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Inhaler technique

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https://www.readbyqxmd.com/read/28222477/checklists-for-the-assessment-of-correct-inhalation-therapy
#1
V Knipel, S Schwarz, F S Magnet, J H Storre, C P Criée, W Windisch
Introduction For the long-term treatment of obstructive lung diseases inhalation therapy with drugs being delivered directly to the lungs as an aerosol has become the method of choice. However, patient-related mistakes in inhalation techniques are frequent and recognized to be associated with reduced disease control. Since the assessment of patient-mistakes in inhalation has yet not been standardized, the present study was aimed at developing checklists for the assessment of correct inhalation. Methods Checklists were developed in German by an expert panel of pneumologists and professionally translated into English following back-translation procedures...
February 2017: Pneumologie
https://www.readbyqxmd.com/read/28216536/the-fraction-of-exhaled-nitric-oxide-feno-and-forced-oscillation-technique-fot-can-predict-bronchial-hyperresponsiveness-against-acetylcholine-in-treated-asthmatics
#2
Masanori Fukuhara, Takahiro Tsuburai, Yuto Nakamura, Yasuhiro Tomita, Yuto Hamada, Kentaro Watai, Hiroaki Hayashi, Yousuke Kamide, Kiyoshi Sekiya, Chihiro Mitsui, Yuma Fukutomi, Akio Mori, Masami Taniguchi
BACKGROUND: The bronchial hyperresponsiveness (BHR) test is useful to diagnose or evaluate effect of therapy in asthmatics, but invasive. On the other hands, the fraction of exhaled nitric oxide (FENO) is a useful noninvasive marker of eosinophilic airway inflammation in asthmatics. And also, the forced oscillation technique (FOT) is a noninvasive method that is used to measure respiratory mechanics, including respiratory resistance and reactance at multiple frequencies. AIM: To evaluate the complementary roles of FENO and FOT to predict bronchial hyperresponsiveness in adult stable asthmatic patients taking inhaled corticosteroids...
2017: Arerugī, [Allergy]
https://www.readbyqxmd.com/read/28216453/quantification-of-myocardial-oxygenation-in-heart-failure-using-blood-oxygen-level-dependent-t2-magnetic-resonance-imaging-comparison-with-cardiopulmonary-exercise-test
#3
Michinobu Nagao, Yuzo Yamasaki, Satoshi Kawanami, Takeshi Kamitani, Koji Sagiyama, Taiki Higo, Tomomi Ide, Atsushi Takemura, Umiko Ishizaki, Kenji Fukushima, Yuji Watanabe, Hiroshi Honda
PURPOSE: Quantification of myocardial oxygenation (MO) in heart failure (HF) has been less than satisfactory. This has necessitated the use of invasive techniques to measure MO directly or to determine the oxygen demand during exercise using the cardiopulmonary exercise (CPX) test. We propose a new quantification method for MO using blood-oxygen-level-dependent (BOLD) myocardial T2* magnetic resonance imaging (M-T2* MRI), and investigate its correlation with CPX results. METHODS: Thirty patients with refractory HF who underwent cardiac MRI and CPX test for heart transplantation, and 24 healthy, age-matched volunteers as controls were enrolled...
February 16, 2017: Magnetic Resonance Imaging
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
#4
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/28213945/optimization-of-initial-propofol-bolus-dose-for-eeg-narcotrend-index-guided-transition-from-sevoflurane-induction-to-intravenous-anesthesia-in-children
#5
Nils Dennhardt, Dietmar Boethig, Christiane Beck, Sebastian Heiderich, Martin Boehne, Andreas Leffler, Barbara Schultz, Robert Sümpelmann
BACKGROUND: Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. OBJECTIVE: The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI)...
February 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28193360/a-review-of-rapid-and-field-portable-analytical-techniques-for-the-diagnosis-of-cyanide-exposure
#6
REVIEW
Randy Jackson, Brian A Logue
Although commonly known as a highly toxic chemical, cyanide is also an essential reagent for many industrial processes in areas such as mining, electroplating and synthetic fiber production. The "heavy" use of cyanide in these industries, along with its necessary transportation, increases the possibility of human exposure. Another relatively common, but consistently overlooked, mode of cyanide exposure is inhalation of fire smoke. Both civilians and fire rescue personnel risk exposure during the unfortunate event of a structure fire...
