Safety of formoterol Turbuhaler1 at cumulative dose of 90 mg in patients with acute bronchial obstruction. J. Malolepszy, G. Böszörményi Nagy, O. Selroos, P. Larsson, R. Brander. #ERS Journals Ltd 2001. ABSTRACT: This study compared the safety of formoterol (Oxis1 Turbuhaler1; 90 mg delivered dose; 120 mg metered dose) with terbutaline (Bricanyl1 Turbuhaler1; 10 mg), in patients with acute bronchoconstriction.Forty-eight patients (31 females) with a mean age of 45 yrs, were randomized into two parallel groups (double-blind design). Mean baseline forced expiratory volume in one second (FEV1) was 0.98 L (33% of predicted normal). Study drugs were administered on six occasions during 3 h (formoterol 4.5 mg or terbutaline 0.5 mg?inhalation -1 , 20 inhalations). Patients received intravenous prednisolone after 1.5 h and oxygen during the first 3 h. Pulse rate, serum potassium, 12-lead electrocardiogram (ECG), Holter ECG, arterial blood gases and FEV1 were assessed during 12 h after the first dose.Four patients (one formoterol, three terbutaline) discontinued. The 12-h mean values of serum potassium decreased from 4.02 to 3.89 mmol?L -1 for formoterol and from 4.22 to 3.76 mmol?L -1 for terbutaline. Mean 12-h pulse rate was significantly (pv0.01) higher in the terbutaline group (101.7 beats per minute (bpm)) than in the formoterol group (93.5 bpm). No individual patient value was considered clinically important or alarming. FEV1 improved in both groups but with no statistically significant difference between treatments.Oxis1 Turbuhaler1 (90 mg) was at least as safe and well tolerated as terbutaline (110 mg) in patients with acute bronchoconstriction. Eur Respir J 2001; 18: 928-934.
Inhaled corticosteroids was the most frequent treatment prescribed for asthma patients in the study. However, patients reported substantial asthma-related morbidity. Children used more resources than adults, despite being classified as having better control. Patients with poor control of asthma symptoms incurred the highest societal cost, improving patient control may reduce cost to society by 40% or more.
Continuous positive airway pressure (CPAP) provides a well‐documented symptomatic relief for most patients with obstructive sleep apnea (OSA); however, its effect on dyslipidaemia remains contradictory. The aim of this longitudinal pilot study was to investigate the effect of long‐term CPAP treatment on the lipid profile of patients with severe OSA. Fasting serum levels of total cholesterol (TC), low‐ and high‐density lipoprotein cholesterol (LDL‐C and HDL‐C) and triglyceride (TG) were longitudinally measured in 33 OSA patients with an apnea‐hypopnea index (AHI) of ≥30 events/hr, at the time of diagnosis (baseline) and at control visits following fixed‐pressure CPAP treatment. Compared to baseline values, even as short as a 2‐month CPAP therapy resulted in a significant decrease of both TC and LDL‐C levels (TC, 5.62 ± 0.22 vs. 5.18 ± 0.21 mmol/L; LDL‐C, 3.52 ± 0.19 vs. 3.19 ± 0.2 mmol/L; p < 0.05 for each). These lipid fractions exhibited similar improvements at 6 months and after 5 years of CPAP treatment (TC, 5.1 ± 0.17 mmol/L; LDL‐C, 2.86 ± 0.16 mmol/L; p < 0.01 for each). The reduction in lipid levels was greater in younger patients and/or in those who had higher body mass index (BMI) (p < 0.05). There were no significant correlations between AHI and lipid levels (p > 0.05); BMI showed a weak negative association with HDL‐C fraction (BMI, r = −0.263, p < 0.05). CPAP therapy had neither short‐ nor long‐term effects on TG and HDL‐C levels (p > 0.05). CPAP therapy has a rapid and long‐lasting beneficial effect on the lipid profile of patients with severe OSA.
The annual incidence of lung cancer in Hungary is about 6,000. Since in our series of lung cancer patients about 4% were observed, which could be accepted as representing occupational disease because of a cumulative exposure to 25 fibre-years or more, the annual asbestos related lung tumour incidences may be estimated to be approximately 150 or more. The proportion of nearly two estimated cases of lung cancer per case of pleural mesothelioma corresponds to international experience. Up to now, lung cancer cases only exceptionally have been registered as occupational diseases, i.e. they were seriously under-diagnosed in Hungary. For improving this situation, diagnostic assistance by a self-interview with a questionnaire covering the working history for all newly diagnosed lung cancer patients would be helpful.
Continuous positive airway pressure (CPAP) treatment results in nearly complete remission of symptoms of obstructive sleep apnoea (OSA); however, its effect on OSA comorbidities including cardiovascular diseases remains contradictory. Here we investigated the short-and long-term effect of CPAP treatment on matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in patients with severe OSA. Serum levels of 7 MMPs and 3 TIMPs were followed in OSA patients (n = 28) with an apnoea-hypopnoea index of ≥30 events/h at the time of diagnosis and at control visits (2 months, 6 months and 5 years) after initiation of fixed-pressure CPAP treatment. The first few months of CPAP therapy resulted in significant decrease of MMP-8 and MMP-9 levels (MMP-8: 146 (79-237) vs. 287 (170-560) pg/mL; MMP
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