scholarly journals ONE-YEAR FOLLOW-UP OF EXERCISES IN CHILDREN WITH ALLERGIC ASTHMA

2021 ◽  
Vol 9 (04) ◽  
pp. 134-140
Author(s):  
Viara Dimitrova ◽  
◽  
Penka Perenovska ◽  
Assen Aleksiev ◽  
◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Exercise Intensity ◽  
Inhaled Corticosteroids ◽  
Day Treatment ◽  
Balance Training ◽  
Respiratory Muscle Training ◽  
Exercise Frequency ◽  
Once Daily ◽  
One Year ◽  
Post Hoc

Aim:- To study the effect of exercises in childhood allergic asthma, and to reveal their optimal frequency, intensity, and duration, because of missing consensus about them. Material and Methods:- 12 children (age 11.17 ± 2.69 years) with allergic asthma were followed for one year. At the beginning and the end of the year, they were treated for 10 days with low daily doses of inhaled corticosteroids and exercises (breathing retraining, respiratory muscle training, and musculoskeletal flexibility with posture/balance training). The children and their parents were instructed to continue the same exercises at home as frequently, intensely, and prolong as possible for one year. Standard spirometry was performed four times – at the beginning and the end of the two 10-day treatment courses. The results were recorded as percentages of the actual versus the predicted spirometric parameters. MANOVA with Bonferronis multiple comparison post-hoc tests and Pearsons correlation with multiple regression post-hoc tests were used for the statistical analysis. Results:- The spirometric parameters showed a significant improvement at the end of each 10-day treatment course versus at the beginning (P<0.05), as well as at the end of the year versus at the beginning (P<0.05). There was a significant correlation of the spirometric parameters versus the exercise frequency (P<0.05) and versus the exercise intensity (P<0.05), but not versus the exercise duration (P>0.05). The regression analysis revealed that with increasing the exercise intensity and frequency (at least once daily) the spirometric parameters are improving significantly (P<0.05). Conclusion:- Exercises significantly improve the spirometric parameters in children with allergic asthma. The optimal exercise frequency is at least once daily with high intensity and short duration.

scholarly journals Efficacy of umeclidinium/vilanterol according to the degree of reversibility of airflow limitation at screening: a post hoc analysis of the EMAX trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Claus F. Vogelmeier ◽  
Paul W. Jones ◽  
Edward M. Kerwin ◽  
Isabelle H. Boucot ◽  
François Maltais ◽  
...  
Keyword(s):  
Lung Function ◽  
Rescue Medication ◽  
Inhaled Corticosteroids ◽  
Full Range ◽  
Medication Use ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Double Blind ◽  
Once Daily ◽  
Post Hoc

Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the relationship between short-term bronchodilator reversibility and longer-term response to bronchodilators is unclear. Here, we investigated whether the efficacy of long-acting bronchodilators is associated with reversibility of airflow limitation in patients with COPD with a low exacerbation risk not receiving inhaled corticosteroids. Methods The double-blind, double-dummy EMAX trial randomised patients to umeclidinium/vilanterol 62.5/25 µg once daily, umeclidinium 62.5 µg once daily, or salmeterol 50 µg twice daily. Bronchodilator reversibility to salbutamol was measured once at screening and defined as an increase in forced expiratory volume in 1 s (FEV1) of ≥ 12% and ≥ 200 mL 10−30 min post salbutamol. Post hoc, fractional polynomial (FP) modelling was conducted using the degree of reversibility (mL) at screening as a continuous variable to investigate its relationship to mean change from baseline in trough FEV1 and self-administered computerised-Transition Dyspnoea Index (SAC-TDI) at Week 24, Evaluating Respiratory Symptoms-COPD (E-RS) at Weeks 21–24, and rescue medication use (puffs/day) over Weeks 1–24. Analyses were conducted across the full range of reversibility (−850–896 mL); however, results are presented for the range −100–400 mL because there were few participants with values outside this range. Results The mean (standard deviation) reversibility was 130 mL (156) and the median was 113 mL; 625/2425 (26%) patients were reversible. There was a trend towards greater improvements in trough FEV1, SAC-TDI, E-RS and rescue medication use with umeclidinium/vilanterol with higher reversibility. Improvements in trough FEV1 and reductions in rescue medication use were greater with umeclidinium/vilanterol compared with either monotherapy across the range of reversibility. Greater improvements in SAC-TDI and E-RS total scores were observed with umeclidinium/vilanterol versus monotherapy in the middle of the reversibility range. Conclusions FP analyses suggest that patients with higher levels of reversibility have greater improvements in lung function and symptoms in response to bronchodilators. Improvements in lung function and rescue medication use were greater with umeclidinium/vilanterol versus monotherapy across the full range of reversibility, suggesting that the dual bronchodilator umeclidinium/vilanterol may be an appropriate treatment for patients with symptomatic COPD, regardless of their level of reversibility.

