Associations between PM10 from Traffic, Resuspension, Sand Storms and Volcanic Sources and Asthma Drugs Dispensing

BackgroundParticle matter (PM) is detrimental to respiratory health, particularly in individuals with underlying respiratory disease, e.g. asthma. In the capital area of Iceland PM is both from anthropogenic sources, mainly traffic and local resuspension, as well as natural sources, such as dust-and volcanic ash storms. The aim was to study the association between all kinds of PM events from and daily dispensing of asthma drug as a proxy for respiratory health.Material and methodsThe study period was 2005-2015. Dispensing of asthma drugs for all individuals living in the capital area of Iceland were obtained from health registries. Concentrations of daily air pollution, pollen, and meteorological variables were obtained. Dust sources were determined for days when PM exceeded the health limit (24-hour mean 50 µg/m3) which are defined as “PM events”. The data were analysed using generalised non-linear models (GNM) methods and adjusted for both season and time trend. Results There were 137 PM event days where PM exceeded the health limit, and the source of the particles could be determined. The source of PM events was most often traffic (5%) or local resuspension 92(%), but PM events were also due to dust storms (1%) and volcanic ash (0.2%). During the 11 year study period there were on average 85 (standard deviation 45) daily dispensings of short-acting asthma drugs and 31 (19 standard deviations) dispensing of long-acting drugs. In the regression analysis, PM events from traffic and resuspension sources were associated with increases in the number of individuals who filled prescriptions for both long- and short-acting asthma drug in the following 7 days. Volcanic ash PM events were associated with dispensing of long-acting drugs, and short-acting drug use in summer and in individuals aged less than 18 years. DiscussionPM from traffic and local resuspension are the largest contributors to respiratory morbidity in Iceland’s capital area, although volcanic particles were also a significant contributor. PM from dust storms which did not originate from recent volcanic sources, was not associated with this indicator of poor respiratory health.

COMPARISON OF TREMOR RELATED ADVERSE DRUG REACTION BETWEEN INTRAVENOUS AMINOPHYLLINE AND NEBULIZED SALBUTAMOL FOR ASTHMA EXACERBATION TREATMENT

The Department of Health estimates that asthma including 10 major causes of morbidity and mortality in the hospital. Asthma is a chronic respiratory disease that is becoming a serious health problem in many countries around the world. Drugs used in the treatment of asthma exacerbations is salbutamol and aminophylline. Drugs such as salbutamol and aminophylline can cause ADR (Adverse Drug Reaction) in the form of tremor with a sign involuntary shaking part of the hand. This research was conducted at the RSAL Dr. Oepomo to sample Aminofilin and in hospitals Seowandi to sample Salbutamol. The method used was quasi experimental. This study was conducted to compare the incidence of tremor in both asthma drug that is often used for the treatment of asthma such as Salbutamol and Aminofilin. The results of this study indicate there are differences in the incidence rate of ADR-related tremor between salbutamol and Aminofilin. Knowing the difference in incidence rate of tremor between aminophylline and salbutamol can assist in the selection of treatment which safer to avoid the effects of tremors that can occur from the use of of drugs asthma exacerbations.

