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  1 / 27252 MEDLINE  
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[PMID]:28470142
[Au] Autor:Nordlund M; Belka M; Kuczaj AK; Lizal F; Jedelsky J; Elcner J; Jicha M; Sauser Y; Le Bouhellec S; Cosandey S; Majeed S; Vuillaume G; Peitsch MC; Hoeng J
[Ad] Endereço:a Philip Morris International Research & Development, Philip Morris Products S.A. , Neuchâtel , Switzerland.
[Ti] Título:Multicomponent aerosol particle deposition in a realistic cast of the human upper respiratory tract.
[So] Source:Inhal Toxicol;29(3):113-125, 2017 02.
[Is] ISSN:1091-7691
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Inhalation of aerosols generated by electronic cigarettes leads to deposition of multiple chemical compounds in the human airways. In this work, an experimental method to determine regional deposition of multicomponent aerosols in an in vitro segmented, realistic human lung geometry was developed and applied to two aerosols, i.e. a monodisperse glycerol aerosol and a multicomponent aerosol. The method comprised the following steps: (1) lung cast model preparation, (2) aerosol generation and exposure, (3) extraction of deposited mass, (4) chemical quantification and (5) data processing. The method showed good agreement with literature data for the deposition efficiency when using a monodisperse glycerol aerosol, with a mass median aerodynamic diameter (MMAD) of 2.3 µm and a constant flow rate of 15 L/min. The highest deposition surface density rate was observed in the bifurcation segments, indicating inertial impaction deposition. The experimental method was also applied to the deposition of a nebulized multicomponent aerosol with a MMAD of 0.50 µm and a constant flow rate of 15 L/min. The deposited amounts of glycerol, propylene glycol and nicotine were quantified. The three analyzed compounds showed similar deposition patterns and fractions as for the monodisperse glycerol aerosol, indicating that the compounds most likely deposited as parts of the same droplets. The developed method can be used to determine regional deposition for multicomponent aerosols, provided that the compounds are of low volatility. The generated data can be used to validate aerosol deposition simulations and to gain insight in deposition of electronic cigarette aerosols in human airways.
[Mh] Termos MeSH primário: Aerossóis/farmacocinética
Modelos Anatômicos
Sistema Respiratório/metabolismo
[Mh] Termos MeSH secundário: Administração por Inalação
Glicerol/farmacocinética
Seres Humanos
Tamanho da Partícula
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Aerosols); PDC6A3C0OX (Glycerol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1080/08958378.2017.1315196


  2 / 27252 MEDLINE  
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[PMID]:29449208
[Au] Autor:Keeley D
[Ad] Endereço:Thame OX9 3JF, UK.
[Ti] Título:Everyone with asthma should have a metered dose inhaler and a spacer.
[So] Source:BMJ;360:k648, 2018 02 15.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma
Nebulizadores e Vaporizadores
[Mh] Termos MeSH secundário: Administração por Inalação
Albuterol
Broncodilatadores
Seres Humanos
Inaladores Dosimetrados
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k648


  3 / 27252 MEDLINE  
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[PMID]:29317387
[Au] Autor:Keeley D; Baxter N
[Ad] Endereço:Primary Care Respiratory Society UK, Solihull, UK duncan.keeley@nhs.net.
[Ti] Título:Conflicting asthma guidelines cause confusion in primary care.
[So] Source:BMJ;360:k29, 2018 01 09.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma/diagnóstico
Asma/terapia
Guias de Prática Clínica como Assunto
Atenção Primária à Saúde/normas
[Mh] Termos MeSH secundário: Administração por Inalação
Corticosteroides/administração & dosagem
Corticosteroides/uso terapêutico
Asma/economia
Asma/epidemiologia
Inglaterra/epidemiologia
Seres Humanos
Antagonistas de Leucotrienos/uso terapêutico
Espirometria
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Leukotriene Antagonists)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k29


  4 / 27252 MEDLINE  
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[PMID]:29425003
[Au] Autor:Gevorkyan ES; Minasyan SM; Adamyan TI; Ksadzhikyan NN
[Ti] Título:[Sedative effect of lavender during physical loads].
