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1.
Neuroscience ; 535: 184-193, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-37944583

ABSTRACT

Recent studies have explored the circuitry involving the ventral hippocampus (vHPC), the amygdala, and the prefrontal cortex, a pathway mainly activated to store contextual information efficiently. Lesions in the vHPC impair remote memory, but not in the short term. However, how the vHPC is affected by distinct memory strength or its role in systems consolidation has not yet been elucidated. Here, we investigated how distinct training intensities, with strong or weak contextual fear conditioning, affect activation of the dorsal hippocampus (dHPC) and the vHPC. We found that the time course of memory consolidation differs in fear memories of different training intensities in both the dHPC and vHPC. Our results also indicate that memory generalization happens alongside greater activation of the vHPC, and these processes occur faster with stronger fear memories. The vHPC is required for the expression of remote fear memory and may control contextual fear generalization, a view corroborated by the fact that inactivation of the vHPC suppresses generalized fear expression, making memory more precise again. Systems consolidation occurs concomitantly with greater activation of the vHPC, which is accelerated in stronger fear memories. These findings lead us to propose that greater activation of the vHPC could be used as a marker for memory generalization.


Subject(s)
Fear , Memory Consolidation , Fear/physiology , Amygdala/physiology , Memory Consolidation/physiology , Hippocampus/metabolism
2.
Front Mol Biosci ; 10: 1072751, 2023.
Article in English | MEDLINE | ID: mdl-36845546

ABSTRACT

Amblyomin-X is a Kunitz-type FXa inhibitor identified through the transcriptome analysis of the salivary gland from Amblyomma sculptum tick. This protein consists of two domains of equivalent size, triggers apoptosis in different tumor cell lines, and promotes regression of tumor growth, and reduction of metastasis. To study the structural properties and functional roles of the N-terminal (N-ter) and C-terminal (C-ter) domains of Amblyomin-X, we synthesized them by solid-phase peptide synthesis, solved the X-Ray crystallographic structure of the N-ter domain, confirming its Kunitz-type signature, and studied their biological properties. We show here that the C-ter domain is responsible for the uptake of Amblyomin-X by tumor cells and highlight the ability of this domain to deliver intracellular cargo by the strong enhancement of the intracellular detection of molecules with low cellular-uptake efficiency (p15) after their coupling with the C-ter domain. In contrast, the N-ter Kunitz domain of Amblyomin-X is not capable of crossing through the cell membrane but is associated with tumor cell cytotoxicity when it is microinjected into the cells or fused to TAT cell-penetrating peptide. Additionally, we identify the minimum length C-terminal domain named F2C able to enter in the SK-MEL-28 cells and induces dynein chains gene expression modulation, a molecular motor that plays a role in the uptake and intracellular trafficking of Amblyomin-X.

3.
Pediatr Transplant ; 27(3): e14445, 2023 05.
Article in English | MEDLINE | ID: mdl-36435975

ABSTRACT

BACKGROUND: Inflammatory myofibroblastic tumors (IMTs) of the liver are rare neoplasms. These tumors are difficult to distinguish from other neoplasms by radiological examination, have uncertain evolution, and there is no consensus on the treatment of these lesions. Hilar tumors can involve the portal vein, hepatic artery, bile duct, and spread to the branches of the portal triad, causing obstructive symptoms, occlusive phlebitis, and portal hypertension. Thus, liver transplantation (LT) is an excellent alternative for locally advanced hilar tumors, since it ensures complete tumor resection with free margins. METHODS/RESULTS: We present a literature review and a case report showing a 3-year-old boy with liver IMT invading the hepatic hilum and inferior vena cava, who underwent a successful living donor liver transplantation that required portal vein and vena cava replacement. CONCLUSION: The incidence of hilar IMTs is low and there is no well-established standard treatment. Liver transplantation for a hilar tumor with vascular invasion was acceptable in this case because the radically of the surgery was the key for the cure, and because the tumor was benign in nature.


