scholarly journals Dynamics of inhaled corticosteroid use are associated with asthma attacks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joy Lee ◽  
Jacqueline Huvanandana ◽  
Juliet M. Foster ◽  
Helen K. Reddel ◽  
Michael J. Abramson ◽  
...  
Keyword(s):  
Electronic Monitoring ◽  
Inhaled Corticosteroids ◽  
Symptom Control ◽  
Area Under The Curve ◽  
Adherence Behavior ◽  
Baseline Status ◽  
Multivariable Analyses ◽  
Transitional Probabilities ◽  
Blood Eosinophils

AbstractInhaled corticosteroids (ICS) suppress eosinophilic airway inflammation in asthma, but patients may not adhere to prescribed use. Mean adherence—averaging total doses taken over prescribed—fails to capture many aspects of adherence. Patients with difficult-to-treat asthma underwent electronic monitoring of ICS, with data collected over 50 days. These were used to calculate entropy (H) a measure of irregular inhaler use over this period, defined in terms of transitional probabilities between different levels of adherence, further partitioned into increasing (Hinc) or decreasing (Hdec) adherence. Mean adherence, time between actuations (Gapmax), and cumulative time- and dose-based variability (area-under-the-curve) were measured. Associations between adherence metrics and 6-month asthma status and attacks were assessed. Only H and Hdec were associated with poor baseline status and 6-month outcomes: H and Hdec correlated negatively with baseline quality of life (H:Spearman rS = − 0·330, p = 0·019, Hdec:rS = − 0·385, p = 0·006) and symptom control (H:rS = − 0·288, p = 0·041, Hdec: rS = − 0·351, p = 0·012). H was associated with subsequent asthma attacks requiring hospitalisation (Wilcoxon Z-statistic = − 2.34, p = 0·019), and Hdec with subsequent asthma attacks of other severities. Significant associations were maintained in multivariable analyses, except when adjusted for blood eosinophils. Entropy analysis may provide insight into adherence behavior, and guide assessment and improvement of adherence in uncontrolled asthma.

scholarly journals Effects of the first three doses of benralizumab on symptom control, lung function, blood eosinophils, oral corticosteroid intake, and nasal polyps in a patient with severe allergic asthma

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090696 ◽  
Author(s):  
Corrado Pelaia ◽  
Maria Teresa Busceti ◽  
Alessandro Vatrella ◽  
Marco Ciriolo ◽  
Eugenio Garofalo ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Oral Corticosteroid ◽  
Inhaled Corticosteroids ◽  
Symptom Control ◽  
Serum Levels ◽  
Forced Expiratory Volume ◽  
High Serum ◽  
Asthma Control Test ◽  
Eosinophilic Asthma ◽  
Blood Eosinophils

Severe allergic eosinophilic asthma can be characterized by inadequate control, despite the regular use of high dosages of inhaled corticosteroids/long-acting β2-adrenergic agonists combinations, and the very frequent utilization of oral corticosteroids. Therefore, under these circumstances, an add-on biological treatment with monoclonal antibodies directed against suitable molecular targets, involved in the pathobiology of type-2 airway inflammation, is very useful. Within such a context, our case report refers to a 46-year-old woman with severe allergic eosinophilic asthma and relapsing nasal polyps, not eligible to add-on biological therapy with omalizumab because of her very high serum levels of immunoglobulins E (IgE). She is currently under treatment with the humanized monoclonal antibody benralizumab (30 mg subcutaneous injection, administered every 4 weeks for the first three doses, and every 8 weeks thereafter), an eosinophil-depleting anti-interleukin-5-receptor biologic. Our patient experienced relevant clinical and functional improvements already after the first dose, and subsequently striking changes were recorded after the second and third doses, including remarkable increases in asthma control test scores and forced expiratory volume in 1 s values, associated with a complete depletion of blood eosinophils and the interruption of oral corticosteroid intake, as well as with the concomitant disappearance of nasal polyps after the second dose. In conclusion, this case study suggests that benralizumab can exert a very rapid and effective therapeutic action in patients with severe eosinophilic asthma and nasal polyposis.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

scholarly journals Discovery and Evaluation of Protein Biomarkers as a Signature of Wellness in Late-Stage Cancer Patients in Early Phase Clinical Trials

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2443
Author(s):  
Bethany Geary ◽  
Erin Peat ◽  
Sarah Dransfield ◽  
Natalie Cook ◽  
Fiona Thistlethwaite ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Early Phase ◽  
Characteristic Curve ◽  
Performance Status ◽  
Area Under The Curve ◽  
Protein Biomarkers ◽  
Late Stage Cancer ◽  
Early Phase Clinical Trials