scholarly journals Salbutamol use in relation to maintenance bronchodilator efficacy in COPD: a prospective subgroup analysis of the EMAX trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
F. Maltais ◽  
I. P. Naya ◽  
C. F. Vogelmeier ◽  
I. H. Boucot ◽  
P. W. Jones ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Once Daily ◽  
Fractional Polynomial ◽  
Exacerbation Risk ◽  
Symptom Outcome ◽  
Post Hoc

Abstract Background Short-acting β2-agonist (SABA) bronchodilators help alleviate symptoms in chronic obstructive pulmonary disease (COPD) and may be a useful marker of symptom severity. This analysis investigated whether SABA use impacts treatment differences between maintenance dual- and mono-bronchodilators in patients with COPD. Methods The Early MAXimisation of bronchodilation for improving COPD stability (EMAX) trial randomised symptomatic patients with low exacerbation risk not receiving inhaled corticosteroids 1:1:1 to once-daily umeclidinium/vilanterol 62.5/25 μg, once-daily umeclidinium 62.5 μg or twice-daily salmeterol 50 μg for 24 weeks. Pre-specified subgroup analyses stratified patients by median baseline SABA use (low, < 1.5 puffs/day; high, ≥1.5 puffs/day) to examine change from baseline in trough forced expiratory volume in 1 s (FEV1), change in symptoms (Transition Dyspnoea Index [TDI], Evaluating Respiratory Symptoms-COPD [E-RS]), daily SABA use and exacerbation risk. A post hoc analysis used fractional polynomial modelling with continuous transformations of baseline SABA use covariates. Results At baseline, patients in the high SABA use subgroup (mean: 3.91 puffs/day, n = 1212) had more severe airflow limitation, were more symptomatic and had worse health status versus patients in the low SABA use subgroup (0.39 puffs/day, n = 1206). Patients treated with umeclidinium/vilanterol versus umeclidinium demonstrated statistically significant improvements in trough FEV1 at Week 24 in both SABA subgroups (59–74 mL; p < 0.001); however, only low SABA users demonstrated significant improvements in TDI (high: 0.27 [p = 0.241]; low: 0.49 [p = 0.025]) and E-RS (high: 0.48 [p = 0.138]; low: 0.60 [p = 0.034]) scores. By contrast, significant reductions in mean SABA puffs/day with umeclidinium/vilanterol versus umeclidinium were observed only in high SABA users (high: − 0.56 [p < 0.001]; low: − 0.10 [p = 0.132]). Similar findings were observed when comparing umeclidinium/vilanterol and salmeterol. Fractional polynomial modelling showed baseline SABA use ≥4 puffs/day resulted in smaller incremental symptom improvements with umeclidinium/vilanterol versus umeclidinium compared with baseline SABA use < 4 puffs/day. Conclusions In high SABA users, there may be a smaller difference in treatment response between dual- and mono-bronchodilator therapy; the reasons for this require further investigation. SABA use may be a confounding factor in bronchodilator trials and in high SABA users; changes in SABA use may be considered a robust symptom outcome. Funding GlaxoSmithKline (study number 201749 [NCT03034915]).

scholarly journals Dose-dependent effects of insoluble fibre on glucose metabolism: a stratified post hoc analysis of the Optimal Fibre Trial (OptiFiT)

2021 ◽  
Author(s):  
Stefan Kabisch ◽  
Caroline Honsek ◽  
Margrit Kemper ◽  
Christiana Gerbracht ◽  
Ayman M. Arafat ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Dose Effect ◽  
Oral Glucose ◽  
Oat Hulls ◽  
Post Hoc Analysis ◽  
Fibre Intake ◽  
Glucose Levels ◽  
Insoluble Fibre ◽  
One Year ◽  
Post Hoc