Subject(s)
Bile Duct Neoplasms , Liver Transplantation , Male , Humans , Child, Preschool , Hepatectomy , Living Donors , Liver/surgery , Hepatic Artery/surgery , Portal Vein/surgery , Portal Vein/pathology
4.
Appl Ergon ; 96: 103488, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34120001

ABSTRACT

This work examined the physical demands associated with 4 commercially available direct current right-angle power tools along with their computer controlled fastening strategies. Physical demands were measured via an external instrumented handle that could also control the trigger of each tool. Data revealed that forces recorded by the external handle for each of the 4 tools differed. Independent of Joint-Hardness and Target Torque the Atlas Copco TurboTight® and Cleco Low Torque Reaction fastening strategies, both using a rapid spindle-head rotation strategy, produced the lowest peak and impulse force, respectfully, when compared to the 2 tools that were designed to fasten with a longer duration. This work has shown that short duration fastening strategies provide an ergonomics benefit to the users as it requires less force to operate, such force reduction in previous research has been linked to reduced handle displacement and lower muscle effort.


Subject(s)
Ergonomics , Biomechanical Phenomena , Humans , Rotation , Torque
5.
Appl Ergon ; 93: 103374, 2021 May.
Article in English | MEDLINE | ID: mdl-33545561

ABSTRACT

The purpose of this work was to evaluate the physical demands associated with three direct current powered right-angle power tool tightening strategies at various fastener-location-orientations, target torques and joint-hardness. Physical demands were measured using surface electromyography, handle force and upper body kinematics. Results identified TurboTight®, a rapid and short duration fastening strategy, to produce lower handle force impulse, less joint angle displacement, and lower EMG magnitudes when compared to the longer duration fastening strategies tested. The reduced magnitudes associated with TurboTight®, independent of fastener-location-orientations, target torques and joint-hardness, indicate a lower physical demand on power tool operators, providing a significant ergonomic benefit when compared to the slower fastening strategies.


Subject(s)
Ergonomics , Technology , Biomechanical Phenomena , Electromyography , Humans , Torque
6.
Clin Exp Immunol ; 198(2): 273-280, 2019 11.
Article in English | MEDLINE | ID: mdl-31314904

ABSTRACT

Regulated transcriptional readthrough during stress maintains genome structure and ensures access to genes that are necessary for cellular recovery. A broad number of genes, including of the bacterial sensor Toll-like receptor 4 (TLR-4), are markedly transcribed on initiating the systemic inflammatory response. Here we study the transcriptional patterns of tlr4 and of its modulator grp78 during human sepsis, and establish their correlations with the outcome of patients. We measured the daily tlr4 and grp78 RNA expression levels in peripheral blood of septic patients, immediately after admission to intensive care, and modeled these RNA values with a sine damping function. We obtained negative correlations between the transcription of tlr4 and grp78 RNA in the survivor group. In contrast, such relation is lost in the deceased patients. Loss of transcriptional homeostasis predicted by our model within the initial 4 days of hospitalization was confirmed by death of those patients up to 28 days later.


Subject(s)
Heat-Shock Proteins/immunology , Models, Biological , Sepsis/immunology , Toll-Like Receptor 4/immunology , Transcription, Genetic/immunology , Adult , Aged , Disease-Free Survival , Endoplasmic Reticulum Chaperone BiP , Female , Heat-Shock Proteins/blood , Humans , Male , Middle Aged , RNA, Messenger/blood , RNA, Messenger/immunology , Sepsis/blood , Sepsis/mortality , Survival Rate , Toll-Like Receptor 4/blood
7.
Carbohydr Polym ; 136: 46-53, 2016 Jan 20.
Article in English | MEDLINE | ID: mdl-26572327

ABSTRACT

In this contribution a novel green chemistry approach for the synthesis of nanofibrous materials based on blends of carboxymethyl-cellulose (CMC)-silver nanoparticles (AgNPs) composite and polyvinyl-alcohol (PVA) is proposed. These nanofibrous materials were obtained from the electrospinning of blends of aqueous solutions of CMC-AgNPs composite and PVA, which were prepared at different CMC/PVA weight ratios in order to electrospin nanofibers applying a constant tension of 15kV. The synthesized materials were characterized by means of transmission electron microscopy, scanning electron microscopy; as well as Fourier-transform infrared, ultraviolet and Raman spectroscopic techniques. Experimental evidence suggests that the diameter of the nanofibers is thinner than any other reported in the literature regarding the electrospinning of CMC. This feature is related to the interactions of AgNPs with carboxyl functional groups of the CMC, which diminish those between the later and acetyl groups of PVA.


