Acute asthma in children: treatment in emergency.

Eur Rev Med Pharmacol Sci. 2011 Jun;15(6):711-6

Authors: Pavone P, Longo MR, Taibi R, Nunnari G, Romano C, Passaniti E, Falsaperla R

Asthma is one of the most common chronic diseases, leading to an increased rate of hospitalization.

PMID: 21796876 [PubMed - in process]

A review of the use of fluticasone furoate since its launch.

Expert Opin Pharmacother. 2011 Jul 29;

Authors: Villa E, Magnoni MS, Micheli D, Canonica GW

Introduction: Fluticasone furoate (FF) is the latest glucocorticoid officially approved for the treatment of allergic rhinitis. FF has shown the highest affinity and selectivity for the glucocorticoid receptors as well the longest tissue retention compared with other available intranasal steroids; these new pharmacologic characteristics provide the basis for its potent and prolonged anti-inflammatory activity at the target site. Areas covered: A literature review achieved through PubMed and Medline research methods supports the clinical efficacy of FF versus placebo in reducing ocular and nasal symptoms related to allergic rhinitis (at the recommended starting doses of 110 μg once daily for adults and adolescents and 55 μg once daily for children), with a good safety profile. Moreover, the present review also compares FF with other intranasal steroids: FF represents a molecular evolution of fluticasone propionate (FP), and there is scientific evidence of therapeutic advantages over FP. Expert opinion: Fluticasone furoate is a promising molecule in the treatment of allergic rhinitis as it fits fully all the official guidelines' criteria. It is now being considered as a topical steroid that is quite close to the ideal pharmacological model for glucocorticoids due to its satisfying safety/tolerability profile, both in adults and children, leads FF to be considered as a topical steroid that is quite close to the ideal pharmacologic model for glucocorticoids. More studies should be directed to assess the improvement of quality of life in subjects with allergic rhinitis treated with FF, in comparison with other intranasal steroids and even H1-antihistamines; in addition, it could be also interesting to analyze eventual, additional effects of FF in patients with bronchial asthma, which is frequently associated with allergic rhinitis.

PMID: 21797803 [PubMed - as supplied by publisher]

Association of upper gastrointestinal symptoms with functional and clinical charateristics in elderly.

World J Gastroenterol. 2011 Jul 7;17(25):3020-6

Authors: Pilotto A, Maggi S, Noale M, Franceschi M, Parisi G, Crepaldi G

To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients.

PMID: 21799648 [PubMed - in process]

Sputum inflammation predicts exacerbations after cessation of inhaled corticosteroids in COPD.

Respir Med. 2011 Jul 28;

Authors: Liesker JJ, Bathoorn E, Postma DS, Vonk JM, Timens W, Kerstjens HA

INTRODUCTION: The GOLD guidelines advocate not to institute inhaled corticosteroids (ICS) in patients with mild-to-moderate COPD. However, many patients do use ICS and in some patients, withdrawal is associated with deteriorating lung function and increased exacerbation rates. Unfortunately, physicians do not know in which patients they can stop ICS treatment safely. AIM: To identify predictors of COPD exacerbations after ICS withdrawal. METHODS: During ICS treatment, post-bronchodilator spirometry, body plethysmography, and health status assessment were performed in 68 COPD patients using ICS. Additionally, sputum cell differentials, supernatant leukotriene B(4), eosinophilic cationic protein, and myeloperoxidase, serum C-reactive protein and soluble intracellular adhesion molecule, and urinary desmosine were assessed. Sputum was also analysed for mRNA levels of haemoxygenase-1, tumour necrosis factor-α, RANTES, interleukin 5(IL-5), IL-10, IL-12, IL-13, transforming growth factor-β, and interferon-γ. STATISTICS: Cox regression analyses were performed using time to exacerbation as outcome variable to identify significant hazards for a COPD exacerbation after ICS withdrawal. RESULTS: Higher sputum % eosinophils, higher sputum MPO/neutrophil level, longer duration of COPD symptoms, <40 packyears smoking, and ICS withdrawal in November, December or January were significant hazards (all p<0.05) for experiencing a COPD exacerbation after ICS withdrawal in a monovariate model. In a multivariate model, all factors proved independent predictors except for sputum MPO/neutrophil level. CONCLUSIONS: Decisions on whether or not inhaled corticosteroids can be safely withdrawn in mild-to-moderate COPD can be facilitated by assessment of sputum inflammation, particularly eosinophil numbers, next to packyears smoking, season, and duration of COPD symptoms.

PMID: 21802933 [PubMed - as supplied by publisher]