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https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#1
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28540844/a-6-month-safety-and-efficacy-study-of-fluticasone-propionate-and-fluticasone-propionate-salmeterol-multidose-dry-powder-inhalers-in-persistent-asthma
#2
L Mansfield, G Yiu, A Sakov, S Liu, C Caracta
BACKGROUND: A novel multidose dry powder inhaler (MDPI) that is breath actuated, easy, and intuitive to use has beendeveloped for administering fluticasone propionate (Fp) and Fp/salmeterol (FS). OBJECTIVE: To assess the safety and efficacy of Fp MDPI versus Fp hydrofluoroalkane (HFA) and FS MDPI versus FS dry-powder inhaler (DPI). METHODS: This phase III, 26-week, open-label, active drug-controlled study enrolled subjects 12 years old with persistentasthma...
May 24, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#3
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28480166/albuterol-as-an-adjunctive-treatment-to-enzyme-replacement-therapy-in-infantile-onset-pompe-disease
#4
Yin-Hsiu Chien, Wuh-Liang Hwu, Ni-Chung Lee, Fuu-Jen Tsai, Dwight D Koeberl, Wen-Hui Tsai, Pao-Chin Chiu, Chaw-Liang Chang
BACKGROUND: Early initiation of enzyme replacement therapy (ERT) with recombinant human acid alpha-glucosidase is an effective treatment for patients with infantile-onset Pompe disease (IOPD) but cannot prevent a slow progression of myopathy. Albuterol has been shown to be helpful in adult patients with Pompe disease, and therefore, we administered an open-label adjunctive therapy with albuterol in IOPD patients undergoing ERT. METHODS: Fourteen patients, aged 2 to 12 years, were enrolled in this study; all of them had a disease onset before 12 months of life, and 13 of them were ambulatory because of early initiation of ERT...
June 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28450164/a-novel-approach-to-study-the-pmdi-plume-using-an-infrared-camera-and-to-evaluate-the-aerodynamic-properties-after-varying-the-time-between-actuations
#5
Nitesh K Kunda, Julia Hautmann, Sebastián E Godoy, Patricia Marshik, Ramesh Chand, Sanjay Krishna, Pavan Muttil
Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir(®) HFA, Proventil(®) HFA, and Ventolin(®) HFA...
April 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28441240/emergency-department-management-of-bronchiolitis-in-the-united-states
#6
Constance Gong, Terri Byczkowski, Constance McAneney, Monika K Goyal, Todd A Florin
OBJECTIVE: The aim of this study was to examine differences between general and pediatric emergency departments (PEDs) in adherence to the American Academy of Pediatrics bronchiolitis management guidelines. METHODS: We conducted a nationally representative study of ED visits by infants younger than 24 months with bronchiolitis from 2002 to 2011 using the National Hospital Ambulatory Medical Care Survey. Diagnostic testing (complete blood counts, radiographs) and medication use (albuterol, corticosteroids, antibiotics and intravenous fluids) in general emergency departments (GEDs) were compared with those in PEDs before and after 2006 American Academy of Pediatrics guideline publication...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28434454/measuring-to-improve-medication-reconciliation-in-a-large-subspecialty-outpatient-practice
#7
Elizabeth Kern, Meg B Dingae, Esther L Langmack, Candace Juarez, Gary Cott, Sarah K Meadows
BACKGROUND: To assess performance in medication reconciliation (med rec)-the process of comparing and reconciling patients' medication lists at clinical transition points-and demonstrate improvement in an outpatient setting, sustainable and valid measures are needed. METHODS: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs), and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR)...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28428890/asthma-in-the-elderly-a-double-blind-placebo-controlled-study-of-the-effect-of-montelukast
#8
Michele Columbo
BACKGROUND: Little is known about asthma in the elderly as most studies of this condition have not included this patient group. It is unclear whether leukotriene antagonists benefit older asthmatics. We studied the effect of adding montelukast to the asthma treatment of elderly subjects. METHODS: Twenty-five subjects 65 years old and older with asthma were evaluated at week 0, 1, 5, 9, 13, and 17. Each subject received montelukast 10 mg and placebo each for 8 weeks in a cross-over design...
