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Inhaler technique

Muhammad Adnan, Shahid Karim, Shamshir Khan, Naser Al Wabel
No abstract text is available yet for this article.
September 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Luzmercy Perez, Knashawn H Morales, Heather Klusaritz, Xiaoyan Han, Jingru Huang, Marisa Rogers, Ian M Bennett, Cynthia S Rand, Grace Ndicu, Andrea J Apter
BACKGROUND: Self-management of moderate/severe asthma depends upon patients' ability to: 1) navigate (access health care to obtain diagnoses and treatment), 2) use inhaled corticosteroids (ICS) properly, and 3) understand ICS function. OBJECTIVE: To test whether navigation skills (medication recall, knowledge of copay requirements ability to provide information needed for a medical visit about a persistent cough unresponsive to medication), are related to other self-management skills and to health literacy...
October 12, 2016: Journal of Allergy and Clinical Immunology
Erin Davis, Carlo Marra, John-Michael Gamble, Jamie Farrell, Joe Lockyer, J Mark FitzGerald, Waseem Abu-Ashour, Charlie Gillis, John Hawboldt
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are often nonadherent with medications and have poor inhaler technique. Community pharmacists can help to improve health-related quality of life and overall outcomes in patients with COPD. We aim to measure the effectiveness of a systematic, pharmacist-driven intervention on patients with diagnosed COPD. METHODS/DESIGN: This pragmatic, parallel-group, cluster randomized controlled trial is designed to determine the effectiveness of a multifactorial, pharmacist-led intervention on medication adherence, inhaler technique, health-related quality of life, health care resource utilization including COPD exacerbations, and use of medications...
October 13, 2016: Trials
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
Haruko Yokoyama, Kanako Ito, Hirokazu Mihashi, Yasuyuki Shiraishi, Risa Takayanagi, Yasuhiko Yamada
The aim of this study was to establish an appropriate inhalation method with a mometasone furoate dry powder inhaler (MF-DPI). Utilizing a tone-based inhalation training device, we investigated the maximum peak inspiratory flow rate time (Tmax PIFR) and peak inspiratory flow rate (PIFR) to determine whether either had an influence on lung deposition with use of an MF-DPI. A low tone indicated a PIFR of 28 L/min and a high tone that of 40 L/min, while 60 L/min was considered to be the standard. We established an inhalation profile in consideration of a human inhalation pattern, in which Tmax PIFR was set at 0...
2016: Biological & Pharmaceutical Bulletin
Teri M Furlong, Jhodie R Duncan, Laura H Corbit, Caroline D Rae, Benjamin D Rowlands, Anthony D Maher, Fatima A Nasrallah, Carol J Milligan, Steven Petrou, Andrew J Lawrence, Bernard W Balleine
Toluene is a commonly abused inhalant that is easily accessible to adolescents. Despite the increasing incidence of use, our understanding of its long-term impact remains limited. Here we used a range of techniques to examine the acute and chronic effects of toluene exposure on glutameteric and GABAergic function, and on indices of psychological function in adult rats after adolescent exposure. Metabolomics conducted on cortical tissue established that acute exposure to toluene produces alterations in cellular metabolism indicative of a glutamatergic and GABAergic profile...
October 1, 2016: Journal of Neurochemistry
Peiying Liu, Babu G Welch, Yang Li, Hong Gu, Darlene King, Yihong Yang, Marco Pinho, Hanzhang Lu
Diagnosis and treatment monitoring of cerebrovascular diseases routinely require hemodynamic imaging of the brain. Current methods either only provide part of the desired information or require the injection of multiple exogenous agents. In this study, we developed a multiparametric imaging scheme for the imaging of brain hemodynamics and function using gas-inhalation MRI. The proposed technique uses a single MRI scan to provide simultaneous measurements of baseline venous cerebral blood volume (vCBV), cerebrovascular reactivity (CVR), bolus arrival time (BAT), and resting-state functional connectivity (fcMRI)...
