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Sample records for acutely inhaled plutonium-239

  1. Subchronic inhalation of carbon tetrachloride alters the tissue retention of acutely inhaled plutonium-239 nitrate in F344 rats and syrian golden hamsters

    Carbon tetrachloride (CCl4) has been used extensively in the nuclear weapons industry, so it is likely that nuclear plant workers have been exposed to both CCl4 and plutonium compounds. Future exposures may occur during open-quotes cleanupclose quotes operations at weapons productions sites such as the Hanford, Washington, and Rocky Flats, Colorado, facilities. Inhalation of 20 and 100 ppm CCl4 by hamsters reduces uptake of 239Pu solubilized from lung, shunting the 239Pu to the skeleton

  2. Subchronic inhalation of carbon tetrachloride alters the tissue retention of acutely inhaled plutonium-239 nitrate in F344 rats and syrian golden hamsters

    Benson, J.M.; Barr, E.B.; Lundgren, D.L. [and others

    1995-12-01

    Carbon tetrachloride (CCl{sub 4}) has been used extensively in the nuclear weapons industry, so it is likely that nuclear plant workers have been exposed to both CCl{sub 4} and plutonium compounds. Future exposures may occur during {open_quotes}cleanup{close_quotes} operations at weapons productions sites such as the Hanford, Washington, and Rocky Flats, Colorado, facilities. Inhalation of 20 and 100 ppm CCl{sub 4} by hamsters reduces uptake of {sup 239}Pu solubilized from lung, shunting the {sup 239}Pu to the skeleton.

  3. 'In-vivo' and bioassay results from two contrasting cases of plutonium-239 inhalation

    'In-vivo' and bioassay measurements following two incidents involving plutonium-239 inhalation are described and contrasted. Incident 1, involving the inhalation of insoluble plutonium oxide, resulted in a lung content of about 20 nCi after the initial clearance. Urine excretion was negligible and the estimation of exposure was based on 'in-vivo' data and faecal excretion. Incident,2, involving the inhalation of soluble plutonium, proved negligible and the estimation of exposure, based on urinary excretion, was 0.6 nCi. (author)

  4. Plutonium-239

    This sheet belongs to a collection which relates to the use of radionuclides essentially in unsealed sources. Its goal is to gather on a single document the most relevant information as well as the best prevention practices to be implemented. These sheets are made for the persons in charge of radiation protection: users, radioprotection-skill persons, labor physicians. Each sheet treats of: 1 - the radio-physical and biological properties; 2 - the main uses; 3 - the dosimetric parameters; 4 - the measurement; 5 - the protection means; 6 - the areas delimitation and monitoring; 7 - the personnel classification, training and monitoring; 8 - the effluents and wastes; 9 - the authorization and declaration administrative procedures; 10 - the transport; and 11 - the right conduct to adopt in case of incident or accident. This sheet deals specifically with Plutonium-239

  5. Dosimetry of inhaled plutonium-239 dioxide in rodent lung: a morphometric study

    Morphometric analysis of rat and hamster lung did not demonstrate any extensive changes in lung composition or structure following inhalation exposure to 239Pu02 at levels near that for maximum tumor yield in rats. The problem of dosimetry for this compound thus appears to be relatively uncomplicated by any major radiation-induced pathological alterations in the lung. Rat and hamster lung were found to be similar in structure and composition, with few significant differences which could be directly related to the different tumor responses. The distribution of 239Pu02 particles was not uniform in all regions of the lung; thus estimation of the dose to specific tissues or regions within the lung requires a correction for this effect. Species differences were found for particle distribution in the subpleural region and major airways, and in the spatial association of particles, both of which may affect the tumor development process. These regions contain the principal target cells for tumor production and serve as foci for the origin of tumors. Different dose distributions within these regions may therefore explain, at least in part, the difference in tumor response to inhaled 239Pu02 for rats and hamsters

  6. Dosimetry of inhaled plutonium-239 dioxide in rodent lung: a morphometric study

    Rhoads, K.

    1979-06-01

    Morphometric analysis of rat and hamster lung did not demonstrate any extensive changes in lung composition or structure following inhalation exposure to /sup 239/Pu0/sub 2/ at levels near that for maximum tumor yield in rats. The problem of dosimetry for this compound thus appears to be relatively uncomplicated by any major radiation-induced pathological alterations in the lung. Rat and hamster lung were found to be similar in structure and composition, with few significant differences which could be directly related to the different tumor responses. The distribution of /sup 239/Pu0/sub 2/ particles was not uniform in all regions of the lung; thus estimation of the dose to specific tissues or regions within the lung requires a correction for this effect. Species differences were found for particle distribution in the subpleural region and major airways, and in the spatial association of particles, both of which may affect the tumor development process. These regions contain the principal target cells for tumor production and serve as foci for the origin of tumors. Different dose distributions within these regions may therefore explain, at least in part, the difference in tumor response to inhaled /sup 239/Pu0/sub 2/ for rats and hamsters.

  7. Pulmonary connective tissue modifications induced by internal α-irradiation. II. Alterations of collagen and non collagen proteins biosynthesis following inhalation of plutonium 239 dioxide aerosol in rat

    Preliminary studies have shown that internal α irradiation following inhalation of plutonium 239 dioxide in rat increased collagen content in the lung. Effect was maximal at 200 days with the highest dose. This increase was found transient and collagen dropped back to control values after 400 days in rats with the same initial lung burden or the same total dose. A new increase was observed later on, largely related to oncoming death. Here, we have studied, simultaneously, content and biosynthesis of collagen and non collagen proteins, 200 d and 400 d after 239PuO2 inhalation (100-150 nCi ILB). The results confirmed a biphasic effect of inhaled 239PuO2 on the pulmonary connective tissue: a/ A significant increase (p < 0.01) of soluble non-collagen proteins correlated to a decrease of the insoluble fraction was observed 200 d after inhalation. Similar parameters were not significantly different in controls on irradiated rats after 400 days. b/ Soluble and non-soluble collagen contents increased by a factor of 3 and 1.5 respectively 200 d after inhalation. No effect after 400 d. c/ Biosynthesis of non-collagen connective tissue components were 2 to 5 lower than in controls at 400d. d/collagen biosynthesis was decreased by a factor between 4 and 6 for the soluble and insoluble fractions at 200 d but normal at 400 d

  8. Effects of combined exposure of F344 rats to inhaled Plutonium-239 dioxide and a chemical carcinogen (NNK)

    Lundgren, D.L.; Carlton, W.W. [Purdue Univ., Lafayette, IN (United States); Griffith, W.C. [and others

    1995-12-01

    Workers in nuclear weapons facilities have a significant potential for exposure to chemical carcinogens and to radiation from external sources or from internally deposited radionuclides such as {sup 239}Pu. Although the carcinogenic effects of inhaled {sup 239}Pu and many chemicals have been studied individually, very little information is available on their combined effects. One chemical carcinogen that workers could be exposed to via tobacco smoke is the tobacco-specific nitrosamine 4-(N-methyl-n-nitrosamino)-1-(3-pyridyl)-1(3-pyridyl)-1-butanone (NNK), a product of tobacco curing and the pyrolysis of nicotine in tobacco. NNK causes lung tumors in rats, regardless of the route of administration and to a lesser extent liver, nasal, and pancreatic tumors. From the results presented, it can be concluded that exposure to a chemical carcinogen (NNK) in combination with {alpha}-particle radiation from inhaled {sup 239}PuO{sub 2} acts in, at best, an additive manner in inducing lung cancer in rats.

  9. Distribution of intratracheally administered plutonium-239 within the skeleton bones

    The data are presented on distribution of the intratracheally administered plutonium-239 within the skeleton bones. Plutonium was found to be distributed non-uniformly within the skeleton: it was concentrated mainly in the bones where the trabecular fraction of the bone tissue was most manifest. The results obtained were supported by the correlation analysis

  10. Airborne plutonium-239 and americium-241 concentrations measured from the 125-meter Hanford Meteorological Tower

    Airborne plutonium-239 and americium-241 concentrations and fluxes were measured at six heights from 1.9 to 122 m on the Hanford meteorological tower. The data show that plutonium-239 was transported on nonrespirable and small particles at all heights. Airborne americium-241 concentrations on small particles were maximum at the 91 m height

  11. Assessment of internal dose from incorporated plutonium-239 by means of biological dosimetry

    Intra- and inter-chromosomal aberration frequency in Mayak P.A. nuclear workers was studied by mFISH and mBAND techniques. Intra-chromosomal aberrations in lymphocytes from the peripheral blood were found to be a bio marker of densely-ionizing radiation (alpha-particles) in workers exposed to radiation many years ago. A dependence of the frequency of intra-chromosomal aberrations in plutonium workers on absorbed dose to the red bone marrow from internal exposure to incorporated plutonium-239 was found. A preliminary 'bio dosimetry system' was developed. Its capability to estimate internal doses from incorporated plutonium-239 in plutonium production workers based on the frequency of intra-chromosomal aberrations detected in these workers was tested. Estimates of internal doses from incorporated plutonium - 239 obtained using the preliminary 'bio dosimetry system' were compared with doses calculated by a model based on measurements of plutonium excretion in urine ('Mayak Doses-2000'). Estimates of internal doses from incorporated plutonium-239 obtained using both independent techniques demonstrated a highly significant correlation (correlation coefficient, R2 = 74%). At the current research phase, the developed 'bio dosimetry system' is to be adjusted, which will allow to estimate plutonium-239 body burden with an uncertainty less than 30%. (authors)

  12. National Low-Level Waste Management Program Radionuclide Report Series, Volume 17: Plutonium-239

    J. P. Adams; M. L. Carboneau

    1999-03-01

    This report, Volume 17 of the National Low-Level Waste Management Program Radionuclide Report Series, discusses the radiological and chemical characteristics of plutonium-239 (Pu-239). This report also discusses waste types and forms in which Pu-239 can be found, waste and disposal information on Pu-239, and Pu-239 behavior in the environment and in the human body.

