What pulmonologists think about the asthma–COPD overlap syndrome

Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma–COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity ,0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting β2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting β2-agonist/inhaled corticosteroids

Evaluation de la prise en charge de 299 accès palustres à Lille et à Tourcoing entre 2003 et 2001 [i.e. 2011] (impact de la conférence de consensus française de 2007)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Les Médicaments dits sensibles en Région Rhône-Alpes (création d'un outil de veille)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Development of On-Line Solid-Phase Extraction-Liquid Chromatography Coupled with Tandem Mass Spectrometry Method to Quantify Pharmaceutical, Glucuronide Conjugates and Metabolites in Water

International audienceThe present work describes the development of an analytical method, based on automated on-line solid phase extraction followed by ultra high-performance liquid chromatography coupled with tandem mass spectrometry (SPELC- MS/ MS) for the quantification of 37 pharmaceutical residues, covering various therapeutic classes, and some of their main metabolites, in surface and drinking water. A special attention was given to some glucuronide conjuguates and metabolites of active subtances. Multiple Reaction Monitoring (MRM) was chosen and two transitions per compound are monitored (quantification and confirmation transitions). Quantification is performed by standard addition approach to correct matrix effect. The method provides limit of quantification inferior to 20 ng.L-1 for all compounds. The methodology was successfully applied to the analysis of surface water and drinking water of 8 drinking water treatment plant in west of France. The highest drug concentrations in surface water and drinking water were reported for ketoprofen, hydroxyibuprofen, acetaminophen, caffeine and danofloxacin

Search for conjugated drug metabolites in surface water and during drinking water treatment

International audiencePharmaceuticals for human or veterinary use are found, by various means, in aquatic environments and particularly in drinking water treatment plants. Pharmaceuticals are partially metabolized after ingestion (the percentage depends on the parent drug and falls between 1 and 99%), and consequently pharmaceuticals can be found in drinking water at concns. ranging from the ng·L-1 to hundreds of ng·L-1. Different types of metabolites exist, among them conjugates that can represent up to 90% of the released metabolites of a pharmaceutical. The present work describes the development of an anal. method using "online Solid Phase Extn." (SPE) - high performance liq. chromatog. - tandem mass spectrometry (LC-MS/MS) for the detn. and quantification of the active substances and their conjugates in surface waters and during drinking water treatment. These conjugates may be subjected to a deconjugation during treatment, resulting in the release of the parent pharmaceutical. Hence, it is necessary to focus on these mols. and in particular on the glucuronide conjugates. As all stds. are not com. available, a new synthetic route in an aq. medium has been explored. Analyses are performed on the input and output of drinking water treatment plants to det. the concns. of parent drugs and their conjugates. The obtained limits of detection and quantification are in the order of 1 to 10 ng·L-1

Historia de Binaced

Grabs. intercal

Action-FRET: probing local conformation of molecules and molecular complexes in the gas phase

communication par afficheInternational audienc