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Inhaler technique

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https://www.readbyqxmd.com/read/28332886/inhaler-technique-mastery-and-maintenance-in-healthcare-professionals-trained-on-different-devices
#1
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
#2
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)
https://www.readbyqxmd.com/read/28325160/-procedural-sedation-and-analgesia-with-nitrous-oxide-for-children-in-the-emergency-department
#3
W P Kluijfhout, R T C Welsing
Procedural sedation and analgesia with nitrous oxide in children who are anxious or in pain is a relatively new type of sedation in emergency departments in the Netherlands. The gas is inhaled through a face mask and does not require intravenous access. Furthermore, nitrous oxide does not influence the circulatory and respiratory systems and airway reflexes remain intact, which means that the child does not need to be fasted. Children who are treated with nitrous oxide experience significantly less pain and discomfort compared to the application of conventional analgesia...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28318749/experience-and-outcomes-of-micrografting-for-major-paediatric-burns
#4
H Rode, R Martinez, D Potgieter, S Adams, A D Rogers
BACKGROUND: The deficit of donor sites in major burns over 50% of the total body surface area has necessitated the application of methods besides traditional meshed autografting to achieve definitive skin cover. The Meek micrografting technique was introduced at this hospital in 2011, especially in the absence of a reliable source of deceased donor allograft skin. The purpose of this study was to evaluate this strategy with reference to its technical execution, efficacy and indications in the context of major paediatric burn surgery...
March 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28315491/vibrating-mesh-nebulizer-maintenance-by-cf-patients-results-from-a-french-survey
#5
Melisande Baravalle-Einaudi, Nadine Dufeu, Christian Dupont, Laurent Vecellio, Bertrand Delaisi, Ania Carsin, Jean-Christophe Dubus
PURPOSE OF THE STUDY: Vibrating-mesh nebulizers are widely used at home for cystic fibrosis (CF) treatment, with a therapeutic efficiency closely linked to the mesh performance. This national study looks at the maintenance at home by CF patients and their families of the mesh of the eFlow(®)rapid nebulizer. Ninety-two patients from 34 French CF centers, treated at home with inhaled drugs delivered with a vibrating-mesh nebulizer, answered to a phone standardized questionnaire specifying the different techniques of maintenance of the nebulizer...
March 14, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28303465/pharmacotherapy-in-generalized-anxiety-disorder-novel-experimental-medicine-models-and-emerging-drug-targets
#6
REVIEW
David S Baldwin, Ruihua Hou, Robert Gordon, Nathan T M Huneke, Matthew Garner
Many pharmacological and psychological approaches have been found efficacious in patients with generalized anxiety disorder (GAD), but many treatment-seeking patients will not respond and others will relapse despite continuing with interventions that initially had beneficial effects. Other patients will respond but then stop treatment early because of untoward effects such as sexual dysfunction, drowsiness, and weight gain. There is much scope for the development of novel approaches that could have greater overall effectiveness or acceptability than currently available interventions or that have particular effectiveness in specific clinical subgroups...
March 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28302419/intravenous-15-isoflurane-lipid-nanoemulsion-for-general-anesthesia-in-dogs
#7
Claudio C Natalini, Carolina L Krahn, Priscila B S Serpa, Joanna E Griffith, Ricardo Miyasaka de Almeida
OBJECTIVE: To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs. STUDY DESIGN: Prospective, crossover, experimental study. ANIMALS: Seven healthy, mature, mixed-breed dogs, three male and four female, weighing 11.5 ± 1.5 kg. METHODS: Anesthesia was induced with propofol for instrumentation. Measurements were obtained before administration of either inhaled isoflurane (Iso-I) or IV 15% isoflurane-loaded lipid nanoemulsion (Iso-nano)...
