Academic literature on the topic 'BAP-65'

IntroductionThere is no established clinical prediction model for in-hospital death among patients with pneumonic COPD exacerbation. We aimed to externally validate BAP-65 and CURB-65 and to develop a new model based on the eXtreme Gradient Boosting (XGBoost) algorithm.MethodsThis multicentre cohort study included patients aged ≥40 years with pneumonic COPD exacerbation. The input data were age, sex, activities of daily living, mental status, systolic and diastolic blood pressure, respiratory rate, heart rate, peripheral blood eosinophil count and blood urea nitrogen. The primary outcome was in-hospital death. BAP-65 and CURB-65 underwent external validation using the area under the receiver operating characteristic curve (AUROC) in the whole dataset. We used XGBoost to develop a new prediction model. We compared the AUROCs of XGBoost with that of BAP-65 and CURB-65 in the test dataset using bootstrap sampling.ResultsWe included 1190 patients with pneumonic COPD exacerbation. The in-hospital mortality was 7% (88 out of 1190). In the external validation of BAP-65 and CURB-65, the AUROCs (95% confidence interval) of BAP-65 and CURB-65 were 0.69 (0.66–0.72) and 0.69 (0.66–0.72), respectively. XGBoost showed an AUROC of 0.71 (0.62–0.81) in the test dataset. There was no significant difference in the AUROCs of XGBoost versus BAP-65 (absolute difference 0.054; 95% CI −0.057–0.16) or versus CURB-65 (absolute difference 0.0021; 95% CI −0.091–0.088).ConclusionBAP-65, CURB-65 and XGBoost showed low predictive performance for in-hospital death in pneumonic COPD exacerbation. Further large-scale studies including more variables are warranted.

Clasificar la severidad de las exacerbaciones de la enfermedad pulmonar obstructiva crónica (EPOC) es un reto porque no hay una escala unificada y específica. El objetivo del estudio es utilizar la escala BAP65 para relacionar manejo ambulatorio, intrahospitalario, necesidad de unidad de cuidados intensivos, ventilación mecánica y mortalidad. Materiales y métodos: estudio de cohorte descriptiva retrospectiva de pacientes con EPOC exacerbado que ingresaron al servicio de urgencias del Hospital de San José de Bogotá DC en el período 2011-2012. Resultados: de 252 pacientes 28 correspondieron a clasificación BAP-65: I (11.11%), 146 a BAP-65: II (57.9%), 70 a BAP-65: III (27.8%), 7 a BAP-65: IV (2.8%) y uno a BAP-65: V (0.39%). Ocho requirieron ventilación mecánica invasiva (3.1%), 11 hospitalización en UCI (4.3%) y se presentó una mortalidad (0.4%). Los que requirieron ventilación mecánica correspondieron a la escala III. Los días de hospitalización aumentaron con el grado de severidad de la escala. El único caso de mortalidad fue grado IV. Conclusiones: la escala BAP-65 se relaciona con el aumento de los días de hospitalización, manejo en UCI y mortalidad. Se requiere un estudio con mayor número de pacientes grado V para definir su conducta clínica. Abreviaturas: EPOC, enfermedad pulmonar obstructiva crónica.

Introduction: Exacerbations are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. COPD AE is one of the commonest case presenting to the TUTH Emergency, average being 5 patients a day. The aim of the study was to co-relate the BAP 65 score, mortality and mechanical ventilation in patients with acute exacerbation of COPD. Methods: It was an observational study, 648 patients from emergency of TUTH were screened for the study from Magh 2073 to Asar 2074 after getting approval from the institutional review boards, among them 114 were included after applying inclusion and exclusion criteria and BAP 65 score was calculated. The patients were followed till discharge, mechanical ventilation or mortality. Data entry was done in MS EXCEL and statistical analysis was done using SPSS version 24. Results: Total of 114 patients enrolled for the study from the emergency of TUTH. There were total 16 mortality and 12 patients were mechanically ventilated. Most of the mortality and mechanical ventilation were from severe group ie BAP class IV and V. We used Pearson Chi-squared test to compare between BAP 65 class and Mortality, and found that mortality rate increased with increasing BAP 65 class with a p value of < 0.0001. The need of Mechanical Ventilation increased as well, as the BAP 65 Class increased, less than 1% of the patients with BAP class I needed MV, the cause being Type II Respiratory Failure, while around 50% of the patients with BAP class V needed MV. Conclusions: BAP 65 score is an effective and simple tool to classify the patients presenting with AECOPD, it correlated well with both the need of mechanical ventilation and mortality. Higher the score higher the chances of severe disease.

