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asthma and spacers

Susanne Mueller-Rompa, Tobias Janke, Karin Schwaiger, Melanie Mayer, Johann Bauer, Jon Genuneit, Charlotte Braun-Fahrlaender, Elisabeth Horak, Andrzej Boznanski, Erika von Mutius, Markus Johannes Ege
BACKGROUND: Exposure to moulds 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 though 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...
October 6, 2016: Pediatric Allergy and Immunology
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...
2016: Cochrane Database of Systematic Reviews
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
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
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...
August 10, 2016: CJEM
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
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
Nicholas Ogrodnik, Victor Azzi, Elizabeth Sprigge, Sandra Fiset, Edgar Matida
BACKGROUND: Pressurized metered-dose inhalers (pMDIs) are commonly used to administer medication to patients suffering from chronic lower respiratory tract diseases such as asthma. Inhaling medication directly from a pMDI can prove difficult for some patients and, as a result, add-on devices (or spacers) have been designed to aid in the delivery of medication. Although spacers increase the percentage of medication that reaches the patient, medication will also nonsymmetrically deposit on the walls of the device and will be lost to the device itself...
May 25, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Sally Schoessler, Tonya Winders
Asthma is one of the most prevalent chronic diseases managed by school nurses, and its management often includes the administration of bronchodilators delivered via a metered dose inhaler (MDI). The use of an MDI requires coordination and mastery of steps that must be performed correctly and in the proper order. These steps are greatly enhanced, especially in the pediatric population, through the use of medical devices-spacers and valved holding chambers. The purpose of this article is to review the rationale and implications for the use of these devices in the school setting...
July 2016: NASN School Nurse
Niki Mitselou, Gunilla Hedlin, Carl-Axel Hederos
OBJECTIVE: To compare administration of bronchodilators by nebulizers with delivery by metered dose inhalers (MDIs) with spacers and to evaluate the clinical effect of the treatment of acute asthma in preschool children. METHODS: A prospective randomized clinical trial in a pediatric emergency department (PED). Preschool children who were admitted for virus induced wheezing or acute asthma exacerbation were randomly allocated to receive bronchodilator treatment by nebulizer or by metered dose inhaler...
December 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
J Pourchez, L Leclerc, G Sarry, J-M Vergnon, J C Dubus
INTRODUCTION: Use of a spacer device to optimize the delivery of fluticasone to infants with asthma is an important issue and clinicians require guidance around the choice of device. This in vitro study characterizes the particle size and the fluticasone delivery via 9 spacers. METHODS: We used an in vitro infant nasal cast with two different inspiratory flow rates (50 and 100mL/s). Fluticasone particle size in the aerosol was evaluated by laser diffractometry and tracheal deposition by spectrophotometric assay...
May 4, 2016: Revue des Maladies Respiratoires
Maha Al Ammari, Khizra Sultana, Faisal Yunus, Mohammed Al Ghobain, Shatha M Al Halwan
OBJECTIVES: To assess the proportion of critical errors committed while demonstrating the inhaler technique in hospitalized patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD).  METHODS: This cross-sectional observational study was conducted in 47 asthmatic and COPD patients using inhaler devices. The study took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia between September and December 2013. Two pharmacists independently assessed inhaler technique with a validated checklist...
May 2016: Saudi Medical Journal
Chris Gillette, Nicole Rockich-Winston, JoBeth A Kuhn, Susan Flesher, Meagan Shepherd
BACKGROUND: Pediatric asthma is an important public health problem worldwide. The primary methods of medication delivery are inhalation devices. OBJECTIVES: This systematic review examined: 1) what is the prevalence of correct inhaler technique among children with asthma, 2) are educational interventions associated with improved rates of correct inhalation technique, and 3) is improved inhaler technique associated with improved asthma outcomes? DATA SOURCES: We included experimental and observational studies through searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL Complete, and clinicaltrials...
