IntroductionPeople with COPD have a decline in functional status, but little is known about the rate of decline and factors that contribute. Of particular concern is the decline in cognitive and functional performance. Decrease in cognitive and functional performance will finally lead to decreased health status, sedentary life style and premature frailty.AimThe aim of this study is to compare functional performance and cognitive status in patients with COPD of different ages and to examine the changes in extrapulmonary effects.Patients and methodsThis study included 62 patients with COPD risk class D who were divided into two groups (<70 years, N=30 and >70 years, N=32). Patients first completed the Montreal Cognitive Assessment (MoCA), which is a 30-point test that assesses different cognitive domains, while isometric knee extension (IKE) was measured using a digital handheld dynamometer, and functional exercise level was assessed using the 6-minute walking distance (6MWD) test.ResultsThe patients’ older age (age higher than 70 years) was associated with a significantly lower body mass index (BMI, 27.50 vs 24.24 kg/m2; P=0.020), higher vital capacity parameters, forced vital capacity (FVC, 2.74 vs 2.82 L; P=0.799), FVC (%) (73.00 vs 66.50, P=132), forced expiratory volume in the first second (FEV1, 0.93 vs 1.13 L; P=0.001) and FEV1 (%) (28.50 vs 30.50, P=0.605). In addition, patients at older age presented a significantly reduced physical activity capacity, 6MWD (385.93 vs 320.84 m, P<0.001) and IKE (24.75 vs 22.55 kgf, P=0.005), as well as higher values for inflammatory biomarkers, C-reactive protein (8.77 vs 3.34 mg/L, P=0.022). Moreover, patients at older age presented significantly lower score at the cognitive assessment, MoCA (23.50 vs 20.00, P<0.001).ConclusionElderly COPD patients have reduced exercise capacity and muscle strength, deteriorated cognitive function and increased inflammatory markers. Furthermore, inflammation markers were significantly correlated with muscle strength, walking distance and cognitive impairment.

Free radical scavenging activity, total phenolic content and the chemical composition of the essential oil isolated by steam distillation from Artemisia dracunculus L. was investigated. The isolation yield was 0.24% (v/w) based on the fresh plant material (leaves). GC-MS investigation identified 21 components, accounting 99.93% of the total amount. The major components were sabinene (42.38%), isoelemicin (12.91%), methyl eugenol (9.09%), elemicin (7.95%) and beta-ocimene (6.46%). The free radical scavenging activity of the essential oil of Artemisia dracunculus L. was evaluated in vitro by the DPPH assay (IC50 = 0.730 � 0.213 mg/mL), BHA and alpha-tocopherol were used as a positive control. The total phenolic content of the tarragon essential oil was evaluated by the Folin-Ciocalteu method (GAE = 0.451 � 0.001 mg/g sample). In view of these data, we consider that tarragon essential oil could represent a new antioxidants source as a reliable option to reduce the usage of synthetic additives.

Asthma is a variable chronic respiratory disease characterized by airway inflammation and hyperresponsiveness, bronchoconstriction, and mucus hypersecretion. While most patients with asthma achieve good control of the disease, 5-10% experience severe symptoms and recurrent exacerbation despite the maximal offered therapy with inhaled corticosteroids and long acting bronchodilators. In previous years, novel biological therapies have become available, and various asthma phenotypes that are characterized by specific biomarkers have been identified. Currently approved biological agents target inflammatory molecules of the type 2 inflammatory pathway, and are effective at decreasing the frequency of asthma attacks, controlling symptoms and decreasing use of systemic steroids. The present study reviewed the effectiveness and safety profile of the currently approved biological drugs and provided an overview of the assessment of patients with severe asthma who are potentially suitable for biological therapy, in order to help clinicians to select the most appropriate biological agent. Contents1. Introduction 2. Pathophysiology of severe asthma 3. Targeting T2 severe asthma phenotypes-currently approved treatments and biological drugs under investigation 4. Discussion 5. Conclusion

BackgroundNon-adherence to treatment is associated with poor asthma control, increased exacerbations, decline in lung function, and decreased quality of life. M-health applications have become increasingly in the last years, but little research regarding the efficiency of the instructional videos for correct inhaler use exist. The aim of this study is to assess and improve the inhalator technique and to establish which types of errors were made more often with the help of a mobile health application.Materials and methodsSeventy-five patients with partially controlled or uncontrolled asthma, using any of turbuhaler, diskus, pressurized metered dose inhaler (pMDI) or soft mist inhaler (SMI), were included in the study. When they first entered the study, the patient’s inhaler technique was assessed by a trained medical professional and the technique errors were categorized in handling, respectively inhalation errors. After the first evaluation, the patients downloaded an application on their Smartphone and were encouraged to use the application as much as needed to remind them the correct inhalation technique. The patients were re-called every three months for evaluation, treatment, and assessment of inhalation technique.ResultsWe analyzed both handling and inhalation errors for each of the four considered inhalers. We observed a significantly reduced number of inhalation technique errors after using the mobile phone application. Turbuhaler median errors were 6.00, and after six months we did not observe errors. Diskus median error was 6.00, and after six months we observed a maximum of one error. pMDI median errors were 7.00, and after six months we observed just one error. Similarly, SMI median error was 7.00, and after six months we observed just one error.ConclusionAlthough technique inhalation errors are very common among asthma patients, video instructions provided through specific mobile phone applications could improve the inhaler technique in order to achieve a better control of the disease.

Telocytes (TCs) are stromal cells defined by peculiar long, thin, moniliform prolongations known as telopodes. When isolated, their morphology often lacks the specificity for the proper definition of a particular cell type. Recent studies have linked TCs with different functions and different cell lineages. Although some authors have studied pulmonary TCs, their research has important limitations that we will attempt to summarize in this article. We will focus our analysis on the following: the culture methods used to study them, the lack of proper discrimination of TCs from lymphatic endothelial cells (LECs), whose ultrastructures are very similar, and the immune phenotype of TCs, which may appear in other cell types such as those related to the endothelial lineage or stem/progenitor cells. In conclusion, the cellular diagnosis of lung TCs should be considered with caution until properly designed studies can positively identify these cells and differentiate them from other cell types such as LECs and stem/progenitor cells.Abbreviations list: BEC = blood endothelial cell; EC = endothelial cell; ICC = interstitial Cajal cell; ICLC = interstitial Cajal-like cell; IHC = immunohistochemistry; LEC = lymphatic endothelial cell; MSC = mesenchymal stem cell; NSE = neuron-specific enolase; PDGF = platelet-derived growth factor; PDGFR = plateletderived growth factor receptor; TC = telocyte; TEM = transmission electron microscopy; Tps = telopodes; VEGF = vascular endothelial growth factor; VEGFR = vascular endothelial growth factor receptor *Correspondence to: Ariadna P. Fildan