Bronchodilators, namely long-acting inhaled β2-agonists and long-acting muscarinic antagonists, are the first-line medications for chronic obstructive pulmonary disease (COPD). The safety of these medicines is of great concern since COPD patients usually have other co-morbidities such as cardio- and cerebrovascular diseases. Areas covered: In this review we present information about the safety and the use of indacaterol in COPD. Indacaterol is the first once-daily, long-acting inhaled β2-agonist approved for COPD. We provide data about its mechanism of action as well as, pharmacodynamics and pharmacokynetics. Moreover, we present the available literature data focused on the the safety of indacaterol. Data from post-marketing studies are presented and also data from comparative reviews and meta-analysis. Expert opinion: Indacaterol's safety is very favorable since in controlled trials it was similar to placebo. Nevertheless, physicians must be alerted to use indacaterol only according to its approved indications They must be aware of the possible adverse events since side effects may appear when the medicine is used for a prolonged period of time.

Tuberculous pericarditis is a form of extrapulmonary tuberculosis that is considered unusual in western coun-tries. Diagnosis is often challenging, while proper treatment has a major impact on prognosis. We present three interesting cases, with complicated or unusual manifestations of tuberculous pericarditis: a patient with cardiac tamponade as the initial manifestation of tuberculosis; a patient progressing to constriction despite adequate treatment; and a patient receiving anti-TNFalpha, who developed pericarditis in the context of immune reconstitution inflammatory syndrome. We briefly review the clinical features of tuberculous pericarditis, whilst our main focus is on the available diagnostic techniques and treatment aspects. In conclusion, tuberculous pericarditis remains an active thread in the western world. A high index of suspicion combined with the use of all available diagnostic techniques are important to increase diagnostic yield. Prompt and effective treatment is essential to reduce morbidity and mortality.

Background:During the past few years, the use of criteria introduced by Global Initiative for Chronic Obstructive Lung Disease (GOLD) is recommended for the diagnosis and classification of Chronic Obstructive Pulmonary Disease(COPD),taking into account the values of a Forced Expiratory Volume In 1 second (FEV1) and a Forced Expiratory Volume In 1 second (FEV1) to Forced Vital Capacity (FVC) ratio. In Europe, the reference values of the European Coal and Steel Community (ECSC), that were originally developed in 1993 are still used.Aim of the Study:The study aimed to carry out measurement of spirometric values in a healthy, non smoking Greek population, development of local equations and comparison with ECSC and Global Lung Initiative(GLI) equations, in order to see if there is a need for separate ones in everyday use.Methods:Normal predicted values for FEV1 and FEV1/FVC% were obtained from a group of 500 healthy subjects, aged 18-89 years. In addition, a group of 124 COPD patients, with no other comorbidities was studied. Patients were classified according to GOLD criteria in four groups with ECSC, GLI predicted values or with our own predicted values.Results:The statistical analysis has revealed that there is no significant difference among the three sets of predicted values and no statistical difference was detected among the classification of COPD patients.Conclusion:It is shown that the 3 sets of predicted values are almost identical, despite the fact that they have been collected from different study populations.Αccording to the study, there is no need in recalculating values for Greek population.

Our aim was to prospectively assess the prognostic value of beta2- microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient. In this preliminary study, baseline b2-M levels significantly correlated with the impairment of oxygenation and with all the parameters that are used for the early risk stratification of patients. In multivariate analysis, patients’ age and baseline b2-M levels were significantly associated with an increased risk of death. These findings require further prospective validation.