September 2016: Academic Pediatrics
Delesha M Carpenter, Dayna S Alexander, Alice Elio, Darren DeWalt, Charles Lee, Betsy L Sleath
UNLABELLED: Our purpose was to test whether a tailored inhaler technique video intervention: (1) could be feasibly implemented by school nurses and (2) improve the inhaler technique of children with asthma. METHODS: School nurses recruited a convenience sample of 25 children with asthma (ages 7-17) and assessed their inhaler technique. Children then watched a tailored video that provided: (1) step-by-step feedback on which steps (out of 8) they performed correctly, (2) praise for correctly-performed steps, and (3) statements about why incorrectly-performed steps are important...
July 2016: Journal of Pediatric Nursing
Geun Mi Park, Hye Won Han, Hee Se Kim, Jae Youn Kim, Eun Lee, Hyun-Ju Cho, Song-I Yang, Young-Ho Jung, Soo-Jong Hong, Hyung Young Kim, Ju-Hee Seo, Jinho Yu
PURPOSE: Adherence to treatment with inhaled corticosteroids (ICS) is a critical determinant of asthma control. The objective of this study was to assess factors that determine adherence to ICS therapy in children with asthma. METHODS: Fifty-eight children with asthma, aged 5 to 16 years, used ICS with or without a spacer for 3 months. Adherence rates as measured from questionnaires and canisters, asthma symptom scores, and inhalation technique scores were assessed every 30 days...
December 2015: Korean Journal of Pediatrics
Fábio Pereira Muchão, Luiz Vicente Ribeiro Ferreira da Silva Filho, Antonio Carlos Pastorino, Joaquim Carlos Rodrigues
OBJECTIVE: To evaluate the effect of a theoretical and practical guidance on knowledge of pediatricians regarding the use of metered dose inhalers with spacers. To identify major deficiencies, correct them and train these physicians on the correct use of the devices. METHODS: Pediatricians who participated in a theoretical-practical program focusing on the use of inhaler devices answered a questionnaire with five questions about the use of these devices before and after the program...
September 2011: Einstein
Mara Lelii, Nicola Principi, Susanna Esposito
BACKGROUND: Inhaled corticosteroids (ICSs) are currently used to prevent and treat asthma and recurrent wheezing attacks in children. Fluticasone propionate (FP) is one of the most commonly prescribed ICSs because it is considered effective and well tolerated. CASE PRESENTATION: A male infant of approximately 1 year of age, who was born to parents without relevant clinical problems or family histories including diabetes, was brought to our attention for recurrent wheezing...
2016: BMC Pulmonary Medicine
H Shonna Yin, Ruchi S Gupta, Suzy Tomopoulos, Alan L Mendelsohn, Maureen Egan, Linda van Schaick, Michael S Wolf, Dayana C Sanchez, Christopher Warren, Karen Encalada, Benard P Dreyer
BACKGROUND AND OBJECTIVES: The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram- and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan. METHODS: Physicians at 2 academic centers randomized to use a low-literacy or standard action plan (American Academy of Allergy, Asthma and Immunology) to counsel the hypothetical parent of child with moderate persistent asthma (regimen: Flovent 110 μg 2 puffs twice daily, Singulair 5 mg daily, Albuterol 2 puffs every 4 hours as needed)...
January 2016: Pediatrics
Sharon R Davis, Seeta Durvasula, Diana Merhi, Paul M Young, Daniela Traini, Sinthia Z Bosnic Anticevich
BACKGROUND: Fifteen percent of Australians with intellectual disability (ID) are reported to have asthma. People with ID are at risk of poor health knowledge due to deficits in intellectual and adaptive functioning, but their medication knowledge has largely been ignored in research to date. OBJECTIVE: To explore the level of understanding of asthma medication use of people with ID who self-administer their inhaled medications, in order to inform future educational support...
February 2016: International Journal of Clinical Pharmacy
Richard A Sharpe, Kate Le Cocq, Vasilis Nikolaou, Nicholas J Osborne, Christopher R Thornton
The aim of this study was to determine the accuracy of monoclonal antibodies (mAbs) in identifying culturable allergenic fungi present in visible mould growth in energy efficient homes, and to identify risk factors for exposure to these known allergenic fungi. Swabs were taken from fungal contaminated surfaces and culturable yeasts and moulds isolated by using mycological culture. Soluble antigens from cultures were tested by ELISA using mAbs specific to the culturable allergenic fungi Aspergillus and Penicillium spp...
January 2016: Environmental Research
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