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Saeed Alipour Parsa, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian
To present an unusual case in order to clarify one of the most important differential diagnoses of ST-elevation myocardial infarction in a postmenopausal woman. A 72-year-old woman with asthma attack and retrosternal chest pain was presented to our emergency unit. She had used albuterol spray ten-times before admission due to accentuated dyspnea. Initial ECG revealed ST-segment elevation in leads V1-V6, I and aVL. Emergent coronary angiography indicated normal coronary arteries, and left ventriculography showed significant akinesia of apical segments...
October 19, 2016: Future Cardiology
Jennifer Shin Zank, Rani Singh, Michele Carney
Vigorous coughing leading to internal carotid artery dissection has been described in the adult literature but has not been reported in the pediatric population. We describe an 8-year-old right-handed girl who had a 1-week history of increased work of breathing and vigorous coughing. She initially presented to her pediatrician's office for her respiratory symptoms which improved with steroid therapy and albuterol treatments. However, she developed evolving left-sided motor weakness over the course of 2 days and presented to our pediatric emergency department where she was found to have an ischemic stroke in the right corona radiata with a right internal carotid artery dissection...
October 2016: Pediatric Emergency Care
Nathan Rabinovitch, Colby D Adams, Matthew Strand, Kirsten Koehler, John Volckens
BACKGROUND: Most particulate matter (PM) and health studies in children with asthma use exposures averaged over the course of a day and do not take into account spatial/temporal variability that presumably occurs as children move from home, into transit and then school microenvironments. The objectives of this work were to identify increases in morning PM exposure occurring within home, transit and school microenvironments and determine their associations with asthma-related inflammation and rescue medication use...
October 10, 2016: Environmental Health: a Global Access Science Source
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
A Brad Hall, April Novotny, Donna M Bhisitkul, James Melton, Tim Regan, Maureen Leckie
Introduction While 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. Our primary outcome measured the rate of asthma revisits to the ED or admissions to the hospital within 28 days...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Janaina Melo, Adriana Moreno, Virginia Ferriani, Ana Carla Araujo, Elcio Vianna, Marcos Borges, Pérsio Roxo, Marcos Gonçalves, Luane Mello, Rosa Parreira, Jorgete Silva, Patricia Stefanelli, Larissa Panazolo, Andrea Cetlin, Luana Queiroz, Rosângela Araujo, Marina Dias, Davi Aragon, Nélio Domingos, L Karla Arruda
OBJECTIVE: Asthma is under-diagnosed in many parts of the world. We aimed to assess the outcome of a capacitating program on asthma for non-specialist physicians and other healthcare professionals working in the public health system in Ribeirão Preto, Brazil. METHODS: A group of 16 asthma specialists developed a one-year capacitating program in 11 healthcare clinics in the Northern District of the city, which included lectures on asthma, training on inhalation device use and spirometry, and development of an asthma management protocol...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Jing Yuan, Zhiqiang Kevin Lu, Yanjun Zhang, Jun Wu, Bryan L Love, Richard M Schulz
OBJECTIVE: Racemic albuterol and levalbuterol are used to treat acute episodes of asthma. The main objective of this study was to compare levalbuterol therapy to albuterol therapy on incidence rates of subsequent emergency department (ED) visits and hospitalizations. METHOD: We conducted a retrospective cohort study of asthmatic children who had pharmacy refills for levalbuterol/albuterol in the South Carolina Medicaid database in 2002-2011. Children receiving levalbuterol were matched to those receiving albuterol using propensity score matching technique...
October 4, 2016: Pediatric Pulmonology
Shao-Hui Lin, Wei Cui, Gui-Ling Wang, Shuai Meng, Ying-Chun Liu, Hong-Wei Jin, Liang-Ren Zhang, Ying Xie
Albumin-based nanoparticles (NPs) are a promising technology for developing drug-carrier systems, with improved deposition and retention profiles in lungs. Improved understanding of these drug-carrier interactions could lead to better drug-delivery systems. The present study combines computational and experimental methods to gain insights into the mechanism of binding of albuterol sulfate (AS) to bovine serum albumin (BSA) on the molecular level. Molecular dynamics simulation and surface plasmon resonance spectroscopy were used to determine that there are two binding sites on BSA for AS: the first of which is a high-affinity site corresponding to AS1 and the second of which appears to represent the integrated functions of several low-affinity sites corresponding to AS2, AS3, and AS8...
