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Inhaler technique

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https://www.readbyqxmd.com/read/29468423/a-novel-method-for-studying-airway-hyperresponsiveness-in-allergic-guinea-pigs-in-vivo-using-the-preciseinhale-system-for-delivery-of-dry-powder-aerosols
#1
A J Lexmond, S Keir, W Terakosolphan, C P Page, B Forbes
Inhaled adenosine receptor agonists induce bronchoconstriction and inflammation in asthma and are used as bronchial challenge agents for the diagnosis of asthma and in respiratory drug development. Recently developed dry powder aerosols of adenosine have several advantages over nebulised adenosine 5'-monophosphate (AMP) as bronchial challenge agents. However, reverse translation of this bronchial challenge technique to pre-clinical drug development is limited by the difficulty of administering powder aerosols to animals...
February 21, 2018: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/29468074/development-of-a-patient-centred-evidence-based-and-consensus-based-discharge-care-bundle-for-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#2
Maria B Ospina, Marta Michas, Lesly Deuchar, Richard Leigh, Mohit Bhutani, Brian H Rowe, Darcy Marciniuk, Donna Goodridge, Gail Dechman, Jean Bourbeau, Meyer Balter, Pat Camp, Paul Hernandez, Roger S Goldstein, Michael K Stickland
Introduction: Hospital and emergency department discharge for patients with chronic obstructive pulmonary disease (COPD) is often poorly organised. We developed a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbations of COPD. Methods: A purposeful sample of clinicians and patients were invited to participate in a two-round Delphi study (July-November 2015). In round 1, participants rated on a seven-point Likert scale (1=not at all important; 7=extremely important) the importance of 29 unique COPD care actions...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29461890/small-airway-disease-syndromes-piercing-the-quiet-zone
#3
Kenneth I Berger
The role for direct assessment of small airway function in subjects with respiratory symptoms but normal airflow by spirometry is discussed. Small airway disease syndrome is described in numerous disease states using a multidisciplinary approach. Data demonstrate that small airway disease is related to presence of respiratory symptoms, exposure to inhaled toxins, presence of local and systemic inflammation, and presence of histologic abnormalities within the distal lung. Investigation of immunological derangements associated with distal airway dysfunction in the setting of normal spirometry may provide insight into pathophysiological mechanisms that are present at disease onset...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29457215/the-effect-of-anaesthetic-technique-during-primary-breast-cancer-surgery-on-neutrophil-lymphocyte-ratio-platelet-lymphocyte-ratio-and-return-to-intended-oncological-therapy
#4
A Ní Eochagáin, D Burns, B Riedel, D I Sessler, D J Buggy
Inflammation and immunosuppression contribute to the pathogenesis of cancer. An increased neutrophil-lymphocyte ratio reflects these processes and is associated with adverse cancer outcomes. Whether anaesthetic technique for breast cancer surgery influences these factors, and potentially cancer recurrence, remains unknown. We conducted a secondary analysis in patients enrolled in an ongoing trial of anaesthetic technique on breast cancer recurrence. The primary hypothesis was that postoperative neutrophil-lymphocyte ratio is lower in patients allocated to receive propofol-paravertebral rather than inhalational agent-opioid anaesthesia for primary breast cancer surgery...
February 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29454905/relationships-between-surface-coverage-ratio-and-powder-mechanics-of-binary-adhesive-mixtures-for-inhalation
#5
Jonas Rudén, Göran Frenning, Tobias Bramer, Kyrre Thalberg, Göran Alderborn
The aim of this paper was to study relationships between the content of fine particles and the powder mechanics of binary adhesive mixtures and link these relationships to the blend state. Mixtures with increasing amounts of fine particles (increasing surface coverage ratios (SCR)) were prepared using Lactopress SD as carrier and micro particles of lactose as fines (2.7 µm). Indicators of unsettled bulk density, compressibility and flowability were derived and the blend state was visually examined by imaging...
