| 1. |
- Selroos, O, et al.
(author)
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National and regional asthma programmes in Europe
- 2015
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In: European respiratory review : an official journal of the European Respiratory Society. - : European Respiratory Society (ERS). - 1600-0617. ; 24:137, s. 474-83
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Journal article (peer-reviewed)abstract
- This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.
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| 2. |
- Selroos, O, et al.
(author)
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"National and regional asthma programmes in Europe." Olof Selroos, Maciej Kupczyk, Piotr Kuna, Piotr Łacwik, Jean Bousquet, David Brennan, Susanna Palkonen, Javier Contreras, Mark FitzGerald, Gunilla Hedlin, Sebastian L. Johnston, Renaud Louis, Leanne Metcalf, Samantha Walker, Antonio Moreno-Galdó, Nikolaos G. Papadopoulos, José Rosado-Pinto, Pippa Powell and Tari Haahtela. Eur Respir Rev 2015; 24: 474-483
- 2019
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In: European respiratory review : an official journal of the European Respiratory Society. - : European Respiratory Society (ERS). - 1600-0617. ; 28:154
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Journal article (peer-reviewed)
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| 3. |
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| 4. |
- Davy, P., et al.
(author)
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DFN, why, how and what for, concepts, theories and issues
- 2018
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In: 2nd International Discrete Fracture Network Engineering Conference, DFNE 2018. - : American Rock Mechanics Association (ARMA).
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Conference paper (peer-reviewed)abstract
- DFN – Discrete Fracture Network – is primarily a modeling framework for fractured geological systems that aims to integrate field data into simulations of flow and/or deformation. It is complementary to, or competing with, continuum methods with both advantages of easily integrating the statistical properties of fracture networks, and of not assuming any homogenization scale. The core element is the DFN conceptual model, which makes a functional link between data from different sources, prior knowledge and medium models. We discuss some fundamental issues about this conceptual model, namely (i) the upscaling of small-scale measurements to site-scale relationships, (ii) intrinsic variability versus geological determinism, (iii) the way to incorporate a priori knowledge, (iv) the transformation of a statistical description into a medium model, (v) the critical characteristics (length scales, scaling laws or physical properties) of fractures for a given DFN application. The main product of the DFN conceptual model is medium models, whose role is to extrapolate/interpolate data with a faithful representation of the geological system. The way in which fracture correlations are taken into account, or not, in the generation process plays an important control on the connectivity and flow properties of medium models.
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| 5. |
- Destouni, Georgia, et al.
(author)
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Lagrangian pathway-travel time theory and scenario analysis of tracer-pollutant and uncertainty propagation through catchments
- 2012
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In: Geophysical Research Abstracts, Vol. 14, EGU2012-6940, 2012.
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Conference paper (peer-reviewed)abstract
- This paper presents how tracer, nutrient and pollutant transport through a catchment can be analyzed based on mean flow and other flow-transport properties given or resolved by simulations, by following the trajectories (pathways) of transport through the catchment and the flow-transport property distribution among them. Convolution of relevant property distributions across consecutive hydrological units, aggregated over the trajectories that originate from the tracer/pollutant-specific injection area, captures hydrological dispersion with its basic measure derived as the travel time coefficient of variation. Various memory functions can be introduced in a relatively simple manner for incorporating retention/mass transfer mechanisms under conditions of statistical stationarity. The paper further shows how spatial and temporal flow variability can be accounted for in this general theory, and how each and both of these variability components influence hydrological transport in catchments. Moreover, the paper outlines how the theory can be used in a scenario analysis approach to quantify and map the effects of uncertainty in physical and biogeochemical characteristics on diffuse hydrological transport and its uncertainty
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| 6. |
- Edsbacker, S, et al.
(author)
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Do airway clearance mechanisms influence the local and systemic effects of inhaled corticosteroids?
- 2008
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In: Pulmonary Pharmacology & Therapeutics. - : Elsevier BV. - 1522-9629 .- 1094-5539. ; 21:2, s. 247-258
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Journal article (peer-reviewed)abstract
- The role of airway clearance in inhaled drug therapy is complex. Disease-induced bronchoconstriction results in a central drug-deposition pattern where mucociliary clearance is most efficient. When drug-induced bronchodilation is achieved, deposition and uptake becomes more peripheral, and because there is less mucociliary clearance in the periphery, this will lead to an unintentional increase in lung exposure and enhance the risk of systemic side effects. In addition, mucociliary clearance is pathologically reduced in both asthma and chronic obstructive pulmonary disease. Among inhaled corticosteroids, rate of dissolution and lung uptake differs considerably. For the slowly dissolving, lipophilic steroids, the contribution of mucociliary clearance to these findings appears significant, and variability in lung and systemic exposure resulting from variable mucociliary function appears to be amplified. In addition, dose optimisation of non-stable asthma becomes more complex. The present review highlights the impact of mucociliary clearance on inhaled corticosteroid disposition and identifies critical areas where more research is needed.
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| 7. |
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| 8. |
- Haahtela, T, et al.