[So] Source:Gig Sanit;95(7):665-9, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:There was investigated the dynamics of the functional state of the cardiovascular system of students after bicycle exercise load, followed by cold inhalation of lavender oil. Examinations were performed in the first half of the day at the same time, three times: 1) before exercise load (the state ofphysiological norm); 2) immediately after the load for 15minutes on the bike training apparatus «Proteus Pec 3320¼ in the third position, followed by aromatherapy; 3) at the 15 minute of the post-exercise load recovery period. Aromacorrection was executed by the method of cold inhalation. Registration and analysis of ECG by variation pulsometry was implemented by hardware-software complex, which combined the portable electrocardiograph of brand "Bio-Arm 001", a personal computer and software for automatic recording and analysis of ECG with the method of variation pulsometry according to parameters of the cardiac rhythm. In the absence of correction factors (control group) the work on a stationary bike was established to be accompanied by significant deviations of all investigated parameters of the heart rhythm, the majority of which persisted at the 15 minute of the post-exercise load period also. Inhalation with the essential lavender oil (control group) under the bicycle load has a sedative effect on the activity of regulatory mechanisms of heart rhythm students. Releasing of the increased sympathetic influence on heart rate, initiated by the physical activity, it facilitates the rapid recovery of the functional state of the body in the post-exercise load period, thereby promoting its tolerance to effects of stress factors.
[Mh] Termos MeSH primário: Aromaterapia/métodos
Óleos Voláteis/farmacologia
Esforço Físico/fisiologia
Óleos Vegetais/farmacologia
[Mh] Termos MeSH secundário: Administração por Inalação
Eletrocardiografia/métodos
Teste de Esforço/métodos
Feminino
Voluntários Saudáveis
Seres Humanos
Masculino
Terapia de Relaxamento
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Oils, Volatile); 0 (Plant Oils); ZBP1YXW0H8 (lavender oil)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29320603
[Au] Autor:McTague A; Martland T; Appleton R
[Ad] Endereço:Molecular Neurosciences, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
[Ti] Título:Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.
[So] Source:Cochrane Database Syst Rev;1:CD001905, 2018 01 10.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tonic-clonic convulsions and convulsive status epilepticus (currently defined as a tonic-clonic convulsion lasting at least 30 minutes) are medical emergencies and require urgent and appropriate anticonvulsant treatment. International consensus is that an anticonvulsant drug should be administered for any tonic-clonic convulsion that has been continuing for at least five minutes. Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs. This is an update of a Cochrane Review first published in 2002 and updated in 2008. OBJECTIVES: To evaluate the effectiveness and safety of anticonvulsant drugs used to treat any acute tonic-clonic convulsion of any duration, including established convulsive (tonic-clonic) status epilepticus in children who present to a hospital or emergency medical department. SEARCH METHODS: For the latest update we searched the Cochrane Epilepsy Group's Specialised Register (23 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 23 May 2017), MEDLINE (Ovid, 1946 to 23 May 2017), ClinicalTrials.gov (23 May 2017), and the WHO International Clinical Trials Registry Platform (ICTRP, 23 May 2017). SELECTION CRITERIA: Randomised and quasi-randomised trials comparing any anticonvulsant drugs used for the treatment of an acute tonic-clonic convulsion including convulsive status epilepticus in children. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and extracted data. We contacted study authors for additional information. MAIN RESULTS: The review includes 18 randomised trials involving 2199 participants, and a range of drug treatment options, doses and routes of administration (rectal, buccal, nasal, intramuscular and intravenous). The studies vary by design, setting and population, both in terms of their ages and also in their clinical situation. We have made many comparisons of drugs and of routes of administration of drugs in this review; our key findings are as follows:(1) This review provides only low- to very low-quality evidence comparing buccal midazolam with rectal diazepam for the treatment of acute tonic-clonic convulsions (risk ratio (RR) for seizure cessation 1.25, 95% confidence interval (CI) 1.13 to 1.38; 4 trials; 690 children). However, there is uncertainty about the effect and therefore insufficient evidence to support its use. There were no included studies which compare intranasal and buccal midazolam.