Calcifediol for Use in Treatment of Respiratory Disease.

Calcifediol is the prohormone of the vitamin D endocrine system (VDES). It requires hydroxylation to move to 1,25(OH)2D3 or calcitriol, the active form that exerts its functions by activating the vitamin D receptor (VDR) that is expressed in many organs, including the lungs. Due to its rapid oral absorption and because it does not require first hepatic hydroxylation, it is a good option to replace the prevalent deficiency of vitamin D (25 hydroxyvitamin D; 25OHD), to which patients with respiratory pathologies are no strangers. Correcting 25OHD deficiency can decrease the risk of upper respiratory infections and thus improve asthma and COPD control. The same happens with other respiratory pathologies and, in particular, COVID-19. Calcifediol may be a good option for raising 25OHD serum levels quickly because the profile of inflammatory cytokines exhibited by patients with inflammatory respiratory diseases, such as asthma, COPD or COVID-19, can increase the degradation of the active metabolites of the VDES. The aim of this narrative revision is to report the current evidence on the role of calcifediol in main respiratory diseases. In conclusion, good 25OHD status may have beneficial effects on the clinical course of respiratory diseases, including COVID-19. This hypothesis should be confirmed in large, randomized trials. Otherwise, a rapid correction of 25(OH)D deficiency can be useful for patients with respiratory disease.

El test de adhesión a los inhaladores sobrestima el cumplimiento de la medicación en el asma / The test of the adhesion to inhalers overestimates medication compliance in asthma

OBJETIVOS: valorar el cumplimiento de la medicación en pacientes asmáticos comparando lo estimado por el Test de Adhesión a los Inhaladores (TAI) con el control electrónico de la retirada del medicamento en farmacia así como el grado de control del asma medido por el ACT (test de control del asma). PACIENTES Y MÉTODOS: estudio descriptivo y transversal, con una muestra de 87 pacientes (60 mujeres y 27 hombres) diagnosticados de asma y en tratamiento con glucocorticoides inhalados ± un segundo controlador inhalado, al menos un año antes del inicio del estudio. A todos se les realizó TAI, ACT y se calculó la cantidad de medicación que teóricamente debería de haber retirado en el último año, en función del medicamento y la dosis prescrita. RESULTADOS: edad media 54,71 ± 14,41 años. Puntuación media en el TAI 47,77 ± 3,04 puntos. Puntuación media en el ACT 20 ± 4,08 puntos. Medicación: la dosis teórica media prescrita fue de 12,36 ± 4,74 envases por paciente al año. Cada paciente retiró una media de 7,52 ± 3,96 envases, porcentaje medio de cumplimiento (≥ 80% de retirada de la medicación prescrita correspondiente) de 64,41% ± 29,38. Los pacientes que presentaron buen cumplimiento (TAI 50, n = 43) presentaron un porcentaje de retirada significativamente mayor que el resto: 70,67 ± 28,37 vs 58,24 ± 29,37 (p = 0,048) De los 43 pacientes que tuvieron puntuación de 50 en el TAI, 22 (51,16%) no habían retirado al menos el 80% de la medicación. No se encontraron diferencias significativas en la puntuación ACT entre las diferentes categorías del TAI. (Anova, p = 0,609). CONCLUSIONES: un 51,16% de los pacientes con buen cumplimiento en el TAI no retira, al menos, el 80% de la medicación

OBJECTIVES: To evaluate medication compliance in asthmatic patients comparing estimates from the Test of the Adhesion to Inhalers (TAI) with the electronic control from medication withdrawal in a pharmacy as well as the degree of asthma control measured by the ACT (Asthma Control Test). PATIENTS AND METHODS: A transversal, descriptive study with a sample of 87 patients (60 women and 27 men) diagnosed with asthma who had undergone treatment with inhaled glucocorticoids ± a second inhaled controller for at least a year before the start of the study. All of them completed the TAI, ACT, and the amount of medication they should have theoretically used in the past year was calculated based on the medication and the prescribed dose. RESULTS: average age 54.71 ± 14.41 years. Average TAI score 47.77 ± 3.04 points. Average ACT score 20 ± 4.08 points. Medication: the theoretical average dose prescribed was 12.36 ± 4.74 canisters per patient per year. Each patient withdrew an average of 7.52 ± 3.96 cannisters, for an average compliance percentage (≥ 80% of the corresponding prescribed medication withdrawn) of 64.41% ± 29.38. The patients who had good compliance (TAI 50, n = 43) had a significantly higher percentage of withdrawal than the rest: 70.67 ± 28.37 vs 58.24 ± 29.37 (p = 0.048). Of the 43 patients who had a score of 50 on the TAI, 22 (51.16%) had not withdrawn at least 80% of their medication. No significant differences were found in ACT scores between the different TAI categories (Anova, p = 0.609). CONCLUSIONS: 51.16% of patients with good compliance in the TAI do not withdraw at least 80% of their medication

Nanocomposite Polymeric Materials Based on Eucalyptus Lignoboost® Kraft Lignin for Liquid Sensing Applications.

