Application of the forced oscillation technique in diagnosing and monitoring asthma in preschool children

The measurement of lung function in preschool children for the diagnosis of asthma is not routinely used. The need to perform forced expiratory manoeuvres requires active cooperation and thus limits the use of spirometry in this age group. The forced oscillation technique (FOT) is a simple and noninvasive method of assessing the mechanical properties of the respiratory system during tidal breathing. It is used in young patients and requires minimal cooperation. It provides an objective assessment of the respiratory system in a group of patients in whom we have not yet had appropriate diagnostic tools. In recent years, due to the availability of new technical solutions, FOT has been increasingly used and has a chance to become a method used routinely in diagnosing and monitoring treatment in preschool children. This article presents the possibility of the clinical application of FOT in diagnosing and monitoring of early childhood asthma

Fluticasone/formoterol combination therapy is as effective as fluticasone/salmeterol in the treatment of asthma, but has a more rapid onset of action: an open-label, randomized study

<p>Abstract</p> <p>Background</p> <p>The inhaled corticosteroid (ICS) fluticasone propionate (fluticasone) and the long-acting β₂-agonist (LABA) formoterol fumarate (formoterol) are being made available as a combination product (fluticasone/formoterol, <b><it>flutiform</it></b>^®) in a single aerosol inhaler. This 12-week, open-label, randomized, active-controlled, parallel-group, multicentre, phase 3 study compared the efficacy and safety of fluticasone/formoterol with the commercially available combination product fluticasone/salmeterol.</p> <p>Methods</p> <p>Patients aged ≥ 18 years (N = 202) with mild-to-moderate–severe, persistent asthma for ≥ 6 months prior to screening were included in the study. After a screening phase (4–10 days), eligible patients were randomized 1:1 to receive fluticasone/formoterol or fluticasone/salmeterol during the 12-week treatment period. The primary objective was to demonstrate non-inferiority of fluticasone/formoterol versus fluticasone/salmeterol, measured by pre-dose forced expiratory volume in the first second (FEV₁), at week 12.</p> <p>Results</p> <p>Fluticasone/formoterol was comparable to fluticasone/salmeterol for the primary efficacy endpoint, mean pre-dose FEV₁at week 12. The new combination was also comparable to fluticasone/salmeterol for change from baseline to week 12 in pre-dose FEV₁, change from pre-dose FEV₁at baseline to 2-hour post-dose FEV₁at week 12 and discontinuations due to lack of efficacy. Importantly, fluticasone/formoterol was superior to fluticasone/salmeterol in time to onset of action throughout the duration of the study. The two treatments demonstrated similar results for various other secondary efficacy parameters, including other lung function tests, patient-reported outcomes, rescue medication use, asthma exacerbations and Asthma Quality of Life Questionnaire scores. Fluticasone/formoterol was well tolerated and had a good safety profile that was similar to fluticasone/salmeterol.</p> <p>Conclusions</p> <p>The results of this study indicate that fluticasone/formoterol is as effective as fluticasone/salmeterol, and has a more rapid onset of action, reflecting the faster bronchodilatory effects of formoterol compared with those of salmeterol. If patients perceive the benefits of therapy with fluticasone/formoterol more rapidly than with fluticasone/salmeterol, this could have a positive impact on preference and adherence.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00476073">NCT00476073</a></p

Soft Set Theory Applied to General Algebras

The notions of a soft general algebra and a soft subalgebra are introduced and studied. The operations on them such as a restricted intersection, an extended intersection, a restricted union, a ∧-intersection, a ∨-union and a cartesian product are established

(Fuzzy) Ideals of BN-Algebras

The notions of an ideal and a fuzzy ideal in BN-algebras are introduced. The properties and characterizations of them are investigated. The concepts of normal ideals and normal congruences of a BN-algebra are also studied, the properties of them are displayed, and a one-to-one correspondence between them is presented. Conditions for a fuzzy set to be a fuzzy ideal are given. The relationships between ideals and fuzzy ideals of a BN-algebra are established. The homomorphic properties of fuzzy ideals of a BN-algebra are provided. Finally, characterizations of Noetherian BN-algebras and Artinian BN-algebras via fuzzy ideals are obtained

On maximal ideals of pseudo MVMV-algebras

We investigate maximal ideals of pseudo MV-algebras and give some characterizations of them. Some properties of a family of maximal ideals of a pseudo MV-algebra generating this algebra are shown as well. Finally, we are interested in finding an example of a pseudo MV-algebra generated by its maximal ideal

Combined therapy of patients with uterine sarcomas – evaluation of treatment results and analysis of prognostic factors

