Characterization of asthma exacerbations in primary care using cluster analysis.

Rationale: Patients with a history of asthma exacerbations are at a higher risk for future episodes of severe asthma exacerbations. Characterization of asthma phenotypes could help improve asthma management, including reducing exacerbations.

Aim: The aim of this study is to identify distinctive patient characteristics associated with a history of asthma exacerbations using cluster analysis.

Reading and interpretation of chest X-ray in adults with community-acquired pneumonia.

Introduction: Traditional reading of chest X-rays usually has a low prognostic value and poor agreement.

Objective: This study aimed to determine the interobserver and intraobserver agreement using two reading formats in patients with community-acquired pneumonia, and to explore their association with etiology and clinical outcomes.

Methods: A pulmonologist and a radiologist, who were blind to clinical data, interpreted 211 radiographs using a traditional analysis format (type and location of pulmonary infiltrates and pleural findings), and a quantitative analysis (pulmonary damage categorized from 0 to 10).

Levels of heat shock protein transcripts in normal follicles and ovarian follicular cysts.

In the study, the gene expression of several heat shock proteins (HSPs) was determined in normal follicles and cystic follicles from cattle. A lower expression of HSP10 and HSP40 was observed in granulosa and theca cells of cysts compared to normal follicles. HSP27 was significantly less expressed in granulosa cells in cystic and large antral follicles than in other follicular categories.

Human milk adiponectin affects infant weight trajectory during the second year of life.

Objective: Serum adiponectin (APN) is associated with lower childhood obesity, and APN concentration in human milk is associated with slower growth during active breast-feeding. We examined infant weight gain in the second year of life after exposure to high or low levels of mother's milk APN.

Methods: Breast-feeding mother-infant pairs were recruited in Mexico City and studied for 2 years; 192 infants with at least 12 months' follow-up were analyzed.

Alterations of the extracellular matrix of lung during zinc deficiency.

Suboptimal intake of Zn is one of the most common nutritional problems worldwide. Previously, we have shown that Zn deficiency (ZD) produces oxidative and nitrosative stress in the lung of rats. We analyse the effect of moderate ZD on the expression of several intermediate filaments of the cytoskeleton, as well as the effect of restoring Zn during the refeeding period.

Intergeneric phylogenetic relationships in catfishes of the Loricariinae (Siluriformes: Loricariidae), with the description of Fonchiiloricaria nanodon: a new genus and species from Peru.

Recent investigations in the upper Río Huallaga in Peru revealed the presence of an intriguing species of the Loricariinae. To characterize and place this species within the evolutionary tree of the subfamily, a molecular phylogeny of this group was inferred based on the 12S and 16S mitochondrial genes and the nuclear gene F-reticulon4. The phylogeny indicated that this distinctive species was a member of the subtribe Loricariina.

Influence of insulin-like growth factor-binding proteins-2 and -3 in the pathogenesis of cystic ovarian disease in cattle.

Ovarian cysts are one of the major causes of infertility in dairy cows. The development is associated with an endocrine imbalance in the hypothalamo-hypophyseal-gonadal axis in which endocrine factors participate in follicular growth and differentiation and in the secretion of ovarian hormones. Insulin-like growth factor family are essential local regulators of ovarian follicle development and functionality and actions are mediated by binding protein activity.

Ultraviolet radiation on innate immunity and growth of broad-snouted caiman (Caiman latirostris): implications for facilities design.

Sunlight is a key environmental factor in almost all ecosystems, and it is necessary for many physiological functions. Many vertebrates require ultraviolet (UV) radiation to perform different physiological processes. Artificial light is used to supplement UV in captive animals, through appropriate photoperiods and UV wavelengths.

Proinflammatory cytokines and CD14 expression in mammary tissue of cows following intramammary inoculation of Panax ginseng at drying off.

