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https://www.readbyqxmd.com/read/29775668/current-approaches-to-the-discovery-of-novel-inhaled-medicines
#1
REVIEW
Peter Strong, Kazuhiro Ito, John Murray, Garth Rapeport
Inhaled administration is underutilised because the drug discovery process is viewed as challenging, risky, and expensive. However, unmet medical need continues to grow, and significant opportunities exist to discover novel inhaled medicines delivering the required lung concentrations while minimising systemic exposure. This profile could be achieved by a combination of properties, including lung retention and low oral bioavailability. Property-based rules exist for orally administered compounds, but there has been limited progress defining in silico predictors to guide the discovery of novel inhaled drugs...
May 15, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29773947/efficacy-safety-and-pharmacokinetics-of-budesonide-formoterol-fumarate-delivered-via-metered-dose-inhaler-using-innovative-co-suspension-delivery-technology-in-patients-with-moderate-to-severe-copd
#2
Edward M Kerwin, Thomas M Siler, Samir Arora, Patrick Darken, Earl Rose, Colin Reisner
Purpose: This study investigated the efficacy, safety, and pharmacokinetics of the inhaled corticosteroid/long-acting β2 -agonist fixed-dose combination budesonide/formoterol fumarate (BFF) metered dose inhaler (MDI), compared with the monocomponents budesonide (BD) MDI and formoterol fumarate (FF) MDI, in patients with moderate-to-severe COPD. Materials and methods: In this Phase IIb, randomized, double-blind, four-period, five-treatment, incomplete-block, crossover study (NCT02196077), all patients received BFF MDI 320/9...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29773689/risk-factors-for-lung-disease-progression-in-children-with-cystic-fibrosis
#3
Marieke van Horck, Kim van de Kant, Bjorn Winkens, Geertjan Wesseling, Vincent Gulmans, Han Hendriks, Chris van der Grinten, Quirijn Jӧbsis, Edward Dompeling
To identify potential risk factors for lung disease progression in children with cystic fibrosis (CF), we studied the longitudinal data of all children with CF (aged ≥5 years) registered in the Dutch CF Registry (2009-2014). Lung disease progression was expressed as a decline in lung function (FEV1 %pred) and the pulmonary exacerbation rate (PEx). Potential risk factors at baseline included: sex, age, best FEV1%pred, best forced vital capacity (FVC)%pred, genotype, BMI z-score, pancreatic insufficiency, medication use (proton pump inhibitors [PPI], prophylactic antibiotics, and inhaled corticosteroids), CF-related diabetes, allergic bronchopulmonary aspergillosis, and colonisation with Pseudomonas aeruginosa The data of 545 children were analysed...
May 17, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#4
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29766487/inhaled-corticosteroids-for-bronchiectasis
#5
REVIEW
Nitin Kapur, Helen L Petsky, Scott Bell, John Kolbe, Anne B Chang
BACKGROUND: Bronchiectasis is being increasingly diagnosed and recognised as an important contributor to chronic lung disease in both adults and children in high- and low-income countries. It is characterised by irreversible dilatation of airways and is generally associated with airway inflammation and chronic bacterial infection. Medical management largely aims to reduce morbidity by controlling the symptoms, reduce exacerbation frequency, improve quality of life and prevent the progression of bronchiectasis...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29765586/design-of-a-clinical-decision-support-system-for-fracture-prediction-using-imbalanced-dataset
#6
Yung-Fu Chen, Chih-Sheng Lin, Kuo-An Wang, La Ode Abdul Rahman, Dah-Jye Lee, Wei-Sheng Chung, Hsuan-Hung Lin
More than 1 billion people suffer from chronic respiratory diseases worldwide, accounting for more than 4 million deaths annually. Inhaled corticosteroid is a popular medication for treating chronic respiratory diseases. Its side effects include decreased bone mineral density and osteoporosis. The aims of this study are to investigate the association of inhaled corticosteroids and fracture and to design a clinical support system for fracture prediction. The data of patients aged 20 years and older, who had visited healthcare centers and been prescribed with inhaled corticosteroids within 2002-2010, were retrieved from the National Health Insurance Research Database (NHIRD)...
