ABSTRACT
According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored all alternatives currently available for a large part of severe asthmatics.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bronchiectasis , Patient Care Management , Pseudomonas Infections , Pseudomonas aeruginosa/isolation & purification , Aged , Bronchiectasis/diagnosis , Bronchiectasis/epidemiology , Bronchiectasis/microbiology , Bronchiectasis/physiopathology , Female , Humans , Italy/epidemiology , Male , Medical Audit , Middle Aged , Needs Assessment , Patient Care Management/methods , Patient Care Management/standards , Prevalence , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Pseudomonas Infections/epidemiology , Symptom Flare UpABSTRACT
A type of non-acute pulmonary aspergilloses, defined as 'semi-invasive' and 'chronic necrotizing aspergillosis', respectively, was described by Geffer, and later by Binder in the 1980s. Subsequently, a terminological uncertainty prevailed, favored by a preference in choosing the predisposing diseases. The simple term 'chronic pulmonary aspergillosis', as well as a classification based on the pulmonary anatomy, is proposed in this review. The most significant Medline and Embase indexed papers published between 1966 and the present day, including coverage of classification, diagnosis and treatment of aspergillosis are analyzed. In addition, an open study, carried out on 23 patients treated with terbinafine is reported. The results obtained suggest the need for further randomized studies.
