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Inhaler technique

Abd-Elazeem Elbakry, Wesam-Eldin Sultan, Ezzeldin Ibrahim
STUDY OBJECTIVE: Laparoscopic sleeve gastrectomy is commonly performed under total intravenous anaesthesia (TIVA) or balanced anaesthesia using an intravenous and inhalation agent. It is still unclear which anaesthesia regimen is better for this group of patients. The present study has been conducted to compare the use of the inhalation anaesthesia technique using desflurane with the TIVA technique, using propofol and dexmedetomidine. DESIGN: Prospective, randomised, double-blinded study...
December 7, 2017: Journal of Clinical Anesthesia
Gabriela Daisy Hadiwinoto, Philip Chi Lip Kwok, Richard Lakerveld
This review discusses recent developments in the manufacture of inhalable dry powder formulations. Pulmonary drugs have distinct advantages compared with other drug administration routes. However, requirements of drugs properties complicate the manufacture. Control over crystallization to make particles with the desired properties in a single step is often infeasible, which calls for micronization techniques. Although spray drying produces particles in the desired size range, a stable solid state may not be attainable...
January 2018: Therapeutic Delivery
Till F Kaireit, Sajoscha A Sorrentino, Julius Renne, Christian Schoenfeld, Andreas Voskrebenzev, Marcel Gutberlet, Angela Schulz, Peter M Jakob, Gesine Hansen, Frank Wacker, Tobias Welte, Burkhard Tümmler, Jens Vogel-Claussen
PURPOSE: To test quantitative functional lung MRI techniques in young adults with cystic fibrosis (CF) compared to healthy volunteers and to monitor immediate treatment effects of a single inhalation of hypertonic saline in comparison to clinical routine pulmonary function tests. MATERIALS AND METHODS: Sixteen clinically stable CF patients and 12 healthy volunteers prospectively underwent two functional lung MRI scans and pulmonary function tests before and 2h after a single treatment of inhaled hypertonic saline or without any treatment...
2017: PloS One
Sarah Barbara, Vicky Kritikos, Sinthia Bosnic-Anticevich
Poor inhaler technique and inferior asthma outcomes are evident in older adults. Reviews comparing metered dose inhaler (MDI) and dry powder inhaler (DPI) techniques across older adults and younger cohorts are scarce. This systematic review aimed to determine whether differences exist between such cohorts with regards to the number and type of MDI and DPI errors made. A systematic literature search was conducted in Embase, Medline and PubMed from July 1 to December 31, 2016. Studies were selected in accordance with preset inclusion criteria, relevant data were extracted, and quality was assessed with validated checklists...
December 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
Rebecca L Cordell, Thalassa S E Valkenburg, Hitesh C Pandya, Daniel B Hawcutt, Malcolm G Semple, Paul S Monks
OBJECTIVES: A novel gas chromatography-mass spectrometry (GC-MS) method has been developed to quantify salbutamol in micro-volumes (10 µL) of blood. A potential application is paediatric therapeutic dose monitoring (TDM) in acute severe asthma. METHODS: At presentation, the children receive multiple doses of salbutamol (inhaled, nebulised and occasionally intravenous) but it is difficult to distinguish children who do not respond to treatment because of inadequate concentrations from those with toxicity, as symptoms are similar...
December 6, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
A Salomone, A Bozzo, D Di Corcia, E Gerace, M Vincenti
Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair are effective direct biomarkers of ethanol ingestion, whose analytical determination can be used to discriminate between chronic and occasional ethanol intake. Ethanol is a compound widely used in some workplaces (e.g., clinics, hospitals) and is present in considerable amounts in mouthwash for oral cleaning, medications, cosmetic products, hydro-alcoholic disinfectants and antiseptics for hands. This study examined the ethyl alcohol exposure derived from hand disinfectants (in gel form) by simulating the typical occupational situation of medical-health workers (healthcare workers, nurses, surgeons, etc...
December 1, 2017: Journal of Analytical Toxicology
Roxanne Bournival, Raphaël Coutu, Nicolas Goettel, Chun Dian Yang, Antoine Cantin-Lafleur, Catherine Lemieux, Anne-Marie Lévesque, Jean-François Patenaude-Monette, François-Olivier Roy, Lucie Blais, Fanny Arbour, Anne Fillion, Marie-France Beauchesne
BACKGROUND: Inhaler technique and patient preferences are often overlooked when selecting maintenance treatments for patients with chronic obstructive pulmonary disease (COPD), but are important issues in ensuring drug efficacy and patient adherence. Few data on these issues are available for new inhalation devices. OBJECTIVES: To evaluate the inhalation techniques for the HandiHaler®, Breezhaler®, Genuair®, and Respimat® inhalation devices, and patient preferences for the three latter inhalers that were recently developed...