The lack of efficacy of conventional strategies for the maintenance of healthy udders in domestic cattle has prompted studies on the use of immunomodulators or biological response modifiers (BRM) for this purpose. These compounds are agents that modify the host's response to pathogens leading to beneficial effects on disease outcome. The objective of this study was to evaluate the effects of a single intramammary infusion of Panax ginseng (GS) extract on the amount of pro-inflammatory cytokines and the number of monocytes/macrophages present in bovine mammary tissues at drying off.

An antibody against IL-5 reduces numbers of esophageal intraepithelial eosinophils in children with eosinophilic esophagitis.

Background & Aims: The role of interleukin (IL)-5 in the pathogenesis of eosinophilic esophagitis (EoE) has been established in animal models; anti-IL-5 therapy has been reported to be effective in adults. We investigated whether IL-5 has a role in accumulation of esophageal eosinophils in children with EoE and whether therapy with mepolizumab, an antibody against IL-5, reduces the number of esophageal intraepithelial eosinophils in children with EoE.

Methods: We performed an international, multicenter, double-blind, randomized, prospective study of 59 children with EoE, defined as baseline peak count of esophageal intraepithelial eosinophils of ≥ 20 in at least 1 high-power field (hpf).

Titration of sevoflurane in elderly patients: blinded, randomized clinical trial, in non-cardiac surgery after beta-adrenergic blockade.

Background: Monitoring depth of anesthesia via the processed electroencephalogram (EEG) has been found useful in reducing the amount of anesthetic drugs, optimizing wake-up times, and, in some studies, reducing awareness. Our goal was to determine if titrating sevoflurane as the maintenance anesthetic to a depth of anesthesia monitor (SEDLine™, Masimo, CA) would shorten time to extubation in elderly patients undergoing non-cardiac surgery while on beta-adrenergic blockade. This patient population was selected because the usual cardiovascular signs of inadequate general anesthesia may be masked by beta-blocker therapy.

Sympathetic nerve activity in normal and cystic follicles from isolated bovine ovary: local effect of beta-adrenergic stimulation on steroid secretion.

Cystic ovarian disease (COD) is an important cause of abnormal estrous behavior and infertility in dairy cows. COD is mainly observed in high-yielding dairy cows during the first months post-partum, a period of high stress. We have previously reported that, in lower mammals, stress induces a cystic condition similar to the polycystic ovary syndrome in humans and that stress is a definitive component in the human pathology.

Steroid receptor mRNA expression in the ovarian follicles of cows with cystic ovarian disease.

Steroid receptors have been demonstrated to be important intra-ovarian regulators of follicular development and ovulatory processes. The aim of the present study was to determine the expression of steroid receptor mRNA in ovarian follicular structures from cows with cystic ovarian disease (COD) compared with ovarian structures from regularly cycling cows using reverse transcription polymerase chain reaction (RT-PCR). The cystic follicles showed a higher estrogen receptor α (ESR1) mRNA expression in the theca and granulosa and a lower estrogen receptor β (ESR2) expression.

Intramammary inoculation of Panax ginseng extract in cows at drying off enhances early mammary involution.

This study was designed to evaluate the effects of a single intramammary infusion of Panax ginseng extract on cell proliferation and death mechanism in bovine mammary gland during early involution. Eight mammary quarters from six non-pregnant cows in late lactation were infused with 10 ml of ginseng solution (3 mg/ml), six quarters were treated with 10 ml of placebo (vehicle alone) and six quarters were maintained as uninoculated controls. Milking was interrupted after infusion.

Expression of melanocortin receptors mRNA, and direct effects of ACTH on steroid secretion in the bovine ovary.

Melanocortin receptors (MCRs) are involved in physiological responses to ACTH, as well as to α-, β- and γ-melanocyte-stimulating hormone (α-, β- and γ-MSH). Their expression has previously been analyzed in various bovine tissues; however, there are apparently no reports regarding their localization in the ovaries. In the present study, the expression of MCR mRNA in various bovine ovarian structures was characterized with reverse transcription polymerase chain reaction (RT-PCR).

Electrical signalling of dominance in a wild population of electric fish.

