319 research outputs found
Airway Elastin is increased in severe asthma and relates to proximal wall area: histological and computed tomography findings from the U-BIOPRED severe asthma study
No full textBackground: Airway remodelling, which may include goblet cell hyperplasia / hypertrophy, changes in epithelial integrity, accumulation of extracellular matrix components, smooth muscle hypertrophy and thickening of the lamina reticularis, is a feature of severe asthma and contributes to the clinical phenotype. Objective: Within the U-BIOPRED severe asthma study, we have assessed histological elements of airway remodelling and their relationship to computed tomography (CT) measures of proximal airway dimensions. Methods: Bronchial biopsies were collected from two severe asthma groups, one non-smoker (SAns, n=28) and one current/ex-smoker (SAs/ex, n=13), and a mild-moderate asthma group (MMA, n=28) classified and treated according to GINA guidelines, plus a healthy control group (HC, n=33). A Movat’s pentachrome technique was used to identify mucin, elastin and total collagen in these biopsies. The number of goblet cells (mucin+) were counted as a percentage of the total number of epithelial cells and the percentage mucin epithelial area measured. The percentage area of elastic fibres and total collagen within the submucosa were also measured, and the morphology of the elastic fibres classified. Participants in the asthma groups also had a CT scan to assess large airway morphometry.Results: The submucosal tissue elastin percentage was higher in both severe asthma groups (16.1% SAns, 18.9% SAs/ex) compared to the HC (9.7%) but did not differ between asthma groups. There was a positive relationship between elastin and airway wall area measured by CT (n= 18-20, rho=0.544, p=0.024), which also related to an increase in elastic fibres with a thickened lamellar morphological appearance. Mucin epithelial area and total collagen were not different between the four groups. Due to small numbers of suitable CT scans it was not feasible to compare airway morphometry between the asthma groups. Conclusion: These findings identify a link between extent of elastin deposition and airway wall thickening in severe asthma.<br/
A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma
No full textBackground: Most patients with asthma are managed exclusively in primary care. Little is known about the patterns of airway dysfunction in these patients and how these relate to other aspects of the disease.Aims: We set out to assess this in a cross-sectional study of 262 patients.Methods: Symptoms, spirometry, airway responsiveness, reversibility, and airway inflammation were all assessed. Exacerbations requiring oral corticosteroids in the preceding year were enumerated.Results: Patients had heterogeneous patterns of airway dysfunction. Those with a post-bronchodilator forced expiratory volume in 1 sec/forced vital capacity ratio of <0.7 had more exacerbations in the previous year (2.2 vs. 0.8; mean difference 1.4; 95% CI 0.4 to 2.4;p=0.007). Patients with normal results had less inflammation (proportion with a sputum eosinophil count of >1.9%, 20% vs. 48%,?2=14.8, df=3; p<0.001) and fewer exacerbations (0.5 vs. 1.4; mean difference –0.9; 95% CI –1.4 to –0.4; p=0.001) but similar symptom scores (6.2 vs. 6.9; p=0.2) compared with patients with any abnormality.Conclusions: Patients with a diagnosis of asthma have mixed patterns of physiological impairment; many have no airflow obstruction or airway hyper-responsiveness. The physiological characterisation of asthma is not related to symptoms and is of little value in predicting exacerbations or eosinophilic airway inflammation
Non-invasive markers of airway inflammation in the clinical assessment and management of asthma
