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https://www.readbyqxmd.com/read/28318865/anterior-vs-posterior-periarticular-multimodal-drug-injections-a-randomized-controlled-trial-in-simultaneous-bilateral-total-knee-arthroplasty
#1
Artit Laoruengthana, Piti Rattanaprichavej, Supachok Rasamimongkol, Monton Galassi
BACKGROUND: Currently, various techniques are used to overcome postoperative pain after total knee arthroplasty. A local analgesic infiltration with periarticular multimodal drug injection (PMDI) is favorable because of its simplicity, safety, and efficacy. The present study compared the efficacy of a PMDI at the anterior vs posterior compartments. METHODS: Forty-six patients were randomized to receive the PMDI at either the anterior or posterior compartment, with the contralateral knee receiving the PMDI at the opposite compartment...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28256307/efficacy-and-safety-of-budesonide-formoterol-pmdi-vs-budesonide-pmdi-in-asthmatic-children-6-12-years
#2
David S Pearlman, Göran Eckerwall, Julie McLaren, Rosa Lamarca, Margareta Puu, Ileen Gilbert, Carin Jorup, Kristina Sandin, Miguel J Lanz
BACKGROUND: The efficacy and safety of budesonide/formoterol pressurized metered-dose inhaler (pMDI) have been demonstrated in patients with asthma at least 12 years old. OBJECTIVE: To evaluate the efficacy of 2 formoterol doses added to budesonide as fixed combinations vs budesonide alone in children 6 to younger than 12 years with asthma. METHODS: This randomized, double-blinded, parallel-group, multicenter study (NCT02091986; CHASE 3) included children 6 to younger than 12 years with asthma previously receiving a medium-dose inhaled corticosteroid (ICS) or an ICS plus a long-acting β2-agonist...
February 27, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28245825/predictors-of-correct-technique-in-patients-using-pressurized-metered-dose-inhalers
#3
Kyra Bartolo, Martin Balzan, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon, Stephen Montefort
BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical...
February 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28221733/regional-lung-ventilation-pattern-in-preschool-children-with-bronchopulmonary-dysplasia-is-modified-by-bronchodilator-response
#4
Wojciech Durlak, Małgorzata Klimek, Przemko Kwinta
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains a significant long-term complication of prematurity. A standardized method of pulmonary function testing is still not available in preschool children with BPD. We investigated the feasibility of Electrical Impedance Segmentography (EIS) monitoring in this group and the impact of bronchodilator response (BDR) to salbutamol on the pattern of lung ventilation. METHODS: We conducted a follow-up study of 4-year-old premature children who had been treated in the tertiary NICU...
March 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28216389/mastery-of-pmdi-technique-asthma-control-and-quality-of-life-of-children-with-asthma-a-randomized-controlled-study-comparing-two-inhaler-technique-training-approaches
#5
Wesam G Ammari, Nussaibah Al-Hyari, Nathir Obeidat, Mona Khater, Amal Sabouba, Mark Sanders
OBJECTIVE: Verbal counselling (VC) is the clinical standard for training patients on correct inhaler use. Patients fail to recall their VC with time. Ethical approval was obtained to compare the pressurized metered dose inhaler (pMDI) VC with Trainhaler (TH), a novel pMDI inhalation flow and technique training device, in children with asthma. METHODS: At visit 1, 7-17 year-old children with a pMDI hand-lung coordination problem including a fast peak inhalation flow (PIF) through pMDI >60 L/min were randomized into either VC group that received verbal pMDI training; or into TH group that were trained on- and given TH to practice at home...
February 16, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28182569/chronic-obstructive-pulmonary-disease-exacerbation-and-inhaler-device-handling-real-life-assessment-of-2935-patients
#6
Mathieu Molimard, Chantal Raherison, Severine Lignot, Aurelie Balestra, Stephanie Lamarque, Anais Chartier, Cecile Droz-Perroteau, Regis Lassalle, Nicholas Moore, Pierre-Olivier Girodet
Acute exacerbations of chronic obstructive pulmonary disease (COPD) can be prevented by inhaled treatment. Errors in inhaler handling, not taken into account in clinical trials, could impact drug delivery and minimise treatment benefit. We aimed to assess real-life inhaler device handling in COPD patients and its association with COPD exacerbations.To this end, 212 general practitioners and 50 pulmonologists assessed the handling of 3393 devices used for continuous treatment of COPD in 2935 patients. Handling errors were observed in over 50% of handlings, regardless of the device used...
