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Inhaler technique

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https://www.readbyqxmd.com/read/28410043/optimising-inhaler-technique-in-chronic-obstructive-pulmonary-disease-a-complex-issue
#1
Jo Riley, Phillip Krüger
Inhaled therapies play a central role in the management of chronic obstructive pulmonary disease (COPD); however, studies indicate that many patients do not use their inhaled medication as directed, resulting in decreased medication delivery and suboptimal disease control. Key factors that should be considered when evaluating whether patients are achieving optimal outcomes with inhaled therapies are: if patients are using a correct inhalation technique; if patients have adequate dexterity to use the prescribed inhaler; if patients have sufficient inspiratory flow rate to achieve adequate lung deposition (for dry powder inhalers); and if the inhaler is accepted by the patient...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28408742/effectiveness-and-success-factors-of-educational-inhaler-technique-interventions-in-asthma-copd-patients-a-systematic-review
#2
Sven L Klijn, Mickaël Hiligsmann, Silvia M A A Evers, Miguel Román-Rodríguez, Thys van der Molen, Job F M van Boven
With the current wealth of new inhalers available and insurance policy driven inhaler switching, the need for insights in optimal education on inhaler use is more evident than ever. We aimed to systematically review educational inhalation technique interventions, to assess their overall effectiveness, and identify main drivers of success. Medline, Embase and CINAHL databases were searched for randomised controlled trials on educational inhalation technique interventions. Inclusion eligibility, quality appraisal (Cochrane's risk of bias tool) and data extraction were performed by two independent reviewers...
April 13, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28404553/airway-emergencies-presenting-to-the-paediatric-emergency-department-requiring-advanced-management-techniques
#3
Leopold Simma, Domenic Cincotta, Stefan Sabato, Elliot Long
BACKGROUND: Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. AIMS: This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. METHODS: A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia...
April 12, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28401142/comprehensive-survey-of-household-radon-gas-levels-and-risk-factors-in-southern-alberta
#4
Fintan K T Stanley, Siavash Zarezadeh, Colin D Dumais, Karin Dumais, Renata MacQueen, Fiona Clement, Aaron A Goodarzi
BACKGROUND: The inhalation of naturally occurring radon (222Rn) gas from indoor air exposes lung tissue to α-particle bombardment, a highly mutagenic form of ionizing radiation that damages DNA and increases the lifetime risk of lung cancer. We analyzed household radon concentrations and risk factors in southern Alberta, including Calgary, the third-largest Canadian metropolis. METHODS: A total of 2382 residential homes (2018 in Calgary and 364 in surrounding townships) from an area encompassing 82% of the southern Alberta population were tested for radon, per Health Canada guidelines, for at least 90 days (median 103 d) between 2013 and 2016...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28389274/significance-of-breath-hold-time-in-dry-powder-aerosol-drug-therapy-of-copd-patients
#5
Alpár Horváth, Imre Balásházy, Gábor Tomisa, Árpád Farkas
Aerosol drugs are effectively used to treat chronic respiratory diseases. The efficiency of the therapy depends also on the amount and distribution of drug deposited within the airways. The objective of this study is to apply numerical techniques to analyse the effect of the duration of breath-hold after the inhalation of six different commercialized dry powder drugs on their lung deposition. For this purpose a computational airway deposition model has been adapted and validated to the special case of therapeutic aerosols...
April 4, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28386274/do-face-to-face-training-and-telephonic-reminder-improve-dry-powder-inhaler-technique-in-patients-with-copd
#6
Ramesh Sharma Poudel, Shakti Shrestha, Pawan Bhatta, Rano Mal Piryani
Introduction. Current modes of instruction on inhaler technique are inadequate. We aimed to evaluate the value of face-to-face training and telephonic reminder (FFTTR) for improving Rotahaler technique in experienced patients with COPD. Materials and Methods. A single group pre-/postinterventional study was conducted at Chitwan Medical College Teaching Hospital, Nepal. We assessed the Rotahaler technique of thirty consecutive patients using Rotahaler device for more than one year. Patients with incorrect technique (n = 20) were instructed and trained by a pharmacist...
2017: International Journal of Telemedicine and Applications
https://www.readbyqxmd.com/read/28374886/total-intravenous-anaesthesia-versus-inhalational-anaesthesia-for-adults-undergoing-transabdominal-robotic-assisted-laparoscopic-surgery
#7
REVIEW
Suzanne Forsyth Herling, Bjørn Dreijer, Gitte Wrist Lam, Thordis Thomsen, Ann Merete Møller
BACKGROUND: Rapid implementation of robotic transabdominal surgery has resulted in the need for re-evaluation of the most suitable form of anaesthesia. The overall objective of anaesthesia is to minimize perioperative risk and discomfort for patients both during and after surgery. Anaesthesia for patients undergoing robotic assisted surgery is different from anaesthesia for patients undergoing open or laparoscopic surgery; new anaesthetic concerns accompany robotic assisted surgery. OBJECTIVES: To assess outcomes related to the choice of total intravenous anaesthesia (TIVA) or inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic gynaecological, urological or gastroenterological surgery...
