Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis.

Intranasal corticosteroids (INSs) are a mainstay of treatment of allergic rhinitis (AR) nasal symptoms. The INS mometasone furoate nasal spray (MFNS) has well-documented efficacy and safety for the treatment and prophylaxis of nasal symptoms of seasonal AR (SAR) and for the treatment of nasal symptoms of perennial AR (PAR). Increasing interest has focused on whether INSs, including MFNS, may have beneficial effects on the ocular symptoms frequently associated with AR.

Methods:  We performed a meta-analysis of 10 randomized, placebo-controlled trials of the efficacy of MFNS 200 mcg daily in relieving ocular allergy symptoms, including itching/burning, redness, and tearing/watering in both SAR and PAR. Four PAR studies and six SAR studies are included in the analysis. A fixed-effect inverse variance model was used to calculate weighted mean differences, 95% confidence intervals (CIs) for each comparison, and a combined overall treatment effect (Z) with P-value.

Results:  In both analyses of SAR and PAR studies, including 3132 patients, all individual ocular symptoms were reduced in patients treated with MFNS. Overall treatment effect was significant for all three individual ocular symptoms in the SAR studies (Z = 9.18 for tearing, Z = 10.15 for itching, and Z = 8.88 for redness; P < 0.00001 for all) and in the PAR studies (Z = 5.94, P < 0.00001 for tearing; Z = 2.43, P = 0.02 for itching; and Z = 2.42, P = 0.02 for redness).

Conclusions:  Our findings add to the growing body of literature supporting the positive class effect of INSs, including MFNS, on ocular symptoms associated with SAR and PAR.

Roflumilast for COPD.

Patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis have a reduction in lung function and a higher risk of suffering exacerbations, which result in a deterioration in their quality of life, an accelerated progression of the disease and a greater mortality. COPD is currently considered an inflammatory disease involving airways and lung parenchyma. The symptoms that are typical of chronic bronchitis (chronic cough and sputum production) are markers of underlying inflammation, characteristic of COPD. Roflumilast, an antiinflammatory drug that belongs to the new therapeutic class of phosphodiesterase PDE4 inhibitors, is the first drug developed for the treatment of a specific phenotype of COPD (COPD associated with chronic bronchitis).

The results of clinical trials indicated that in patients with COPD associated with chronic bronchitis and a history of exacerbations, roflumilast improves lung function and reduces the frequency of exacerbations that require medical interventions. This effect remained when it was added to a regular treatment with long-acting bronchodilators such as tiotropium or long-acting β₂-adrenoceptor agonists (LABAs) such as salmeterol.

Roflumilast has been shown to be generally well tolerated. Side effects were typically mild to moderate and included diarrhea, nausea, weight decrease and headache. Gastrointestinal side effects mainly occurred within the first weeks of therapy and mostly resolved on continued treatment.

Mesenchymal stromal cells in bronchoalveolar lavage as predictors of bronchiolitis obliterans syndrome.

Bronchoalveolar lavage fluid (BAL) from human lung allografts demonstrates the presence of a multipotent mesenchymal stromal cell (MSC) population. However, the clinical relevance of this novel cellular component of BAL and its association with bronchiolitis obliterans syndrome (BOS), a disease marked by progressive airflow limitation secondary to fibrotic obliteration of the small airways, remains to be determined.

OBJECTIVE: In this study we investigate the association of number of MSCs in BAL with development of BOS in human lung transplant recipients.

METHODS: Mesenchymal CFUs were quantitated in a cohort of 405 BAL samples obtained from 162 lung transplant recipients. Poisson generalized estimating equations were utilized to determine the predictors of BAL mesenchymal CFU count. Measurement and

MAIN RESULTS: Higher CFU counts were noted early post-transplantation; time from transplant to BAL of > 3 months predicted 0.4 fold lower CFU counts (P=0.0001). BOS diagnosis < 365 days before BAL was associated with a 2.11 fold higher CFU count (P=0.02). 2.62 and 2.70 fold higher CFU counts were noted in the presence of histologic diagnosis of bronchiolitis obliterans (p= 0.05) and organizing pneumonia (0.0003) respectively. In BAL samples obtained from BOS-free patients greater than 6 months post-transplantation (n=173), higher mesenchymal CFU counts (≥ 10) significantly predicted BOS onset in both univariate (hazard ratio [HR], 5.61; 95% CI, 3.03-10.38; p<0.0001) and multivariate (HR, 5.02; 95% CI, 2.40-10.51; p<0.0001) Cox regression analysis.

CONCLUSIONS: Measurement of mesenchymal CFUs in the BAL provides predictive information regarding future BOS onset.

Lung Cancer in Chronic Obstructive Pulmonary Disease: Enhancing Surgical Options and Outcomes.

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for both the development of primary lung cancer, as well as poor outcome following lung cancer diagnosis and treatment. Because of existing impairments in lung function, patients with COPD often do not meet traditional criteria for tolerance of definitive surgical lung cancer therapy.
Emerging information regarding the physiology of lung resection in COPD indicates that post-operative decrements in lung function may be less than anticipated by traditional prediction tools. In COPD patients, more inclusive consideration for surgical resection with curative intent may be appropriate as limited surgical resections or non-surgical therapeutic options provide...

Novel Developments in the Epidemic of HIV and TB Co-Infection.

Tuberculosis (TB) disease remains one of the highest causes of mortality in HIV infected individuals, and HIV-TB co-infection continues to grow at alarming rates especially in sub-saharan Africa. Surprisingly, a number of important areas regarding co-infection remain unclear. For example, increased risk of TB disease begins early in the course of HIV infection, however the mechanism of how HIV increases this risk is not well understood.
In addition, there is lack of consensus on the optimal way to diagnose latent infection and to manage active disease in the HIV infected. Furthermore, effective point-of care testing for TB disease remains elusive. This review will discuss key areas in the epidemiology, pathogenesis, d...

Search

Search