January 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28297304/evaluation-of-kidney-motion-and-target-localization-in-abdominal-sbrt-patients
#8
Marcus Sonier, William Chu, Nafisha Lalani, Darby Erler, Patrick Cheung, Renee Korol
The purpose of this study was to evaluate bilateral kidney and target translational/rotational intrafraction motion during stereotactic body radiation therapy treatment delivery of primary renal cell carcinoma and oligometastatic adrenal lesions for patients immobilized in the Elekta BodyFIX system. Bilateral kidney motion was assessed at midplane for 30 patients immobilized in a full-body dual-vacuum-cushion system with two patients immobilized via abdominal compression. Intrafraction motion was assessed for 15 patients using kilovoltage cone-beam computed tomography (kV-CBCT) datasets (n=151) correlated to the planning CT...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28291926/development-of-a-deep-inspiration-breath-hold-system-for-radiotherapy-utilizing-a-laser-distance-measurer
#9
Christer Andre Jensen, Nils Skottner, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath-hold (DIBH) is a technique for treating left-sided breast cancer (LSBC). In modern radiotherapy, one of the main aims is to exclude the heart from the beam aperture with an individualized beam design for LSBC. A deep inhalation will raise the chest wall while the volume of the lungs increase, this will again push the heart away from the breast to be treated. There are a few commercial DIBH systems, both invasive and noninvasive. We present an alternative noninvasive DIBH system based upon an industrial laser distance measurer...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28290735/quantitative-biokinetics-of-titanium-dioxide-nanoparticles-after-intratracheal-instillation-in-rats-part-3
#10
Wolfgang G Kreyling, Uwe Holzwarth, Nadine Haberl, Jan Kozempel, Alexander Wenk, Stephanie Hirn, Carsten Schleh, Martin Schäffler, Jens Lipka, Manuela Semmler-Behnke, Neil Gibson
The biokinetics of a size-selected fraction (70nm median size) of commercially available and (48)V-radiolabeled [(48)V]TiO2 nanoparticles has been investigated in healthy adult female Wistar-Kyoto rats at retention time-points of 1h, 4h, 24h, 7d and 28d after intratracheal instillation of a single dose of an aqueous [(48)V]TiO2-nanoparticle suspension. A completely balanced quantitative biodistribution in all organs and tissues was obtained by applying typical [(48)V]TiO2-nanoparticle doses in the range of 40-240 μg·kg(-1) bodyweight and making use of the high sensitivity of the radiotracer technique...
March 14, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28290015/a-review-of-electronic-devices-to-assess-inhaler-technique
#11
REVIEW
Delesha M Carpenter, Courtney A Roberts, Adam J Sage, Johnson George, Robert Horne
PURPOSE OF REVIEW: Multiple electronic devices exist that provide feedback on the accuracy of patient inhaler technique. Our purpose is to describe the inhaler technique feedback provided by these devices, including specific technique steps measured, how feedback is displayed, target of feedback (patient, provider, researcher), and compatibility with inhaler type (metered-dose inhaler [MDI], diskus, etc.). RECENT FINDINGS: We identified eight devices that provide feedback on inhaler technique...
March 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28288272/interventions-to-improve-inhaler-technique-for-people-with-asthma
#12
REVIEW
Rebecca Normansell, Kayleigh M Kew, Alexander G Mathioudakis
BACKGROUND: Asthma is a common chronic disease worldwide. Inhalers are often prescribed to help control asthma symptoms, improve quality of life and reduce the risk of exacerbations or flare-ups. However, evidence suggests that many people with asthma do not use their inhaler correctly. It is therefore important to evaluate whether interventions aimed specifically at improving technique are effective and safe, and whether use of these interventions translates into improved clinical outcomes...
March 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28286157/inhaler-errors-in-the-critikal-study-type-frequency-and-association-with-asthma-outcomes
#13
David B Price, Miguel Román-Rodríguez, R Brett McQueen, Sinthia Bosnic-Anticevich, Victoria Carter, Kevin Gruffydd-Jones, John Haughney, Svein Henrichsen, Catherine Hutton, Antonio Infantino, Federico Lavorini, Lisa M Law, Karin Lisspers, Alberto Papi, Dermot Ryan, Björn Ställberg, Thys van der Molen, Henry Chrystyn
BACKGROUND: Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. OBJECTIVE: The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific inhaler errors and asthma outcomes. METHODS: This analysis used data from the iHARP asthma review service-a multicenter cross-sectional study of adults with asthma...
March 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28284317/the-level-of-diagnostic-assessment-in-severe-asthma-a-nationwide-real-life-study
#14
Anna von Bülow, Vibeke Backer, Uffe Bodtger, Niels Ulrik Søes-Petersen, Karin Dahl Assing, Tina Skjold, Celeste Porsbjerg
INTRODUCTION: Systematic assessment of patients with severe asthma is pivotal to decide which patients are eligible to new biological therapies. However, the level of diagnostic work-up in patients with severe asthma is only poorly investigated. AIMS & OBJECTIVES: To describe the diagnostic work-up in a complete population of patients with severe asthma including: objective confirmation of the asthma diagnosis, and identification of potential treatment barriers, such as poor adherence and poor inhaler technique...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28283013/-molecular-characterization-of-echinococcus-granulosus-isolates-obtained-from-different-hosts
#15
Emrah Erdoğan, Bora Özkan, Fatih Mutlu, Serkan Karaca, İzzet Şahin
Echinococcus granulosus is a parasite that can be seen throughout the world. So far, five species of genus Echinococcus have been identified as parasite in people: E.granulosus, E.multilocularis, E.vogeli, E.oligarthrus, E.shiquicus. Larval (metacestod) form of parasite settles in internal organs of hoofed animals (cattle, goats, pigs, horses, sheep, etc.) and human; the adult form is found in small intestine of final host, canine. Disease caused by parasite called as "Cystic echinococcosis" (CE) is an important health problem and causes economic losses in many countries including our country that livestock is common...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28277810/the-impact-of-common-inhaler-errors-on-drug-delivery-investigating-critical-errors-with-a-dry-powder-inhaler
#16
Imran Sulaiman, Jansen Seheult, Nirmal Sadasivuni, Elaine MacHale, Isabelle Killane, Spiros Giannoutsos, Breda Cushen, Matshediso Constantina Mokoka, Aoife Sartini Bhreathnach, Fiona Boland, Richard B Reilly, Richard W Costello
BACKGROUND: Researchers, using checklists, have identified that 30%-90% of patients make errors in inhaler use. It is not certain whether these errors affect the delivery of medication. We have developed an electronic monitor (INCA™) that records audio each time an inhaler is used, providing objective information on inhaler technique. The aim of this study was to assess the effect that correctly identified inhaler errors, with the INCA device, have on drug delivery. METHODS: This was a prospective study of healthy volunteers using a salbutamol Diskus™...
