Notes

Documenting Indigenous dispossession.
The majority of the studies were classified as having "fair" or "poor" methodological quality. CONCLUSIONS There is a limited number of studies examining the prognostic value of simple measures of physical function and muscle strength in relation to exacerbations, hospitalizations and mortality in individuals with COPD. To date, the HGS and 1-min STS tests are the most studied tests and seem to be suitable for prognosis purposes in individuals with COPD. STI571 chemical structure However, more studies with better methodological quality are needed to confirm these findings. BACKGROUND Viral respiratory infections (VRI) in people living with Cystic fibrosis (CF) is less well understood than respiratory bacterial infections, particularly adults with CF and few studies have compared children with adults. This study evaluated the frequency of respiratory viruses in patients with cystic fibrosis (CF) in Western Australia (WA). We determined the VRI in CF and compared them with non-CF patients. Further, we compared CF patients that were hospitalised with those that were not. PATIENTS/METHODS Nucleic acid from sputum of 157 CF and 348 non-CF patients was analysed for influenzavirus A (Flu A) and B, (Flu B), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), human rhinovirus (RV), and parainfluenza viruses (PIV 1-3) by RT-PCR, during the 2016 winter respiratory season. RESULTS No significant difference in the frequency of respiratory virus detection between CF and non-CF patients was found. link2 RV was the most frequently detected virus in CF patients, and in hospitalised CF. RSV and hMPV were found less frequently in CF patients and RSV was not found in any hospitalised CF patient. A trend for fewer influenzavirus detections in adult CF patients was observed, however the trend was opposite for paediatric patients. RV and Flu A were the most common viruses detected in hospitalised CF patients. CONCLUSION There was no significant difference in VRI between CF and non-CF patients. RV and influenza A were most commonly found in hospitalised CF patients, suggesting that infection with these viruses may contribute to hospitalisation for CF respiratory exacerbations. BACKGROUND Limited data exist on the development of tuberculosis (TB) in cancer patients receiving immune checkpoint inhibitors (ICIs). METHOD s We evaluated the development of TB in 1144 solid-cancer patients who started ICIs (pembrolizumab, nivolumab, or atezolizumab) between July 2014 and December 2018. RESULTS A total of 1144 cancer patients were treated with ICIs. The median age of the patients at the start of ICI treatment was 62 years (interquartile range [IQR]; 53-69 years). Lung cancer (n = 796, 69.6%) was the most common cancer followed by melanoma (n = 115, 10.1%), and lymphoma (n = 85, 7.4%). Pembrolizumab (n = 612, 53.5%) was the most common treatment, followed by nivolumab (n = 474, 41.4%) and atezolizumab (n = 58, 5.1%). The median treatment duration with ICIs was 42 days (IQR; 18-154 days), and the median follow-up duration after initiating ICIs was 187 days (IQR; 70-342 days). Overall, three patients developed TB, two of whom received nivolumab and one who received pembrolizumab. CONCLUSIONS Our data showed that TB can develop in cancer patients receiving ICIs. However, due to the small number of study population, it is insufficient to draw accurate conclusions about the role of ICIs in the development of TB. Moreover, it is unclear whether the incidence of TB would be comparable with the incidence of TB in elderly cancer patients. Further studies are needed to evaluate whether diagnosis and treatment of latent TB infections before starting ICIs could be helpful in preventing the development of TB in these patients. OBJECTIVE The aim of the study was to investigate the mechanism and effect of FBXL10 in myocardial ischemia reperfusion injury in vivo and in vitro. METHODS The myocardial ischemia reperfusion (I/R) model was established by 30 min of coronary occlusion followed by 2 h of reperfusion in rats. Western blot and TUNEL assay were used to measure the apoptosis during I/R. The expression levels of endoplasmic reticulum related proteins in myocardial tissues and H9c2 cells were detected by immunohistochemistry staining and immunofluorescence staining. Flow cytometry and CCK-8 were used to detect the apoptosis and viability of H9c2 cells. RESULTS The results revealed that FBXL10 significantly reduced myocardial infarction, improved the pathological morphology of myocardium, markedly reduced inflammatory response in the myocardial ischemia reperfusion rats. Moreover the expressions of endoplasmic reticulum stress key proteins were caused by I/R were suppressed significantly by FBXL10 treatment, including CHOP, GRP78, ATF4 and p-PERK. Additionally FBXL10 inhibited the expression of endoplasmic reticulum stress key proteins in H/R H9c2 cells. Furthermore, FBXL10 reduced the levels of apoptotic cells and inflammatory response compared with I/R and H/R group. CONCLUSION Taken together, we found that FBXL10 could attenuate I/R injury through inhibiting endoplasmic reticulum stress (ERs). Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common among patients attending pulmonary rehabilitation (PR) and may compromise its outcomes. Neuromuscular electrical stimulation (NMES) seems one of the few exercise modalities that can actually be continued during AECOPD, due to its low burden on the impaired respiratory and cardiovascular system. However, the quality of evidence is low. The purpose of this study was to assess the impact of mild-to-moderate AECOPD on adherence/outcomes of a high-frequency (HF) or low-frequency (LF) NMES training program, as part of inpatient PR, in severely dyspneic, weakened individuals with COPD. 62 patients who received NMES as the sole supervised muscle training modality during an 8-week PR program (HF-NMES n = 33; LF-NMES n = 29) were analyzed retrospectively. 