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- Laryngeal sensory neuropathy in patients with diabetes mellitus. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Jul 22.:1-5.
Objective: To determine the prevalence of laryngeal sensory neuropathy in patients with type 2 diabetes mellitus. Methods: A cross-sectional study was performed, comprising 50 patients diagnosed with type 2 diabetes mellitus and 36 healthy controls. In the diabetic group, glycaemic control level, disease duration and presence of neuropathy were assessed. Participants were diagnosed with laryngeal sensory neuropathy if they had a cough, globus pharyngeus or throat clearing lasting for more than six weeks, in the absence of laryngopharyngeal reflux disease, allergies, asthma, angiotensin-converting enzyme inhibitor intake or psychogenic disorders. Results: In the diabetic group, the mean age ± standard deviation was 44.66 ± 10.07 years. Sixty per cent of patients were male, 42 per cent had had diabetes for more than five years and 52 per cent had average to poor glycaemic control. The prevalence of laryngeal sensory neuropathy was 42 per cent in the diabetic group, compared with 13.9 per cent in controls; this difference was statistically significant (p = 0.005). There was no association between the prevalence of laryngeal sensory neuropathy and glycaemic control level, disease duration or presence of neuropathy. Conclusion: Laryngeal sensory neuropathy is more common in patients with type 2 diabetes mellitus than in controls.
- Association Between Quality Of Life In Parents And Components Of Asthma Control In Children. [JOURNAL ARTICLE]
- J Asthma 2014 Jul 22.:1-17.
Abstract Objective: Describe the association between parents' quality of life and the two components of asthma control in children: impairment and risk. Methods: Cross-sectional study with children between 4 and 14 years of age with active asthma recruited at primary care centers in Spain. Asthma control was assessed according to the Third National Asthma Expert Panel Report, classifying "impairment" in three levels (well controlled asthma, partially controlled and poorly controlled), and "risk" as high or low. The parents' quality of life was evaluated using the specific Family Impact of Childhood Bronchial Asthma Questionnaire instrument (IFABI-R). The association between asthma control and the parents' quality of life was analyzed using multivariate regression models adjusted for other social and family variables. Results: Data from 408 children were analyzed. The parents' quality of life was affected in the partially controlled asthma group when compared with well controlled asthma, as showed by an increase in IFABI-R scores in all dimensions: functional 17.2% (p<0.001), emotional 10.4% (p=0.021), socio-occupational 6.8% (p=0.056). The differences were higher in poorly controlled asthma compared with well controlled asthma: functional 24.3% (p=0.001), emotional 18.9% (p=0.008), socio-occupational 11.5% (p=0.036). The "risk" component was independently associated with the parents' quality of life. Of all the elements used to assess the control the only one independently associated with the parents' quality of life was recurrent asthma crisis. Conclusions: In asthma control, both "impairment" and "risk" in children are gradually associated with the parents' quality of life. The global assessment of the control surpasses the importance of each individual element used in this assessment.
- Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma. [JOURNAL ARTICLE]
- J Asthma 2014 Jul 22.:1-25.
Abstract Objective: The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. Methods: We conducted a secondary data analysis of asthma self-efficacy using the 2009 and 2011-2012 California Health Interview Survey, in adults with asthma (n = 7874). In order to examine if and how the effect of race /ethnicity and income on asthma self-efficacy may have been altered by health status, acculturation, and health care factors, we used staged multivariable logistic regression models. We conducted mediation analyses to evaluate which of these factors might mediate disparities in self-efficacy by race/ethnicity and income. Results: 69.8% of adults reported having high asthma self-efficacy. Latinos (OR 0.66; 95% CI 0.51-0.86), African-Americans (OR 0.50; 95% CI 0.29-0.83), American Indian/Alaskan Natives (OR 0.55; 95% CI 0.31-0.98), and Asian/Pacific Islanders (OR 0.34; 95% CI 0.23-0.52) were less likely to report high self-efficacy compared to Whites. Individuals with income below the federal poverty level (OR 0.56; 95% CI 0.40-0.78) were less likely to report high self-efficacy compared to higher income individuals. The relationship between income and self-efficacy was no longer significant after further adjustment for health care factors; however, the differences in race and ethnicity persisted. Receiving an asthma management plan mediated the relationship in certain subgroups. Conclusions: Addressing modifiable health care factors may play an important role in reducing disparities in asthma self-efficacy.
- The Effect of Beclometasone Dipropionate/Formoterol Extra-Fine Fixed Combination on the Peripheral Airway Inflammation in Controlled Asthma. [JOURNAL ARTICLE]
- J Aerosol Med Pulm Drug Deliv 2014 Jul 22.
