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asthma and spacers

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https://www.readbyqxmd.com/read/28510491/short-term-growth-during-treatment-with-inhaled-fluticasone-propionate-formoterol-fluticasone-and-beclomethasone-treatment
#1
Ole D Wolthers, Ainslee Moore, Sabine Mersmann, Sanjeeva Dissanayake
BACKGROUND: Fluticasone propionate/formoterol (FP/FORM) is a pressurized metered-dose inhaler (pMDI; Flutiform(®)) approved for use in adolescents and adults and under development for pediatric use. OBJECTIVE: To compare short-term growth in asthmatic children treated with FP/FORM, FP pMDI with valved holding chamber, and beclomethasone dipropionate (BDP) in a breath-actuated device. METHODS: Children with persistent asthma (n = 48; 5 to <12 years) participated in an assessor-blinded, randomized, three-way crossover trial with run in, wash out, and active treatment periods, each of 2 weeks duration...
May 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#2
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28402017/asthma-education-for-school-staff
#3
REVIEW
Kayleigh M Kew, Robin Carr, Tim Donovan, Morris Gordon
BACKGROUND: Teachers and school staff should be competent in managing asthma in schools. Demonstrated low levels of asthma knowledge mean that staff may not know how best to protect a child with asthma in their care, or may fail to take appropriate action in the event of a serious attack. Education about asthma could help to improve this knowledge and lead to better asthma outcomes for children. OBJECTIVES: To assess the effectiveness and safety of asthma education programmes for school staff, and to identify content and attributes underpinning them...
April 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28366780/design-of-a-pragmatic-trial-in-minority-children-presenting-to-the-emergency-department-with-uncontrolled-asthma-the-chicago-plan
#4
Jerry A Krishnan, Molly A Martin, Cortland Lohff, Giselle S Mosnaim, Helen Margellos-Anast, Julie A DeLisa, Kate McMahon, Kim Erwin, Leslie S Zun, Michael L Berbaum, Michael McDermott, Nina E Bracken, Rajesh Kumar, S Margaret Paik, Sharmilee M Nyenhuis, Stacy Ignoffo, Valerie G Press, Zachary E Pittsenbarger, Trevonne M Thompson
Among children with asthma, black children are two to four times as likely to have an emergency department (ED) visit and die from asthma, respectively, compared to white children in the United States. Despite the availability of evidence-based asthma management guidelines, minority children are less likely than white children to receive or use effective options for asthma care. The CHICAGO Plan is a three-arm multi-center randomized pragmatic trial of children 5 to 11years old presenting to the ED with uncontrolled asthma that compares: [1] an ED-focused intervention to improve the quality of care on discharge to home, [2] the same ED-focused intervention together with a home-based community health worker (CHW)-led intervention, and [3] enhanced usual care...
March 31, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28245825/predictors-of-correct-technique-in-patients-using-pressurized-metered-dose-inhalers
#5
Kyra Bartolo, Martin Balzan, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon, Stephen Montefort
BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical...
February 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#6
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28137226/management-of-status-asthmaticus-in-children
#7
Kam-Lun E Hon, Alexander K C Leung
BACKGROUND: Status asthmaticus is an acute exacerbation of asthma that is persistent and intractable and remains unresponsive to initial treatment with bronchodilators and systemic corticosteroids and that can result in hypoxemia, hypercarbia, and secondary respiratory failure. METHOD: We reviewed treatment and recent patents on management of status asthmaticus. CONCLUSIONS: Supplemental oxygen should be given to maintain an oxygen saturation of ≥92% in room air...
