Efficacy of theophylline in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis

Objectives: To determine the efficacy of oral theophylline compared with placebo in people with stable chronic obstructive pulmonary disease (COPD).Methods: Systematic review of randomized-controlled trials comparing oral Theophylline; with placebo for a minimum of 7 days in people with stable COPD.Results: Twenty randomized-controlled trials were included in this review. the Meta-analysis; following outcomes showed significant improvement with theophylline compared with placebo: FEV, and FVC both improved with theophylline (weighted mean difference [WMD] 0.10 L; 95% confidence interval [95% CI] 0.04-0.16 and WMD 0.21 L; 95% CI 0.10-0.32, respectively). VO2 max also improved with theophylline (WMD 195.27mL/ min; 95% Cl 112.71-277.83), as did PaO2 and PaCO2 (WMD 3.18mmHg;,95% Cl 1.23-5.13 and WMD -2.36mmHg; 95% Cl -3.52 to -1.21, respectively). Patients preferred theophylline over placebo (relative risk 2.27; 95% Cl 1.26-4.11). Theophylline increased the risk of nausea compared with placebo (RR 7.67; 95% Cl 1.47-39.94).Conclusion: This review has shown that theophylline still has a role in the management of stable COPD, and is preferred by patients over placebo. However, the benefits of theophylline in stable COPD have to be weighed against the risk of adverse effects. (C) 2004 Elsevier B.V. All rights reserved.Natl Collaborating Ctr Womens & Childrens Hlth, London, EnglandUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilEmergency Med Div, São Paulo, BrazilFed Univ Alagoas, Vasc Dis Div, São Paulo, BrazilUNIFESP, Div Resp, Pulm Rehabil Ctr, São Paulo, BrazilUniv Toronto, W Pk Healthcare Ctr, Toronto, ON, CanadaUniv Laval, Hop Laval, Ctr Pneumol, Inst Cardiol & Pneumol, Laval, PQ, CanadaUniversidade Federal de São Paulo, Div Internal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilUNIFESP, Div Resp, Pulm Rehabil Ctr, São Paulo, BrazilUniversidade Federal de São Paulo, Div Internal Med, São Paulo, BrazilWeb of Scienc

Effectiveness of Asthma Inhaler Pharmacotherapy must take into consideration both the device and drug and which is guided by clinically meaningful outcomes

Introduction: The&nbsp; inhalation&nbsp; route&nbsp; remains&nbsp; the&nbsp; mainstay&nbsp; of&nbsp; therapy&nbsp; for asthma&nbsp; and&nbsp; chronic obstructive&nbsp; pulmonary&nbsp; disease&nbsp; (COPD). This confers&nbsp; a&nbsp; number&nbsp; of&nbsp; advantages&nbsp; such&nbsp; as&nbsp; delivery&nbsp; of medication&nbsp; directly&nbsp; to&nbsp; the site of&nbsp; action&nbsp; resulting&nbsp; in&nbsp; faster onset. It also allows&nbsp; smaller&nbsp; doses&nbsp; to&nbsp; be&nbsp; administered&nbsp; and therefore significantly reduces systemic side effects compared with oral therapy. The drug treatment regime for the majority of patients&nbsp; with&nbsp; asthma&nbsp; and&nbsp; COPD is straightforward and is documented in many guidelines [1-3]. However, the choice of which inhaler device to use is less straightforward. Rather than being spoilt for choice, we are frequently confused by the ever-increasing&nbsp; number&nbsp; of&nbsp; devices&nbsp; available.&nbsp; Although&nbsp; inhalation therapy&nbsp; is&nbsp; now&nbsp; the&nbsp; mainstay&nbsp; of&nbsp; asthma&nbsp; treatment,&nbsp; for&nbsp; most patients&nbsp; such&nbsp; treatment&nbsp; is&nbsp; still&nbsp; not&nbsp; optimal.</p

Notes for genera – Ascomycota

Knowledge of the relationships and thus the classification of fungi, has developed rapidly with increasingly widespread use of molecular techniques, over the past 10--15 years, and continues to accelerate. Several genera have been found to be polyphyletic, and their generic concepts have subsequently been emended. New names have thus been introduced for species which are phylogenetically distinct from the type species of particular genera. The ending of the separate naming of morphs of the same species in 2011, has also caused changes in fungal generic names. In order to facilitate access to all important changes, it was desirable to compile these in a single document. The present article provides a list of generic names of Ascomycota (approximately 6500 accepted names published to the end of 2016), including those which are lichen-forming. Notes and summaries of the changes since the last edition of `Ainsworth Bisby's Dictionary of the Fungi' in 2008 are provided. The notes include the number of accepted species, classification, type species (with location of the type material), culture availability, life-styles, distribution, and selected publications that have appeared since 2008. This work is intended to provide the foundation for updating the ascomycete component of the ``Without prejudice list of generic names of Fungi'' published in 2013, which will be developed into a list of protected generic names. This will be subjected to the XIXth International Botanical Congress in Shenzhen in July 2017 agreeing to a modification in the rules relating to protected lists, and scrutiny by procedures determined by the Nomenclature Committee for Fungi (NCF). The previously invalidly published generic names Barriopsis, Collophora (as Collophorina), Cryomyces, Dematiopleospora, Heterospora (as Heterosporicola), Lithophila, Palmomyces (as Palmaria) and Saxomyces are validated, as are two previously invalid family names, Bartaliniaceae and Wiesneriomycetaceae. Four species of Lalaria, which were invalidly published are transferred to Taphrina and validated as new combinations. Catenomycopsis Tibell Constant. is reduced under Chaenothecopsis Vain., while Dichomera Cooke is reduced under Botryosphaeria Ces. De Not. (Art. 59)