  13. National Low-Level Waste Management Program Radionuclide Report Series, Volume 17: Plutonium-239

    This report, Volume 17 of the National Low-Level Waste Management Program Radionuclide Report Series, discusses the radiological and chemical characteristics of plutonium-239 (Pu-239). This report also discusses waste types and forms in which Pu-239 can be found, waste and disposal information on Pu-239, and Pu-239 behavior in the environment and in the human body

  14. Acute Respiratory Distress Due to Methane Inhalation

    Jo, Jun Yeon; Kwon, Yong Sik; Lee, Jin Wook; Park, Jae Seok; Rho, Byung Hak; Choi, Won-Il

    2013-01-01

    Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest rad...

  15. SKIN DOSIMETRY IN CONDITIONS OF ITS CONSTANT SURFACE CONTAMINATION WITH SOLUTIONS OF PLUTONIUM-239 AND AMERICIUM-241

    E. B. Ershov

    2012-01-01

    Full Text Available The article considers, on the basis of experimental data, the issue of assessing dose burdens to the skin basal layer in conditions of its permanent contamination with solutions of plutonium-239 and americium-241 and subsequent decontamination.

  16. Fetal doses from plutonium-239 and polonium-210

    The transfer of 239Pu and 210Po from the maternal circulation to the developing embryo and fetus was studied in rodents. The highest concentrations of both isotopes were measured in the yolk sac. In utero doses to haemopoietic tissue have been calculated taking account of transfer to the blastocyst/egg cylinder, yolk sac, liver and bone marrow. From animal data, the concentration ratios relative to maternal liver for these tissues were taken to be 0.1, 2, 0.01 and o.02, respectively for 239Pu; and 1, 2, 0.1 and 0.1, respectively, for 210Po. These concentration ratios were applied to periods of human gestation of 0-2.5 weeks, 2.5-6 weeks, 6-12 weeks and 12-38 weeks, and used to calculate fetal tissue doses for chronic maternal intake by ingestion of 1 kBq 239Pu or 2 kBq 210Po in the year of pregnancy (1 ALI for a member of the public). On this basis, the total in utero dose to haemopoietic tissue was about 1 μSv from 239Pu and 60 μSv from 210Po compared with red bone marrow doses to the mother in the year of 19 μSv from 239Pu and 160 μSv from210Po. The yolk sac and bone marrow dominated in utero doses from both nuclides. For 239Pu, because of its long half life, an important consideration was activity present in the offspring at birth and committed dose equivalents to red bone marrow in the child and mother. The total dose to haemopoietic tissue in the offspring to age 70 years, including in utero doses, was calculated as 13 μSv compared with a maternal dose to red bone marrow of 1400 μSv. For both isotopes the risk of leukaemia in the year of pregnancy was estimated to be of the same order for mother and fetus. For 239Pu, the overall risk to 70 years of age was two orders of magnitude higher for the mother than her offspring. For 239Pu, an acute intake of 1 kBq by ingestion during the period of yolk sac haemopoiesis would result in the highest in utero dose, estimated at about 20 μSv. However, activity at birth would be lower and the overall risk would be

  17. Acute myocardial involvement after heroin inhalation

    Ritu Karoli; Fatima, J.; Pushker Singh; Kazmi, Khursheed I.

    2012-01-01

    Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  18. Acute myocardial involvement after heroin inhalation

    Ritu Karoli

    2012-01-01

    Full Text Available Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  19. Metabolism and toxicology of plutonium-239 - evaluation of the internal contamination of persons professionally exposed (1963)

    After reviewing the main metabolic and toxicological properties of plutonium 239 as well as the professional norms now in force, the report considers the difficult problem of the evaluation of the internal contamination of persons professionally exposed. This evaluation is dependent on the practical organisation of the supervision involved: - systematic supervision by periodic analysis of urinary Pu and special supervision in the case of incidents by an examination adapted to each case. A simple interpretation of the systematic analyses, as well as the evaluation methods used in the main cases of occidental contamination are outlined. (author)

  20. Assesment of Plutonium 238 and Plutonium 239+240 in soils of different agricultural regions of Guatemala

    In this report an assesment and measurement of PLUTONIUM 238, PLUTONIUM 239, and PLUTONIUM 240 are made. Samples of cultivated soils in 15 provinces of Guatemala were taken. To separate plutonium isotopes a radiochemical method was made using extraction, precipitation and ionic interchange. By electrodeposition the plutonium was measured using an alpha spectroscopy by PIPS method. The radioactivity ranges from 2.84 mBq/Kg to 36.38 mBq/Kg for plutonium 238, and 8.46 mBq/Kg to 26.61 mBq/Kg for plutonium 239+240

  1. Metabolism and toxicology of plutonium-239 - evaluation of the internal contamination of persons professionally exposed (1963); Metabolisme et toxicologie du plutonium 239 - evaluation de la contamination interne des personnes professionnellement exposees (1963)

    Henry, Ph. [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1963-07-01

    After reviewing the main metabolic and toxicological properties of plutonium 239 as well as the professional norms now in force, the report considers the difficult problem of the evaluation of the internal contamination of persons professionally exposed. This evaluation is dependent on the practical organisation of the supervision involved: - systematic supervision by periodic analysis of urinary Pu and special supervision in the case of incidents by an examination adapted to each case. A simple interpretation of the systematic analyses, as well as the evaluation methods used in the main cases of occidental contamination are outlined. (author) [French] Apres avoir passe en revue les principales proprietes metaboliques et toxicologiques du plutonium 239, ainsi que les normes professionnelles actuellement en vigueur, le rapport aborde le probleme difficile de l'evaluation de la contamination interne des personnes professionnellement exposees. Cette evaluation est fonction de l'organisation pratique de la surveillance: - surveillance systematique par des analyses periodiques de Pu urinaire et surveillance speciale en cas d'incidents par des examens appropries a chaque cas. Une interpretation simple des analyses systematiques, ainsi que des methodes d'evaluation utilisables dans les principaux cas de contamination accidentelle sont exposees. (auteur)

  2. Acute myocardial infarction related to smoke inhalation and myocardial bridging.

    McCabe, M J; Weston, C. F.; Fraser, A G

    1992-01-01

    A previously healthy 26 year old woman who was exposed to smoke during a house fire developed acute anterior myocardial infarction complicated by ventricular fibrillation. Subsequent left ventriculography confirmed anterior infarction, but coronary arteriography was normal apart from myocardial bridging over a segment of the left anterior descending artery. The development of acute myocardial infarction in this patient suggests that, in the presence of bridging, carbon monoxide inhalation may...

  3. Determination of plutonium-239/240 in fish in Low-Level Radioactive Ocean Waste dump sites

    There was concern that radioactivity might find its way into the food chain, namely fish, via low-level radioactive waste Ocean Dump Sites. This led the U.S. Food and Drug Administration, in collaboration with other Federal Agencies, to the monitoring and determination of radioactivity in fish samples from these Ocean Dump Sites. The radionuclide thought to be of major concern was plutonium-239/240. These sites were monitored at various periods from 1980. The sites were located off the coasts of New Jersey, California (near San Francisco) and Massachusetts Bay. The fish samples selected were shellfish that inhabited the ocean floor and bottom-feeders. The levels of activities required sophisticated measuring techniques since for plutonium-239/240, they were below the range. After a radiochemical procedure is used to separate the plutonium, it was measured using solid-state silicon detectors. These are coupled to a computer based multi-channel analyzer system. A plutonium-236 tracer is used to measure the recovery. The levels were found to be at background or in the 10 mBq range. (author). 10 refs., 2 tabs

  4. The bone volume effect on the dosimetry of plutonium-239 and americium-241 in the skeleton of man and baboon

    Studies were undertaken using bone removed from young adult baboons, which had been contaminated with plutonium-239 at various times prior to sacrifice, and human bone from adult male (USTR Case 246), who had received an internal deposition of americium-241 as a result of a glove-box explosion 11 years prior to his death. The baboon bone was supplied by the CEA, France, and the human bone by the United States Transuranium registry. The bone samples, examined by qualitative and quantitative autoradiography with CR 39 detectors, demonstrated the rapid redistribution of bone surface-seeking radionuclides in younger primates due to growth and the slower, bone turnover driven redistribution in the adult human bone. In both species, primary and secondary surface deposits of radionuclide remained conspicious despite bone activity; true volumization of radionuclide was seldom seen. The dosimetric implications of these findings are discussed. (author) 21 refs.; 6 figs.; 4 tabs

  5. Combined exposure of F344 rats to beryllium metal and plutonium-239 dioxide

    Finch, G.L.; Carlton, W.W.; Rebar, A.H. [Purdue Univ., Lafayette, IN (United States)] [and others

    1995-12-01

    Nuclear weapons industry workers have the potential for inhalation exposures to plutonium (Pu) and other agents, such as beryllium (Be) metal. The purpose of this ongoing study is to investigate potential interactions between Pu and Be in the production of lung tumors in rats exposed by inhalation to particles of {sup 239}PuO{sub 2}, Be metal, or these agents in combination. Inhaled Pu deposited in the lung delivers high-linear-energy transfer, alpha-particle radiation and is known to induce pulmonary cancer in laboratory animals. Although the epidemiological evidence implicating Be in the induction of human lung cancer is weak and controversial, various studies in laboratory animals have demonstrated the pulmonary carcinogenicity of Be. As a result, Be is classified as a suspect human carcinogen in the United STates and as a demonstrated human carcinogen by the International Agency for Research on Cancer. This study is in progress.

  6. Acute inhalation toxicity of carbonyl sulfide

    Benson, J.M.; Hahn, F.F.; Barr, E.B. [and others

    1995-12-01

    Carbonyl sulfide (COS), a colorless gas, is a side product of industrial procedures sure as coal hydrogenation and gasification. It is structurally related to and is a metabolite of carbon disulfide. COS is metabolized in the body by carbonic anhydrase to hydrogen sulfide (H{sub 2}S), which is thought to be responsible for COS toxicity. No threshold limit value for COS has been established. Results of these studies indicate COS (with an LC{sub 50} of 590 ppm) is slightly less acutely toxic than H{sub 2}S (LC{sub 50} of 440 ppm).

