Beliefs and preferences regarding biological treatments for severe asthma

Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies. We aimed to explore the beliefs and practices in the use of biological therapies in severe asthma, hypothesizing that differences will occur depending on the prescribers’ specialty and experience. Methods: We conducted an online survey composed of 35 questions in English. The survey was circulated via the INterasma Scientific Network (INESNET) platform as well as through social media. Responses from allergists and pulmonologists, both those with experience of prescribing omalizumab with (OMA/IL5) and without (OMA) experience with anti-IL5 drugs, were compared. Results: Two hundred eighty-five (285) valid questionnaires from 37 countries were analyzed. Seventy-on percent (71%) of respondents prescribed biologics instead of oral glucocorticoids and believed that their side effects are inferior to those of Prednisone 5 mg daily. Agreement with ATS/ERS guidelines for identifying severe asthma patients was less than 50%. Specifically, significant differences were found comparing responses between allergists and pulmonologists (Chi-square test, p < 0.05) and between OMA/IL5 and OMA groups (p < 0.05). Conclusions: Uncertainties and inconsistencies regarding the use of biological medications have been shown. The accuracy of prescribers to correctly identify asthma severity, according to guidelines criteria, is quite poor. Although a substantial majority of prescribers believe that biological drugs are safer than low dose long-term treatment with oral steroids, and that they must be used instead of oral steroids, every effort should be made to further increase awareness. Efficacy as disease modifiers, biomarkers for selecting responsive patients, timing for outcomes evaluation, and checks need to be addressed by further research. Practices and beliefs regarding the use of asthma biologics differ between the prescriber's specialty and experience; however, the latter seems more significant in determining beliefs and behavior. Tailored educational measures are needed to ensure research results are better integrated in daily practice

The genus Sternbergia

Abstract Morpho-anatomical and karyologial studies were carried out on plants from S Italy of the three Italian species of the genus Sternbergia: S. colchiciflora, S. lutea and S. sicula. The morpho-anatomical features of the leaves are good taxonomic markers, especially concerning their colour, general shape, width and morphology of the median adaxial keel. Karyological analysis revealed the following chromosome complements: Sternbergia colchiciflora, 2n = 20; Sternbergia lutea, 2n = 22; Sternbergia sicula, 2n = 22. Karyotype variability is discussed in the light of previous literature. According to our results S. colchiciflora is confirmed to be the most isolated species, while S. lutea and S. sicula, easily recognizable on morphological grounds, appear instead very close karyologically

Karyomorphology and systematics of the eastern taxa of Genista

A karyological analysis of some taxa of Genista sect. Spartioides, distributed in the eastern part of the Mediterranean region, was carried out. The three subspecies of Genista pulchella: ssp. pulchella (western Balkan Peninsula), ssp. aquilana (central Apennines) and ssp. villarsiana (southern France) all present the chromosome number 2n = 18 + (0 - 4B). The taxa of G. albida aggr., G. albida (eastern Mediterranean) and G. involucrata (Ana- tolian), both have 2n = 18 + (0 - 2B); 2n = 36 + (0 - 3B) being rarely found in the latter species. As regards the taxa endemic to the Balkan Peninsula, G. halacsyi and G. subcapitata show 2n = 18 + (0 - 2B), G. sakellariadis and G. millii 2n = 36 + 2B. All these numbers may be traced back to the basic number x = 9. G. pulchella has the most symmetric karyotype, while G. albida and G. involucrata result more asymmetric; the four Balkan endemics (G. halacsyi, G. sakellariadis, G. subcapitata and G. millii) present the highest grade of asymmetry. A comparison with karyological data already available for all the taxa of sect. Spartioides was also made