Doina Azoicai

Ciprofloxacin DPI in non-cystic fibrosis bronchiectasis: a Phase II randomized study.

Introduction: In non-cystic fibrosis (CF) bronchiectasis, the chronic airways infection is a risk factor for frequent infectious exacerbations and for an overall poor disease prognosis. Its therapy with inhaled antibiotics might be useful alike in the case of the CF-related disease. Areas covered: Analysis and discussion of the results of a Phase II study evaluating the efficacy and safety of the inhaled ciprofloxacin-dry powder (C-DPI) formulation in patients with non-CF bronchiectasis. Expert opinion: On short-term basis C-DPI is able to reduce the sputum bacterial load in such patients but long-term studies are also needed to better characterize the clinical efficacy of this compound.

MP-376 (Aeroquin) for chronic Pseudomonas aeruginosa infections

Introduction: The chronic airway infection with Pseudomonas aeruginosa (PA) is a risk factor for rapid disease progression in various chronic pulmonary diseases including cystic fibrosis or chronic obstructive pulmonary disease. Inhaled antibiotics are able to treat effectively such chronic airway infections, and MP-376 is currently in late-stage clinical development for such an indication. Areas covered: Review of the existing preclinical and clinical data on MP-376, with a focus on the efficacy and safety of the compound on chronic airways infections due to PA. Expert opinion: Chronic airways infection with PA represents a therapeutic challenge because of its own complex mechanisms of defense, because of the rapid development of antibiotic resistance and by the fact that systemic antibiotics are not always able to achieve appropriate concentrations at lung level. Inhaled antibiotics (tobramycin, aztreonam, etc.) represent optimal alternatives to their systemic homologs due to their better penetrability in the lungs and due to the lower systemic exposure. Inhaled levofloxacin which is currently investigated for chronic airways infection might be another possible antipseudomonal inhaled therapy.

Health status during hospitalisations for chronic obstructive pulmonary disease exacerbations: the validity of the Clinical COPD Questionnaire

Hospitalisations for chronic obstructive pulmonary disease (COPD) exacerbations are characterised by a significant worsening of the respiratory symptoms which can impair the health status (HS). However little is known on the HS behaviour during such events. Prospective study evaluating the validity of the Clinical COPD Questionnaire (CCQ) as a HS measure in hospitalisations for COPD exacerbations. The CCQ total score (CCQ-T) correlated with EQ-VAS (-0.51, p < 0.0001), was able to discriminate between longer and shorter duration hospitalisation (CCQ-T 3.83 vs 3.03, respectively p = 0.001), had a Cronbach-α of 0.86, and improved significantly over the hospitalisation period (CCQ-T on day 7 of hospitalisation 2.55 vs 3.77 at baseline, p < 0.0001). CCQ is an excellent tool for the assessment of the HS dynamics in hospitalisations for COPD exacerbations.

Cognitive-Behavioral Coping, Illness Perception, and Family Adaptability in Oncological Patients with a Family History of Cancer

Aim. The study investigated the differences between patients with and without a family history of cancer regarding coping strategies, illness perception, and family adaptability to the disease. Material and Methods. A total of 124 patients diagnosed with cancer were included in the research (55 of them with a family history of cancer). The Cognitive Emotion Regulation Questionnaire, the Strategic Approach to Coping Scale, the Family Adaptability and Cohesion Scale, and the Illness Perception Questionnaire were applied. The data were processed using the SPSS 21 software. Results. Patients with previous records of cancer in the family get significantly higher scores for the illness coherence factor. Family satisfaction is significantly higher for patients with a genetic risk, compared to the one reported by patients who suffer from the disease but have no genetic risk. Cognitive-behavioral coping strategies and family cohesion are factors that correlate with an adaptive perception of the illness in the case of patients with a family history of cancer. Conclusion. Results are important for the construction of strategies used for patients with a family history of cancer.

Novel amikacin inhaled formulation for the treatment of lower respiratory tract infections.

Lower respiratory tract infections are usually treated with systemic antibiotics, but sometimes in certain conditions inhaled antibiotics may also be used. In cystic fibrosis (CF) for example, inhaled tobramycin is used to treat chronic airways infection due to Pseudomonas aeruginosa, and in other conditions such as ventilator-associated pneumonia, inhaled colistin is used as add-on therapy to reduce the risk of side effects of prolonged systemic exposure. Other inhaled antibiotics are currently under development, and inhaled amikacin is one such example. The two formulations of inhaled amikacin currently under clinical development may have two different therapeutic trajectories: the nebulized liposomal formulation is the first once-daily aminoglycoside for CF patients, whereas the free nebulized amikacin may be used in addition to systemic therapy in ventilator-associated pneumonia patients exploiting reduced systemic exposure to amikacin as a therapeutic advantage, especially in patients with renal impairment.

The Impact of Body Image and Self-Perceived Physical Ability on the Well-Being after Mastectomy without Reconstruction

Introduction: Mastectomy has well-known effects on both physical health status of the patients as well as on their mental life (self-image, daily activities, social integration, lifestyle, etc.). The aim of this study was to identify the physical and psychological factors associated with post-mastectomy distress. Material and Methods: Thirty-one women aged 39 to 69 years old (mean age 57 +/- 7.85 years old) who underwent surgery for tumour excision responded to questionnaires on their current physical and psychological well-being following surgery. 83.33% of the patients underwent mastectomy, 10% lumpectomy, and 6.67% both interventions. Age at the time of surgery ranged from 33 to 67 years old (mean 48.30 +/- 7.54). Fifty percent of the patients had no family cancer history, 30% had a family cancer history, and 16.67% were not aware of their family antecedents. Results: Over half of the women were satisfied with their arm and trunk mobility and the ability to perform strenuous or prolonged exercise; 60% of patients were satisfied and very satisfied with the postoperative scar. 78.56% feel comfortable when making short trips (weekend). A higher depression score was identified in patients who received chemotherapy compared to those who received hormonotherapy, radiation therapy or targeted therapy. Conclusions: The quality of life of mastectomized patients is influenced by the level of satisfaction with body image, perceived physical state, and independence in activities of daily living, and type of therapy. The age at the time of surgery, time passed since surgery or educational level, had no influence on the quality of life.