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Inhalation device

Mohammad S Islam, Suvash C Saha, Tevfik Gemci, Ian A Yang, Emilie Sauret, Y T Gu
The atmospheric particles from different sources, and the therapeutic particles from various drug delivery devices, exhibit a complex size distribution, and the particles are mostly polydisperse. The limited available in vitro, and the wide range of in silico models have improved understanding of the relationship between monodisperse particle deposition and therapeutic aerosol transport. However, comprehensive polydisperse transport and deposition (TD) data for the terminal airways is still unavailable. Therefore, to benefit future drug therapeutics, the present numerical model illustrates detailed polydisperse particle TD in the terminal bronchioles for the first time...
November 6, 2018: Scientific Reports
Barry A Borlaug, Kevin J Anstrom, Gregory D Lewis, Sanjiv J Shah, James A Levine, Gabe A Koepp, Michael M Givertz, G Michael Felker, Martin M LeWinter, Douglas L Mann, Kenneth B Margulies, Andrew L Smith, W H Wilson Tang, David J Whellan, Horng H Chen, Victor G Davila-Roman, Steven McNulty, Patrice Desvigne-Nickens, Adrian F Hernandez, Eugene Braunwald, Margaret M Redfield
Importance: There are few effective treatments for heart failure with preserved ejection fraction (HFpEF). Short-term administration of inorganic nitrite or nitrate preparations has been shown to enhance nitric oxide signaling, which may improve aerobic capacity in HFpEF. Objective: To determine the effect of 4 weeks' administration of inhaled, nebulized inorganic nitrite on exercise capacity in HFpEF. Design, Setting, and Participants: Multicenter, double-blind, placebo-controlled, 2-treatment, crossover trial of 105 patients with HFpEF...
November 6, 2018: JAMA: the Journal of the American Medical Association
I Vilardi, G Antonacci, P Battisti, S Bortoluzzi, C-M Castellani, G M Contessa, N Di Marco, I Giardina, G Iurlaro, G La Notte, L Sperandio, S Zicari
In order to properly respond to an emergency caused by an accident in a nuclear power plant with a spread of radionuclides in the atmosphere, we propose a field procedure to perform a large-scale individual thyroid monitoring of internal contamination due to inhalation of 131 I, by means of non-spectrometric equipment, in particular dose rate meters. Specific attention is paid to the individual monitoring of children, because of the very high radiosensitivity of the child's thyroid to the carcinogenic effects of ionising radiation...
November 6, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Adrian Gillissen, Christian Gessner, Klaus Hechenbichler, Felix J F Herth, Ralf Juenemann, Frank Kanniess, Peter Kardos, Marek Lommatzsch, Regina Schneidereit, Wolfram Windisch
BACKGROUND: The fixed-dose combination of budesonide/formoterol (B/F) has been available in the Spiromax® dry powder inhaler since 2014. OBJECTIVES: To assess patient satisfaction, inhaler use errors, and disease control in patients with asthma or chronic obstructive pulmonary disease (COPD) treated with B/F Spiromax. METHODS: This non-interventional, prospective, 12-week study enrolled consecutive asthma or COPD patients who had recently begun treatment with B/F Spiromax or were switched from another inhaled corticosteroid/long-acting β2-agonist combination to B/F Spiromax in routine clinical practice...
November 2, 2018: Respiration; International Review of Thoracic Diseases
Andrew R Martin, Charles P Moore, Warren H Finlay
Aerosol drug delivery to the lungs via inhalation is widely used in the treatment of respiratory diseases. The inhalation route is most often used to target delivery to the lungs for local effect, but has also been extensively explored for systemic drug delivery. In either case, the deposition pattern of inhaled particles within the airways of the respiratory tract is key in determining the initial delivered dose. Thereafter, dose-dependent processes including drug release or dissolution, clearance, and absorption influence local and systemic exposure to inhaled drugs over time...
November 2, 2018: Expert Opinion on Drug Delivery
Gregor J Kocher, Sergio B Sesia, Felipe Lopez-Hilfiker, Ralph A Schmid
OBJECTIVES: Smoke generated from electrocautery dissection contains irritating and/or carcinogenic components. The aim of this study was to investigate the effectiveness of a mobile smoke evacuation system (SES) in protecting surgical personnel from these hazardous fumes. METHODS: Standardized cuts with an electrocautery device were performed on fresh porcine tissue, and the generated surgical fume was analysed with and without the additional use of a mobile SES using a real-time proton-transfer-reaction time-of-flight mass spectrometer...