No full textAsthma is a condition characterised by airway inflammation, variable airflow obstruction and bronchial hyperresponsiveness. Traditionally asthma is assessed by measurements of symptoms and airway function. Recently there has been interest in assessing airway inflammation using non-invasive tests as it has been shown that controlling eosinophilic airway inflammation, as measured in induced sputum in a population of patients with moderate to severe asthma, can lead to a reduction in asthma exacerbations, when compared to current guidelines. Most patients have mild to moderate asthma and are treated solely in primary care, in a setting not suitable for induced sputum measurements; there exists a need for an easy, safe and inexpensive mecha~ism for monitoring airway inflammation. Previous work has demonstrated that the fraction of nitric oxide in the exhaled breath (FENO) is elevated in asthma and that levels decrease after steroid use. These papers led to an explosion of interest in using FENO as a marker for eosinophilic airway inflammation in asthma. However, few studies have evaluated FENO in a clinical setting and compared its use to management protocols. This thesis explores the relationship between airway inflammation and asthma, and focuses on induced sputum and FENO. I explore the relationship between sputum eosinophil counts and FENO in an observational study, and use these findings to calculate levels for FENO which best identify the presence and absence of a sputum eosinophilia. These levels are then used in a randomised clinical trial, assessing whether FENO measurements can help predict and prevent asthma exacerbations when compared to current clinical guidelines. Lastly, a large cross sectional study explores the relationship between pre- and postbronchodilator FEV1 and measures of airway inflammation, allowing for the effect of confounding fadors, using a multivariate analysis.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
University Chorale, February 3, 1992
No full textRecorded during a live performance at Dalton Center Recital Hall, Western Michigan University, Kalamazoo, Michigan, February 3, 1992, the 267th concert of the School of Music’s 1991-1992 season.University Chorale ; Craig S. Arnold, conductor ; brass ensemble (in the 3rd work): Michael Molloy, Stacey Leva, trumpets ; Andy Schwallier, Brian Campbell, horns ; Christian Parker, David Garry, trombones ; various additional instrumentalists and vocal soloists.Sacred and secular vocal music for mixed chorus (SSAATTBarB) with piano and instrumental ensemble, or unaccompanied.Information from performance program.Exultate Deo / Alessandro Scarlatti -- Ave verum corpus / William Byrd -- Jubilate Deo / Giovanni Gabrieli ; instrumental arrangement by Christian Parker -- ""Gloria"" from the opera, The masque of angels / Dominick Argento -- Serenade to music / Ralph Vaughan Williams ; text: William Shakespeare from The merchant of Venice (Greg Jasperse, piano ; vocal soloists: Holly Shaw, Kathy Seppamaki, Andy Schwallier, David Bright, Christopher Card, Lynne Rothrock, Margaret Lanning, Michael Wheaton, Brian Clissold, Alan Whaley, Adam Wurst, Michael Fallon, Joan Bricker, Carrie Taghon, Regina Hartwig, Sandra Haman, Amy Statz) -- ""Gloria"" from Mass in G minor / Ralph Vaughan Williams (vocal soloists: Andy Schwallier, Michael Wheaton, Regina Hartwig, David Bright, Carrie Taghon) -- In the beginning / Aaron Copland -- Laura Lee ; Oh! Susanna ; Gentle Annie / Stephen Foster (Greg Jasperse, piano ; vocal soloists, Christopher Card, Michael Wheaton) -- Let me fly / Spiritual ; arranged by Robert DeCormier (vocal soloist: Sandra Haman ; Michael Molloy, tambourine)
Chartier, Darnton y la gran matanza del símbolo. Historias. Revista de la Dirección de Estudios Históricos. Num. 25 (1991) octubre-marzo
No full textLas obras en cuestión son: Roger Chartier, "Text, Symbols, and Frenchness", Journal of Modern History, 57 (1985): 682-95 (Traducido en este mismo volumen, pp. 3-17); Robert Darnton, "The Symbolic Element in History", Journal of Modern History, 58(1986):218-34, y La gran matanza de gatos y otros episodios en la historia de la cultura francesa, Fondo de Cultura Económica, México, 1987.1 Claude Lévi-Strauss, Tristes Tropiques [1955], traducción de John Weightman y Doreen Weightman, New York, 1974, pp. 414-15. [Traducción al español: Editorial Universidad de Buenos Aires, Argentina, 1970.)2 Nicolas Contat, Anecdotes