April 1, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28191318/structured-pharmaceutical-care-improves-the-health-related-quality-of-life-of-patients-with-asthma
#7
Philip O Anum, Berko P Anto, Audrey G Forson
BACKGROUND: Asthma as a chronic health condition can be controlled when in addition to clinical care, adequate education and support is provided to enhance self-management. Like many other chronic health conditions improved self-management positively impacts the health-related quality of life (HRQoL). It can therefore be said that a well-structured pharmaceutical care delivery that addresses the issues related to patient education and support towards self-management stands a good chance of positively impacting asthma control...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28185219/polycyclic-aromatic-hydrocarbons-in-urban-street-dust-sources-and-health-risk-assessment
#8
Xue Song Wang
Urban street dust samples from 49 sampling sites in Xuzhou (China) were collected and analyzed for 16 polycyclic aromatic hydrocarbons (PAHs) using gas chromatography/mass spectrometry. The organic matter and total carbon contents were also determined. The results showed that total PAHs concentrations varied from 2174 to 24,499 ng/g with a mean value of 6616 ng/g, organic matter content varied from 3.1 to 8.7% with a mean value of 5.8%, total carbon content varied from 13.2 to 24.2%, with a mean value of 19...
February 9, 2017: Environmental Geochemistry and Health
https://www.readbyqxmd.com/read/28184045/effect-of-novel-inhaler-technique-reminder-labels-on-the-retention-of-inhaler-technique-skills-in-asthma-a-single-blind-randomized-controlled-trial
#9
Iman A Basheti, Nathir M Obeidat, Helen K Reddel
: Inhaler technique can be corrected with training, but skills drop off quickly without repeated training. The aim of our study was to explore the effect of novel inhaler technique labels on the retention of correct inhaler technique. In this single-blind randomized parallel-group active-controlled study, clinical pharmacists enrolled asthma patients using controller medication by Accuhaler [Diskus] or Turbuhaler. Inhaler technique was assessed using published checklists (score 0-9). Symptom control was assessed by asthma control test...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28167004/e-cigarettes-an-update-on-considerations-for-the-otolaryngologist
#10
REVIEW
Sneh Biyani, Craig S Derkay
PURPOSE: We provide an update in the literature and national regulations regarding electronic cigarettes with special attention to the pediatric population. BACKGROUND: Electronic nicotine delivery systems (ENDS) are handheld battery operated devices that vaporize nicotine-containing liquids for inhalation. Use of these products has dramatically increased over the last several years, particularly among the youth. ENDS are being marketed with advertising techniques and flavors which appeal to the adolescent and young adult population...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28162162/-application-of-ultrasound-guidance-for-fascia-iliaca-compartment-block-in-pediatric-femoral-surgery
#11
Y Nan, Q Q Yang, X W Li, T Li, J Li
Objective: To evaluate the efficacy of ultrasound guidance for fascia iliaca compartment block in pediatric femoral surgery. Methods: This study was a prospective study, thirty children who were American Society of Anesthesiologists (ASA) statusⅠ with 5-10 years old scheduled for femoral surgery were selected in orthopedics department in Second Affiliated Hospital of Wenzhou Medical University from May to December in 2014. After induction of general anesthesia, all the children were inserted the laryngeal mask...
January 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28158200/impact-of-online-patient-reminders-to-improve-asthma-care-a-randomized-controlled-trial
#12
Andrew C Pool, Jennifer L Kraschnewski, Jennifer M Poger, Joshua Smyth, Heather L Stuckey, Timothy J Craig, Erik B Lehman, Chengwu Yang, Christopher N Sciamanna
IMPORTANCE: Asthma is one of the most burdensome chronic illnesses in the US. Despite widespread dissemination of evidence-based guidelines, more than half of the adults with asthma have uncontrolled symptoms. OBJECTIVE: To examine the efficacy of an online tool designed to improve asthma control. DESIGN: 12-month single blind randomized controlled trial of the online tool (Intervention condition, IC) versus an active control tool (CC). SETTING: Patients enrolled in an insurance plan...
2017: PloS One
https://www.readbyqxmd.com/read/28157430/factors-determining-in-vitro-lung-deposition-of-albuterol-aerosol-delivered-by-ventolin-metered-dose-inhaler
#13
Rajoshi Biswas, Nicola A Hanania, Ashutosh Sabharwal
BACKGROUND: The effectiveness of metered-dose inhalers (MDIs) in delivering medication to the lungs highly depends on its correct usage technique. Current guidelines state optimal technique for high lung deposition should include a slow inhalation (>5 seconds) at an inspiratory flow rate of 30 L/min and inhaler actuation at the start of inhalation. However, these recommendations were based on clinical studies using CFC (chlorofluorocarbon)-MDIs and in vitro studies of HFA (hydrofluoroalkane)-MDIs using idealized MDI techniques of uniform inhalation and actuation, disregarding the nonuniform techniques of actual patients...