This study reports the synthesis of polyurethane-lignin copolymer blended with carbon multilayer nanotubes to be used in all-solid-state potentiometric chemical sensors. Known applicability of lignin-based polyurethanes doped with carbon nanotubes for chemical sensing was extended to eucalyptus LignoBoost® kraft lignin containing increased amounts of polyphenolic groups from concomitant tannins that were expected to impart specificity and sensitivity to the sensing material. Synthesized polymers were characterized using FT-MIR spectroscopy, electrical impedance spectroscopy, scanning electron microscopy, thermogravimetric analysis, and differential scanning calorimetry and are used for manufacturing of all solid-state potentiometric sensors. Potentiometric sensor with LignoBoost® kraft lignin-based polyurethane membrane displayed theoretical response and high selectivity to Cu (II) ions, as well as long-term stability.

Efficacy and Safety of Reslizumab in Patients with Severe Asthma with Inadequate Response to Omalizumab: A Multicenter, Open-Label Pilot Study.

BACKGROUND: Patients with severe allergic and eosinophilic asthma could qualify for different biologic therapies. OBJECTIVE: To evaluate the efficacy and safety of weight-based intravenous reslizumab dosing in patients who have previously failed therapy with omalizumab. METHODS: We carried out a 24-week prospective, multicenter, open-label, single-group, self-controlled study in patients with severe eosinophilic asthma who had previously failed to respond to omalizumab. The main objective was to determine whether treatment with reslizumab significantly improved asthma symptoms assessed by the Asthma Control Test (ACT) at week 24. Secondary objectives were to evaluate symptoms at weeks 4 and 12, change in FEV1 at week 24, and the incidence of severe exacerbations over the study period. RESULTS: Twenty-nine patients (62.1% women, median age, 50.8 years) were included in the study. The median ACT score significantly increased from 13.0 (interquartile range, 8.0-18.0) at baseline to 21.0 (interquartile range, 14.0-24.0) at 24 weeks (P = .002). Only 2 of 29 patients developed at least 1 severe exacerbation during follow-up and none of them required hospitalization. Overall, 15 of 25 patients (60%) were considered as being controlled (ACT score of ≥20 and no exacerbations) at week 24. The percentage of patients who were receiving daily systemic corticosteroids significantly decreased from 72.4% to 52.0% (P = .019). Adverse events were mostly moderate and within the range of previously reported side effects with reslizumab. CONCLUSION: Reslizumab is an effective and safe option for patients with severe eosinophilic asthma and a history of omalizumab failure.

The role of hybrid chitosan membranes on scarring process following lumbar surgery: post-laminectomy experimental model.

OBJECTIVES: Post-operative scarring process on lumbar surgery is object of several studies mainly because of the epidural fibrosis formation. Hybrid chitosan have shown promising effect on fibrosis prevention. The aim of this study was to determine the influence of chitosan-silane membrane on the lumbar surgery scarring process. These membranes have improved mechanical strength which makes them suitable to maintain a predefined shape. METHODS: A two level lumbar laminectomy was performed in 14 New Zealand male rabbits. Laminectomy sites were randomly selected for biomaterial or control. Chitosan membranes were prepared and care was taken in order to make it adapted to the bone defect dimensions covering the totality of the defect including the bone margins. Histological analysis was performed by haematoxylin/eosin and by Masson's trichrome staining four weeks after laminectomy. RESULTS: Microscope observations revealed the presence of a well-organized regenerating tissue, integrated in the surrounding vertebral bone tissue with a regular and all-site interface on the chitosan sites, in clear contrast with the presence of a disorganized regenerating tissue with aspects consistent with the persistence of a chronic inflammatory condition, on control sites. DISCUSSION: The results of this study clearly demonstrated that hybrid chitosan had an organizing effect on post-operative scarring process. The presence of the hybrid chitosan membrane resulted on a well-organized tissue integrated in the surrounding vertebral bone tissue with signs of regenerative bone tissue in continuity with native bone. This can be a major feature on the dynamics of epidural fibrosis formation.

Major complications following total en bloc spondylectomy for giant-cell tumor.