Background: Prognostic research in exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospitalization has been limited and there appears to be little common ground between predictors of mortality in stable disease and during AECOPD. Furthermore, none of the prognostic tools developed in stable disease have been tested on hospitalised patients, and most require clinical measurements not routinely available at hospital admission. This study intends to test dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) and biological assessment profile (BAP) 65 Scores on Indian patients in a tertiary care set up and validate the same to be used as a routine and effective score in predicting the outcome in AECOPD. Methods: Hospital based prospective observational study was carried out in 100 patients with AECOPD who was present to general medicine. DECAF and BAP-65 Scores were calculated. Data was analyzed using SPSS 22 version software.Results: In our study both DECAF score and BAP‑65 score performed equally well for prediction of need for Mechanical Ventilation. The AUROC for need for Mechanical Ventilation was 0.77 (95% CI=0.67–0.84) for DECAF score and 0.77 (95% CI=0.67–0.85) for BAP‑65 score. The AUROC for prediction of mortality for DECAF score was 0.83 (95% confidence interval [CI]=0.74–0.89) and for BAP‑65 score was 0.79 (95% CI=0.69–0.86).Conclusions: DECAF and BAP-65 are good and also equal in predicting mortality as well as need for mechanical ventilation. Both scores can be easily applicable in AECOPD patients, so that death during hospitalization for AECOPD and need for mechanical ventilation can be minimized.

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a significant morbidity and mortality with a need for frequent hospitalizations and mechanical ventilation. Thus, a model was searched that required simple information that was consistently available in emergency department, upon the presentation of the patient which allowed risk stratification and to identify patients who might potentially benefit from early intervention. METHODS This was a prospective observational study conducted over a period of 6 months, from May 2018 to December 2018 with a study sample of 136 patients. The primary objective was aimed to validate the BAP-65 score system in predicting the need for ventilatory support and mortality in patients who presented with acute exacerbation of COPD. RESULTS Mean age of the study population was 64.13 ± 9.7 and 29 (21.32 %) were females with obvious male predominance. It was observed that as the BAP-65 score increases, the mortality increases. Mortality among the score groups 0, 1 and 2 was one, zero, one respectively. The mortality is about 37.5 % in the score group 3 and it increased to 90.9 % in the score group 4. The patients who needed mechanical ventilation were about 4 % in the score group 2 and it increased to 100 % in the score group 4. BAP-65 scoring system had a sensitivity of 88.89 % and specificity of 90.68 % in predicting the in-hospital mortality, and a sensitivity of 84 % and specificity of 94.59 % in predicting the need for mechanical ventilation during hospital stay. CONCLUSIONS The BAP-65 scoring system seems to be a promising tool which is simple and accurate. The score correlated well with both the mortality and also the need for mechanical ventilation, thus helping in decision making at triage level and also in prognostication of the disease. KEYWORDS Chronic Obstructive Pulmonary Disease, Acute Exacerbation, BAP-65, AECOPD, Mortality, Mechanical Ventilation