Animals often use signals to communicate their dominance status and avoid the costs of combat. We investigated whether the frequency of the electric organ discharge (EOD) of the weakly electric fish, Sternarchorhynchus sp., signals the dominance status of individuals.

Cell proliferation and survival mechanisms underlying the abnormal persistence of follicular cysts in bovines with cystic ovarian disease induced by ACTH.

Cystic ovarian disease (COD) is an important cause of infertility that affects cattle. Alterations in the ovarian micro-environment of females with follicular cysts could alter the normal processes of proliferation and programmed cell death in ovarian cells. Thus, the objective in the present study was to evaluate apoptosis and proliferation in induced ovarian cystic follicles in cows to investigate the follicular persistence.

Effect of Panax ginseng on cytokine expression in bovine mammary glands at drying off.

Biological response modifiers (BRM) are agents that modify the host's response to pathogens with resultant beneficial prophylactic or therapeutic effects. The objectives of this study were to describe the immunomodulatory effects of Panax ginseng (GS) on bovine mammary glands at the end of lactation. Eight mammary quarters from six nonpregnant cows in late lactation were infused with 10mL of BRM (3mg/mL), six quarters were treated with placebo (vehicle alone) and six quarters were maintained as uninoculated controls.

The effect of a single intramammary infusion of a biological response modifier in cows at drying off.

Biological response modifiers (BRM) are compounds that interact with the immune system to regulate specific aspects of host response. The objective of this study was to describe clinical and morphological changes during involution of bovine mammary gland following a single-dose infusion of a BRM containing lipopolysaccharide and cellular fractions of Escherichia coli incorporated into liposomes. A massive leukocyte response and increased subepithelial stroma infiltration of mononuclear cells, eosinophils and mast cells was observed in BRM-treated quarters compared with untreated controls; however, morphologic parameters assessed at 11 days post infusion were indicative of only slightly accelerated involution compared with untreated controls.

Assessing Primary Care Physician's Beliefs and Attitudes of Asthma Exacerbation Treatment and Follow-Up.

Objective: The objective of this survey was to assess adult primary care physicians' and pediatricians' perceptions of asthma exacerbation management, including beliefs concerning the discharge of patients from the emergency department (ED) following asthma exacerbations.

Methods: This was a cross-sectional survey of primary care physicians (PCPs) treating adult or pediatric patients. Surveys were mailed to physicians and included questions on how PCPs define an exacerbation, how they are notified and how they followed-up with their patients who experienced exacerbations.

Status of asthma control in pediatric primary care: results from the pediatric Asthma Control Characteristics and Prevalence Survey Study (ACCESS).

Objective: To estimate the prevalence of uncontrolled asthma in pediatric patients with asthma visiting their primary care provider for any medical reason.

Study Design: This was a cross-sectional survey conducted at 29 pediatric care sites across the United States. Children age 4-17 years with self- or caregiver-reported asthma completed the Childhood Asthma Control Test (C-ACT) or the Asthma Control Test (ACT) and responded to demographic and health-related questions.

Predictors of uncontrolled asthma in adult and pediatric patients: analysis of the Asthma Control Characteristics and Prevalence Survey Studies (ACCESS).

Background: Despite the availability of effective asthma treatments and evidence-based management guidelines focusing on asthma control, many patients have asthma that is inadequately controlled. The objective of this analysis was to identify risk factors for uncontrolled asthma among adult and pediatric patients.

Methods: Two cross-sectional surveys assessing asthma control status were conducted between January 25 and May 2, 2008, among adult and pediatric patients with asthma.

Adding montelukast to fluticasone propionate/salmeterol for control of asthma and seasonal allergic rhinitis.

Limited information exists comparing fluticasone propionate/salmeterol combination (FSC) versus montelukast (MON) in patients with coexistent asthma and allergic rhinitis. The purpose of this study was to compare the addition of MON to patients receiving FSC on asthma control while experiencing asthma and allergy symptoms. Additionally, the effect of fluticasone propionate aqueous nasal spray (FPANS) and MON were assessed in allergic rhinitis control.