Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

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

Do household tobacco smoking habits influence asthma, rhinitis and eczema among 13-14 year-old adolescents?

Although the harmful impact of environmental tobacco smoke on respiratory health in early childhood is well known, its effect in adolescence is still ambiguous. This study aims to examine if parents' and household tobacco smoking habits influence asthma, rhinitis and eczema in early adolescence in The Republic of Macedonia, as a country with a very high rate of household tobacco smoke exposure despite the smoking cessation campaign, and low prevalence rates of asthma, rhinitis and eczema.

METHODS: Children aged 13-14 years (n=3026) from randomly selected schools in Skopje, the capital of Macedonia, completed by themselves the standardised International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires on asthma, rhinitis, eczema and potential environmental risk factors. Maternal and paternal tobacco smoking habits and the number of smokers in households were separately correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) with and without adjustments for potential confounders using binary logistic regression.

RESULTS: The maternal smoking habit was significantly positively associated only with current night dry cough apart from chest infection (aOR: 1.26; 1.03-1.54; p=0.026). No significant association was observed in relation to the other studied variables with either parental smoking habits or the number of smokers in the household.

CONCLUSION: Household tobacco smoking habits were not found to have a significant influence on asthma, rhinitis and eczema in young adolescents. The established results point out the dominant influence of maternal smoking on cough as an unspecific asthma symptom.

The airway sensory hyperreactivity syndrome.

After exclusion of diverse pulmonary illnesses, the remaining explanations for chronic cough include medication with angiotensin-converting enzyme (ACE) inhibitor, gastroesophageal reflux disease (GERD), and post-nasal drip. Different clinics report shifting frequencies for both the causes of chronic cough and the success of treatment. However, after all evaluations, differential diagnosis still leaves a group of patients with unexplained cough.

This unexplained cough is also known as chronic idiopathic cough (CIC), though there are widely varying opinions as to its existence. Among patients previously diagnosed with CIC, a subgroup has been identified with both upper and lower airway symptoms, including cough induced by odours and chemicals, and with increased cough sensitivity to inhaled capsaicin, which is known to stimulate the airway sensory nerves. A suggested explanation for this condition is a hyperreactivity of the sensory nerves of the entire airways, and hence the condition is known as sensory hyperreactivity (SHR).

SHR affects more than 6% of the adult population in Sweden. It is a longstanding condition, and is clearly associated with significant social and psychological impacts.

Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer.

Oncogenic fusion genes consisting of EML4 and anaplastic lymphoma kinase (ALK) are present in a subgroup of non-small-cell lung cancers, representing 2 to 7% of such tumors. We explored the therapeutic efficacy of inhibiting ALK in such tumors in an early-phase clinical trial of crizotinib (PF-02341066), an orally available small-molecule inhibitor of the ALK tyrosine kinase.

METHODS: After screening tumor samples from approximately 1500 patients with non-small-cell lung cancer for the presence of ALK rearrangements, we identified 82 patients with advanced ALK-positive disease who were eligible for the clinical trial. Most of the patients had received previous treatment. These patients were enrolled in an expanded cohort study instituted after phase 1 dose escalation had established a recommended crizotinib dose of 250 mg twice daily in 28-day cycles. Patients were assessed for adverse events and response to therapy.

RESULTS: Patients with ALK rearrangements tended to be younger than those without the rearrangements, and most of the patients had little or no exposure to tobacco and had adenocarcinomas. At a mean treatment duration of 6.4 months, the overall response rate was 57% (47 of 82 patients, with 46 confirmed partial responses and 1 confirmed complete response); 27 patients (33%) had stable disease. A total of 63 of 82 patients (77%) were continuing to receive crizotinib at the time of data cutoff, and the estimated probability of 6-month progression-free survival was 72%, with no median for the study reached. The drug resulted in grade 1 or 2 (mild) gastrointestinal side effects.

CONCLUSIONS: The inhibition of ALK in lung tumors with the ALK rearrangement resulted in tumor shrinkage or stable disease in most patients. (Funded by Pfizer and others; ClinicalTrials.gov number, NCT00585195.).

Osteoprotegerin in sputum is a potential biomarker in COPD.

Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation and inflammation of the respiratory tract. Several inflammatory biomarkers have been evaluated in COPD but are poorly related to disease severity and progression.

Osteoprotegerin (OPG) is a glycoprotein mediator that is expressed in the lung and macrophages so we have studied its concentration in induced sputum and macrophages of patients with COPD.

RESULTS: OPG concentrations measured by ELISA in induced sputum of COPD patients (18.7± 18.6 ng/ml, n=39) were significantly higher than those of healthy smokers (8.1 ± 5.6 ng/ml, n=15), healthy non-smokers (3.5±3.8 ng/ml, n=14) or asthmatic patients (8.0 ±5.4 ng/ml, n=18). Sputum OPG levels in COPD negatively correlated with FEV(1) and positively correlated with RV/TLC (r=0.55, p<0.05), TL(CO) (r=-0.53, p<0.05) and K(CO) (r=-0.61, p<0.01). By contrast, sputum IL-8 concentrations in were related to disease severity but not to RV/TLC or gas diffusion. Airway macrophages and neutrophils were positive for OPG by immunocytochemistry in sputum and peripheral lung tissue. OPG induced matrix metalloproteinase-9 release from sputum macrophages in vitro.

CONCLUSION: Sputum OPG may be a useful biomarker to monitor parenchymal destruction in COPD.

Maintenance Therapy in Advanced Non-small Cell Lung Cancer: Current Status and Future Implications.

Maintenance therapy for patients with advanced non-small cell lung cancer has been an area of intense investigation. Maintenance therapy has been divided into two broad categories: continuation maintenance when the chemotherapy or targeted agent was part of a defined number of cycles of combination therapy and in the absence of disease progression is continued as a single agent or switch maintenance when a third agent is initiated after four cycles of platinum-based double-agent chemotherapy in the absence of disease progression.

Two monoclonal antibodies, cetuximab and bevacizumab, are used as continuation maintenance, but the incremental benefit of the maintenance therapy with these agents is undetermined. Phase III trials have not revealed an overall survival benefit for continuation maintenance chemotherapy, and this approach should be considered investigational. Phase III trials have demonstrated an improvement in overall survival with switch maintenance therapy with pemetrexed compared with placebo in patients with nonsquamous histology and erlotinib compared with placebo. Phase III trials have not revealed an improvement in quality of life with maintenance therapy. In the trials of maintenance therapy, 30 to 40% of patients enrolled in the observation or placebo arm did not receive second-line therapy, and among the patients who did receive second-line therapy, there was significant heterogeneity in the therapy.

The development of maintenance therapy has raised issues about the role of treatment-free intervals in routine clinical care, trial design issues such as the optimal endpoint, the ethics of a placebo arm, and the implications of maintenance therapy for first-line trials.

Search

Search