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REGULAR VERSUS RESCUE BUDESONIDE AND FORMOTEROL COMBINATION FOR MODERATE ASTHMA: A NON INFERIORITY RANDOMISED CLINICAL TRIAL
No full textSmall airway abnormalities in asthmatic patients with persistent airflow limitation
No full textBackground
A subset of patients with asthma develops persistent airflow limitation (PAL) despite optimal treatment. The role of small airways dysfunction (SAD) in this phenotype, and its relationship with symptoms, remains incompletely understood.
Objectives
To assess small airways function in asthmatic patients with PAL and compare it with patients with fully reversible asthma and with COPD; and to explore correlations between small airway indices and patient-reported outcomes.
Methods
We enrolled 60 patients (20 with asthma and PAL, 20 with fully reversible asthma, 20 with COPD) matched for age, sex, and pre-bronchodilator FEV1. Small airways function was evaluated using impulse oscillometry (IOS; R5–R20) and single-breath nitrogen washout test (SBNWT; dN2). Patients completed a daily symptom diary (dyspnea, cough, sputum, and rescue medication use) over four weeks.
Results
Compared with fully reversible asthma, asthmatic patients with PAL showed significantly higher dN2 and R5–R20 values, though less pronounced than in COPD. SAD (R5–R20 > 0.07 kPa·L−1·s) was present in all COPD patients, 79% of PAL patients, and 37% of reversible asthma patients (p < 0.001). In PAL, R5–R20 correlated strongly with dyspnea scores (r = 0.64, p < 0.001). In reversible asthma, R5–R20 correlated with cough and rescue medication use, whereas in COPD, symptoms were primarily related to residual volume.
Conclusions
Small airways dysfunction is highly prevalent in asthmatic patients with PAL and significantly contributes to daily symptom burden. Its intermediate severity between COPD and reversible asthma suggests that SAD plays a central role in the pathogenesis of fixed obstruction, suggesting a potential role for targeted diagnostic and therapeutic strategies
Assessing small airway impairment in mild-to-moderate smoking asthmatic patients
No full textAsthma is characterised by airway inflammation throughout the bronchial tree, including the small airways. In asthma, small airway alterations are associated with poor clinical outcomes [1]. Cigarette smoke is known to induce peripheral airway abnormalities, asthmatic smokers exhibit a more rapid lung function decline, experience more frequent exacerbations and are more likely to be uncontrolled, even when the disease is managed as recommended [2]. The mechanisms accounting for poor responses to treatment in smoking asthmatic patients are currently unclear, although low accessibility to inhaled medications in the peripheral airways is considered a limiting factor for the efficacy of such treatments [3]
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Midazolam in flexible bronchoscopy premedication: effects on patient-related and procedure-related outcomes.
No full textBACKGROUND
The role of midazolam in flexible bronchoscopy premedication has been debated. The aim of the present study was to evaluate whether midazolam premedication increases the patient-reported tolerance and the physician-reported or nurse-reported feasibility of bronchoscopy.
METHODS:
Randomized, double-blinded, placebo-controlled, 3-arm study. The study population included patients undergoing bronchoscopy for appropriate clinical indications. Patients were randomly assigned to receive 0.035 mg/kg intravenous midazolam (low dose), 0.07 mg/kg (high dose), or placebo. Vital parameters were monitored in continuum during the procedure. At the end of the procedure, the operating physician and assisting nurse filled out a questionnaire to score the procedure-related outcomes (satisfaction, feasibility, completeness, and unexpected events). Patients were asked to fill out a specific questionnaire to assess the patient-reported tolerance and satisfaction 2 hours after the bronchoscopy.
RESULTS:
A total of 100 patients (mean age 58.6±1.0; 57% male) were included in the study (33 in the low-dose midazolam group, 34 in the high-dose midazolam group, and 33 in the placebo group). The patient-reported tolerance score was significantly higher in the high-dose midazolam group than in the placebo group (P<0.01). No differences were found in the 3 groups in terms of the physician-reported feasibility and completeness of the procedure. In the groups of patients premedicated with midazolam, significant oxygen desaturation was recorded (at 10 and 8 min after the introduction of the bronchoscope) compared with the baseline value (P<0.01).
CONCLUSIONS:
In our study, premedication with midazolam increased the patient-reported tolerance of the bronchoscopy. However, the absence of premedication did not affect the diagnostic yield of the procedure
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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