RATIONALE: Physical activity enhances uptake of air pollutants in the lung, possibly augmenting its harmful effects on chronic lung disease during exercise.
OBJECTIVES: To examine whether benefits of physical activity on the risk of asthma and COPD are moderated by exposure to high air pollution levels in an urban setting.

METHODS: 53,113 subjects (50-65 years) from the Danish Diet, Cancer, and Health cohort reported physical activity at the recruitment (1993-97) and were followed until 2013 in the National Patient Register for incident hospitalizations for asthma and COPD. Levels of nitrogen dioxide (NO2) were estimated at residence at the recruitment. We used Cox regression to associate physical activities and NO2 (high/medium/low) with asthma and COPD, and then introduced an interaction term between each physical activity and NO2.

MEASUREMENTS AND MAIN RESULTS: 1,151 subjects were hospitalized for asthma and 3,225 for COPD during 16 years. We found inverse associations of participation in sports (hazard ratio: 0.85; 95 % confidence interval: 0.75-0.96) and cycling (0.85; 0.75-0.96) with incident asthma, and of participation in sports (0.82; 0.77-0.89), cycling (0.81; 0.76-0.87), gardening (0.88; 0.81-0.94) and walking (0.85; 0.75-0.95) with incident COPD admissions. We found positive associations between NO2 and incident asthma (1.23; 1.04-1.47) and COPD (1.15; 1.03-1.27) hospitalizations (comparing ≥21.0 µg/m3 to <14.3 µg/m3). We found no interraction between associations of any physical activity and NO2 on incident asthma or COPD hospitalizations.

CONCLUSIONS: Increased exposure to air pollution during exercise does not outweigh beneficial effects of physical activity on the risk of asthma and COPD.

BACKGROUND: Despite improvements in clinical practice, pneumonia remains one of the leading causes of death worldwide. Pathologic findings from autopsy reports could provide more precise and valid data on characteristics of pneumonia patients.

METHODS: We retrospectively reviewed autopsy reports of deceased patients admitted to the Institute for Pulmonary Diseases of Vojvodina in Sremska Kamenica, Serbia, between 1994 and 2003. The patients were classified into two groups: group 1 (n = 161) comprised patients in whom pneumonia was the main cause of death, while group 2 (n = 165) consisted of patients in whom pneumonia was confirmed at autopsy but had various different causes of death.

RESULTS: From 1776 patients who underwent autopsy 326 (18.3%) were diagnosed with pneumonia. The most common underlying diseases were atherosclerosis (29.4%), chronic obstructive pulmonary disease (COPD) (26.7%), and malignancies (20.2%). Pneumonia was the main cause of death in 161 cases (group 1) while in group 2 major causes of death were heart failure (HF) (26.7%), acute myocardial infarction (AMI) (16.4%), and pulmonary embolism (PE) (10.9%). Multilobar involvement (91% vs.27%), pulmonary effusion (29% vs.14%), and lung abscess (23.6% vs.8.5%) were more frequently found in group 1, compared to group 2.

CONCLUSION: In patients with pneumonia who underwent autopsy most common underlying diseases were atherosclerosis, COPD, and malignancies, while major causes of death were: progression of pneumonia, HF, AMI, and PE.

Chronic lung diseases include a variety of obstinate and fatal diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), idiopathic pulmonary fibrosis (IPF), and lung cancers.

Pharmacotherapy is important for the treatment of chronic lung diseases, and current progress in nanoparticles offers great potential as an advanced strategy for drug delivery. Based on their biophysical properties, nanoparticles have shown improved pharmacokinetics of therapeutics and controlled drug delivery, gaining great attention. Herein, we will review the nanoparticle-based drug delivery system for the treatment of chronic lung diseases.

Various types of nanoparticles will be introduced, and recent innovative efforts to utilize the nanoparticles as novel drug carriers for the effective treatment of chronic lung diseases will also be discussed.

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The European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a paediatric assessment.

Pediatr Allergy Immunol. 2016 Sep 17;

Authors: Rodríguez Del Río P, Vidal C, Just J, Tabar AI, Sanchez-Machin I, Eberle P, Borja J, Bubel P, Pfaar O, Demoly P, Calderón MA

Abstract
BACKGROUND: Safety data on "real-life" allergen immunotherapy (AIT) in children and adolescents is usually extrapolated from studies in adults.
METHODS: Patients aged 18 or under initiating aeroallergen AIT were evaluated in a prospective European survey. Patient profiles and systemic reactions (SRs) were recorded. Descriptive, univariate and multivariate analyses were used to identify risk factors for SRs.
RESULTS: A total of 1,563 patients (mean±SD age: 11.7±3.9 years; rhinitis: 93.7%; asthma: 61.5%; polysensitization: 62.5%) and 1,578 courses of AIT were assessed. Single-allergen AIT was administered in 89.5% of cases (n=1,412; mites: 49%; grass pollen: 25.8%; tree pollen: 8.7%; Alternaria: 4.6%; dander: 0.8%; weed pollen: 0.6%). Subcutaneous AIT (SCIT) was used in 71.4% (n=1,127) of the treatments, including 574 (50.9%) with natural extracts. Sublingual AIT (SLIT) was used for the remaining 451 treatments (drops: 73.8%; tablets: 26.2%). The mean±SD follow-up period was 12.9±3.3 months. The estimated total number of doses was 19,669 for SCIT and 131,550 for SLIT. Twenty-four patients (1.53%) experienced 29 SRs. Respiratory (55.7%) and skin symptoms (37.9%) were most frequent. Anaphylaxis was diagnosed in 3 SRs (10.3%), and adrenaline was administered in 2 of these cases. In a univariate analysis, the risk of SRs was lower in mite-sensitized patients and higher in cases of pollen polysensitization (>3), grass pollen extracts and the use of natural extracts (vs. allergoids).
CONCLUSIONS: In a real-life paediatric setting, AIT is safe. SRs are infrequent and generally not severe. Pollen polysensitization, grass pollen extracts and natural extracts (vs. allergoids) were risk factors for AIT-associated SRs. This article is protected by copyright. All rights reserved.

PMID: 27637414 [PubMed - as supplied by publisher]