Health-related quality of life of COPD patients aged over 40 years.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the fourth most frequent disease globally, and its worldwide prevalence is projected to increase in the following decades. Health-related quality of life (HRQOL) of COPD patients depends on multiple factors. OBJECTIVE: The aim of this study was to identify the most important risk factors affecting HRQOL of COPD patients and to measure how specific clinical parameters can predict HRQOL. METHODS: A questionnaire-based cross-sectional study combined with clinical data was conducted among patients diagnosed with COPD (n = 321, 52.6% females, mean age 66.4 ± 9.5) at the National Koranyi Institute for Pulmonology, Budapest in 2019-2020. The inclusion criteria were age ≥40 years and existing COPD. Multivariate linear regression analyses were conducted on three components of the COPD-specific Saint George's Respiratory Questionnaire (SGRQ-C) and on the physical (PCS) and mental component scales (MCS) of the 36-Item Short Form Health Survey (SF-36). Multiple linear regression analysis was performed to evaluate the effects of patient and disease characteristics on COPD Assessment Test (CAT) scores. RESULTS: We found that frequent exacerbations, multiple comorbidities and tobacco smoking were associated with worse HRQOL. Engaging in more frequent physical activity and better 6-minute walking distance results were associated with better HRQOL. CONCLUSIONS: Our results indicate that the complex therapy of COPD should focus not only on improving lung functions and preventing exacerbation, but also on treating comorbidities, encouraging increased physical activity, and supporting smoking cessation to assure better HRQOL for patients.

Evidence-Based Practices to Promote Tobacco Cessation During Pregnancy in a Sample of Romanian General Practitioners.

Changes in confidence in implementing smoking cessation support for pregnant women was assessed among Romanian General Practitioners (GPs) before and after a training program of evidence-based clinical practices to promote quitting. The total number of physicians participating in the study was 69. Before training, 51% of GPs felt somewhat/very confident asking pregnant women about tobacco use, 39% assisted smokers with a quit plan, 38% arranged follow-up for patients. After training, 85-90% found the training informative/very informative on: how to ask patients if they smoke (89%), advising patients to quit (88%), talking about the benefits of quitting (85%), assessing patients readiness to quit (87%), assisting patients in setting a quit date (87%).

Influence of HLA-DPB1 mismatches on MLR responses: the role of high resolution HLA class II typing and MLC in unrelated donor selection for BMT.

Twenty eight Hungarian patients lacking a compatible related donor and their 61 HLA-A,B,DR serologically identical potential unrelated donors (selected from BMDW) were investigated in this study. Out of the 61 donor-recipient pairs only 7 (11,5%) proved to be HLA-identical at DNA level. Thirty one pairs (50,8%) differed in DP alleles, 1 pair (1,6%) has a DQ mismatch only and 22 (36,1%) pairs differed in more alleles. More than one potential donor was found for 26 patients and 5 of them have several donors with DP mismatches only. Among the 31 donor-recipient pairs differing only in DP alleles, 0, 1 and 2 mismatches were observed in GvH direction in 7, 10 and 14 cases, respectively. In the MLC assay no proliferative response was observed when no DP mismatch has been found. Among the 1 and 2 DP mismatched cases 11 (35,5%) gave negative and 13 (41,9%) gave positive MLR results. We have found a large scatter in RR values. On the basis of the DNA typing and MLR results we have found that HLA-DPB1*0101-0201 stimulator-responder combination always gave negative MLR in both direction. HLA-DPB1*0201-0301 and DPB1*0301-0401 allele combinations were reactive in all cases. In conclusion MLC assay might indicate the low immunogeneicity in certain DP allele combinations as well as the avoidable positive combinations, which may help to select the best fitting donor for BMT.

Production of cytokines by rat immunocytoma clonal variants: a new type of intratumor heterogeneity.

A long-term tissue culture line of highly metastatic IR202 immunocytoma of LOU rats, and five of its clones (B4, C2, C4, C5, D3) was examined for their ability to produce cytokines. A combination of cytokine detection bioassays was employed in order to compensate for differences in sensitivity and specificity, and the possibility of inhibitors masking an activity. All the IR202 variants tested were shown to secrete constitutively varying amount of interleukin (IL-6). In addition, most of the cells produce IL-10 and TGF-beta, except clones C4 and C2, respectively. Moreover, supernatants from clone B4, C2, C4, and D3 may contain low levels of soluble IL-1. Membrane-bound IL-1 was found on the surface of B4, C4, and D3 cells. None of the IR202 variants, however, produced IL-2, IL-4, tumor necrosis factor-alpha (TNF-alpha), or LT. These results are consistent with the concept of a new type of intratumor heterogeneity and the ability of immunocytoma tumors to generate different immunoregulatory molecules in tumor-bearing hosts.

Effect of cell cycle on the regulation of the cell surface and secreted forms of type I and type II human tumor necrosis factor receptors.

The cell cycle has been shown to regulate the biological effects of human tumor necrosis factor (TNF), but to what extent that regulation is due to the modulation of TNF receptors is not clear. In the present report we investigated the effect of the cell cycle on the expression of surface and soluble TNF receptors in human histiocytic lymphoma U-937. Exposure to hydroxyurea, thymidine, etoposide, bisbensimide, and demecolcine lead to accumulation of cells primarily in G1/S, S, S/G2/M, G2/M, and M stages of the cell cycle, respectively. While no significant change in TNF receptors occurred in cells arrested in G1/S or S/G2 stages, about a 50% decrease was observed in cells at M phase of the cycle. Scatchard analysis showed a reduction in receptor number rather than affinity. In contrast, cells arrested at S phase (thymidine) showed an 80% increase in receptor number. The decrease in the TNF receptors was not due to changes in cell size or protein synthesis. The increase in receptors, however, correlated with an increase in total protein synthesis (to 3.8-fold of the control levels). A proportional change was observed in the p60 and p80 forms of the TNF receptors. A decrease in the surface receptors in cells arrested in M phase correlated with an increase in the amount of soluble receptors. The cellular response to TNF increased to 8- and 2-fold in cells arrested in G1 and S phase, respectively; but cells at G2/M phase showed about 6-fold decrease in response. In conclusion, our results demonstrate that the cell cycle plays an important role in regulation of cell-surface and soluble TNF receptors and also in the modulation of cellular response.

New theory of the development of myocardial infarction.

Solutions of KCl (1%, 10% and 31.2%) administered into the pericardial fluid or applied onto the surface of the heart evoked a dome-like change of the ECG in dogs, rats and guinea-pigs and led to myocardial infarction in 3-5 days. Both the acute changes in ECG and the infarction itself could be prevented by the application of pericardial fluid samples and by administration of three synthetic compounds onto the heart surface. The same substances also inhibited the development of ECG changes elicited by general hypoxia due to stopping artificial respiration. The existence of a peculiar myocardial space beginning with outer pores and reaching the myocardial cells through connective tissue pathways is postulated. Earlier studies showed that 125I-labelled albumin applied to the epicardial surface through a filter paper reached the endomyocardium through some intramyocardial pathways beginning with epicardial pores. In the present experiments intrapericardial application of India ink led to obstruction of these pores and thus prevented the infarction elicited by intrapericardial administration of KCl solutions. This space, being distinct from that accessible from the coronary arteries, serves for transfer of various substances into the myocardium, while other compounds (e.g. noradrenaline) are not effective through this pathway. Oxygen reaching this space from the epicardial surface protects the myocardium from the damaging effects of hypoxia and KCl.