2017: Asthma research and practice
https://www.readbyqxmd.com/read/28424793/a-model-based-meta-analysis-evaluating-gender-differences-on-blood-flow-responses-to-brachial-artery-infusions-of-acetylcholine-albuterol-atp-bradykinin-estradiol-glyceryl-trinitrate-l-nmma-nevibolol-norepinephrine-sodium-nitroprusside-substance-p-and-verapamil
#9
Andy R Eugene
INTRODUCTION: Numerous studies have emerged over the course of several decades describing the properties of drugs eliciting vasodilatory or vasoconstrictor responses in the human vasculature. During drug development, decisions to move forward with testing with a new chemical entity are very costly. To fund or not to fund development, go or no-go, decisions are often limited by efficacy comparisons with the current products on the market. The primary aim of this paper is to use dose-response modeling and simulations to quantify differences in blood flow to Acetylcholine, Albuterol, ATP, Bradykinin, 17β-Estradiol, Glyceryl Trinitrate, L-NMMA, Nevibolol, Norepinephrine, Sodium Nitroprusside, Substance P, and Verapamil...
June 2016: MEDtube Science
https://www.readbyqxmd.com/read/28414688/ecg-of-the-month-mental-disturbance-for-4-days
#10
D Luke Glancy, Theresa Mills, Fred Lopez
A family brought their 61-year-old mother to the emergency department because for 4 days she had been confused, incoherent, and somnolent. She also had dysphagia, dysarthria, diplopia, and had fallen out of bed. She had been in the hospital 3 weeks earlier for atrial fibrillation and an exacerbation of congestive heart failure. She also carried a diagnosis of chronic obstructive pulmonary disease and used an albuterol inhaler. She was obese (BMI of 45); and had adult-onset diabetes mellitus. She had a 43 pack-year history of cigarette smoking but had recently quit...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28377880/paradoxical-bronchospasm-from-benzalkonium-chloride-bac-preservative-in-albuterol-nebulizer-solution-in-a-patient-with-acute-severe-asthma-a-case-report-and-literature-review-of-airway-effects-of-bac
#11
Mathew George, Saumya Vinod Joshi, Emily Concepcion, Haesoon Lee
Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative, prolonged, and correlates directly with basal airway responsiveness. The multi-dose dropper bottle of albuterol sulfate solution contains 50 μg BAC per/2.5 mg of albuterol, which may be below or at the lower limit of the threshold dose for bronchoconstriction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28367177/bronchoscopy-for-foreign-body-aspiration-and-effects-of-nebulized-albuterol-and-budesonide-combination
#12
Bulent Akcora, Mehmet Emin Celikkaya, Cahit Ozer
OBJECTIVE: A foreign body aspiration in the tracheobronchial tree is a dangerous medical condition in the childhood period. Although rigid bronchoscopy is a safe procedure, it may cause complications. The aim of this study was to present our bronchoscopy experience and to evaluate the efficacy of pre-operative administration of nebulized albuterol and budesonide combination for reducing intra-operative complications in foreign body aspirated cases. METHODS: In this retrospective study our pediatric cases in which a foreign body was removed from tracheobronchial tree in last 8 years were analyzed...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28349590/benzalkonium-chloride-a-bronchoconstricting-preservative-in-continuous-albuterol-nebulizer-solutions
#13
Sreekala Prabhakaran, Mutasim Abu-Hasan, Leslie Hendeles
For convenience, many pediatric hospitals are preparing solutions for continuous nebulized albuterol using the 0.5% 20-ml multidose albuterol dropper bottle. This product contains benzalkonium chloride (BAC) that, by itself, produces bronchospasm that is dose dependent and cumulative. The bronchoconstrictive effects of BAC are greater in patients with more severe airway obstruction and increased airway responsiveness. Use of BAC-containing albuterol during severe acute asthma exacerbations may antagonize the bronchodilator response to albuterol, prolong treatment, and increase the risk of albuterol-related systemic adverse effects...
March 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28336814/airway-smooth-muscle-dysfunction-in-pompe-gaa-mice
#14
Allison M Keeler, Donghai Liu, Marina Zieger, Lang Xiong, Jeffrey Salemi, Karl Bellve, Barry J Byrne, David D Fuller, Ronghua ZhuGe, Mai K ElMallah
Pompe disease is an autosomal recessive disorder caused by a deficiency of acid alpha-glucosidase (GAA) - an enzyme responsible for hydrolyzing lysosomal glycogen. Deficiency of GAA leads to systemic glycogen accumulation in the lysosomes of skeletal muscle, motor neurons and smooth muscle. Skeletal muscle and motor neuron pathology are known to contribute to respiratory insufficiency in Pompe disease, but the role of airway pathology has not been evaluated. Here we propose that GAA enzyme deficiency disrupts the function of the trachea and bronchi, and this lower airway pathology contributes to respiratory insufficiency in Pompe disease...
