BackgroundSymptoms of depression are common in patients diagnosed with benign prostatic hyperplasia (BPH) and are usually a reaction to deterioration of health, severity of lower urinary tract symptoms, and erectile dysfunction. The aim of this observational study was to evaluate the prevalence of depressive symptoms in patients diagnosed with BPH and factors affecting their occurrence in a large Polish cohort.Patients and methodsFour thousand thirty-five men (4,035) diagnosed with BPH participated in the survey (age 65 ± 8 years). The occurrence of symptoms of depression was assessed using the Beck depression inventory, severity of lower urinary tract symptoms (LUTS) on the basis of the international prostate symptoms score, and erectile dysfunction using the international index of erectile function (IIEF-5).ResultsDepressive symptoms were found in 22.4 % of patients (mild in 20.8 % and moderate/severe in 1.6 %). Erectile dysfunction was found in 71.9 % of patients. Monotherapy for BPH was prescribed to 50.9 % of patients (mostly ARA—selective α1-selective alpha-adrenolytic—47.5 %), while polytherapy (ARA with a 5-alpha reductase inhibitor—5αRI) to 47.9 %. Logistic regression analysis showed a bidirectional relation between the occurrence of depressive symptoms and erectile dysfunction. The occurrence of both depressive symptoms and erectile dysfunction was related to severity of LUTS, nocturia, the use of 5αRI, comorbidity, and sedentary life style.ConclusionsPrevalence of depressive symptoms in patients diagnosed with BPH is associated with severity of LUTS, erectile dysfunction, nocturia, BPH pharmacotherapy (5αRIs), sedentary life style, and comorbidities including obesity.

IntroductionThe factors influencing adherence of patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD) include the complexity of the therapy, fear of side effects of drugs, method of taking the drug, dosage regimen, polypharmacy, adverse events, knowledge about the essence of the disease and its complications, illness perception and priorities in life, training on the use of the inhaler, the duration of treatment, social support, and drug availability.AimTo assess the adherence of patients diagnosed with asthma and COPD treated with polytherapy with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler in relation to primary diagnosis and illness perception as well as patients’ and doctors’ opinion about this form of therapy.Material and methodsA questionnaire survey covering adherence, illness perception and opinion about polytherapy using new generation Cyclohaler performed by pulmonologists, allergologists and general practitioners in 3,618 patients with asthma and 2,602 with COPD.ResultsOn visit 1, a lower adherence rate was observed in COPD than in the asthma group (72.0% vs. 61.5%; p < 0.01). During the observation, the adherence rate increased significantly in the COPD group, only (61.5% vs. 73.0%; p < 0.01). A negative correlation between total MMAS-8 and BIPQ scores was observed in both study groups (R = –0.15; p < 0.001 and R = –0.24; p < 0.001, respectively). During the observation, a percentage of patients who believed that the administration of the two drugs in a single inhaler considerably facilitates their use increased significantly in both study groups. In addition, an increased percentage of doctors believed that this therapeutic option facilitated education of patients and decreased the number of errors made by the patients.ConclusionsThe illness perception, younger age, disease duration and severity are predictors of adherence to treatment with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler among patients with asthma and COPD. The positive opinion of patients and doctors about administration of fluticasone propionate and formoterol fumarate using the Fantasmino inhaler increased during observation.

IntroductionThe effectiveness of single-inhaler budesonide/formoterol fumarate combination therapy for asthma has been previously shown for the original product. The aim of this nonrandomized, open-label, postauthorization efficacy study (PAES) real-life clinical assessment was to evaluate the clinical effectiveness of a second product (Bufomix Easyhaler®) in the daily clinical practice of asthma therapy.MethodsThis multicenter PAES was conducted by 220 unselected allergologists and pulmonologists who enrolled 2200 adult outpatients (age 49.8 ± 17.9 years) with asthma treated with Bufomix Easyhaler® for at least 14 days before enrolment. Asthma control was assessed during three subsequent visits with 8–12-week intervals on the basis of the Asthma Control Test (ACT). Adherence was assessed with the Medication Adherence Questionnaire. In addition, patient satisfaction with Bufomix Easyhaler® was scored, and adverse drug reactions were recorded.ResultsThe percentage of patients with well-controlled asthma or total control of asthma (ACT score 20-25 points) increased from 46.6% at the first visit to 90.8% at the third visit (p < 0.001). In addition, the percentage of patients with poor control of asthma (ACT score less than 15 points) decreased from 14.9% to 1.2% (p < 0.001). The adherence rate increased from 88% at the first visit to 95.3% at the third visit. Patient satisfaction with the use of this dry powder inhaler increased with the duration of its use. Only one adverse drug reaction was reported.ConclusionThe results obtained confirm the effectiveness of Bufomix Easyhaler® in the treatment of asthma in outpatient adults in daily clinical practice.FundingOrion Corporation