September 28, 2016: NeuroImage
Gavin Gillmore, David Wertheim, Simon Crust
Solid State Nuclear Track Detectors (SSNTDs) are used extensively for monitoring alpha particle radiation, neutron flux and cosmic ray radiation. Radon gas inhalation is regarded as being a significant contributory factor to lung cancer deaths in the UK each year. Gas concentrations are often monitored using CR39 based SSNTDs as the natural decay of radon results in alpha particles which form tracks in these detectors. Such tracks are normally etched for about 4h to enable microscopic analysis. This study examined the effect of etching time on the appearance of alpha tracks in SSNTDs by collecting 2D and 3D image datasets using laser confocal microscope imaging techniques...
September 29, 2016: Science of the Total Environment
Fabio Rosario Salerno, Grace Parraga, Christopher William McIntyre
Dyspnea is one of the most common symptoms associated with CKD. It has a profound influence on the quality of life of CKD patients, and its underlying causes are often associated with a negative prognosis. However, its pathophysiology is poorly understood. While hemodialysis may address fluid overload, it often does not significantly improve breathlessness, suggesting multiple and co-existing alternative issues exist. The aim of this article is to discuss the main pathophysiologic mechanisms and the most important putative etiologies underlying dyspnea in CKD patients...
September 28, 2016: Seminars in Dialysis
Lia Jahedi, Sue R Downie, Bandana Saini, Hak-Kim Chan, Sinthia Bosnic-Anticevich
BACKGROUND: Correct inhaler technique can increase medication efficacy, reducing both dose and side effects. Patient preference for inhaler device has not been fully explored, and we hypothesized that if patients have a preference and can choose their inhaler, they might be more likely to use it correctly. Our aim was to determine the preferences, attitudes, and perceptions of patients with asthma toward their inhalers, and to evaluate whether any of these factors were related to inhalation technique...
September 27, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Erica Bäckström, Elin Boger, Anders Lundqvist, Margareta Hammarlund-Udenaes, Markus Fridén
Modulating and optimizing the local pharmacokinetics of inhaled drugs by chemical design or formulation is challenged by the lack of predictive in vitro systems and in vivo techniques providing a detailed description of drug location in the lung. The present study investigated whether a new experimental setup of freshly prepared agarose-filled lung slices can be used to estimate lung retention in vitro, by comparing with in vivo lung retention after intratracheal instillation. Slices preloaded with inhaled β-adrenergic compounds (salbutamol, formoterol, salmeterol, indacaterol or AZD3199) were incubated in a large volume of buffer (w/wo monensin to assess the role of lysosomal trapping), and the amount remaining in slices at different time points was determined with liquid chromatography-tandem mass spectrometry...
November 2016: Journal of Pharmaceutical Sciences
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas-Alises, José Francisco Pascual, Albert Roger, Diego Vargas, Adi Bijedic
OBJECTIVE: To assess the economic impact of the introduction of DuoResp(®) Spiromax(®) by focusing on a potential improvement in the inhalation technique to strengthen medication adherence for the treatment of moderate to severe asthmatics in Spain and five Spanish regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the period 2015-2018 from the Spanish Healthcare System perspective. Budesonide-formoterol fixed-dose combination delivered by Turbuhaler(®) was considered to be the most appropriate comparator for assessing the budget impact with the introduction of DuoResp(®) Spiromax(®)...
2016: ClinicoEconomics and Outcomes Research: CEOR
A Dahan, L P H J Aarts
The debate continues whether there is a difference in patient outcome following inhalational versus intravenous anesthesia. A recent meta-analysis showed improved outcome following inhalational anesthesia in patients undergoing cardiac surgery but not in patients undergoing non-cardiac procedures. In this article we discuss the meta-analysis and its caveats, taking into account additional comparative studies. Our overall conclusion is that it is too early to definitively claim that one anesthesia technique results in a better outcome than the other...
2016: Nederlands Tijdschrift Voor Geneeskunde
Gregg A Duncan, James Jung, Justin Hanes, Jung Soo Suk
Recent evidence suggests that the airway mucus gel layer may be impermeable to the viral and synthetic gene vectors used in past inhaled gene therapy clinical trials for diseases like cystic fibrosis. These findings support the logic that inhaled gene vectors that are incapable of penetrating the mucus barrier are unlikely to provide meaningful benefit to patients. In this review, we discuss the biochemical and biophysical features of mucus that contribute its barrier function, and how these barrier properties may be reinforced in patients with lung disease...