2016: Drug Design, Development and Therapy
Steven Pascoe, Wei Wu, Chang-Qing Zhu, Dave Singh
Categorization of patients with COPD as reversible or nonreversible to a bronchodilator may change over time. This post hoc analysis aimed to determine if an individual's reversibility, when treated as a continuous variable, could predict his/her future response to two short-acting bronchodilators: albuterol and ipratropium. The analysis was completed using data from a 4-week, randomized, open-label, two-period crossover study (NCT01691482; GSK study DB2114956). Patients received albuterol (doses: UK =4×100 μg/puff; US =4×90 μg/puff) followed 1 hour later by ipratropium (4×20 μg/puff) or vice versa during treatment Period 1...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Mu He, Bastiaan Driehuys, Loretta G Que, Yuh-Chin T Huang
RATIONALE AND OBJECTIVES: Ventilation heterogeneity is impossible to detect with spirometry. Alternatively, pulmonary ventilation can be imaged three-dimensionally using inhaled (129)Xe magnetic resonance imaging (MRI). To date, such images have been quantified primarily based on ventilation defects. Here, we introduce a robust means to transform (129)Xe MRI scans such that the underlying ventilation distribution and its heterogeneity can be quantified. MATERIALS AND METHODS: Quantitative (129)Xe ventilation MRI was conducted in 12 younger (24...
September 8, 2016: Academic Radiology
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
Jennifer L H Johnson, Danielle Guthrie, Joel Hyde, Thomas Hanson, Kelly Karlage, Paul B Myrdal
BACKGROUND: Three albuterol sulfate metered-dose inhaled (MDI) products (Ventolin HFA, Proventil HFA, and ProAir HFA) are marketed in the United States to provide the same total dose of albuterol sulfate. However, it is widely known that the fine particle dose (<5 μm) is the portion of the particle distribution that actually reaches the lungs and provides therapeutic benefit. OBJECTIVE: To examine the differences in particle size between products and how a valved holding chamber (VHC) can mitigate possible adverse effects...
September 2016: Annals of Allergy, Asthma & Immunology
Koichiro Nandate, Bryan B Voelzke
Indigo carmine (also known as 5,5'-indigodisulfonic acid sodium salt or indigotine) is a blue dye that is administered intravenously to examine the urinary tract and usually is biologically safe and inert. Indigo carmine rarely may cause adverse reactions. We treated a 66-year-old man who had general anesthesia and radical retropubic prostatectomy for prostate cancer. He had a previous history of allergy to bee sting with nausea, vomiting, and dizziness. Within 1 minute after injection of indigo carmine for evaluation of the ureters, the patient developed hypotension to 40 mmHg, severe hypoxia (the value of SpO2 (peripheral capillary oxygen saturation) was 75% on 40% inspired oxygen concentration), poor air movement and bilateral diffuse wheezing on auscultation, and marked subcutaneous erythema at the upper extremities...
2016: Case Reports in Urology
John E Madias
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Li Wang, Chun-Juan Zhai, Yao Liu, Yi Liu, Shu-Juan Jiang
BACKGROUND: The role of umeclidinium plus vilanterol as a combination therapy for chronic obstructive pulmonary disease (COPD) has not yet been clearly defined. OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy and safety of umeclidinium plus vilanterol, in contrast to either monotherapy or placebo. METHODS: Systematic searches were conducted in Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and the Chinese Biomedical Literature Database (CBM)...
November 2016: Clinical Drug Investigation
Kevin M Dube, Kristen L Ditch, Luanne Hills
Smoke inhalation injury (SIJ) is associated with an increase in morbidity and mortality in patients with burns. SIJ causes airway damage, inflammation, and bronchial obstruction, resulting in decreased oxygenation and perfusion status in these patients. Retrospective studies have compared the use of nebulized heparin (NH) plus nebulized N-acetylcysteine (NAC) and albuterol in patients with SIJ to those who received standard ventilator support with bronchodilator therapy. These studies are associated with a decrease in mortality when NH and nebulized NAC are administered to patients with SIJ...
