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The human microbiota: a new direction in the investigation of thoracic diseases.

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The human microbiota: a new direction in the investigation of thoracic diseases.

J Thorac Dis. 2013 Aug;5(Suppl 2):S127-31

Authors: Hui AW, Lau HW, Chan TH, Tsui SK

Abstract
Advancements in next generation sequencing technology have provided means for the comprehensive profiling of the microbial community in the respiratory tract in both physiological and pathological conditions. Recent studies have analyzed the bacterial composition in the respiratory tract of chronic obstructive pulmonary disease (COPD), influenza and tuberculosis patients, and have identified novel targets that may potentially lead to secondary infections. Certain bacteria have also been found to regulate the lung immune system and have unexpected connections with respiratory diseases. Further studies in these areas are necessary to dissect the exact relationship between the dynamics of the microbiota and the health of the respiratory system.

PMID: 23977433 [PubMed]

Oxidative potential of smoke from burning wood and mixed biomass fuels.

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More than half the world's population still rely on burning biomass fuels to heat and light homes and cook food. Household air pollution, a common component of which is inhalable particulate matter (PM), emitted from biomass burning is associated with increased vulnerability to respiratory infection and an enhanced risk of developing chronic obstructive lung disease (COPD).

In the light of an emerging hypothesis linking chronic PM exposure during childhood and increased vulnerability to respiratory diseases in adulthood, in a chain of events involving oxidative stress, reduced immunity and subsequent infection, the aim of this study was to characterise the oxidative potential (OP) of PM collected during the burning of wood and mixed biomass, whilst cooking food in the Kathmandu Valley, Nepal. Our assessments were based on the capacity of the particles to deplete the physiologically relevant antioxidants from a validated, synthetic respiratory tract lining fluid (RTLF).

Incubation of mixed biomass and wood smoke particles suspensions with the synthetic RTLF for 4 hours resulted in a mean loss of ascorbate of 64.76±16.83% and 83.37±14.12% at 50µg/ml respectively. Reduced glutathione was depleted by 49.29±15.22% in mixed biomass and 65.33±13.01% in wood smoke particles under the same conditions. Co-incubation with the transition metal chelator diethylenetriaminepentaacetate did not inhibit the rate of ascorbate oxidation, indicating a negligible contribution by redox-active metals in these samples.

The capacity of biomass smoke particles to elicit oxidative stress certainly has the potential to contribute towards negative health impacts associated with traditional domestic fuels in the developing world.

Oncology in midlife and beyond.

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The onset of the menopause is often a time when women's concerns can act as a powerful trigger to encourage healthy modifications in lifestyle which will maintain, or improve, their general health. This document aims to help women to understand their potential risks, to encourage them to find proactive preventive strategies by modifying some of their attitudes, and to use health resources (when available) to be screened.

Cancer is an important cause of death but not the primary cause of mortality. Cardio/circulatory diseases represent 35-40% of causes of death in most developed countries and 20-25% of women will die from cancers in Western Europe, Australasia, high-income North America, high-income Asia Pacific, East Asia and Southern Latin America. Breast cancer, lung cancer and colorectal cancer are prevalent in most regions of the world. Cervical cancer remains a hallmark of low access to health care. Preventive strategies (decreasing smoking and alcohol consumption, losing weight, eating a healthy diet and undertaking physical activity) and implementation of screening could help to significantly decrease the incidence of and mortality from cancer. The mortality/incidence ratio is higher in developing countries compared to high-income regions as well as in subgroups of populations in developed countries with lower socioeconomic levels. Implementation of better diagnostic methods and management of cancer according to the local resources will help to decrease the mortality rate in developing countries, and effort has to be made to decrease social inequities and improve access to health care for low-income groups. In conclusion, cancer incidence is increasing as a consequence of longer life expectancy all over the world. National health programs are mandatory to implement screening and to improve individual management.

Finally, educating women so that they are aware of ways to improve their general health, to minimize their own risk factors and to identify signs of change in their own health which may be markers of impending cancer will help to reduce the burden of disease and improve the prognosis for tumors detected at an earlier stage.

Baseline tumour measurements predict survival in advanced non-small cell lung cancer.

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The association between tumour measurements and survival has been studied extensively in early-stage and locally advanced non-small cell lung cancer (NSCLC). We analysed these factors in patients with advanced NSCLC.

Methods:Data were derived from the E4599 trial of paclitaxel-carboplatin±bevacizumab. Associations between the Response Evaluation Criteria in Solid Tumors (RECIST) baseline sum longest diameter (BSLD), response rate, progression-free survival (PFS) and overall survival (OS) were evaluated using univariate and multivariable Cox regression models.

Results:A total of 759 of the 850 patients (89%) in the E4599 trial had measurable diseases and were included in this analysis. The median BSLD was 7.5 cm. BSLD predicted OS (hazard ratio (HR) 1.41; P<0.001) and had a trend towards association with PFS (HR 1.14; P=0.08). The median OS was 12.6 months for patients with BSLD <7.5 cm compared with 9.5 months for BSLD 7.5 cm. This association persisted in a multivariable model controlling multiple prognostic factors, including the presence and sites of extrathoracic disease (HR 1.24; P=0.01). There was no association between BSLD and response rate.

Conclusion:Tumour measurements are associated with survival in the E4599 trial. If validated in other populations, this parameter may provide important prognostic information to patients and clinicians.
British Journal of Cancer advance online publication, 13 August 2013; doi:10.1038/bjc.2013.472 www.bjcancer.com.

PMID: 23942074 [PubMed - as supplied by publisher]

New Approaches to Modulating Idiopathic Pulmonary Fibrosis.

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New Approaches to Modulating Idiopathic Pulmonary Fibrosis.

Curr Allergy Asthma Rep. 2013 Aug 21;

Authors: Gomer RH

Abstract
Until recently, idiopathic pulmonary fibrosis (IPF) has been a devastating and generally fatal disease with no effective therapeutic. New developments in understanding the biology of the disease include a growing consensus that the lesions are mainly composed of cells that originated from resident fibroblasts. New developments in therapeutics include recommendations against several treatment regimes that have been previously used. On a positive note, the orally available drug pirfenidone has been approved for use in IPF in China, Japan, India, and the European Union, but not yet in the United States. Other possibilities for managing IPF include managing gastrointestinal reflux, and limiting excessive salt intake. A variety of potential therapeutics for IPF are in clinical trials; for instance, in a Phase 1b trial, intravenous injections of a recombinant version of the normal human serum protein Serum Amyloid P (SAP, also known as PTX2) improved lung function in IPF patients.

PMID: 23959780 [PubMed - as supplied by publisher]

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