April 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28372795/a-four-dimensional-computed-tomography-comparison-of-healthy-and-asthmatic-human-lungs
#8
Nariman Jahani, Sanghun Choi, Jiwoong Choi, Babak Haghighi, Eric A Hoffman, Alejandro P Comellas, Joel N Kline, Ching-Long Lin
The purpose of this study was to explore new insights in non-linearity, hysteresis and ventilation heterogeneity of asthmatic human lungs using four-dimensional computed tomography (4D-CT) image data acquired during tidal breathing. Volumetric image data were acquired for 5 non-severe and one severe asthmatic volunteers. Besides 4D-CT image data, function residual capacity and total lung capacity image data during breath-hold were acquired for comparison with dynamic scans. Quantitative results were compared with the previously reported analysis of five healthy human lungs...
March 18, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28367654/a-review-of-co-milling-techniques-for-the-production-of-high-dose-dry-powder-inhaler-formulation
#9
Michael Lau, Paul M Young, Daniela Traini
Drug delivery by inhalation offers several advantages compared to other dosage forms, including rapid clinical onset, high bioavailability, and minimal systemic side effects. Drug delivery to the lung can be achieved as liquid suspensions or solutions in nebulizers and pressurized metered-dose inhalers (pMDI), or as dry powders in dry powder inhalers (DPIs). Compared to other delivery systems, DPIs are, in many cases, considered the most convenient as they are breath actuated and do not require the use of propellants...
April 19, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28364205/spatial-distribution-of-atmospheric-pahs-and-their-genotoxicity-in-petrochemical-industrialized-lanzhou-valley-northwest-china
#10
Li Wang, Yuan Zhao, Xin Yi, Zhanxiang Wang, Yayi Yi, Tao Huang, Hong Gao, Jianmin Ma
The present study investigated the spatial and seasonal variations and sources of 16 priority polycyclic aromatic hydrocarbons (PAHs) in Lanzhou, a petrochemical industrialized and the capital city of Gansu province, northwest China. The human health risks to these PAHs were assessed using an in vitro genotoxic bioassay technique. Associations among direct genotoxic potency, atmospheric PAH concentrations, and potential carcinogen risks were examined. Due to high PAH emissions from fossil fuel combustion and petrochemical industries, considerable higher PAH levels in the atmosphere were observed in Xigu district, a suburb featured by heavy petrochemical industry, compared with those collected at downtown and rural sampling sites...
March 31, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28362834/the-impact-of-inspired-oxygen-levels-on-calibrated-fmri-measurements-of-m-oef-and-resting-cmro2-using-combined-hypercapnia-and-hyperoxia
#11
Isabelle Lajoie, Felipe B Tancredi, Richard D Hoge
Recent calibrated fMRI techniques using combined hypercapnia and hyperoxia allow the mapping of resting cerebral metabolic rate of oxygen (CMRO2) in absolute units, oxygen extraction fraction (OEF) and calibration parameter M (maximum BOLD). The adoption of such technique necessitates knowledge about the precision and accuracy of the model-derived parameters. One of the factors that may impact the precision and accuracy is the level of oxygen provided during periods of hyperoxia (HO). A high level of oxygen may bring the BOLD responses closer to the maximum M value, and hence reduce the error associated with the M interpolation...
2017: PloS One
https://www.readbyqxmd.com/read/28361641/correct-use-of-inhalers-is-our-responsibility
#12
Jane Scullion, Monica Fletcher
Despite the fact that inhaled medications have been the basis for treating patients with respiratory diseases for more than 60 years, we are repeatedly reminded that many individuals cannot use their inhaler devices correctly ( Capstick and Clifton 2012 , Scullion and Holmes 2013 , Sanchis et al 2016 ).This is often because healthcare professionals cannot use the devices correctly either and they teach less than optimum techniques to patients. This in turn results in poor control and, potentially, death.
March 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28356764/study-of-nasal-exhaled-nitric-oxide-levels-in-diagnosis-of-allergic-rhinitis-in-subjects-with-and-without-asthma
#13
Sy Duong-Quy, Thuc Vu-Minh, Thong Hua-Huy, Tram Tang-Thi-Thao, Khiet Le-Quang, Dinh Tran-Thanh, Nhu Doan-Thi-Quynh, Nhat-Nam Le-Dong, Timothy J Craig, Anh-Tuan Dinh-Xuan
BACKGROUND: The measure of fractional exhaled nitric oxide (FENO) in the airways is a useful tool to guide the diagnosis and titration of inhaled corticosteroids in patients with asthma. However, its role in diagnosis of allergic rhinitis (AR), especially in subjects with asthma, is not well established. OBJECTIVE: To study the cutoff of nasal FENO in the diagnosis of subjects with AR and AR-asthma compared to age-matched subjects without AR or asthma and its correlations with the clinical and functional characteristics...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28355354/cerebral-blood-flow-and-vasoreactivity-in-aging-an-arterial-spin-labeling-study
#14
R F Leoni, I A F Oliveira, O M Pontes-Neto, A C Santos, J P Leite
Regional cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) in young and elderly participants were assessed using pulsed arterial spin labeling (ASL) and blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) techniques in combination with inhalation of CO2. Pulsed ASL and BOLD-MRI were acquired in seventeen asymptomatic volunteers (10 young adults, age: 30±7 years; 7 elderly adults, age: 64±8 years) with no history of diabetes, hypertension, and neurological diseases. Data from one elderly participant was excluded due to the incorrigible head motion...