TARGET (tumour characterisation to guide experimental targeted therapy) is a cancer precision medicine programme focused on molecular characterisation of patients entering early phase clinical trials. Performance status (PS) measures a patient’s ability to perform a variety of activities. However, the quality of present algorithms to assess PS is limited and based on qualitative clinician assessment. Plasma samples from patients enrolled into TARGET were analysed using the mass spectrometry (MS) technique: sequential window acquisition of all theoretical fragment ion spectra (SWATH)-MS. SWATH-MS was used on a discovery cohort of 55 patients to differentiate patients into either a good or poor prognosis by creation of a Wellness Score (WS) that showed stronger prediction of overall survival (p = 0.000551) compared to PS (p = 0.001). WS was then tested against a validation cohort of 77 patients showing significant (p = 0.000451) prediction of overall survival. WS in both sets had receiver operating characteristic curve area under the curve (AUC) values of 0.76 (p = 0.002) and 0.67 (p = 0.011): AUC of PS was 0.70 (p = 0.117) and 0.55 (p = 0.548). These signatures can now be evaluated further in larger patient populations to assess their utility in a clinical setting.

Overview of microscopic colitis

2020 ◽  
Vol 81 (10) ◽  
pp. 1-7
Author(s):  
Omer F Ahmad ◽  
Ayesha Akbar
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Symptom Control ◽  
Microscopic Colitis ◽  
Common Condition ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Rising Incidence ◽  
Inflammatory Drugs

Microscopic colitis encompasses both collagenous and lymphocytic colitis and is a relatively common condition with rising incidence. Diagnosis is by colonoscopy (which is usually normal but may show some mild changes) and biopsies which reveal characteristic histological findings. Symptoms include non-bloody diarrhoea with urgency which may be associated with faecal incontinence and abdominal pain. Microscopic colitis is associated with a reduced health-related quality of life, and treatment is aimed at symptom control. Medications linked with the development of microscopic colitis, including proton pump inhibitors, non-steroidal anti-inflammatory drugs and selective serotonin-reuptake inhibitors, should be discontinued. If symptoms persist, budesonide is a licensed treatment for microscopic colitis which has been shown to be effective in clinical trials and real-world practice.

Current opportunities of inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 31 (1) ◽  
pp. 75-87
Author(s):  
I. V. Leshchenko ◽  
A. S. Meshcheryakova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Fixed Combination ◽  
Chronic Obstructive ◽  
Delivery Device ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting ◽  
Blood Eosinophils

Chronic obstructive pulmonary disease (COPD) is the leading cause of death in the structure of respiratory diseases. The problem of rational pharmacotherapy of COPD have attracted attention of the medical scientific society for many years. The understanding of the pathogenesis of the disease has deepened and approaches to the therapy have changed. Some COPD patients need regular fixed-combination therapy: long-acting bronchodilators (LABD) and inhaled corticosteroids (ICS) in order to prevent exacerbations and reduce the severity of symptoms of the disease. Blood eosinophils count is one of criteria for choosing regular therapy. The appearance of fixed triple combinations of ICS/LABD increased the effectiveness of COPD therapy, and a new delivery device for fixed combination of budesonide/formoterol makes it possible to use ICS successfully in the most severe patients.

Main Directions of Prevention of Group Offenses among Juvenile Convicts in Young Offender Institutions

2021 ◽  
pp. 87-92
Author(s):  
Konstantin V. Karetnikov ◽  
Keyword(s):  
Electronic Monitoring ◽  
Management Systems ◽  
Biometric Identification ◽  
Young Offender ◽  
Criminal Offense ◽  
Video Cameras ◽  
Penal Institutions ◽  
Control And Management ◽  
Special Category

The federal legislation views the prevention of juvenile delinquency and antisocial actions as very significant, since an offense is understood as an administrative offense and a criminal offense, and antisocial actions include other offenses. This issue is topical for young offender institutions; however, the special category of detainees implies a special category of crimes and violations of the established order of serving the sentence (disciplinary responsibility of convicts). By the end of 2020, there were 949 people in 18 young offender institutions. According to the statistics, the convicts did not commit crimes, yet there were more than 545 other violations. In the current circumstances, it is necessary to improve the prevention of offenses by focusing on specific activities in penal institutions, including active use of non-contact supervision over the behavior of convicts (stationary video cameras, portable video recorders, biometric identification means, access control and management systems). The researchers and practitioners are discussing the possibility of using electronic monitoring systems to supervise the behavior of convicts. This will allow a better quality of supervision over the special contingent and more effective preventive activities in young offender institutions.

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