Controller therapy for asthma: montelukast versus fluticasone

Introducción: El asma es un trastorno inflamatorio crónico de las vías aéreas. Esta inflamación genera un aumento asociado de la hiperreactividad de las vías aéreas a una variedad de estímulos y una limitación del flujo aéreo. El tratamiento controlador del asma tiene como objetivos lograr y mantener control de los síntomas, prevenir las exacerbaciones, mantener la función pulmonar lo mas cerca posible a la normalidad, evitar efectos adversos de la medicación, prevenir obstrucción irreversible de la vía aérea y disminuir la mortalidad. Los medicamentos utilizados para este fin son los antinflamatorios dentro de los cuales se incluyen los grupos de corticoesteroides, cromonas y antileucotrienos. Objetivo: El objetivo de esta revisión bibliográfica es indicar las evidencias encontradas sobre mayor efectividad en este cuadro clínico entre Fluticasona y Montelukast. Material y métodos: Se realizó una revisión bibliográfica, en la cual se utilizo para la búsqueda de información las bases de datos PUBMED, MEDLINE y BIBLIOTECA VIRTUAL DE SALUD artículos científicos publicados en los últimos 5 años que comparan el tratamientote ambos fármacos. Conclusión: El fármaco más efectivo como monoterapia para el tratamiento controlador del asma en niños es la fluticasona frente al montelukast, por lo que esta es considerada la terapia de primera línea.Introduction: Asthma is a chronic inflammatory disorder of the airways. This inflammation is an associated increase in Nonspecific hyperresponsiveness airway to a variety of stimuli and airflow limitation. The asthma controller therapy aims to achieve and maintain control of symptoms, prevent exacerbations, maintaining lung function as close as possible to normal, avoid adverse effects of medication, prevent irreversible obstruction of the airway and reduce mortality . Medicines used for this purpose are the anti-inflammatory within which groups include corticosteroids, chromones and leukotriene. Objective: Fluticasone (inhaled corticosteroid) and montelukast (antileukotriene) are commonly used drugs for the treatment of pediatric asthma controller so that the objective of this review is to summarize the evidence on which of the two showed greater effectiveness in the treatment. Methods: A literature review, which was used to search for information databases PUBMED, MEDLINE and HEALTH LIBRARY scientific articles published over the past 5 years, comparing treatment with fluticasone and montelukast. Conclusion: The most effective drug as monotherapy for asthma controller therapy in children is fluticasone compared with montelukast, so this is considered first-line therapy.Fil: Acevedo, Maria E..Fil: Cano, Alejandra A..Fil: Lopez, Vanina A..Fil: Viola, Luciana S..Fil: Gerometta, Rosana María del Rosario. Universidad Nacional del Nordeste. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Preterm Infants’ Follow-Up Program at a Public Hospital in Buenos Aires: Two-Decade Study

Objectives: To analyze temporal trends of mortality, morbidity, growth and neurodevelopment until 2 years of corrected age (CA) of very low birth weight infants (VLBWI) born between 1986- 2005 in Ramon Sardá Maternal Infant Hospital (RSMIH). Methods: Descriptive temporal trend study divided in 5 quinquenniums.1255 VLBWI were born at RSMIH between 1986-2005; 46 were excluded (genetic syndromes, major congenital malformations, confirmed intrauterine infections), 84 were referred out and 1125 were studied. Birth weight (BW), gestational age (GA); morbidity; growth; neurodevelopment at 1 and 2 years of CA; neurological and sensorial disorders, antenatal steroids use, breastfeeding; rehospitalizations; mothers´ age and years of schooling and Unsatisfied Basic Needs Index (UBNI) were recorded. Results: Survival rates increased during the last two periods, especially in <1000g BW infants despite the decrease in GA and BW. Children receiving surfactant (Sf), parenteral nutrition (PN) and antenatal steroids (AS) in the last quinquennium obtained better results in growth (40 weeks GA and 1 CA). The use of these therapies increased greatly in the last decade. Also breastfeeding at 40 weeks GA and 4 months tended to be better. Bronchopulmonary dysplasia (BPD) increased. Rehospitalizations (majorly attributable to lower tract infections) and UBNI stayed equal all along. Mothers’ years of schooling increased a little in the last two quinquenniums. Conclusion: In the last quinquennium children tended to be smaller in GA and BW due to an increase in the survival rate as a result of higher technology and appropriate interventions such as AS, PN, Sf, etc

Neanderthals on the Lower Danube: Middle Palaeolithic evidence in the Danube Gorges of the Balkans

The article presents evidence about the Middle Palaeolithic and Middle to Upper Palaeolithic transition interval in the karst area of the Danube Gorges in the Lower Danube Basin. We review the extant data and present new evidence from two recently investigated sites found on the Serbian side of the Danube River – Tabula Traiana and Dubočka-Kozja caves. The two sites have yielded layers dating to both the Middle and Upper Palaeolithic and have been investigated by the application of modern standards of excavation and recovery along with a suite of state-of-the-art analytical procedures. The presentation focuses on micromorphological analyses of the caves’ sediments, characterisation of cryptotephra, a suite of new radiometric dates (accelerator mass spectrometry and optically stimulated luminescence) as well as proteomics (zooarchaeology by mass spectrometry) and stable isotope data in discerning patterns of human occupation of these locales over the long term