February 15, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29448239/bioaccessibility-and-bioavailability-of-environmental-semi-volatile-organic-compounds-via-inhalation-a-review-of-methods-and-models
#6
REVIEW
Wenjuan Wei, Nathalie Bonvallot, Åsa Gustafsson, Gaëlle Raffy, Philippe Glorennec, Annette Krais, Olivier Ramalho, Barbara Le Bot, Corinne Mandin
Semi-volatile organic compounds (SVOCs) present in indoor environments are known to cause adverse health effects through multiple routes of exposure. To assess the aggregate exposure, the bioaccessibility and bioavailability of SVOCs need to be determined. In this review, we discussed measurements of the bioaccessibility and bioavailability of SVOCs after inhalation. Published literature related to this issue is available for 2,3,7,8-tetrachlorodibenzo-p-dioxin and a few polycyclic aromatic hydrocarbons, such as benzo[a]pyrene and phenanthrene...
February 12, 2018: Environment International
https://www.readbyqxmd.com/read/29439927/characterization-of-pharmacists-interventions-in-asthma-management-a-systematic-review
#7
REVIEW
Carmen Crespo-Gonzalez, Fernando Fernandez-Llimos, Inajara Rotta, Cassyano J Correr, Shalom I Benrimoj, Victoria Garcia-Cardenas
OBJECTIVE: Pharmacists have adopted an active role in asthma management. This review aimed to analyze the intervention dose, understood as the "amount of program delivered," and core components of the intervention provided by pharmacists in asthma management. DATA SOURCES: A literature search was conducted in December 2016 using PubMed. STUDY SELECTION: A 2-stage approach was used. At the first stage, systematic reviews of pharmacists' interventions in asthma management were identified...
February 10, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29438809/flow-visualization-through-particle-image-velocimetry-in-realistic-model-of-rhesus-monkey-s-upper-airway
#8
Ji-Woong Kim, Nguyen Lu Phuong, Shin-Ichiro Aramaki, Kazuhide Ito
Studies concerning inhalation toxicology and respiratory drug-delivery systems require biological testing involving experiments performed on animals. Particle image velocimetry (PIV) is an effective in vitro technique that reveals detailed inhalation flow patterns, thereby assisting analyses of inhalation exposure to various substances. A realistic model of a rhesus-monkey upper airway was developed to investigate flow patterns in its oral and nasal cavities through PIV experiments performed under steady-state constant inhalation conditions at various flow rates-4, 10, and 20 L/min...
February 10, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29436733/placental-perfusion-imaging-using-velocity-selective-arterial-spin-labeling
#9
Zungho Zun, Catherine Limperopoulos
PURPOSE: The placenta remains the least understood human organ, in large part because of the lack of noninvasive tools currently available to examine placental function in vivo. This study investigates the feasibility of using velocity-selective arterial spin labeling (VSASL) to assess placental perfusion. METHODS: In placental perfusion imaging, VSASL was compared with pseudocontinuous ASL (PCASL), which is currently the standard technique in brain arterial spin labeling (ASL)...
February 13, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29429921/comparison-of-lung-tumor-motion-measured-using-a-model-based-4dct-technique-and-a-commercial-protocol
#10
Dylan O'Connell, Narek Shaverdian, Amar U Kishan, David H Thomas, Tai H Dou, John H Lewis, James M Lamb, Minsong Cao, Stephen Tenn, Lee P Percy, Daniel A Low
PURPOSE: To compare lung tumor motion measured with a model-based technique to commercial 4-dimensional computed tomography (4DCT) scans and describe a workflow for using model-based 4DCT as a clinical simulation protocol. METHODS AND MATERIALS: Twenty patients were imaged using a model-based technique and commercial 4DCT. Tumor motion was measured on each commercial 4DCT dataset and was calculated on model-based datasets for 3 breathing amplitude percentile intervals: 5th to 85th, 5th to 95th, and 0th to 100th...