(2) Buccal and intranasal anticonvulsants were shown to lead to similar rates of seizure cessation as intravenous anticonvulsants, e.g. intranasal lorazepam appears to be as effective as intravenous lorazepam (RR 0.96, 95% CI 0.82 to 1.13; 1 trial; 141 children; high-quality evidence) and intranasal midazolam was equivalent to intravenous diazepam (RR 0.98, 95% CI 0.91 to 1.06; 2 trials; 122 children; moderate-quality evidence).(3) Intramuscular midazolam also showed a similar rate of seizure cessation to intravenous diazepam (RR 0.97, 95% CI 0.87 to 1.09; 2 trials; 105 children; low-quality evidence).(4) For intravenous routes of administration, lorazepam appears to be as effective as diazepam in stopping acute tonic clonic convulsions: RR 1.04, 95% CI 0.94 to 1.16; 3 trials; 414 children; low-quality evidence. Furthermore, we found no statistically significant or clinically important differences between intravenous midazolam and diazepam (RR for seizure cessation 1.08, 95% CI 0.97 to 1.21; 1 trial; 80 children; moderate-quality evidence) or intravenous midazolam and lorazepam (RR for seizure cessation 0.98, 95% CI 0.91 to 1.04; 1 trial; 80 children; moderate-quality evidence). In general, intravenously-administered anticonvulsants led to more rapid seizure cessation but this was usually compromised by the time taken to establish intravenous access.(5) There is limited evidence from a single trial to suggest that intranasal lorazepam may be more effective than intramuscular paraldehyde in stopping acute tonic-clonic convulsions (RR 1.22, 95% CI 0.99 to 1.52; 160 children; moderate-quality evidence).(6) Adverse side effects were observed and reported very infrequently in the included studies. Respiratory depression was the most common and most clinically relevant side effect and, where reported, the frequency of this adverse event was observed in 0% to up to 18% of children. None of the studies individually demonstrated any difference in the rates of respiratory depression between the different anticonvulsants or their different routes of administration; but when pooled, three studies (439 children) provided moderate-quality evidence that lorazepam was significantly associated with fewer occurrences of respiratory depression than diazepam (RR 0.72, 95% CI 0.55 to 0.93).Much of the evidence provided in this review is of mostly moderate to high quality. However, the quality of the evidence provided for some important outcomes is low to very low, particularly for comparisons of non-intravenous routes of drug administration. Low- to very low-quality evidence was provided where limited data and imprecise results were available for analysis, methodological inadequacies were present in some studies which may have introduced bias into the results, study settings were not applicable to wider clinical practice, and where inconsistency was present in some pooled analyses. AUTHORS' CONCLUSIONS: We have not identified any new high-quality evidence on the efficacy or safety of an anticonvulsant in stopping an acute tonic-clonic convulsion that would inform clinical practice. There appears to be a very low risk of adverse events, specifically respiratory depression. Intravenous lorazepam and diazepam appear to be associated with similar rates of seizure cessation and respiratory depression. Although intravenous lorazepam and intravenous diazepam lead to more rapid seizure cessation, the time taken to obtain intravenous access may undermine this effect. In the absence of intravenous access, buccal midazolam or rectal diazepam are therefore acceptable first-line anticonvulsants for the treatment of an acute tonic-clonic convulsion that has lasted at least five minutes. There is no evidence provided by this review to support the use of intranasal midazolam or lorazepam as alternatives to buccal midazolam or rectal diazepam.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Epilepsia Tônico-Clônica/tratamento farmacológico
Estado Epiléptico/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração por Inalação
Administração Oral
Administração Retal
Anticonvulsivantes/administração & dosagem
Criança
Diazepam/administração & dosagem
Seres Humanos
Injeções Intramusculares
Injeções Intravenosas
Lorazepam/administração & dosagem
Midazolam/administração & dosagem
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anticonvulsants); O26FZP769L (Lorazepam); Q3JTX2Q7TU (Diazepam); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD001905.pub3


  6 / 27252 MEDLINE  
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[PMID]:29268637
[Au] Autor:Melani AS; Lanzarone N; Rottoli P
[Ad] Endereço:a Fisiopatologia e Riabilitazione Respiratoria, Dipartimento Vasi, Cuore e Torace, Policlinico Le Scotte , Azienda Ospedaliera Universitaria Senese , Siena , Italy.
[Ti] Título:The pharmacological treatment of bronchiectasis.