Neanderthals on the Lower Danube: Middle Palaeolithic evidence in the Danube Gorges of the Balkans

The article presents evidence about the Middle Palaeolithic and Middle to Upper Palaeolithic transition interval in the karst area of the Danube Gorges in the Lower Danube Basin. We review the extant data and present new evidence from two recently investigated sites found on the Serbian side of the Danube River – Tabula Traiana and Dubočka-Kozja caves. The two sites have yielded layers dating to both the Middle and Upper Palaeolithic and have been investigated by the application of modern standards of excavation and recovery along with a suite of state-of-the-art analytical procedures. The presentation focuses on micromorphological analyses of the caves’ sediments, characterisation of cryptotephra, a suite of new radiometric dates (accelerator mass spectrometry and optically stimulated luminescence) as well as proteomics (zooarchaeology by mass spectrometry) and stable isotope data in discerning patterns of human occupation of these locales over the long term

Clean air in europe for all: taking stock of the proposed revision to the ambient air quality directives. A Joint ERS, HEI, and ISEE Workshop Report

Ambient air pollution is a major public health concern and comprehensive new legislation is currently being considered to improve air quality in Europe. The European Respiratory Society (ERS), Health Effects Institute (HEI), and International Society for Environmental Epidemiology (ISEE) organised a joint meeting on May 24, 2023 in Brussels, Belgium, to review and critically evaluate the latest evidence on the health effects of air pollution and discuss ongoing revisions of the European Ambient Air Quality Directives (AAQDs). A multi-disciplinary expert group of air pollution and health researchers, patient and medical societies, and policy representatives participated. This report summarises key discussions at the meeting

Citizen Science Case Studies and Their Impacts on Social Innovation

Social innovation brings social change and aims to address societal challenges and social needs in a novel way. We therefore consider citizen science as both (1) social innovation in research and (2) an innovative way to develop and foster social innovation. In this chapter, we discuss how citizen science contributes to society’s goals and the development of social innovation, and we conceptualise citizen science as a process that creates social innovation. We argue that both citizen science and social innovation can be analysed using three dimensions – content, process, and empowerment (impact). Using these three dimensions as a framework for our analysis, we present five citizen science cases to demonstrate how citizen science leads to social innovation. As a result of our case study analysis, we identify the major challenges for citizen science in stimulating social innovation

New evidence for the Middle to Upper Palaeolithic transition interval in the Danube Gorges of the Balkans

Over the past few years, new investigations in northern Bulgaria at the site of Bacho Kiro have revived the likelihood that the "Danube corridor" route served as a primary axis for the dispersal of modern humans into Europe. The association of modern humans with material remains of Protoaurignacian and Aurignacian provenance and/or transitional industries, would push the start of the dispersal across this region to 47 ka. Furthermore, fossil remains from the cave site of Peștera cu Oase in the Romanian hinterland of the Danube Gorges area of the north-central Balkans provide genetic evidence of admixtures between Neanderthal and modern human populations that might have taken place precisely along this transitory corridor. Yet, there is still relatively little in the way of evidence about, on the one hand, the last Middle Palaeolithic, and by proxy Neanderthal, and, on the other hand, the Initial and Early Upper Palaeolithic, and by proxy modern human, settlement of the region. Our recent investigations in the Danube Gorges area have brought to light two new sites, Tabula Traiana Cave and Dubočka-Kozja Cave, with Middle to Upper Palaeolithic deposits. The application of modern standards of recovery and recording have enabled us to apply a suite of cutting edge and state-of-the-art methodologies backed by extensive radiometric dating of these sites’ deposits. In this paper, we will present most recently obtained radiocarbon accelerator mass spectrometry (AMS) measurements, which allow us to discuss the chronological attribution of different levels of the two sites with more certainty. We will also offer further details regarding the knapped stone assemblages, including the results of use-wear analyses on a select number of artefacts. Finally, this evidence is integrated with the results obtained through the analyses of the faunal assemblages and by characterizing taphonomic factors that impacted their formation. Complementary data come from a relatively large pool of unidentifiable bone samples analyzed through the application of proteomic fingerprinting known as the Zooarchaeology by Mass Spectrometry (ZooMS), which has allowed us to better characterize the animal taxa composition of the faunal assemblages from the two sites and identify agents of bone accumulation. The results indicate a late continuation of the Middle Palaeolithic presence characterized by a Levallois-derived lithic industry at one of the two sites and the broadly contemporaneous appearance of the Early Upper Palaeolithic tools in the lithic assemblage of the other site. We discuss how the locations of the two sites in this specific landscape zone along the Danube might have influenced their respective uses

Are social innovation paradigms incommensurable?

This paper calls attention to the problematic use of the concept of social innovation which remains undefined despite its proliferation throughout academic and policy discourses. Extant research has thus far failed to capture the socio-political contentions which surround social innovation. This paper therefore draws upon the work of Thomas Kuhn and conducts a paradigmatic analysis of the field of social innovation which identifies two emerging schools: one technocratic, the other democratic. The paper identifies some of the key thinkers in each paradigm and explains how the struggle between these two paradigms reveals itself to be part of a broader conflict between neoliberalism and it opponents and concludes by arguing that future research focused upon local contextualised struggles will reveal which paradigm is in the ascendancy