Objectives: The aim of the study was to assess the efficacy of combined therapy (surgery plus radiotherapy) and reasons of treatment failure in patients with uterine sarcoma. Material and methods: The analyzed clinical material involved 95 patients with uterine sarcoma (US) treated in the Cracow Branch of the Center of Oncology between 1980 and 1999. The studied group consisted of 70 patients with leiomyosarcoma (LS) and 25 patients with endometrial stromal sarcoma (ESS). Seventy-three women were diagnosed with stage I and II and 22 with stage III and IVA US. All patients in this group underwent radical hysterectomy with salpingooophorectomy followed by postoperative irradiation consisting of vaginal brachytherapy and external beam radiotherapy of the small pelvic area. Results: Out of 95 patients in the tested group, 46 (48.4%) patients survived 5 years with no evidence of disease. In the group of early-stage US there were 60.3% 5-year disease-free survivals. None of 9 patients with stage IVA was cured. In 36 among 47 uncured patients (76.6%) distant metastases was found. Conclusion: Combined surgery plus radiotherapy treatment was effective therapy in patients with early-stage US, nevertheless, it was ineffective in the group with advanced US, as none of the 9 patients with grade IVA was cured. The basic cause of treatment failure in the LS group was the spread of malignancy, whereas in the ESS group – locoregional recurrence.Cel: Celem pracy była ocena skuteczności leczenia skojarzonego (chirurgia + napromienianie) i analiza przyczyn niepowodzenia leczenia chorych na mięsaka macicy. Materiał i metody: Przeprowadzono analizę materiału klinicznego obejmującego 95 chorych na mięsaka macicy (MM) leczonych w Centrum Onkologii, Oddział Kraków w latach 1980-1999. W skład badanej grupy weszło 70 chorych na leiomyosarcoma (LS) oraz 25 chorych na endometrial stromal sarcoma (ESS). U 73 pacjentek rozpoznano MM w I i II, a u 22 w III i IVA stopniu zaawansowania. W badanej grupie u wszystkich chorych wykonano zabieg radykalnego usunięcia macicy wraz z przydatkami, a następnie przeprowadzono uzupełniające pooperacyjne napromienianie składające się z brachyterapii dopochwowej i teleradioterapii terenu miednicy mniejszej. Wyniki: Spośród 95 chorych z badanej grupy 5 lat bez objawów nowotworu przeżyło 46, tzn. 48,4% chorych. W grupie osób z niezaawansowanym MM uzyskano 60,3% bezobjawowych przeżyć 5-letnich. Skojarzone leczenie chirurgiczne z pooperacyjnym napromienianiem okazało się nieskuteczne w grupie chorych na zaawansowanego MM – nie wyleczono żadnej spośród 9 chorych w IVA stopniu zaawansowania. U 36 spośród 47 chorych (76,6%) z niewyleczonym procesem nowotworowym stwierdzono przerzuty odległe. Wnioski: Skojarzone leczenie chirurgiczne z pooperacyjnym napromienianiem było skuteczne u chorych na niezaawansowanego MM, natomiast u chorych na zaawansowanego MM skojarzone leczenie okazało się nieskuteczne, ponieważ żadna z 9 chorych na MM w stopniu IVA nie została wyleczona. Głównym powodem niepowodzenia leczenia w grupie chorych na LS były przerzuty odległe, a w grupie chorych na ESS – wznowa lokoregionalna

Cecropin D-derived synthetic peptides in the fight against Candida albicans cell filamentation and biofilm formation

The recent progressive increase in the incidence of invasive fungal infections, especially in immunocompromised patients, makes the search for new therapies crucial in the face of the growing drug resistance of prevalent nosocomial yeast strains. The latest research focuses on the active compounds of natural origin, inhibiting fungal growth, and preventing the formation of fungal biofilms. Antimicrobial peptides are currently the subject of numerous studies concerning effective antifungal therapy. In the present study, the antifungal properties of two synthetic peptides $\Delta$M3, $\Delta$M4) derived from an insect antimicrobial peptide - cecropin D - were investigated. The fungicidal activity of both compounds was demonstrated against the yeast forms of Candida albicans, Candida tropicalis, and Candida parapsilosis, reaching a MFC99.9 in the micromolar range, while Candida glabrata showed greater resistance to these peptides. The scanning electron microscopy revealed a destabilization of the yeast cell walls upon treatment with both peptides; however, their effectiveness was strongly modified by the presence of salt or plasma in the yeast environment. The transition of C. albicans cells from yeast to filamentous form, as well as the formation of biofilms, was effectively reduced by ΔM4. Mature biofilm viability was inhibited by a higher concentration of this peptide and was accompanied by increased ROS production, activation of the GPX3 and SOD5 genes, and finally, increased membrane permeability. Furthermore, both peptides showed a synergistic effect with caspofungin in inhibiting the metabolic activity of C. albicans cells, and an additive effect was also observed for the mixtures of peptides with amphotericin B. The results indicate the possible potential of the tested peptides in the prevention and treatment of candidiasis

Fluticasone furoate nasal spray reduces symptoms of uncomplicated acute rhinosinusitis: a randomised placebo-controlled study

Background: Uncomplicated acute rhinosinusitis (ARS) is usually a self-limiting inflammatory condition often treated with antibiotics. Aims: To assess the safety and efficacy of fluticasone furoate nasal spray (FFNS) compared with placebo for symptomatic relief of uncomplicated ARS. Methods: A randomised, double-blind, placebo-controlled, parallel-group, multicentre, 2-week treatment study of FFNS 110 mu g once and twice daily was undertaken in adults/adolescents. Results: A statistically significant reduction was seen in the daily major symptoms score, a composite score of three individual symptoms (nasal congestion/stuffiness, sinus headache/pressure or facial pain/pressure, and postnasal drip on a 0-3 scale) by both FFNS doses compared with placebo (least square mean differences vs. placebo of -0.386 (p=0.008) and -0.357 (p=0.014) for once daily and twice daily FFNS, respectively). The differences in median times to symptom improvement were not statistically significant between each dose of FFNS (7 days) and placebo (8 days). There were no treatment differences in antibiotic use for possible fulminant bacterial rhinosinusitis (3% in each group). The safety profile of FFNS was similar to placebo. Conclusions: FFNS reduces symptoms of uncomplicated ARS compared with placebo and is well tolerated, providing support for withholding antibiotics in selected patients. (C) 2012 Primary Care Respiratory Society UK. All rights reserved. PK Keith et al. Prim Care Respir J 2012; 21(3): 267-275 http://dx.doi.org/10.4104/pcrj.2012.0003