March 23, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28332406/continuous-glucose-monitor-interference-with-commonly-prescribed-medications
#15
Ananda Basu, Michael Q Slama, Wayne T Nicholson, Loralie Langman, Thomas Peyser, Rickey Carter, Rita Basu
BACKGROUND: Reliability of continuous glucose monitors (CGM) is a prerequisite for therapeutic dosing of insulin without the need for confirmatory blood glucose meter measurements. Interference of CGMs with commonly prescribed substances has not been extensively evaluated. METHODS: We sought to undertake a novel pilot study to determine the susceptibility of FDA-approved CGM systems (Medtronic Guardian Sof-Sensor, Dexcom G4 Platinum) to erroneous readings in the presence of common medications...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28302425/characteristics-of-pediatric-emergency-revisits-after-an-asthma-related-hospitalization
#16
Laurie H Johnson, Andrew F Beck, Robert S Kahn, Bin Huang, Patrick H Ryan, Kelly K Olano, Katherine A Auger
STUDY OBJECTIVE: We identify and characterize factors related to subsequent emergency revisits among children hospitalized for asthma. METHODS: This population-based, prospective, observational cohort included children aged 2 to 16 years, hospitalized for asthma at an urban pediatric facility and followed for greater than or equal to 12 months. The primary outcome was asthma-related emergency revisit within 12 months of discharge. Revisits were identified by billing codes, respiratory chief complaints, and medications administered (eg, albuterol, systemic corticosteroids), dispensed, or prescribed...
March 14, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28284473/positive-expiratory-pressure-for-the-treatment-of-acute-asthma-exacerbations-a-randomized-controlled-trial
#17
Nidhya Navanandan, Monica Federico, Rakesh D Mistry
OBJECTIVES: To evaluate the efficacy of brief, single administration of positive expiratory pressure (PEP) therapy in reducing clinical severity and need for additional second-line therapies and hospitalization in children presenting to the emergency department (ED) with acute asthma. STUDY DESIGN: This was a prospective randomized controlled trial of children 2-18 years of age presenting to a tertiary-care academic pediatric ED with moderate-to-severe asthma exacerbations from December 2014 to June 2016...
March 8, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28270542/effects-of-heat-and-moisture-exchangers-and-exhaled-humidity-on-aerosol-deposition-in-a-simulated-ventilator-dependent-adult-lung-model
#18
Arzu Ari, Khalid S Alwadeai, James B Fink
BACKGROUND: Many in vitro models report higher inhaled dose with dry versus heated humidity. Heat-and-moisture exchangers (HMEs) provide passive humidity in ventilator-dependent patients but act as a barrier to aerosol. The HMEs designed to allow aerosol delivery (HME-ADs) have not been well described. The purpose of this study is to determine the impact on aerosol deposition of HME-ADs with and without active exhaled humidity in a simulated ventilator-dependent adult model. METHODS: We used an in vitro lung model consisting of an intubated teaching mannequin with an endotracheal tube of 8...
May 2017: Respiratory Care
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#19
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223976/plant-growth-promotion-by-volatile-organic-compounds-produced-by-bacillus-subtilis-syst2
#20
Hafiz A S Tahir, Qin Gu, Huijun Wu, Waseem Raza, Alwina Hanif, Liming Wu, Massawe V Colman, Xuewen Gao
Bacterial volatiles play a significant role in promoting plant growth by regulating the synthesis or metabolism of phytohormones. In vitro and growth chamber experiments were conducted to investigate the effect of volatile organic compounds (VOCs) produced by the plant growth promoting rhizobacterium Bacillus subtilis strain SYST2 on hormone regulation and growth promotion in tomato plants. We observed a significant increase in plant biomass under both experimental conditions; we observed an increase in photosynthesis and in the endogenous contents of gibberellin, auxin, and cytokinin, while a decrease in ethylene levels was noted...
2017: Frontiers in Microbiology
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