a party (say Alice) with respect to a fixed array of
reference points will be analyzed.Comment: 4 pages, 2 figures. Accepted for publication by Natur
Establishing comprehensive oral assessments for children with safeguarding concerns.
The dental profession is well placed to contribute important information in child protection cases but no previous research has been reported that assesses the volume or impact of this information. Comprehensive oral assessment clinics were introduced and established as an integral part of comprehensive medical assessments for children with welfare concerns in Greater Glasgow and Clyde. An assessment protocol and standardised paperwork for comprehensive oral assessments were developed to enhance information sharing and patient access to appropriate care. Two cases are presented and discussed to demonstrate the value of dental input
The Portuguese Severe Asthma Registry: Development, Features, and Data Sharing Policies
The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient's clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients' electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients' confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma.info:eu-repo/semantics/publishedVersio
Persistence of magnetic field driven by relativistic electrons in a plasma
The onset and evolution of magnetic fields in laboratory and astrophysical
plasmas is determined by several mechanisms, including instabilities, dynamo
effects and ultra-high energy particle flows through gas, plasma and
interstellar-media. These processes are relevant over a wide range of
conditions, from cosmic ray acceleration and gamma ray bursts to nuclear fusion
in stars. The disparate temporal and spatial scales where each operates can be
reconciled by scaling parameters that enable to recreate astrophysical
conditions in the laboratory. Here we unveil a new mechanism by which the flow
of ultra-energetic particles can strongly magnetize the boundary between the
plasma and the non-ionized gas to magnetic fields up to 10-100 Tesla (micro
Tesla in astrophysical conditions). The physics is observed from the first
time-resolved large scale magnetic field measurements obtained in a laser
wakefield accelerator. Particle-in-cell simulations capturing the global plasma
and field dynamics over the full plasma length confirm the experimental
measurements. These results open new paths for the exploration and modelling of
ultra high energy particle driven magnetic field generation in the laboratory
State based model of long-term potentiation and synaptic tagging and capture
Recent data indicate that plasticity protocols have not only synapse-specific but also more widespread effects. In particular, in synaptic tagging and capture (STC), tagged synapses can capture plasticity-related proteins, synthesized in response to strong stimulation of other synapses. This leads to long-lasting modification of only weakly stimulated synapses. Here we present a biophysical model of synaptic plasticity in the hippocampus that incorporates several key results from experiments on STC. The model specifies a set of physical states in which a synapse can exist, together with transition rates that are affected by high- and low-frequency stimulation protocols. In contrast to most standard plasticity models, the model exhibits both early- and late-phase LTP/D, de-potentiation, and STC. As such, it provides a useful starting point for further theoretical work on the role of STC in learning and memory
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