Abstract Background: Suppression of small airway inflammation may contribute to achieving asthma control. We aimed to evaluate the additional effect of beclometasone dipropionate/formoterol (BDP/F) hydrofluoroalkane (HFA) pressurized metered dose inhaler (pMDI) (BDP/F-HFA 100/6 μg pMDI) on airway inflammation and functional parameters in asthma cases, who were optimally controlled by maintenance therapy. Methods: Ninety-five controlled asthmatic patients were included. They were grouped as Group 1 [budesonide/formoterol 320/9 μg dry powder inhaler (DPI)] and Group 2 (fluticasone/salmeterol 500/50 μg DPI) according to the combination they used. Then Group 3 was established by random selection from these two groups, and BDP/F-HFA 100/6 μg pMDI treatment was prescribed. All patients were evaluated in the beginning of the study and were re-evaluated at the end of a 3-week treatment period by spirometry, exhaled nitric oxide (eNO) levels, and small airway functional indices, namely, Sacin and Scond values. Results: There was no significant statistical difference in terms of age, height, weight, disease duration, symptoms, and spirometric parameters between the groups. There was a significant decrease in eNO levels in asthma cases who were on BDP/F-HFA therapy (p=0.001). A significant improvement in Sacin values at the end of the treatment period was observed in cases treated with BDP/F-HFA (p=0.001), indicating that inflammation was suppressed in peripheral airways. Conclusions: These results emphasize that asthma treatment has mainly focused on the strategy to keep the disease under control; maintaining optimal functional level might be underestimated. BDP/F-HFA may have an additional favorable effect on the peripheral airway inflammation in the controlled asthma.
- Exercise Training, Lymphocyte Subsets and Their Cytokines Production: Experience of an Italian Professional Football Team and Their Impact on Allergy. [JOURNAL ARTICLE]
- Biomed Res Int 2014.:429248.
Background. In recent years, numerous articles have attempted to shed light on our understanding of the pathophysiological mechanisms of exercise-induced immunologic changes and their impact on allergy and asthma. It is known that lymphocyte subclasses, cytokines, and chemokines show modifications after exercise, but outcomes can be affected by the type of exercise as well as by its intensity and duration. Interesting data have been presented in many recent studies on mouse models, but few studies on humans have been performed to check the long-term effects of exercise over a whole championship season. Methods. This study evaluated lymphocyte subsets and their intracellular IL-2, IL-4, TNF-α, and IFN-γ production in professional football (soccer) players, at three stages of the season, to evaluate if alterations occur, particularly in relation to their allergic status. Results and Conclusion. Despite significant mid-season alterations, no significant lymphocyte subclasses count modifications, except for NKs that were significantly higher, were observed at the end. IL-2 and IL-4 producing cells showed a significant decrease (P = 0.018 and P = 0.001, but in a steady fashion for IL-4), confirming the murine data about the potential beneficial effects of aerobic exercise for allergic asthma.
- The effect of natural adjuvants (G2, G2F) on lung inflammation of sensitized guinea pigs. [Journal Article]
- Avicenna J Phytomed 2013; 3(4):364-70.
Objective:The effects of natural adjuvants were examined on total and differential WBC counts in lung lavage of sensitized guinea pigs. Materials and
Methods:In three sensitized groups of guinea pigs including: untreated sensitized animals (S), sensitized animals treated with adjuvant G2 (S+G2) and G2F (S+G2F) as well as non-sensitized group (C) (n=6 for each group), total and differential WBC counts of lung lavage were examined. Sensitization of animals was achieved by injection and inhalation of ovalbumin (OA).
Results:The results showed increased total WBC, eosinophil, neutrophil, and basophil counts, and decreased lymphocytes in lung lavage of sensitized animals compared with the control group (p<0.01 for all cases). However, neutrophil, lymphocyte, eosinophil, and basophil counts in lung lavage were decreased in treated groups with either G2 or G2F but total WBC was decreased in lung lavage of treated group with only G2.
Conclusion:These results indicate important preventive effects of two natural adjuvants, especially G2, on lung inflammation of sensitized guinea pigs.
- Hydroalcoholic extract of Crocus sativus effects on bronchial inflammatory cells in ovalbumin sensitized rats. [Journal Article]
- Avicenna J Phytomed 2013; 3(4):356-63.
Objective:Inflammation is one of the major components of asthma. Our aim was to evaluate the effects of C. sativus extract on total and differential white blood cells (WBC) count in lung lavage fluid (LLF) of ovalbumin-sensitized rats. Materials and
Methods:Forty rats were divided into five groups (n = 8 for each group) as control (C), sensitized with injection and inhalation of ovalbumin (OA) alone (S), and three groups of sensitized and treated with different doses of C. sativus extract (S50EX, S100EX, and S200EX groups). Total and differential WBC counts of LLF were evaluated in control, sensitized, and treated sensitized groups.
Results:Total WBC count, neutrophil, and eosinophil percentage in LLF were increased in sensitized animals compared with the control group (p0.001). Treatment of sensitized animals with all doses of the extract significantly reduced WBC number and the percentage of neutrophil and eosinophil compared with the sensitized animals (p0.01-0.001).