November 11, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29427988/emerging-concepts-in-evidence-based-asthma-management
#11
Helen K Reddel
Asthma management is in an intriguing phase, with acceptance of asthma as a heterogeneous condition with different phenotypes and underlying mechanisms and the potential for personalized asthma care, in parallel with increasing evidence about the population-level impact of basic strategies to increase access to medicines and improve inhaler technique and adherence. These changes have been facilitated by a more comprehensive view of evidence, including both randomized controlled trials with high internal validity and pragmatic and observational studies with high generalizability to patients in clinical practice...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29423368/multifaceted-interventions-to-reduce-acute-exacerbations-in-elderly-asthmatics
#12
So-Hee Lee, Woo-Jung Song, Heung-Woo Park, Min-Gyu Kang, Sae-Hoon Kim, Hye-Kyung Park, Sang-Heon Kim, Yong-Eun Kwon, Tae-Bum Kim, Byung-Jae Lee, Young-Koo Jee, Byung-Whui Choi, Sang-Heon Cho, Sun-Sin Kim
Background: Although many risk factors are known to be associated with poor asthma outcomes in the elderly, the literature on the effect of risk factor control on asthma outcomes in the elderly is very sparse. Objective: To evaluate the role of multifaceted interventions in reducing acute exacerbations in elderly asthmatics. Methods: A total of 100 subjects were randomly selected from our prospective cohort of elderly asthmatics aged 65 years or older and were provided multifaceted intervention for 1 year...
January 2018: Asia Pacific Allergy
https://www.readbyqxmd.com/read/29416607/a-method-of-respiratory-phase-optimization-for-better-dose-sparing-of-organs-at-risks-a-validation-study-in-patients-with-lung-cancer
#13
Seong-Hee Kang, Siyong Kim, Dong-Su Kim, Tae-Ho Kim, So-Hyun Park, Dong-Seok Shin, Kyeong-Hyeon Kim, Min-Seok Cho, YeonSil Kim, Tae Suk Suh
Background: To propose an effective and simple cost value function to determine an optimal respiratory phase for lung treatment using either respiratory gating or breath-hold technique. Results: The optimized phase was obtained at a phase close to end inhalation in 11 out of 15 patients. For the rest of patients, the optimized phase was obtained at a phase close to end exhalation indicating that optimal phase can be patient specific. The mean doses of the Organs-at-risk (OARs) significantly decreased at the optimized phase without compromising the planning target volume (PTV) coverage (about 8% for all 3 OARs considered)...
January 2, 2018: Oncotarget
https://www.readbyqxmd.com/read/29416451/which-is-better-for-pain-reduction-during-transrectal-ultrasound-guided-biopsy-of-the-prostate-intravenous-diazepam-local-periprostatic-nerve-block-or-combination-controlled-randomized-study
#14
Haisam Atta, Mohamed F Mostafa, Mahmoud Shalaby
Background: Transrectal ultrasound-guided prostate biopsy (TRUSPB) is considered the procedure of choice for the diagnosis of prostate cancer. Men undergoing this biopsy experience high psychological stress. Different studies recommend techniques as sedation, lidocaine gel intrarectally, periprostatic nerve block alone, or nitrous oxide inhalation as effective methods of analgesia during procedural-related pain or discomfort. We evaluated three techniques for pain relief during TRUSPB and evaluated if there was any increase in the incidence of complications when employing either technique...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416232/the-role-of-neurokinin-1-substance-p-antagonists-in-the-prevention-of-postoperative-nausea-and-vomiting
#15
Dionne Okafor, Alan David Kaye, Rachel J Kaye, Richard D Urman
Postoperative nausea and vomiting (PONV) can be very debilitating for surgical patients, and effective management reduces potential morbidity, aiding in patient satisfaction, and minimizing the need for unintended hospital stays. Risk factors include female sex, nonsmoker, and having a previous history of motion sickness or PONV. Anesthetic risk factors include receiving opioids, not receiving a total intravenous anesthetic (TIVA), exposure to nitrous oxide, and extended length of anesthetic. Many treatments, including serotonin antagonists, dopamine antagonists, corticosteroids, inhaled isopropyl alcohol, and anticholinergics, as well as techniques such as TIVA, have been utilized over recent decades in an attempt to reduce PONV incidence...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29415579/use-of-spacers-for-patients-treated-with-pressurized-metered-dose-inhalers-focus-on-the-ventolin%C3%A2-mini-spacer
#16
Gregor Anderson, Neil Johnson, Aruni Mulgirigama, Bhumika Aggarwal
Spacers offer a multitude of benefits by reducing the requirement to coordinate inhalation with actuation and improving inhaler technique in patients using a pressurized metered dose inhaler (pMDI). Spacers improve drug targeting by retaining within the spacer large particles normally deposited in the oropharynx, and by creating a prolonged aerosol cloud of fine particles to give the user increased time to inhale after actuation. This is particularly important in young children and the elderly to effectively deliver medication to the airways...