The aim: The assessment of the therapeutic effects of the herbal medicine containing of ivy leaf dry extract administered twice a day in children with productive cough and their guardians’ satisfaction with the use of this syrup. Material and methods: A multicenter, observational survey was conducted by 268 doctors working in Primary Health Care. The survey was conducted during two routine, consecutive outpatient visits (including first supplemented retrospectively) resulting from the needs of therapy. Results: The study group consisted of 5162 patients treated for productive cough with the herbal medicine containing of ivy leaf dry extract administered twice a day. In 75.7%, productive cough was intense, in 61.6% it occurred at night, in 49.8% it was very common (several times per hour), and in 62.7% it affected daily activity. Most often the syrup containing of ivy leaf dry extract was used in doses twice a day for 2 ml or 4 ml. During observation the percentage of children with intensive, very common, night and affected daily activities cough decreased significantly. Very satisfied with a therapeutic effect of the preparation containing of ivy leaf dry extract administered twice a day were 68.2% of children guardians. Conclusions: The use of the herbal medicine containing of ivy leaf dry extract administered twice a day may be a good alternative to current therapeutic regimens in the treatment of productive cough in children. This recommendation is supported by effectiveness comparable to other medicines and a high level of satisfaction with its use by patients and guardians of chidren.

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The effectiveness of therapy with ramipril/amlodipine FDC in the study population was high, but slightly lower in overweigh and obese. This FDC was well tolerated and a significant number of patients satisfied with the therapy regardless of nutritional status. Although the perceived tolerance and satisfaction with treatment were lower in obese and overweight than in normal weight patients; the incidence of AE and perceived benefit from the use of a single-pill, compared to multiple tablets, were comparable irrespective of nutritional status.

<b><i>Background:</i></b> Gender-related differences in fat distribution may affect blood pressure (BP) control in hypertensive subjects. The aim of the study was to assess how body mass (BM), BMI, and waist circumference (WC) influence the effectiveness of antihypertension therapy in hypertensive men and women in daily clinical practice. <b><i>Patients and Methods:</i></b> The observational study involved 12,289 adult hypertensive Caucasians (6,163 women) declaring regular use of antihypertensive drugs. BP control was scored based on the mean values of 2 attended office BP measurements. WC thresholds for visceral obesity were adopted from definitions of the International Diabetes Federation (≥94/80 cm for men/women) and National Cholesterol Education Program Adult Treatment Panel III (≥102/88 cm for men/women). Stepwise backward multivariable logistic regression was used to analyse correlates of the effectiveness of hypertension therapy. <b><i>Results:</i></b> The predictive value of BMI ≥30 (for uncontrolled hypertension) was stronger than that of visceral obesity, regardless of the criteria used. In men, BP control rapidly deteriorated with BMI (odds ratio [OR] up to 8.58 [95% CI: 5.74–12.83]) and WC (OR up to 5.09 [3.84–6.74]), while in women, the association was more flattened (OR up to 3.63 [2.78–4.74] and 1.93 [1.59–2.35], respectively). However, the highest risk of uncontrolled BP occurred in women with BM ≥110 kg (OR = 10.47 [5.05–21.71]) and men with BM ≥125 kg (OR = 9.66 [5.86–15.94]). <b><i>Conclusions:</i></b> (1) Obesity and visceral obesity limit the effectiveness of antihypertension therapy more in men than in women. (2) This phenomenon should be taken into account in the prescription of adequate doses of antihypertensive drugs.

1. The prescribed statin doses do not fully explain the lower frequency of achieving the recommended target in a lipid-lowering therapy in the obese patients and the diabetics. 2. In the daily clinical practice the doses of statins are frequently insufficient and not adjusted for a cardiovascular risk.