다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

Global strategy for asthma management and prevention

世界経済・社会統計 = World development indicators

Prospective Cohort Study

The anterior insular cortex (AIC) is implicated in a wide range of conditions and behaviours, from bowel distension and orgasm, to cigarette craving and maternal love, to decision making and sudden insight. Its function in the re-representation of interoception offers one possible basis for its involvement in all subjective feelings. New findings suggest a fundamental role for the AIC (and the von Economo neurons it contains) in awareness, and thus it needs to be considered as a potential neural correlate of consciousness.

How do you feel--now? The anterior insula and human awareness.

The Effect of Subcutaneous German Cockroach Immunotherapy (SCIT) on Nasal Allergen Challenge (NAC) and Cockroach-specific Antibody Responses Among Urban Children and Adolescents

Background: Prior asthma exacerbations have been associated with lung function decline/increased risk of future exacerbations. Dupilumab (DPL) blocks IL-4/IL-13, key drivers of type 2 inflammation. In phase 3 QUEST (NCT02414854), add-on DPL significantly reduced severe exacerbations/improved lung function in patients with uncontrolled, moderate-to-severe asthma. TRAVERSE (NCT02134028), evaluated DPL long-term safety, tolerability, and efficacy in patients from a previous DPL asthma study. Aim: To examine the relationship between prior exacerbations and lung function in T2 asthma patients (serum eos ≥150 cells/µL or FeNO ≥25 ppb at baseline) from QUEST enrolled in TRAVERSE. Methods: Patients on DPL in QUEST continued DPL 300mg (DPL/DPL) in TRAVERSE for up to 96 weeks; patients on placebo in QUEST started DPL (PBO/DPL). Endpoints: annualized severe exacerbation rate (AER); change from baseline in % predicted (pp) FEV1 in non-exacerbators (0 exacerbations) and exacerbators (≥1 exacerbations) during QUEST. Results: In the exacerbator group, DPL vs placebo reduced AER in QUEST (1.67 vs 2.59, respectively) and TRAVERSE (DPL/DPL 0.78 and PBO/DPL 0.56). In the non-exacerbator group, DPL maintained low AER (0.11 DPL/DPL and 0.17 PBO/DPL) in TRAVERSE. Mean pp FEV1 change at Week 96 was 10.09 vs 14.84 for DPL/DPL vs PBO/DPL in the exacerbator group; 13.28 vs 13.10 for DPL/DPL vs PBO/DPL in the non-exacerbator group. DPL safety during TRAVERSE was consistent with the known safety profile. Conclusions: DPL’s dual mechanism of action via IL-4/IL-13 improved exacerbations and lung function in PBO/DPL subjects, and sustained improvement in DPL/DPL subjects irrespective of prior exacerbation status.

Dupilumab improves exacerbations and lung function irrespective of prior asthma exacerbations: TRAVERSE

Asthma exacerbations: the Achilles heel of asthma care.

In lasting tribute: Gail G. Shapiro, January 11, 1947–August 25, 2006

Patients with asthma and pregnancy were found as two groups most at risk for severe respiratory outcomes during the H1N1 epidemic in 2008.1–4 This association raises the question as to what immune dysfunctions may link these two conditions together and lead to an increased susceptibility for viral respiratory infections, and whether both patient populations may have similar defects in antiviral activity. This important and interesting clinical question is the focus of the paper by Forbes et al 5 in Thorax .

In both asthma and pregnancy, there is a loss of the normal Th1/Th2 balance.6 7 In pregnancy, the shift away from a Th1 expression and towards a Th2 dominance during gestation likely reflects an ‘immune necessity’ to prevent the mother from having a ‘graft versus host’ reaction and subsequent loss of the pregnancy.7 In asthma, the immune picture is more complex, but the possible contribution of a Th1/Th2 imbalance with the presence of allergic reactions has been the basis of the hygiene hypothesis and target of new treatments.8 In broad-based terms, allergic sensitisation represents an overexpression of Th2 cytokines, interleukin (IL)-4, IL-5 and IL-13, with the resulting production of IgE antibodies with a capacity to cause allergic inflammation following allergen activation. In asthma, and pregnancy, a shift towards Th2 dominance also means a possible reduction in Th1 cytokines, such as interferons. The consequence of diminished interferon generation could explain the increased risk for respiratory infections in both asthma and pregnancy.

A deficiency in the generation of interferon has been most extensively studied in asthma and has been proposed as a risk …

https://thorax.bmj.com/content/thoraxjnl/early/2011/10/08/thoraxjnl-2011-201007.full.pdf

William W. Busse

Papers

The Effect of Subcutaneous German Cockroach Immunotherapy (SCIT) on Nasal Allergen Challenge (NAC) and Cockroach-specific Antibody Responses Among Urban Children and Adolescents

Dupilumab improves exacerbations and lung function irrespective of prior asthma exacerbations: TRAVERSE

Asthma exacerbations: the Achilles heel of asthma care.

In lasting tribute: Gail G. Shapiro, January 11, 1947–August 25, 2006

Asthma and pregnancy: do they give clues to abnormal antiviral activity?