February 3, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28152435/nmr-spin-lock-induced-crossing-slic-dispersion-and-long-lived-spin-states-of-gaseous-propane-at-low-magnetic-field-0-05t
#14
Danila A Barskiy, Oleg G Salnikov, Alexey S Romanov, Matthew A Feldman, Aaron M Coffey, Kirill V Kovtunov, Igor V Koptyug, Eduard Y Chekmenev
When parahydrogen reacts with propylene in low magnetic fields (e.g., 0.05T), the reaction product propane develops an overpopulation of pseudo-singlet nuclear spin states. We studied how the Spin-Lock Induced Crossing (SLIC) technique can be used to convert these pseudo-singlet spin states of hyperpolarized gaseous propane into observable magnetization and to detect (1)H NMR signal directly at 0.05T. The theoretical simulation and experimental study of the NMR signal dependence on B1 power (SLIC amplitude) exhibits a well-resolved dispersion, which is induced by the spin-spin couplings in the eight-proton spin system of propane...
January 21, 2017: Journal of Magnetic Resonance
https://www.readbyqxmd.com/read/28150197/preparation-and-characterization-of-magnetic-nano-in-microparticles-for-pulmonary-delivery
#15
Amber A McBride, Dominique N Price, Pavan Muttil
The purpose of this chapter is to detail the formulation and characterization of a magnetically-targeted drug delivery vehicle, termed nano-in-microparticles (NIMs), for pulmonary drug delivery. Currently, chemotherapeutics and antibiotics are delivered systemically and result in whole body side-effects. NIMs are formulated with superparamagnetic iron oxide nanoparticles, termed SPIONs, making these particles targetable to specific lung regions using a strong external magnet. Additionally, these particles can be formulated to contain any drug or therapeutic agent, such that a therapeutic dose can be delivered to a specific tissue location using the SPIONs-magnet interaction...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28149580/the-anaesthetic-consideration-of-tracheobronchial-foreign-body-aspiration-in-children
#16
REVIEW
Pinar Kendigelen
Cases of tracheobronchial foreign body aspiration are frequently encountered emergency cases of childhood; and, delays in its recognition and treatment do result in serious morbidity and mortality. Diagnosis mainly relies on taking history which should indicate what the foreign body is, when it has been aspirated and where it is located. Belated consultation can cause misdiagnosis with the mixing of the symptoms and data with those of other pathologies common to childhood and further delays in the correct diagnosis...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28146603/timing-of-hypertonic-saline-inhalation-for-cystic-fibrosis
#17
REVIEW
Mark Elkins, Ruth Dentice
BACKGROUND: Inhalation of hypertonic saline improves sputum rheology, accelerates mucociliary clearance and improves clinical outcomes of people with cystic fibrosis. OBJECTIVES: To determine whether the timing of hypertonic saline inhalation (in relation to airway clearance techniques or in relation to time of day) has an impact on its clinical efficacy in people with cystic fibrosis. SEARCH METHODS: We identified relevant randomised and quasi-randomised controlled trials from the Cochrane Cystic Fibrosis Trials Register, the Physiotherapy Evidence Database (PEDro), and international cystic fibrosis conference proceedings...
December 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28137488/patient-characteristics-associated-with-poor-inhaler-technique-among-a-cohort-of-patients-with-copd
#18
Anne C Melzer, Bijan J Ghassemieh, Suzanne E Gillespie, Peter K Lindenauer, Mary Ann McBurnie, Richard A Mularski, Edward T Naureckas, William M Vollmer, David H Au
BACKGROUND: Inhaled therapies are the cornerstone of pharmacologic management for COPD. Each device requires a unique series of steps to be most effective, making appropriate instruction in inhaler technique a key part of the management of COPD. OBJECTIVES: Examine characteristics of patients and devices associated with poor technique among patients with COPD. METHODS: Cross-sectional study of subjects with COPD using at least one of: metered dose inhaler, Advair Diskus, Spiriva Handihaler, identified from the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) registry...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28137486/how-many-instructions-are-required-to-correct-inhalation-errors-in-patients-with-asthma-and-chronic-obstructive-pulmonary-disease
#19
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/28130133/inhalable-bioresponsive-chitosan-microspheres-of-doxorubicin-and-soluble-curcumin-augmented-drug-delivery-in-lung-cancer-cells
#20
Kiran Jyoti, Ravi Shankar Pandey, Preeti Kush, Dinesh Kaushik, Upendra Kumar Jain, Jitender Madan
In present investigation, doxorubicin (Dox) and soluble curcumin (Cur-2-HP-β-CD-complex) combination was simultaneously loaded in inhalable bioresponsive chitosan microspheres (Dox/Cur-2-HP-β-CD-complex-elastin-CMs) bearing a substrate-stimuli, elastin. The mean particle size and mean aerodynamic diameter of inhalable bioresponsive microspheres displayed noteworthy differences after incorporation of elastin. Moreover, combination of Dox and soluble curcumin was molecularly dispersed in microspheres matrix as substantiated by a range of spectral techniques...
January 25, 2017: International Journal of Biological Macromolecules
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