December 5, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Ezgi Mutluay Yayla, Leyla Ozdemir
BACKGROUND: Needle insertion into an implantable central venous port catheter may lead to procedural pain and anxiety in cancer patients. OBJECTIVE: The aim of this study was to determine the effects of inhalation aromatherapy on procedural pain and anxiety after needle insertion into an implantable central venous port catheter. METHODS: This study included 123 cancer patients who were scheduled to undergo chemotherapy. Patients were randomly assigned to either the lavender group (n = 41), the eucalyptus group (n = 41), or a control group (n = 41)...
December 2, 2017: Cancer Nursing
Martin Wallin, Tatsuaki Tagami, Lan Chen, Mingshi Yang, Hak-Kim Chan
Pulmonary diseases, such as asthma and chronic obstructive pulmonary disease (COPD), are common in older people. Treatment principles are well established in this group of patients; however, inadequate training and improper inhaler techniques often results in poor treatment outcomes. Healthcare professionals often do not have the required knowledge about the most common inhaler devices. Age-related conditions like cognitive ability and physical strength would also impact on the inhaler usage. Pharmacokinetics and pharmacodynamics may be affected by physiological changes, like impaired renal and hepatic functions and reduced lung functions...
November 29, 2017: Advanced Drug Delivery Reviews
Bruce G Bender
Nonadherence to asthma medications is well recognized. Interventions to improve adherence, however, have been only moderately successful and are not often adopted because of limited provider time, training, or institutional support. The potential for mobile communication technology to improve adherence has gathered sharply growing interest. Technology-based adherence tracking devices have been in existence for almost 3 decades, but have only recently reached a level of reliability and utility to be considered in allergy practice...
November 29, 2017: Journal of Allergy and Clinical Immunology in Practice
Lisa McDermott, Geraldine M Leydon, Amy Halls, Jo Kelly, Amanda Nagle, Jennifer White, Paul Little
OBJECTIVE: To explore perceptions of illness, the decisions to consult and the acceptability of delayed antibiotic prescriptions and self-help treatments for respiratory tract infections (RTIs). DESIGN: Qualitative semistructured interview study. SETTING: UK primary care. PARTICIPANTS: 20 adult patients who had been participating in the 'PIPS' (Pragmatic Ibuprofen Paracetamol and Steam) trial in the South of England...
November 26, 2017: BMJ Open
Hadeer M Abdelaziz, Mohamed Gaber, Mahmoud M Abd-Elwakil, Moustafa T Mabrouk, Mayada M Elgohary, Nayra M Kamel, Dalia M Kabary, May S Freag, Magda W Samaha, Sana M Mortada, Kadria A Elkhodairy, Jia-You Fang, Ahmed O Elzoghby
There is progressive evolution in the use of inhalable drug delivery systems (DDSs) for lung cancer therapy. The inhalation route offers many advantages, being non-invasive method of drug administration as well as localized delivery of anti-cancer drugs to tumor tissue. This article reviews various inhalable colloidal systems studied for tumor-targeted drug delivery including polymeric, lipid, hybrid and inorganic nanocarriers. The active targeting approaches for enhanced delivery of nanocarriers to lung cancer cells were illustrated...
November 24, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
Nagamalleswara Rao Alluri, Venkateswaran Vivekananthan, Arunkumar Chandrasekhar, Sang-Jae Kim
Contrary to traditional planar flexible piezoelectric nanogenerators (PNGs), highly adaptable hemispherical shape-flexible piezoelectric composite strip (HS-FPCS) based PNGs are required to harness/measure non-linear surface motions. Therefore, a feasible, cost-effective and less-time consuming groove technique was developed to fabricate adaptable HS-FPCSs with multiple lengths. A single HS-CSPNG generates 130 V/0.8 μA and can also work as a self-powered muscle monitoring system (SP-MMS) to measure maximum human body part movements, i...
