• Title/Summary/Keyword: Secondary Disease

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Direct Switch from Tiotropium to Indacaterol/Glycopyrronium in Chronic Obstructive Pulmonary Disease Patients in Korea

  • Lee, Sang Haak;Rhee, Chin Kook;Yoo, Kwangha;Park, Jeong Woong;Yong, Suk Joong;Kim, Jusang;Lee, Taehoon;Lim, Seong Yong;Lee, Ji-Hyun;Park, Hye Yun;Moon, Minyoung;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.96-104
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    • 2021
  • Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV1) ≥50%, post-bronchodilator FEV1/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV1 at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV1 versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

PM2.5 in poultry houses synergizes with Pseudomonas aeruginosa to aggravate lung inflammation in mice through the NF-κB pathway

  • Li, Meng;Wei, Xiuli;Li, Youzhi;Feng, Tao;Jiang, Linlin;Zhu, Hongwei;Yu, Xin;Tang, Jinxiu;Chen, Guozhong;Zhang, Jianlong;Zhang, Xingxiao
    • Journal of Veterinary Science
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    • v.21 no.3
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    • pp.46.1-46.18
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    • 2020
  • Background: High concentrations of particulate matter less than 2.5 ㎛ in diameter (PM2.5) in poultry houses is an important cause of respiratory disease in animals and humans. Pseudomonas aeruginosa is an opportunistic pathogen that can induce severe respiratory disease in animals under stress or with abnormal immune functions. When excessively high concentrations of PM2.5 in poultry houses damage the respiratory system and impair host immunity, secondary infections with P. aeruginosa can occur and produce a more intense inflammatory response, resulting in more severe lung injury. Objectives: In this study, we focused on the synergistic induction of inflammatory injury in the respiratory system and the related molecular mechanisms induced by PM2.5 and P. aeruginosa in poultry houses. Methods: High-throughput 16S rDNA sequence analysis was used for characterizing the bacterial diversity and relative abundance of the PM2.5 samples, and the effects of PM2.5 and P. aeruginosa stimulation on inflammation were detected by in vitro and in vivo. Results: Sequencing results indicated that the PM2.5 in poultry houses contained a high abundance of potentially pathogenic genera, such as Pseudomonas (2.94%). The lung tissues of mice had more significant pathological damage when co-stimulated by PM2.5 and P. aeruginosa, and it can increase the expression levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α through nuclear factor (NF)-κB pathway in vivo and in vitro. Conclusions: The results confirmed that poultry house PM2.5 in combination with P. aeruginosa could aggravate the inflammatory response and cause more severe respiratory system injuries through a process closely related to the activation of the NF-κB pathway.

The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial

  • Derakhshan, Ali Reza;Saeidinejat, Shahin;Khadem-Rezaiyan, Majid;Asnaashari, Amir-Mohammad-Hashem;Mirsadraee, Majid;Salari, Roshanak;Jabbari-Azad, Farahzad;Jalali, Shima;Jalali, Shabnam
    • Journal of Pharmacopuncture
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    • v.25 no.3
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    • pp.233-241
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    • 2022
  • Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

Expert Opinion Questionnaire About Chest CT Scan Using A Negative Pressure Isolation Strecher in COVID-19 Patients: Image Quality and Infection Risk (COVID-19 환자에서 음압격리들것을 이용한 흉부 CT 검사에 대한 전문가 의견 설문: 영상품질과 감염위험)

  • Kwang Nam Jin;Bo Da Nam;Jaemin Shin;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.891-899
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    • 2023
  • Purpose To survey perceptions of certified physicians on the protocol of chest CT in patients with coronavirus (COVID-19) using a negative pressure isolation stretcher (NPIS). Materials and Methods This study collected questionnaire responses from a total of 27 certified physicians who had previously performed chest CT with NPIS in COVID-19 isolation hospitals. Results The nine surveyed hospitals performed an average of 116 chest CT examinations with NPIS each year. Of these, an average of 24 cases (21%) were contrast chest CT. Of the 9 pulmonologists we surveyed, 5 (56%) agreed that patients who showed abnormalities in serum D-dimer required contrast chest CT. All 9 surveyed radiologists agreed that the image quality of the chest CT with NPIS was sufficient for CT image interpretation regarding pneumonia or pulmonary embolism. Furthermore, in our 9 surveyed infectionologists, 5 (56%) agreed that a risk of secondary infection in the CT room after temporary opening of NPIS could be prevented through a process of disinfection. Conclusion Experienced physicians considered that the effects of NIPS on chest CT image quality was minimal in patients with COVID-19, and the risk of CT room contamination was easily controlled.