November 2, 2018: European Journal of Cardio-thoracic Surgery
Thomas J Martin, Shyam A Patel, Megan Tran, Ashley Szabo Eltorai, Alan H Daniels, Adam E M Eltorai
BACKGROUND: Incentive spirometers (IS) are commonly prescribed after various surgical procedures with the intended effect of reducing postoperative pulmonary complications. Factors associated with correct use of IS by postoperative patients has not previously been studied. METHODS: A cross-sectional analysis of postoperative patients was completed to assess whether patients knew how to correctly inhale on their IS. For each patient, the following variables were collected: whether the device was within arm's reach of the patient, if the patient reported having used their IS, if they considered the IS to be helpful, and if they felt more confident using IS after a brief educational intervention was performed by study investigators...
November 1, 2018: Rhode Island Medical Journal
Nicola A Hanania, Sidney Braman, Sandra G Adams, Ruth Adewuya, Arzu Ari, JoAnn Brooks, Donald A Mahler, Jill A Ohar, Jay Peters, Shahin Sanjar
Background: Inhaled medications form the foundation of pharmacologic treatment for chronic obstructive pulmonary disease (COPD).The Delivery Makes a Difference (DMaD) project was conducted to better understand health care provider (HCP) and patient perspectives about the role of inhalation delivery devices in COPD, and to examine the nature of educational efforts between HCPs and patients on proper device technique. Methods: Data were derived from 2 original quantitative, web-based, descriptive, cross-sectional surveys distributed to HCPs who manage COPD (n=513) and patients with COPD (n=499) in the United States...
April 1, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Michelle R Peace, Haley A Mulder, Tyson R Baird, Karen E Butler, Alaina K Friedrich, Joseph W Stone, Joseph B McGee Turner, Alphonse Poklis, Justin L Poklis
Electronic cigarettes (e-cigs) deliver nicotine in an aerosol to the user that simulates the smoke of traditional cigarettes purportedly without the pathology of inhaling tobacco smoke due to the absence of combustion. Advanced versions of e-cigs enable the user to potentially moderate the concentration of drug in the aerosol by selecting from a range of voltages on the power supply. A method was developed to trap the aerosol produced by a KangerTech AeroTank, 1.8 Ω preassembled atomizer in order to analyze the concentration of nicotine and to evaluate the constituents of the aerosol at various voltages on the power supply...
October 1, 2018: Journal of Analytical Toxicology
Per Rönmark, Birgitta Jagorstrand, Guilherme Safioti, Sreedevi Menon, Leif Bjermer
Background: Many patients do not use inhalers correctly. Inhalers associated with good technique have the potential to improve symptom control and are often preferred by patients. Methods: Inhaler-naïve, adult volunteers were randomized to use empty Spiromax®, Easyhaler®, and Turbuhaler® dry powder inhalers (DPIs) in one of six possible sequences in this single-site, single-visit, crossover study conducted in Sweden. Randomization was stratified by age and gender. Participants attempted to use each device intuitively (no instructions) and after reading the instructions for use from the patient information leaflet...
2018: European Clinical Respiratory Journal
Ya-Ru Wang, Hui Guan, Yan Wang, Qing Miao, Li Xiang
OBJECTIVE: To study the applicability of Multi-Test II prick device in the skin prick test (SPT) for allergens in children. METHODS: A total of 87 children with allergic diseases who attended the hospital between March and September, 2017 were enrolled as subjects. The SPT for six inhaled allergens and serum specific IgE (sIgE) measurement were performed for all children. SPT was performed with a single-headed device on the left forearm and Multi-Test II prick device on the right forearm...
October 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Maria Vera Cruz de Oliveira, Emilio Pizzichini, Claudia Henrique da Costa, Carlos Cezar Fritscher, Elcio Oliveira Vianna, Paulo José Zimermann Teixeira, Roberto Stirbulov, Marcelo Fouad Rabahi, Nadine Cordeiro de Pinho
The INHALATOR study was a randomized, multicentre, open label, two-period of 7 days each, crossover study, with 7 days of washout in-between, aiming to evaluate the correct use, satisfaction and preference between Breezhaler® and Respimat® devices in patients under daily use of open Spiriva® or open Onbrize® , as monotherapy for treatment of mild or moderate COPD. Patients aged ≥40 years with a smoking history of at least 10 pack-year were included in the study. Primary endpoint was the rate of correct use of each device at the first day of treatment after reading the drug leaflet information and was evaluated under the supervision of a trained evaluator...
November 2018: Respiratory Medicine
Tu-Son Nguyen, Thi Lien Huong Nguyen, Thi Thuy Van Pham, Thi Bich Thao Cao, Van Khai Nguyen, Susan Hua, Shu Chuen Li
OBJECTIVE: Community pharmacists can make significant contributions and be an indispensable member in the asthma therapy chain. The present study aimed to investigate the current knowledge level of Vietnamese community pharmacists in asthma counselling and the impact of a short training program on asthma knowledge and practice. METHOD: 300 community pharmacists participated in the study. A knowledge questionnaire about asthma medications and a standardized inhaler checklist were designed to evaluate their knowledge before and after a 4-h training program...