February 8, 2018: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/29413991/gas-embolism-as-a-potential-cause-of-death-by-helium-poisoning-postmortem-computed-tomography-changes-in-two-cases-of-suicidal-helium-inhalation
#17
Aleksandra Borowska-Solonynko, Agnieszka Dąbkowska
Evaluation of two suicidal helium inhalation cases is presented, comprising both conventional autopsy methods and postmortem computed tomography. Conventional postmortem examinations reveal no characteristic changes. Modern diagnostic techniques enabled to disclosethe presence of a very large amount of accumulated gas in all examined areas, including veins and arteries of the head, torso, lower extremities, heart chambers, and between muscle fibers in both cases. The changes due to possible putrefaction were taken into consideration - radiological alteration index was calculated...
January 10, 2018: Legal Medicine
https://www.readbyqxmd.com/read/29408439/clinician-agreement-self-efficacy-and-adherence-with-the-guidelines-for-the-diagnosis-and-management-of-asthma
#18
Michelle M Cloutier, Paivi M Salo, Lara J Akinbami, Richard D Cohn, Jesse C Wilkerson, Gregory B Diette, Sonja Williams, Kurtis S Elward, Jacek M Mazurek, Jovonni R Spinner, Tracey A Mitchell, Darryl C Zeldin
BACKGROUND: The 2007 Guidelines for the Diagnosis and Management of Asthma provide evidence-based recommendations to improve asthma care. Limited national-level data are available about clinician agreement and adherence to these guidelines. OBJECTIVE: To assess clinician-reported adherence with specific guideline recommendations, as well as agreement with and self-efficacy to implement guidelines METHODS: We analyzed 2012 National Asthma Survey of Physicians data for 1412 primary care clinicians and 233 asthma specialists about four cornerstone guideline domains: asthma control, patient education, environmental control, and pharmacologic treatment...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29408236/the-strength-of-mechanical-forces-determines-the-differentiation-of-alveolar-epithelial-cells
#19
Jiao Li, Zheng Wang, Qiqi Chu, Kewu Jiang, Juan Li, Nan Tang
The differentiation of alveolar epithelial type I (AT1) and type II (AT2) cells is essential for the lung gas exchange function. Disruption of this process results in neonatal death or in severe lung diseases that last into adulthood. We developed live imaging techniques to characterize the mechanisms that control alveolar epithelial cell differentiation. We discovered that mechanical forces generated from the inhalation of amniotic fluid by fetal breathing movements are essential for AT1 cell differentiation...
February 5, 2018: Developmental Cell
https://www.readbyqxmd.com/read/29402495/effect-of-inhaled-medication-on-dental-caries-index-in-asthmatic-children
#20
Z Bahrololoomi, M H Bemanian, R Ghaffourifard, B Ahmadi
INTRODUCTION: Asthma is a chronic inflammatory disease of airways with a high prevalence among children in pre-school ages. Considering controversial results in different studies about the effect of this disease on the indices of dental caries, the aim of this study was to compare dmft (decay, missing, filling teeth) situation in asthmatic and non-asthmatic 6-12-year-old children. METHODS: This was a case-control study on 46 asthmatic and 47 non-asthmatic children aged 6-12 years...
February 2, 2018: Allergologia et Immunopathologia
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