2018: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29763411/characteristics-and-health-care-resource-use-of-subjects-with-copd-in-the-year-before-initiating-lama-monotherapy-or-lama-laba-combination-therapy-a-u-s-database-study
#7
Saurabh Nagar, Jeetvan Patel, Richard H Stanford
PURPOSE: To characterize subjects with chronic obstructive pulmonary disease (COPD) newly initiated on long-acting muscarinic antagonists (LAMA) or dual LAMA/long-acting β2-adrenergic agonist (LABA) therapy. DESIGN: This pilot/preliminary analysis was a retrospective crosssectional study of subjects with COPD from the Optum Impact National Managed Care Benchmark Database. METHODOLOGY: Subjects with at least one LAMA prescription in the index period (July 2008-June 2009) were included and stratified by treatment...
May 2018: Managed Care
https://www.readbyqxmd.com/read/29762633/using-a-mixture-of-bivariate-regression-model-to-explore-heterogeneity-of-effects-of-use-of-inhaled-corticosteroids-on-gestational-age-and-birthweight-among-pregnant-women-with-asthma
#8
Mariia Samoilenko, Lucie Blais, Isabelle Boucoiran, Geneviève Lefebvre
Asthma is a heterogeneous disease, and responses to asthma medications vary noticeably among patients. A substantively oriented objective of this study was to explore the potential heterogeneous effects of maternal inhaled corticosteroids (ICS) exposure on gestational age (GA) at delivery and birthweight (BW) using a cohort of 6,197 pregnancies from women with asthma (Quebec, Canada, 1998-2008). A methodologically oriented objective was to comprehensively describe the application of a Bayesian two-component mixture of bivariate regressions to address this issue and estimate the effects of ICS on GA and BW jointly...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#9
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29760612/trends-in-folic-acid-supplementation-during-pregnancy-the-effect-on-allergy-development-in-children
#10
Anna Socha-Banasiak, Barbara Kamer, Krzysztof Pacześ, Barbara Ślusarek, Bartosz Pawlikowski, Elżbieta Czkwianianc
Introduction: The results of some previous studies suggested that maternal folate supplementation during pregnancy may contribute to allergy development in offspring. Aim: This study was performed to examine the influence of maternal folic acid intake prior to and during pregnancy on the development of various types of allergy in children taking into account the timing and dosage of supplemented folate. Material and methods: The retrospective study was performed between 2010 and 2014 in 307 child-mother pairs (203 allergic children and 104 children without allergy symptoms, aged 2-72 months)...
April 2018: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/29757890/pediatric-carbon-monoxide-poisoning-in-southern-israel-a-cross-sectional-study
#11
Yariv Fruchtman, Zvi H Perry, Tom Leibson, Liat Vered Cohen, Matitiahu Lifshitz, Eugene Leibovitz
OBJECTIVES: This study aimed to describe the epidemiology and clinical burden of unintended carbon monoxide (CO) poisoning among children in the Negev region of southern Israel. METHODS: This was a cross-sectional retrospective study of CO poisoning patients admitted to Soroka University Medical Center in 2011 through 2015. RESULTS: Overall, 43 cases of CO poisoning were recorded among children younger than 18 years. Five patients died, all upon admission...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#12
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29755809/a-12-week-randomized-parallel-group-phase-iii-study-comparing-the-efficacy-of-once-daily-budesonide-formoterol-turbuhaler-160-4-5-%C3%AE-g-d-with-twice-daily-budesonide-400-%C3%AE-g-d-during-the-step-down-period-in-well-controlled-asthma
#13
Narongwit Nakwan, Thitima Perkleang, Thanida Tamsawai, Pattarawadee Taptawee, Sirikade Usaha
OBJECTIVES: Budesonide/formoterol fumarate (BUD/FF) is recommended in the stepwise management of uncontrolled asthma, but data on a once-daily dose of this medication in a step-down period are lacking. We aimed to compare BUD/FF and BUD in terms of the changes in asthma control scores and lung functions. MATERIAL AND METHODS: This 12-week, randomized, parallel-group, single-center, open-label study was conducted in well-controlled asthmatic patients receiving twice-daily BUD/FF (160/4...
