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Didier Cataldo,1 Eric Derom,2 Giuseppe Liistro,3 Eric Marchand,4,5 Vincent Ninane,6 Rudi Peché7 Hans Slabbynck,8 Walter Vincken,9 Wim Janssens10 1Department of Respiratory Medicine, Centre Hospitalier Universitaire de Liège (CHU) and University of Liège, Liège, Belgium; 2Department of Respiratory Medicine, Ghent University Hospital, Gent, Belgium; 3Department of Respiratory Medicine, University Hospitals Saint-Luc, Brussels, Belgium; 4Department of Respiratory Medicine, University Hospital UCL Namur, Yvoir, Belgium; 5URPhyM, University of Namur, Namur, Belgium; 6Department of Respiratory Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium; 7Department of Respiratory Medicine, University Hospital Vésale, Montigny-le-Tilleul, Belgium; 8Department of Respiratory Medicine, ZNA Middelheim, Antwerpen, Belgium; 9Respiratory Division, University Hospital Brussels (UZ Brussel), Vrije Universiteit Brussel, Brussels, Belgium; 10Department of Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium Abstract: Evidence and guidelines are becoming increasingly clear about imbalance between the risks and benefits of inhaled corticosteroids (ICSs) in patients with COPD. While selected patients may benefit from ICS-containing regimens, ICSs are often inappropriately prescribed with – according to Belgian market research data – up to 70% of patients in current practice receiving ICSs, usually as a fixed combination with a long-acting β2-adrenoreceptor agonist. Studies and recommendations support withdrawal of ICSs in a large group of patients with COPD. However, historical habits appear difficult to change even in the light of recent scientific evidence. We have built a collaborative educational platform with chest physicians and primary care physicians to increase awareness and provide guidance and support in this matter. Keywords: COPD, exacerbation, withdrawal, inhaled steroids, systematic review, education

Didier Cataldo,1 Jean-Louis Corhay,1 Eric Derom,2 Renaud Louis,1 Eric Marchand,3,4 Alain Michils,5 Vincent Ninane,6 Rudi Peché,7 Charles Pilette,8 Walter Vincken,9 Wim Janssens10 1Department of Respiratory Diseases, CHU Liège, University of Liège, Liège, 2Department of Respiratory Medicine, Ghent University Hospital, Ghent, 3Department of Respiratory Medicine, CHU – UCL – Namur, Université catholique de Louvain, Yvoir, 4Molecular Physiology Research Unit (URPhyM)-NARILIS, Laboratory of General Physiology, University of Namur, Namur, 5Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, 6Department of Respiratory Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles, Brussels, 7Department of Respiratory Medicine, University Hospital Vésale, Montigny-le-Tilleul, 8Department of Respiratory Medicine, Cliniques universitaires St Luc, Université Catholique de Louvain, Brussels, 9Respiratory Division, University Hospital Brussels (UZ Brussel), Vrije Universiteit Brussel, Brussels, 10Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium Introduction: Patients with chronic airway disease may present features of both asthma and COPD, commonly referred to as asthma–COPD overlap syndrome (ACOS). Recommendations on their diagnosis are diffuse and inconsistent. This survey aimed to identify consensus on criteria for diagnosing ACOS.Methods: A Belgian expert panel developed a survey on ACOS diagnosis, which was completed by 87 pulmonologists. Answers chosen by ≥70% of survey respondents were considered as useful criteria for ACOS diagnosis. The two most frequently selected answers were considered as major criteria, others as minor criteria. The expert panel proposed a minimal requirement of two major criteria and one minor criterion for ACOS diagnosis. Respondents were also asked which criteria are important for considering inhaled corticosteroids prescription in a COPD patient.Results: To diagnose ACOS in COPD patients, major criteria were “high degree of variability in airway obstruction over time (change in forced expiratory volume in 1 second ≥400 mL)” and “high degree of response to bronchodilators (>200 mL and ≥12% predicted above baseline)”. Minor criteria were “personal/family history of atopy and/or IgE sensitivity to ≥1 airborne allergen”, “elevated blood/sputum eosinophil levels and/or increased fractional exhaled nitric oxide”, “diagnosis of asthma 40 years”; “emphysema on chest computed tomography scan”.Conclusion: Specific criteria were identified that may guide physicians to a more uniform diagnostic approach for ACOS in COPD or asthma patients. These criteria are largely similar to those used to prescribe inhaled corticosteroids in COPD. Keywords: ACOS, airway obstruction, asthma, COPD, diagnosis, inhaled corticosteroids

