Prevalence of tracheobronchomalacia and excessive dynamic airway collapse in bronchial asthma of different severity

BACKGROUND: Tracheobronchomalacia (TBM) is a pathologic condition in which softening of tracheal and bronchial cartilage causes the dynamic narrowing of transverse or sagittal diameters of tracheobronchial lumen; an excessive dynamic airway collapse (EDAC) may also be associated, with a substantial invagination of the posterior membrane of trachebronchial tree. The aim of this study was to assess the prevalence of both TBM and EDAC in a population of asthmatics with different degrees of disease severity compared to a reference group of subjects without any bronchial obstruction. METHODS: A cohort of 202 asthmatics was investigated by means of a dynamic flexible videobronchoscopy: 74 mild persistent (MPA - age 18–68 ys; 35 males; mean FEV(1) = 88.6% pred. ± 8.3 sd); 63 moderate (MA - age 21–71 ys; 30 males; mean FEV(1) = 71.3% pred. ± 9.1 sd), 65 severe asthmatics (SA - age 33–70 ys; 25 males; mean FEV(1) = 48.5% pred. ± 7.6 sd), and 62 non obstructed subjects (NO - age 18–71 ys; 38 males; mean FEV(1) 98.6% pred. ± 2.7 sd). TBM and EDAC were classified according to FEMOS classification. RESULTS: TBM and EDAC were observed in only 1/62 subjects (both 1.61%) of NO group, while their prevalence was 2.70% and 6.75% in MPA group; 7.93% and 19.04% in MA group; 18.46% and 69.23% in SA group, respectively. The crude prevalence of thyroid disorders in the population was 12.9%. In particular, the prevalence of thyroid disorders was significantly higher in females than in men, but 54-fold higher in females than in men in the presence of EDAC. CONCLUSIONS: 1) The prevalence of both TBM and EDAC is directly related to age, gender (females), and asthma severity; 2) EDAC is much more frequent than TBM in all asthma patients; 3) both tracheal abnormalities proved to be more represented in asthmatics with thyroid disorders, and particularly in female asthmatics with EDAC

ANÁLISE TEMPORAL DE HERBIVORIA EM Laguncularia racemosa (L.) (COMBRETACEAE)

Os Manguezais colonizam as áreas de interface entre os ambientes continental e marinho, cujo tipo de vegetação arbóreo-arbustiva, comumente chamada de mangue, se desenvolve principalmente nos solos pouco consolidados dos rios tropicais e subtropicais ao longo da zona de influência das marés. Como todas as florestas, as folhas das espécies do ecossistema manguezal são fonte de alimento para os herbívoros, sendo a herbívoria definida como a quantidade de material foliar consumido pelos animais. O presente estudo teve como objetivo analisar por meio das mudanças da área foliar as influências dos fatores ambientais nos períodos de verão e outono a contribuição da espécie L. racemosa na herbivoria. Foram utilizados dados pretéritos de área foliar em papel milimetrado não analisados de coletas das folhas da espécie L. racemosa obtidas mensalmente entre os anos de 2008 e 2009, com N > 30. As coletas foram realizadas no manguezal do rio Itaúnas, localizado no município de Conceição da Barra, Espírito Santo. Para a estação de verão, correspondente aos meses de dezembro de 2008, janeiro e fevereiro de 2009, as folhas apresentaram maior área foliar (27,31 ± 13,44 cm2) e menor taxa de herbívoria (1,04 ± 1,44 cm2) do que os meses de março, abril e maio de 2010, referentes ao outono, sendo a área total equivalente a 19,6 ± 9,47cm2 e a área pastoreada a 5,52 ± 3,58cm2. A temperatura é um parâmetro vital para o desenvolvimento das plantas de Manguezais, e maiores superfícies de contato possibilitam maior dispersão de calor, o que pode explicar o fato das folhas coletadas entre dezembro e fevereiro se apresentarem maiores. Para a estação de outono, os resultados foram menores do que o esperado, já que as folhas tendem a ser maiores durante as estações mais frias, com o objetivo de aumentar a superfície de contato para obter o máximo de luz solar, assim mantendo a capacidade fotossintética da planta. Por fim, os fatores ambientais como quantidade de radiação e taxa de herbívoria são parâmetros determinantes para o crescimento e desenvolvimento foliar, ligados diretamente à sobrevivência da espécie. Além disso, a baixa taxa de herbívoria indica condições normais para o manguezal uma vez que sua maior contribuição em biomassa é para o nível de decompositores. Palavras-chave: Manguezal. Pastejo. Sazonalidade

Structure and litter production of mangrove forests under different tidal influences in babitonga bay, Santa Catarina, Southern Brazil

