Diagnostic values of bronchodilator response versus 9-question questionnaire for asthma

Introduction: Several studies have investigated different tools for asthma diagnosis in order to reduce the cost and improve its early recognition. The goal of this study is to establish a short questionnaire to be used in practice for asthma screening and compare diagnostic values between this method and spirometric response to bronchodilators.Material and method: 208 patients presenting with chronic stable dyspnea (> 6 months) and definite clinical diagnosis of chronic obstructive pulmonary disease, bronchiectasis, pulmonary fibrosis or asthma, were enrolled. 9 questions out of 43 based on the literature search were selected by regression analysis. Patients were asked to complete the questionnaire and then their spirometric responses to bronchodilators were evaluated. Results: Of all, 53.8% of cases were diagnosed clinically to have asthma. For establishing diagnosis of asthma, the bronchodilator test had 48.2% sensitivity, 78.1% specificity, 72% positive, 56.4% negative predictive values, 2.2 positive, 0.66 negative likeli-hood ratios, and false positive, false negative and accuracy of 21.9%, 51.8% and 62.01%, respectively. The revised 9 questions from the questionnaire had 97.3% sensitivity, 77.1% specificity, 83.2% positive, 96.1% negative predictive values, 4.24 positive,  0.03 negative likelihood ratios, 22.9% false positive, 2.7% false negative and 87.98% accuracy.Conclusions: The 9-question questionnaire had better diagnostic values in defining asthma in patients with chronic dyspnea than reversibility of airway obstruction to salbutamol and can be used as a useful screening test for diagnosis of asthma in clinical practice and for investigational purposes

Preparation and evaluation of a thermosensitive liposomal hydrogel for sustained delivery of danofloxacin using mesoporous silica nanoparticles

BACKGROUND: Sustained release delivery system can reduce the dosage frequency and maintain the therapeutic level of drugs for a longer time. Biodegradable, biocompatible and thermosensitive chitosan-beta-glycerophosphate (C-GP) solutions can solidify at body temperature and maintain their physical integrity for a longer duration. OBJECTIVES: To develop a novel delivery system based on the integration of liposomes in hydrogel using mesoporous silica nanoparticles (MSNs) for sustained release of danofloxacin in farm animals. METHODS: The MSNs were prepared using N-cetyltrimethylammonium bromide and tetraethylortho silica. The liposomes were prepared by thin film hydration method. C-GP solution containing danofloxacin-loaded MSN liposomes underwent different in-vitro tests, including evaluation of the entrapment efficiency, gelation time, morphology, drug release pattern as well as antimicrobial activities against S. aureus and E. coli. RESULTS: The mean pore size of MSNs was 2.8 nm and the mean MSN entrapment efficiency was 45%. Kinetics of danofloxacin release from liposomal hydrogel followed the Higuchi’s model. This formulation was capable of sustaining the danofloxacin release for more than 96 h. The FTIR studies showed that there were no interactions between danofloxacin and hydrogel excipients. Scanning electron microscopy (SEM) showed that the formed gel had a continuous texture, while the swelled gel in the phosphate buffer had a porous structure. Microbiological tests revealed a high antibacterial activity for lipomosal hydrogel of danofloxacin-loaded MSN comparable with danofloxacin solution. CONCLUSIONS: The liposomal hydrogel solidified at body temperature, effectively sustained the release of danofloxacin and showed in vitro antibacterial effects

Preparation and in vitro evaluation of chitosan-based films for the sustained delivery of enrofloxacin

The implantable drug products are developed mainly to sustain the drug release. This study was conducted to formulate and evaluate cross-linked films of chitosan/β-glycerophosphate (β-GP) for the sustained delivery of enrofloxacin (ENR). Two types of formulations, single-layer (F1 and F2) and triple-layer (F3 and F4) films, were prepared. In vitro drug release, kinetic modelling, Fourier transform infrared spectroscopy (FTIR) spectra, morphological and microbiological studies were performed. Drug release from F1 and F2 continued up to 5 hours but from F3 and F4, it was extended over 96 and 168 hours, respectively. The cumulative drug release for F1, F2, F3 and F4 were 72.6, 70.1, 90.5 and 82.4%, respectively. The inhibition zones of bacterial growth by using positive controls and single layer films were significantly greater than those of triple-layer films (p < 0.05), indicating sustained drug release pattern of the multi-layer films.These findings suggest that the triple-layer chitosan/ β-GP films could be effective to deliver ENR for a long period

第711回 千葉医学会例会・第20回 佐藤外科例会 32.

