Salt-sensitive hypertension is common in people of African origin, and may be caused by increased transepithelial sodium absorption. The pH of nasal secretions is negatively correlated with the difference in Na(+) concentration between nasal secretions and plasma, and may be a marker of transepithelial sodium absorption. Nasal pH was measured using a probe sited under the inferior turbinate. Measurements of nasal pH were reproducible, with a coefficient of variation of 3.3% for repeated measurements on the same day and of 2.7% between measurements on different days. Nasal pH did not correlate with nasal potential difference, a measure of transepithelial sodium absorption. Nasal pH was significantly lower in 89 black individuals (24 normotensive and 65 hypertensive) than in 51 white individuals (26 normotensive and 25 hypertensive) (black normotensive. 6.44+/-0.08; black hypertensive, 6.62+/-0.05; white normotensive, 6.91+/-0.06; white hypertensive, 6.98+/-0.06), after adjustment for age, gender, current smoking status, body mass index and 24 h urinary sodium excretion (P=0.002), but was not significantly different between the normotensive and hypertensive individuals. Nasal pH was more acidic in black than in white individuals, which may represent generalized up-regulation of sodium transport in black people. However, the lack of correlation between nasal pH and potential difference suggests that nasal pH is, at best, only weakly related to transepithelial sodium absorption. Ethnic differences in nasal pH may be of direct relevance in the airways, as many of the functions of airway surface liquid are dependent on pH.

Background Chronic Obstructive Pulmonary Disease (COPD) is associated with an increased risk of myocardial infarction and stroke but it remains unclear how to identify microvascular changes in this population. Objectives We hypothesized that simple non-mydriatic retinal photography is feasible and can be used to assess microvascular damage in COPD. Methods Novel Vascular Manifestations of COPD was a prospective study comparing smokers with and without COPD, matched for age. Non-mydriatic, retinal fundus photographs were assessed using semi-automated software. Results Retinal images from 24 COPD and 22 control participants were compared. Cases were of similar age to controls (65.2 vs. 63.1 years, p = 0.38), had significantly lower Forced Expiratory Volume in one second (FEV 1) (53.4 vs 100.1% predicted; p < 0.001) and smoked more than controls (41.7 vs. 29.6 pack years; p = 0.04). COPD participants had wider mean arteriolar (155.6 ±15 uM vs. controls [142.2 ± 12 uM]; p = 0.002) and venular diameters (216.8 ±20.7 uM vs. [201.3± 19.1 uM]; p = 0.012). Differences in retinal vessel caliber were independent of confounders, odds ratios (OR) = 1.

Poster sessions A142Thorax 2012;67(Suppl 2):A1-A204Prescription refill data were used to calculate percentage adherence by dividing the amount collected by the amount prescribed, multiplied by 100. Participants were categorised as adherent (score≥80%) and non-adherent (score<80%) to inhaled antibiotics and other respiratory medicines using this method. Participants completed the modified Self-reported Medication-taking Scale for ACT (score 0-5; adherent score≥4, non-adherent score<4). Spirometry was performed according to ATS/ERS guidelines. Chi square tests were used for between group analyses. Results 75 participants were recruited: 24M/51F; mean (SD) age 64 (8) yrs; FEV 1 61 (25) % predicted. Sixty-four (85%) participants were prescribed colomycin, 11 (15%) were prescribed tobramycin, 68 (91%) were prescribed bronchodilators and 65 (87%) were prescribed inhaled corticosteroids. All participants were prescribed ACT; active cycle of breathing techniques (n=39, 53%) and Acapella ® (n=45, 61%) were most commonly prescribed. Eleven percent (16%) participants were adherent to all treatments. Fifty-two percent and 51% of participants were adherent to inhaled antibiotics and other respiratory medicines, respectively. Thirty-nine percent of participants were adherent to ACT. Adherence category varied significantly between inhaled antibiotics and other respiratory medicines (p=0.04), with 34% of participants being adherent to one treatment and not the other. Conclusion Patients with bronchiectasis patients infected with P. aeruginosa have a high burden of treatment. Only 11% of patients were adherent to all treatments, half were adherent to medicines and even fewer were adherent to ACT, indicating that patients make decisions about which treatments to use.

Conclusion In acute exacerbation of COPD there is no difference between 7-day and 14-day courses of treatment with oral prednisolone. The peak of FEV 1 and FVC in 7-day group on day-10 where corticosteroid was already stopped on day-7, (peak in 14-day group was on day-7) might be due to some other factor/factors responsible which would be cleared by further study. Clinical implications There was no difference between 7-day and 14-day courses of prednisolone treatment, so, 7-day might be the shortest effective course of steroid treatment in acute exacerbation of COPD to avoid the burden of cost and side effects.