Improved adherence with once-daily versus twice-daily dosing of mometasone furoate administered via a dry powder inhaler: a randomized open-label study

Background Poor adherence with prescribed asthma medication is a major barrier to positive treatment outcomes. This study was designed to determine the effect of a once-daily administration of mometasone furoate administered via a dry powder inhaler (MF-DPI) on treatment adherence compared with a twice-daily administration. Methods This was a 12-week open-label study designed to mimic an actual clinical setting in patients ≥12 years old with mild-to-moderate persistent asthma. Patients were randomized to receive MF-DPI 400 μg once-daily in the evening or MF-DPI 200 μg twice-daily. Adherence was assessed primarily using the number of actual administered doses reported from the device counter divided by the number of scheduled doses. Self-reports were also used to determine adherence. Health-related quality of life, healthcare resource utilization, and days missed from work or school were also reported. Results 1233 patients were randomized. The mean adherence rates, as measured by the automatic dose counter, were significantly better (P < 0.001) with MF-DPI 400 μg once-daily in the evening (93.3%) than with MF-DPI 200 μg twice-daily (89.5%). Mean adherence rates based on self-reports were also significantly better (P < 0.001) with MF-DPI 400 μg QD PM (97.2%) than with MF-DPI 200 μg twice-daily (95.3%). Adherence rates were lower in adolescents (12-17 years old). Health-related quality of life improved by 20% in patients using MF-DPI once-daily in the evening and by 14% in patients using MF-DPI twice-daily. Very few (<8%) patients missed work/school. Conclusion Mean adherence rates were greater with a once-daily dosing regimen of MF-DPI than with a twice-daily dosing regimen. This trial was completed prior to the ISMJE requirements for trial registration

Metabolic Effects Associated with ICS in Patients with COPD and Comorbid Type 2 Diabetes: A Historical Matched Cohort Study

Background Management guidelines for chronic obstructive pulmonary disease (COPD) recommend that inhaled corticosteroids (ICS) are prescribed to patients with the most severe symptoms. However, these guidelines have not been widely implemented by physicians, leading to widespread use of ICS in patients with mild-to-moderate COPD. Of particular concern is the potential risk of worsening diabetic control associated with ICS use. Here we investigate whether ICS therapy in patients with COPD and comorbid type 2 diabetes mellitus (T2DM) has a negative impact on diabetic control, and whether these negative effects are dose-dependent. Methods and Findings This was a historical matched cohort study utilising primary care medical record data from two large UK databases. We selected patients aged >= 40 years with COPD and T2DM, prescribed ICS (n = 1360) or non-ICS therapy (n = 2642) between 2008 and 2012. The primary endpoint was change in HbA(1c) between the baseline and outcome periods. After 1:1 matching, each cohort consisted of 682 patients. Over the 12-18-month outcome period, patients prescribed ICS had significantly greater increases in HbA1c values compared with those prescribed non-ICS therapies; adjusted difference 0.16% (95% confidence interval [Cl]: 0.05-0.27%) in all COPD patients, and 0.25% (95% Cl: 0.10-0.40%) in mild-to-moderate COPD patients. Patients in the ICS cohort also had significantly more diabetes-related general practice visits per year and received more frequent glucose strip prescriptions, compared with those prescribed non-ICS therapies. Patients prescribed higher cumulative doses of ICS (> 250 mg) had greater odds of increased HbA(1c) and/or receiving additional antidiabetic medication, and increased odds of being above the Quality and Outcomes Framework (QOF) target for HbA1c levels, compared with those prescribed lower cumulative doses ( Conclusion For patients with COPD and comorbid T2DM, ICS therapy may have a negative impact on diabetes control. Patients prescribed higher cumulative doses of ICS may be at greater risk of diabetes progression

An in situ Raman Investigation of Organic Species Incorporated in Cu Layers Electrodeposited from PEG-containing Acidic Sulphate and Cyanoalkaline Electrolytes

In situ surface Raman spectroscopy was used to detect organic species embedded in Cu electrodeposits obtained from PEG-containing cyanoalkaline and acidic sulphate solutions. These measurements rely on the release of the organic species at the surface of the electrode during controlled corrosion in pure acidic aqueous solutions and on the development of surface-enhancing morphological elements in the course of the anodic dissolution. After an induction period, well defined vibrational bands appear, assigned to vinyl and hydroxyl groups that can result from cleavage reactions of the PEG chain. This technique is shown to be robust and to exhibit negligible dependence on details of the corrosion process (either galvanostatic of potentiostatic) or of the environment (0.5M H2SO4 or HCl)

Electrodeposition of Cu from Acidic Sulphate Solutions in the Presence of PEG: An Electrochemical and Spectroelectrochemical Investigation – Part I

none5Codice ISI: WOS:000239207400008 Codice SCOPUS: 2-s2.0-33748323146 Codice DOI: 10.1007/s10800-006-9139-6 Citazioni ricevute: 16B. BOZZINI; C. MELE; L. D'URZO; G. GIOVANNELLI; S. NATALIBozzini, Benedetto; Mele, Claudio; D'Urzo, Lucia; G., Giovannelli; S., Natal

An in situ spectroelectrochemical investigation into the electrodeposition of CU from acidic sulphate solutions in the presence of poly(ethylene glycol)

This research deals with the effects of PEG during Cu electrodeposition from an acidic sulphate solution. This investigation was carried out with electrochemical (cyclic voltammetry with a rotating-disk electrode, potentiostatic and galvanostatic electrodeposition), and spectroelectrochemical (in situ Surface Enhanced Raman Spectroscopy) techniques. Potentiostatically grown layers were examined by scanning electron microscopy. Adsorption of PEG on the growing Cu surface can be inferred from electrokinetic, SERS and morphological evidence, gathered with PEG-free and PEG-containing solutions: variations of the estimated exchange current density, qualitative and quantitative differences in the potentiostatic transients, effects on the three-dimensional crystallisation mode under both compact and dendritic growth conditions, appearance of surface-enhanced PEG-related Raman bands. Surface spectra also revealed cathodic reactivity of adsorbed PEG. Spectral features can be interpreted as relating to a vinyl ether group deriving from polymer fragmentation with ether bond cleavage, followed by an elimination reaction

The use of diagnostic optical tools to assess nitrogen status and to guide fertilization of vegetables

Dynamic fertilization management is a way of bringing nutrients to the plant when they are crucial for its development. However, destructive measurements of crop nitrogen (N) status are still too costly and time consuming to justify their use, and the implementation of methodologies based upon non-destructive, quick and easy to use tools for plant nutritional status monitoring appears as an appealing opportunity. Several optical tools for plant monitoring have been developed in recent years and many studies have assessed their ability to discriminate plant N status. Such tools can measure at leaf level (hand-held optical instruments) or may consider the canopy of a plant or few plants (portable radiometers) or even measure areas, such as a field, a farm or a region (aerial photography). The application of vegetation indices, which combine the readings at different wavelengths, may improve the reliability of the collected data, giving a more precise determination of the plant nutritional status. In this paper we report on the state of the art of the available optical tools for plant N status monitoring