Dual bronchodilator in the era of triple therapy

Pharmacological medications used for the treatment of COPD patients have increased significantly. Long-acting bronchodilators have been recognized as the mainstay of the treatment of stable COPD, while ICS are usually added in patients with COPD who experience exacerbations, despite bronchodilator treatment. In the latest years, several studies have been published showing the beneficial effect of adding ICS on dual bronchodilation in patients suffering from more severe disease comparing triple therapy with several therapeutic regiments including dual bronchodilation and providing a message that this triple therapy might be more appropriate for COPD patients. However, not all COPD patients have a desirable response to ICS treatment while long-term ICS use in COPD is associated with several side effects. In this report, we aimed to provide a review of the current knowledge on the importance of dual bronchodilation on COPD patients and to compare its use with triple therapy, by covering a wide spectrum of topics. Finally, we propose an algorithm on performing treatment step up from dual bronchodilation to triple therapy and step down from triple to double bronchodilation considering the current evidence. © 2020 Papaioannou et al

Determination of enterobacteria in air and wastewater samples from a wastewater treatment plant by epi-fluorescence microscopy

Δημοσίευση σε επιστημονικό περιοδικόSummarization: Bacteria, fungi and viruses are often encountered in aerosols and they can be pathogenic or cause allergies following inhalation. Wastewater treatment facilities have been found to generate bioaerosols, which are transported by the prevailing winds downstream to areas that can be up to several hundred meters away. Bioaerosol formation has a significant effect on air quality in the vicinity of the treatment plants. The amount and characteristics of the formed bioaerosols depend on the aeration system employed at the aeration tank of the wastewater treatment facility. In this work we determined Enterobacteria in air and wastewater samples at the main wastewater treatment facility of the city of Chania (Crete, Greece). Concentrations of airborne bacteria were measured near the aeration and sedimentation tanks. Samples of airborne bacteria were taken by using Merck’s MAS-100 bioaerosol collector followed by incubation and enumeration of the colonies. The use of different growth media enabled the separation and enumeration of several classes of microorganisms. As part of this study, Enterobacteria in air samples were also determined by filtration sampling followed by analysis of the collected microorganisms using DAPI staining to determine total cell counts (both viable and non-viable cells). Fluorescence in situ hybridization (FISH) with specific 23S rRNA probes was also used in order to identify specific groups of microorganisms (well known pathogens) present in the bioaerosols. The analysis was also performed in wastewater taken from the aeration and secondary sedimentation tanks in an effort to correlate the airborne bacteria with those in the wastewater.Presented on: Water, Air, and Soil Pollution: Focu