This work aimed to evaluate the influence of different flooding frequencies on structure and litter production of a mesohaline mangrove forest near to the southern limit of mangrove forest in South Atlantic. Tree sites with different flooding frequencies were selected. In each site 100m plots were placed to evaluate species density, height, diameter and biomass, and 0.25m litter traps were placed to evaluate monthly litter production from February 1998 to January 1999. Salinity, temperature and rainfall were recorded during the period. The structural data and specific litter fall were correlated with flooding frequency (FF). was the dominant species at the higher FF, presenting higher density (4000 trees ha ; 52%) tree biomass (25 tones ha ; 60%) and litter annual production (2.35 tones ha year ; 70%) at site A. was the dominant species at the lower FF, presenting higher density (4700 trees ha ; 65%) and litter annual production (2.36 tones ha year ; 65%), at site C, but biomass was always low. presented low density and litter production in all sites. As and presented this inverse pattern, total annual litter fall (3.8 tones ha year ) was not correlated with the flooding frequency gradient

Salinity and flooding frequency as determinant of mangrove forest structure in Babitonga Bay, Santa Catarina state, southern Brazil

This work aimed to evaluate the effects of salinity and flooding frequency on structure of mangrove forests in Babitonga Bay, State of Santa Catarina (southern Brazil). Eight sites were selected along a salinity gradient. Into each site, 100m2 plots were positioned along the flooding frequency gradient, 50m from each other, from water edge to landwards. All the trees into the plot was identified and measured to estimate structural parameters of the forest. Data were compared using cluster and canonical correspondence analyses. was dominant in oligohaline plots with high flooding frequencies, which showed lower densities and higher diameters and biomass. Euhaline and mesohaline plots with high flooding frequencies were clustered due to lower total densities, high diameter and tree height and high biomass. Low flooding frequencies plots presented high tree densities and low biomass, and were separated in two clusters: euhaline and mesohaline forests. In euhaline forests with low flooding frequencies was the dominant species, with higher densities and biomass. In mesohaline forests with low flooding frequencies was largely dominant in density, but biomass was very similar among species. In Babitonga Bay, mangrove structure is primarily related to flooding frequencies, but it is also dependent on salinity

Capture and commercialization of blue land crabs ("guaiamum") Cardisoma guanhumi (Lattreille, 1825) along the coast of Bahia State, Brazil: an ethnoecological approach

<p>Abstract</p> <p>Background</p> <p>Blue Land Crab (<it>Cardisoma guanhumi</it>) is one of the most important crustacean species captured and commercialized in Brazil. Although this species is not considered to be threatened with extinction, populations of <it>C. guanhumi </it>are known to be rapidly diminishing due to heavy harvesting pressures and degradation of their natural habitats, highlighting the necessity of developing and implanting management and protection strategies for their populations. There have been no ethnozoological publications that have focused specifically on <it>C. guanhumi</it>, in spite of importance of this type of information for developing efficient management plans of resource utilization. So, the present work describes the ethnoecological aspects of the capture and commercialization of <it>C. guanhumi </it>by a fishing community in northeastern Brazil.</p> <p>Methods</p> <p>Field work was carried out in the municipality of Mucuri, Bahia in Brazil, between the months of January and March/2011 through the use of open semi-structured interviews with all of the crustacean harvesters in city who acknowledged their work in capturing this species, totaling 12 interviewees. The informants were identified through the use of the "snowball" sampling technique. In addition to the interviews themselves, the "guided tour" technique and direct observations was employed.</p> <p>Results</p> <p>According all the interviewees, the <it>C. guanhumi </it>is popularly called "guaiamum" and is collected in "apicum" zones. They recognize sexual dimorphism in the species based on three morphological characteristics and the harvesters also pointed two stages in the reproductive cycle during the year and another phase mentioned by the interviewees was ecdysis. All of the interviewed affirmed that the size and the quantities <it>C. guanhumi </it>stocks in Mucuri have been diminishing. All of the interviewees agreed that the species and other mangrove resources constituted their principal source of income. The harvesters dedicated three to five days a week to collect Blue Land Crabs and the principal technique utilized for capturing is a trap called a "ratoeira" (rat-trap).</p> <p>Conclusions</p> <p>The results of the present work demonstrated that the community retains a vast and important volume of knowledge about <it>C. guanhumi </it>that could subsidize both scientific studies and the elaboration of viable management and conservation strategies for this species.</p

Use of aerosols in bronchiectasis patients

Bronchiectasis is a chronic respiratory disease which recognises different etiologies, and characterised by persistent cough, bronchial hypersecretion, airway colonisation with Gram-negative pathogens; frequent infectious exacerbations; progressive lung function decline, and poor quality of life. Several therapeutic strategies are used for managing bronchiectasis, and nebulised medications are regarded with great and ever increasing interest because they allow the direct medication of targets airway structures, higher concentrations of the drug employed, and much less systemic effects. In general terms, the available therapeutic strategies lead to different results depending of whether bronchiectasis are related to cystic fibrosis or not. The effects of the main classes of drugs for aerosol delivery in bronchiectasis patients have been reviewed and updated. Further research is needed in order to ameliorate therapeutic interventions in bronchiectasis, both in terms of new molecules and aerosol formulations to use, and of systems able to optimize drug delivery and drug effectiveness

Disruption of smooth pursuit eye movements in cirrhosis: relationship to hepatic encephalopathy and its treatment.

