Saras Mane

Hypertension is associated with enhanced cardiac sympathetic transmission, although the exact mechanisms underlying this are still unknown. We hypothesized that defective function of the norepinephrine uptake transporter (NET) may contribute to the sympathetic phenotype of the spontaneously hypertensive rat, and that this may occur before the development of hypertension itself. The dynamic kinetics of NET were monitored temporally using a novel fluorescent assay of the transporter in cultured postganglionic sympathetic neurons from the cardiac stellate ganglion, the superior cervical ganglion, the celiac ganglia/superior mesenteric ganglia, and the renal sympathetic chain. All NET activity was blocked by desipramine. NET rate was significantly impaired in cardiac stellate sympathetic neurons from the prehypertensive spontaneously hypertensive rat compared with age-matched normotensive Wistar-Kyoto rats. A similar response was seen in hypertensive spontaneously hypertensive rats stellate sympathetic neurons. However, no reduction in transporter rate was observed at either age in the other major noncardiac sympathetic ganglia. Depolarization of cardiac stellate neurons by electrical field stimulation further potentiated the difference in transporter rate observed between the hypertensive and normotensive rats at both developmental ages. In conclusion, dysregulation of the norepinephrine transporter in the hypertensive rat is ganglion-specific, where NET impairment in the stellate neurons may contribute to the increased cardiac norepinephrine spillover seen in hypertension.

Actinic keratoses form as rough, scaly plaques on sun-exposed areas; they can be an important step in premalignant progression to squamous cell cancer of the skin. Currently, pharmacological treatments consist of topical immunomodulatory agents with poor side effect profiles. Use of honey has been common in both ancient and modern medicine, where it is now a key therapy in the management of wound healing. In vitro studies show the New Zealand native Kanuka honey to have immunomodulatory and antimitotic effects, with recent evidence suggesting efficacy of topical application in a variety of dermatological contexts, including rosacea and psoriasis. Here, we present a case report of a 66-year-old gentleman with an actinic keratosis on his hand, which had been present for years. Regular application of Kanuka honey over three months resulted in remission immediately following the treatment period with no signs of recurrence at nine months.

<b>Introduction:</b> Knowledge of patient priorities is important to select appropriate treatment. Discrete choice experiment (DCE) methodology involves making trade-offs which indicate patients’ preferences. <b>Aim:</b> To determine the relative importance to participants in the PRACTICAL study, a 12-month open-label RCT of symptom-driven budesonide-formoterol versus regular budesonide plus as-needed terbutaline, of attributes distinguishing these regimens. <b>Methods:</b> Regimen attributes were identified using focus groups. Participants finishing the PRACTICAL study after 26 March 2018 at 6/14 sites completed one of two DCEs based on their stated preference for as-needed combined preventer/reliever therapy or regular preventer and as needed reliever. 1000minds software and the PAPRIKA method were used for the DCEs. <b>Results:</b> The DCEs were completed by 296 of 407 (73%) eligible participants. Figure 1 shows preference weights representing the relative importance of the attributes in the DCEs. Frequency of breathlessness had a stronger influence on choice than risk of flare up, type of regimen or steroid dose. Within each DCE, attribute weights were not affected by the patient’s randomisation group. <b>Conclusions:</b> In these DCEs, participant’s preferences were influenced by several attributes in addition to as-needed versus regular treatment. The relative importance of such attributes should be considered during shared decision-making with patients.

<b>Introduction:</b> Many candidate treatable traits have been proposed for the management of airways disease. However, trait prevalence in the general asthma population and which traits are associated with future exacerbation risk are unknown. <b>Methods:</b> The prevalence of 17 treatable traits and their association with future exacerbation risk was derived from the previously reported New Zealand Respiratory Health Survey, ACTRN12610000666022. Adults aged 18-75 with symptoms of wheeze and breathlessness, recruited from a random population sample, underwent detailed characterisation with questionnaires, pulmonary function, and biomarkers including blood eosinophils and FeNO. ACQ5 score was a co-variate. <b>Results:</b> 175 participants had both a doctor9s diagnosis of asthma and severe exacerbation data. Traits are shown in figure 1. Six traits were significantly associated with future exacerbation: <b>Conclusions:</b> We have demonstrated that 5 of 17 traits are associated with increased future risk of exacerbation in this population. These traits may be of particular importance for personalised treatment.