The authors present the case of a 32-year-old Caucasian female with a giant-cell tumor of the eighth thoracic vertebra, causing unremitting pain, segmental kyphosis and imminent local instability. A total en bloc spondylectomy by a posterior-only approach was performed, complemented with anterior-column reconstruction with a titanium mesh and structural allograft, as well as pedicle screw fixation. Despite the surgery being uneventful, several complications developed over the ensuing weeks: bilateral hemothorax, empyema and sepsis, requiring numerous revision surgeries for postoperative infection. The same pathogen was identified in different samples collected, including a sample from the allograft used. Only the aggressive therapeutic measures adopted allowed improvement in clinical and analytic parameters. The present report alerts to the possible complications following major spine surgery, and raises concerns on the safety of the bone allografts provided, renewing the interest in the development of alternative bone substitutes.

Rolipram promotes functional recovery after contusive thoracic spinal cord injury in rats.

Numerous animal model studies in the past decade have demonstrated that pharmacological elevation of cyclic AMP (cAMP) alone, or in combination with other treatments, can promote axonal regeneration after spinal cord injury. Elevation of cAMP via the phosphodiesterase 4 (PDE4) inhibitor, rolipram, decreases neuronal sensitivity to myelin inhibitors, increases growth potential and is neuroprotective. Rolipram's ability to cross the blood-brain barrier makes it a practical and promising treatment for CNS regeneration. However, several studies have questioned the efficacy of rolipram when given alone. The purpose of this investigation was to determine the effects of continuous administration of rolipram, given alone for 2 weeks, following a moderate T10 contusion injury in rat. Functional recovery was evaluated using the 21-point Basso, Beattie and Bresnahan (BBB) locomotor recovery scale and the beam walk. We used three-dimensional (3D) instrumented gait analysis to allow detailed assessment and quantification of hindlimb motion. The amount of the damaged tissue and spared white matter was estimated stereologically. Our results show that administration of rolipram following acute spinal cord contusion results in improved motor performance at each time-point. Dynamic assessment of foot motion during treadmill walking revealed a significantly decreased external rotation during the entire step cycle after 8 weeks in rolipram-treated animals. Stereological analysis revealed no significant differences in lesion volume and length. By contrast, spared white matter was significantly higher in the group treated with rolipram. Our results suggest a therapeutic role for rolipram delivered alone following acute SCI.

The effect of gait speed on three-dimensional analysis of hindlimb kinematics during treadmill locomotion in rats.

The two-dimensional (2D) kinematic approach is by far the most popular technique in rat gait analysis. This is a simple inexpensive procedure, which requires only one camera to record the movement. However, maximal precision and accuracy of the kinematic values are expected when the experimental protocol includes a three-dimensional (3D) motion analysis methodology. Locomotor speed is a basic kinematic parameter that is often neglected in most studies of movement disorders and neurological diseases. Because locomotor speed can act as confounder for the interpretation of the obtained results we also focused our attention on the relation between speed and 3D hindlimb kinematics. Our experimental set-up consisted of a motion capture system with four CMOS cameras which allowed a non-invasive estimation of the instantaneous position of color markers in a 3D measurement volume. Data were recorded while rats walked at different treadmill speeds (30 vs 60 cm/s). For the first time we reported detailed kinematic data for the sagittal, coronal and transverse plane during treadmill locomotion in rats. Despite the overall time course patterns of the curves were identical, we found significant differences between values of joint angular motion at 30 and 60 cm/s at selected points of the step cycle. The adaptation to higher treadmill walking included greater joint angular excursions. The present report highlights the importance of walking speed when evaluating rat hindlimb kinematics during gait. Hopefully, this study will be useful in experimental data assessment when multiple gait abnormalities are expected to occur in all planes of motion.

Methylprednisolone fails to improve functional and histological outcome following spinal cord injury in rats.

Currently, methylprednisolone sodium succinate (MPSS) is the standard treatment following acute spinal cord injury (SCI) as a consequence of the results obtained from the National Acute Spinal Cord Injury Studies. However, many have questioned the efficacy of MPSS because of its marginal effects. Additionally there has been criticism of both study design and statistical interpretation. The functional consequences of experimental SCI have been assessed in many ways. The purpose of this investigation was to determine the effects of MPSS vs. saline solution (SS) following moderate T10 contusion injury in rat. Functional recovery was evaluated using the 21-point Basso, Beattie and Bresnahan (BBB) locomotor recovery scale, the inclined plane, the beam walk, footprint analysis and the horizontal ladder. To optimize the precision and accuracy of functional results we examined the locomotion on a treadmill using three-dimensional (3D) analysis. Stereology was used to estimate the amount of damaged tissue. The results of the traditional functional methods showed that administration of the NASCIS dosage of MPSS following acute spinal cord contusion did not lead to any significant differences in the functional recovery of MPSS- vs. SS-treated animals. More importantly, the results of the 3D kinematic showed that the MPSS administration did not affect the flexion/extension of the hip, knee and ankle joints during the step cycle. Finally, stereological results revealed no statistically significant differences between the two experimental groups. Altogether, our results support data previously reported by several authors, suggesting that MPSS does not lead to improved functional outcome following experimental acute SCI.

