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Inhaler technique

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https://www.readbyqxmd.com/read/28079564/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-artisanal-anesthetic-era-1846-to-1904
#1
Adrian A Matioc
This second installment of the history of basic airway management covers the early-artisanal-years of anesthesia from 1846 to 1904. Anesthesia was invented and practiced as a supporting specialty in the context of great surgical and medical advances. The current-day anesthesia provider tends to equate the history of airway management with the history of intubation, but for the first 58 yr after the introduction of ether anesthesia, airway management was provided by basic airway techniques with or without the use of a face mask...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28075194/aerosol-drug-delivery-during-noninvasive-positive-pressure-ventilation-effects-of-intersubject-variability-and-excipient-enhanced-growth
#2
Ross L Walenga, P Worth Longest, Anubhav Kaviratna, Michael Hindle
BACKGROUND: Nebulized aerosol drug delivery during the administration of noninvasive positive pressure ventilation (NPPV) is commonly implemented. While studies have shown improved patient outcomes for this therapeutic approach, aerosol delivery efficiency is reported to be low with high variability in lung-deposited dose. Excipient enhanced growth (EEG) aerosol delivery is a newly proposed technique that may improve drug delivery efficiency and reduce intersubject aerosol delivery variability when coupled with NPPV...
January 11, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28066588/real-world-asthma-management-with-inhaler-devices-in-switzerland-results-of-the-asthma-survey
#3
Christian F Clarenbach, Laurent P Nicod, Malcolm Kohler
BACKGROUND: The aim of the Asthma Survey was to generate insights about the daily practice of physicians with regard to inhaler devices used for treating asthma under real-world conditions in Switzerland. METHODS: A questionnaire was administered to 605 participating hospital- and practice-based Swiss physicians. Areas of interest were practical aspects of patient education, typical difficulties encountered when prescribing pressurized metered-dose inhalers (pMDI) and dry-powder inhalers (DPI), and reasons for physician preferences...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065689/virtual-teach-to-goal%C3%A2-adaptive-learning-of-inhaler-technique-for-inpatients-with-asthma-or-copd
#4
Valerie G Press, Colleen A Kelly, John J Kim, Steven R White, David O Meltzer, Vineet M Arora
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) result in more than 1 million hospitalizations annually. Most hospitalized patients misuse respiratory inhalers. This misuse can be corrected with in-person education; however, this strategy is resource intensive and skills wane quickly after discharge. OBJECTIVE: The objective of this study was to develop and pilot a virtual teach-to-goal™ (V-TTG™) inhaler skill training module, using innovative adaptive learning technology...
January 5, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28055000/personalising-care-of-adults-with-asthma-from-asia-a-modified-e-dephi-consensus-study-to-inform-management-tailored-to-attitude-and-control-profiles
#5
Alison Chisholm, David B Price, Hilary Pinnock, Tan Tze Lee, Camilo Roa, Sang-Heon Cho, Aileen David-Wang, Gary Wong, Thys van der Molen, Dermot Ryan, Nina Castillo-Carandang, Yee Vern Yong
REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management...
