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Pohunek P, Varoli G, Reznichenko Y, Mokia-Serbina S, Brzostek J, Kostromina V, Kaladze M, Muraro A, Carzana E, Armani S, Kaczmarek J. Bronchodilating effects of a new beclometasone dipropionate plus formoterol fumarate formulation via pressurized metered-dose inhaler in asthmatic children: a double-blind, randomized, cross-over clinical study. Eur J Pediatr 2021; 180:1467-1475. [PMID: 33404895 DOI: 10.1007/s00431-020-03888-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/06/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
A new pediatric fixed combination of beclometasone dipropionate (BDP) 50 μg and formoterol fumarate (FF) 6 μg via pressurized metered-dose inhaler (pMDI) (CHF1535, Chiesi, Italy) was investigated. In a double-blind, randomized, placebo-controlled, cross-over study, a single CHF1535 administration using AeroChamber Plus™ spacer device (2 actuations, total dose BDP 100 μg/FF 12 μg) was compared to the same pMDI free combination in 56 asthmatic children aged ≥ 5 and < 12 years. Primary efficacy variable was forced expiratory volume during the first second (FEV1) area under the curve corrected by time over 12 h following morning dose (AUC0-12h). Further CHF1535 doses (50 μg/6 μg, 100 μg/12 μg, and 200 μg/24 μg) were also explored. Adverse events, electrocardiogram, and vital signs were monitored for safety. CHF1535 was non-inferior to free combination [adjusted mean difference (95% CI) 0.004 L (- 0.050, 0.041] with lower confidence limit greater than the limit set at 0.1 L. FEV1 AUC0-12h of each CHF1535 dose vs placebo were 0.037 L (p = 0.160), 0.119 L (p < 0.001), and 0.094 (p < 0.001) for 50/6, 100/12, and 200/24, respectively. No safety signals were found.Conclusion: CHF1535 was as effective as free combination BDP/FF, with a trend towards a dose-related response. All treatments were safe.Trial registration: ClinicalTrials.gov ID: NCT01584492 What is Known: •Inhaled pressurized metered-dose solutions (pMDI) are the preferred treatment for pediatric asthma. •Combination therapy of inhaled corticosteroids and long-acting β2- agonists is a well-established approach to control airway inflammation and airway obstruction also in pediatric patients. What is New: •A novel pediatric pMDI fixed combination of beclomethasone dipropionate 50 μg and formoterol fumarate 6 μg (CHF 1535) was non-inferior to the free combination at the same dose in pulmonary function over the 12-h post-dose period in asthmatic children, with trend towards a dose-related response.
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Affiliation(s)
- Petr Pohunek
- Paediatric Department, University Hospital Motol, V Uvalu 84, 150 06, Praha, Czech Republic.
| | - Guido Varoli
- Global Clinical Development, Chiesi Farmaceutici S.p.A., Via Palermo 26/A, 43122, Parma, Italy
| | - Yuriy Reznichenko
- Pulmonology Department of Community Institution "Zaporizhzhya Regional Clinical Child Hospital" of Zaporizhzhya Regional Council, Zaporizhzhya State Medical University, 70 Lenina str, Zaporizhzhya, 69063, Ukraine
| | | | - Jerzy Brzostek
- Poradnia Alergologiczna, ZOZ Debica, ul., Krakowska 91, 39-200, Debica, Poland
| | - Viktoriya Kostromina
- Department of Child Pulmonology and Allergology, State Institution "National Institute of Physiatry and Pulmonology n.a. F.G. Yanovskyy of AMS of Ukraine", 10, Amosova str., Kyiv, 03680, Ukraine
| | - Mykola Kaladze
- 1st City Children Clinical Association of Simferopol City, Department of Pulmonology, Simferopol, Department of Pediatry with Physiotherapy Course of Faculty of Postgraduate Education, State Institution "Crimean State Medical University n.a. S.I. Georgiyivskiy", 31, K. Libknehta, Simferopol, Crimea, Russia
| | - Annamaria Muraro
- Global Clinical Development, Chiesi Farmaceutici S.p.A., Via Palermo 26/A, 43122, Parma, Italy
| | - Elena Carzana
- Global Clinical Development, Chiesi Farmaceutici S.p.A., Via Palermo 26/A, 43122, Parma, Italy
| | - Silvia Armani
- Global Clinical Development, Chiesi Farmaceutici S.p.A., Via Palermo 26/A, 43122, Parma, Italy
| | - Jadwiga Kaczmarek
- Outpatient Clinic of Allergology, Kopcinskiego Str 22, 90-153, Lodz, Poland