November 27, 2017: Nanoscale
Sewunet Admasu Belachew, Fasil Tilahun, Tirsit Ketsela, Asnakew Achaw Ayele, Adeladlew Kassie Netere, Amanual Getnet Mersha, Tamrat Befekadu Abebe, Begashaw Melaku Gebresillassie, Henok Getachew Tegegn, Daniel Asfaw Erku
BACKGROUND: When compared to systemic administration, if used correctly inhalers deliver a smaller enough percent of the drug right to the site of action in the lungs, with a faster onset of effect and with reduced systemic availability that minimizes adverse effects. However, the health professionals' and patients' use of metered dose inhaler is poor. OBJECTIVE: This study was aimed to explore community pharmacy professionals' (pharmacists' and druggists') competency on metered dose inhaler (MDI) technique...
2017: PloS One
Layla J Barkal, Clare L Procknow, Yasmín R Álvarez-García, Mengyao Niu, José A Jiménez-Torres, Rebecca A Brockman-Schneider, James E Gern, Loren C Denlinger, Ashleigh B Theberge, Nancy P Keller, Erwin Berthier, David J Beebe
We inhale respiratory pathogens continuously, and the subsequent signaling events between host and microbe are complex, ultimately resulting in clearance of the microbe, stable colonization of the host, or active disease. Traditional in vitro methods are ill-equipped to study these critical events in the context of the lung microenvironment. Here we introduce a microscale organotypic model of the human bronchiole for studying pulmonary infection. By leveraging microscale techniques, the model is designed to approximate the structure of the human bronchiole, containing airway, vascular, and extracellular matrix compartments...
November 24, 2017: Nature Communications
Bruce G Weniger, Ian E Anglin, Tina Tong, Michael Pensiero, Jeffrey K Pullen
On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities...
November 21, 2017: Vaccine
Leon Dunn, John Kenny
AIM: The aim of this work was to design and evaluate a software tool for analysis of a patient's respiration, with the goal of optimizing the effectiveness of motion management techniques during radiotherapy imaging and treatment. MATERIALS AND METHODS: A software tool which analyses patient respiratory data files (.vxp files) created by the Varian Real-Time Position Management System (RPM) was developed to analyse patient respiratory data. The software, called RespAnalysis, was created in MATLAB and provides four modules, one each for determining respiration characteristics, providing breathing coaching (biofeedback training), comparing pre and post-training characteristics and performing a fraction-by-fraction assessment...
October 2017: Physica Medica: PM
Katelyn Hasse, Dylan O'Connell, Yugang Min, John Neylon, Daniel A Low, Anand Santhanam
PURPOSE: Lung diseases are commonly associated with changes in lung tissue's biomechanical properties. Functional imaging techniques, such as elastography, have shown great promise in measuring tissue's biomechanical properties, which could expand the utility and effectiveness of radiotherapy treatment planning. We present a novel methodology for characterizing a key biomechanical property, parenchymal elasticity, derived solely from 4DCT datasets. METHODS: Specifically, end-inhalation and end-exhalation breathing phases of the 4DCT datasets were deformably registered and the resulting displacement maps were considered to be ground-truth...
November 24, 2017: Medical Physics
Daisuke Kawahara, Shuichi Ozawa, Kazushi Yokomachi, Sodai Tanaka, Toru Higaki, Chikako Fujioka, Tatsuhiko Suzuki, Masato Tsuneda, Takeo Nakashima, Yoshimi Ohno, Yasushi Nagata
OBJECTIVE: The aim of this study is to evaluate the accuracies of the raw-data based effective atomic number (Zeff) and monochromatic CT numbers for varying contrast material iodine concentration obtained using dual-energy CT. METHODS: We used a tissue characterization phantom and different concentrations of iodinated contrast medium. A comparison between the calculated values of Zeff and that provided by the manufacturer was performed. Moreover, the measured monochromatic CT number and monochromatic CT number calculated at 40-130 keV were compared...
November 21, 2017: British Journal of Radiology
Kian Fan Chung
The introduction of 16s ribosomal RNA sequencing as a nonculture technique has led to the discovery of the presence of microbiota in the lower airways of healthy individuals. These bacterial communities may originate from the mouth and nasopharynx or from the environment by inhalation. The microbial composition of the lower airways may be modulated by dietary factors, antibiotic therapy, and microbial infections, particularly in early life. In addition, circulatory products from gut microbiota may influence the lung microbiota to maintain mucosal immunity...
November 2017: Annals of the American Thoracic Society
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