Skin prick test reactivity to aeroallergens in Jordanian allergic rhinitis patients.
Journal - Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-?i??iyah li-sharq al-mutawassi? (Egypt )
Identification of the most common aeroallergens to which patients are sensitized in a specific area is important in the diagnosis and treatment of allergic rhinitis. The aim of this cross-sectional study was to investigate the pattern of skin prick test reactivity to various aeroallergens among allergic rhinitis patients attending outpatient clinics in Amman, Jordan. Skin prick test with 18 standardized allergen extracts was performed on 538 patients. Most allergic rhinitis patients in the study sample had polysensitization. Grasses mix (51.4% of patients), thistleweed (46.9%) and olive tree (45.3%) pollens were the most common allergens in this group of patients (all seasonal). Cat allergen was the most common perennial allergen (41.6%), followed by dust mite Dermatophagoides pteronyssinus (32.9%). These allergens should be given the highest priority when educating allergic rhinitis patients in Amman regarding allergen avoidance strategies.
A cross-sectional study evaluating the relationship between cortisol suppression and asthma control in patients with difficult asthma.
Journal - British journal of clinical pharmacology (England )
AIM: To examine the relationship between cortisol suppression and asthma symptoms in patients with difficult asthma. METHODS: Patients, referred to a specialist difficult asthma service and who fulfilled the criteria for difficult asthma, were recruited to the study in a sequential, unselected manner. At each clinic visit, all patients completed a validated asthma control questionnaire. For measuring cortisol suppression, early morning urinary cortisol [corrected for creatinine to give urinary cortisol creatinine ratio (UCC ratio)] was used. The urine samples were collected and stored at -70 degrees C until ready for analysis. Urinary cortisol was extracted (solid-phase extraction) and analysed using high-performance liquid chromatography. The Pearson correlation coefficient was used for correlation analysis while t-tests were used for between-group differences for normally distributed data. If the data were not normally distributed, nonparametric statistics were used. A P-value < 0.05 was considered statistically significant. RESULTS: During the study period all the patients who attended the difficult asthma clinic and fulfilled the criteria for difficult asthma (n = 66) agreed to take part in the study. There were moderate to strong and significant associations between several measures of asthma control and UCC ratio. The correlation coefficient with five indicators of asthma control ranged between 0.3 and 0.5 (P < 0.05). CONCLUSIONS: We have demonstrated a relationship between cortisol suppression and asthma control in difficult asthmatics on high-dose steroid therapy. We have proposed a model based on the relationship between symptom control and cortisol suppression, whereby both adherence and therapeutic adjustments could potentially be made. A properly controlled prospective clinical trial should examine the utility of this approach in clinical practice.
|ISSN : ||0306-5251|
|Mesh Heading : ||Adult Aged Anti-Asthmatic Agents Anti-Inflammatory Agents Asthma Cross-Sectional Studies Female Humans Hydrocortisone Male Middle Aged|
|Mesh Heading Relevant : ||therapeutic use therapeutic use drug therapy therapeutic use|
Assessment of impairment in health-related quality of life in patients with difficult asthma: psychometric performance of the Asthma Quality of Life Questionnaire.
