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Inhaler technique

C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
Hai Wu, Miaomiao Chen, Mengting Shang, Xiang Li, Kui Mu, Suhua Fan, Shuanglin Jiang, Wenyong Li
Black carbon (BC) is a main component of particulate matter (PM2.5 ). Due to their small size (<100nm), inhaled ultrafine BC nanoparticles may penetrate the lung alveoli, where they interact with surfactant proteins and lipids, causing more serious damage to human health. Here, BC was analyzed to investigate the binding mechanism of its interaction with protein and induction of cytotoxicity changes. The binding process and protein conformation between BC and a serum protein (bovine serum albumin, BSA) were monitored by using a fluorescence quenching technique and UV-vis absorption, Fourier transform infrared (FTIR) and circular dichroism (CD) spectroscopies...
April 6, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
Madhusudan Upadya, P J Saneesh
Any technique that employs a fresh gas flow that is less than the alveolar ventilation can be classified as low-flow anaesthesia. The complexities involved in the calculation of uptake of anaesthetic agents during the closed-circuit anaesthesia made this technique less popular. However, the awareness of the dangers of theatre pollution with trace amounts of the anaesthetic agents and the prohibitively high cost of the new inhalational agents, have helped in the rediscovery of low-flow anaesthesia. Moreover, the time has arrived for each of us, the practicing anaesthesiologists, to move towards the practice of low-flow anaesthesia, to achieve lesser theatre and environmental pollution and also to make anaesthesia more economical...
March 2018: Indian Journal of Anaesthesia
Saraswathi Nagappa, Sandhya Kalappa, Raghavendra Biligiri Sridhara
Background: The application of the skull-pin head-holder, used to stabilize the head during neurosurgical procedures, produces an intense nociceptive stimulus and results in abrupt increases in blood pressure and cerebral blood flow under general anesthesia. Different anesthetic and pharmacologic techniques, including local anesthetics, narcotics, antihypertensives, and deepening of anesthesia with inhalation anesthetics, have been used to blunt this deleterious effect with variable success...
January 2018: Anesthesia, Essays and Researches
A Galy, P Loubet, N Peiffer-Smadja, Y Yazdanpanah
Plague is a bacterial zoonosis caused by Yersinia pestis, usually found in fleas and small rodents that constitute the reservoir of the disease. It is transmitted to humans by flea bite, contact with rodents or inhalation of infected droplets. There are three clinical forms: bubonic plague, pulmonary plague and septicemic plague. The usual presentation is a flu-like syndrome possibly accompanied by an inflammatory lymphadenopathy which appears after 1 to 7days of incubation. Bubonic plague has a case fatality rate of about 50% while other forms of plague are almost always fatal without treatment...
April 5, 2018: La Revue de Médecine Interne
C A Alves, M Evtyugina, A M P Vicente, E D Vicente, T V Nunes, P M A Silva, M A C Duarte, C A Pio, F Amato, X Querol
Road dust resuspension is one of the main sources of particulate matter with impacts on air quality, health and climate. With the aim of characterising the thoracic fraction, a portable resuspension chamber was used to collect road dust from five main roads in Oporto and an urban tunnel in Braga, north of Portugal. The PM10 samples were analysed for: i) carbonates by acidification and quantification of the evolved CO2 , ii) carbonaceous content (OC and EC) by a thermo-optical technique, iii) elemental composition by ICP-MS and ICP-AES after acid digestion, and iv) organic speciation by GC-MS...
April 4, 2018: Science of the Total Environment
Jalal Arvin, Maryam Ashrafi, Saeedeh Lotfi, Arash Dadvand Meshgin Shahr, Elvira Schomann, Kristina Scheerer, Elke Schulmeyer
Uterus transplantation may become the surgical therapeutic modality of choice for uterine factor infertility. However, this procedure still faces technical, therapeutic, and immunologic challenges that limit its success and clinical application. Experimental studies are therefore still needed to address various challenges in the field of uterus transplantation. Among various laboratory animals, small animals are ideal models for the purpose of experimental uterus transplant. However, clinical success in small animal models is not generalizable to clinical application and treatment for uterine factor infertility in humans...