Abstract Aims As the first long-term RCT on insoluble cereal fibre, the optimal fibre trial demonstrated glycometabolic benefits, confirming cohort studies. The combined study intervention of lifestyle recommendations and supplementation with insoluble oat hulls fibre allows to clarify, which amount of fibre is required for a beneficial effect. Methods One hundred and eighty participants with impaired glucose tolerance underwent the one-year PREDIAS lifestyle programme and received a blinded, randomized fibre or placebo supplement for two years. We conducted a regression analyses and cut-off-based tertile comparisons in subjects with full data on dietary compliance (food records and accounted supplement; n = 120) after one year, investigating effects on fasting blood parameters, oral glucose tolerance test and anthropometry. Results We found a nonlinear inverse relation between fibre intake and change in postprandial 2-h glucose levels, showing a metabolic benefit beyond 14 g and a plateau beyond 25 g of total insoluble fibre per day. 2-h glucose levels improved significantly stronger in both upper tertiles (−0.9 [−1.6;−0.2] mmol/l, p = 0.047, and −0.6 [−1.6;0.3] mmol/l, p = 0.010) compared to the lowest tertile (0.1 [−1.2;1.1] mmol/l), also when adjusted for changes in bodyweight. Subjects with the highest fibre intake showed superior effects on fasting and postprandial insulin resistance, hepatic insulin clearance, leucocyte count and fatty liver index. Conclusions Extending the knowledge on the benefits of insoluble oat hulls fibre, our post hoc analysis demonstrates a dose effect for glycaemia and associated metabolic markers. Further research is needed in order to replicate our findings in larger trials.

Abstract 223: Impact of Differences in Once- vs Twice-Daily Medications Adherence on the Risk of Bleed and Stroke in Non-Valvular Atrial Fibrillation: Analysis of Randomized Trials and Claims Data Sources

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Colleen A McHorney ◽  
Eric D Peterson ◽  
Mike Durkin ◽  
Veronica Ashton ◽  
François Laliberté ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Risk ◽  
Claims Data ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Once Daily ◽  
Cardiovascular Medications ◽  
One Year ◽  
The Impact ◽  
Similar Risk

Background: In non-valvular atrial fibrillation (NVAF) patients, those receiving once-daily (QD) versus twice-daily (BID) non vitamin-K antagonist oral anticoagulants (NOACs) may have better medication adherence. The impact on stroke and bleed risk is not known. Objective: To estimate the impact of adherence differences between QD vs BID therapies on bleed and stroke risks in NVAF patients. Methods: The relation between adherence (proportion of days covered [PDC]) for QD vs BID NOACs and one year bleed risk was modeled using claims data from Truven Health Analytics MarketScan databases (7/2012-10/2015). Next, the relation between adherence and bleeding was calibrated to match that seen in the placebo and NOAC arms of previous randomized controlled trials (RCTs). Finally, we used adherence rates for QD (PDC=0.849) and BID (PDC=0.738) cardiovascular medications from a meta-analysis (Coleman et al.). These rates were used in the calibrated model to estimate bleeds. An analogous method was applied to evaluate the impact of QD vs BID adherence on stroke risk. Results: The relation between PDC and risks of bleed and stroke was modeled using claims data (N=65,022) and calibrated using RCTs. In the calibrated model, compared with BID dosing, QD dosing was associated with 81 fewer strokes (34% reduction) and 14 more bleeds (6% more) per 10,000 patients/year (Figure). Conclusion: Among NVAF patients, better adherence to QD dosing was associated with a significantly lower stroke risk of QD but similar risk of bleed.

scholarly journals The Fluorocycline TP-271 Is Efficacious in Models of Aerosolized Bacillus anthracis Infection in BALB/c Mice and Cynomolgus Macaques

2017 ◽  
Vol 61 (10) ◽  
Author(s):  
Trudy H. Grossman ◽  
Michael S. Anderson ◽  
Lindsay Drabek ◽  
Melanie Gooldy ◽  
Henry S. Heine ◽  
...  
Keyword(s):  
Bacillus Anthracis ◽  
Protective Antigen ◽  
Day Treatment ◽  
Inhalation Exposure ◽  
Treated Group ◽  
Average Dose ◽  
Once Daily ◽  
Content Type ◽  
Cynomolgus Macaques ◽  
Observation Period

