Search

Aim: To assess the proportion of patients with asthma or chronic obstructive pulmonary disease (COPD) with significant bronchoobstruction who do not have inspiratory flows necessary for the adequate use of dry powder inhaler (DPI) devices Diskus and Turbuhaler., Patients and Methods: multicentre cross-sectional study that included 400 patients with asthma or COPD (with FEV1 < 60%) aged 5-91 years tested during exacerbation or usual control visit. All patients underwent lung function testing and measurement of inspiratory flows using In-check Dial., Results: Significantly lower proportion of patients didn't have inspiratory flows necessary for the regular adequate use of Diskus than for Turbuhaler (21.0% vs 87.0%, chi2 = 350.72, p < 0.0001). In patients tested during exacerbation these proportions were marginally greater. Regression analysis showed a weak association of inspiratory flows measured with different resistance settings with parameters of lung function (best association was seen between resistance setting for Diskus and PEF [%], r2 = 0.104)., Conclusions: Significant proportion of patients with asthma or COPD with significant bronchoobstruction do not exhibit satisfactory inspiratory flows for the use of dry powder inhaler (DPI) devices (Diskus < Turbuhaler). Spirometry is not to be used for selection of the device for drug application and In-check Dial should be used instead.

Intense industrial development has been accompanied by the production of wastewaters of very complex content, which pose a serious hazard to the environment, put at risk sustainable development, and call for new treatment technologies that would more effectively address the issue. One particular challenge in terms of science and technology is how to biodegrade xenobiotics such as azo dyes, which practically do not degrade under natural environmental conditions. These compounds tend to bioaccumulate in the environment, and have allergenic, carcinogenic, mutagenic, and teratogenic properties for humans. Removal of azo dyes from effluents is mostly based on physical-chemical methods. These methods are often very costly and limited, as they accumulate concentrated sludge, which also poses a significant secondary disposal problem, or produce toxic end-products. Biotechnological approach may offer alternative, lowcost biological treatment systems that can completely biodegrade and detoxify even the hard-to-biodegrade azo dyes.

The global use of guidelines for proper diagnosis and management of asthma was worldwide aimed toward obtaining effective control of asthma. Until now, the most often used guidelines in Croatia were the ones issued by the Global Initiative for Asthma (GINA). Their implementation significantly improved and uniformed the diagnosis and management of asthma at different levels of the national health system. The obtained level of knowledge has enabled the making of local guidelines which acknowledge economic, cultural and even traditional specificities of Croatia. It was supposed that Croatian medical professionals would more effectively use guidelines they actively supported to prepare and which were appropriated to local work environment and medicines available. Therefore, based on current scientific evidence, the Croatian Respiratory Society has prepared Croatian Guidelines for Diagnosis and Management of Asthma in Adults purposed for wide use among Croatian doctors and other health professionals.

The allergic rhinitis (AR) is an important risk factor for the development of asthma. In significant number of patients with AR, the non-specific bronchial hyperresponsiveness (BHR) could be demonstrated. It has been anticipated that these patients were at the greater risk for asthma. This study was aimed to determine the frequency and intensity of BHR in patients with seasonal AR (SAR) due to Wall pellitory allergy. The patients who were sensitized solely to Parietaria officinalis (Wall pellitory) pollen allergen were recruited in the study, namely patients with SAR (n = 26), SAR with seasonal asthma (n = 23) as well as healthy volunteers (n = 10). In all subjects the clinical check-up, spirometry and bronchial challenge test with metacholine were performed before, during the peak, and after the peak of pollination of pellitory. Comparing to initial findings (23%), in patients with SAR the prevalence of BHR significantly increased during the peak of pollination (50%, p = 0.0039), and remained increased thereafter (43%, p = 0.0319). In patients with SAR and asthma prevalence and intensity of BHR was even higher with the similar seasonal variations. Comparing to initial findings (83%), the prevalence of BHR significantly increased during the peak of season (100%, p = 0.0001), and remained increased thereafter (87%, p = 0.061). In both groups of patients the intensity of BHR (median PC20) increased as well: 4.8, 2.05, and 2.45 mg/mL in patients with SAR, and 0.35, 0.16, and 0.20 mg/mL in patients with SAR and asthma. In healthy volunteers no significant BHR was observed. The results of the present study confirm significant prevalence of BHR in patients with SAR due to pellitory allergy. It is important to determine BHR in patients with SAR and without asthma because the appropriate pharmacotherapeutic and preventive measures (anti-inflammatory medication and specific immunotherapy) could prevent the development of asthma in these patients.