April 2018: Experimental and Clinical Transplantation
Wanis H Ibrahim, Fatima Rasul, Mushtaq Ahmad, Abeer S Bajwa, Laith I Alamlih, Anam M El Arabi, Mujahed M Dauleh, Ibrahim Y Abubeker, Muhammed U Khan, Tayseer S Ibrahim, Azdin A Ibrahim
Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient's knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma...
January 1, 2018: Chronic Respiratory Disease
Thomas Rothe, Paolo Spagnolo, Pierre-Olivier Bridevaux, Christian Clarenbach, Christine Eich-Wanger, Franca Meyer, David Miedinger, Alexander Möller, Laurent P Nicod, Geneviève Nicolet-Chatelain, Alain Sauty, Claudia Steurer-Stey, Joerg D Leuppi
The Global Initiative for Asthma (GINA) is a network of individuals, organizations, and public health officials that was established to disseminate information about the care of patients with asthma and to improve asthma care. The GINA ("Global Strategy for Asthma Management and Prevention") report has been updated annually since 2002. Due to new knowledge and therapeutic development in the field, the Swiss Respiratory Society felt the need to provide a new document that is based on both the available literature and the recommendations of the 2016 GINA report...
April 3, 2018: Respiration; International Review of Thoracic Diseases
Hassan Keramati, Raheb Ghorbani, Yadolah Fakhri, Amin Mousavi Khaneghah, Gea Oliveri Conti, Margherita Ferrante, Mansour Ghaderpoori, Mahmoud Taghavi, Zahra Baninameh, Abotaleb Bay, Mohammad Golaki, Bigard Moradi
The current study was performed to review the conducted studies regarding the concentration of radon 222 in the tap drinking water; furthermore, by estimation of ingestion and inhalation effective dose, the health risk assessment in the adults and children using MCS technique was assessed. All related studies published among January 1990 to October 2016; were screened in the available databases such as Web of Science, PubMed, Science Direct, Scopus, SID, and Irandoc. The total effective dose was estimated by calculating Eing (Effective dose of ingestion) and Einh (Effective dose of inhalation) by Monte Carlo simulation (MCS) method...
March 30, 2018: Food and Chemical Toxicology
Satvinder Singh, Mamta Sharma, Nitika Rohilla, Varun Salgotra, Varun Kumar, Rahul K Sharma
INTRODUCTION: One of the common practices observed in many parts of the world is smoking, of which tobacco forms an important constituent which is burned and inhaled. Smoking is known to have potential effect on body's immune system, antioxidants level, and salivary cotinine levels. Hence, we planned the present study to evaluate the impact of cigarette smoke on salivary anti-oxidant levels and cotinine levels in smokers and nonsmokers. MATERIALS AND METHODS: The present study included assessment of salivary parameters of smokers and nonsmokers...
March 1, 2018: Journal of Contemporary Dental Practice
Ailin Hou, Lu Li, Ying Huang, Vikramjeet Singh, Chune Zhu, Xin Pan, Guilan Quan, Chuanbin Wu
Dry powder inhalers (DPIs) have been proposed as an alternative administration route for protein and peptide drugs. However, DPI particles are easy to aggregate due to the strong interactions between the particles, leading to poor aerosolization performance. In this study, fragmented particles containing octreotide acetate (OA) were prepared by spray drying technique for dry powder inhalation, which were expected to decrease the particle-particle interaction by reducing the contact sites. Mannitol and ammonium carbonate were used as protein stabilizer and fragment-forming agent, respectively...
March 29, 2018: Drug Delivery and Translational Research
Sinthia Zrinka Bosnic-Anticevich
When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases...