  7. Medical Care for Accidental Deposition of Plutonium (239Pu) Within the Body

    With expanding uses of plutonium chances for accidental deposition within the body are increasing. Metabolism of plutonium within the body is variable, depending on chemical composition, particle size and shape, monomeric or polymeric physical state, route of entry (inhalation,or through wounds) and many other factors. A notable exception is the negligible absorption from the gastrointestinal tract. It is difficult to determine lung deposition of poorly soluble plutonium by either bioassay or in vivo counting. The intravenous administration of the chelating agent tri-sodium calcium salt of diethylenetriamine- pentaacetic acid (DTPA), soon after an accident, is quite effective in removing soluble plutonium which has been inhaled or deposited in wounds. Conditions requiring prolonged therapy are described. Effectiveness of treatment of 239Pu body depositions is greatly influenced by the solubility of the plutonium at the site of deposition. Size, frequency and duration of dose of DTPA is recommended. Mice developed fibrosarcomas following subcutaneous injections of 0.064 μCi of 239Pu, while an employee apparently developed a pre-cancerous condition after subcutaneous deposition of only 0.005 μCi. It is our policy to recommend excision of any measurable quantity of 239Pu in a superficial wound when this may be accomplished with little hazard. The maximum permissible deposition in skin or subcutaneous tissue may be much lower than that for depositions in bone liver, lung or tracheo-bronchial lymph nodes. No limiting value has been set for depositions in wounds by any official body; The surgeon must balance the benefits to be secured against the risk of the operation. A wound bearing 239Pu should be immediately washed with DTPA, normal saline, or water, in that order of preference. Methods of removal of 239Pu from the intact skin are briefly discussed. A U.S. Plutonium Registry will assist in evaluating depositions of 239Pu and effectiveness of therapy by reconciling

  8. Osteosarcoma induction by plutonium-239, americium-241 and neptunium-237 : the problem of deriving risk estimates for man

    Spontaneous bone cancer (osteosarcoma) represents only about 0.3% of all human cancers, but is well known to be inducible in humans by internal contamination with radium-226 and radium-224. plutonium-239, americium-241 and neptunium-237 form, or will form, the principal long-lived alpha particle emitting components of high activity waste and burnt-up nuclear fuel elements. These three nuclides deposit extensively in human bone and although, fortunately, no case of a human osteosarcoma induced by any of these nuclides is known, evidence from animal studies suggests that all three are more effective than radium-226 in inducing osteosarcoma. The assumption that the ratio of the risk factors, the number of osteosarcoma expected per 10000 person/animal Gy, for radium-226 and any other bone-seeking alpha-emitter will be independent of animal species has formed the basis of all the important studies of the radiotoxicity of actinide nuclides in experimental animals. The aim of this communication is to review the risk factors which may be calculated from the various animal studies carried out over the last thirty years with plutonium-237, americium-241 and neptunium-237 and to consider the problems which may arise in extrapolating these risk factors to homo sapiens

  9. The inhalation of insoluble iron oxide particles in the sub-micron ranges. Part II - Plutonium-237 labelled aerosols

    The results of a series of inhalation studies using iron oxide particles in the size range 0.1 to 0.3 um (count median diameter) are described. In this series the aerosols were labelled with plutonium 237. In vivo detection, excretion analysis and crude location studies were obtainable and the results compared to the earlier studies using chromium 51 labelled aerosols. Plutonium 237 can be considered as a simulator for plutonium 239 and attempts are made to extrapolate the results to the problem of the estimation of plutonium 239 in the human lung. (author)

  10. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults

    Afshari, Arash; Brok, Jesper; Møller, Ann;

    2010-01-01

    Acute hypoxaemic respiratory failure (AHRF), defined as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), are critical conditions. AHRF results from a number of systemic conditions and is associated with high mortality and morbidity in all ages. Inhaled nitric oxide (INO) has...

  11. Inhaled nitric oxide exacerbated phorbol-induced acute lung injury in rats.

    Lin, Hen I; Chu, Shi Jye; Hsu, Kang; Wang, David

    2004-01-01

    In this study, we determined the effect of inhaled nitric oxide (NO) on the acute lung injury induced by phorbol myristate acetate (PMA) in isolated rat lung. Typical acute lung injury was induced successfully by PMA during 60 min of observation. PMA (2 microg/kg) elicited a significant increase in microvascular permeability, (measured using the capillary filtration coefficient Kfc), lung weight gain, lung weight/body weight ratio, pulmonary arterial pressure (PAP) and protein concentration of the bronchoalveolar lavage fluid. Pretreatment with inhaled NO (30 ppm) significantly exacerbated acute lung injury. All of the parameters reflective of lung injury increased significantly except PAP (P<0.05). Coadministration of Nomega-nitro-L-arginine methyl ester (L-NAME) (5 mM) attenuated the detrimental effect of inhaled NO in PMA-induced lung injury, except for PAP. In addition, L-NAME (5 mM) significantly attenuated PMA-induced acute lung injury except for PAP. These experimental data suggest that inhaled NO significantly exacerbated acute lung injury induced by PMA in rats. L-NAME attenuated the detrimental effect of inhaled NO. PMID:14643171

  12. Expression of calgranulin A/B heterodimer after acute inhalation of endotoxin: proteomic approach and validation

    Michel, Olivier; Doyen, Virginie; LEROY, Baptiste; Bopp, Benjamin; Dinh, Duc Huy Phong; Corazza, Francis; Wattiez, Ruddy

    2013-01-01

    Background The acute inhalation of endotoxin mimicks several aspects of the inflammation related to chronic obstructive pulmonary disease (COPD). The aim of the current study was to identify and to validate biomarkers of endotoxin-induced airways’ inflammation. Methods The cellular count in the induced-sputum, was measured before and after an inhalation of 20 mcg endotoxin, in 8 healthy volunteers. A proteomic analysis was applied to identify the more relevant proteins expression, before meas...

  13. TIP peptide inhalation in experimental acute lung injury: effect of repetitive dosage and different synthetic variants

    Hartmann, Erik K.; Thomas, Rainer; Liu, Tanghua; Stefaniak, Joanna; Ziebart, Alexander; Duenges, Bastian; Eckle, Daniel; Markstaller, Klaus; David, Matthias

    2014-01-01

    Background Inhalation of TIP peptides that mimic the lectin-like domain of TNF-α is a novel approach to attenuate pulmonary oedema on the threshold to clinical application. A placebo-controlled porcine model of acute respiratory distress syndrome (ARDS) demonstrated a reduced thermodilution-derived extravascular lung water index (EVLWI) and improved gas exchange through TIP peptide inhalation within three hours. Based on these findings, the present study compares a single versus a repetitive ...

  14. Compared biokinetic and biological studies of chronic and acute inhalations of uranium compounds in the rat

    Uranium is a natural, radioactive heavy metal, widely used in the nuclear industry in various chemical and isotopic forms. Its use in the fuel cycle involves the risk of radiological exposure for the workers, mainly via the inhalation of uranium particles. According to the workplace configuration, uranium contaminations can be acute or repeated, involve various chemical forms and different levels of enrichment, as well as involving one or several components. The dosimetric concepts and models available for workers' radiological protection, as well as most of the studies of the biological effects, correspond to acute exposure situations. Moreover the processes leading to pathological effects are little known in vivo. In this context, the main question is to know whether exposures due to repeated inhalation by rats induce the element kinetics and toxicity, which may be different from those observed after an acute exposure. In this study, comparison of the experimental and theoretical biokinetics of an insoluble uranium repeatedly inhaled over three weeks shows that a chronic contamination is correctly modelled, except for bone retention, by the sum of acute, successive and independent incorporations. Moreover, the kinetics of a soluble uranium inhaled irregularly can be modified by previous repeated exposure to an insoluble uranium. In certain cases therefore, exposure to uranium could modify its biokinetics during later exposures. At a toxicological level, the study demonstrates that the uranium particles inhaled repeatedly induce behavioural disruptions and genotoxic effects resulting in various sorts of DNA damage, in several cell types and certainly depending on the quantity inhaled. Exposures involving several uraniferous components produce a synergy effect. Moreover, repeated inhalations worsen the genotoxic effects in comparison to an acute exposure. This work demonstrates the importance of not ignoring the effects of the repetition of uranium exposure. It

  15. Inhalants

    ... or LSD. But you may not realize the dangers of substances in your own home. Household products such as glues, hair sprays, paints and lighter fluid can be drugs for kids in search of a quick high. Many young people ... need to know the dangers. Even inhaling once can disrupt heart rhythms and ...

  16. Inhalants

    ... Listen Drug Facts Alcohol Anabolic Steroids Bath Salts Cocaine Cough and Cold Medicine (DXM and Codeine Syrup) Heroin Inhalants Marijuana MDMA (Ecstasy or Molly) Methamphetamine (Meth) Prescription Drugs Salvia Spice Brain and Addiction Tobacco, Nicotine, & E-Cigarettes HIV/AIDS ...

  17. Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography

    Vorstrup, S; Paulson, O B; Lassen, N A

    1986-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They...

  18. 40 CFR 799.9135 - TSCA acute inhalation toxicity with histopathology.

    2010-07-01

    ... histopathology. 799.9135 Section 799.9135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... the gross pathology and histopathology resulting from acute inhalation exposure to a substance.... (b) Source. This a new section developed by the United States Environmental Protection Agency....