March 9, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28276077/quantifying-the-reproducibility-of-lung-ventilation-images-between-4-dimensional-cone-beam-ct-and-4-dimensional-ct
#17
Henry C Woodruff, Chun-Chien Shieh, Fiona Hegi-Johnson, Paul J Keall, John Kipritidis
PURPOSE: Deformable image registration (DIR) based computed tomography ventilation imaging derived from four-dimensional cone-beam CT (CTVI(4)(DCBCT) ) can complement existing 4DCT-based methods (CTVI(4)(DCT) ) to track lung function changes over a course of lung cancer radiation therapy. However the accuracy of CTVI(4)(DCBCT) needs to be assessed since anatomic 4DCBCT has demonstrably poor image quality and small field of view (FOV) compared to treatment planning 4DCT. We perform a direct comparison between short interval CTVI(4)(DCBCT) and CTVI(4)(DCT) pairs to understand the patient specific image quality factors affecting the intermodality CTVI reproducibility in the clinic...
March 9, 2017: Medical Physics
https://www.readbyqxmd.com/read/28275141/cutting-edge-targeting-epithelial-ormdl3-increases-rather-than-reduces-airway-responsiveness-and-is-associated-with-increased-sphingosine-1-phosphate
#18
Marina Miller, Arvin B Tam, James L Mueller, Peter Rosenthal, Andrew Beppu, Ruth Gordillo, Matthew D McGeough, Christine Vuong, Taylor A Doherty, Hal M Hoffman, Maho Niwa, David H Broide
In this study, we used cre-lox techniques to generate mice selectively deficient in ORMDL3 in airway epithelium (Ormdl3(Δ2-3/Δ2-3)/CC10) to simulate an inhaled therapy that effectively inhibited ORMDL3 expression in the airway. In contrast to the anticipated reduction in airway hyperresponsiveness (AHR), OVA allergen-challenged Ormdl3(Δ2-3/Δ2-3)/CC10 mice had a significant increase in AHR compared with wild-type mice. Levels of airway inflammation, mucus, fibrosis, and airway smooth muscle were no different in Ormdl3(Δ2-3/Δ2-3)/CC10 and wild-type mice...
March 8, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28275111/tidal-breathing-parameters-measured-using-structured-light-plethysmography-in-healthy-children-and-those-with-asthma-before-and-after-bronchodilator
#19
Hamzah Hmeidi, Shayan Motamedi-Fakhr, Edward Chadwick, Francis J Gilchrist, Warren Lenney, Richard Iles, Rachel C Wilson, John Alexander
Structured light plethysmography (SLP) is a light-based, noncontact technique that measures tidal breathing by monitoring displacements of the thoracoabdominal (TA) wall. We used SLP to measure tidal breathing parameters and their within-subject variability (v) in 30 children aged 7-16 years with asthma and abnormal spirometry (forced expiratory volume in 1 sec [FEV1] <80% predicted) during a routine clinic appointment. As part of standard care, the reversibility of airway obstruction was assessed by repeating spirometry after administration of an inhaled bronchodilator...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28275108/maternal-high-fat-diet-in-mice-leads-to-innate-airway-hyperresponsiveness-in-the-adult-offspring
#20
Kelvin D MacDonald, Aurelia R Moran, Ashley J Scherman, Cindy T McEvoy, Astrid S Platteau
Maternal obesity prior to and during pregnancy has been associated with an increased incidence of childhood asthma. As diets rich in saturated fat are linked to obesity and inflammation, we created a murine model to investigate the effect of maternal high-fat diet (HFD) on adult offspring airway hyperreactivity (AHR), a cardinal feature of asthma. Balb/cByJ dams were fed a HFD (60% fat Calories) or normal-fat diet (NFD) (10% fat Calories) from 8 weeks prior to first breeding through their pregnancies. Pups were weaned to either a HFD or NFD (at 4 weeks of age)...
March 2017: Physiological Reports
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