February 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28181839/anhydrous-reverse-micelle-nanoparticles-new-strategy-to-overcome-sedimentation-instability-of-peptide-containing-pressurized-metered-dose-inhalers
#7
Zhengwei Huang, Han Wu, Beibei Yang, Longkai Chen, Ying Huang, Guilan Quan, Chune Zhu, Xing Li, Xin Pan, Chuanbin Wu
The objective of this study was to develop a novel anhydrous reverse micelle nanoparticles (ARM-NPs) system to overcome the sedimentation instability of peptide-containing pressurized metered-dose inhalers (pMDIs). A bottom-up method was utilized to fabricate ARM-NPs. Tertiary butyl alcohol (TBA)/water system, freeze-drying and lipid inversion method were successively used to produce the ARM-NPs for pMDI. Various characteristics of ARM-NPs were investigated including particle size, morphology, secondary structure of the peptide drug, aerosolization properties and storage stability...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28159683/measurement-of-the-raman-spectra-and-hygroscopicity-of-four-pharmaceutical-aerosols-as-they-travel-from-pressurised-metered-dose-inhalers-pmdi-to-a-model-lung
#8
N Davidson, H-J Tong, M Kalberer, P C Seville, A D Ward, M K Kuimova, F D Pope
Particle inhalation is an effective and rapid delivery method for a variety of pharmaceuticals, particularly bronchodilation drugs used for treating asthma and COPD. Conditions of relative humidity and temperature inside the lungs are generally very different from the outside ambient air, with the lung typically being warmer and more humid. Changes in humidity, from inhaler to lung, can cause hygroscopic phase transitions and particle growth. Increasing particle size and mass can negatively affect particle deposition within the lung leading to inefficient treatment, while deliquescence prior to impaction is liable to accelerate drug uptake...
January 31, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28137486/how-many-instructions-are-required-to-correct-inhalation-errors-in-patients-with-asthma-and-chronic-obstructive-pulmonary-disease
#9
Yotaro Takaku, Kazuyoshi Kurashima, Chie Ohta, Takashi Ishiguro, Naho Kagiyama, Tsutomu Yanagisawa, Noboru Takayanagi
In the treatment of asthma and chronic obstructive pulmonary disease (COPD), errors in handling and wrong techniques in using inhalation devices are associated with poor disease control. The aim of this study was to evaluate the number of instructions that are necessary to minimize errors in using pressurized metered-dose inhaler (pMDI), soft mist inhaler (SMI), and dry powder inhaler (DPI). Among 216 patients with asthma (n = 135) and COPD (n = 81), we studied 245 cases that used different types of inhalation devices...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28110057/real-life-outcomes-for-patients-with-asthma-prescribed-spacers-for-use-with-either-extrafine-or-fine-particle-inhaled-corticosteroids
#10
Theresa W Guilbert, Gene Colice, Jonathan Grigg, Wim van Aalderen, Richard J Martin, Elliot Israel, Dirkje S Postma, Nicolas Roche, Wanda Phipatanakul, Elizabeth V Hillyer, Jennifer M Evans, Myrna B Dolovich, David B Price
BACKGROUND: Spacers are often used with pressurized metered-dose inhalers (pMDIs) to eliminate the need for coordinating inhalation with actuation. OBJECTIVE: To investigate the real-life effectiveness of spacers prescribed for use with either extrafine- or fine-particle inhaled corticosteroids (ICSs). METHODS: This historical matched cohort study examined anonymous medical record data over 2 years (1-year baseline, 1-year outcome) for patients with asthma aged 12 to 80 years initiating ICSs by pMDI with or without prescribed spacer...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28097509/revealing-pmdi-spray-initial-conditions-flashing-atomisation-and-the-effect-of-ethanol
#11
Nicholas Mason-Smith, Daniel J Duke, Alan L Kastengren, Daniela Traini, Paul M Young, Yang Chen, David A Lewis, Daniel Edgington-Mitchell, Damon Honnery
PURPOSE: Sprays from pressurised metered-dose inhalers are produced by a transient discharge of a multiphase mixture. Small length and short time scales have made the investigation of the governing processes difficult. Consequently, a deep understanding of the physical processes that govern atomisation and drug particle formation has been elusive. METHODS: X-ray phase contrast imaging and quantitative radiography were used to reveal the internal flow structure and measure the time-variant nozzle exit mass density of 50 µL metered sprays of HFA134a, with and without ethanol cosolvent...