January 5, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28053522/do-nanoparticles-provide-a-new-opportunity-for-diagnosis-of-distal-airspace-disease
#6
Jakob Löndahl, Jonas Kf Jakobsson, David M Broday, H Laura Aaltonen, Per Wollmer
There is a need for efficient techniques to assess abnormalities in the peripheral regions of the lungs, for example, for diagnosis of pulmonary emphysema. Considerable scientific efforts have been directed toward measuring lung morphology by studying recovery of inhaled micron-sized aerosol particles (0.4-1.5 µm). In contrast, it is suggested that the recovery of inhaled airborne nanoparticles may be more useful for diagnosis. The objective of this work is to provide a theoretical background for the use of nanoparticles in measuring lung morphology and to assess their applicability based on a review of the literature...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28053517/the-use-of-multiple-respiratory-inhalers-requiring-different-inhalation-techniques-has-an-adverse-effect-on-copd-outcomes
#7
Sinthia Bosnic-Anticevich, Henry Chrystyn, Richard W Costello, Myrna B Dolovich, Monica J Fletcher, Federico Lavorini, Roberto Rodríguez-Roisin, Dermot Ryan, Simon Wan Yau Ming, David B Price
BACKGROUND: Patients with COPD may be prescribed multiple inhalers as part of their treatment regimen, which require different inhalation techniques. Previous literature has shown that the effectiveness of inhaled treatment can be adversely affected by incorrect inhaler technique. Prescribing a range of device types could worsen this problem, leading to poorer outcomes in COPD patients, but the impact is not yet known. AIMS: To compare clinical outcomes of COPD patients who use devices requiring similar inhalation technique with those who use devices with mixed techniques...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28052185/early-administration-of-inhaled-corticosteroids-for-preventing-chronic-lung-disease-in-very-low-birth-weight-preterm-neonates
#8
REVIEW
Vibhuti S Shah, Arne Ohlsson, Henry L Halliday, Michael Dunn
BACKGROUND: Chronic lung disease (CLD) remains a common complication among preterm infants. There is increasing evidence that inflammation plays an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties, corticosteroids are an attractive intervention strategy. However, there are growing concerns regarding short- and long-term effects of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28048355/th-cd-207a-04-optimized-respiratory-gating-for-abnormal-breathers-in-pancreatic-sbrt
#9
W Campbell, M Miften, T Schefter, K Goodman, B Jones
PURPOSE: Pancreatic SBRT is uniquely challenging due to both the erratic/unstable motion of the pancreas and the close proximity of the radiosensitive small bowel. Respiratory gating can mitigate this effect, but the irregularity of motion severely affects traditional phase-based gating. The purpose of this study was to analyze real-time motion data of pancreatic tumors to optimize the efficacy and accuracy of respiratory gating, with the overall goal of enabling dose escalated pancreatic SBRT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047522/su-f-t-636-comprehensive-approach-to-motion-assessment-for-liver-and-pancreas-sbrt-patients
#10
P Halvorsen, I Iftimia, K Hunter
PURPOSE: Our past practice for liver and pancreas SBRT consisted of free breathing (FB) with gated treatment delivery using a 30-70% phase window. We have recently adopted an assessment method leading to individualized motion management to minimize target motion. We present our results from 47 patients treated with this new approach. METHODS: We perform an initial patient coaching and assessment session in our conventional simulator suite to observe the motion of the implanted fiducials with FB anterior and lateral 20-second cine acquisitions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047298/tu-h-campus-tep2-01-a-comparison-of-noninvasive-techniques-to-assess-radiation-induced-lung-damage-in-mice
#11
A Rubinstein, C Kingsley, A Melancon, R Tailor, J Pollard, M Guindani, D Followill, J Hazle, L Court
PURPOSE: To evaluate the use of post-irradiation changes in respiratory rate and CBCT-based morphology as predictors of survival in mice. METHODS: C57L/J mice underwent whole-thorax irradiation with a Co-60 beam to four different doses [0Gy (n=3), 9Gy (n=5), 11Gy (n=7), and 13Gy (n=5)] in order to induce varying levels of pneumonitis. Respiratory rate measurements, breath-hold CBCTs, and free-breathing CBCTs were acquired pre-irradiation and at six time points between two and seven months post-irradiation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046807/su-f-j-80-deformable-image-registration-for-residual-organ-motion-estimation-in-respiratory-gated-treatments-with-scanned-carbon-ion-beams
#12
G Meschini, M Seregni, A Pella, G Baroni, M Riboldi
PURPOSE: At the Centro Nazionale di Adroterapia Oncologica (CNAO, Pavia, Italy) C-ions respiratory gated treatments of patients with abdominal tumours started in 2014. In these cases, the therapeutic dose is delivered around end-exhale. We propose the use of a respiratory motion model to evaluate residual tumour motion. Such a model requires motion fields obtained from deformable image registration (DIR) between 4DCT phases, estimating anatomical motion through interpolation. The aim of this work is to identify the optimal DIR technique to be integrated in the modeling pipeline...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043636/evaluation-the-virulence-of-mycobacterium-bovis-isolated-from-milk-samples-through-histopathological-study-in-laboratory-animals