Subject(s)
Carboxymethylcellulose Sodium/chemistry , Green Chemistry Technology , Nanofibers/chemistry , Nanotechnology , Silver/chemistry , Chemistry Techniques, Synthetic , Metal Nanoparticles/chemistry , Models, Molecular , Molecular Conformation , Polyvinyl Alcohol/chemistry
8.
J Helminthol ; 89(3): 367-74, 2015 May.
Article in English | MEDLINE | ID: mdl-24703095

ABSTRACT

Helminths use several strategies to evade and/or modify the host immune response, including suppression or inactivation of the host antigen-specific response. Several helminth immunomodulatory molecules have been identified. Our studies have focused on immunosuppression induced by the roundworm Ascaris suum and an A. suum-derived protein named protein 1 from A. suum (PAS-1). Here we assessed whether PAS-1 is an excretory/secretory (E/S) protein and whether it can suppress lipopolysaccharide-induced inflammation. Larvae from infective eggs were cultured in unsupplemented Dulbecco's modified Eagle medium (DMEM) for 2 weeks. PAS-1 was then measured in the culture supernatants and in adult A. suum body fluid at different time points by enzyme-linked immunosorbent assay (ELISA) with the monoclonal antibody MAIP-1. Secreted PAS-1 was detected in both larval culture supernatant and adult body fluid. It suppressed lipopolysaccharide (LPS)-induced leucocyte migration and pro-inflammatory cytokine production, and stimulated interleukin (IL)-10 secretion, indicating that larval and adult secreted PAS-1 suppresses inflammation in this model. Moreover, the anti-inflammatory activity of PAS-1 was abolished by treatment with MAIP-1, a PAS-1-specific monoclonal antibody, confirming the crucial role of PAS-1 in suppressing LPS-induced inflammation. These findings demonstrate that PAS-1 is an E/S protein with anti-inflammatory properties likely to be attributable to IL-10 production.


Subject(s)
Ascaris suum/physiology , Helminth Proteins/immunology , Helminth Proteins/metabolism , Immune Tolerance , Immunosuppressive Agents/metabolism , Animals , Ascaris suum/chemistry , Ascaris suum/immunology , Cell Movement/drug effects , Culture Media/chemistry , Cytokines/metabolism , Enzyme-Linked Immunosorbent Assay , Host-Pathogen Interactions , Larva/chemistry , Larva/immunology , Larva/physiology , Leukocytes/metabolism , Leukocytes/physiology , Time Factors
9.
Prog Urol ; 23(9): 647-56, 2013 Jul.
Article in French | MEDLINE | ID: mdl-23830259

ABSTRACT

INTRODUCTION: Premature ejaculation (PE) is the most common masculine sexual disorder with a potentially deleterious effect on the patient's morale and the relationship with the partner. It is underdiagnosed, or self-diagnosed, and as patients hesitate to confide in their doctor, and doctors do not enquire about it, it is rarely treated. Effective medication does exist, in particular serotonin reuptake inhibitors. METHODS: Medical literature was reviewed and combined with expert opinion of the authors. RESULTS: The distinction is rarely made between lifelong, primary and acquired PE but this distinction determines the choice and efficacy of the therapeutic strategy. Originally seen from a psychoanalytical viewpoint, it was later seen from a behavioral angle. For primary PE, according to Kaplan and contemporary sexology, a psycho-sexological concept has been evoked: sinful stain and symbolic frustration of the woman following an unresolved conflict, revived by a conflict with the partner. For primary PE, a pathophysiological origin with the notion of genetic susceptibility with possible variation of the central serotoninergic neurotransmission has been suggested. We give here the different etiological hypotheses, the clinical types and the different therapeutic strategies for management of PE (a more precise etio-pathological diagnosis). Some key points are highlighted: factors related to the partner are underestimated, her 'use' as therapy is underexploited, an integrated or combined approach which is potentially more efficacious can go beyond the prolongation of the ejaculation time lapse to optimize the patient's relationship and equilibrium. Maintaining the results over time is however problematic. CONCLUSION: When rapid ejaculation causes a distress, it is a sexual dysfunction deserving medical and/or psycho-sexological management currently evidence-based.