  19. Inhaled and intravenous treatment in acute severe and life-threatening asthma.

    Sellers, W F S

    2013-02-01

    Management of life-threatening acute severe asthma in children and adults may require anaesthetic and intensive care. The inhaled route for drug delivery is not appropriate when only small respiratory gas volumes are shifted; the i.v. route may be associated with greater side-effects. Magnesium sulphate i.v. has a place in acute asthma management because it is a mild bronchodilator, and has a stabilizing effect on the atria which may attenuate tachycardia occurring after inhaled and i.v. salbutamol. If intubation and ventilation are required, a reduction in bronchoconstriction by any means before and during these procedures should reduce morbidity. This narrative review aims to show strengths and weakness of the evidence, present controversies, and forward opinions of the author. The review contains a practical guide to the setting up, use and efficiency of nebulizers, metered dose inhalers, and spacers (chambers). It also presents a commonsense approach to the management of severe asthmatics in whom delay in bronchodilatation would cause clinical deterioration. When self-inhaled agents have had no effect, i.v. drugs may help avoid intubation and ventilation. The review includes suggestions for the use of inhaled anaesthetics, anaesthetic induction, and brief notes on subsequent ventilation of the lungs. PMID:23234642

  20. Sidestream smoke inhalation decreases respiratory clearance of 99mTc-DTPA acutely

    The permeability of the alveolar-capillary barrier to an inhaled aerosol of technetium 99m labelled diethylenetriamine penta-acetate (99mTc-DTPA is used as an index of alveolar epithelial injury. Permeability is greatly increased in active smokers. The aim of this study was to determine the effect of sidestream smoke inhalation on permeability as this has not been described previously. Lung clearance of inhaled 99mTc-DTPA aerosol was measured in 20 normal non-smoking subjects before and after exposure to one hours sidestream smoke inhalation. Measured carbon monoxide (CO) levels rose to a maximum of 23.5 ±6.2 ppm from baseline values of 0.6±1.3 (p99mTc-DTPA clearance rose from baseline 69.1± 15.6 (mean ± to 77.4 ±17.8) after smoke exposure. No effect of 99mTc-DTPA scanning of sidestream smoke was demonstrated on lung function. It was concluded that low level sidestream smoke inhalation decreases 99mTc-DTPA clearance acutely in humans. The mechanism of this unexpected result is not established but may include differences in constituents between sidestream and mainstream smoke, alterations in pulmonary microvascular blood flow, or changes in surfactant due to an acute phase irritant response. 34 refs., 2 figs

  1. Acute Adrenal Crisis in an Asthmatic Child Treated with Inhaled Fluticasone Proprionate

    Angela H. Santiago

    2010-01-01

    Full Text Available Adrenal suppression secondary to prolonged inhaled corticosteroid use is usually limited to biochemical abnormalities, with no obvious clinical effects. Acute adrenal crisis is much rarer event but has been reported with increasing frequency. We report a case of a 7-year-old asthmatic child who presented with an acute history of lethargy after a respiratory infection. He was maintained on 220 μg/day of fluticasone propionate for several years. Initial evaluation revealed severe adrenal suppression, with undetectable cortisol levels and minimal response after stimulation with ACTH. After fluticasone was discontinued, a gradual recovery of the adrenal axis was seen. This case shows that acute adrenal crisis may be a consequence even at the usual prescribed doses, stressing the importance of using the lowest dose of inhaled steroids needed to control symptoms and having an increased awareness of this complication.

  2. 40 CFR 799.9130 - TSCA acute inhalation toxicity.

    2010-07-01

    ...) Definitions. The definitions in section 3 of TSCA and the definitions in 40 CFR Part 792—Good Laboratory... minimize the need for animal testing, the Agency encourages the review of existing acute toxicity... need for further animal testing. (ii) Limit test. When data on structurally related chemicals...

  3. Expression of transforming growth factor alpha and epidermal growth factor receptor in rat lung neoplasms induced by plutonium-239

    Ninety-two rat lung proliferative lesions and neoplasms induced by inhaled 239PuO2 were evaluated for aberrant expression of transforming growth factor alpha (TGF-α) and epidermal growth factor receptor (EGFR). Expression of TGF-α protein, measured by immunohistochemistry, was higher in 94% of the squamous cell carcinomas and 87% of the foci of alveolar epithelial squamous metaplasia than that exhibited by the normal-appearing, adjacent lung parenchyma. In contrast, only 20% of adenocarcinomas and foci of epithelial hyperplasia expressed elevated levels of TGF-α. Many neoplasms expressing TGF-α also expressed excessive levels of EGFR mRNA. Southern and DNA slot blot analyses showed that the elevated EGFR expression was not due to amplification of the EGFR gene. These data suggest that increased amounts of TGF-α were early alterations in the progression of plutonium-induced squamous cell carcinoma, and these increases may occur in parallel with overexpression of the receptor for this growth factor. Together, these alterations create a potential autocrine loop for sustaining clonal expansion of cells initiated by high-LET radiation. 44 refs., 4 figs., 1 tab

  4. Potential mechanisms for acute health effects and lung retention of inhaled particles of different origin

    Klepczynska Nyström, Anna

    2012-01-01

    Background: Environmental particle exposure is known to have negative health effects. There is limited knowledge about how size and origin of particles influence these effects. There is also little known regarding the fate of ultrafine particles (particles in nanosize;< 100 nanometers in diameter) after being inhaled. Aim: The main objective of this thesis was to study acute health effects in humans and their potential underlying mechanisms, resulting from exposure to particles of different o...

  5. HADOC: a computer code for calculation of external and inhalation doses from acute radionuclide releases

    The computer code HADOC (Hanford Acute Dose Calculations) is described and instructions for its use are presented. The code calculates external dose from air submersion and inhalation doses following acute radionuclide releases. Atmospheric dispersion is calculated using the Hanford model with options to determine maximum conditions. Building wake effects and terrain variation may also be considered. Doses are calculated using dose conversion factor supplied in a data library. Doses are reported for one and fifty year dose commitment periods for the maximum individual and the regional population (within 50 miles). The fractional contribution to dose by radionuclide and exposure mode are also printed if requested

  6. Comparative efficacy of terbutaline sulphate delivered by Turbuhaler dry powder inhaler or pressurised metered dose inhaler with Nebuhaler spacer in children during an acute asthmatic episode

    Drblik, S; Lapierre, G; Thivierge, R; Turgeon, J; Gaudreault, P; Cummins-McManus, B; Verdy, I; Haddon, J; Lee, J.; Spier, S

    2003-01-01

    Aims: To compare the efficacy of terbutaline sulphate delivered via Turbuhaler with a pressurised metered dose inhaler (pMDI) connected to Nebuhaler spacer in a population of asthmatic children presenting to emergency departments because of an acute episode of asthma.

  7. [Effect of inhaled terbutaline sulphate (dry powder, Turbuhaler and nebulizer solution) in children with acute asthma].

    Solé, D; Rizzo, M C; Pimentel, A F; Sano, F; Barreto, B A; Wandalsen, N F; Naspitz, C K

    1995-01-01

    Forty seven children (6-14 years), with an acute mild or moderate attack of asthma (clinical score 3 or FEV1 > 50% of the predicted), were treated with terbutaline sulphate, by inhalation route with a dry powder inhaler (Turbuhaler - 0,5 mg - group T; N=27, or by a nebulizer 1% solution-in saline-compressed air (6 l/min.) group S; N=20. The children were evaluated at 5, 15, 25 and 30 minutes after the initial treatment. In both groups a significant fall of the clinical score (starting at 15 minutes) (p 0.05). At the end of the first treatment, the number of patients with a FEV(1) < 80% was similar in both groups (T = 13/27 and S = 10/20). The same treatment was repeated, and all the children showed a marked improvement, except for one boy of the group T was hospitalized. In conclusion, children with mild or moderate acute attacks of asthma can be treated up to a week with an inhalation of dry powder, resulting in adequate bronchodilatation without important side effects. PMID:14689023

  8. Acute Inhalation Exposure to Titanium Ethanolate as a Possible Cause of Metal Fume Fever

    M Ahmadimanesh

    2014-04-01

    Full Text Available Occupational inhalation exposure to noxious agents is not uncommon. Herein, we present a 26-year-old male student who had accidental acute inhalation exposure to a large quantity of titanium ethanolate and hydrogen chloride in chemistry lab. He was referred to the emergency department of our hospital with low-grade fever, dyspnea, headache, fatigue and myalgia. After 24 hrs of symptomatic treatment (oxygen therapy and acetaminophen, the fever was subsided and the patient discharged home in a good clinical condition. The presented symptoms could be interpreted as a form of metal fume fever. It can therefore be concluded that organo-metallic compound of titanium metal may have the potential to produce metal fume fever in human.

  9. Particle-induced pulmonary acute phase response may be the causal link between particle inhalation and cardiovascular disease

    Saber, Anne T.; Jacobsen, Nicklas R.; Jackson, Petra;

    2014-01-01

    Inhalation of ambient and workplace particulate air pollution is associated with increased risk of cardiovascular disease. One proposed mechanism for this association is that pulmonary inflammation induces a hepatic acute phase response, which increases risk of cardiovascular disease. Induction of...... epidemiological studies. In this review, we present and review emerging evidence that inhalation of particles (e.g., air diesel exhaust particles and nanoparticles) induces a pulmonary acute phase response, and propose that this induction constitutes the causal link between particle inhalation and risk of...... cardiovascular disease. Increased levels of acute phase mRNA and proteins in lung tissues, bronchoalveolar lavage fluid and plasma clearly indicate pulmonary acute phase response following pulmonary deposition of different kinds of particles including diesel exhaust particles, nanoparticles, and carbon nanotubes...

  10. Acute Impact of Inhaled Short Acting B-Agonists on 5 Km Running Performance

    John Dickinson

    2014-06-01

    Full Text Available Whilst there appears to be no ergogenic effect from inhaled salbutamol no study has investigated the impact of the acute inhalation of 1600 µg, the World Anti-Doping Agency (WADA daily upper limit, on endurance running performance. To investigate the ergogenic effect of an acute inhalation of short acting β2-agonists at doses up to 1600 µg on 5 km time trial performance and resultant urine concentration. Seven male non-asthmatic runners (mean ± SD; age 22.4 ± 4.3 years; height 1.80 ± 0.07 m; body mass 76.6 ± 8.6 kg provided written informed consent. Participants completed six 5 km time-trials on separate days (three at 18 °C and three at 30 °C. Fifteen minutes prior to the initiation of each 5 km time-trial participants inhaled: placebo (PLA, 800 µg salbutamol (SAL800 or 1600 µg salbutamol (SAL1600. During each 5 km time-trial HR, VO2, VCO2, VE, RPE and blood lactate were measured. Urine samples (90 ml were collected between 30-180 minutes post 5 km time-trial and analysed for salbutamol concentration. There was no significant difference in total 5 km time between treatments (PLA 1714.7 ± 186.2 s; SAL800 1683.3 ± 179.7 s; SAL1600 1683.6 ± 190.7 s. Post 5 km time-trial salbutamol urine concentration between SAL800 (122.96 ± 69.22 ug·ml-1 and SAL1600 (574.06 ± 448.17 ug·ml-1 were not significantly different. There was no improvement in 5 km time-trial performance following the inhalation of up to 1600 µg of salbutamol in non-asthmatic athletes. This would suggest that the current WADA guidelines, which allow athletes to inhale up to 1600 µg per day, is sufficient to avoid pharmaceutical induced performance enhancement.