April 2018: Tuberculosis and Respiratory Diseases
Elaine Yang, Lianteng Zhi, Qiansheng Liang, Manuel Covarrubias
Voltage-gated ion channels (VGICs) of excitable tissues are emerging as targets likely involved in both the therapeutic and toxic effects of inhaled and intravenous general anesthetics. Whereas sevoflurane and propofol inhibit voltage-gated Na+ channels (Navs), sevoflurane potentiates certain voltage-gated K+ channels (Kvs). The combination of these effects would dampen neural excitability and, therefore, might contribute to the clinical endpoints of general anesthesia. As the body of work regarding the interaction of general anesthetics with VGICs continues to grow, a multidisciplinary approach involving functional, biochemical, structural, and computational techniques, many of which are detailed in other chapters, has increasingly become necessary to solve the molecular mechanism of general anesthetic action on VGICs...
2018: Methods in Enzymology
Piyush Mehta
Inhalation therapy has strong history of more than 4000 years and it is well recognized around the globe within every culture. In early days, inhalation therapy was designed for treatment of local disorders such as asthma and other pulmonary diseases. Almost all inhalation products composed a simple formulation of a carrier, usually α -lactose monohydrate orderly mixed with micronized therapeutic agent. Most of these formulations lacked satisfactory pulmonary deposition and dispersion. Thus, various alternative carrier's molecules and powder processing techniques are increasingly investigated to achieve suitable aerodynamic performance...
2018: Journal of Drug Delivery
P M Raste, B K Sahoo, J J Gaware, Anil Sharma, M R Waikar, A A Shaikh, R G Sonkawade
Researchers have already established that inhalation of high radon concentration is hazardous to human health. Radon concentration has been measured in water and soil, in various part of Kolhapur district has been carried out by the AQTEK Smart RnDuo which is an active device technique. The observed minimum value of the radon mass exhalation rate of the soil is 13.16 ± 0.83 mBq/kg/h and maximum is 35.11 ± 1.84 mBq/kg/h. The minimum value of the Radon concentration in water is 0.33 ± 0.052 Bq/L and maximum is 7...
March 19, 2018: Radiation Protection Dosimetry
Shaymaa Abdalwahed Abdulameer
Background: Inadequate inhaled aerosol device demonstration and technique by health care professionals can lead to poor disease control. The aims of this study were to develop and validate Knowledge of Aerosol Tool (KAT) among registered and unregistered pharmacists and to assess the pharmaceutical care practice among registered pharmacists. Methods: The KAT and pharmaceutical care practice questionnaires were developed and modified from previous reports, then an observational cross-sectional study with a convenience sample size of 340 was carried out among registered and unregistered pharmacists...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Rajiv Dhand, Donald A Mahler, Brian Carlin, Nicola Hanania, Jill Ohar, Victor Pinto-Plata, Tina Shah, David Eubanks, Sidney S Braman
BACKGROUND: Successful inhalation therapy depends on the ability of patients with COPD to properly use devices. We explored subjects' COPD knowledge, including education they receive from health care providers, treatment experiences, and practices with inhalation devices. METHODS: A multiple-choice online survey, developed by a steering committee of American Thoracic Society clinicians and scientists, was administered to subjects with COPD who were sourced from the Harris Poll Online panel...
March 20, 2018: Respiratory Care
Verónica Giubergia, María J Ramirez Farías, Verónica Pérez, Adriana González, Nancy Crespi, Nora Fridman, Claudio Castaños
INTRODUCTION: Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). OBJECTIVE: To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. METHODS: Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma...
April 1, 2018: Archivos Argentinos de Pediatría
Tomotaka Kawayama, Takashi Kinoshita, Kazuko Matsunaga, Yoshiko Naito, Jun Sasaki, Yoshikazu Tominaga, Tomoaki Hoshino
Asthma is an allergic disease characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), reversibility and remodeling. Inhaled corticosteroids (ICS) are effective in many patients with asthma. However, ICS are a controlling, but not but curative treatment, and there are still many patients with refractory and difficult-to-treat asthma. The evaluation of airway inflammation by induced sputum, non-specific AHR by methacholine, and asthmatic reactions by specific allergen challenge techniques are useful not only to investigate the pathogenesis of asthma but also to help develop new drugs for asthma management...
March 16, 2018: Kurume Medical Journal
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