Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.info:eu-repo/semantics/publishedVersio

Redox-Active Drug, MnTE-2-PyP5+, Prevents and Treats Cardiac Arrhythmias Preserving Heart Contractile Function

Background. Cardiomyopathies remain among the leading causes of death worldwide, despite all efforts and important advances in the development of cardiovascular therapeutics, demonstrating the need for new solutions. Herein, we describe the effects of the redox-active therapeutic Mn(III) meso-tetrakis(N-ethylpyridinium-2-yl)porphyrin, AEOL10113, BMX-010 (MnTE-2-PyP5+), on rat heart as an entry to new strategies to circumvent cardiomyopathies. Methods. Wistar rats weighing 250-300 g were used in both in vitro and in vivo experiments, to analyze intracellular Ca2+ dynamics, L-type Ca2+ currents, Ca2+ spark frequency, intracellular reactive oxygen species (ROS) levels, and cardiomyocyte and cardiac contractility, in control and MnTE-2-PyP5+-treated cells, hearts, or animals. Cells and hearts were treated with 20 μM MnTE-2-PyP5+ and animals with 1 mg/kg, i.p. daily. Additionally, we performed electrocardiographic and echocardiographic analysis. Results. Using isolated rat cardiomyocytes, we observed that MnTE-2-PyP5+ reduced intracellular Ca2+ transient amplitude, without altering cell contractility. Whereas MnTE-2-PyP5+ did not alter basal ROS levels, it was efficient in modulating cardiomyocyte redox state under stress conditions; MnTE-2-PyP5+ reduced Ca2+ spark frequency and increased sarcoplasmic reticulum (SR) Ca2+ load. Accordingly, analysis of isolated perfused rat hearts showed that MnTE-2-PyP5+ preserves cardiac function, increases SR Ca2+ load, and reduces arrhythmia index, indicating an antiarrhythmic effect. In vivo experiments showed that MnTE-2-PyP5+ treatment increased Ca2+ transient, preserved cardiac ejection fraction, and reduced arrhythmia index and duration. MnTE-2-PyP5+ was effective both to prevent and to treat cardiac arrhythmias. Conclusion. MnTE-2-PyP5+ prevents and treats cardiac arrhythmias in rats. In contrast to most antiarrhythmic drugs, MnTE-2-PyP5+ preserves cardiac contractile function, arising, thus, as a prospective therapeutic for improvement of cardiac arrhythmia treatment

Validation of app and phone versions of the Control of Allergic Rhinitis and Asthma Test (CARAT)

Assessment of asthma control at every opportunity is recommended. Control of Allergic Rhinitis and Asthma Test (CARAT) is a patient reported outcome measure commonly used to assess asthma control in clinical practice.It includes ten questions answered in a 4 point Like rt scale that address upper and lower airway symptoms, sleep interference, limitation of activities , and the need to increase medication over a 4 week period. CARAT is frequently administered on paper during medical visits, but digital versions through website and mobile apps are available.info:eu-repo/semantics/publishedVersio

Resultados de Pesquisa em Nutrição de Aves no Brasil: Resumo dos Ultimos 5 anos Results of Poultry Nutrition Research in Brazil: A Summary of the Last 5 years

Foi realizada uma revisão bibliográfica sobre as pesquisas brasileiras na área de nutrição avícola, entre 1994 a l999. Nesse período, foi publicado um total de 496 trabalhos, com uma média de 82,7 trabalhos/ ano. Os trabalhos na área de nutrição revelaram que 64,52% foram realizados com frangos de corte; 24,19%, com poedoiras e aves de reposição; 3,93%, com matrizes pesadas; e 7,66%, com outras aves. Com relação às publicações em forma de resumos expandidos, foram publicados 226 e 163 resumos, nos Anais das Reuniões Anuais da Fundação APINCO de Ciência e Tecnologia Avícolas e da Sociedade Brasileira de Zootecnia, respectivamente. Na Revista da Sociedade Brasileira de Zootecnia e no Arquivo Brasileiro de Medicina Veterinária e Zootecnia foram publicados, respectivamente, 65 e 34 trabalhos completos. Os pesquisadores das instituições UFV, UNESP-Jaboticabal e UFRGS publicaram no total 104, 92 e 46 trabalhos. As pesquisas concentraram-se principalmente nas áreas de proteína/aminoácidos (21,77%), avaliação de alimentos (21,77%), minerais (19,15%) e aditivos (16,33%).<br>A literature review of the papers published in the area of poultry nutrition was done considering Brazilian publications from the period of 1994 to 1999. During this period a total of 496 papers were published, with an average of 82. 7 papers/year. The publications in nutrition revealed that 64. 52% were made with broiler chickens, 24. 19% with laying hens and replacement birds, 3.93% with broiler breeders and 7.66% with other type of birds. Considering the publications in the form of summary, 226 and 163, were published in the Proceedings of Fundação APINCO de Ciência e Tecnologia Avícola and Sociedade Brasileira de Zootecnia, respectively. In the Revista da Sociedade Brasileira de Zootecnia and Arquivo Brasileiro de Medicina Veterinária e Zootecnia were published, 65 and 34 papers, respectively. Researches in the Universities UFV, UNESP-Jaboticabal and UFRGS, accounted for a total 104, 92 and 46 papers, respectively. The papers in poultry nutrition concentrated mainly in the area of protein/amino acid (21.77%), feedstuffs evaluation (21.77%), minerals (19.15%) and additives (16.33%)