Subject(s)
Premature Ejaculation , Algorithms , Humans , Male , Premature Ejaculation/diagnosis , Premature Ejaculation/epidemiology , Premature Ejaculation/therapy
12.
An. pediatr. (2003, Ed. impr.) ; 71(1): 64-67, jul. 2009. tab
Article in Spanish | IBECS | ID: ibc-72529

ABSTRACT

Objetivo: Describir la forma de presentación de maltrato infantil en la unidad de cuidados intensivos pediátricos (UCIP). Pacientes y métodos: Estudio retrospectivo (2000 2008). Se incluyeron los casos diagnosticados de maltrato físico que precisaron atención en la UCIP. Se excluyeron otras formas de malos tratos (negligencia grave, abuso sexual y quemaduras). Resultados: Se recogieron 8 casos (3 varones y 5 mujeres). La mediana de edad fue de 5,2 meses. Seis pacientes tenían menos de 7 meses. El síntoma guía más frecuente fue el neurológico: crisis convulsivas (4 casos), hematoma subdural (2 casos), traumatismo craneoencefálico grave (un caso). Otras formas de presentación fueron hemotórax (un caso) y parada cardiorrespiratoria de origen desconocido (un caso). La tomografía computarizada craneal evidenció hematoma subdural en 5 casos, 3 de ellos necesitaron drenaje quirúrgico. La sospecha de malos tratos pudo confirmarse por la historia social y la presencia de lesiones no fortuitas. Tres pacientes presentaban fracturas de huesos largos (tibia, cúbito y radio y fracturas costales bilaterales) y 4 hemorragias retinianas. Un paciente falleció y 3 quedaron con graves secuelas neurológicas. Conclusión: Los niños gravemente maltratados pueden identificarse falsamente con enfermedad neurológica casual. En la presente serie, la forma más frecuente de aparición es el hematoma subdural, asociado o no a otros signos indicativos de malos tratos. Diagnosticar esta forma de maltrato es decisivo para evitar la repetición de las lesiones (AU)


Objective: To describe cases of severe child abuse admitted to PICU. Methods and patients: It is a retrospective study (2000 2008) in which patients diagnosed with physical child abuse admitted to PICU were included. Other abuse patterns were excluded (severe negligence, sexual abuse or scalding). Results: There were 8 patients included (3 boys and 5 girls). The median age was 5.2 months, with 6 patients were less than 7 months old. The most frequent sign was neurological symptoms: seizures (4 patients), subdural haematoma (2 patients), traumatic brain injury (1 patient). Other: haemothorax (1 patient) and cardiac arrest of no known aetiology (1 patient). The CT showed a subdural haematoma in 5 patients, 3 of which needed surgical drainage. Child abuse was confirmed using the social history and the presence of inflicted injuries. There were long bones fractures (tibia, ulna and radius, bilateral rib fractures) in 3 patients and 4 patients had retinal haemorrhages. There was one death and 3 had severe neurological after effects. Conclusion: Severely abused children can be falsely diagnosed with a casual neurological disease. The most frequent injury is subdural haematoma with or without another injury associated to child abuse. It very important to diagnose child abuse in order to prevent recurrent injuries (AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Child Abuse/diagnosis , Mandatory Reporting , Domestic Violence/statistics & numerical data , Hemothorax/epidemiology , Heart Arrest/epidemiology , Tomography, X-Ray Computed , Retrospective Studies , Hematoma, Subdural/epidemiology , Craniocerebral Trauma/epidemiology , Intensive Care Units, Pediatric
13.
Mini Rev Med Chem ; 9(7): 820-8, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19519507

ABSTRACT

Bacterial pathogenicity is a result of a combination of factors, including resistance to environmental threats and to the host's defenses, growth capability, localization in the host, tissue specificity, resource obtaining mechanisms and the bacterium's own defenses to aggression. A variety of bacterial components, often specific to each strain, are involved in the microorganism's survival, adhesion and growth in the host. Many of them are harmful and, therefore, are called virulence factors. The effects caused by the virulence factors determine the degree of aggressivity of the strain. In many cases the virulence factors are secreted proteins or enzymes, sometimes performing very specific functions. The enzymatic activity is directed to specific proteins from cell membranes, synaptic vesicle fusion proteins, among other important targets. One of the most toxic bacterial proteins is secreted by Clostridium botulinum, targeted to synaptic vesicle fusion proteins, cleaving them with a zinc-metalloprotease activity, which results in severe neurotoxic effects with a lethal dose as low as eight nanograms per kilogram of body weight. The tetanus neurotoxin acts in a similar way but is less active and Bacillus anthracis also presents a potent metalloprotease activity. In this work we describe a selection of these specially interesting and important bacterial proteins and proteases, stressing their relevance in the pathological process and in medical studies.