Chapter 7: Methods and protocols in peripheral nerve regeneration experimental research: part IV-kinematic gait analysis to quantify peripheral nerve regeneration in the rat.

Functional recovery is one of the primary goals of therapeutic intervention in peripheral nerve research. The number and diversity of tests which have been used to assess functional recovery after experimental interventions often makes it difficult to recommend any particular indicator of nerve regeneration. Functional assessment after sciatic nerve lesion has long been focused on walking track analysis; however, it is important to note that the validity of the sciatic functional index has been questioned by several researchers. In the last decade, several authors have designed a series of sensitive quantitative methods to assess the recovery of locomotor function using computerized rat gait analysis. The objective of the present review is to provide a helpful tool for the peripheral nerve investigator, by integrating the most important gait kinematic measures described in the literature that can be gathered with this technology.

A comparison of two-dimensional and three-dimensional techniques for the determination of hindlimb kinematics during treadmill locomotion in rats following spinal cord injury.

Of all the detrimental effects of spinal cord injury (SCI), one of the most devastating effects is the disruption of the ability to walk. Therefore, much effort has been focused on developing several methods to document the recovery of locomotor function after experimental SCI. Computerized rat gait analysis is becoming increasingly popular in the SCI research community. The two-dimensional (2D) kinematic approach is by far the most popular technique in rat gait analysis. This is a simple inexpensive procedure, which requires only one camera to record the movement. Our study included an examination of locomotion on a treadmill using 2D and three-dimensional (3D) analysis, in neurologically intact animals and following moderate T9 contusion injury. Despite the overall time course patterns of the curves were identical, we found significant differences between values of the 2D and 3D joint angular motion. In conclusion, maximal precision and accuracy of the kinematic values are expected when the experimental protocol includes a 3D motion analysis methodology. Moreover, a 2D method cannot be used to determine the external or internal rotations of the foot because this movement occurs in the transverse plane.

A comparison analysis of hindlimb kinematics during overground and treadmill locomotion in rats.

The convenience of the motor-driven treadmill makes it an attractive instrument for investigating rat locomotion. However, no data are available to indicate whether hindlimb treadmill kinematic findings may be compared or generalized to overground locomotion. In this investigation, we compared overground and treadmill locomotion for differences in the two-dimensional angular kinematics and temporal and spatial measurements for the hindlimb. Ten female rats were evaluated at the same speed for natural overground and treadmill walking. The walking velocity, swing duration and stride length were statistically indistinguishable between the two testing conditions. Significant differences were found between overground and treadmill locomotion for step cycle duration and stance phase duration parameters. During the stance phase of walking, the angular movement of the hip, knee and ankle joints were significantly different in the two conditions, with greater flexion occurring on the overground. Despite this, the sagittal joint movements of the hindlimb were similar between the two walking conditions, with only three parameters being significantly different in the swing. Hip height and angle-angle cyclograms were also only found to display subtle differences. This study suggests that reliable kinematic measurements can be obtained from the treadmill gait analysis in rats.

Effect of skin movement on the analysis of hindlimb kinematics during treadmill locomotion in rats.

In rat gait kinematics, the method most frequently used for measuring hindlimb movement involves placing markers on the skin surface overlying the joints being analyzed. Soft tissue movement around the knee joint has been considered the principle source of error when estimating hindlimb joint kinematics in rodents. However, the motion of knee marker was never quantified, nor the different variations in joint angle associated with this gait analysis system. The purpose of this study was two-fold. The first purpose was to expand upon the limited pool of information describing the effect of soft tissue movement over the knee upon the angular positions of the hip, knee and ankle of rats during treadmill locomotion. Secondly, it was a goal of this study to document the magnitude of the skin displacement when using markers that were attached superficially to the knee joint. This was examined by comparing the hindlimb kinematics in sagittal plane during treadmill locomotion determined from the marker attached to the knee and when the knee position was determined indirectly by computer analysis. Results showed that there is a considerable skin movement artefact which propagates to knee joint position and hindlimb kinematics estimates. It was concluded that these large errors can decrease data reliability in the research of rat gait analysis.