  11. Comparison of acute mortality in baboons and dogs after inhalation of 239PuO2

    Results from experiments with baboons were compared with those from experiments with dogs to determine the relative sensitivity of the two species to acute mortality from inhaled 239PuO2. To assure a valid comparison of data developed at two laboratories, methodology differences were minimized by establishing a common pool of raw data, using the same computer programs to analyze the data, and standardizing assumptions regarding the calculation of radiation doses to lungs. Several comparison methods were used involving variations in estimating different parameters such as the concentration of plutonium in the lungs. Although nearly all comparisons suggested baboons were slightly more sensitive, none of the methods for comparing the relationship between dose and survival time showed consistently significant differences between baboons and dogs. Although the baboons were physiologically and morphologically immature when exposed to plutonium, whereas the dogs were mature, it was concluded that adult baboons and dogs are similarly sensitive to the acute effects of inhaled 239PuO2. Since only acute mortality was considered in this comparison, the results do not apply to possible late effects caused by much lower levels of plutonium than were used in these experiments

  12. Impaired mitochondrial respiration and protein nitration in the rat hippocampus after acute inhalation of combustion smoke

    Survivors of massive inhalation of combustion smoke endure critical injuries, including lasting neurological complications. We have previously reported that acute inhalation of combustion smoke disrupts the nitric oxide homeostasis in the rat brain. In this study, we extend our findings and report that a 30-minute exposure of awake rats to ambient wood combustion smoke induces protein nitration in the rat hippocampus and that mitochondrial proteins are a sensitive nitration target in this setting. Mitochondria are central to energy metabolism and cellular signaling and are critical to proper cell function. Here, analyses of the mitochondrial proteome showed elevated protein nitration in the course of a 24-hour recovery following exposure to smoke. Mass spectrometry identification of several significantly nitrated mitochondrial proteins revealed diverse functions and involvement in central aspects of mitochondrial physiology. The nitrated proteins include the ubiquitous mitochondrial creatine kinase, F1-ATP synthase α subunit, dihydrolipoamide dehydrogenase (E3), succinate dehydrogenase Fp subunit, and voltage-dependent anion channel (VDAC1) protein. Furthermore, acute exposure to combustion smoke significantly compromised the respiratory capacity of hippocampal mitochondria. Importantly, elevated protein nitration and reduced mitochondrial respiration in the hippocampus persisted beyond the time required for restoration of normal oxygen and carboxyhemoglobin blood levels after the cessation of exposure to smoke. Thus, the time frame for intensification of the various smoke-induced effects differs between blood and brain tissues. Taken together, our findings suggest that nitration of essential mitochondrial proteins may contribute to the reduction in mitochondrial respiratory capacity and underlie, in part, the brain pathophysiology after acute inhalation of combustion smoke

  13. Detection of experimentally produced acute pulmonary arterial occlusion by methyl iodide-131 inhalation imaging

    Methyl iodide-131 (CH3I-131) is described as an agent for detection of acute experimentally produced pulmonary arterial occlusion in dogs. When gaseous CH3I-131 is inhaled, radioactivity passes instantaneously from the alveoli to the lung capillary bed. Where pulmonary blood flow exists, activity is washed out into the systemic circulation, but in areas of blood stasis, a transient pulmonary hot spot remains. CH3I-131 is easily produced and inexpensive, but administration is awkward and strict radiation safety precautions are mandatory

  14. ACRO: a computer program for calculating organ doses from acute or chronic inhalation and ingestion of radionuclides

    ACRO was developed as a computer program to calculate internal exposure doses resulting from acute or chronic inhalation and oral ingestion of radionuclides. The ICRP Task Force Lung Model (TGLM) was used as the inhalation model in ACRO, and a simple one-compartment model was used as the ingestion model. The program is written in FORTRAN IV, and it requires about 260 KB memory capacity

  15. Criticality Evaluation of Plutonium-239 Moderated by High-Density Polyethylene in Stainless Steel and Aluminum Containers Suitable for Non-Exclusive Use Transport

    Watson, T T

    2007-08-10

    Research is conducted at the Joint Actinide Shock Physics Experimental Facility (JASPER) on the effects of high pressure and temperature environments on plutonium-239, in support of the stockpile stewardship program. Once an experiment has been completed, it is necessary to transport the end products for interim storage or final disposition. Federal shipping regulations for nonexclusive use transportation require that no more than 180 grams of fissile material are present in at least 360 kilograms of contiguous non-fissile material. To evaluate the conservatism of these regulatory requirements, a worst-case scenario of 180g {sup 239}Pu and a more realistic scenario of 100g {sup 239}Pu were modeled using one of Lawrence Livermore National Laboratory's Monte Carlo transport codes known as COG 10. The geometry consisted of {sup 239}Pu spheres homogeneously mixed with high-density polyethylene surrounded by a cube of either stainless steel 304 or aluminum. An optimized geometry for both cube materials and hydrogen-to-fissile isotope (H/X) ratio were determined for a single unit. Infinite and finite 3D arrays of these optimized units were then simulated to determine if the systems would exceed criticality. Completion of these simulations showed that the optimal H/X ratio for the most reactive units ranged from 800 to 1600. A single unit of either cube type for either scenario would not reach criticality. An infinite array was determined to reach criticality only for the 180g case. The offsetting of spheres in their respective cubes was also considered and showed a considerable decrease in the number of close-packed units needed to reach criticality. These results call into question the current regulations for fissile material transport, which under certain circumstances may not be sufficient in preventing the development of a critical system. However, a conservative, theoretical approach was taken in all assumptions and such idealized configurations may not be

  16. Bronchodilatory effect of inhaled budesonide/formoterol and budesonide/salbutamol in acute asthma: a double-blind, randomized controlled trial

    Arun Jenish J; Lodha Rakesh; Kabra Sushil K

    2012-01-01

    Abstract Background There are no published studies that have compared bronchodilatory effect of inhaled budesonide/formoterol combination with budesonide/salbutamol delivered by metered dose inhaler with a spacer in acute exacerbation of asthma in children. We, therefore, compared the bronchodilatory effects of inhaled budesonide/formoterol (dose: 200 μg and 12 μg respectively) combination with budesonide (200 μg)/salbutamol (200 μg) administered by metered dose inhaler and spacer in children...

  17. Acute respiratory toxicity following inhalation exposure to soman in guinea pigs

    Respiratory toxicity and lung injury following inhalation exposure to chemical warfare nerve agent soman was examined in guinea pigs without therapeutics to improve survival. A microinstillation inhalation exposure technique that aerosolizes the agent in the trachea was used to administer soman to anesthetized age and weight matched male guinea pigs. Animals were exposed to 280, 561, 841, and 1121 mg/m3 concentrations of soman for 4 min. Survival data showed that all saline controls and animals exposed to 280 and 561 mg/m3 soman survived, while animals exposed to 841, and 1121 mg/m3 resulted in 38% and 13% survival, respectively. The microinstillation inhalation exposure LCt50 for soman determined by probit analysis was 827.2 mg/m3. A majority of the animals that died at 1121 mg/m3 developed seizures and died within 15-30 min post-exposure. There was a dose-dependent decrease in pulse rate and blood oxygen saturation of animals exposed to soman at 5-6.5 min post-exposure. Body weight loss increased with the dose of soman exposure. Bronchoalveolar lavage (BAL) fluid and blood acetylcholinesterase and butyrylcholinesterase activity was inhibited dose-dependently in soman treated groups at 24 h. BAL cells showed a dose-dependent increase in cell death and total cell counts following soman exposure. Edema by wet/dry weight ratio of the accessory lung lobe and trachea was increased slightly in soman exposed animals. An increase in total bronchoalveolar lavage fluid protein was observed in soman exposed animals at all doses. Differential cell counts of BAL and blood showed an increase in total lymphocyte counts and percentage of neutrophils. These results indicate that microinstillation inhalation exposure to soman causes respiratory toxicity and acute lung injury in guinea pigs.

  18. Acute and Subchronic Toxicity of Inhaled Toluene in Male Long-Evans Rats: Oxidative Stress Markers in Brain

    The effects of exposure to volatile organic compounds (VOCs), which are of concern to the EPA, are poorly understood, in part because of insufficient characterization of how human exposure duration impacts VOC effects. Two inhalation studies with multiple endpoints, one acute an...

