End-stage renal disease in a Down syndrome patient caused by delayed diagnosis of nonneurogenic bladder: A case report.

Rationale: Patients with Down syndrome (DS) have a higher incidence of nonneurogenic neurogenic bladder (NNB) than do normal subjects. Renal failure may occur frequently in NNB patients. Although most of the cases of NNB patients with DS reported to date have been acute renal injuries, we report a patient with DS who was diagnosed late with urinary tract obstruction due to NNB that finally proceeded to end-stage renal disease (ESRD).

Precision health: treating the individual patient with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is defined based on a reduced ratio of forced expiratory volume in one second (FEV ) to forced vital capacity (FVC) on spirometry. However, within this definition, there is significant heterogeneity of pathophysiological processes that lead to airflow obstruction and variation in phenotypic manifestations across patients. Current pharmacological treatments are based on large randomised clinical trials that apply to an "average" patient.

Inhaled corticosteroids and the risk of lung cancer in COPD: a population-based cohort study.

Inhaled corticosteroids (ICSs) are often prescribed in patients with chronic obstructive pulmonary disease (COPD). Their impact on the risk of lung cancer, a leading cause of mortality in COPD patients, remains uncertain.Population-based linked administrative data between the years 1997 and 2007 from the province of British Columbia, Canada, were used to evaluate the association between lung cancer risk and ICS use in COPD patients.

External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study.

The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX).

Operational and Institutional Recommendations and Requirements for TAVR: A Review of Expert Consensus and the Impact on Health Care Policy.

When transcatheter aortic valve replacement (TAVR) was first approved for use in the United States in 2012, multiple leading surgical and cardiology societies were tasked with creating recommendations and requirements for operators and institutions starting and maintaining TAVR programs. Creation of this consensus document was challenging due to limited experience with this new technology, and a lack of robust centralized data that could be used to validate outcome measures and create benchmarks for self-assessment and improvement. Despite these limitations, this document provided government agencies a framework for regulation that ultimately determined requirements for Medicare payment for TAVR and therefore greatly determined how and where care was delivered for patients with aortic stenosis.

Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019.

Precision medicine is a patient-specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side-effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) patients. Blood eosinophil counts are a biomarker with potential to be used in clinical practice, to help target ICS treatment with more precision in COPD patients with a history of exacerbations despite appropriate bronchodilator treatment.

Hedgehog signaling in the airway epithelium of patients with chronic obstructive pulmonary disease.

Genome-wide association studies have linked gene variants of the receptor patched homolog 1 (PTCH1) with chronic obstructive pulmonary disease (COPD). However, its biological role in the disease is unclear. Our objective was to determine the expression pattern and biological role of PTCH1 in the lungs of patients with COPD.

Newly Diagnosed Sarcopenia and Alzheimer's Disease in an Older Patient With Chronic Inflammation.

A 78-year-old man presented with the aggravation of weakness in the lower extremities, gait disturbance, and cognitive impairment. He was diagnosed with sarcopenia, distal sensorimotor polyneuropathy, and Alzheimer's disease. Low-grade chronic elevation of inflammatory markers was also revealed.

New genetic signals for lung function highlight pathways and chronic obstructive pulmonary disease associations across multiple ancestries.

Reduced lung function predicts mortality and is key to the diagnosis of chronic obstructive pulmonary disease (COPD). In a genome-wide association study in 400,102 individuals of European ancestry, we define 279 lung function signals, 139 of which are new. In combination, these variants strongly predict COPD in independent populations.

Smooth Muscle Cells Contribute the Majority of Foam Cells in ApoE (Apolipoprotein E)-Deficient Mouse Atherosclerosis.

Objective- Smooth muscle cells (SMCs) are the most abundant cells in human atherosclerotic lesions and are suggested to contribute at least 50% of atheroma foam cells. In mice, SMCs contribute fewer total lesional cells. The purpose of this study was to determine the contribution of SMCs to total foam cells in apolipoprotein E-deficient (ApoE) mice, and the utility of these mice to model human SMC foam cell biology and interventions.

Phenotyping and outcomes of hospitalized COPD patients using rapid molecular diagnostics on sputum samples.

Background: Etiologies of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are heterogeneous. We phenotyped severe AECOPD based on molecular pathogen detection of sputum samples collected at hospitalization of COPD patients and determined their outcomes.

Methods: We phenotyped 72 sputum samples of COPD patients who were hospitalized with a primary diagnosis of AECOPD using a molecular array that detected common bacterial and viral respiratory pathogens.

Accelerated lung aging and chronic obstructive pulmonary disease.

The prevalence of chronic obstructive pulmonary disease (COPD) increases exponentially with aging. Its pathogenesis, however, is not well known and aside from smoking cessation, there are no disease-modifying treatments for this disease. Areas covered: COPD is associated with accelerating aging and aging-related diseases.

Introduction to precision medicine in COPD.

Although there has been tremendous growth in our understanding of chronic obstructive pulmonary disease (COPD) and its pathophysiology over the past few decades, the pace of therapeutic innovation has been extremely slow. COPD is now widely accepted as a heterogeneous condition with multiple phenotypes and endotypes. Thus, there is a pressing need for COPD care to move from the current "one-size-fits-all" approach to a precision medicine approach that takes into account individual patient variability in genes, environment and lifestyle.

Development and Validation of the Evaluation Platform in COPD (EPIC): A Population-Based Outcomes Model of COPD for Canada.

Background: We report the development, validation, and implementation of an open-source population-based outcomes model of chronic obstructive pulmonary disease (COPD) for Canada.

Methods: Evaluation Platform in COPD (EPIC) is a discrete-event simulation model of Canadians 40 years of age or older. Three core features of EPIC are its open-population design (incorporating projections of future population growth, aging, and smoking trends), its incorporation of heterogeneity in lung function decline and burden of exacerbations, and its modeling of the natural history of COPD from inception.

Intergrain Connection of Organometal Halide Perovskites: Formation Mechanism and Its Effects on Optoelectrical Properties.

Two-step processes are commonly used for the fabrication of organic-inorganic perovskite solar cells; they convert a PbI film to a perovskite film by dipping it in CHNHI (MAI) solution or spin-coating the MAI solution onto it. Dipping yields perovskite films with discrete and rough morphologies, whereas spinning yields films with smooth and connected morphologies. The residual MAI solution that remains after spinning is the key factor that governs the smoothness of the resulting morphology; centrifugal force has no influence.

Psychological distress is related to poor health behaviours in COPD and non-COPD patients: Evidence from the CanCOLD study.

Background: Patients with psychiatric disorders (depression, anxiety) are more likely to have poor health behaviours, including higher smoking and lower physical activity (PA) levels. Smoking is a major risk factor for Chronic Obstructive Pulmonary Disease (COPD), and PA is critical for COPD management. However, no studies have assessed associations between psychological distress and these behaviours among patients with vs without COPD.

Inhaled corticosteroids and fractures in chronic obstructive pulmonary disease: current understanding and recommendations.

Purpose Of Review: Inhaled corticosteroid (ICS) is commonly used in the management of patients with chronic obstructive pulmonary disease (COPD) for symptom relief and exacerbation prevention; however, there is a growing concern that ICS increases risk of osteoporosis and fractures in patients with COPD.

Recent Findings: Osteoporosis is a major comorbidity of COPD. There is evidence from large observational studies that use of ICS for prolonged period of time (e.