O objetivo deste trabalho foi avaliar os efeitos de BAP (6-benzilaminopurina) e NAA (ácido naftaleno acético) na indução, na multiplicação in vitro de gemas, nas brotações de Ananas comosus da cultivar 'IAC Gomo-de-mel' e a correlação desses efeitos com a atividade de peroxidase e o teor de proteína solúvel total. Foram utilizadas gemas axilares retiradas da coroa de frutos sadios, inoculadas em tubo de ensaio contendo meio de cultura MS solidificado com ágar a 5%, pH ajustado para 5,7, contendo os tratamentos que incluíam diferentes concentrações e combinações de BAP (0, 0,5, 1,0 e 1,5mg L-1) e NAA (0, 0,5 e 1,0mg L-1). Nessa fase, aos 65 dias, ocorreu a formação de 2,24 brotações, utilizando-se 1mg L-1 de BAP. Após o desenvolvimento, as gemas foram inoculadas em meio MS líquido associado a dois tratamentos (1,0mg L-1 BAP + 0,5mg L-1 NAA e 1,0mg L-1 BAP + 1,0mg L-1 NAA) e, aos 95 dias, o meio de cultura mais adequado foi aquele que continha 1,0mg L-1 BAP + 0,5mg L-1 NAA, proporcionando 7,42 brotações, menor porcentagem de hiper-hidricidade, maior número de brotações e indução de gemas. As proteínas solúveis apresentaram relação negativa com hiper-hidricidade e comprimento de brotações. A atividade da peroxidase foi maior em plantas com maior número de brotos e com maior porcentagem de hiper-hidricidade.

The potato (Solanum tuberosum L.) plant is grown in about 150 countries of the world and is considered an important food crop. However, this crop is susceptible to different biotic and abiotic factors, which can affect its crop yield. This vulnerability can be reduced or eliminated by growing potatoes under sterilized conditions. Cytokinins, such as 6-Benzylaminopurine, are proven to show a significant role in the in vitro regulation of plants. In the current study, explants of Kuroda variety were/potato cv. Kuroda were grown using diverse concentrations of 6-Benzylaminopurine (BAP), which displayed varied results. BAP concentration of 0.01 mg/l showed a 10 cm shoot length with 41 shoots having 66.66% regeneration efficiency. Meanwhile, the explant grown in 0.25 mg/l BAP concentration showed 16 cm shoot length with 65 shoots having 83.33% regeneration efficiency. On the other hand, the explants that were grown using 0.05 mg/l and 1 mg/l BAP concentration showed 7 cm and 10 cm shoot length with 35 and 52 shoots having 63.33% and 76.66% regeneration efficiency, respectively. Therefore, it was concluded that 0.25 mg/L of BAP showed the best results with the highest number of shoots and shoot length as well as maximum regeneration efficiency among all the tested concentrations.

The dormant nature of Morinda citrifolia seeds is a limitation to its efficient in-vitro plantlet multiplication. Hence, the use of embryo culture for successful in-vitro culture initiation. Matured embryo of freshly collected noni seeds were cultured on Murashige and Skoog basal medium supplemented with kinetin (Kn) and Benzyl amino purine (BAP) in the range of A: control (no addition); B: 0.5 mg/l Kn+1.0 mg/l BAP; C: 1.0 mg/l Kn+2.0 mg/l Bap; D: 1.5 mg/l Kn+3.0 mg/l BAP and E: 2.0 mg/l Kn+4.0 mg/l BAP. The results at 4 weeks after inoculation (WAI) showed that germination was faster from medium A without hormone whereas highest percentage germination was obtained from both medium D and E with 80 %. Medium B and C had 65 % each while medium A gave the least (40%). The development of the plantlets showed that longest shoot (3.9 cm) from medium A was closely related to 3.58 cm from Medium B while root lengths (2.28 cm) and number of adventitious roots (26) from medium A were significantly higher than other media at 12 WAI. Highest number of nodes (2.25) obtained from medium D was comparable to Media C and B while medium A had the least at 12 WAI. Number of leaves obtained was similar between the media at 12 WAI. These results indicated that using embryo is reliable for fast in-vitro propagation and shoot development of noni plant with optimum cytokinins (0.5/1.0 mg/l Kn/BAP) application. Keywords: Culture initiation, Cytokinins, Embryo culture, Plantlet, Shoot development