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Piccoli A, Pomiato E, Golia G, Destro G, Cacici G, Cenzi D, Armani S, Variola A, Malago" R, Ribichini F. P585Intramural haemangioma of the interventricular septum in a patient with strong family history of sudden cardiac death. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez108.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Piccoli
- University of Verona, Cardiology, Verona, Italy
| | - E Pomiato
- University of Verona, Cardiology, Verona, Italy
| | - G Golia
- University of Verona, Cardiology, Verona, Italy
| | - G Destro
- University of Verona, Cardiology, Verona, Italy
| | - G Cacici
- University of Verona, Cardiology, Verona, Italy
| | - D Cenzi
- University Hospital, Pathology and Diagnostics, Radiology Unit, Verona, Italy
| | - S Armani
- University of Verona, Cardiology, Verona, Italy
| | - A Variola
- University of Verona, Cardiology, Verona, Italy
| | - R Malago"
- University of Verona, Diagnostic Imaging, Verona, Italy
| | - F Ribichini
- University of Verona, Cardiology, Verona, Italy
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Abstract
Pneumothorax is one of the most frequent complications during percutaneous central vascular cannulation. When choosing a site for central vascular access, the internal jugular vein is preferable to other vessels, for the lower frequency of related complications, including pneumothorax. This review intends to summarize the current state of the art on how to avoid and, if it occurs, to manage this rare but relevant complication. In order to prevent pneumothorax, as well as other relevant complications of central vein cannulation, it is advisable to use ultrasound guidance whenever possible. If pneumothorax occurs, it is important to recognize its signs and symptoms. To exclude the presence of asymptomatic pneumothorax, in the normal clinical routine a chest X-ray should be obtained within 4 hours from the procedure of central vein cannulation of subclavian and internal jugular veins. If promptly recognized, pneumothorax can be managed quickly and in a relatively easy way. Depending on its size and symptoms, and in particular when a tension pneumothorax is supected, treatment can vary from simple observation to a chest tube insertion or, in the latter case, to an emergency thoracentesis needle insertion in the pleural space.
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Affiliation(s)
- M Giacomini
- Anesthesia and Intensive Care Department, San Paolo Hospital, Milano; Universita' degli Studi di Milano, Italy
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Iapichino G, Radrizzani D, Armani S, Noto A, Spanu P, Mistraletti G. Metabolic treatment of critically ill patients: energy balance and substrate disposal. Minerva Anestesiol 2006; 72:533-41. [PMID: 16682927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Oxidation of substrates is the main biochemical process used by the human body to produce energy. Different substrates (carbohydrates, lipids, and proteins) have different effects on oxygen consumption and carbon dioxide production: during the critical phase of pathologies it could be relevant pay attention to the use of various nutrients, that have some altered effect respect to the normal subjects metabolism, and during the length of metabolic treatment, too. Generally, nutrition lead to replenish body stores, while endogenous substrates are used to be oxidized. Critically ill patients show a preference for prompt energy availability (i.e. glucose) to avoid endogenous protein catabolism; lipids are shown to have a more pronounced storage effect. Adequate amount of energy intake in carbohydrates determine an increase of RQ, that means a shift from a more lipid-based to a more glucose-based oxidation. Composition of dietary intake can be usefully different for each pathology, and also for different periods of the same pathology, because critically ill patients have a variety of metabolic needs during their stay in ICU.
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Affiliation(s)
- G Iapichino
- Department of Anesthesiology and Intensive Care, San Paolo Hospital, University of Milan, Milan, Italy.
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