Targeted Therapy for Severe Asthma: Identifying the Right Patients.

Asthma affects over 300 million people worldwide. Most asthmatics are well controlled with inhaled corticosteroids and long-acting beta-agonists; however, a proportion of patients are unresponsive and attain limited disease control. This group represents a considerable healthcare and financial burden, particularly patients who experience frequent exacerbations and require hospital admission.

Abnormal vocal cord function in difficult-to-treat asthma.

Rationale: Upper airway dysfunction may complicate asthma but has been largely ignored as an etiological factor. Diagnosis using endoscopic evaluation of vocal cord function is difficult to quantify, with limited clinical application.

Objectives: A novel imaging technique, dynamic 320-slice computerized tomography (CT), was used to examine laryngeal behavior in healthy individuals and individuals with asthma.

Laryngeal penetration and aspiration in individuals with stable COPD.

Background And Objective: Swallowing is closely coordinated with breathing but in COPD altered synchronization may predispose patients to a breach of the upper airway protective mechanisms. However, aspiration during swallow has never been shown in COPD. We examined penetration of liquid material into the airway of patients with COPD and correlated it with breathing-swallow patterns.

Diagnosis of vocal cord dysfunction in asthma with high resolution dynamic volume computerized tomography of the larynx.

Background And Objective: Vocal cord dysfunction (VCD) often masquerades as asthma and reports have suggested that up to 30% of patients with asthma may have coexistent VCD. Diagnosis of VCD is difficult, in part because it involves laryngoscopy which has practical constraints, and there is need for rapid non-invasive diagnosis. High speed 320-slice volume CT demonstrates laryngeal function during inspiration and expiration and may be useful in suspected VCD.

T-cell cytokine profiles are altered in childhood asthma exacerbation.

Background And Objective: Stable asthma is characterized by the production of Th2 cytokines, although Th1 cytokines may play a key role in aspects such as airway hyper-responsiveness. This study explored cytokine profiles associated with asthma exacerbation.

Methods: Intracellular T-cell cytokine production was measured in 16 children with acute severe asthma (emergency department), after convalescence (6 weeks, n = 13), with stable disease (after 6 months, n = 7) and in 14 age-matched hospital controls.

The internal control group in a register of antiepileptic drug use in pregnancy.

The aim of this study was to determine how valid 68 first-trimester pregnancies of untreated epileptic women would prove as an internal control group for investigating foetal malformation rates in 709 simultaneously collected antiepileptic drug-exposed pregnancies in an Australian register of pregnancies in epileptic women. We carried out comparisons of values for parameters relating to personal details, obstetric aspects, and epilepsies prior to and during pregnancy in the drug-exposed and drug-unexposed pregnancies, with observations on subpopulations within the drug-unexposed group. Statistically significant (p<0.

Seizure control in antiepileptic drug-treated pregnancy.

This brief report covers an analysis of 7 years outcome data from the Australian Register of Antiepileptic Drugs in Pregnancy. In studying the control of antiepileptic drug-treated epileptic seizures during pregnancy, it was found that pregnancy had little influence on antiepileptic drug-treated epileptic seizure disorders. Seizures during pregnancy occurred in 49.

The Australian Register of Antiepileptic Drugs in Pregnancy: the first 1002 pregnancies.

Background: Prospective studies are needed to assess the maternal and fetal hazards of antiepileptic drug (AED) therapy in pregnancy.

Aims: To make the Australian Register of AEDs in Pregnancy better known to the Australian obstetric community by presenting results derived from it.

Methods: Analysis of data collected by the Register between 1999 and December 2006.

Pharmacotherapy of epilepsy: new armamentarium, new issues.

Since 1990 there have been over ten antiepileptic drugs (AEDs) approved for the therapy of epilepsy. These agents have a new spectrum of efficacy and novel adverse effects, some totally unexpected. They also represent an enormous escalation of costs.

Treatment of obstructive airway diseases with roflumilast, a novel phosphodiesterase 4 inhibitor.

Obstructive airway diseases, chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence worldwide and constitute a considerable burden of disease. Although various treatments have evolved for these illnesses, they are often only partially effective in relieving symptoms and reducing underlying airway abnormalities. Inhaled bronchodilators and glucocorticosteroids have been the mainstay of therapy and no new classes of drug with effective anti-inflammatory activities have been introduced to clinical practice for almost 20 years.

The Australian antiepileptic drug in pregnancy register: aspects of data collection and analysis.

Internal comparisons using the data of the Australian Register of Antiepileptic Drugs in Pregnancy as of November 2005, and comparisons with Australian population data, were carried out. It was found that (i) except for under-representation of mothers of Asian origin, the demography of the register population was reasonably representative of the Australian situation; (ii) except for more pregnancies terminated for foetal malformation, malformation rates were similar in retrospectively and non-retrospectively enrolled pregnancies; (iii) some 21% of foetal malformations would have been excluded by not including malformations first recognised after the neonatal period; and (iv) in practice, the comparator against which malformation rates were expressed made little difference to the rates found. It is desirable to have available such analyses of pregnancy register data before comparing the findings of different registers.

The case for an Australian national neurosciences trial network.

Currently the majority of neurological clinical trials are initiated by industry. Their purpose is largely promotional. There is a need for conducting investigator-initiated trials, which are disease oriented, and try to answer questions related to problems in diagnosis, investigation and therapy, in addition to the comparative benefits individual preparations.

Clinical predictors for buserelin acetate treatment of uterine fibroids: a prospective study of 40 women.

Buserelin acetate, a luteinizing hormone-releasing hormone agonist, is known to be effective in the shrinkage of uterine fibroids. A prospective trial was undertaken (1) to compare the efficacy of intranasal (IN) and subcutaneous (SC) administration of buserelin acetate and (2) to assess if tumor regression correlated with fibroid size and/or patient age. Forty patients were randomly allocated to receive 6 months of either IN buserelin acetate (n = 21) or SC buserelin acetate (n = 19).