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https://www.readbyqxmd.com/read/28157430/factors-determining-in-vitro-lung-deposition-of-albuterol-aerosol-delivered-by-ventolin-metered-dose-inhaler
#1
Rajoshi Biswas, Nicola A Hanania, Ashutosh Sabharwal
BACKGROUND: The effectiveness of metered-dose inhalers (MDIs) in delivering medication to the lungs highly depends on its correct usage technique. Current guidelines state optimal technique for high lung deposition should include a slow inhalation (>5 seconds) at an inspiratory flow rate of 30 L/min and inhaler actuation at the start of inhalation. However, these recommendations were based on clinical studies using CFC (chlorofluorocarbon)-MDIs and in vitro studies of HFA (hydrofluoroalkane)-MDIs using idealized MDI techniques of uniform inhalation and actuation, disregarding the nonuniform techniques of actual patients...
February 3, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28150188/customized-smartpeg-for-measurement-of-resonance-frequency-of-mini-dental-implants
#2
Jagjit Singh Dhaliwal, Rubens F Albuquerque, Ali Fakhry, Sukhbir Kaur, Jocelyne S Feine
BACKGROUND: One-piece narrow diameter implants (NDIs) have been recommended as "Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width." (ITI consensus 2013). Since NDIs can be immediately loaded, it is important to be able to carry out stability testing. We developed and validated a customized SmartPeg for this type of implant to measure the Implant Stability Quotient (ISQ)...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28137488/patient-characteristics-associated-with-poor-inhaler-technique-among-a-cohort-of-patients-with-copd
#3
Anne C Melzer, Bijan J Ghassemieh, Suzanne E Gillespie, Peter K Lindenauer, Mary Ann McBurnie, Richard A Mularski, Edward T Naureckas, William M Vollmer, David H Au
BACKGROUND: Inhaled therapies are the cornerstone of pharmacologic management for COPD. Each device requires a unique series of steps to be most effective, making appropriate instruction in inhaler technique a key part of the management of COPD. OBJECTIVES: Examine characteristics of patients and devices associated with poor technique among patients with COPD. METHODS: Cross-sectional study of subjects with COPD using at least one of: metered dose inhaler, Advair Diskus, Spiriva Handihaler, identified from the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) registry...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28108685/a-tablet-based-multimedia-education-tool-improves-provider-and-subject-knowledge-of-inhaler-use-techniques
#4
Aaron M Mulhall, Muhammad A Zafar, Samantha Record, Herman Channell, Ralph J Panos
BACKGROUND: Although inhaled medications are effective therapies for COPD, many patients and providers use them incorrectly. METHODS: We recruited providers who prescribe inhalers or teach inhaler technique and assessed their use of metered-dose inhalers (MDIs), various dry powder inhalers (DPIs), and Respimat using predefined checklists. Then they watched tablet-based multimedia educational videos that demonstrated correct inhaler technique by a clinical pharmacist with teach-back from a patient and were re-evaluated...
February 2017: Respiratory Care
https://www.readbyqxmd.com/read/28095080/missed-opportunities-to-transition-from-nebulizers-to-inhalers-during-hospitalization-for-acute-asthma-a-multi-center-observational-study
#5
Valerie G Press, Kohei Hasegawa, Jonathan Heidt, Jane C Bittner, Carlos A Camargo
OBJECTIVE: Hospitalizations for acute asthma are thought to be highly preventable through the use of efficacious medications, though many patients have poor metered-dose inhaler (MDI) technique, lessening these medications' real-world effectiveness. Teaching MDI technique during hospitalization may therefore lead to improved outcomes. However, MDIs may be underutilized to deliver short-acting β-agonists in the inpatient setting, despite equivalent efficacy to nebulizer delivery. We sought to characterize delivery methods of short-acting beta-agonist (SABA) therapy among hospitalized patients with acute asthma to understand if there are missed opportunities for self-management education...
January 17, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28061907/a-randomized-seven-day-study-to-assess-the-efficacy-and-safety-of-a-glycopyrrolate-formoterol-fumarate-fixed-dose-combination-metered-dose-inhaler-using-novel-co-suspension%C3%A2-delivery-technology-in-patients-with-moderate-to-very-severe-chronic-obstructive-pulmonary
#6
Colin Reisner, Leonardo M Fabbri, Edward M Kerwin, Charles Fogarty, Selwyn Spangenthal, Klaus F Rabe, Gary T Ferguson, Fernando J Martinez, James F Donohue, Patrick Darken, Earl St Rose, Chad Orevillo, Shannon Strom, Tracy Fischer, Michael Golden, Sarvajna Dwivedi
BACKGROUND: Long-acting muscarinic antagonist/long-acting β2-agonist combinations are recommended for patients whose chronic obstructive pulmonary disease (COPD) is not managed with monotherapy. We assessed the efficacy and safety of glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination delivered via a Co-Suspension™ Delivery Technology-based metered dose inhaler (MDI) (GFF MDI). METHODS: This was a Phase IIb randomized, multicenter, placebo-controlled, double-blind, chronic-dosing (7 days), crossover study in patients with moderate-to-very severe COPD ( NCT01085045 )...