April 2018: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29755346/a-multicenter-randomized-double-blind-placebo-controlled-study-of-the-effects-of-loki-zupa-in-patients-with-chronic-asthma
#14
Yubao Lv, Ying Wei, Muhammadjan Abduwaki, Tohti Jurat, Fengsen Li, Huaizhen Wang, Yuhua Wu, Zheng Li, Bo Liu, Hongjun Yin, Yuxue Cao, Mammat Nurahmat, Zihui Tang, Jingcheng Dong
The purpose of this study was to evaluate the efficacy and safety of Uyghur medical formula Loki zupa in patients with chronic asthma. Adult patients with chronic asthma randomly received placebo or Loki zupa as add-on to inhaled corticosteroids (ICS) maintenance treatment. Loki zupa or mimics was administered orally 10 ml per time, three times a day for 8 weeks. The primary endpoints were asthma control test (ACT) score and peak expiratory flow (PEF). The secondary endpoints were acute exacerbation rate, lung function, night waking days, and symptom-free days in the near 2 weeks, Asthma Quality of Life Questionnaire (AQLQ) score and some inflammatory cytokines in peripheral blood...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29754592/general-practitioners-views-on-the-influence-of-cost-on-the-prescribing-of-asthma-preventer-medicines-a-qualitative-study
#15
Jacqueline Tudball, Helen K Reddel, Tracey-Lea Laba, Stephen Jan, Anthony Flynn, Michele Goldman, Kirsty Lembke, Elizabeth Roughead, Guy B Marks, Nick Zwar
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29753606/immunizations-under-sedation-at-a-paediatric-hospital-in-melbourne-australia-from-2012-2016
#16
Daryl R Cheng, Sonja Elia, Kirsten P Perrett
BACKGROUND: Sedation for immunizations is of particular importance in a subset of paediatric patients with anxiety disorders, needle phobia, developmental or behavioural disorders. The Royal Children's Hospital (RCH) Melbourne offers a unique immunization under sedation service for these patients. We aimed to evaluate the number and types of patients using inpatient sedation for immunizations, distraction and sedation techniques used, and outcomes of these procedures. METHODS: A medical record review was conducted on all patients who had immunization under sedation between January 2012 to December 2016 in the RCH Day Medical Unit (DMU)...
May 9, 2018: Vaccine
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#17
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29750674/evaluating-plutonium-intake-and-radiation-dose-following-extensive-chelation-treatment
#18
Sara Dumit, Maia Avtandilashvili, Sergei Y Tolmachev
A voluntary partial-body donor (U.S. Transuranium and Uranium Registries Case 0785) was accidentally exposed to Pu via inhalation and wounds. This individual underwent medical treatment including wound excision and extensive chelation treatment with calcium ethylenediaminetetraacetic acid and calcium diethylenetriaminepentaacetic acid. Approximately 2.2 kBq of Pu was measured in the wound site 44 y after the accident. Major soft tissues and selected bones were collected at autopsy and radiochemically analyzed for Pu, Pu, and Am...
May 4, 2018: Health Physics
https://www.readbyqxmd.com/read/29750177/error-estimation-of-deformable-image-registration-of-pulmonary-ct-scans-using-convolutional-neural-networks
#19
Koen A J Eppenhof, Josien P W Pluim
Error estimation in nonlinear medical image registration is a nontrivial problem that is important for validation of registration methods. We propose a supervised method for estimation of registration errors in nonlinear registration of three-dimensional (3-D) images. The method is based on a 3-D convolutional neural network that learns to estimate registration errors from a pair of image patches. By applying the network to patches centered around every voxel, we construct registration error maps. The network is trained using a set of representative images that have been synthetically transformed to construct a set of image pairs with known deformations...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29750142/single-inhaler-triple-therapy-in-symptomatic-copd-patients-fulfil-subgroup-analyses
#20
David M G Halpin, Ruby Birk, Noushin Brealey, Gerard J Criner, Mark T Dransfield, Emma Hilton, David A Lomas, Chang-Qing Zhu, David A Lipson
Triple inhaled corticosteroid (ICS)/long-acting muscarinic antagonist (LAMA)/long-acting β2 -agonist (LABA) therapy is recommended for symptomatic patients with chronic obstructive pulmonary disease (COPD) and at risk of exacerbations. However, the benefits versus side-effects of triple inhaled therapy for COPD, based on distinct patient clinical profiles, are unclear. FULFIL, a phase III, randomised, double-blind study, compared 24 weeks of once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62...
April 2018: ERJ Open Research
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