Obesity and Obstructive Airways Disease: Clinical Correlates and Therapeutic Considerations

Obese patients are more likely to suffer from severe asthma symptoms and less likely to be able to control them. In obese patients, there is evidence that shows decreased efficacy of inhaled corticosteroids and beta-2 adrenergic agonists, the core treatment options for achieving and maintaining asthma control. This may be due to mechanical reasons like decreased ventilation and medication delivery, but there are many more pathologies of obesity that interact with pathways of both asthma pathology and asthma control. This review explores the epidemiological significance of obesity, many physiological changes in patients with obesity, the physiological interactions of asthma and obesity in patients with both issues, and the therapeutic impacts of these interactions with asthma to find appropriate areas where new research is needed. More research to understand the mechanism of decreased inhaled corticosteroid and beta-2 adrenergic agonist efficacy is necessary to improve treatment efficacy and decrease morbidity and mortality in this population of patients with asthma

SOWFIA Project - Work Package 3 Interim Report

The Streamlining of Ocean Wave Farms Impact Assessment (SOWFIA) Project (IEE/09/809/ SI2.558291) is an EU Intelligent Energy Europe (IEE) funded project that draws together ten partners, across eight European countries, who are actively involved with planned wave farm test centres. The SOWFIA project aims to achieve the sharing and consolidation of pan-European experience of consenting processes and environmental and socio-economic impact assessment (IA) best practices for offshore wave energy conversion developments. Studies of wave farm demonstration projects in each of the collaborating EU nations are contributing to the findings. The study sites comprise a wide range of device technologies, environmental settings and stakeholder interests. Through project workshops, meetings, on-going communication and networking amongst project partners, ideas and experiences relating to IA and policy are being shared, and co-ordinated studies addressing key questions for wave energy development are being carried out. The overall goal of the SOWFIA project is to provide recommendations for approval process streamlining and European-wide streamlining of IA processes, thereby helping to remove legal, environmental and socio-economic barriers to the development of offshore power generation from waves. By utilising the findings from technology-specific monitoring at multiple sites, SOWFIA will accelerate knowledge transfer and promote European-wide expertise on environmental and socio-economic impact assessments of wave energy projects. In this way, the development of the future, commercial phase of offshore wave energy installations will benefit from the lessons learned from existing smaller-scale developments

Enabling Wave Power: Streamlining processes for progress

The Streamlining of Ocean Wave Farms Impact Assessment (SOWFIA) Project (IEE/09/809/ SI2.558291) is an EU Intelligent Energy Europe (IEE) funded project that draws together ten partners, across eight European countries, who are actively involved with planned wave farm test centres. The SOWFIA project aims to achieve the sharing and consolidation of pan-European experience of consenting processes and environmental and socio-economic impact assessment (IA) best practices for offshore wave energy conversion developments. Studies of wave farm demonstration projects in each of the collaborating EU nations are contributing to the findings. The study sites comprise a wide range of device technologies, environmental settings and stakeholder interests. Through project workshops, meetings, on-going communication and networking amongst project partners, ideas and experiences relating to IA and policy are being shared, and co-ordinated studies addressing key questions for wave energy development are being carried out. The overall goal of the SOWFIA project is to provide recommendations for approval process streamlining and European-wide streamlining of IA processes, thereby helping to remove legal, environmental and socio-economic barriers to the development of offshore power generation from waves. By utilising the findings from technology-specific monitoring at multiple sites, SOWFIA will accelerate knowledge transfer and promote European-wide expertise on environmental and socio-economic impact assessments of wave energy projects. In this way, the development of the future, commercial phase of offshore wave energy installations will benefit from the lessons learned from existing smaller-scale developments

Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management

BACKGROUND: Cyclic Vomiting Syndrome (CVS) is a disorder characterized by recurrent, stereotypic episodes of incapacitating nausea, vomiting and other symptoms, separated by intervals of comparative wellness. This report describes the clinical features, co-morbidities and problems encountered in management of 41 adult patients who met the diagnostic criteria for CVS. METHODS: This is a retrospective study of adults with CVS seen between 1994 and 2003. Follow-up data were obtained by mailed questionnaires. RESULTS: Age of onset ranged from 2 to 49 years. The duration of CVS at the time of consultation ranged from less than 1 year to 49 years. CVS episodes were stereotypic in respect of their hours of onset, symptomatology and length. Ninety-three percent of patients had recognizable prodromes. Half of the patients experienced a constellation of symptoms consisting of CVS episodes, migraine diathesis, inter-episodic dyspeptic nausea and a history of panic attacks. Deterioration in the course of CVS is indicated by coalescence of episodes in time. The prognosis of CVS is favorable in the majority of patients. CONCLUSION: CVS is a disabling disorder affecting adults as well as children. Because its occurrence in adults is little known, patients experience delayed or mis-diagnosis and ineffectual, sometimes inappropriately invasive management

Indomethacin reduces the antihypertensive action of enalapril

We evaluated the influence of indomethacin on the pharmacological actions of Enalapril in 9 uncomplicated essential hypertensives. While on chronic treatment with Enalapril, these patients randomly received indomethacin (50 mg bid) or a corresponding placebo for 1 week and the opposite treatment after a 2 week interval. Indomethacin, which decreased serum thromboxane B2 and urinary 6-keto prostaglandin-F1 alpha, reduced the plasma renin activity (PRA) increased by Enalapril. Indomethacin did not modify serum ACE, whose activity had been reduced by the ACE inhibitor. Mean blood pressure (MBP) values, which were significantly and to a similar extent reduced by Enalapril at the beginning of the cross-over, after placebo addition and at the end of the two week interval, were significantly increased by indomethacin, despite being still significantly lower than baseline values. These data show that systemic and renal prostaglandin (PG) synthesis inhibition induced by indomethacin can blunt the antihypertensive effect of chronic Enalapril treatment in patients with essential hypertension