  19. Continuous Inhalation of Ipratropium Bromide for Acute Asthma Refractory to β2-agonist Treatment.

    Koumbourlis, Anastassios C; Mastropietro, Christopher

    2015-01-01

    To present the case of a patient with persistent bronchospasm, refractory to treatment with β2-agonists, that resolved promptly with continuous inhalation of large dose (1000 mcg/hr) ipratropium bromide, and to discuss the possibility of tolerance to β2-agonists as the cause for his failure to respond to adrenergic medications. The patient had received multiple doses of albuterol, as well as subcutaneous terbutaline (0.3 mg), intravenous magnesium sulfate (1 g) and intravenous dexamethasone (10 mg) prior to his admission to the intensive care unit. He remained symptomatic despite systemic intravenous steroids, continuous intravenous terbutaline (up to 0.6 mcg/kg/min), and continuous nebulized albuterol (up to 20 mg/hr for 57 hr) followed by 49 hours of continuous levalbuterol (7 mg/hr). Due to the lack of response, all β2-agonists were discontinued at 106 hours post-admission, and he was started on large dose ipratropium bromide (1000 mcg/hr) by continuous nebulization. Clinical improvement was evident within 1 hour and complete resolution of his symptoms within 4 hours. Continuous inhalation of large dose ipratropium bromide may be an effective regimen for the treatment of patients hospitalized with acute asthma who are deemed to be nonresponsive and/or tolerant to β2-agonist therapy. PMID:25859173

  20. Long-term follow-up of HAN-1, an acute plutonium oxide inhalation case

    Extensive data obtained over the past 12 years as follow-up monitoring for a worker who incurred an acute inhalation exposure of high-fired plutonium oxide indicate that the biokinetic retention of this material differs substantially from the conventionally assumed ICRP class Y assumptions. In vivo lung measurements show an unusually long lung clearance half-time of 6200 days. Virtually all faecal clearance occurred in the first voiding, with no activity detected in samples at 600 and 2200 days post-intake. Early urine samples showed only a very slight systemic uptake, and dropped below detectability (239Pu at about 0.17 mBq. This case underscores the importance of incorporating long-term follow-up into bioassay and dosimetry programs, and cautions against strict reliance on standard model parameters for dose assessment. (author)

  1. Assessment of inhaled acute ammonia-induced lung injury in rats.

    Perkins, Michael W; Wong, Benjamin; Tressler, Justin; Coggins, Andrew; Rodriguez, Ashley; Devorak, Jennifer; Sciuto, Alfred M

    2016-02-01

    This study examined acute toxicity and lung injury following inhalation exposure to ammonia. Male Sprague-Dawley rats (300-350 g) were exposed to 9000, 20 000, 23 000, 26 000, 30 000 or 35 000 ppm of ammonia for 20 min in a custom head-out exposure system. The exposure atmosphere, which attained steady state within 3 min for all ammonia concentrations, was monitored and verified using a Fourier transform infrared spectroscopy (FTIR) gas analyzer. Animals exposed to ammonia resulted in dose-dependent increases in observed signs of intoxication, including increased chewing and licking, ocular irritation, salivation, lacrimation, oronasal secretion and labored breathing. The LCt50 of ammonia within this head-out inhalation exposure model was determined by probit analysis to be 23 672 ppm (16 489 mg/m(3)) for the 20 min exposure in male rats. Exposure to 20 000 or 23 000 ppm of ammonia resulted in significant body weight loss 24-h post-exposure. Lung edema increased in all ammonia-exposed animal groups and was significant following exposure to 9000 ppm. Bronchoalveolar fluid (BALF) protein concentrations significantly increased following exposure to 20 000 or 23 000 ppm of ammonia in comparison to controls. BAL cell (BALC) death and total cell counts increased in animals exposed to 20 000 or 23 000 ppm of ammonia in comparison to controls. Differential cell counts of white blood cells, neutrophils and platelets from blood and BALF were significantly increased following exposure to 23 000 ppm of ammonia. The following studies describe the validation of a head-out inhalation exposure model for the determination of acute ammonia-induced toxicity; this model will be used for the development and evaluation of potential therapies that provide protection against respiratory and systemic toxicological effects. PMID:26821737

  2. Acute and repeated inhalation lung injury by 3-methoxybutyl chloroformate in rats: CT-pathologic correlation

    Objectives: To investigate the acute and repeated pulmonary damage in Sprague-Dawley rats caused by the inhalation of 3-methoxybutyl chloroformate (3-MBCF) using computed tomography (CT), and to correlate these results with those obtained from a pathological study. Methods: Sixty, 7-week-old rats were exposed to 3-MBCF vapor via inhalation (6 h/day) for 1 day (N = 20), 3 days (N = 20), and 28 days (5 days/week) (N = 20) using whole body exposure chambers at a concentration of 0 (control), 3, 6 and 12 ppm. CT examinations including densitometry and histopathologic studies were carried out. For the follow-up study, the rats exposed for 3 days were scanned using CT and their pathology was examined at 7, 14, and 28 days. Results: There was a significant decrease in the parenchymal density in the groups exposed to the 3-MBCF vapors for 1 day at 3 ppm (p = 0.022) or 6 ppm (p = 0.010), compared with the control. The parenchymal density of the rats exposed to12 ppm was significantly higher. The pathological findings in this period, the grades of vascular congestion, tracheobronchial exfoliation, and alveolar rupture were significant. In the groups exposed for 3 days, there was a large decrease in the parenchymal density with increasing dose (control: -675.48 ± 32.82 HU, 3 ppm: -720.65 ± 34.21 HU, 6 ppm: -756.41 ± 41.68 HU, 12 ppm: -812.56 ± 53.48 HU) (p = 0.000). There were significant density differences between each dose in the groups exposed for 28 days (p = 0.000). The CT findings include an irregular lung surface, areas of multifocal, wedge-shaped increased density, a heterogeneous lung density, bronchial dilatation, and axial peribronchovascular bundle thickening. The histopathology examination revealed the development of alveolar interstitial thickening and vasculitis, and an aggravation of the mainstem bronchial exudates and bronchial inflammation. The alveolar wall ruptures and bronchial dilatation became severe during this period. On the follow-up study, the

  3. Acute and repeated inhalation lung injury by 3-methoxybutyl chloroformate in rats: CT-pathologic correlation

    Lim, Yeon Soo [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Chung, Myung Hee [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)]. E-mail: mhchung@catholic.ac.kr; Park, Seog Hee [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Kim, Hyeon-Yeong [Industrial Chemicals Research Center, Industrial Safety and Health Research Institute KISCO, 104-8, Moonji-dong, Yusong-gu, Taejon-si 305-380 (Korea, Republic of); Choi, Byung Gil [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Lim, Hyun Wook [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Kim, Jin Ah [Department of Pathology, Holy Family Hospital, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon-si, Kyung gi-do 420-717 (Korea, Republic of); Yoo, Won Jong [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)

    2007-05-15

    Objectives: To investigate the acute and repeated pulmonary damage in Sprague-Dawley rats caused by the inhalation of 3-methoxybutyl chloroformate (3-MBCF) using computed tomography (CT), and to correlate these results with those obtained from a pathological study. Methods: Sixty, 7-week-old rats were exposed to 3-MBCF vapor via inhalation (6 h/day) for 1 day (N = 20), 3 days (N = 20), and 28 days (5 days/week) (N = 20) using whole body exposure chambers at a concentration of 0 (control), 3, 6 and 12 ppm. CT examinations including densitometry and histopathologic studies were carried out. For the follow-up study, the rats exposed for 3 days were scanned using CT and their pathology was examined at 7, 14, and 28 days. Results: There was a significant decrease in the parenchymal density in the groups exposed to the 3-MBCF vapors for 1 day at 3 ppm (p = 0.022) or 6 ppm (p = 0.010), compared with the control. The parenchymal density of the rats exposed to12 ppm was significantly higher. The pathological findings in this period, the grades of vascular congestion, tracheobronchial exfoliation, and alveolar rupture were significant. In the groups exposed for 3 days, there was a large decrease in the parenchymal density with increasing dose (control: -675.48 {+-} 32.82 HU, 3 ppm: -720.65 {+-} 34.21 HU, 6 ppm: -756.41 {+-} 41.68 HU, 12 ppm: -812.56 {+-} 53.48 HU) (p = 0.000). There were significant density differences between each dose in the groups exposed for 28 days (p = 0.000). The CT findings include an irregular lung surface, areas of multifocal, wedge-shaped increased density, a heterogeneous lung density, bronchial dilatation, and axial peribronchovascular bundle thickening. The histopathology examination revealed the development of alveolar interstitial thickening and vasculitis, and an aggravation of the mainstem bronchial exudates and bronchial inflammation. The alveolar wall ruptures and bronchial dilatation became severe during this period. On the follow

  4. Is there a place for inhaled nitric oxide in the therapy of acute pulmonary embolism?

    Tanus-Santos, Jose E; Theodorakis, Michael J

    2002-01-01

    Acute pulmonary embolism (PE) is a serious complication resulting from the migration of emboli to the lungs. Although deep venous thrombi are the most common source of emboli to the lungs, other important sources include air, amniotic fluid, fat and bone marrow. Regardless of the specific source of the emboli, very little progress has been made in the pharmacological management of this high mortality condition. Because the prognosis is linked to the degree of elevation of pulmonary vascular resistance, any therapeutic intervention to improve the hemodynamics would probably increase the low survival rate of this critical condition. Inhaled nitric oxide (iNO) has been widely tested and used in cases of pulmonary hypertension of different causes. In the last few years some authors have described beneficial effects of iNO in animal models of acute PE and in anecdotal cases of massive PE. The primary cause of death in massive PE that is caused by deep venous thrombi, gas or amniotic fluid, is acute right heart failure and circulatory shock. Increased pulmonary vascular resistance following acute PE is the cumulative result of mechanical obstruction of pulmonary vessels and pulmonary arteriolar constriction (attributable to a neurogenic reflex and to the release of vasoconstrictors). As such, the vasodilator effects of iNO could actively oppose the pulmonary hypertension following PE. This hypothesis is consistently supported by experimental studies in different animal models of PE, which demonstrated that iNO decreased (by 10 to 20%) the pulmonary artery pressure without improving pulmonary gas exchange. Although maximal vasodilatory effects are probably achieved by less than 5 parts per million iNO, which is a relatively low concentration, no dose-response study has been published so far. In addition to the animal studies, a few anecdotal reports in the literature suggest that iNO may improve the hemodynamics during acute PE. However, no prospective, controlled

  5. Assessing acute systemic effects of an inhaled drug with serial echocardiography: a placebo-controlled comparison of inhaled and intravenous dihydroergotamine