January 30, 2017: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/28110057/real-life-outcomes-for-patients-with-asthma-prescribed-spacers-for-use-with-either-extrafine-or-fine-particle-inhaled-corticosteroids
#8
Theresa W Guilbert, Gene Colice, Jonathan Grigg, Wim van Aalderen, Richard J Martin, Elliot Israel, Dirkje S Postma, Nicolas Roche, Wanda Phipatanakul, Elizabeth V Hillyer, Jennifer M Evans, Myrna B Dolovich, David B Price
BACKGROUND: Spacers are often used with pressurized metered-dose inhalers (pMDIs) to eliminate the need for coordinating inhalation with actuation. OBJECTIVE: To investigate the real-life effectiveness of spacers prescribed for use with either extrafine- or fine-particle inhaled corticosteroids (ICSs). METHODS: This historical matched cohort study examined anonymous medical record data over 2 years (1-year baseline, 1-year outcome) for patients with asthma aged 12 to 80 years initiating ICSs by pMDI with or without prescribed spacer...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28045551/use-of-a-low-literacy-written-action-plan-to-improve-parent-understanding-of-pediatric-asthma-management-a-randomized-controlled-study
#9
Hsiang Shonna Yin, Ruchi Gupta, Alan L Mendelsohn, Benard P Dreyer, Linda van Schaick, Christina R Brown, Karen Encalada, Dayana Sanchez, Christopher Warren, Suzy Tomopoulos
OBJECTIVES: To determine whether parents who use a low literacy, pictogram- and photograph-based written asthma action plan have a better understanding of child asthma management compared to parents using a standard plan. METHODS: Randomized controlled study in 2 urban pediatric outpatient clinics. INCLUSION CRITERIA: English/Spanish-speaking parents of 2-12 year old asthmatic children. Parents were randomized to receive a low literacy or standard asthma action plan (American Academy of Allergy, Asthma and Immunology) for a hypothetical patient on controller and rescue medications...
January 3, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27934805/comparison-of-clinical-effects-of-beclomethasone-dipropionate-budesonide-in-treatment-of-children-with-mild-persistent-asthma-a-double-blind-randomized-controlled-study
#10
Anju Singh, Devki Nandan, Vivek Dewan, Jhuma Sankar
BACKGROUND & OBJECTIVES: Various inhaled corticosteroids (ICSs) are available to control the symptoms of asthma. Although beclomethasone dipropionate (BDP) and budesonide (BUD) are one of the oldest ICSs, their wide availability and low cost make them attractive options in developing countries. Due to lack of consensus on which of the two drugs is better for controlling mild persistent asthma, we undertook this study to compare the efficacy of these two drugs by measuring the change in percentage predicted forced expiratory volume in one second (FEV 1 ) from baseline in children with mild persistent asthma...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27914817/what-really-happens-in-the-home-the-medication-environment-of-urban-minority-youth
#11
Andrea A Pappalardo, Kelly Karavolos, Molly A Martin
BACKGROUND: Asthma disproportionately affects minority youth. Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes. OBJECTIVE: The objective of this study was to describe the asthma medication environment in the homes of urban minority youth and to determine predictors of medication use and technique in this population. METHODS: Baseline data from 2 cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27863828/-health-care-providers-knowledge-and-abilities-to-use-inhalation-devices-and-spacers
#12
S Orfanos, A Carsin, M Baravalle, J-C Dubus
INTRODUCTION: Inhaled therapy is the mainstay of asthma treatment due to its local and rapid action. However, its efficiency relies on the teaching of a good inhalation technique by health care providers. We assessed health care providers' knowledge and practical skills in the use of inhalation devices. METHODS: An observational multicenter study was conducted in the pulmonology and paediatric wards in Marseille. The departments' common practices, theoretical knowledge and practical skills were assessed through a questionnaire and a demonstration using a spacer device...
November 15, 2016: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27843842/evaluation-of-proficiency-in-using-different-inhaler-devices-among-intern-doctors
#13
Ravish M Kshatriya, Nimit V Khara, Rajiv P Paliwal, Satish N Patel
CONTEXT: Doctors may have deficiencies in the ability to use different inhalers, which in turn, can result in improper technique by the patients and poorly controlled asthma and chronic obstructive pulmonary disease (COPD). AIMS: To evaluate intern doctors' proficiency in using various inhaler devices. MATERIALS AND METHODS: Seventy interns were evaluated for their proficiency in using pressurized metered dose inhaler (pMDI), pMDI with spacer, rotahaler, turbuhaler, and nebulizer...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27711990/identification-of-fungal-candidates-for-asthma-protection-in-a-large-population-based-study
#14
Susanne Mueller-Rompa, Tobias Janke, Karin Schwaiger, Melanie Mayer, Johann Bauer, Jon Genuneit, Charlotte Braun-Fahrlaender, Elisabeth Horak, Andrzej Boznanski, Erika von Mutius, Markus J Ege
BACKGROUND: Exposure to molds has been related to asthma risk both positively and negatively, depending on the environmental setting. The pertinent results are based on generic markers or culturing methods although the majority of present fungi cannot be cultured under laboratory conditions. The aim of the present analysis was to assess environmental dust samples for asthma-protective fungal candidates with a comprehensive molecular technique covering also non-cultivable and non-viable fungi...