[So] Source:Expert Rev Clin Pharmacol;11(3):245-258, 2018 Mar.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Until recently considered as a minor health problem, the role of bronchiectasis is now increasingly recognized. New specific drugs are being approved for treatment of bronchiectasis. Possibly they will offer better perspectives to bronchiectatic subjects with evolving course. Areas covered: We provide an overview of aetiopathogenesis, clinics and non-pharmacological management, extending the topic of pharmacological treatment. Present therapies were extrapolated from other chronic lung diseases, but newer promising specific drugs are being awaited. Therapy aims at improving mobilisation of bronchial secretions and, if any, reversing airflow obstruction. Antibiotics are indicated to treat exacerbations, eradicate or reduce sputum bacterial load. Expert commentary: Over the last years evidence is mounted that bronchiectatic subjects with accelerated course of disease should be referred to secondary and tertiary centres. This requires increased awareness on the role and the frequency of bronchiectasis in primary care. Long-term continuous or cyclical use of antibiotics is recommended to stabilize or improve the course of evolving disease. Macrolides are a currently preferred option. Inhaled antibiotics are gaining importance and are the object of ongoing research interest. Practical challenges of inhaled antibiotic treatment remain the need of defining the best therapeutic regimen and optimizing true adherence.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Bronquiectasia/tratamento farmacológico
Desenho de Drogas
[Mh] Termos MeSH secundário: Administração por Inalação
Obstrução das Vias Respiratórias/tratamento farmacológico
Obstrução das Vias Respiratórias/etiologia
Bronquiectasia/microbiologia
Bronquiectasia/patologia
Seres Humanos
Macrolídeos/administração & dosagem
Adesão à Medicação
Escarro
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Macrolides)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2018.1421064


  7 / 27252 MEDLINE  
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Registro de Ensaios Clínicos
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[PMID]:29320647
[Au] Autor:Bassler D; Shinwell ES; Hallman M; Jarreau PH; Plavka R; Carnielli V; Meisner C; Engel C; Koch A; Kreutzer K; van den Anker JN; Schwab M; Halliday HL; Poets CF; Neonatal European Study of Inhaled Steroids Trial Group
[Ad] Endereço:From the Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich (D.B.), and the Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel (J.N.A.) - both in Switzerland; Ziv Medical Center, Faculty of Medicine in the Galilee,
[Ti] Título:Long-Term Effects of Inhaled Budesonide for Bronchopulmonary Dysplasia.
[So] Source:N Engl J Med;378(2):148-157, 2018 01 11.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The long-term effects on neurodevelopment of the use of inhaled glucocorticoids in extremely preterm infants for the prevention or treatment of bronchopulmonary dysplasia are uncertain. METHODS: We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to receive early (within 24 hours after birth) inhaled budesonide or placebo. The prespecified secondary long-term outcome was neurodevelopmental disability among survivors, defined as a composite of cerebral palsy, cognitive delay (a Mental Development Index score of <85 [1 SD below the mean of 100] on the Bayley Scales of Infant Development, Second Edition, with higher scores on the scale indicating better performance), deafness, or blindness at a corrected age of 18 to 22 months. RESULTS: Adequate data on the prespecified composite long-term outcome were available for 629 infants. Of these infants, 148 (48.1%) of 308 infants assigned to budesonide had neurodevelopmental disability, as compared with 165 (51.4%) of 321 infants assigned to placebo (relative risk, adjusted for gestational age, 0.93; 95% confidence interval [CI], 0.80 to 1.09; P=0.40). There was no significant difference in any of the individual components of the prespecified outcome. There were more deaths in the budesonide group than in the placebo group (82 [19.9%] of 413 infants vs. 58 [14.5%] of 400 infants for whom vital status was available; relative risk, 1.37; 95% CI, 1.01 to 1.86; P=0.04). CONCLUSIONS: Among surviving extremely preterm infants, the rate of neurodevelopmental disability at 2 years did not differ significantly between infants who received early inhaled budesonide for the prevention of bronchopulmonary dysplasia and those who received placebo, but the mortality rate was higher among those who received budesonide. (Funded by the European Union and Chiesi Farmaceutici; ClinicalTrials.gov number, NCT01035190 .).