August 16, 2016: Journal of Pharmacy Practice
William J Sheehan, David T Mauger, Ian M Paul, James N Moy, Susan J Boehmer, Stanley J Szefler, Anne M Fitzpatrick, Daniel J Jackson, Leonard B Bacharier, Michael D Cabana, Ronina Covar, Fernando Holguin, Robert F Lemanske, Fernando D Martinez, Jacqueline A Pongracic, Avraham Beigelman, Sachin N Baxi, Mindy Benson, Kathryn Blake, James F Chmiel, Cori L Daines, Michael O Daines, Jonathan M Gaffin, Deborah A Gentile, W Adam Gower, Elliot Israel, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Ngoc Ly, Jyothi Marbin, Wayne J Morgan, Ross E Myers, J Tod Olin, Stephen P Peters, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Shannon M Thyne, Michael E Wechsler, Wanda Phipatanakul
BACKGROUND: Studies have suggested an association between frequent acetaminophen use and asthma-related complications among children, leading some physicians to recommend that acetaminophen be avoided in children with asthma; however, appropriately designed trials evaluating this association in children are lacking. METHODS: In a multicenter, prospective, randomized, double-blind, parallel-group trial, we enrolled 300 children (age range, 12 to 59 months) with mild persistent asthma and assigned them to receive either acetaminophen or ibuprofen when needed for the alleviation of fever or pain over the course of 48 weeks...
August 18, 2016: New England Journal of Medicine
Allyson McIntire, Serena A Harris, Jessica A Whitten, Andrew C Fritschle-Hilliard, David R Foster, Rajiv Sood, Todd A Walroth
Inhalation injury (IHI) causes significant morbidity and mortality in burn victims due to both local and systemic effects. Nebulized heparin promotes improvement in lung function and decreased mortality in IHI by reducing the inflammatory response and fibrin cast formation. The study objective is to determine if nebulized heparin 10,000 units improves lung function and decreases mechanical ventilation duration, mortality, and hospitalization length in IHI with minimal systemic adverse events. This retrospective, case-control study evaluated efficacy and safety of nebulized heparin administered to mechanically ventilated adults admitted within 48 hr of confirmed IHI...
August 15, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Anoshie Ratnayake, Herminia Taveras, Harald Iverson, Paul Shore
BACKGROUND: Many children struggle with the use of albuterol hydrofluoroalkane (HFA) inhalers. Albuterol multidose dry powder inhaler (MDPI) may simplify rescue bronchodilator use in children. OBJECTIVE: To compare the pharmacokinetics (PK), pharmacodynamics (PD), and tolerability of albuterol MDPI and albuterol HFA after a single inhaled dose in children with asthma. METHODS: This single-center, open-label, two-period crossover study randomized children to albuterol MDPI or HFA 180 μg on two treatment days with a 4- to 14-day washout...
September 2016: Allergy and Asthma Proceedings:
Suchitra Rao, Kevin Messacar, Michelle R Torok, Anne-Marie Rick, Jeffrey Holzberg, Aaron Montano, Dayanand Bagdure, Donna J Curtis, M Steven Oberste, W Allan Nix, Gina de Masellis, Christine C Robinson, Samuel R Dominguez
OBJECTIVE: In 2014, the Unites States experienced an outbreak of enterovirus D68 associated with severe respiratory illness. The clinical characteristics associated with severe illness from enterovirus D68 during this outbreak compared with those associated with the 2009 H1N1 influenza virus outbreak are unknown. DESIGN AND SETTING: In this retrospective cohort study, we characterized the clinical features of children with enterovirus D68 admitted to the PICU between August 1, 2014, and November 1, 2014, and compared them with critically ill children infected with H1N1 influenza during the pandemic admitted between May 1, 2009, and January 31, 2010...
August 8, 2016: Pediatric Critical Care Medicine
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