November 2018: Respiratory Medicine
Kyu Kyu Than, Victoria Oliver, Yasmin Mohamed, Thazin La, Pete Lambert, Michelle McIntosh, Stanley Luchters
OBJECTIVE: This study assessed the potential operational feasibility and acceptability of a heat-stable, inhaled oxytocin (IOT) product for community-based prevention of postpartum haemorrhage in Myanmar. METHODS: A qualitative inquiry was conducted between June 2015 and February 2016 through focus group discussions and in-depth interviews. Research was conducted in South Dagon township (urban setting) and in Ngape and Thanlyin townships (rural settings) in Myanmar...
October 24, 2018: BMJ Open
Sarah Zellnitz, Eva Roblegg, Joana Pinto, Eleonore Frohlich
Dry powder inhalers are medical devices used to deliver powder formulations of active pharmaceutical ingredients via oral inhalation to the lungs. Drug particles, from a biological perspective, should reach the targeted site, dissolve and permeate through the epithelial cell layer in order to deliver a therapeutic effect. However, drug particle attributes that lead to a biological activity are not always consistent with the technical requirements necessary for formulation design. For example, small cohesive drug particles may interact with neighbouring particles, resulting in large aggregates or even agglomerates that show poor flowability, solubility and permeability...
October 24, 2018: Current Drug Delivery
Marian S Boshra, Ahmed G Almeldien, Randa Salah Eldin, Ahmed A Elberry, Nada Sayed Abdelwahab, Mohamed Nabil Salem, Hoda Rabea, Mohamed E A Abdelrahim
The aim of the present study was to compare the performance of two different dry powder inhalers (DPIs) at different inhalations volumes and inhalation flows. Ventolin Diskus contain blisters of 200µg salbutamol. To test the TED from Aerolizer, salbutamol in Diskus blister was emptied and placed in size 3 capsules suitable for use with Aerolizer. Total emitted dose (TED) delivered by Diskus and Aerolizer was determined using DPI sampling apparatus after one and two inhalations from the same dose. 10-60L/min inhalation flows at 2 and 4L inhalation volume were used in the determination...
October 22, 2018: Experimental Lung Research
Bharat Dalvi, Shreepal Jain, Robin Pinto
OBJECTIVE: To describe a subset of atrial septal defect (ASD) with severe pulmonary hypertension (PHT) that is suitable for closure. BACKGROUND: As per American Heart Association/American College of Cardiology guidelines, ASD with elevated pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) >2/3rd systemic is considered as a contraindication for closure. METHODS: Patients with anatomically large ASD measuring >25 mm and a high probability of reversible pulmonary vascular disease were subjected to fenestrated device closure, despite severe PHT and elevated PVR...
October 22, 2018: Catheterization and Cardiovascular Interventions
Hyo-Jung Lee, In-Ho Kwon, Hong-Goo Lee, Yong-Bin Kwon, Hye-Min Woo, Sang-Min Cho, Youn-Woong Choi, Jinmann Chon, Kibum Kim, Dong-Wook Kim, Chun-Woong Park
This study presents the effect of a spiral mouthpiece design in a carrier-based dry powder inhalation on particle aerosol characteristics. Two kinds of mouthpieces, with spiral and non-spiral shaped flow channels, were fabricated by 3D-printing; particle image velocimetry and Anderson cascade impactor were performed to evaluate the drug aerosol characteristics. The obtained experimental results were in agreement with the simulation results of the computational fluid dynamics analysis. The spiral channel created a strong swirl motion of the air flow emitted from the mouthpiece exit, which produced angular momentum rather than the axial flow velocity in the forward direction...
October 16, 2018: International Journal of Pharmaceutics
Krishna Pudi, Gregory Feldman, Faisal Fakih, Peter Mack, Andrea Maes, Shahid Siddiqui, Earl St Rose, Colin Reisner
BACKGROUND: GFF MDI is a glycopyrrolate/formoterol fumarate fixed-dose combination metered dose inhaler formulated using co-suspension delivery technology. This open-label, single-arm multicenter study (NCT02268396) evaluated the accuracy, reliability, and functionality of the GFF MDI AeroCount® dose indicator when used by patients with chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: The study enrolled subjects (40-80 years of age) with an established clinical history (≥6 months) of COPD, who completed an electronic diary twice daily to record study-drug administration time, the number of actuations used, and pre- and post-dose dose indicator readings...
November 1, 2018: Journal of Aerosol Medicine and Pulmonary Drug Delivery
E C Hensel, S Jayasekera, R J Robinson
Laboratory emissions testing of electronic cigarettes continues to be a focus in the tobacco research community. In particular, to inform policy regarding appropriate test protocols to regulate the manufacture, marketing and sale of tobacco products. This study aims to enhance current understanding of the way laboratory systems used to generate topography profiles and capture resultant emissions from inhaled tobacco products may interact with the device under test. A programmable emission system (vaping machine) is introduced and characterized...
October 17, 2018: Inhalation Toxicology
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