typographiques, 1762, ed. Giles Barber, Oxford, 1980.3 Sobre este problema véase mi "Is everyone a Mentalité Case? Transference and the 'Culture' Concept", en History and Criticism, lthaca, N. Y., and London, Cornell University Press, 1985.4 Véase e.g. Jean Starobinski, Jean-Jacques Rousseau: La transparence et l'obstacle, París, 1957; y Jacques Derrida, Of Grammatology, trad. Gayatri Chakravorty Spivak, 1967; reimpresión, Baltimore and London, 1974. [Traducción al español: De la Gramatología, Ed. Siglo XXI, 1971.]5 Jean Jacques Rousseau, La Nouvelle Hélöise, en Oeuvres complétes, ed. Bernard Gagnebin y Marcel Raymond, París, 1961, vol. 2, p. 27 (traducción del autor).6 Ibid., p. 5.7 Ibid.8 Ibid., p. 11.9 Ibid., p. 28.10 Ibid., p. 30.Tomado de Journal of Modern History, núm. 60, marzo de 1988. Nuestra preocupación antropológica y antropocéntrica por ver las cosas desde la perspectiva del “nativo” nos obliga a identificarnos con el gato, víctima ejemplar de la crueldad y la “diversión”. Parece que los historiadores estamos por fin volviendo los ojos al problema de la “lectura” y que incluso mostramos cierta apertura a la “jerga de la textualidad” -o al menos así podría pensarse a partir de la polémica entre Roger Chartier y Robert Darnton originada por el reciente libro de Darnton La gran matanza de los gatos. Sin embargo, la abertura a través de la cual la lectura y la textualidad hacen su entrada en la profesión histórica parece de pronto no más grande que el proverbial guiño del ojo gatuno. Si bien la cuestión suscitada por la polémica Chartier-Darnton es la de la naturaleza e importancia de la lectura de textos en la historia, el enfoque con que la abordan es más bien limitado. Una aproximación diferente a la lectura ¿podría dejar lugar a la excluida perspectiva del gato y atenuar de este modo el imperialismo de la especie así como el carácter de chivo expiatorio metodológico del “otro” que parecen encerrar hasta las más generosas y tolerantes perspectivas humanistas o antropológicas? ¿Tendría incluso algún sentido dejar de intentar comprender la “broma” de la “gran matanza de gatos” con la que Robert Darnton trata de familiarizarnos a medida que penetra en los secretos aparentemente enigmáticos del Antiguo Régimen -una “broma” que no fue tan divertida para sus felinas víctimas? En todo caso, ¿qué significan “lectura” y “textos”, estas misteriosas palabras clave que a menudo parecen rodeadas de una mayor oscuridad que cualquier otra cosa que el Antiguo Régimen pudiera ofrecer a nuestra curiosa indagación etnográfica
. 25 (1991) octubre-marzo. Historias. Revista de la Dirección de Estudios Históricos
No full text- Texto, símbolos y lo francés por Roger Chartier. - ¿Historia interpretativa o historia cuantitativa? por Philip Benedict. - Chartier, Darnton y la gran matanza del símbolo por Dominick La Capra. - Los historiadores cuentan cuentos: de gatos cartesianos y peleas de gallos gálicos por James Fernández. - Comercio y conquista en el Nuevo Mundo: Vitoria, Sepúlveda y Las Casas. Un análisis de la mentalidad de los tratadistas españoles por Patricia Nettel. - Encomiendas, repartimientos y conquista en Nueva Vizcaya por Chantal Cramaussel. - El poder misionero frente al desafío de la colonización civil (Sonora siglo XVIII) por José Luis Mirafuentes Galván. - "Si Dios no existe, alguien debe otorgar los certificados”. (Nota sobre la Academia de Letrán) por Carlos Monsiváis. - Nuestras propias voces. Las mujeres en la Revolución Mexicana por Martha Eva Rocha Islas. - Del centro occidente al Medio oeste: historiografía chicana por Gerardo Necoechea. - Promesas, seducción y matrimonio en Antioquia colonial por Pablo Rodríguez. - Literatura popular: bibliografía por Isabel Quiñónez. - El Imperio estremecido por J. R. Elliott. - La Odisea de Tocqueville por Julio Bracho. - Población y registros parroquiales por Rodrigo Martínez. - Bajo el signo de Alain Corbin por Eloísa Uribe. - Los primeros artífices de un oficio nuevo por Patricia Masse. - Crestomanía por José Mariano Leyva
Relations between texts and contexts contributions from the intellectual history to historiography.
