Latent viral infection has been implicated in the pathophysiology of chronic obstructive pulmonary disease (COPD). Epstein-Barr virus (EBV) is known to be important in pulmonary fibrosis. The current authors hypothesised that EBV is associated with the pathogenesis of COPD. Sputum samples were collected from patients both during exacerbations of COPD and when stable. A control group of smokers who did not have airways obstruction also had their sputum examined. The presence of EBV DNA was established and quantified using a real-time nucleic acid amplification assay. A total of 136 patients with COPD were recruited during an acute exacerbation and a total of 68 when stable. EBV was detected in 65 (48%) exacerbation cases and 31 (46%) stable patients. In the comparison group of 16 nonobstructed smokers, EBV was demonstrated in only one (6%) case. Risk of COPD in patients with EBV and who are smokers confers an odds ratio of 12.6. Epstein-Barr virus DNA is more frequently identified in the respiratory tract of chronic obstructive pulmonary disease patients in comparison with unaffected smokers. It is present both during exacerbation and when stable, suggesting that infection is persistent. Smokers who do not develop chronic obstructive pulmonary disease rarely have Epstein-Barr virus in their sputum. This finding may be of importance in the pathogenesis of chronic obstructive pulmonary disease.
n = 12), the slope of QoL indices vs. PDAI became flatter at PDAI = 7 and the P-value decreased dramatically beginning at PDAI ≥ 7 to P < 0Á1 for the ABQOL and Skindex-E.These findings suggest that at PDAI ≥ 7, every incremental increase in PDAI had a smaller detrimental impact on QoL.For the ABSIS, there was no significant difference in slopes before and after a given score, along with a higher P-value overall.Our results support previous findings 6 that the PDAI is superior to the ABSIS at capturing disease severity, especially at the lower end of disease activity (Figure 1c,d).To significantly improve QoL for patients with mucosal and nonmucosal PV, complete disease clearance may be necessary.Small amounts of worsening activity have an increasingly significant impact on QoL at the lower end of the spectrum.Above mild levels of activity, increasing activity has linear but detrimental smaller effects on QoL.The findings for patients with mucosal PV further support this, likely because oral erosions are painful and impact eating.Consistent with prior findings, 2 the Skindex-S best correlates with PDAI score in all patients.A notable limitation of this study is that our population had milder disease, with a median PDAI of 6Á75 and ABSIS of 11Á75.However, we are still able to show a change in QoL as the PDAI decreases, even at lower PDAI levels.Our findings have important clinical implications in determining appropriate outcomes for therapies. 7Unlike dermatomyositis and systemic lupus erythematosus, 4 in patients with PV, complete clearance should be the goal.
This report describes a unique method for identifying and quantifying lewisite degradation products using arsenic (III) and arsenic (IV) speciation in solids and in solutions. Gas chromatographic methods, as well as high-performance liquid chromatographic methods are described for separation of arsenic species. Inductively coupled plasma-mass spectrographic methods are presented for the detection of arsenic.
The various parameters of odor sensation can be evaluated to yield their relative potential to cause annoyance. The effect of prolonged exposure to odors on the human sense of smell is not clear, but circumstantial evidence points to the possibility of deleterious changes.
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