[Mh] Termos MeSH primário: Displasia Broncopulmonar/prevenção & controle
Budesonida/administração & dosagem
Deficiências do Desenvolvimento/epidemiologia
Glucocorticoides/administração & dosagem
Lactente Extremamente Prematuro
[Mh] Termos MeSH secundário: Administração por Inalação
Cegueira/epidemiologia
Paralisia Cerebral/epidemiologia
Transtornos Cognitivos/epidemiologia
Feminino
Seguimentos
Idade Gestacional
Perda Auditiva/epidemiologia
Seres Humanos
Recém-Nascido
Doenças do Prematuro/mortalidade
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Glucocorticoids); 51333-22-3 (Budesonide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1708831


  8 / 27252 MEDLINE  
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[PMID]:29364929
[Au] Autor:Price DB; Gefen E; Gopalan G; McDonald R; Thomas V; Ming SWY; Davis E
[Ad] Endereço:Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
[Ti] Título:Real-life effectiveness and safety of salbutamol Steri-Neb™ vs. Ventolin Nebules® for exacerbations in patients with COPD: Historical cohort study.
[So] Source:PLoS One;13(1):e0191404, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Ventolin Nebules® (reference product; GlaxoSmithKline) was the first licensed nebulizer solution containing the rapid-onset, short-acting ß2-agonist salbutamol. Salbutamol Steri-Neb™ (comparator; Teva Pharmaceuticals, Inc.) has the same chemical composition as the reference product. This study evaluated whether the effectiveness of the comparator is non-inferior to the reference product alongside concomitant medications during real-life clinical management of COPD exacerbations. Safety in terms of adverse events (AEs) was also examined. METHODS: This matched (1:1) historical cohort study evaluated data from 2 UK primary care databases on patients prescribed the salbutamol comparator or reference. The study included a 1-year baseline period, starting 1 year before the index prescription date, and 1-year outcome period. Cohorts were matched for baseline COPD respiratory medications. The primary outcome was analysis of non-inferiority for the comparator versus reference product for the rate of moderate and severe COPD exacerbations. Non-inferiority was satisfied if the 95% confidence interval (CI) upper limit for mean differences in proportions between treatments was <15%. Secondary outcomes were examined through rate ratios (RR) of severe exacerbations and AEs. RESULTS: After matching, 1191 patients were included in each cohort. Adjusted upper 95% CI for the difference in proportion of patients experiencing moderate or severe exacerbations between comparator and reference groups was 0.032 (3.2%), demonstrating non-inferiority. No significant differences were observed in rates of moderate and severe exacerbations (RR: 1.00; 95% CI: 0.91, 1.10), severe exacerbations (RR: 0.76; 95% CI: 0.49, 1.17), or AEs (RR: 0.98; 95% CI: 0.78, 1.22) after adjusting for baseline confounders. No significant differences across cohorts were observed for rates of any AE or death. CONCLUSION: This matched cohort study of real-life management of COPD patients supports the salbutamol comparator as non-inferior to the reference product, providing an effective treatment alternative for COPD exacerbations. Comparator and reference safety profiles were similar.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem
Albuterol/administração & dosagem
Broncodilatadores/administração & dosagem
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração por Inalação
Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos
Adulto
Idoso
Idoso de 80 Anos ou mais
Albuterol/efeitos adversos
Broncodilatadores/efeitos adversos
Estudos de Coortes
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Nebulizadores e Vaporizadores
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Bronchodilator Agents); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191404


  9 / 27252 MEDLINE  
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[PMID]:29384621
[Au] Autor:Jasim R; Schneider EK; Han M; Azad MAK; Hussein M; Nowell C; Baker MA; Wang J; Li J; Velkov T
[Ti] Título:A Fresh Shine onCystic Fibrosis Inhalation Therapy: Antimicrobial Synergy of Polymyxin B in Combination with Silver Nanoparticles.
[So] Source:J Biomed Nanotechnol;13(4):447-57, 2017 Apr.
