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Nocturnal GERD - a risk factor for rhinitis/rhinosinusitis: the RHINE study.

It has been suggested that gastroesophageal reflux disease (GERD) is a risk factor for developing rhinitis/rhinosinusitis, but data are lacking. This is a prospective 10-year follow-up study of a large multicenter cohort from Northern Europe, evaluating the relationship between nocturnal GERD and non-infectious rhinitis (NIR)

METHODS: The study comprised 5,417 subjects born between 1945 and 1973, who answered a questionnaire in 1999-2001 and again in 2010-2012. Non-infectious rhinitis was defined as having nasal obstruction, secretion and/or sneezing without having the common cold. Odds ratios for developing NIR in relation to age, gender, BMI, smoking, asthma and nocturnal GERD were calculated

RESULTS: During the 10-year observation period, 1,034 subjects (19.1%) developed NIR. Subjects reporting nocturnal gastroesophageal reflux in both 1999 and 2010 had more NIR in 2010 (2.8% vs 1.2%, p<0.001). There was a significant dose-response relationship between the number of reflux episodes/week in 1999 and the risk of having NIR in 2010, p=0.02. In the multiple regression adjusted for age, gender, BMI, tobacco smoke and asthma, those with nocturnal GERD in 1999 (≥3 episodes of nocturnal gastroesophageal reflux symptoms per week) had an OR of 1.6 (95% CI 1.0-2.5, p=0.03) to develop NIR in 2010. Smoking was associated both with an increased risk of developing NIR (30.7% vs 24.0%, p<0.001) and with the development of nocturnal GERD

CONCLUSION: This large, population-based, 10-year study indicates that nocturnal GERD was a risk factor for non-infectious rhinitis/rhinosinusitis. GERD should therefore be considered in patients with rhinitis of known and unknown origin This article is protected by copyright. All rights reserved.

Stratification of patients with severe asthma.

Lancet Respir Med. 2015 Mar 20;
Authors: Bousquet J

Advances in allergen immunotherapy: Aiming for complete tolerance to allergens.

Allergen-specific immunotherapy (AIT) has been used for more than 100 years as a tolerance-inducing therapy for allergic diseases and represents a potentially curative method of treatment. AIT functions through multiple mechanisms, including regulating T and B cell responses, changing antibody isotypes, and decreasing mediator release and migration of eosinophils, basophils, and mast cells to affected tissues.

Despite the relative success of AIT, attempts are being made to improve this therapy in order to overcome problems in standardization, efficacy, safety, long duration of treatment, and costs. These have led to the development of biotechnological products with successful clinical results.

Formulation development and evaluation of fast disintegrating tablets of salbutamol sulphate, cetirizine hydrochloride in combined pharmaceutical dosage form: a new era in novel drug delivery for pediatrics and geriatrics.

The objective of the present study was to prepare the fast disintegrating tablet of Salbutamol Sulphate, Cetirizine Hydrochloride in combined tablet dosage form for respiratory disorders such as bronchitis, asthma, and coughing for pediatrics and geriatrics.

The tablets were prepared by direct compression technique. Superdisintegrant such as Sodium Starch Glycolate was optimized as 4% on the basis of least disintegration time. Different binders such as MCC and PVP K-30 were optimized along with optimized superdisintegrant concentration. 1% MCC was selected as optimum binder concentration on the basis of least disintegration time. The tablets were evaluated for hardness, friability, weight variation, wetting time, disintegration time, and drug content uniformity. Optimized formulation was further evaluated by in vitro dissolution test, drug-excipient compatibility, and accelerated stability study. Percent weight variation and content uniformity were within the acceptable limit. The friability was less than 1%. The wetting time and disintegration time were practically good for all formulations. FTIR studies and accelerated stability study showed that there was no interaction between the drug and excipients.

It was concluded that, by employing commonly available pharmaceutical excipients such as superdisintegrants, hydrophilic and swellable excipients and proper filler, a fast disintegrating tablet of Salbutamol Sulphate, Cetirizine Hydrochloride in combined tablet dosage form, were formulated successfully with desired characteristics.

Invasive Home Mechanical Ventilation: Living Conditions and Health-Related Quality of Life.

Related Articles

Invasive Home Mechanical Ventilation: Living Conditions and Health-Related Quality of Life.

Respiration. 2015 Mar 19;

Authors: Huttmann SE, Windisch W, Storre JH

Abstract
BACKGROUND: The number of patients with invasive home mechanical ventilation (HMV) following unsuccessful weaning is steadily increasing, but little is known about the living conditions and health-related quality of life (HRQL) in these patients.
OBJECTIVES: To establish detailed information on living conditions and HRQL in patients with invasive HMV.
METHODS: The Severe Respiratory Insufficiency Questionnaire (SRI) was used to measure specific HRQL aspects in addition to patient interviews on individual living conditions during home visits.
RESULTS: Thirty-two patients with lung disease, most prominently COPD (n = 18), and neuromuscular disorders (n = 14) were included. The overall mean SRI summary scale score (range 0-100) was 53 ± 16, with a broad range amongst individuals (23-86). Neuromuscular patients were younger than those with lung diseases (49 ± 18 vs. 67 ± 11 years; p < 0.005), and although they had a higher nursing dependency and fewer comorbidities, they tended to have higher (better) SRI summary scale scores (58 ± 16 vs. 48 ± 15; p = 0.092). Living in a private home compared to living in nursing facilities did not influence the SRI scores.
CONCLUSIONS: Patients undergoing invasive HMV primarily following unsuccessful weaning reported an individual HRQL which, when taken together, was highly heterogeneous and ranged from very good to extremely bad. Older patients with COPD and more comorbidities are likely to have a worse HRQL than neuromuscular patients, while the living situation does not influence the HRQL. © 2015 S. Karger AG, Basel.

PMID: 25791249 [PubMed - as supplied by publisher]

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