September 20, 2016: Molecular Therapy: the Journal of the American Society of Gene Therapy
Yanfei Wang, Ivan J Dmochowski
Molecular imaging holds considerable promise for elucidating biological processes in normal physiology as well as disease states, by determining the location and relative concentration of specific molecules of interest. Proton-based magnetic resonance imaging ((1)H MRI) is nonionizing and provides good spatial resolution for clinical imaging but lacks sensitivity for imaging low-abundance (i.e., submicromolar) molecular markers of disease or environments with low proton densities. To address these limitations, hyperpolarized (hp) (129)Xe NMR spectroscopy and MRI have emerged as attractive complementary methodologies...
October 18, 2016: Accounts of Chemical Research
Kapil S Agrawal, Raghav Shrotriya, Mansi Pabari
Loss of columella is a significant deformity and its reconstruction proves to be quite difficult. An 18-year-old lady had loss of columella due to burn while steam inhalation at a young age and required reconstruction for the same. Labial mucosa has been used as a source of tissue for columellar reconstruction since long. We describe a modification of the buccal mucosal flap to manage a difficult case of columellar deficiency. The buccal mucosa flap was used to cover the columellar defect in the usual manner in the first stage and in second stage, along with division of the base, the residual length of the mucosal flap was used to add to the thickness of columella by doubling it on itself...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Jai Bharat Mullerpattan, Zarah Zarir Udwadia, Sushil S Kathar, Hardik D Shah, Sarthak Ashok Rastogi, Kamlesh V Pandey, Zarir Farokh Udwadia
INTRODUCTION: The proper use of inhalers is essential for ensuring proper control of the disease. Various studies have shown high levels of improper use and lack of knowledge of the correct technique among patients with asthma. However, less data are available on how health care workers (HCW's) use inhalers. MATERIALS AND METHODS: The study was conducted at a Tertiary Care Hospital in Mumbai. We evaluated the pMDI technique in 141 consecutive adult asthmatics and 100 HCW's...
September 2016: Lung India: Official Organ of Indian Chest Society
Ramon M Molina, Nagarjun V Konduru, Hugo Hirano, Thomas C Donaghey, Benoit Adamo, Brendan Laurenzi, Georgios Pyrgiotakis, Joseph D Brain
Particles can be delivered to the respiratory tract of animals using various techniques. Inhalation mimics environmental exposure but requires large amounts of aerosolized NPs over a prolonged dosing time, varies in deposited dose among individual animals, and results in nasopharyngeal and fur particle deposition. Although less physiological, intratracheal (IT) instillation allows quick and precise dosing. Insufflation delivers particles in their dry form as an aerosol. We compared the distribution of neutron-activated (141)CeO2 nanoparticles (5 mg/kg) in rats after (1) IT instillation, (2) left intrabronchial instillation, (3) microspraying of nanoceria suspension and (4) insufflation of nanoceria dry powder...
October 2016: Inhalation Toxicology
Norie Kanzaki, Takahiro Kataoka, Reo Etani, Kaori Sasaoka, Akihiro Kanagawa, Kiyonori Yamaoka
In our previous studies, we found that low-dose radiation inhibits oxidative stress-induced diseases due to increased antioxidants. Although these effects of low-dose radiation were demonstrated, further research was needed to clarify the effects. However, the analysis of oxidative stress is challenging, especially that of low levels of oxidative stress, because antioxidative substances are intricately involved. Thus, we proposed an approach for analysing oxidative liver damage via use of a self-organizing map (SOM)-a novel and comprehensive technique for evaluating hepatic and antioxidative function...
September 10, 2016: Journal of Radiation Research
Hemanshu Prabhakar, Gyaninder Pal Singh, Charu Mahajan, Indu Kapoor, Mani Kalaivani, Vidhu Anand
BACKGROUND: Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With the availability of newer intravenous and inhalational anaesthetic agents, all of which have inherent advantages and disadvantages, we remain uncertain as to which technique may result in more rapid early recovery from anaesthesia...
September 9, 2016: Cochrane Database of Systematic Reviews
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