January 17, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28066588/real-world-asthma-management-with-inhaler-devices-in-switzerland-results-of-the-asthma-survey
#12
Christian F Clarenbach, Laurent P Nicod, Malcolm Kohler
BACKGROUND: The aim of the Asthma Survey was to generate insights about the daily practice of physicians with regard to inhaler devices used for treating asthma under real-world conditions in Switzerland. METHODS: A questionnaire was administered to 605 participating hospital- and practice-based Swiss physicians. Areas of interest were practical aspects of patient education, typical difficulties encountered when prescribing pressurized metered-dose inhalers (pMDI) and dry-powder inhalers (DPI), and reasons for physician preferences...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065679/acute-cardiovascular-safety-of-two-formulations-of-beclometasone-dipropionate-formoterol-fumarate-in-copd-patients-a-single-dose-randomised-placebo-controlled-crossover-study
#13
Dave Singh, Giorgia Ciurlia, Annalisa Piccinno, Annamaria Muraro, Maria Bocchi, Mario Scuri
INTRODUCTION: An extrafine combination of beclometasone dipropionate (BDP) and formoterol fumarate (FF) via a pressurised metered-dose inhaler (pMDI) has been commercially available for some years for the management of asthma and chronic obstructive pulmonary disease (COPD). A dry powder inhaler (DPI) formulation of extrafine BDP/FF is now also available. This study evaluated the cardiovascular safety of BDP/FF DPI in comparison to BDP/FF pMDI and placebo. METHODS: Single-dose, partially-blind, randomised, placebo-controlled, 5-period crossover study...
February 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27977309/drug-delivery-in-asthmatic-children-following-coordinated-and-uncoordinated-inhalation-maneuvers-a-randomized-crossover-trial
#14
Ariel Berlinski, Dirk von Hollen, Ross H M Hatley, Lucy E A Hardaker, Kurt Nikander
BACKGROUND: Valved holding chambers (VHCs) are used in children to deliver pressurized metered dose inhalers (pMDI). In vitro data suggest that uncoordinated use decreases the amount of drug available for inhalation. We hypothesize that in an ex vivo study, the coordinated maneuver will deliver more drug than the uncoordinated one. PATIENTS AND METHODS: Thirty-two clinically stable asthmatic children, ages 5-8 years, completed the study. An aerosol filter was interposed between a small-volume nonelectrostatic VHC and a mouthpiece to capture the drug emitted by one puff of Flovent(®) 220 mcg during tidal breathing...
December 15, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27938358/high-strength-extrafine-pmdi-beclometasone-formoterol-200-6%C3%A2-%C3%AE-g-is-effective-in-asthma-patients-not-adequately-controlled-on-medium-high-dose-of-inhaled-corticosteroids
#15
Pierluigi Paggiaro, Massimo Corradi, Manuela Latorre, Helene Raptis, Annamaria Muraro, Christian Gessner, Zenon Siergiejko, Mario Scuri, Stefano Petruzzelli
BACKGROUND: A high strength of beclomethasone/formoterol fumarate (BDP/FF) in a pressurised metered dose inhaler (pMDI), which contains extrafine BDP (200 μg/actuation) and FF (6 μg/actuation) has been developed to treat those asthmatics who are not adequately controlled on previous treatments. METHODS: A 12-week, randomized, double-blind, parallel group study was performed to compare the efficacy and safety of pMDI BDP/FF 200/6 (two actuations bid) with BDP 100 μg (four actuation bid) in a population of 376 randomized adult asthmatics not adequately controlled with high dose of inhaled corticosteroids (ICS) or medium dose of ICS plus long acting β2agonists (LABA)...