[Is] ISSN:1550-7033
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This in vitro study aimed to investigate the synergistic antibacterial activity of polymyxin B in combination with 2 nm silver nanoparticles (NPs) against Gram-negative pathogens commonly isolated from the cystic fibrosis (CF) lung. The in vitro synergistic activity of polymyxin B with silver NPs was assessed using the checkerboard assay against polymyxinsusceptible and polymyxin-resistant Pseudomonas aeruginosa isolates from the lungs of CF patients. The combination was also examined against the Gram-negative species Haemophilus influenzae, Burkholderia cepacia, Burkholderia pseudomallei, Stenotrophomonas maltophilia, Klebsiella pneumoniae and Acinetobacter baumannii that are less common in the CF lung. The killing kinetics of the polymyxin B-silver NPs combinations was assessed against P. aeruginosa by static time-kill assays over 24 h. Polymyxin B and silver NPs alone were not active against polymyxin-resistant (MIC ≥4 mg/L) P. aeruginosa. Whereas, the combination of a clinically-relevant concentration of polymyxin B (2 mg/L) with silver NPs (4 mg/L) successfully inhibited the growth of polymyxin-resistant P. aeruginosa isolates from CF patients as demonstrated by ≥2 log10 decrease in bacterial count (CFU/mL) after 24 h. Treatment of P. aeruginosa cells with the combination induced cytosolic GFP release and an increase of cellular reactive oxygen species. In the nitrocefin assay, the combination displayed a membrane permeabilizing activity superior to each of the drugs alone. The combination of polymyxin B and silver NPs displays excellent synergistic activity against highly polymyxin-resistant P. aeruginosa and is potentially of considerable clinical utility for the treatment of problematic CF lung infections.
[Mh] Termos MeSH primário: Fenômenos Fisiológicos Bacterianos/efeitos dos fármacos
Fibrose Cística/tratamento farmacológico
Fibrose Cística/microbiologia
Nanopartículas Metálicas/administração & dosagem
Pneumonia Bacteriana/diagnóstico por imagem
Polimixina B/administração & dosagem
Prata/administração & dosagem
[Mh] Termos MeSH secundário: Administração por Inalação
Anti-Infecciosos/administração & dosagem
Anti-Infecciosos/química
Sobrevivência Celular/efeitos dos fármacos
Fibrose Cística/patologia
Difusão
Relação Dose-Resposta a Droga
Combinação de Medicamentos
Sinergismo Farmacológico
Seres Humanos
Nanopartículas Metálicas/química
Pneumonia Bacteriana/microbiologia
Polimixina B/química
Terapia Respiratória/métodos
Prata/química
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Drug Combinations); 1404-26-8 (Polymyxin B); 3M4G523W1G (Silver)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE


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[PMID]:29338445
[Au] Autor:Antoniu SA
[Ad] Endereço:a Department of Medicine II-Nursing/Palliative Care , University of Medicine and Pharmacy Grigore T Popa Iasi , Iasi , Romania.
[Ti] Título:Investigational inhaled therapies for non-CF bronchiectasis.
[So] Source:Expert Opin Investig Drugs;27(2):139-146, 2018 Feb.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Bronchiectasis not related to cystic fibrosis (non-CF bronchiectasis) are associated with a high unmet therapeutic need due to the lack of specifically authorized medications, especially via the inhalation route. In non-CF bronchiectasis chronic infection with Pseudomonas aeruginosa is common and favored by the persistent local inflammation and viscid sputum production. Therefore inhaled antibiotics, mucolytics or anti-inflammatory agents could represent appropriate therapeutic interventions in this setting Areas covered: This review herein discusses the inhaled therapies currently under investigation for non-CF bronchiectasis and their potential therapeutic positioning in exacerbation versus stable state. Expert opinion: Inhaled antipseudomonal antibiotics are of promising efficacy, but further efforts should also be made to detect bactericidal approaches against Burkholderia cepacia complex, and to interfere chronic inflammation topically.
[Mh] Termos MeSH primário: Bronquiectasia/tratamento farmacológico
Desenho de Drogas
Drogas em Investigação/uso terapêutico
[Mh] Termos MeSH secundário: Administração por Inalação
Animais
Antibacterianos/administração & dosagem
Antibacterianos/uso terapêutico
Anti-Inflamatórios/administração & dosagem
Anti-Inflamatórios/uso terapêutico
Bronquiectasia/etiologia
Bronquiectasia/microbiologia
Doença Crônica
Drogas em Investigação/administração & dosagem
Drogas em Investigação/farmacologia
Expectorantes/administração & dosagem
Expectorantes/uso terapêutico
Seres Humanos
Infecções por Pseudomonas/tratamento farmacológico
Pseudomonas aeruginosa
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents); 0 (Drugs, Investigational); 0 (Expectorants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2018.1427728



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