scholarly journals Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Carlos Kofman ◽  
Alejandro Teper
Keyword(s):  
Risk Factors ◽  
Fluticasone Propionate ◽  
Young Children ◽  
Respiratory Symptoms ◽  
Term Treatment ◽  
Recurrent Wheezing ◽  
Inhaled Steroids ◽  
Long Term Treatment ◽  
Metered Dose

Background. In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma. Objective. To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Patients and Methods. Outpatient children (6 to 20 months old) with recurrent wheezing and risk factors for asthma were randomized to receive a 6-month treatment with metered-dose inhaler (MDI) of Fluticasone Propionate 125 mcg BID through an NVS or through a VHC. Parents recorded daily their child’s respiratory symptoms and rescue medication use. Results. 46 patients of 13.4 ± 5 months old were studied. During the study period, the NVS group (n=25) experienced 3.9 ± 2.4 obstructive exacerbations, and the VHC group (n=21) had 2.6 ± 1.6 (p=0.031). The NVS group had 17.4 ± 14% of days with respiratory symptoms, and the VHC group had 9.7 ± 7% (p=0.019). The NVS group spent 29.8 ± 22 days on albuterol while the VHC group spent 17.9 ± 11 days (p=0.022). Conclusion. Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

Bronchodilator ‘syrups’ and childrens teeth

1983 ◽  
Vol 21 (14) ◽  
pp. 56-56
Keyword(s):  
Dental Caries ◽  
Young Children ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Liquid Preparation

Young children needing long-term treatment with a bronchodilator, who cannot manage an aerosol or tablets, are often given a liquid preparation. Many of these are sweetened with sucrose or another fermentable carbohydrate which can cause extensive and severe dental caries.1,2 The table lists single-ingredient bronchodilator preparations which do and do not contain such sugars:

709 LONG-TERM TREATMENT WITH LAMIVUDINE UP TO TEN YEARS: PREDICTIVE VALUE OF HOST AND VIRUS RELATED RISK FACTORS FOR THE DEVELOPMENT OF HBV RESISTANCE

2008 ◽  
Vol 48 ◽  
pp. S264-S265 ◽  
Author(s):  
F. van Bömmel ◽  
A. Brodzinski ◽  
U. Mihm ◽  
M.C. Jung ◽  
C. Sarrazin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Value ◽  
Term Treatment ◽  
Related Risk ◽  
Long Term Treatment

scholarly journals Tumor-necrosis Factor Inhibitors Improve Aortic Stiffness in Patients With Longstanding Rheumatoid Arthritis

2020 ◽  
Author(s):  
Alessandro Giollo ◽  
Giovanni Cioffi ◽  
Federica Ognibeni ◽  
Giovanni Orsolini ◽  
Andrea Dalbeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Aortic Stiffness ◽  
Term Treatment ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Long Term Treatment ◽  
Necrosis Factor

Abstract Background. Major cardiovascular disease (CVD) benefits of disease-modifying anti-rheumatic drugs (DMARDs) therapy occur in early RA patients with treat-to-target strategy. However, it is unknown whether long-term DMARDs treatment in established RA could be useful to improve CVD risk profile.Methods. Ultrasound aortic stiffness index (AoSI) has to be considered a proxy outcome measure in established RA patients. We measured AoSI in a group of RA patients on long-term treatment with tumour necrosis factor inhibitors (TNFi) or conventional synthetic DMARDs (csDMARDs). Eligible participants were assessed at baseline and after 12 months; changes in serum lipids, glucose and arterial blood pressure were assessed. All patients were on stable medications during the entire follow-up. Results. We included 107 (64 TNFi and 43 csDMARDs) RA patients. Most patients (74%) were in remission or low disease activity and had some CVD risk factors (45.8% hypertension, 59.8% dyslipidemia, 45.3% smoking). The two groups did not differ significantly for baseline AoSI (5.95±3.73% vs 6.08±4.20%, p=0.867). Follow-up AoSI was significantly increased from baseline in the csDMARDs group (+1.00%; p<0.0001) but not in the TNFi group (+0.15%, p=0.477). Patients on TNFi had significantly lower follow-up AoSI from baseline than the csDMARD group (-1.02%, p<0.001; ANCOVA corrected for baseline AoSI, age and systolic blood pressure). Furthermore, follow-up AoSI was significantly lower in TNFi users with 1-2 or >2 CVD risk factors than in those without. Conclusion. Long-term treatment with TNFi was associated with reduced aortic stiffness in patients with established RA and several CVD risk factors.

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