February 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/27569680/bronchodilators-delivered-by-nebuliser-versus-pmdi-with-spacer-or-dpi-for-exacerbations-of-copd
#15
REVIEW
Wouter H van Geffen, W R Douma, Dirk Jan Slebos, Huib A M Kerstjens
BACKGROUND: Bronchodilators are a central component for treating exacerbations of chronic obstructive pulmonary disease (COPD) all over the world. Clinicians often use nebulisers as a mode of delivery, especially in the acute setting, and many patients seem to benefit from them. However, evidence supporting this choice from systematic analysis is sparse, and available data are frequently biased by the inclusion of asthma patients. Therefore, there is little or no formal guidance regarding the mode of delivery, which has led to a wide variation in practice between and within countries and even among doctors in the same hospital...
August 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27552795/optimising-the-management-of-wheeze-in-preschool-children
#16
Steven McVea, Thomas Bourke
One third of all preschool children will have an episode of wheeze and many of these present to primary care. Most will fall within a spectrum of diagnosis ranging from episodic viral wheeze to multiple trigger wheeze or early onset asthma. A small proportion will have other rare, but important, diagnoses such as foreign body aspiration, anaphylaxis, gastro-oesophageal reflux, congenital anatomical abnormalities or other chronic lung diseases. Clinical assessment should try to classify children into either episodic viral wheeze or multiple trigger wheeze phenotypes...
June 2016: Practitioner
https://www.readbyqxmd.com/read/27540215/inhaler-counselling-the-real-deal-or-just-fresh-air
#17
Richard Goodwin, Tiranvir Chander, Neha Shah, Steve Tomlin
AIM: To evaluate whether healthcare professionals within the local community are able to counsel paediatric patients on the essential steps required for drug delivery with multi-dose inhalers (MDI), MDIs with a spacer and turbohalers. METHOD: An expert panel produced and piloted checklists for essential and good practice counselling steps. Eligible participants included healthcare professionals regularly counselling children on inhaler devices, including doctors, nurses and pharmacy team members...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27506243/a-cost-analysis-of-salbutamol-administration-by-metered-dose-inhalers-with-spacers-versus-nebulization-for-patients-with-wheeze-in-the-pediatric-emergency-department-evidence-from-observational-data-in-nova-scotia
#18
Paul Spin, Ingrid Sketris, Barbara Hill-Taylor, Courtney Ward, Katrina F Hurley
BACKGROUND: Despite evidence demonstrating the advantages of metered-dose inhalers with spacers (MDI-s), nebulization (NEB) remains the primary method of asthma treatment in some pediatric emergency departments (PEDs). There is a perception that delivering salbutamol by MDI-s is more costly than by NEB. This research evaluates the relative costs of MDI-s and NEB using local, hospital-specific, patient-level data. METHODS: Regression models estimated associations between the salbutamol inhalation method and costs, length of stay (LOS) in the PED and hospital, and the probability of admission...
January 2017: CJEM
https://www.readbyqxmd.com/read/27403173/evaluation-of-proper-usage-of-glucocorticosteroid-inhalers-and-their-adverse-effects-in-asthmatic-patients
#19
Mohammad Esmayil Hejazi, Afsaneh Shafiifar, Siminozar Mashayekhi, Mohammadreza Sattari
BACKGROUND: The frequent use of corticosteroid inhalers (CSIs), especially at higher doses, has been accompanied by concern about both systemic and local adverse reactions. The local adverse reactions of inhaled corticosteroids (ICSs) are considered to constitute infrequent and minor problems. However, while not usually serious, these local adverse reactions are of clinical importance. This study assessed the prevalence of local adverse reactions, their clinical features, role of inhaler devices and current measures that have been suggested to prevent the problem...
2016: Tanaffos
https://www.readbyqxmd.com/read/27251668/pressurised-metered-dose-inhaler-spacer-technique-in-young-children-improves-with-video-instruction
#20
Nicole Shaw, Peter Le Souëf, Lidija Turkovic, Lucy McCahon, Anthony Kicic, Peter D Sly, Sunalene Devadason, André Schultz
UNLABELLED: The importance of good device technique to maximise delivery of aerosolised medications is widely recognised. Pressurised metered dose inhaler (pMDI)-spacer technique was investigated in 122 children, aged 2-7 years, with asthma. Eight individual steps of device technique were evaluated before and after viewing an instructional video for correct device technique. Video measurements were repeated every three months for nine months. Device technique improved directly after video instruction at the baseline study visit (p < 0...
July 2016: European Journal of Pediatrics
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