48.4% experienced ≥1 AECOPD during PR and were classified as exacerbators. Exacerbators completed 75 NMES sessions (interquartile range 73-78) and were able to increase training intensity with 24 mA (15-39), while non-exacerbators completed 76 sessions (73-79) and increased training intensity with 35 mA (22-50), with no between-group differences (p = 0.474 and p = 0.065, respectively). link3 The median change in 6-min walking distance, cycle endurance time, and isokinetic quadriceps strength and endurance did not differ between the exacerbation and non-exacerbation group. To conclude, the occurrence of mild-to-moderate AECOPD during a PR program primarily focused on NMES, does not affect adherence, intensity, and clinical outcomes in patients with severe COPD. Continuing NMES seems a feasible way to potentially counteract exacerbation-related lower-limb muscle dysfunction and improve outcomes of PR, with HF-NMES being the preferential muscle training modality. BACKGROUND Hospitalizations in pulmonary arterial hypertension (PAH) are common and are often for cardiac conditions. Using the National (Nationwide) Inpatient Sample (NIS), we examined characteristics and mortality of primary cardiac hospitalizations in PAH from 2001 to 2014. METHODS Adult hospitalizations with any diagnosis code for PAH were identified. Primary cardiac disease was defined as a primary discharge diagnosis of congestive heart failure (CHF), pulmonary heart disease, coronary atherosclerosis, acute myocardial infarction, dysrhythmia, conduction disorder, cardiomyopathy or carditis, heart valve disorder, or cardiac arrest. Temporal trends, characteristics, and in-hospital mortality were analyzed. RESULTS From 2001 to 2014, there were 207,095 hospitalizations in PAH, of which 100,509 (48.5%) carried a primary cardiac diagnosis. Most primary cardiac hospitalizations in PAH were for CHF, and pneumonia was the most common primary non-cardiac diagnosis. Over the study period, primary cardiac hospitalizations in PAH fell from 52.9% to 41.4% (p less then 0.001). CHF was the most frequent primary cardiac diagnosis associated with death, with sepsis representing the most common primary non-cardiac disease (1,226; 25.0%). Overall, the mortality in primary cardiac hospitalizations in PAH was 5.3% (vs. in primary non-cardiac, 6.9%, p less then 0.001). On multivariable analysis, a primary cardiac discharge diagnosis remained associated with a decreased risk of death (odds ratio 0.85, p = 0.010). CONCLUSION Primary cardiac hospitalizations in PAH are common and are associated with decreased mortality compared to admissions for primary non-cardiac diagnoses. BACKGROUND In Sweden, sarcoidosis prevalence varies geographically, but it is unclear whether diagnosis and treatment patterns vary by geographical area and calendar period. We sought to investigate differences in sarcoidosis diagnosis and treatment by healthcare region and calendar period using nationwide register data. METHODS We included 4777 adults who had at least two ICD-coded visits for sarcoidosis in the National Patient Register (2007-2012). We compared patterns of healthcare use (visits and medication dispensations), and data on sarcoidosis diagnosis and treatment spanning two years before to two years after diagnosis stratified by healthcare region and calendar period at diagnosis. RESULTS Compared to other regions, individuals diagnosed in Stockholm were younger, more likely female, and had a higher education level. In all regions, there was an increase in healthcare use at least six months before sarcoidosis diagnosis with small variation among regions. Most patients were diagnosed in pulmonary and internal medicine outpatient clinics, but compared to the national average more patients were diagnosed in rheumatology in the West and ophthalmology and cardiology in the South. Corticosteroid dispensations at diagnosis varied widely by region (48% in the South/Southeast vs. 30% in Stockholm/North). Demographic factors could not explain these differences. We found no differences by calendar period. CONCLUSION Our findings suggest a six-month delay in sarcoidosis diagnosis irrespective of region. The observed regional variation likely reflects differences in diagnosis and treatment patterns. Stakeholders should ensure diagnosis and treatment recommendations are closely followed. BACKGROUND In Niger, the Shorter Treatment Regimen (STR) has been implemented nationwide for rifampicin resistant tuberculosis (RR-TB), since 2008. No previous publication has shown the results from countrywide programmatic implementation using few exclusion criteria, nor exhaustively assessed the effect of initial resistance to companion drugs on outcomes. METHODS The National Tuberculosis Programme and the Damien Foundation conducted a retrospective observational study to evaluate the management of RR-TB from 2008 to 2016. Baseline resistance to drugs was assessed phenotypically, complemented by screening the inhA, katG and pncA genes. Cured patients were followed-up for a period of one year after cure. FINDINGS Among 1044 patients tested for rifampicin resistance, mainly previously treated patients, 332 were diagnosed with pulmonary RR/TB, 288 were enrolled on treatment and 255 started on STR. Six patients received a modified STR. Among 249 patients on standardised STR, 207 (83·1%) were cured relapse-free, eight (3·2%) had failure, 23 (9·2%) died, seven (2·8%) were lost to follow-up and four (1·6%) relapsed.
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