A protein that binds polycyclic aromatic hydrocarbons (PAHs) with high affinity and sediments in a sucrose gradient at 4 S has been described in rat liver cytosol. This « 4 S » PAH binding protein precipitates at a 40–60% ammonium sulfate saturation. This partial purification procedure allows assay of this protein by using purified 3H-benzo(a)pyrene (3H-BaP) as radioactive ligand and dextran-coated charcoal as adsorbent for unreacted 3H-BaP. The 3H-BaP binding activity measured as a function of pH shows its maximum activity between pH 7.3 and 10.5. The « 4 S » PAH binding protein is stable up to 42 °C even in the absence of the ligand. At 65 °C the binding sites for 3H-BaP are destroyed. The binding activity assayed as a function of protein concentration is linear between 0.4 and 2 mg/ml at 0 °C, whereas at 37 °C higher protein concentrations (4 mg/ml) can be reached. Exposure to guanidine-HCl (3 M) and urea (5 M) for 20 min at 4 °C inhibits the PAH binding completely to the « 4 S » protein. Quick dilution or dialysis does not restore the binding activity. The dissociation rate of the « 4 S » PAH binding protein measured in the presence of an excess of unlabeled ligand at 0 °C is biphasic and shows a two-step, first-order kinetic pattern. At 37 °C the dissociation rate is linear and faster, and is complete after 5 min of incubation. The association rate shows the same behavior: the binding is complete after 10 min at 0 °C, whereas at 37 °C the reaction is 10 times as fast. The dissociation equilibrium constants at 0 °C and 37 °C are respectively 2.45 × 10−9 M and 1.09×10−9 M. The high rates of association and dissociation of BaP to « 4 S » PAH binding protein were used to set up an assay to exchange radioactive 3H-BaP with cold BaP.

Las especies Peltophorum dubium (Spreng.) (Caña fístula) y Enterolobium contortosiliquum (Vell.) Morong (Timbó), nativas del bosque atlántico interior, son de interés para la foresto-industria de la región. El desarrollo de un protocolo de propagación in vitro para ambas especies es necesario para contar con herramientas para un programa de conservación ex situ. El objetivo del presente trabajo fue determinar el medio nutritivo, concentración y tipo de reguladores de crecimiento vegetal, y tipo de explantes necesarios para la proliferación in vitro de brotes axilares, adventicios y embriones somáticos de P. dubium y E. contortisiliquum. El 100% de los explantos obtenidos de plántulas germinadas in vitro de P. dubium formaron brotes axilares, con una producción promedio de dos brotes por explante a partir de segmentos nodales cultivados en MS½+0,1 mg/l BAP. El 65% de estos brotes formaron raíces cuando fueron subcultivados a medio MS½, libre de RCV. Se reporta además en P. dubium, la formación de brotes adventicios y la inducción de embriones somáticos, que alcanzaron estadio acorazonado a partir de segmentos apicales, inducidos en MS½ suplementados con 2,4-D y BAP y diferenciados en MS½ en presencia de BAP. Por otro lado, también por primera vez, se obtuvo en E. contortisiliquum, la producción de brotes axilares a partir de segmentos nodales cultivados en MS+0,1 mg/l BAP en un 100% de los explantos y la producción de brotes adventicios (con un máximo de 6 brotes/explanto), a partir de segmentos apicales, inter-cotiledonares y nodales, cultivados en medio MS suplementados con BAP y ANA

