Beclomethasone dipropionate given to adult asthmatics through a new spacer device: effects of high-dose administration.

The usefulness of a metered-dose inhaler equipped with a new spacer device (Jet spacer) was evaluated and compared with that of a standard actuator in the administration of high-dose inhaled beclomethasone dipropionate (0.5 mg four times daily) to adults with moderate asthma. After a 2-week run-in period, 36 patients were enrolled in a 4-week study according to a randomized, parallel-group design. Efficacy was assessed by measurements of pulmonary function and daily beta 2-agonist consumption. Morning serum and 24-hour urinary cortisol levels were measured at baseline and after treatment; adrenocorticotropic hormone (ACTH) stress testing was also done. Spirometric parameters significantly improved in both groups; peak expiratory flow rate measured at the final visit was significantly higher (P < .01) in the group using the Jet spacer than in patients using the standard actuator. Beta 2-agonist consumption decreased in both groups. The number of patients with a normal response to ACTH was significantly higher (P < .01) in the Jet group than in the standard actuator group; concomitant urinary cortisol excretion decreased significantly (P < .05) in the standard actuator group. Local irritation was reported by 1 patient in the Jet group and by 2 patients in the standard actuator group. Use of the new Jet spacer was found to reduce the potential for adrenal suppression and increase the efficacy of high-dose inhaled beclomethasone dipropionate given to adults with asthma.

[A new anti-inflammatory--analgesic--antipyretic for the treatment of acute disease of the bronchi ]. / Un nuovo antiflogistico-analgesico-antipiretico nel trattamento delle affezioni acute delle vie bronchiali.

Sixty adult patients, 31 men and 29 women, aged 44 to 60, and affected by acute bronchitis of probable bacterial aetiology were randomly divided into 3 groups of 20 and treated respectively with: 1) morniflumate (one 700 mg tablet twice a day) + amoxicillin (one 1 g tablet twice a day); 2) feprazone (one 200 mg tablet twice a day) + amoxicillin (one 1 g tablet twice a day); 3) amoxicillin (one 1 g tablet twice a day). Mean therapy duration was 9 days. The action of the drugs under study was assessed by objective chest examination and by evaluating the modifications of cough intensity and frequency, chest pain expectorating difficulty, amount of expectoration, body temperature. The overall assessments were completed by side-effect recording and by laboratory examinations carried out at the beginning and end of the study. Checks were made regularly on admission, and in the 3rd, 5th, 7th and last day of therapy. The above mentioned parameters showed a quicker regression of bronchial inflammation in the subjects treated also with the antiinflammatory drug compared to those treated only with the antibiotic. Furthermore, in the subjects treated with morniflumate such improvement was more rapidly achieved compared to those who received feprazone. The analgesic and antipyretic effects of morniflumate were also remarkable. All tested drugs were well tolerated.

[Results of 7 years of prophylactic immunotherapy using a bacterial vaccine in chronic bronchopneumopathies]. / Risultati di un settennio di immunoterapia preventiva con vaccino antibatterico in broncopneumopatici cronici.

Within the framework of a clinical study intended to evaluate the prophylactic efficacy of polymicrobial vaccines, 90 patients with chronic bronchopulmonary disease were treated for four successive years with an oral bacterial vaccine. The following parameters were considered: number of episodes of acute bronchitis per years, hospitalizations for respiratory events, number of housebound days due to flare-ups, number of days on antibiotics. Results were favorable: in the 4th year of treatment, acute episodes were reduced by 46%, hospitalizations by 50%, housebound days by 46%, and days on antibiotics by 52%. These results appear to be closely related to the careful selection of patients (exclusion of subjects in initial or advanced stages of disease) and to scrupulous compliance with treatment protocol. In fact, out of the 162 subjects entering the trial, only 90 followed it regularly.

[Combination of oral bacterial vaccines and antibiotics in acute recurrent respiratory infections]. / Sull'associazione vaccino batterico orale e antibiotici in corso di infezioni respiratorie acute ricorrenti.

The authors treated 34 patients with acute bronchopulmonary disease or flare-ups of chronic ones with equal doses of ambroxol and ceftriaxone considering the homogeneity of the morbid processes. Patients were divided into two groups of 17 subjects each: group A was given a polyvalent oral bacterial vaccine, group B a placebo. Relevant differences were found between the experimental and control groups concerning cough (score: A = 108, B = 119), duration of expectoration (A = 5.3 days, B = 6.4 days), duration of antibiotic therapy (A = 8.0 days, B = 8.8 days), and length of hospitalization (A = 10.9 days, B = 12.0 days). Differences were slight as far as duration of fever, characteristics of cough and objective findings on the chest were concerned.