March 23, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28351904/evaluation-of-the-prevalence-and-effectiveness-of-education-on-metered-dose-inhaler-technique
#15
Kayce M Shealy, Victoria C Paradiso, Megan L Slimmer, Darien L Campbell, Tiffaney B Threatt
BACKGROUND: The objectives of this study were: (1) to assess the prevalence of and types of education methods provided to participants who use a metered-dose inhaler (MDI), (2) to determine the prevalence of MDI misuse in adults using objective and subjective assessments, and (3) to determine whether any associations exist between the education method and the participant's ability to properly use an MDI. METHODS: Adult participants who had a current or previous history of MDI use were recruited from retail pharmacies and physician offices in Laurens County, South Carolina...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28347847/dry-powder-inhaler-performance-of-spray-dried-mannitol-with-tailored-surface-morphologies-as-carrier-and-salbutamol-sulphate
#16
M Mönckedieck, J Kamplade, P Fakner, N A Urbanetz, P Walzel, H Steckel, R Scherließ
Nowadays, dry powder inhalation as applied in the therapy of pulmonary diseases is known as a very effective route of drug delivery to the lungs. Here, the system of coarse carrier and fine drug particles attached to the carrier surface has successfully been applied to overcome the cohesiveness of small drug particles. Particle properties of both carrier and drug are known to affect drug dispersion as has widely been discussed for lactose monohydrate and various drugs. This study utilises particle-engineered mannitol as an alternative carrier to discover the effect of mannitol carrier particle properties like particle shape, surface roughness, flowability or particle size on aerodynamic performance during inhalation...
March 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28347687/effects-of-chronic-inhalation-of-electronic-cigarettes-containing-nicotine-on-glial-glutamate-transporters-and-%C3%AE-7-nicotinic-acetylcholine-receptor-in-female-cd-1-mice
#17
Fawaz Alasmari, Laura E Crotty Alexander, Jessica A Nelson, Isaac T Schiefer, Ellen Breen, Christopher A Drummond, Youssef Sari
Alteration in glutamate neurotransmission has been found to mediate the development of drug dependence, including nicotine. We and others, through using western blotting, have reported that exposure to drugs of abuse reduced the expression of glutamate transporter-1 (GLT-1) as well as cystine/glutamate antiporter (xCT), which consequently increased extracellular glutamate concentrations in the mesocorticolimbic area. However, our previous studies did not reveal any changes in glutamate/aspartate transporter (GLAST) following exposure to drugs of abuse...
March 27, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28336254/effectiveness-of-training-patients-using-dvd-in-the-accurate-use-of%C3%A2-inhalers-for-the-treatment-of-bronchial-asthma
#18
Koichiro Takita, Rieko Kondo, Takahiko Horiguchi
BACKGROUND: Inhalants are the standard treatment for patients with bronchial asthma. Inaccurate inhaler use leads to inadequate therapeutic effects and unnecessary dosage increases. However, it is a challenge for practitioners to master the various devices available and train patients on the accurate use of inhalers. Thus, establishing a system to instruct patients on how to accurately use inhalers is essential. We prepared a DVD and accompanying user manual explaining the operation of each inhaler device used in Japan...
March 20, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28332886/inhaler-technique-mastery-and-maintenance-in-healthcare-professionals-trained-on-different-devices
#19
Sinthia Bosnic-Anticevich, Christina Callan, Henry Chrystyn, Federico Lavorini, Vasilis Nikolaou, Vicky Kritikos, P N Richard Dekhuijzen, Nicolas Roche, Leif Bjermer, Cynthia Rand, Nicholas Zwar, David B Price
OBJECTIVE: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). METHODS: We conducted a randomised, un-blinded, cross-over study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use)...
March 23, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28328861/relationship-between-anesthesia-and-postoperative-endophthalmitis-a-retrospective-study
#20
Hou-Chuan Lai, Wei-Cheng Tseng, Shu-I Pao, Chih-Shung Wong, Ren-Chih Huang, Wei-Hung Chan, Zhi-Fu Wu
Previous study showed that patients under general anesthesia (GA) had nasopharyngeal secretions on the face at the end of ocular surgery, especially in propofol-based total intravenous anesthesia (TIVA), it might induce postoperative endophthalmitis. Therefore, we conducted a retrospective study to compare the incidence of endophthalmitis after ocular surgery under topical, inhalation anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015.A total of 21,032 patients were included, and we evaluated epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of ocular surgery, method of antibiotic prophylaxis, vitreous culture, and vision outcome in these patients...
March 2017: Medicine (Baltimore)
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