No full textO presente artigo, resultado de reflexões sobre Teoria de História em
cursos de pós-graduação e graduação, tem como objetivo mapear
discussões realizadas no seio da História Intelectual; em especial,
naquilo que concerne os debates acerca das relações entre autor,
texto e contexto. Com esse objetivo, analisaremos as propostas de
Quentin Skinner, Reinhart Koselleck, Dominick LaCapra, Hayden
White para explicar as complexas e múltiplas relações entre os
autores, suas produções textuais e os contextos.This article is the result of reflections on Theory of History made on
graduate and undergraduate classes and aims to map discussions
within the Intellectual History field, especially in what concerns the
debate about the relationships between author, text and context.
With this objective, we analyze the proposals of Quentin Skinner,
Reinhart Koselleck, Dominick LaCapra, Hayden White to explain the
complex and multiple relationships between authors, their textuak
productions and contexts
Stratification of asthma by lipidomic profiling of induced sputum supernatant.
No full textBACKGROUND
Asthma is a chronic respiratory disease with significant heterogeneity in its clinical presentation and pathobiology. There is need for improved understanding of respiratory lipid metabolism in asthma patients and its relation to observable clinical features.
OBJECTIVE
To perform a comprehensive, prospective, cross-sectional analysis of the lipid composition of induced sputum supernatant obtained from asthma patients with a range of disease severities, as well as healthy controls.
METHODS
Induced sputum supernatant was collected from 211 asthmatic adults and 41 healthy individuals enrolled in the U-BIOPRED study. Sputum lipidomes were characterised by semi-quantitative shotgun mass spectrometry, and clustered using topological data analysis to identify lipid phenotypes.
RESULTS
Shotgun lipidomics of induced sputum supernatant revealed a spectrum of nine molecular phenotypes, highlighting not just significant differences between the sputum lipidomes of asthmatics and healthy controls, but within the asthmatic population as well. Matching clinical, pathobiological, proteomic and transcriptomic data informed on the underlying disease processes. Sputum lipid phenotypes with higher levels of non-endogenous, cell-derived lipids were associated with significantly worse asthma severity, worse lung function, and elevated granulocyte counts.
CONCLUSION
We propose a novel mechanism of increased lipid loading in the epithelial lining fluid of asthmatics, resulting from the secretion of extracellular vesicles by granulocytic inflammatory cells, which could reduce the ability of pulmonary surfactant to lower surface tension in asthmatic small airways, as well as compromise its role as an immune regulator.
CLINICAL IMPLICATION
Immunomodulation of extracellular vesicle secretion in the lungs may provide a novel therapeutic target for severe asthma
A retrospective database study of oral corticosteroid and bisphosphonate prescribing patterns in England
No full text© 2020, The Author(s). Exposure to oral corticosteroids (OCS) is associated with an increased risk of osteoporosis and fragility fractures. Guidelines suggest bisphosphonate (BP) therapy as the first-line treatment of glucocorticoid-induced osteoporosis (GIOP). This population study used publicly available data, including prescription annual cost analysis and monthly practice-level data. Our aim was to examine the prescribing of OCS and BP at practice level and investigate reasons for variation using a mixed-effect negative binomial regression analysis. There was a rise in OCS and BP prescriptions of 55% and 1200% from 1998 to 2018, respectively. Of the 6586 included practices, the median (IQR) of OCS and BP prescriptions were 120.8 (84.8–160.4) and 107.7 (73.8–147.4) per 1000 patients, respectively. Asthma and chronic obstructive pulmonary disease (COPD) were significantly associated with OCS use (p < 0.0001), but only COPD was associated with BP use (p < 0.0001). Higher OCS prescribing rates were associated with higher BP prescribing rates (5th to 1st quintile—IRR = 1.99; 95% CI: 1.88–2.10). Practice list size, deprivation and advanced age were all associated with both drugs (p < 0.0001). In conclusion, although OCS use is positively associated with BP prescription, variation among practices and CCGs exists. The variation in prescribing suggests there is still a need to improve GIOP prevention
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