    Noveck RJ

    2013-07-01

    Full Text Available Robert J Noveck,1 Pamela S Douglas,2 Shein-Chung Chow,3 Barry Mangum,4 Shashidhar Kori,5 Donald J Kellerman51Duke Clinical Research Unit, Division of Clinical Pharmacology, Duke University School of Medicine, Durham, NC, USA; 2Imaging Program, Duke Clinical Research Institute, Durham, NC, USA; 3Department of Biostatistics and Bioinformatics, Duke-NUS Graduate Medical School, Durham, NC, USA; 4Clinical Pharmacology, Duke Clinical Research Unit, Duke University School of Medicine, Durham, NC, USA; 5MAP Pharmaceuticals, Inc, Mountain View, CA, USAObjective: MAP0004 is an investigational product which delivers dihydroergotamine (DHE through the lung via a breath-synchronized metered dose inhaler. The objective of this study was to compare the acute effects of orally inhaled and intravenous (IV DHE to placebo on maximum change and area under the curve for pulmonary arterial systolic pressure (PASP.Research design and methods: A randomized, double-blind, placebo-controlled, 3-period, crossover study of 24 health adults. Trial registration NCT01089062. Study assessments included pharmacokinetics, electrocardiograms (ECG, and validated echocardiographic (Doppler-derived measures of PASP by echocardiogram. The primary endpoint was the absolute change in calculated PASP using area under the curve, 0 to 2 hours (AUC0–2h.Results: The change in PASP with IV DHE was significantly different than MAP0004 and placebo (AUC0–2h2857, 2624, and 2453 mmHg*min, respectively. After a second dose of MAP0004, AUC0–4h remained lower with MAP0004 than with a single dose of IV DHE. Adverse events were more common with IV DHE than with MAP0004 or placebo. None of the treatments produced clinically significant changes in PASP or other cardiac parameters. Changes in PASP were significantly smaller with MAP0004 compared with IV DHE.Conclusion: These results indicate the effects 1 mg of orally inhaled DHE on the cardiovascular system are less than with 1 mg of IV DHE, and

  6. Acute respiratory distress following the inhalation of an aerosol upholstery cleaner: the importance of reporting from the Emergency Department

    Mistry, Dipak; Meredith, Carolyn

    2009-01-01

    Aerosols are commonplace in the home and in industry as they provide a quick and controlled way of distributing chemicals or perfumes. It is well known that deliberating concentrating and inhaling vapours may result in dizziness, euphoria, blackouts, respiratory distress, cardiac and renal failure. However, in the most part, warnings and guidance on use are sparse. Here, a proven case of acute respiratory distress is presented and a reporting mechanism via the UK National Poisons Information ...

  7. Compared biokinetic and biological studies of chronic and acute inhalations of uranium compounds in the rat; Etudes biocinetique et biologique comparees d'inhalations chroniques et aigues de composes uraniferes chez le rat

    Monleau, M

    2005-12-15

    Uranium is a natural, radioactive heavy metal, widely used in the nuclear industry in various chemical and isotopic forms. Its use in the fuel cycle involves the risk of radiological exposure for the workers, mainly via the inhalation of uranium particles. According to the workplace configuration, uranium contaminations can be acute or repeated, involve various chemical forms and different levels of enrichment, as well as involving one or several components. The dosimetric concepts and models available for workers' radiological protection, as well as most of the studies of the biological effects, correspond to acute exposure situations. Moreover the processes leading to pathological effects are little known in vivo. In this context, the main question is to know whether exposures due to repeated inhalation by rats induce the element kinetics and toxicity, which may be different from those observed after an acute exposure. In this study, comparison of the experimental and theoretical biokinetics of an insoluble uranium repeatedly inhaled over three weeks shows that a chronic contamination is correctly modelled, except for bone retention, by the sum of acute, successive and independent incorporations. Moreover, the kinetics of a soluble uranium inhaled irregularly can be modified by previous repeated exposure to an insoluble uranium. In certain cases therefore, exposure to uranium could modify its biokinetics during later exposures. At a toxicological level, the study demonstrates that the uranium particles inhaled repeatedly induce behavioural disruptions and genotoxic effects resulting in various sorts of DNA damage, in several cell types and certainly depending on the quantity inhaled. Exposures involving several uraniferous components produce a synergy effect. Moreover, repeated inhalations worsen the genotoxic effects in comparison to an acute exposure. This work demonstrates the importance of not ignoring the effects of the repetition of uranium exposure

  8. Combined effects of radon inhalation and antioxidant vitamin administration on acute alcohol-induced hepatopathy in mice

    It has been reported that radon inhalation activates antioxidative functions in liver and has an antioxidative effect against hepatopathy similar to that of the antioxidative effects of ascorbic acid (VC) or α-tocopherol (VE). In this study, we examined the combined effects of radon inhalation and antioxidant vitamin administration on acute alcohol-induced hepatopathy in mice. ICR mice were subjected to intraperitoneal (i.p.) administration of alcohol after pretreating with air only (sham) or radon at a concentration of approximately 2000 Bq/m3 for 24 hours and i.p. administration of VC (300 mg/kg body weight) or VE (300 mg/kg body weight). In mice injected with alcohol, the combined radon and antioxidant vitamins treatment significantly decreased the activities of glutamic oxaloacetic transaminase in serum compared to not only the alcohol-administered group (sham group), but also the radon inhalation with alcohol administration group or the vitamin and alcohol administration group. In addition, radon inhalation significantly increased the antioxidant level, in such as the catalase activity and the total glutathione content in liver compared to the sham group. These results suggested that the combined radon and antioxidant vitamin treatment could effectively inhibit alcohol-induced hepatopathy in mice without any antagonizing action. (author)

  9. Decorporation of inhaled actinides by chelation therapy

    This article describes recent work in NRPB laboratories that has identified some of the factors influencing the behaviour of plutonium, americium and curium compounds in the body after inhalation, together with a number of experimental approaches that are being developed to optimise their treatment with DTPA. It is concluded that the most effective treatment has yet to be developed, but progress must depend on a better understanding of the factors governing the transport of actinides in the body. It cannot be assumed that because the inhaled material is readily translocated to blood, that treatment regimens with Ca-DTPA based solely on previous understanding of the metabolic fate of soluble actinide complexes will be successful. In fact, depending on the nature of the material involved in the accident, inhalation alone or combined with prolonged infusion of DTPA may be more effective than the periodic intravenous injections of the chelating agent alone. For poorly transportable materials such as insoluble plutonium-239 dioxide, chelation treatment remains essentially ineffective. (U.K.)

  10. Hyperresponsiveness to inhaled but not intravenous methacholine during acute respiratory syncytial virus infection in mice

    Colasurdo Giuseppe N

    2005-12-01

    Full Text Available Abstract Background To characterise the acute physiological and inflammatory changes induced by low-dose RSV infection in mice. Methods BALB/c mice were infected as adults (8 wk or weanlings (3 wk with 1 × 105 pfu of RSV A2 or vehicle (intranasal, 30 μl. Inflammation, cytokines and inflammatory markers in bronchoalveolar lavage fluid (BALF and airway and tissue responses to inhaled methacholine (MCh; 0.001 – 30 mg/ml were measured 5, 7, 10 and 21 days post infection. Responsiveness to iv MCh (6 – 96 μg/min/kg in vivo and to electrical field stimulation (EFS and MCh in vitro were measured at 7 d. Epithelial permeability was measured by Evans Blue dye leakage into BALF at 7 d. Respiratory mechanics were measured using low frequency forced oscillation in tracheostomised and ventilated (450 bpm, flexiVent mice. Low frequency impedance spectra were calculated (0.5 – 20 Hz and a model, consisting of an airway compartment [airway resistance (Raw and inertance (Iaw] and a constant-phase tissue compartment [coefficients of tissue damping (G and elastance (H] was fitted to the data. Results Inflammation in adult mouse BALF peaked at 7 d (RSV 15.6 (4.7 SE vs. control 3.7 (0.7 × 104 cells/ml; p 200 Raw adults: RSV 0.02 (0.005 vs. control 1.1 (0.41 mg/ml; p = 0.003 (PC200 Raw weanlings: RSV 0.19 (0.12 vs. control 10.2 (6.0 mg/ml MCh; p = 0.001. Increased responsiveness to aerosolised MCh was matched by elevated levels of cysLT at 5 d and elevated VEGF and PGE2 at 7 d in BALF from both adult and weanling mice. Responsiveness was not increased in response to iv MCh in vivo or EFS or MCh challenge in vitro. Increased epithelial permeability was not detected at 7 d. Conclusion Infection with 1 × 105 pfu RSV induced extreme hyperresponsiveness to aerosolised MCh during the acute phase of infection in adult and weanling mice. The route-specificity of hyperresponsiveness suggests that epithelial mechanisms were important in determining the physiological

  11. [Duration of bronchodilator effect of inhaled Salmeterol (dry powder x metered dose inhaler) in children with acute asthma attack].