Conclusion:According to these results, the extract of C. sativus could be effective on alleviating lung inflammatory cells specially eosinophils in lung lavage of sensitized animals which may indicate a preventive effect of this plant on lung inflammation in asthma.
- Preventive effects of hydroalcoholic extract of saffron on hematological parameters of experimental asthmatic rats. [Journal Article]
- Avicenna J Phytomed 2013; 3(3):279-87.
Objective:Asthma is a chronic inflammatory disease of the respiratory airways distinguished by edema and infiltration of inflammatory immune cells. To test our hypothesis about the anti-inflammatory effect of saffron, we examined effects of Crocus sativus (C. sativus) extract as a prophylactic anti-inflammatory agent in sensitized rats. Materials and
Methods:To induce experimental asthma, rats were sensitized with injection and inhalation of ovalbumin (OA). Forty male Wistar rats were divided into 5 groups (n=8 for each): control, sensitized (asthma), and sensitized and pretreated with three different concentrations of extract, 50, 100, and 200 mg/kg, 2 times a week (group asthma+50EX, group asthma+100EX, and group asthma+200EX). After 32 days, total white blood cells (WBC) counts, red blood cells (RBC), and platelet counts in blood were examined.
Results:Total WBC number and eosinophil and neutrophil percentage in blood were increased, but lymphocyte decreased in sensitized animals compared with those of control group (p<0.05 to p<0.001). We observed also elevated levels in RBC and platelet counts after sensitization in the asthma group. Pretreatment of sensitized rats in all concentrations decreased WBC count which was significant in first two concentrations (p<0.01 compared with group asthma). All concentrations of extract decreased eosinophil percentage significantly (p<0.001 compared with group asthma), however, for neutrophil percentage this improvement was not significant. Lymphocyte percentage increased in group asthma+100EX compared with group asthma (p<0.05). Moreover, in all concentrations, the extract reduced RBC and platelet count in pretreated sensitized rats compared with group asthma (p<0.01 to p<0.001).
Conclusion:Our findings indicated that the extract of C. sativus could be useful to prevent asthma as an anti-inflammatory treatment.
- Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries. [Journal Article]
- Multidiscip Respir Med 2014; 9(1):38.
Chronic respiratory diseases, like bronchial asthma and chronic obstructive pulmonary disease (COPD), are a worldwide health problem. Quantitative and qualitative assessment of asthma and COPD-related research from Arab countries has not been explored and there are few internationally published reports on such field. The main objectives of this study were to analyze research output originating from Arab countries in the field of bronchial asthma and COPD.Original scientific articles or reviews published from the 22 Arab countries were screened using specific words pertaining to asthma and COPD using Scopus database and search engine. Research productivity was evaluated based on: (a) total and trends of contribution of each Arab country to asthma and COPD research and (b) journals in which researchers from Arab countries published their research.The total number of original research and review articles published globally about bronchial asthma and COPD was 163,964. The leading country in bronchial asthma and COPD research was United States of America (38,632; 23.56%). Worldwide, Turkey ranked 19th while Israel and Iran ranked 25th and 29th respectively. Among Arab countries, Egypt and Kingdom of Saudi Arabia came on positions 39th and 43rd, respectively. A total of 1,304 documents about bronchial asthma and COPD were published from Arab countries which represents 0.8% of the global research output. Research in bronchial asthma was almost double that in COPD. Research from Arab countries was low and showed a significant increase after 2000. Approximately 12% of research activity in asthma and COPD from Arab countries was published in Saudi Medical Journal, Annals of Saudi Medicine, Eastern Mediterranean Health Journal and Tunisie Medicale. Kingdom of Saudi Arabia, with a total publication of 353 (27.07%) ranked first among the Arab countries while University of Kuwait was the most productive institution with a total of 123 (9.43%) documents.The present data showed relatively low research productivity about bronchial asthma and COPD in Arab countries. Research output can be improved by investing more in international and national collaborative research projects in the field of asthma and COPD.
- Two Potent OXE-R Antagonists: Assignment of Stereochemistry. [Journal Article]
- ACS Med Chem Lett 2014 Jul 10; 5(7):815-9.
5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is formed by the oxidation of 5-hydroxy-6E,8Z,11Z,14Z-eicosatetraenoic acid (5-HETE), which is a major metabolite of enzymatic oxidation of arachidonic acid (AA). 5-Oxo-ETE is the most potent lipid chemoattractant for human eosinophils. Its actions are mediated by the selective OXE receptor, which is therefore an attractive target in eosinophilic diseases such as allergic rhinitis and asthma. Recently, we have reported two excellent OXE receptor antagonists that have IC50 values at low nanomolar concentrations. Each of these antagonists has a chiral center, and the isolation of the individual enantiomers by chiral high-performance liquid chromatography (HPLC) revealed that in each case one enantiomer is over 300 times more potent than the other. To unambiguously assign the stereochemistry of these enantiomers and to provide access to larger amounts of the active compounds for biological testing, we report here their total synthesis.