December 9, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27885203/examination-of-the-effectiveness-of-slow-and-deep-inhalation-of-fp-fm-pmdi-for-the-small-airways-dysfunction-of-adult-onset-asthma
#16
Shoji Hashimoto
BACKGROUNDS: To date adult-onset asthmatic patients who lack a clear stridor and show prolonged coughs and chest discomfort caused by small-airways dysfunction have increased. We examined the small-airways function of these cases and the effectiveness of slow and deep inhalation of FP/FM-pMDI. METHODS: 62 adult-onset asthmatic patients who had prolonged coughs and chest discomfort with the middle or high dose of ICS/LABA combination agents under well technique (32 of BUD/FM-DPI group and 30 of FP/SM-pMDI group) were included into this study...
2016: Arerugī, [Allergy]
https://www.readbyqxmd.com/read/27843842/evaluation-of-proficiency-in-using-different-inhaler-devices-among-intern-doctors
#17
Ravish M Kshatriya, Nimit V Khara, Rajiv P Paliwal, Satish N Patel
CONTEXT: Doctors may have deficiencies in the ability to use different inhalers, which in turn, can result in improper technique by the patients and poorly controlled asthma and chronic obstructive pulmonary disease (COPD). AIMS: To evaluate intern doctors' proficiency in using various inhaler devices. MATERIALS AND METHODS: Seventy interns were evaluated for their proficiency in using pressurized metered dose inhaler (pMDI), pMDI with spacer, rotahaler, turbuhaler, and nebulizer...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27836120/computationally-efficient-analysis-of-particle-transport-and-deposition-in-a-human-whole-lung-airway-model-part-ii-dry-powder-inhaler-application
#18
Arun V Kolanjiyil, Clement Kleinstreuer, Ruxana T Sadikot
Pulmonary drug delivery is becoming a favored route for administering drugs to treat both lung and systemic diseases. Examples of lung diseases include asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD) as well as respiratory distress syndrome (ARDS) and pulmonary fibrosis. Special respiratory drugs are administered to the lungs, using an appropriate inhaler device. Next to the pressurized metered-dose inhaler (pMDI), the dry powder inhaler (DPI) is a frequently used device because of the good drug stability and a minimal need for patient coordination...
November 3, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27817816/incidence-of-oral-thrush-in-patients-with-copd-prescribed-inhaled-corticosteroids-effect-of-drug-dose-and-device
#19
P N Richard Dekhuijzen, Maria Batsiou, Leif Bjermer, Sinthia Bosnic-Anticevich, Henry Chrystyn, Alberto Papi, Roberto Rodríguez-Roisin, Monica Fletcher, Lucy Wood, Alessandra Cifra, Joan B Soriano, David B Price
BACKGROUND AND AIMS: Little information is available on real-life occurrence of oral thrush in COPD patients treated with ICS. We investigated oral thrush incidence in COPD patients prescribed FDC ICS/LABA therapies and assessed whether it is modulated by the ICS type, dose, and delivery device. METHODS: We conducted a historical, observational, matched cohort study (one baseline year before and one outcome year after initiation of therapy) using data from the UK Optimum Patient Care Research Database...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27635793/variability-in-delivered-dose-from-pressurized-metered-dose-inhaler-formulations-due-to-a-delay-between-shake-and-fire
#20
Ross H M Hatley, Jacob Parker, John N Pritchard, Dirk von Hollen
BACKGROUND: Pressurized metered-dose inhalers (pMDIs) should be shaken before use to prevent creaming or sedimentation of the drugs in solution; however, data published on this topic are limited, and it is rarely specified how soon after shaking the device should be actuated. Delays between shaking and firing the pMDI have previously been shown to cause significant inhomogeneity in delivered dose. We studied the effect of various shake-fire delays on the drug delivered from five commercially available pMDIs commonly prescribed for asthma and chronic obstructive pulmonary disease to assess the potential variability in delivered dose...
February 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
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