<p>It obtained by maximum likelihood method using HKY+<i>Г</i>+I as nucleotides' substitution model. Triangleshows the position of cluster C which is detailed in (A). See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0162492#pone.0162492.g001" target="_blank">Fig 1</a> legend for more details.</p

Diagnostic Values of Bronchodilator Response versus 9-Question Questionnaire for Asthma

Introduction: Several studies have investigated different tools for asthma diagnosis in order to reduce the cost and improve its early recognition. The goal of this study is to establish ashort questionnaire to be used in practice for asthma screening and compare diagnostic values between this method and spirometric response to bronchodilators. Material and method: 208 patients presenting with chronic stable dyspnea (&gt; 6 months) and definite clinical diagnosis of chronic obstructive pulmonary disease, bronchiectasis, pulmonary fibrosis or asthma, were enrolled. 9 questions out of 43 based on the literature search were selected by regression analysis. Patients were asked to complete the questionnaire and then their spirometric responses to bronchodilators were evaluated. Results: Of all, 53.8% of cases were diagnosed clinically to have asthma. For establishing diagnosis of asthma, the bronchodilator test had 48.2% sensitivity, 78.1% specificity, 72% positive, 56.4% negative predictive values, 2.2 positive, 0.66 negative likeli-hood ratios, and false positive, false negative and accuracy of 21.9%, 51.8% and 62.01%, respectively. The revised 9 questions from the questionnaire had 97.3% sensitivity, 77.1% specificity, 83.2% positive, 96.1% negative predictive values, 4.24 positive, 0.03 negative likelihood ratios, 22.9% false positive, 2.7% false negative and 87.98% accuracy. Conclusions: The 9-question questionnaire had better diagnostic values in defining asthma in patients with chronic dyspnea than reversibility of airway obstruction to salbutamol and can be used as auseful screening test for diagnosis of asthma in clinical practice and for investigational purposes

Epidemic History of Hepatitis C Virus among Patients with Inherited Bleeding Disorders in Iran.

The high rate of hepatitis C virus (HCV) infection among transfusion related risk groups such as patients with inherited bleeding disorders highlighting the investigation on prevalent subtypes and their epidemic history among this group. In this study, 166 new HCV NS5B sequences isolated from patients with inherited bleeding disorders together with 29 sequences related to hemophiliacs obtained from a previous study on diversity of HCV in Iran were analyzed. The most prevalent subtype was 1a (65%), followed by 3a (18.7%),1b (14.5%),4(1.2%) and 2k (0.6%). Subtypes 1a and 3a showed exponential expansion during the 20th century. Whereas expansion of 3a started around 20 years earlier than 1a among the study patients, the epidemic growth of 1a revealed a delay of about 10 years compared with that found for this subtype in developed countries. Our results supported the view that the spread of 3a reached the plateau 10 years prior to the screening of blood donors for HCV. Rather, 1a reached the plateau when screening program was implemented. The differences observed in the epidemic behavior of HCV-1a and 3a may be associated with different transmission routes of two subtypes. Indeed, expansion of 1a was more commonly linked to blood transfusion, while 3a was more strongly associated to drug use and specially IDU after 1960. Our findings also showed HCV transmission through blood products has effectively been controlled from late 1990s. In conclusion, the implementation of strategies such as standard surveillance programs and subsiding antiviral treatments seems to be essential to both prevent new HCV infections and to decline the current and future HCV disease among Iranian patients with inherited bleeding disorders

Assessing the prevalence and treatment of malnutrition in hospitalized children in Mofid Children's Hospital during 2015-2016