Change of Dendritic Cell Subsets Involved in Protection Against Listeria monocytogenes Infection in Short-Term-Fasted Mice

  • Young-Jun Ju;Kyung-Min Lee;Girak Kim;Yoon-Chul Kye;Han Wool Kim;Hyuk Chu;Byung-Chul Park;Jae-Ho Cho;Pahn-Shick Chang;Seung Hyun Han;Cheol-Heui Yun
    • IMMUNE NETWORK
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    • v.22 no.2
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    • pp.16.1-16.20
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    • 2022
  • The gastrointestinal tract is the first organ directly affected by fasting. However, little is known about how fasting influences the intestinal immune system. Intestinal dendritic cells (DCs) capture antigens, migrate to secondary lymphoid organs, and provoke adaptive immune responses. We evaluated the changes of intestinal DCs in mice with short-term fasting and their effects on protective immunity against Listeria monocytogenes (LM). Fasting induced an increased number of CD103+CD11b- DCs in both small intestinal lamina propria (SILP) and mesenteric lymph nodes (mLN). The SILP CD103+CD11b- DCs showed proliferation and migration, coincident with increased levels of GM-CSF and C-C chemokine receptor type 7, respectively. At 24 h post-infection with LM, there was a significant reduction in the bacterial burden in the spleen, liver, and mLN of the short-term-fasted mice compared to those fed ad libitum. Also, short-term-fasted mice showed increased survival after LM infection compared with ad libitum-fed mice. It could be that significantly high TGF-β2 and Aldh1a2 expression in CD103+CD11b- DCs in mice infected with LM might affect to increase of Foxp3+ regulatory T cells. Changes of major subset of DCs from CD103+ to CD103- may induce the increase of IFN-γ-producing cells with forming Th1-biased environment. Therefore, the short-term fasting affects protection against LM infection by changing major subset of intestinal DCs from tolerogenic to Th1 immunogenic.

Measurement of Quality of Life related to Health by demographic characteristics of adult patients with cancer using EQ-5D Index -Focused on the Korea Health & Nutrition Examination Survey- (EQ-5D Index 이용 성인 암 환자의 인구사회학적 특성별 건강관련 삶의 질 측정 -국민건강영양조사를 중심으로-)

  • Kim, Jong-Geu;Kwon, Lee-Seung
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.281-291
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    • 2013
  • This study is the secondary statistical analysis calculating the quality of life of patients with cancer by giving the integrative weight based on National Health and Nutrition Examination Survey data of the Centers for Disease Control for five years from 2007 to 2011 for the first time in Korea. The results of measurement showed that the number of cancer patients was 201, which accounted for about 0.8 % of 26,260 subjects. The quality of life of cancer patients was higher when they had lower age(p<0.0001), more professional occupations(p<0.0001), and higher educational history(p=0.0002). When they lived in apartment(p<0.0001), got unmarried(p<0.0001), the quality of life was higher. In particular, the measurement of quality of life of cancer patients based on type of health insurance was the result of new study for the first time in Korea.

The Usefulness of Blink Reflex in the Evaluation of Early Stage of Bell's Palsy (발병초기 벨마비 환자의 진단에서 순목 반사(blink reflex)의 유용성)

  • Seok, Jung Im;Lee, Dong Kuck;Kim, Chang-Hyeong
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.25-28
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    • 2012
  • Background: Bell's palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell's palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell's palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell's palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex, but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell's palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell's palsy, although it could be normal in patients with mild Bell's palsy.

Symptom Clusters in Korean Patients with Acute Myocardial Infarction (급성 심근경색 환자의 증상클러스터)

  • Park, Eunjin;Lee, Jia
    • Journal of Korean Academy of Nursing
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    • v.45 no.3
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    • pp.378-387
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    • 2015
  • Purpose: Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. Methods: The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. Results: Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p =.040; F=3.62, p =.006, respectively). Conclusion: Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

Diabetes, Overweight and Risk of Postmenopausal Breast Cancer: A Case-Control Study in Uruguay

  • Ronco, Alvaro L.;Stefani, Eduardo De;Deneo-Pellegrini, Hugo;Quarneti, Aldo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.139-146
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    • 2012
  • Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

Role of dietary nucleotides to mitigate post-weaning stress in newly weaned pigs

  • Shin, Taeg Kyun;Wickramasuriya, Samiru Sudharaka;Cho, Hyun Min;Kim, Eunjoo;Kim, Younghwa;Park, Juncheol;Macelline, Shemil Priyan;Heo, Jung Min;Yi, Young-Joo
    • Korean Journal of Agricultural Science
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    • v.44 no.4
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    • pp.477-486
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    • 2017
  • This review provides an overview of dietary nucleotides as an alternative to in-feed antibiotics for weaning pigs. Dietary nucleotides are composed of DNA or RNA molecules and are normally contained in protein-rich feed ingredient, brewer's yeast, yeast extract, and milk. Weaning pigs are suffering from several stresses, such as environmental challenges (i.e. crowding, transportation, and feeding). Such stressors can damage the intestinal epithelium and cause an invasion by Escherichia coli, secondary inflammatory responses, and post weaning diarrhea. To overcome weaning disorder, people often use antibiotics which reduce symptoms and boost growth performance. However, since antibiotics were banned due to concerns of antibiotic resistant bacteria, researchers are studying alternative materials to antibiotics. Dietary nucleotides are one of the alternative materials for replacing antibiotics and can be used in abnormal conditions, such as weaning diarrhea, low digestibility, and disease condition. Nucleotides have substances that have important roles in cell division and cell growth, affecting growth performance, intestinal condition, and immunological effect at the weaning stage. However, nucleotides' composition is very different between sources and this aspect makes it difficult to utilize nucleotides at the weaning stage. Therefore, this review paper focuses on i) the characteristics and functions of dietary nucleotides and ii) the effect of dietary nucleotides on the growth performance and immune system of pigs.