EVALUASI PENGGUNAAN OBAT PADA PASIEN ASMA DI INSTALASI RAWAT INAP RSUP PROF. DR. R. D. KANDOU MANADO

ABSTRACTAsthma is a disease in the top five causes of death in the world, which varies between 5-10%. Drug use accuracy in this study was that patients who received treatment were evaluated for accuracy based on the category of indication, drug, patient and the correct dose. This study aims to identify the characteristics and presentation of the accuracy of drug use in asthma patients. This study is a descriptive study with retrospective data collection from 59 medical records of asthma patients for the period January - December 2017. The results of the study based on the characteristics of asthma patients show the number of female patients more than men, namely 33 patients (55.93%) and the highest number of patients age is in the 56 - 65 years for 10 patients (16.95%). Endocrine diseas, nutritional and metabolic disorders were the most common comorbidities was found in 13 patients (17.33%) and 3-4 drugs were prescribed more, namely 28 patients (47.46%). The accuracy percentage of drug use consisted of 81.36% right indication, 74.58% right drug, 94.92% right patient, and 86.44% correct dose. Keywords: Inpatient Asthma, Drug evaluation ABSTRAKPenyakit asma merupakan penyakit lima besar penyebab kematian di dunia yang bervariasi antara 5 - 10%. Ketepatan penggunaan obat dalam penelitian ini adalah pasien menerima pengobatan yang kemudian di evaluasi ketepatannya berdasarkan kategori tepat indikasi, tepat obat, tepat pasien, dan tepat dosis. Penelitian ini bertujuan untuk mengidentifikasi karakteristik dan presentasi ketepatan penggunaan obat pada pasien asma. Penelitian ini merupakan penelitian deskriptif dengan pengambilan data secara retrospektif dari 59 catatan rekam medik pasien asma periode Januari - Desember 2017. Hasil penelitian berdasarkan karakteristik pasien asma menunjukkan jumlah pasien perempuan lebih banyak dibanding laki-laki yaitu sebesar 33 pasien (55,93%) dan jumlah pasien terbanyak pada kelompok usia 56 - 65 tahun sebesar 10 pasien (16,95%). Penyakit endoktrin, nutrisi dan gangguan metabolik merupakan penyakit penyerta terbanyak yang ditemukan pada 13 pasien (17,33%) dan 3 - 4 obat diresepkan lebih banyak yaitu pada 28 pasien (47,46%). Persentase ketepatan penggunaan obat terdiri dari tepat indikasi 81,36%, tepat obat 74,58%, tepat pasien 94,92%, dan tepat dosis 86,44%. Kata Kunci: Asma rawat inap, Evaluasi obat

Sarcoidosis exosomes stimulate monocytes to produce pro-inflammatory cytokines and CCL2

Pulmonary sarcoidosis has unknown etiology, a difficult diagnostic procedure and no curative treatment. Extracellular vesicles including exosomes are nano-sized entities released from all cell types. Previous studies of exosomes from bronchoalveolar lavage fluid (BALF) of sarcoidosis patients have revealed pro-inflammatory components and abilities, but cell sources and mechanisms have not been identified. In the current study, we found that BALF exosomes from sarcoidosis patients, but not from healthy individuals, induced a dose-dependent elevation of intracellular IL-1β in monocytes. Analyses of supernatants showed that patient exosomes also induced release of IL-1β, IL-6 and TNF from both PBMCs and enriched monocytes, suggesting that the observed effect is direct on monocytes. The potently chemotactic chemokine CCL2 was induced by exosomes from a subgroup of patients, and in a blocking assay the exosome-induced CCL2 was reduced for 13 out of 19 patients by the asthma drug Montelukast, a cysteinyl leukotriene receptor antagonist. Further, reactive oxygen species generation by PBMCs was induced to a higher degree by patient exosomes compared to healthy exosomes. These findings add to an emerging picture of exosomes as mediators and disseminators of inflammation, and open for further investigations of the link between CCL2 and exosomal leukotrienes in sarcoidosis.

Comparative Metabolite Profiling of Wild and Cultivated Justicia procumbens L. Based on 1H-NMR Spectroscopy and HPLC-DAD Analysis

Justicia procumbens L. is known across Korea, India, China, and Taiwan as a remedy against fever, cough, sore throat, and cirrhosis of ascites. J. procumbens provides the raw material for a candidate anti-asthma drug (DW2008S) currently completing phase I clinical trials sponsored by Dong Wha Pharmaceutical Company. HPLC-DAD was used to quantify phytochemical constituents of J. procumbens, and HPLC and 1H-NMR results were assessed by multivariate analysis. This is the first time a comparative study using HPLC-DAD and NMR fingerprints has been applied to identify chemical differences between wild and cultivated J. procumbens. The amount of justicidin B as the marker compound was higher in cultivated samples (0.80 ± 0.25 mg/g) than in wild ones (0.63 ± 0.30 mg/g). Orthogonal partial least squares discriminant analysis (OPLS-DA) from HPLC and NMR data revealed that there were clear differences between wild and cultivated types and identified five secondary metabolites, which could help distinguish between wild and cultivated plants. Among these five lignans, diphyllin showed the most potent discrimination between two types and was significantly detected higher in cultivated ones than in wild ones. A combination of 1H-NMR and HPLC-DAD analysis is effective for J. procumbens standardization and metabolomics studies.