ABSTRACT The fluorocycline TP-271 was evaluated in mouse and nonhuman primate (NHP) models of inhalational anthrax. BALB/c mice were exposed by nose-only aerosol to Bacillus anthracis Ames spores at a level of 18 to 88 lethal doses sufficient to kill 50% of exposed individuals (LD50). When 21 days of once-daily dosing was initiated at 24 h postchallenge (the postexposure prophylaxis [PEP] study), the rates of survival for the groups treated with TP-271 at 3, 6, 12, and 18 mg/kg of body weight were 90%, 95%, 95%, and 84%, respectively. When 21 days of dosing was initiated at 48 h postchallenge (the treatment [Tx] study), the rates of survival for the groups treated with TP-271 at 6, 12, and 18 mg/kg TP-271 were 100%, 91%, and 81%, respectively. No deaths of TP-271-treated mice occurred during the 39-day posttreatment observation period. In the NHP model, cynomolgus macaques received an average dose of 197 LD50 of B. anthracis Ames spore equivalents using a head-only inhalation exposure chamber, and once-daily treatment of 1 mg/kg TP-271 lasting for 14 or 21 days was initiated within 3 h of detection of protective antigen (PA) in the blood. No (0/8) animals in the vehicle control-treated group survived, whereas all 8 infected macaques treated for 21 days and 4 of 6 macaques in the 14-day treatment group survived to the end of the study (56 days postchallenge). All survivors developed toxin-neutralizing and anti-PA IgG antibodies, indicating an immunologic response. On the basis of the results obtained with the mouse and NHP models, TP-271 shows promise as a countermeasure for the treatment of inhalational anthrax.

scholarly journals The effect of the queen's age on the Varroa mite (Varroa destructor) burden of honey bee (Apis mellifera L.) colonies

2018 ◽  
pp. 83-87
Author(s):  
Marianna Takács ◽  
János Oláh
Keyword(s):  
Apis Mellifera ◽  
Honey Bee ◽  
Varroa Destructor ◽  
Early Spring ◽  
Brood Chamber ◽  
One Year ◽  
The One ◽  
Post Hoc ◽  
Bee Colonies ◽  
Mite Mortality

An apiary trial was conducted in 2016 August to October in Szabolcs-Szatmár-Bereg County, Nyírmada to evaluate the influence of queen’s age on the Varroa destructor-burden in the treatment colonies. Sixty colonies of bees belonging to the subspecies Apis mellifera carnica pannonica in Hunor loading hives (with 10 frames in the brood chamber/deep super) were used. The colonies were treated with amitraz and the organophosphate pesticide coumaphos active ingredients. The amitraz treatment includes 6 weeks. The coumaphos treatment with Destructor 3.2% can be used for both diagnosis and treatment of Varroasis. For diagnosis, one treatment is sufficient. For control, two treatments at an interval of seven days are required. The colonies were grouped by the age of the queen: 20 colonies with one-year-old, 20 colonies with two-year-old and 20 colonies with three-year-old queen. The mite mortality of different groups was compared. The number of fallen mites was counted at the white bottom boards. The examination of spring growth of honey bee colonies has become necessary due to the judgement of efficiency of closing treatment. The data was recorded seven times between 16th March 2017 and 19th May 2017. Data on fallen mites were subjected to one-way analysis of variance (ANOVA) and Post-Hoc Tukey-test. Statistical analysis was performed using the software of IBM SPSS (version 21.). During the first two weeks after treatments, the number of fallen mites was significantly higher in the older queen’s colonies (Year 2014). The total mite mortality after amitraz treatment in the younger queen’s colonies was lower (P<0.05) compared to the three-year-old queen’s colonies. According to Takács and Oláh (2016) although the mitemortality tendency, after the coumaphos (closing) treatment in colonies which have Year 2014 queen showed the highest rate, considering the mite-burden the colonies belongs to the average infected category. The colonial maintenance ability of three-year-old queen cannot be judged based on the influencing effect on the mite-burden. The importance of the replacement of the queen was judged by the combined effect of several factors. During the spring-growth study (16th March–19th May) was experienced in the three-year-old queen’s colonies the number of brood frames significantly lower compared to the one- and two-year-old queen’s colonies. In the study of 17th April and 19th May each of the three queen-year-groups were varied. Therefore in the beekeeping season at different times were determined the colonial maintenance ability of queens by more factors: efficiency of closing treatment in early spring, the spring-growth of bee colonies, the time of population shift (in current study, this time was identical in each queen-year), honey production (from black locust).

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