Sintesi in lingua italiana – Parte prima Nei pazienti con BPCO, le riacutizzazioni sono una frequente causa di accesso in pronto soccorso e possono condizionarne negativamente la prognosi. Obiettivi dello studio erano: 1) descrivere le caratteristiche socio-demografiche e cliniche, nonché la gestione in pronto soccorso dei pazienti con riacutizzazione di bronco-pneumopatia ostruttiva cronica (BPCO); 2) stimarne i costi. Abbiamo condotto uno studio di coorte retrospettivo in Italia, raccogliendo dati su 4,396 pazienti da 34 centri. I pazienti avevano un’età media (deviazione standard [DS]) di 77 (11) anni, ed erano femmine nel 39% dei casi. Oltre il 70% dei pazienti presentava un indice di comorbidità moderato o severo, e nel 26% dei casi era presenta anche una diagnosi di scompenso cardiaco. Il 65% dei pazienti è stato ospedalizzato, per una durata media (DS) di 11 (10) giorni. Il costo stimato per paziente è 2.617 €. In conclusione, I pazienti che afferiscono in pronto soccorso con una riacutizzazione di BPCO sono anziani e gravate da importanti comorbidità. Il tasso di ricovero in questi pazienti è alto, e i costi onerosi. Sintesi in lingua italiana – Parte seconda Le riacutizzazioni di BPCO esitano frequentemente in ospedalizzazione, possono richiedere il trattamento con ventilazione invasiva e sono associate a elevata mortalità intraospedaliera. Il BAP-65 è modello di predizione del rischio di eventi avversi per pazienti con riacutizzazione di BPCO. Il BAP-65 è semplice da utilizzare e, se la sua accuratezza prognostica fosse confermata, potrebbe essere utilizzato per guidare la gestione dei pazienti. Abbiamo condotto uno studio retrospettivo, multicentrico in pazienti che afferivano in pronto soccorso per una riacutizzazione di BPCO durante il 2014. Lo scopo dello studio era validare il modello BAP-65 per la predizione dell’outcome combinato mortalità intraospedaliera e ricorso alla ventilazione invasiva. Abbiamo arruolato 2.908 pazienti da 20 centri Italiani. L’età media (DS) era 76 (11) anni, e il 38% dei pazienti era femmina. L’outcome combinato si è verificato nel 5% dei pazienti. L’area sotto la curva (AUROC) stimata per l’outcome combinato è risultata pari a 0,64 (95%CI 0,59-0,68). Un punteggio BAP-65 ≥ 4 ha mostrato una sensibilità pari a 44% (95% CI 34%-55%) nel predire la mortalità intraospedaliera, con specificità 84% (95% CI 82%-85%), valore predittivo positivo 9% (95% CI 6%-12%) e valore predittivo negativo 98% (95% CI 97%-98%). In conclusione, il modello BAP-65 non ha dimostrato accuratezza sufficiente per un’efficacie stratificazione del rischio di prognosi infausta nella popolazione studiata. DOI del primo articolo: https://doi.org/10.1016/j.ejim.2018.01.010 DOI del secondo articolo: https://doi.org/10.1016/j.ejim.2018.10.018.
Abstract part 1 Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) frequently cause patients with COPD to access the emergency department and have a negative impact on the course of the disease. The objectives of our study were: 1) describing the socio-demographic and clinical characteristics, and the clinical management, of patients with AECOPD, when they present to the emergency department; and 2) estimating the costs related to the management of these patients. We conducted a retrospective cohort study in Italy, collecting data on 4,396 patients, from 34 centres. Patients had a mean (SD) age of 76,6 (10.6) years, and 61.2 % of them where males. More than 70 % of the patients had a moderate to very high comorbidity burden, and heart failure was present in 26.4 % of the cohort. The 64.6 % of patients were admitted to hospital wards, with a mean (SD) length of stay of 10.8 (9.8) days. The estimated cost per patient was 2617 €. Conclusions: Patients attending the ED for an AECOPD are old and present important comorbidities. The rate of admission is high, and costs are remarkable. Abstract part 2 Exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with AECOPD. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for an AECOPD during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59-0.68). The sensitivity of BAP-65 score ≥ 4 to predict in-hospital mortality was 44% (95% CI 34%-55%), the specificity was 84% (95% CI 82%-85%), the positive predictive value was 9% (95% CI 6%-12%), and the negative predictive value was 98% (95% CI 97%-98%). Conclusions: In patients attending Italian EDs with an AECOPD, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes. DOI of published article # 1: https://doi.org/10.1016/j.ejim.2018.01.010 DOI of published article # 2: https://doi.org/10.1016/j.ejim.2018.10.018.