Steinskinner0484
01), and levels were inversely related to sinus symptoms (p=0.02) and asthma control (p<0.01).
8-isoprostanes in nasal lavage are increased in obesity, and increased in Caucasians compared with African Americans. However, levels are higher in obese controls than obese people with asthma, and appear inversely related to symptoms of airway disease.
Airway 8-isoprostanes likely reflect complex oxidative signaling pathways, which are altered in obesity and those of different race, rather than being a simple marker of airway oxidative injury.
Increased airway oxidative signaling (8-isoprostanes), may reflect normal physiology in the setting of obesity, as decreased levels are associated with disease activity in people with chronic sinonasal disease and asthma.
Increased airway oxidative signaling (8-isoprostanes), may reflect normal physiology in the setting of obesity, as decreased levels are associated with disease activity in people with chronic sinonasal disease and asthma.
Asthma and COPD are leading causes of disability-adjusted life-years worldwide representing a huge burden on the health system and among patients. One of the reasons for the lack of disease control is poor inhalation technique, with impact on quality of life and symptom control.
To assess the effectiveness of a community pharmacist-led educational intervention on asthma and COPD patients' inhalation technique.
The INspira study is a 6-month pilot cluster randomized controlled trial, conducted in community pharmacies of Portugal, enrolling adults aged 18 years or older, with a self-reported diagnosis of asthma or COPD and on inhaled therapy. Pharmacies were randomly allocated to Intervention or Control group. Intervention focused mainly on inhalation technique education via demonstration and repetition. Primary outcome was the proportion of patients scoring 100% in at least one inhaler.
From January to November 2019, 48 pharmacies recruited 201 asthma and COPD patients, of which 132 completed the 6-month follow-up. At the end of follow-up, the odds of intervention group patients score 100% compared to the control group were 5.63 (95% CI, [2.21; 14.35]) in all inhalers in use and 6.77 (95% CI, [2.52; 18.20]) considering at least one inhaler. Intervention group patients reported having a significantly lower number of scheduled appointments compared with the control group (OR=0.17; 95% CI, [0.037; 0.79]; p=0.0135). No other significant differences were found between groups.
This pilot study suggested that pharmacist interventions can improve patients' inhalation technique, with possible positive impact in healthcare resource use.
This pilot study suggested that pharmacist interventions can improve patients' inhalation technique, with possible positive impact in healthcare resource use.
To determine whether baseline diaphragm (T
), rectus femoris (RF) and vastus intermedius (VI) muscle thickness (T
and T
) are associated with weaning success.
Right T
, T
and T
were measured by ultrasonography within 36h of intubation and diaphragmatic excursion (DE) was evaluated at the first spontaneous breathing trial in adult critically-ill patients. Reintubation or death within 7 days after extubation was defined as weaning failure. Weaning failure and success groups were compared in terms of ultrasonographic measurements and clinical features.
Thirty-eight patients were assessed for weaning, 15 (39.4%) being in the weaning failure group. The median body mass index (BMI) was lower while the median clinical frailty scale (CFS), vasopressor use, duration of mechanical ventilation, intensive care and hospital mortality rate were higher in the weaning failure group, and the median T
(14.0 [12.3-26.2] vs 23.6 [21.3-27.1] mm, p = 0.03) and median DE (19.4 [14.6-24.0] vs 25.9 [19.3-38.5] mm, p = 0.045) were lower. The median T
was similar in two groups (1.9 [1.5-2.3] vs 2.0 [1.7-2.4] mm, p = 0.26). In ROC analysis, area under the curve for T
was 0.71 (95% CI 0.51-0.90; p = 0.035), with 21mm cut-off having sensitivity of 82% and specificity of 57%. Binary logistic regression analysis revealed T
<21mm as the only predictor of weaning failure with an odds ratio of 10.5 (95% CI 1.1-97.8, p = 0.038) after adjusting for age, sex, BMI and CFS.
T
lower than 21mm, measured by ultrasonography within 36h of intubation, was associated with weaning failure among critically-ill patients.
TRF + VI lower than 21 mm, measured by ultrasonography within 36 h of intubation, was associated with weaning failure among critically-ill patients.Spices and herbs are widely used in almost all types of food preparation and their microbial contamination may cause spoilage and pose public health risk. Thus, the aim of this study was to assess the effect of packaging, source and a food safety management system (FSMS) on the microbiological quality of spices and dried herbs in a developing country, like Lebanon. For this, a total of 96 composite samples of thirteen most commonly consumed types of spices and dried herbs were collected twice at three-month interval. Each type was purchased in 5 common brands from 4 categories packaged in companies with FSMS, packaged in companies without FSMS, packaged imported, and unpackaged. Total aerobic mesophilic bacteria (TAMB), sulfite reducing anaerobic bacteria, C. perfringens, coliforms, E. coli, yeasts and molds were found in 89%, 43%, 18%, 15%, 1% and 54% of the samples, respectively. All samples were negative for Salmonella. One per cent, 4%, 6%, 1% and 7% of the samples had unacceptable levels of TAMB, coliforms, sulfite reducing anaerobic bacteria, E. coli, yeasts and molds, respectively. Among the four categories, imported samples had the lowest microbiological load, followed by locally packaged in companies with FSMS, then locally packaged in companies without FSMS and the highest microbiological load was for the unpackaged spices and dried herbs. This study highlighted the importance of storage conditions, good hygienic practices, process controls and FSMSs in the spices and dried herbs sector.Crustaceans inhabiting metal-contaminated freshwaters are susceptible to toxic insult to their osmoregulatory systems. The main osmoregulatory organs of decapod crustaceans, the gills, are continually bathed in freshwater and are therefore at risk from trace metal impacts. The effects of chronic (21 d) exposure to raised dissolved concentrations of Zn, Cd, Cu and Pb on aspects of hydromineral balance were investigated in Potamonautes warreni, a freshwater crab endemic to rivers in South Africa at potential risk from trace metal contamination from mining operations. Generally, hydromineral balance of P. Tanespimycin in vitro warreni was tolerant to chronic metal exposures although sublethal cadmium exposure of 860 µg.l-1 for 21 days resulted in a reduced sodium concentration in the haemolymph. A chronic exposure to 43 µg.l-1 cadmium produced an elevated maximum unidirectional sodium uptake, possibly resulting from acclimation to the metal exposure. Branchial Na+/K+-ATPase and V-Type H+-ATPase activity were not affected by chronic in vivo Cd (43 µg.