Subject(s)
Bacteria/metabolism , Bacterial Toxins/metabolism , Peptide Hydrolases/metabolism , Virulence Factors/metabolism , Animals , Bacteria/enzymology , Bacteria/pathogenicity , Humans , Virulence
14.
An Pediatr (Barc) ; 71(1): 64-7, 2009 Jul.
Article in Spanish | MEDLINE | ID: mdl-19481991

ABSTRACT

OBJECTIVE: To describe cases of severe child abuse admitted to PICU. METHODS AND PATIENTS: It is a retrospective study (2000-2008) in which patients diagnosed with physical child abuse admitted to PICU were included. Other abuse patterns were excluded (severe negligence, sexual abuse or scalding). RESULTS: There were 8 patients included (3 boys and 5 girls). The median age was 5.2 months, with 6 patients were less than 7 months old. The most frequent sign was neurological symptoms: seizures (4 patients), subdural haematoma (2 patients), traumatic brain injury (1 patient). Other: haemothorax (1 patient) and cardiac arrest of no known aetiology (1 patient). The CT showed a subdural haematoma in 5 patients, 3 of which needed surgical drainage. Child abuse was confirmed using the social history and the presence of inflicted injuries. There were long bones fractures (tibia, ulna and radius, bilateral rib fractures) in 3 patients and 4 patients had retinal haemorrhages. There was one death and 3 had severe neurological after effects. CONCLUSION: Severely abused children can be falsely diagnosed with a casual neurological disease. The most frequent injury is subdural haematoma with or without another injury associated to child abuse. It very important to diagnose child abuse in order to prevent recurrent injuries.


Subject(s)
Child Abuse/statistics & numerical data , Intensive Care Units , Child , Female , Humans , Infant , Injury Severity Score , Male , Retrospective Studies
15.
Trop Anim Health Prod ; 41(7): 1421-6, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19319656

ABSTRACT

In order to determine the role of Mycoplasma spp, Ureaplasma diversum and BHV-1 as causal agents of Granular Vulvovaginitis Syndrome in Nelore heifers raised under tropical conditions and based on the hypothesis that stressful conditions during puberty or breeding season would be a determinant factor for the infection, 340 heifers not vaccinated against BHV-1 were divided in Post-pubertal, in the beginning of the first breeding season, and Pubertal heifers. The vaginal lesion score (VLS) Grade 1 to 4 was giving according to lesion area and severity. Vaginal mucus was used to isolate Mycoplasma spp., Ureaplasma diversum and BHV-1. The predominant VLS was 2. No sample was positive for BHV-1; 48% were positive for Mycoplasma spp., Ureaplasma diversum, or both, with predominance of Ureaplasma diversum. Serum neutralization for BHV-1 showed more positive animals in pubertal group (23%); 3 of the paired sera demonstrated seroconversion. These data indicated that post-pubertal and pubertal Nelore heifers raised under extensive conditions are more susceptible to Mycoplasma spp. and Ureaplasma diversum. The hypothesis that the stress of pubertal period could lead to an acute vaginal infection by HBV-1 was not proofed.


Subject(s)
Cattle Diseases/etiology , Herpesvirus 1, Bovine , Mycoplasma , Ureaplasma , Vagina/pathology , Vulvovaginitis/veterinary , Animals , Brazil , Cattle , Cattle Diseases/microbiology , Cattle Diseases/pathology , Cattle Diseases/virology , Female , Neutralization Tests/veterinary , Risk Factors , Stress, Physiological/physiology , Syndrome , Tropical Climate , Vagina/microbiology , Vagina/virology , Vulvovaginitis/etiology , Vulvovaginitis/microbiology , Vulvovaginitis/pathology , Vulvovaginitis/virology
18.
Mem Inst Oswaldo Cruz ; 100 Suppl 1: 25-7, 2005 Mar.
Article in English | MEDLINE | ID: mdl-15962095

ABSTRACT

We have previously reported that in comparison with normal rats, the presence of experimental allergic encephalomyelitis (EAE) leads to decreased endogenous inhibitory activity (EIA) of Ca2+-dependent nitric oxide synthase (NOS) in both brain and serum, and increased expression of protein 3-nitrotyrosine (NT) in brain. In this work we show that animals recovered from the clinical signs of EAE are not different from controls in terms of either brain NOS activity, EIA of NOS, or NT expression. These results suggest that parallel to the reversal of the disease symptoms, a normalization of the production of nitric oxide and related species occurs.


