Aerosolized amikacin for treatment of pulmonary Mycobacterium avium infections: an observational case series

BACKGROUND: Current systemic therapy for nontuberculous mycobacterial pulmonary infection is limited by poor clinical response rates, drug toxicities and side effects. The addition of aerosolized amikacin to standard oral therapy for nontuberculous mycobacterial pulmonary infection may improve treatment efficacy without producing systemic toxicity. This study was undertaken to assess the safety, tolerability and preliminary clinical benefits of the addition of aerosolized amikacin to a standard macrolide-based oral treatment regimen. CASE PRESENTATIONS: Six HIV-negative patients with Mycobacterium avium intracellulare pulmonary infections who had failed standard therapy were administered aerosolized amikacin at 15 mg/kg daily in addition to standard multi-drug macrolide-based oral therapy. Patients were monitored clinically and serial sputum cultures were obtained to assess response to therapy. Symptomatic improvement with radiographic stabilization and eradication of mycobacterium from sputum were considered markers of success. Of the six patients treated with daily aerosolized amikacin, five responded to therapy. All of the responders achieved symptomatic improvement and four were sputum culture negative after 6 months of therapy. Two patients became re-infected with Mycobacterium avium intracellulare after 7 and 21 months of treatment. One of the responders who was initially diagnosed with Mycobacterium avium intracellulare became sputum culture positive for Mycobacterium chelonae resistant to amikacin after being on intermittent therapy for 4 years. One patient had progressive respiratory failure and died despite additional therapy. There was no evidence of nephrotoxicity or ototoxicity associated with therapy. CONCLUSION: Aerosolized delivery of amikacin is a promising adjunct to standard therapy for pulmonary nontuberculous mycobacterial infections. Larger prospective trials are needed to define its optimal role in therapy of this disease

Part-time work and gender inequality in Europe: a comparative analysis of satisfaction with work–life balance

Part-time work is an increasingly common strategy for handling work and family – but is it an effective strategy everywhere and for everyone? To answer this question, we examine satisfaction with work–life balance (SWLB) of workers in 22 European countries. Our results show that part-time workers have higher SWLB than full-time workers; the more so, the fewer hours they put in. Yet, we find an important gender difference: women in marginal part-time work are more satisfied than men in a similar situation, and conversely men in full-time work have higher SWLB than women working full-time. Further, the societal context plays an important role: substantial part-time work is more conducive to SWLB in more gender-egalitarian countries than in countries with low gender equality. Hence, a supportive gender climate and institutional support may entice workers to reduce working hours moderately, which results in markedly increased levels of SWLB

Part-time work and gender inequality in Europe: a comparative analysis of satisfaction with work–life balance

Part-time work is an increasingly common strategy for handling work and family – but is it an effective strategy everywhere and for everyone? To answer this question, we examine satisfaction with work–life balance (SWLB) of workers in 22 European countries. Our results show that part-time workers have higher SWLB than full-time workers; the more so, the fewer hours they put in. Yet, we find an important gender difference: women in marginal part-time work are more satisfied than men in a similar situation, and conversely men in full-time work have higher SWLB than women working full-time. Further, the societal context plays an important role: substantial part-time work is more conducive to SWLB in more gender-egalitarian countries than in countries with low gender equality. Hence, a supportive gender climate and institutional support may entice workers to reduce working hours moderately, which results in markedly increased levels of SWLB

Asthma prevalence in Olympic summer athletes and the general population: an analysis of three European countries.

Background: Some studies have shown a higher prevalence of asthma in elite athletes as compared to the general population. It is inconclusive to what extent certain sport categories are especially affected. The present study offered a unique opportunity to assess these differences in asthma prevalence in the general population and elite summer athletes from a wide range of sport disciplines across various geographical areas. Methods: Cross-sectional data for 1568 general population participants from the European Community Respiratory Health Survey II and 546 elite athletes from the Global Allergy and Asthma European Network Olympic study from three European countries were analyzed. Using logistic regression, the asthma risks associated with athlete sport practice, endurance level and aquatic sport practice, respectively, were investigated. Results: Athletes in the highest endurance category had increased risk of doctor-diagnosed asthma (OR 3.5; 95% CI 1.7–7.5), asthma symptoms (OR 3.0; CI 1.5–6.0) and asthma symptoms or medication use (OR 3.5; CI 1.8–6.7) compared to the general population. Aquatic athletes were at increased risk of doctor-diagnosed asthma (OR 2.0; CI 1.1–3.9), asthma symptoms (OR 2.6; CI 1.3–5.0) and asthma symptoms or medication use (OR 2.3; CI 1.2–4.4) when compared to individuals not involved in aquatic sports. Regarding the entire athlete population, no increase in asthma was found when compared to the general population. Conclusions: Practice of very high endurance and aquatic sports may be associated with increased asthma risks. Athlete participation as such showed no association with asthma risk. (aut. ref.