January 6, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28042449/stress-and-strain-distribution-in-three-different-mini-dental-implant-designs-using-in-implant-retained-overdenture-a-finite-element-analysis-study
#7
W Aunmeungtong, P Khongkhunthian, P Rungsiyakull
: Finite Element Analysis (FEA) has been used for prediction of stress and strain between dental implant components and bone in the implant design process. PURPOSE: Purpose of this study was to characterize and analyze stress and strain distribution occurring in bone and implants and to compare stress and strain of three different implant designs. MATERIALS AND METHODS: Three different mini dental implant designs were included in this study: 1...
October 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28034717/crystal-structure-of-a-phospholipase-a2-from-bothrops-asper-venom-insights-into-a-new-putative-myotoxic-cluster
#8
Guilherme H M Salvador, Juliana I Dos Santos, Bruno Lomonte, Marcos R M Fontes
Snake venoms from the Viperidae and Elapidae families often have several phospholipases A2 (PLA2s), which may display different functions despite having a similar structural scaffold. These proteins are considered an important target for the development of drugs against local myotoxic damage because they are not efficiently neutralized by conventional serum therapy. PLA2s from these venoms are generally divided into two classes: (i) catalytic PLA2s (or Asp49-PLA2s) and (ii) non-catalytic PLA2-like toxins (or Lys49-PLA2s)...
February 2017: Biochimie
https://www.readbyqxmd.com/read/27999471/use-of-simulated-patient-approach-to-assess-the-community-pharmacists-knowledge-of-appropriate-use-of-metered-dose-inhaler
#9
Sunday O Nduka, Maureen U Anetoh, Kosisochi C Amorha, Okechukwu O Henry, Mathew J Okonta
RATIONALE: The pharmacist charged with the responsibility of drug administration and counseling should have the basic knowledge and skills necessary to demonstrate the use of metered dose inhalers (MDIs) to asthma patients for the maximization of treatment outcomes. OBJECTIVE: This study was designed to evaluate the community pharmacists' knowledge of the appropriate use of MDIs in Anambra State, Nigeria. METHODS: The study was carried out in two major cities in Anambra State, Nigeria, using 41 registered community pharmacists...
September 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/27999149/time-required-to-rectify-inhaler-errors-among-experienced-subjects-with-a-faulty-technique
#10
Andrea S Melani, Marco Bonavia, Eliuccia Mastropasqua, Alessandro Zanforlin, Marco Lodi, Paola Martucci, Nicola Scichilone, Maria Aliani, Margherita Neri, Piersante Sestini
BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices. METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 experienced adult subjects (mean ± SD age 64 ± 15 y), mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27916620/efficacy-and-safety-of-glycopyrrolate-formoterol-mdi-formulated-using-co-suspension%C3%A2-delivery-technology-in-patients-with-copd
#11
Fernando J Martinez, Klaus F Rabe, Gary T Ferguson, Leonardo M Fabbri, Stephen Rennard, Gregory J Feldman, Sanjay Sethi, Selwyn Spangenthal, Gregory M Gottschlich, Roberto Rodriguez-Roisin, Samir Arora, Thomas M Siler, Shahid Siddiqui, Patrick Darken, Tracy Fischer, Andrea Maes, Michael Golden, Chad Orevillo, Colin Reisner
BACKGROUND: Long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) combinations are a treatment option for patients with chronic obstructive pulmonary disease (COPD) who continue to have symptoms despite treatment with a LAMA or LABA alone. OBJECTIVES: The PINNACLE-1 (NCT01854645) and -2 (NCT01854658) trials investigated the efficacy and safety of a novel GFF MDI (glycopyrrolate [GP]/formoterol [FF] 18/9.6 μg metered dose inhaler [MDI]) formulated using Co-Suspension™ Delivery Technology, in patients with moderate-to-very severe COPD...
December 1, 2016: Chest
https://www.readbyqxmd.com/read/27748638/the-history-of-therapeutic-aerosols-a-chronological-review
#12
Stephen W Stein, Charles G Thiel
In 1956, Riker Laboratories, Inc., (now 3 M Drug Delivery Systems) introduced the first pressurized metered dose inhaler (MDI). In many respects, the introduction of the MDI marked the beginning of the modern pharmaceutical aerosol industry. The MDI was the first truly portable and convenient inhaler that effectively delivered drug to the lung and quickly gained widespread acceptance. Since 1956, the pharmaceutical aerosol industry has experienced dramatic growth. The signing of the Montreal Protocol in 1987 led to a surge in innovation that resulted in the diversification of inhaler technologies with significantly enhanced delivery efficiency, including modern MDIs, dry powder inhalers, and nebulizer systems...