(author)
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Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air : A SOMA study
- 2006
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In: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 28:4, s. 748-755
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Journal article (peer-reviewed)abstract
- Patients with mild intermittent asthma sometimes show signs of inflammation, and guidelines suggesting bronchodilator therapy alone as needed may be questioned. The current study compared as-needed use of a rapid-acting β2-agonist with as-needed use of a β2-agonist and corticosterold combination as the only medication in asthma patients with intermittent symptoms. A total of 92 nonsmoking asthma patients (of 187 screened) using only an inhaled β2-agonist as needed (28 males, 64 females, mean age 37 yrs, mean forced expiratory volume in one second (FEV1) 101% predicted, mean reversibility 6.5% pred and fractional exhaled nitric oxide (FeNO) ≥20 parts per billion (ppb)) were randomised to treatment with formoterol (Oxis® Turbuhaler®) 4.5 μg as needed (n=47) or budesonide/formoterol (Symbicort® Turbuhaler®) 160/4.5 pg as needed (n=45) in a double-blind, parallel-group 24-week study. The primary variable of efficacy was change in FeNO. Baseline FeNO was 60 ppb and 59 ppb in the budesonide/formoterol and formoterol groups, respectively. Mean reductions in FeNO in the budesonide/formoterol and formoterol groups were 18.2 ppb and 2.8 ppb, respectively (95% confidence interval (CI) 7.5-23.5 ppb). The reduction in the budesonide/formoterol group occurred during the first 4 weeks of treatment and remained at this low level. Mean FEV1 increased by 1.8% pred normal value in the budesonide/formoterol group and decreased by 0.9% pred normal value in the formoterol group (95% Cl -4.7 - -0.7). In the budesonide/formoterol group, use of ≥4 inhalations-day-1 of study medication was seen on 21 treatment days compared with 74 in the formoterol group. In conclusion, as-needed use of an inhaled corticosteroid together with a rapid-acting bronchodilator may be more beneficial than a β2-agonist alone in patients with intermittent asthma and signs of airway inflammation. The long-term benefits are unknown. Copyright © ERS Journals Ltd 2006.
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| 9. |
- Libby, S., et al.
(author)
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Dynamic fracture network generation : A new method for growing fractures according to their deformation history
- 2019
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In: 53rd U.S. Rock Mechanics/Geomechanics Symposium. - : American Rock Mechanics Association (ARMA).
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Conference paper (peer-reviewed)abstract
- This paper presents a new method for generation of simulated fractures where fractures ‘grow’ dynamically, permitting interaction during formation. These interactions mimic the natural processes of stress shadowing, termination of fractures on other fractures, linking of fractures, and the varied growth on a single fracture due to contrasting rock properties. By simulating these interactions and providing the user with fine control over them, the new fracture generation method can create simulated fracture networks that match natural fracture networks more closely than other established methods. These behaviours are implemented mechanistically, allowing fracture generation to be achieved without the significant additional computational cost required to explicitly model the stresses in a fracturing rock volume. A suite of test cases is demonstrated, illustrating how different configurations of the dynamic fracture model allows different connectivity characteristics to be modelled.
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| 10. |
- Nana, A, et al.
(author)
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High-dose inhaled budesonide may substitute for oral therapy after an acute asthma attack
- 1998
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In: Journal of Asthma. - 0277-0903. ; 35:8, s. 647-655
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Journal article (peer-reviewed)abstract
- Patients attending the emergency room with acute asthma, participating in a study comparing salbutamol (albuterol in the United States) via a dry powder inhaler (Turbuhaler) with pressurized metered-dose inhaler (pMDI), were included in this 1-week follow-up study with the aim of assessing whether inhaled budesonide via Turbuhaler may be an alternative to prednisolone tablets after an acute asthma attack. Eighty-one patients with a mean age of 38 years and forced expiratory volume in 1 sec (FEV1) of 64% predicted normal value after treatment with salbutamol were randomized in this double-blind, double-dummy, parallel-group study. The doses given were budesonide 1600 microg b.i.d. or prednisolone in daily doses from 40 mg (day 1) decreased to 5 mg (day 7). FEV1 was recorded before and after the 7-day treatments and peak expiratory flow (PEF) morning and evening, clinical symptoms (visual analogue scale 0-100), and doses of rescue medication (terbutaline Turbuhaler 0.25 mg/dose) were recorded daily. The mean increase in FEV1 from baseline to day 7 was 17.3% in the budesonide Turbuhaler group and 17.6% in the prednisolone group. Mean values of morning PEF increased from day 1 to day 7 by 67 L/min in the budesonide Turbuhaler group and by 57 L/min in the prednisolone group (not significant). There were no statistically significant differences between the groups in clinical symptoms and in the number of doses of rescue medication. Because of disease deterioration, five patients in the Turbuhaler group and three in the prednisolone group needed additional symptomatic as well as corticosteroid treatment. Inhaled budesonide in high doses may be a substitute for oral therapy as follow-up treatment after an acute asthma attack.
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