Journal - Respirology (Carlton, Vic.) (Australia )
OBJECTIVE AND BACKGROUND: To understand the effects of asthma and its treatment and to draw accurate conclusions with respect to different management programmes, including clinical trials. In more severe asthmatics, it is imperative that the health-related quality of life (HRQL) be measured accurately and validly. This study had a twofold objective: (i) to examine the psychometric characteristics of the Asthma Quality of Life Questionnaire (AQLQ) in patients with difficult asthma, and (ii) to explore to what extent suffering from asthma affects the HRQL in patients with difficult asthma. METHODS: Eighty-six adult patients with difficult asthma (33 men) participated in the study. RESULTS: The internal consistency reliability (alpha) ranged from 0.80 (environment subscale) to 0.96 (overall score), and the 2- to 4-week reproducibility (intraclass correlation coefficients) ranged from 0.82 (environment subscale) to 0.92 (overall score).The AQLQ correlated significantly with an asthma disease severity scale, the EQ-5D, and the visual analogue scale indicator of global quality of life (P < 0.0001). No relationship was found between the AQLQ score and FEV1%. CONCLUSIONS: The results suggest that the AQLQ may be a useful outcome measure for clinical trials in severe asthmatics. The results of this study showed that the HRQL in patients with difficult asthma is substantially impaired. The dominant feature of this group is high symptom scores, with environmental exposure scoring lowest. Mean AQLQ values for this group compared with published means from other less severe asthmatics suggest that patients with difficult asthma experience clinically significant, poorer health-related quality of life. This study presents the poorest health-related quality of life reported in patients with asthma.
|ISSN : ||1323-7799|
|Mesh Heading : ||Adult Asthma Female Humans Male Outcome Assessment (Health Care) Prognosis Psychometrics Severity of Illness Index|
|Mesh Heading Relevant : ||Health Status Quality of Life Questionnaires psychology methods methods|
Relationship between lung function and asthma symptoms in patients with difficult to control asthma.
Journal - The Journal of asthma : official journal of the Association for the Care of Asthma (United States )
Several studies have demonstrated a poor relationship between measures of asthma control and lung function in patients with asthma. We sought to examine this relationship in a cohort of difficult to control asthmatics attending a hospital outpatient clinic. FEV1 % and asthma control scores (ACSs) were measured at the first clinic visit and at a follow-up visit. A total of 59 patients took part in the study. At the initial visit, FEV1 % correlated with limitation of activity (p = 0.002), shortness of breath (p = 0.02), wheezing (p = 0.029), and ACS (p = 0.014). However, at follow-up, there was no correlation between FEV1 % and any measured index of asthma control. When patients with severe fixed airflow obstruction were excluded from the analysis (n = 16), FEV1 % at follow-up became significantly correlated with night waking (p = 0.02), wheezing (p = 0.05), and ACS (p = 0.036). The improvement in asthma control score at follow-up was significantly and strongly associated (r = 0.51 for total asthma control, p < 0.001) with the improvement in lung function in patients without severe fixed airflow obstruction. Lung function was not associated with any measure of asthma control in patients with severe fixed airflow obstruction. FEV1 % correlates well with asthma symptoms in difficult asthma patients with poor control but not when control improves. This loss of relationship is due to subjects with severe fixed airflow obstruction where good subjective control does not exclude the presence of significant obstruction. How severe fixed airflow obstruction should be prevented, delayed, or managed in asthma requires further research.
|ISSN : ||0277-0903|
|Mesh Heading : ||Adult Aged Airway Obstruction Anti-Asthmatic Agents Asthma Cohort Studies Dyspnea Exercise Tolerance Female Humans Male Middle Aged Outpatient Clinics, Hospital Respiratory Function Tests Respiratory Sounds Severity of Illness Index drug therapy etiology therapeutic use complications drug therapy etiology etiology|
|Mesh Heading Relevant : ||diagnosis diagnosis|
Dried blood spot liquid chromatography assay for therapeutic drug monitoring of metformin.
Journal - Journal of chromatography. B, Analytical technologies in the biomedical and life sciences (Netherlands )
The use of blood spot collection cards is a simple way to obtain specimens for analysis of drugs for the purpose of therapeutic drug monitoring, assessing adherence to medications and preventing toxicity in routine clinical setting. We describe the development and validation of a microanalytical technique for the determination of metformin from dried blood spots. The method is based on reversed phase high-performance liquid chromatography with ultraviolet detection. Drug recovery in the developed method was found to be more than 84%. The limits of detection and quantification were calculated to be to be 90 and 150 ng/ml, respectively. The intraday and interday precision (measured by CV%) was always less than 9%. The accuracy (measured by relative error, %) was always less than 12%. Stability analysis showed that metformin is stable for at least 2 months when stored at -70 degrees C. The small volume of blood required (10 microL), combined with the simplicity of the analytical technique makes this a useful procedure for monitoring metformin concentrations in routine clinical settings. The method is currently being applied to the analysis of blood spots taken from diabetic patients to assess adherence to medications and relationship between metformin level and metabolic control of diabetes.