This article discusses the surveillance and management of branch duct intraductal papillary-mucinous neoplasms (BD-IPMNs) in a real-life cohort of patients at an Italian level III center. The authors propose discontinuing follow-up after 5 years of stability in certain patient groups. The study found that the risk of malignant transformation, surgery, and death related to BD-IPMN without worrisome features or high-risk stigmata is low, particularly after 5 years of follow-up. However, the incidence and mortality of pancreatic cancer related to BD-IPMN are not negligible, emphasizing the importance of continued surveillance in some cases. [Extracted from the article]

Multiple anthropogenic stressors act simultaneously on the environment, with consequences different from those caused by single-stressor exposure. We investigated how the combination of the invasive mussel Limnoperna fortunei and a widely applied herbicide, Roundup Max®, affected freshwater microscopic communities and water quality. Further, we compared these results with those induced by the combination of the mussel and technical-grade glyphosate. We carried out a 34-day experiment in outdoor mesocosms, applying the following six treatments: 6 mg L of technical-grade glyphosate (G), the equivalent concentration of glyphosate in Roundup Max® (R), 100 mussels (M), the combination of mussels and herbicide either in the technical-grade or formulated form (MG and MR, respectively), and control (C). Herbicides significantly increased total phosphorus in water; R and MR showed greater initial total nitrogen and ammonium. R increased picoplankton abundance and caused an eightfold increase in phytoplankton, with high turbidity values; G had a lower effect on these variables. Herbicide-mussel combination induced an accelerated dissipation of glyphosate in water (MG 6.36 ± 0.83 mg G g DW day and MR 5.16 ± 1.26 mg G g DW day). A synergistic effect on ammonium was observed in MR but not in MG. MR and MG had an antagonistic effect on phytoplankton, which showed a drastic reduction due to grazing, as revealed by M. We provide evidence of differential effects of Roundup Max® and technical-grade glyphosate over water quality and microscopic communities, and in combination with mussels. However, in the combination of mussels and herbicides, mussels seem to play a leading role. In the presence of L. fortunei, the effects of higher nutrient availability provided by herbicides addition were counteracted by the filtration activity of mussels, which released nutrients, grazed on picoplankton and phytoplankton, and boosted the development of other primary producers, periphyton and metaphyton. [ABSTRACT FROM AUTHOR]

Background and objective The aim of this study was test the hypothesis that homeopathy (H) enhances the effects of scaling and root planing (SRP) in patients with chronic periodontitis (CP). Materials and Methods 50 patients with CP were randomly allocated to one of two treatment groups: SRP (C-G) or SRP + H (H-G). Assessments were made at baseline and after 3 and 12 months of treatments. The local and systemic responses to the treatments were evaluated by clinical and serologic parameters, respectively. Results Both groups displayed significant improvements, however, using clinical attachment gain and reductions in HDL, LDL and Total Cholesterol, Triglycerides, Glucose and Uric acid, from baseline to 1 year, as criteria for treatment success, H-G performed significantly better than C-G. Conclusion The findings of this 1-year follow-up randomized clinical trial suggest that homeopathic medicines, as an adjunctive to SRP, can provide significant local and systemic improvements for CP patients. [ABSTRACT FROM AUTHOR]

Abstract: A multi residue method based on the modified Quick Easy Cheap Effective Rugged and Safe (QuEChERS) sample preparation method and liquid chromatography coupled to mass spectrometry (LC–MS/MS) was adopted for the analysis of 14 pesticides in 145 vegetable samples from the intensive Sele agricultural plain in south west region of Campania, Italy, tilled by integrated pest management practices and destined to refurnish the Italian fresh cut commercial market. In 51.7% of the samples no residues were found, 41.4% of samples contained pesticide residues at or below the maximum residue level (MRL) and 2.1% of samples contained pesticide residues above MRL. Significant was also the proportion of samples, 4.8%, containing no authorized products due to incorrect agricultural practices. This was the case of Etofenprox and Dimethomorph used at levels above the MRLs. Propamocarb, cyprodinil, and boscalid were the pesticides most frequently found and were detected in 10% of the samples analysed. The application of an index of quality for residues to the analysis of data revealed that most of the analysed samples fall into the category range of excellent-good highlighting the adequacy of the products to the fresh cut market. [Copyright &y& Elsevier]