Subject(s)
Brain/enzymology , Encephalomyelitis, Autoimmune, Experimental/enzymology , Nitric Oxide Synthase Type III/metabolism , Nitric Oxide/metabolism , Animals , Cytoplasmic Dyneins , Dyneins/metabolism , Encephalomyelitis, Autoimmune, Experimental/blood , Male , Nitric Oxide Synthase Type III/antagonists & inhibitors , Rats , Rats, Inbred Lew
19.
Mem. Inst. Oswaldo Cruz ; 100(supl.1): 25-27, Mar. 2005. ilus, tab
Article in English | LILACS | ID: lil-402172

ABSTRACT

We have previously reported that in comparison with normal rats, the presence of experimental allergic encephalomyelitis (EAE) leads to decreased endogenous inhibitory activity (EIA) of Ca2+-dependent nitric oxide synthase (NOS) in both brain and serum, and increased expression of protein 3-nitrotyrosine (NT) in brain. In this work we show that animals recovered from the clinical signs of EAE are not different from controls in terms of either brain NOS activity, EIA of NOS, or NT expression. These results suggest that parallel to the reversal of the disease symptoms, a normalization of the production of nitric oxide and related species occurs.


Subject(s)
Animals , Male , Rats , Brain/enzymology , Encephalomyelitis, Autoimmune, Experimental/enzymology , Nitric Oxide Synthase Type III/metabolism , Nitric Oxide/metabolism , Dyneins/metabolism , Encephalomyelitis, Autoimmune, Experimental/blood , Nitric Oxide Synthase Type III/antagonists & inhibitors , Rats, Inbred Lew
20.
Drugs Exp Clin Res ; 30(4): 143-52, 2004.
Article in English | MEDLINE | ID: mdl-15553660

ABSTRACT

Erdosteine is a new thiol compound with effects on bacterial adhesiveness as well as antioxidant and mucoactive properties. The EQUALIFE study, a fully randomized, double-blind, placebo-controlled, parallel-group, multicenter study, was designed to assets the effectiveness of long-term treatment with erdosteine in patients with moderate chronic obstructive pulmonary disease (COPD). One hundred and fifty-five patients received oral erdosteine, 300 mg b.i.d., or placebo for 8 months during the winter season to assess the effect of treatments on exacerbation rate, hospitalization, lung function and quality of life, assessed using the Short Form 36 and the St. George's Respiratory Questionnaire. A pharmacoeconomic analysis was also conducted to compare the two treatments. One hundred and twenty-four patients completed the study with erdosteine (n = 63) or placebo (n = 61). The group of COPD patients who received 8 months of continuous treatment with erdosteine had significantly fewer exacerbations and spent fewer days in the hospital than did the placebo group; furthermore, they had no loss of lung function. Patients in the erdosteine group also showed a significant improvement in health-related quality of life. The mean total COPD-related disease costs per patient were lower in the erdosteine group than in the placebo group over the study period. The results indicate that 8 months of treatment with erdosteine is effective in reducing exacerbation and hospitalization rates and in improving health status. The study suggests that erdosteine is likely to provide an important contribution to the therapy of patients with symptomatic COPD.


Subject(s)
Drug Administration Schedule , Pulmonary Disease, Chronic Obstructive/drug therapy , Thioglycolates/therapeutic use , Thiophenes/therapeutic use , Administration, Oral , Aged , Capsules , Economics, Pharmaceutical/statistics & numerical data , Exercise Test/methods , Female , Humans , Italy , Male , Patient Selection , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/physiopathology , Quality of Life/psychology , Spirometry/methods , Surveys and Questionnaires , Thioglycolates/adverse effects , Thioglycolates/economics , Thiophenes/adverse effects , Thiophenes/economics , Time Factors , Treatment Outcome
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