Background: Malnutrition in hospitalized patients causes problems in treatment and increases hospitalization duration. The aim of this research was to determine the prevalence of malnutrition in hospitalized children. Methods: Children aged 1 month to 18 years (n = 1186) who were admitted to medical and surgery wards of Mofid children’s hospital from November 2015 to February 2016, entered the study. We measured different anthropometric variables in patients with malnutrition. Also, nutritional counseling was performed and three months follow-up was done. Results: Patient data were registered in questionnaires particularly for children 2 years old and less. 597 children under 2 years of age and 607 children over two years entered the study. The data analysis was done by SPSS version 22.0 (Chicago, IL, USA). The t test inferential method was used in comparing variables. P values less than 0.05 were considered statistically significant. Based on the body mass index (BMI) Z score, and in accordance with the World Health Organization (WHO) cut-off, among children over 2 years, 9% were diagnosed as overweight or obese, 54% were within the normal range and 37% were underweight at time of admission. In the underweight group, 43% were mildly, 21.2% were moderately and 35.8% were severely underweight. Based on the weight for length Z score in patients less than 2 years of age at time of admission, 6% were overweight, 60% were in normal range and 34% were underweight. Among children with malnutrition, 21% had mild, 3.0% had moderate and 10% had severe malnutrition. No significant meaningful relation was found between prevalence of malnutrition and severity of illness. In the moderate to severe undernutrition group, nutritionist counseling was done. Comparison of BMI and weight, before and after admission (the baseline and the follow up visits), was done by means of repeated measurements. Comparison of the patient’s weight at time of admission with weight at 1, 2 and 3 months after the first nutritional consultation showed statistically meaningful difference (P value &lt; 0.05). Conclusion: Growth indices need to be evaluated in every hospitalized child. Nutritional consultation is useful in children with malnutrition. The main purpose of early diagnosis of malnutrition is to prevent its progression, and also to design a useful, applicable and cost-effective nutritional intervention for malnutrition treatment

Assessing the prevalence and treatment of malnutrition in hospitalized children in Mofid Children's Hospital during 2015-2016

Background: Malnutrition in hospitalized patients causes problems in treatment and increases hospitalization duration. The aim of this research was to determine the prevalence of malnutrition in hospitalized children. Methods: Children aged 1 month to 18 years (n = 1186) who were admitted to medical and surgery wards of Mofid children’s hospital from November 2015 to February 2016, entered the study. We measured different anthropometric variables in patients with malnutrition. Also, nutritional counseling was performed and three months follow-up was done. Results: Patient data were registered in questionnaires particularly for children 2 years old and less. 597 children under 2 years of age and 607 children over two years entered the study. The data analysis was done by SPSS version 22.0 (Chicago, IL, USA). The t test inferential method was used in comparing variables. P values less than 0.05 were considered statistically significant. Based on the body mass index (BMI) Z score, and in accordance with the World Health Organization (WHO) cut-off, among children over 2 years, 9% were diagnosed as overweight or obese, 54% were within the normal range and 37% were underweight at time of admission. In the underweight group, 43% were mildly, 21.2% were moderately and 35.8% were severely underweight. Based on the weight for length Z score in patients less than 2 years of age at time of admission, 6% were overweight, 60% were in normal range and 34% were underweight. Among children with malnutrition, 21% had mild, 3.0% had moderate and 10% had severe malnutrition. No significant meaningful relation was found between prevalence of malnutrition and severity of illness. In the moderate to severe undernutrition group, nutritionist counseling was done. Comparison of BMI and weight, before and after admission (the baseline and the follow up visits), was done by means of repeated measurements. Comparison of the patient’s weight at time of admission with weight at 1, 2 and 3 months after the first nutritional consultation showed statistically meaningful difference (P value &lt; 0.05). Conclusion: Growth indices need to be evaluated in every hospitalized child. Nutritional consultation is useful in children with malnutrition. The main purpose of early diagnosis of malnutrition is to prevent its progression, and also to design a useful, applicable and cost-effective nutritional intervention for malnutrition treatment

Estimated dates of HCV subtypes origin, as obtained under model combinations A to F.

<p>(A) Subtype 1a, cluster A. (B) subtype 1b, cluster B. (C) subtype 3a, cluster D. (D) subtype 3a, cluster E (see text for further details). The bars show the 95% credible intervals of each estimate.</p