Background:Overall clinical outcome for advanced lung cancer remains very disappointing despite recent advances in treatment. Curcumin has been reported as potentially active against cancer.Methods:Owing to poor curcumin solubility, we have used cyclodextrins (CD) as an excipient allowing a considerable increase of aqueous solubility and bioavailability of curcumin. The effects of solubilised curcumin have been evaluated in cell cultures as well as in an in vivo orthotopic lung tumour mouse model.Results:Cell proliferation was reduced while apoptosis rates were increased when lung epithelial tumour cells were cultured in the presence of curcumin-CD complexes. For in vivo experiments, cells were grafted into lungs of C57Bl/6 mice treated by an oral administration of a non-soluble form of curcumin, CDs alone or curcumin-CD complexes, combined or not with gemcitabine. The size of orthotopically implanted lung tumours was reduced upon curcumin complex administration as compared with treatments with placebo or non-solubilised curcumin. Moreover, curcumin potentiated the gemcitabine-mediated antitumour effects.Conclusion:Our data demonstrate that curcumin, when given orally in a CD-solubilised form, reduces lung tumour size in vivo. In vitro experiments show impaired tumour cell proliferation and increased cell apoptosis. Moreover, our data underline a potential additive effect of curcumin with gemcitabine thus providing an efficient therapeutic option for antilung cancer therapy. [ABSTRACT FROM AUTHOR]

A new species of Stipa, endemic to Sicily, named Stipa valdemonensis is described here. The new taxon is related to Stipa crassiculmis. Owing to the small number of individuals observed, in few restricted localities only, it is assigned the IUCN threat status “vulnerable”. [ABSTRACT FROM PUBLISHER]

Background and objective The aim of this study was test the hypothesis that homeopathy (H) enhances the effects of scaling and root planing (SRP) in patients with chronic periodontitis (CP). Materials and Methods 50 patients with CP were randomly allocated to one of two treatment groups: SRP (C-G) or SRP + H (H-G). Assessments were made at baseline and after 3 and 12 months of treatments. The local and systemic responses to the treatments were evaluated by clinical and serologic parameters, respectively. Results Both groups displayed significant improvements, however, using clinical attachment gain and reductions in HDL, LDL and Total Cholesterol, Triglycerides, Glucose and Uric acid, from baseline to 1 year, as criteria for treatment success, H-G performed significantly better than C-G. Conclusion The findings of this 1-year follow-up randomized clinical trial suggest that homeopathic medicines, as an adjunctive to SRP, can provide significant local and systemic improvements for CP patients. [ABSTRACT FROM AUTHOR]

A Disintegrin and Metalloprotease (ADAM) are transmembrane proteases displaying multiple functions. ADAM with ThromboSpondin-like motifs (ADAMTS) are secreted proteases characterised by thrombospondin (TS) motifs in their C-terminal domain. The aim of this work was to evaluate the expression pattern of ADAMs and ADAMTS in non small cell lung carcinomas (NSCLC) and to investigate the possible correlation between their expression and cancer progression. Reverse transcriptase-polymerase chain reaction (RT-PCR), Western blot and immunohistochemical analyses were performed on NSCLC samples and corresponding nondiseased tissue fragments. Among the ADAMs evaluated (ADAM-8, -9, -10, -12, -15, -17, ADAMTS-1, TS-2 and TS-12), a modulation of ADAM-12 and ADAMTS-1 mRNA expression was observed. Amounts of ADAM-12 mRNA transcripts were increased in tumour tissues as compared to the corresponding controls. In sharp contrast, ADAMTS-1 mRNA levels were significantly lower in tumour tissues when compared to corresponding nondiseased lung. These results were corroborated at the protein level by Western blot and immunohistochemistry. A positive correlation was observed between the mRNA levels of ADAM-12 and those of two vascular endothelial growth factor (VEGF)-A isoforms (VEGF-A(165) and VEGF-A(121)). Taken together, these results providing evidence for an overexpression of ADAM-12 and a lower expression of ADAMTS-1 in non-small-cell lung cancer suggest that these proteases play different functions in cancer progression. [ABSTRACT FROM AUTHOR]