#13
I M Al-Saqur, A N Al-Thwani, I M Al-Attar, M S Al-Mashhadani
INTRODUCTION: Mycobacterium bovis has a broad host range, and it is the principal agent responsible for tuberculosis (TB) in bovine, domestic and wild mammals. M. bovis also infects human, causing zoonotic TB through ingestion, inhalation and, less frequently by contact with mucous membranes and broken skin. Zoonotic TB was formerly an endemic disease, usually transmitted to man by consumption of raw cow's milk. It is indistinguishable clinically or pathologically from TB caused by M...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043593/new-approaches-in-drug-treatment-for-tuberculosis-inhalation-using-liposomes-only-a-future-vision-or-soon-in-clinical-practice
#14
Lars-Olof Larsson
A major change of therapy in respiratory medicine has been the transition from oral or parenteral to inhalation therapy, for example, in asthma. Inhalation of anti-infectious drugs has however not a key-role in the treatment of pulmonary infections such as tuberculosis (TB). The inhalation therapy provides several benefits; the target is reached directly with evasion of first-pass metabolism, thereby resulting in reduced systemic side effects. Furthermore, the drug is delivered to an extensive surface area that is rich in lymphoid tissue...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28032044/psychosocial-factors-associated-with-reverse-smoking-a-qualitative-research
#15
G Harini, K V Krishnam Raju, D V S Kiran Raju, K Kalyan Chakravarthy, S Nagasri Kavya
OBJECTIVES: Reverse smoking is a peculiar form of smoking in which the smoker puts the lit end of the cigarette into the mouth and then inhales the smoke. There may be many predisposing factors that influence an individual to cultivate this habit, of which psychosocial habits could be the predominating factor. Hence, the present study was undertaken to evaluate the psychosocial factors that influence an individual to undertake this peculiar habit of reverse smoking. MATERIALS AND METHODS: A total of 128 habitual reverse smokers were included in the study, out of which 121 were females and 7 were males...
November 2016: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/28029474/hypertension-after-injury-among-burned-combat-veterans-a-retrospective-cohort-study
#16
Ian J Stewart, Jonathan A Sosnov, Brian D Snow, Augen Batou, Jeffrey T Howard, Jud C Janak, Mary Bollinger, Kevin K Chung
BACKGROUND: The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension. METHODS: Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation...
October 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28028187/evaluating-the-effectiveness-of-written-dry-powder-inhaler-instructions-and-health-literacy-in-subjects-diagnosed-with-copd
#17
Hana J Alsomali, David L Vines, Brian D Stein, Ellen A Becker
BACKGROUND: Improper inhaler use results in decreased drug deposition in the lungs. The impact of health literacy and poor vision on the patient's ability to learn inhaler technique by reading instructions has not been confirmed. This study evaluated the effectiveness of learning inhaler technique from written instructions and the impact of health literacy for patients diagnosed with COPD who used a dry powder inhaler (DPI). METHODS: This pilot study recruited subjects diagnosed with COPD...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28005566/anesthesia-for-functional-endoscopic-sinus-surgery
#18
Daniel A Carlton, Satish Govindaraj
PURPOSE OF REVIEW: The present article summarizes anesthetic techniques used during functional endoscopic sinus surgery to decrease bleeding and aid in creating a clear surgical field. The applicable physiology behind these anesthetic techniques is reviewed with emphasis on the effect on bleeding and the surgical field. Deliberate hypotension, reverse Trendelenburg positioning, regional anesthesia, and cerebral monitoring are discussed. RECENT FINDINGS: There are mixed data as to whether traditional inhalation anesthesia or total intravenous anesthesia is superior with respect to better surgical fields and decreased blood loss...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28003554/reliability-of-vibrating-mesh-technology
#19
Ashwin A Gowda, Ann D Cuccia, Gerald C Smaldone
BACKGROUND: For delivery of inhaled aerosols, vibrating mesh systems are more efficient than jet nebulizers are and do not require added gas flow. We assessed the reliability of a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd, Galway Ireland) suitable for use in mechanical ventilation. METHODS: An initial observational study was performed with 6 nebulizers to determine run time and efficiency using normal saline and distilled water. Nebulizers were run until cessation of aerosol production was noted, with residual volume and run time recorded...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27999149/time-required-to-rectify-inhaler-errors-among-experienced-subjects-with-a-faulty-technique
#20
Andrea S Melani, Marco Bonavia, Eliuccia Mastropasqua, Alessandro Zanforlin, Marco Lodi, Paola Martucci, Nicola Scichilone, Maria Aliani, Margherita Neri, Piersante Sestini
BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices. METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 experienced adult subjects (mean ± SD age 64 ± 15 y), mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics...
December 20, 2016: Respiratory Care
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