Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

peer reviewedBackground: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non–oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non–OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction. © 202

Experimental studies on thermal behaviour and diurnal activity rhythms of juvenile European sturgeons (Acipenser sturio)

International audienceExperiments were performed to determine the temperature preference of juvenile sturgeons. The biorhythms of activity and the location of fish in a thermal gradient of an electronic shuttlebox were registered. The fish showed dominant 24 h activity rhythms with its maximum at the nightime. A temperature preference range or an active thermoregulatory behavior could not be demonstrated by our experiments. The behavior of sturgeons was influenced by temperature; activity and swimming speed were positively correlated to rising temperatures. There are indications that the fish could have been attracted by low light intensities at night.Ne connaissant quasiment rien de l'écologie des phases juvéniles de l'esturgeon A. sturio et ne pouvant y avoir accès directement à cause de la faiblesse du stock, il est apparu utile d'appréhender le comportement des juvéniles indirectement par des études en laboratoire. Pour cela un dispositif à deux compartiments développé pour une autre espèce a été adapté à l'esturgeon. Les animaux utilisés ont un peu plus d'un an (Lm = 27cm ; Pm = 125g). Aucun preferendum thermique marqué n'a pu être mis en évidence dans la gamme 8-24°C. L'activité des animaux est plus importante durant la phase nocturne. Le comportement (activité et vitesse de nage) est corrélé positivement à la température. Il y a des indications pour penser que les animaux étaient attirés par une faible source lumineuse en période nocturne

Effects of water depth and hydrodynamics on the growth and distribution of juvenile cyprinids in the littoral zone of a large pre-alpine lake.

In enclosure experiments in the littoral zone of Lake Constance, Germany, juvenile cyprinids showed significantly reduced somatic growth in the shallow eulittoral zone (0 to 5 m depth)compared to the sublittoral zone (1 to 6 m depth). Growth was especially reduced in larger and more deep-bodied fish groups, providing evidence that this is due to increased hydrodynamic stress, induced by ship and wind waves, in the shallow habitats compared to the deep habitat. Other factors such as water temperature and food availability seemed to be of minor importance for the observed growth differences. Gillnet catches at the experimental site and an adjacent site showed that most juvenile cyprinids, including the species from the enclosure study, bream Abramis brama and dace Leuciscus leuciscus, nonetheless prefer shallow habitats compared to deeper sublittoral habitats. Juvenile cyprinids in Lake Constance may prefer these shallow habitats as refuges against larger piscivorous predators, mainly perch Perca fluviatilis, despite the cost in terms of reduced somatic growth indicating that juvenile cyprinids first of all optimize survival rate instead of somatic growth rate

Inleiding

Background: EUS-guided FNA is currently advocated in lung cancer staging guidelines as an alternative for surgical staging to prove mediastinal metastases. To date, training requirements for chest physicians to obtain competency in EUS for lung cancer staging are unknown. Objective: To test a training and implementation strategy for EUS for the diagnosis and staging of lung cancer. Design: Prospective national multicenter implementation trial. Nine (chest) physicians from 5 hospitals participated in a dedicated EUS educational program (investigation of 50 patients) for the diagnosis and staging of lung cancer. EUS outcomes Of trainees were compared with those of the training center. Setting: Four general hospitals, the national cancer center (implementation centers), and a tertiary referral center (expert center). Patients: This study involved 551 consecutive patients with (suspected) lung cancer, all candidates for surgical staging, who underwent EUS in 1 of the 5 implementation centers (n = 346) or the single expert center (n = 205). Surgical-pathological staging was the reference standard in case no tnediastinal metastases were found. Results: EUS had a sensitivity Of 83% versus 82% and accuracy Of 89% versus 88% For mediastinal nodal Staging (implementation center vs expert center). Surgery was spared because of EUS findings in 51% versus 54% of patients. A single complication occurred in each group. Limitation: Surgical-pathological verification Of mediastinal nodes was not available in all patients staged negative at EUS. Conclusion: Chest physicians who participate in a dedicated training and implernentation program for EUS in king Cancer Staging Call Obtain results similar to those of experts for mediastinal nodal staging. (Gastrointest Endose 2010;71:641-70.)Pathogenesis and treatment of chronic pulmonary disease