|ISSN : ||1570-0232|
|Mesh Heading : ||Humans Hypoglycemic Agents Metformin Reference Standards Sensitivity and Specificity therapeutic use therapeutic use|
|Mesh Heading Relevant : ||Drug Monitoring blood blood|
Validation of a comprehensive classification tool for treatment-related problems.
Journal - Pharmacy world & science : PWS (Netherlands )
OBJECTIVE : Several drug-related problem classification systems can be found in the literature. However, it is generally agreed that a comprehensive, well constructed and validated instrument is currently lacking. The aim of this study is the development and validation of a comprehensive treatment-related problems assessment and classification tool for use in teaching, practicing and researching pharmaceutical care and to improve identification, resolving and preventing of treatment-related problems. METHOD : The development and validation involved five steps starting with literature search to define a treatment related problem and also to form a database of treatment-related problems identified in the literature. In the next step, all problems that were identified in the first step and passed the evaluation of the three authors were pooled together and then divided into groups according to their common or shared construct, in the third step a suitable assessment method was developed according to the construct of the different problems, in the next step the developed instrument was validated for content, internal and external validity. Finally the tool was finalized and tested for reproducibility and inter-rater agreement. RESULTS : The final validated version included six main categories for treatment-related problems (Indication, Effectiveness, Safety, Knowledge, Adherence and Miscellaneous). These categories include a total of nine subcategories and a total of 29 treatment related problems. CONCLUSION : The treatment-related problems assessment and classification tool introduced in this paper was applied to actual patient cases and proved to be valid. This tool also has several features that are new.
|ISSN : ||0928-1231|
|Mesh Heading : ||Adverse Drug Reaction Reporting Systems Developing Countries Drug Therapy Education, Pharmacy Health Knowledge, Attitudes, Practice Humans Jordan Patient Care Planning Patients Pharmaceutical Services Pharmacists Professional Role Reproducibility of Results Students, Pharmacy Teaching Time Factors methods trends statistics & numerical data standards statistics & numerical data statistics & numerical data methods|
|Mesh Heading Relevant : ||classification adverse effects|
The development and validation of liquid chromatography method for the simultaneous determination of metformin and glipizide, gliclazide, glibenclamide or glimperide in plasma.
Journal - Journal of chromatography. B, Analytical technologies in the biomedical and life sciences (United States )
This article describes the development of SPE and HPLC methods for the simultaneous determination of metformin and glipizide, gliclazide, glibenclamide or glimperide in plasma. Several extraction and HPLC methods have been described previously for the determination of each of these analytes in plasma separately. The simultaneous determination of these analytes is important for the routine monitoring of diabetic patients who take combination medications and for studying the pharmacokinetics of the combined dosage forms. In addition this developed method can serve as a standard method for the plasma determination of these analytes therefore saving time, effort and money. The recoveries of the developed methods were found to be between 76.3% and 101.9%. The limits of quantification were between 5 and 22.5 ng/ml. The intraday and interday precision (measured by coefficient of variation, CV%) was always less than 9%. The accuracy (measured by relative error %) was always less than 12%. Stability analysis showed that all analytes are stable for at least 3 months when stored at -70 degrees C.
|ISSN : ||1570-0232|
|Mesh Heading : ||Chromatography, High Pressure Liquid Gliclazide Glipizide Glyburide Humans Hypoglycemic Agents Metformin Reference Standards Sensitivity and Specificity|
|Mesh Heading Relevant : ||methods blood blood blood blood blood|