February 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27715361/association-of-emergency-department-albuterol-dispensing-with-pediatric-asthma-revisits-and-readmissions
#13
A Brad Hall, April Novotny, Donna M Bhisitkul, James Melton, Tim Regan, Maureen Leckie
INTRODUCTION: Although pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. METHODS: We conducted a retrospective cohort study of pediatric patients discharged from the pediatric ED with a diagnosis of asthma...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27652005/anti-inflammatory-and-cytoprotective-effects-of-a-squalene-synthase-inhibitor-tak-475-active-metabolite-i-in-immune-cells-simulating-mevalonate-kinase-deficiency-mkd-like-condition
#14
Nobutaka Suzuki, Tatsuo Ito, Hisanori Matsui, Masayuki Takizawa
TAK-475 (lapaquistat acetate) and its active metabolite-I (TAK-475 M-I) inhibit squalene synthase, which catalyzes the conversion of farnesyl diphosphate (FPP) to squalene. FPP is a substrate for synthesis of other mevalonate-derived isoprenoids (MDIs) such as farnesol (FOH), geranlygeranyl diphosphate (GGPP), and geranylgeraniol. In patients with MKD, a rare autosomal recessive disorder, defective activity of mevalonate kinase leads to a shortage of MDIs. MDIs especially GGPP are required for prenylation of proteins, which is a posttranslation modification necessary for proper functioning of proteins like small guanosine triphosphatases...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27632275/a-pilot-study-on-mandibular-overdentures-retained-by-mini-dental-implants-marginal-bone-level-changes-and-patient-based-ratings-of-clinical-outcome
#15
Kostas Zygogiannis, Daniel Wismeijer, Azin Parsa
PURPOSE: The aim of this study was to investigate the effect of immediately loaded mini dental implants (MDIs) used to support mandibular overdentures on the peri-implant bone level as well as patients' related levels of satisfaction and quality of life. MATERIALS AND METHODS: Four MDIs were placed in the interforaminal region of 10 completely edentulous patients, and the implants were loaded immediately (same day) with an overdenture. Radiographic assessment of the bone loss during a period of 18 months was performed by measuring the bone level changes at the mesial and distal aspects of each implant on panoramic radiographs...
September 2016: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/27630006/improving-resident-knowledge-of-spacers
#16
Brian Kilgore, Khalid Al Katranji, Meredith Woodall, Meagan Shepherd, Susan L Flesher
Studies show the delivery of inhaled medications is maximized when a metered-dose inhaler (MDI) with a spacer is utilized. Our residents expressed concern with their knowledge of MDIs and spacers. This study was designed to address those concerns. Residents were given a 12-question pre-intervention, self-assessment questionnaire that explored their overall knowledge and comfort in utilizing MDI with spacers. Participants then received educational intervention via multimedia videos and a demonstration of proper use of MDI with spacer...
October 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27616891/historical-cohort-study-examining-comparative-effectiveness-of-albuterol-inhalers-with-and-without-integrated-dose-counter-for-patients-with-asthma-or-chronic-obstructive-pulmonary-disease
#17
David B Price, Anna Rigazio, Mary Buatti Small, Thomas J Ferro
BACKGROUND: Using a metered-dose inhaler (MDI) beyond the labeled number of actuations may result in inadequate dosing of medication, which can lead to poor clinical outcomes. This study compared respiratory-related emergency department (ED) visit rates in patients with asthma, chronic obstructive pulmonary disease, or both when they used albuterol MDIs with versus without dose counters. METHODS: This retrospective study used US claims data to identify patients (ages 4-64 years) with asthma, chronic obstructive pulmonary disease, or both, using albuterol MDIs with or without an integrated dose counter...
2016: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/27593413/factors-affecting-the-efficiency-of-aerosolized-salbutamol-delivery-via-a-metered-dose-inhaler-and-equine-spacer-device
#18
R S Pirie, B C McGorum, C Owen, O Carr, H Oakley, G McLachlan
Despite frequent use of metered dose inhalers (MDIs) and spacers in equine practice, limited information exists on the efficiency of aerosol delivery using such devices. We determined the particle size distribution within an MDI-generated salbutamol aerosol delivered via an equine spacer using 'best practice' delivery technique and assessed the effect of variations in MDI use technique (shaking prior to each actuation, rapid repetitive actuations, and MDI angulation) on aerosol delivery efficiency. Under optimal conditions, only 53(±18) μg salbutamol per 100 μg actuation was delivered beyond the spacer...
September 4, 2016: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27553984/s-sulfhydration-of-atp-synthase-by-hydrogen-sulfide-stimulates-mitochondrial-bioenergetics
#19
Katalin Módis, YoungJun Ju, Akbar Ahmad, Ashley A Untereiner, Zaid Altaany, Lingyun Wu, Csaba Szabo, Rui Wang
Mammalian cells can utilize hydrogen sulfide (H2S) to support mitochondrial respiration. The aim of our study was to explore the potential role of S-sulfhydration (a H2S-induced posttranslational modification, also known as S-persulfidation) of the mitochondrial inner membrane protein ATP synthase (F1F0 ATP synthase/Complex V) in the regulation of mitochondrial bioenergetics. Using a biotin switch assay, we have detected S-sulfhydration of the α subunit (ATP5A1) of ATP synthase in response to exposure to H2S in vitro...
November 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27540215/inhaler-counselling-the-real-deal-or-just-fresh-air
#20
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
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