Smooth pursuit eye movements (SPEM) are the conjugate movements used to track the smooth trajectory of small dots. Jerky or 'saccadic' ocular pursuit has been reported in patients with cirrhosis, but no formal assessment of SPEM has ever been undertaken. The aim of this study was to evaluate SPEM in patients with cirrhosis and varying degrees of hepatic encephalopathy. The patient population comprised 56 individuals (31 men, 25 women) of mean age 51.1 (range, 25-70) years, with biopsy-proven cirrhosis, classified, using clinical, electroencephalographic, and psychometric variables, as either neuropsychiatrically unimpaired or as having minimal or overt hepatic encephalopathy; patients were further categorized in relation to their treatment status. The reference population comprised 28 healthy volunteers (12 men, 16 women) of mean age 47.3 (range, 26-65) years. SPEM was assessed using an electro-oculographic technique. Visual inspection of the SPEM recordings showed clear disruption of smooth pursuit in the patients with minimal hepatic encephalopathy, and more pronounced disruption, if not complete loss, of smooth pursuit in patients with overt hepatic encephalopathy. The differences observed in quantifiable SPEM indices between the healthy volunteers/unimpaired patients and those with overt hepatic encephalopathy were significant (P < .05). In conclusion, SPEM performance is impaired in patients with hepatic encephalopathy in parallel with the degree of neuropsychiatric disturbance: the pathophysiology of these changes is unknown, but retinal, extrapyramidal, and attentional abnormalities are likely to play a role. Treatment status confounds the classification of neuropsychiatric status and should be taken into account when categorizing these patients

Prevalence of severe asthma according to the drug regulatory agency perspective: An Italian experience

Severe asthma prevalenc

Perceptions of environmental changes and Lethargic crab disease among crab harvesters in a Brazilian coastal community

<p>Abstract</p> <p>Background</p> <p>Lethargic Crab Disease (LCD) has caused significant mortalities in the population of <it>Ucides cordatus </it>crabs in the Mucuri estuary in Bahia State, Brazil, and has brought social and economic problems to many crab-harvesting communities that depend on this natural resource. The present work examined the perceptions of members of a Brazilian crab harvesting community concerning environmental changes and the Lethargic Crab Disease.</p> <p>Methods</p> <p>Field work was undertaken during the period between January and April/2009, with weekly or biweekly field excursions during which open and semi-structured interviews were held with local residents in the municipality of Mucuri, Bahia State, Brazil. A total of 23 individuals were interviewed, all of whom had at least 20 years of crab-collecting experience in the study region. Key-informants (more experienced crab harvesters) were selected among the interviewees using the "native specialist" criterion.</p> <p>Results</p> <p>According to the collectors, LCD reached the Mucuri mangroves between 2004 and 2005, decimating almost all crab population in the area, and in 2007, 2008 and 2009 high mortalities of <it>U. cordatus </it>were again observed as a result of recurrences of this disease in the region. In addition to LCD, crabs were also suffering great stock reductions due to habitat degradation caused by deforestation, landfills, sewage effluents, domestic and industrial wastes and the introduction of exotic fish in the Mucuri River estuary. The harvesting community was found to have significant ecological knowledge about the functioning of mangrove swamp ecology, the biology of crabs, and the mass mortality that directly affected the economy of this community, and this information was largely in accordance with scientific knowledge.</p> <p>Conclusions</p> <p>The study of traditional knowledge makes it possible to better understand human interactions with the environment and aids in the elaboration of appropriate strategies for natural resource conservation.</p

Computed tomography for evaluation of abdominal wall hernias-what is the value of the Valsalva maneuver?

PURPOSE To investigate the differences in the visibility and size of abdominal wall hernias in computed tomography (CT) with and without Valsalva maneuver. METHODS This single-center retrospective study included consecutive patients who underwent abdominal CTs with Valsalva maneuver between January 2018 and January 2022. Inclusion criteria was availability of an additional non-Valsalva CT within 6 months. A combined reference standard including clinical and surgical findings was used. Two independent, blinded radiologists measured the hernia sac size and rated hernia visibility on CTs with and without Valsalva. Differences were tested with a Wilcoxon signed rank test and McNemar's test. RESULTS The final population included 95 patients (16 women; mean age 46 ± 11.6 years) with 205 hernias. Median hernia sac size on Valsalva CT was 31 mm compared with 24 mm on non-Valsalva CT (p < 0.001). In 73 and 82% of cases, the hernias were better visible on CT with Valsalva as compared to that without. 14 and 17% of hernias were only visible on the Valsalva CT. Hernia visibility on non-Valsalva CT varied according to subtype, with only 0 and 3% of umbilical hernias not being visible compared with 43% of femoral hernias. CONCLUSIONS Abdominal wall hernias are larger and better visible on Valsalva CT compared with non-Valsalva CT in a significant proportion of patients and some hernias are only visible on the Valsalva CT. Therefore, this method should be preferred for the evaluation of abdominal wall hernias