0000000001133321
AUTHOR
Scichilone N
Evaluation of health outcomes in elderly patients with asthma and COPD using disease-specific and generic instruments: the Salute Respiratoria nell'Anziano (Sa.R.A.) Study.
To compare the effects of asthma and COPD on health status (HS) in elderly patients, and to assess the correlation between disease-specific and generic instruments assessing HS.Multicenter, cross-sectional, observational study.The Salute Respiratoria nell'Anziano (respiratory health in the elderly) Study network of outpatient departments.One hundred ninety-eight asthma patients and 230 COPD patientsor = 65 years old.HS was assessed by the Saint George's Respiratory Questionnaire (SGRQ) and five generic outcomes: Barthel's index, 6-min walk test, mini mental state examination, geriatric depression scale (GDS), and quality-of-sleep index. Independent correlates of SGRQ scores were assessed by…
Asthma in pregnancy: One more piece of the puzzle
Asthma is the most commonly occurring respiratory complication during pregnancy, and is associated with a wide range of adverse maternal and perinatal outcomes. However, there is strong evidence that an adequate control of asthma can improve the health of both mothers and their babies. Despite the well-known risks of poorly-controlled asthma during pregnancy, a large proportion of women have sub-optimal asthma control, due to concerns surrounding risks related to pharmacological agents and uncertainties regarding the effectiveness and safety of different management strategies. A recent retrospective study showed that step-up therapy with low-dose inhaled corticosteroids / long-acting β2-ago…
Lung penetration and patient adherence considerations in the management of asthma: role of extra fine formulations
Nicola Scichilone, Mario Spatafora, Salvatore Battaglia, Rita Arrigo, Alida Benfante, Vincenzo BelliaDipartimento di Biomedicina e Medicina Interna e Specialistica, Sezione di Pneumologia, University of Palermo, Palermo, ItalyAbstract: The mainstay of management in asthma is inhalation therapy at the target site, with direct delivery of the aerosolized drug into the airways to treat inflammation and relieve obstruction. Abundant evidence is available to support the concept that inflammatory and functional changes at the level of the most peripheral airways strongly contribute to the complexity and heterogeneous manifestations of asthma. It is now largely accepted that there is a wide range …
Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma
BACKGROUND: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. METHODS: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 microg daily or fluticasone prop…
Machine learning classification for COVID19 patients performed on small datasets of CT scans.
In this work we evaluated the possibility of carrying out classifications of the outcome of patients with COVID19 disease through machine learning (ML) techniques working on small datasets of computed tomography (CT) images. In fact, one of the most common problems for medical artificial intelligence (AI) applications is the limited availability of annotated clinical data for model training. In the framework of the artificial intelligence in medicine (AIM) project funded by INFN, we analyzed datasets of CT scans of 79 subjects combined with clinical data containing information relating to positive outcome (no need for intensive care) or poor prognosis (admission into intensive care unit and…
Allergen sensitizations in southern Italy: a 5-year retrospective study in allergic respiratory patients
The assessment of the distribution of allergen skin test sensitizations is highly recommended for the optimal management of allergic respiratory conditions. We aimed at evaluating the distribution of allergen sensitizations in individuals with asthma and/or rhinitis in the Southern region of ltaly, and at exploring whether changes in the frequency of allergen sensitizations occurred after a 5-year period. Demographic data and skin prick test sensitizations to allergens from asthmatics and/or rhinitis attending the Division of Respiratory Diseases, University of Palermo, Italy in 2005 (Phase 1) and in 2010 (Phase 2) were extrapolated and retained for analysis. A total of 2033 allergic respir…
Increased airway inflammatory cells in endurance athletes: what do they mean?
Inflammatory cells are increased in the airways of endurance athletes, but their role in causing exercise-induced respiratory symptoms and bronchoconstriction, or their possible long-term consequences, are uncertain.To put the results of athlete studies in perspective, by analysing the pathogenesis of airway cell changes and their impact on respiratory function.Athletes of different endurance sports at rest showed increased airway neutrophils. Elite swimmers and skiers also showed large increases in airway eosinophils and lymphocytes, possibly related to chronic, exercise-related exposure to irritants or cold and dry air, respectively. Post-exercise studies reported variable responses of ai…
The prevalence of sleep impairments and predictors of sleep quality among patients with asthma
Background: Sleep is a significant dimension of daily life. However, only a few studies have examined the sleep quality of asthmatics in a real-world clinical settings. Objective: This study is aimed to estimate the prevalence of sleep impairments among asthmatic patients and examine the relationship between sleep quality, asthma control, rhinitis symptoms, and sociodemographic characteristics. Methods: The present study adopted the observational cross-sectional research design that has been designed by the Italian Respiratory Society and used valid assessments to measure the study variables. Results: Data from 1150 asthmatic patients (mean age 51.01 years ± 16.03) were subjected to analysi…