    Solé, D; Rizzo, M C; Porto, I M; Gomez, I D; Sano, F; Figueiredo, M A; Naspitz, C K

    1996-01-01

    Patients during a mild to moderate acute attack of asthma (FEV1: 50 - 80% of predicted) were treated with Salmeterol MDI - 50mcg or Rotadisk - 50mcg or Salbutamol (MDI -200mcg). The children were followed by Spirometry, measuring FEV1 (basal) and after treatment: at 30 minutes, 60 minutes and thereafter every 60 minutes until 780 minutes, if the patients maintained the FEV1 above 80% of the predicted value and/or an increment of 20% in the VEF1 basal value. The Salmeterol group showed a significant bronchodilation at 60 minutes which was maintained in half of the patients up to 9 hours. This was not observed in the Salbutamol group: the peak bronchodilatation was observed at 30 minutes and the bronchodilation effect was observed in half of the patients up to 6 hours. There were no significant differences between both presentations of Salmeterol. This drug allowed a prolonged bronchodilator effect and is, according to the several consensus on management of asthma, an adequate option in the treatment of moderate to severe asthma. PMID:14688969

  12. Bronchodilatory effect of inhaled budesonide/formoterol and budesonide/salbutamol in acute asthma: a double-blind, randomized controlled trial

    Arun Jenish J

    2012-03-01

    Full Text Available Abstract Background There are no published studies that have compared bronchodilatory effect of inhaled budesonide/formoterol combination with budesonide/salbutamol delivered by metered dose inhaler with a spacer in acute exacerbation of asthma in children. We, therefore, compared the bronchodilatory effects of inhaled budesonide/formoterol (dose: 200 μg and 12 μg respectively combination with budesonide (200 μg/salbutamol (200 μg administered by metered dose inhaler and spacer in children of 5-15 years with mild acute exacerbation of asthma [Modified Pulmonary Index Score (MPIS between 6-8] in this double-blind, randomized controlled trial. The primary outcome was FEV1 (% predicted in the two groups at 1, 5, 15, 30, 60 min after administration of the study drug. Results We did not observe any significant differences in the % predicted FEV1 and MPIS between formoterol and salbutamol at various time points from 1 min to 60 min post drug administration. There was significant improvement in FEV1 (% predicted from baseline in both the groups as early as 1 min after drug administration. Conclusions Salbutamol or formoterol delivered along with inhaled corticosteroid by metered dose inhaler with spacer in children between 5-15 years of age with mild acute exacerbation of asthma had similar bronchodilatory effects. Trial Registration ClinicalTrials.gov: NCT00900874

  13. Lack of acute phase response in the livers of mice exposed to diesel exhaust particles or carbon black by inhalation

    Saber, Anne T; Halappanavar, Sabina; Folkmann, Janne K;

    2009-01-01

    BACKGROUND: Epidemiologic and animal studies have shown that particulate air pollution is associated with increased risk of lung and cardiovascular diseases. Although the exact mechanisms by which particles induce cardiovascular diseases are not known, studies suggest involvement of systemic acute...... phase responses, including C-reactive protein (CRP) and serum amyloid A (SAA) in humans. In this study we test the hypothesis that diesel exhaust particles (DEP) - or carbon black (CB)-induced lung inflammation initiates an acute phase response in the liver. RESULTS: Mice were exposed to filtered air......, 20 mg/m3 DEP or CB by inhalation for 90 minutes/day for four consecutive days; we have previously shown that these mice exhibit pulmonary inflammation (Saber AT, Bornholdt J, Dybdahl M, Sharma AK, Loft S, Vogel U, Wallin H. Tumor necrosis factor is not required for particle-induced genotoxicity and...

  14. Particle-induced pulmonary acute phase response correlates with neutrophil influx linking inhaled particles and cardiovascular risk

    Saber, Anne Thoustrup; Lamson, Jacob Stuart; Jacobsen, Nicklas Raun;

    2013-01-01

    Background Particulate air pollution is associated with cardiovascular disease. Acute phase response is causally linked to cardiovascular disease. Here, we propose that particle-induced pulmonary acute phase response provides an underlying mechanism for particle-induced cardiovascular risk. Methods...... at a biofuel plant. Mice were exposed to single or multiple doses of particles by inhalation or intratracheal instillation and pulmonary mRNA expression of Saa3 was determined at different time points of up to 4 weeks after exposure. Also hepatic mRNA expression of Saa3, SAA3 protein levels in...... broncheoalveolar lavage fluid and in plasma and high density lipoprotein levels in plasma were determined in mice exposed to multiwalled carbon nanotubes. Results Pulmonary exposure to particles strongly increased Saa3 mRNA levels in lung tissue and elevated SAA3 protein levels in broncheoalveolar lavage fluid and...

  15. Particle-induced pulmonary acute phase response correlates with neutrophil influx linking inhaled particles and cardiovascular risk.

    Anne Thoustrup Saber

    Full Text Available BACKGROUND: Particulate air pollution is associated with cardiovascular disease. Acute phase response is causally linked to cardiovascular disease. Here, we propose that particle-induced pulmonary acute phase response provides an underlying mechanism for particle-induced cardiovascular risk. METHODS: We analysed the mRNA expression of Serum Amyloid A (Saa3 in lung tissue from female C57BL/6J mice exposed to different particles including nanomaterials (carbon black and titanium dioxide nanoparticles, multi- and single walled carbon nanotubes, diesel exhaust particles and airborne dust collected at a biofuel plant. Mice were exposed to single or multiple doses of particles by inhalation or intratracheal instillation and pulmonary mRNA expression of Saa3 was determined at different time points of up to 4 weeks after exposure. Also hepatic mRNA expression of Saa3, SAA3 protein levels in broncheoalveolar lavage fluid and in plasma and high density lipoprotein levels in plasma were determined in mice exposed to multiwalled carbon nanotubes. RESULTS: Pulmonary exposure to particles strongly increased Saa3 mRNA levels in lung tissue and elevated SAA3 protein levels in broncheoalveolar lavage fluid and plasma, whereas hepatic Saa3 levels were much less affected. Pulmonary Saa3 expression correlated with the number of neutrophils in BAL across different dosing regimens, doses and time points. CONCLUSIONS: Pulmonary acute phase response may constitute a direct link between particle inhalation and risk of cardiovascular disease. We propose that the particle-induced pulmonary acute phase response may predict risk for cardiovascular disease.

  16. Comparative Plutonium-239 Dose Assessment for Three Desert Sites: Maralinga, Australia; Palomares, Spain; and the Nevada Test Site, USA - Before and After Remedial Action

    Church, B W; Shinn, J; Williams, G A; Martin, L J; O' Brien, R S; Adams, S R

    2000-07-14

    As a result of nuclear weapons testing and accidents, plutonium has been distributed into the environment. The areas close to the sites of these tests and accidental dispersions contain plutonium deposition of such a magnitude that health authorities and responsible officials have mandated that the contaminated areas be protected, generally through isolation or removal of the contaminated areas. In recent years remedial actions have taken place at all these sites. For reasons not entirely clear, the public perceives radiation exposure risk to be much greater than the evidence would suggest [1]. This perception seems to be particularly true for plutonium, which has often been ''demonized'' in various publications as the ''most hazardous substance known to man'' [2]. As the position statement adapted by the Health Physics Society explains, ''Plutonium's demonization is an example of how the public has been misled about radiation's environmental and health threats generally, and in cases like plutonium, how it has developed a warped ''risk perception'' that does not reflect reality'' [3]. As a result of this risk perception and ongoing debate surrounding environmental plutonium contamination, remedial action criteria are difficult to establish. By examining the data available before and after remedial actions taken at the three sites discussed in our report, we hope to present data that will illustrate that plutonium measured as aged deposition (older than several months) does not present as high a dose or risk as many had expected. The authors show that even though dose to the lung from inhalation (the primary pathway for the high-fired plutonium oxide particles present at these sites) is reduced, such a reduction is achieved at significant cost. The cost comes from damage to the environment, large expenditures per hectare rehabilitated, and the risk to occupational workers

  17. Inhaled Steroids

    ... Medications > Long-Term Control Medications > Inhaled Steroids Inhaled Steroids What are some common inhaled steroids? How are ... more about steroids? What are some common inhaled steroids? Common inhaled steroids include: Asmanex ® (mometasone) Alvesco ® (ciclesonide) ...

  18. Lack of acute phase response in the livers of mice exposed to diesel exhaust particles or carbon black by inhalation

    Williams Andrew

    2009-04-01

    Full Text Available Abstract Background Epidemiologic and animal studies have shown that particulate air pollution is associated with increased risk of lung and cardiovascular diseases. Although the exact mechanisms by which particles induce cardiovascular diseases are not known, studies suggest involvement of systemic acute phase responses, including C-reactive protein (CRP and serum amyloid A (SAA in humans. In this study we test the hypothesis that diesel exhaust particles (DEP – or carbon black (CB-induced lung inflammation initiates an acute phase response in the liver. Results Mice were exposed to filtered air, 20 mg/m3 DEP or CB by inhalation for 90 minutes/day for four consecutive days; we have previously shown that these mice exhibit pulmonary inflammation (Saber AT, Bornholdt J, Dybdahl M, Sharma AK, Loft S, Vogel U, Wallin H. Tumor necrosis factor is not required for particle-induced genotoxicity and pulmonary inflammation., Arch. Toxicol. 79 (2005 177–182. As a positive control for the induction of an acute phase response, mice were exposed to 12.5 mg/kg of lipopolysaccharide (LPS intraperitoneally. Quantitative real time RT-PCR was used to examine the hepatic mRNA expression of acute phase proteins, serum amyloid P (Sap (the murine homologue of Crp and Saa1 and Saa3. While significant increases in the hepatic expression of Sap, Saa1 and Saa3 were observed in response to LPS, their levels did not change in response to DEP or CB. In a comprehensive search for markers of an acute phase response, we analyzed liver tissue from these mice using high density DNA microarrays. Globally, 28 genes were found to be significantly differentially expressed in response to DEP or CB. The mRNA expression of three of the genes (serine (or cysteine proteinase inhibitor, clade A, member 3C, apolipoprotein E and transmembrane emp24 domain containing 3 responded to both exposures. However, these changes were very subtle and were not confirmed by real time RT

  19. Acute Response of Right Ventricular Function to Iloprost Inhalations in Patients with Pulmonary Arterial Hypertension: Preliminary Evaluation 
with Cardiac Magnetic Resonance Imaging

    Qingqing LU

    2015-03-01

    Full Text Available Background and objective Pulmonary arterial hypertension (PAH is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. Without treatment, PAH progresses rapidly to right ventricular (RV failure and even death. Cardiac magnetic resonance imaging (CMRI has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PAH. The aim of this study is to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMRI. Method From March 2012 to March 2014, 48 patients with PAH underwent CMRI before and immediately after inhalation of iloprost with a single dose of 20 μg over 15 min-20 min. RV function parameters derived from CMRI images were analyzed before and after iloprost inhalation, including end-diastolic volume (EDV, end-diastolic area (EDA, end-systolic volume (ESV, end-systolic area (ESA, stroke volume (SV, ejection fraction (EF and cardiac output (CO. Percentage of RV area change was also calculated [%RVAC=(EDA-ESA/EDA×100%]. Wilcoxon's Sign Rank Test or Paired Samples t-Test was used to compare the differences of RV function parameters before and after inhalation. Results After iloprost inhalation, all patients showed significant decrease in RV EDV and RV ESV (P=0.007, P<0.001 respectively. Whereas, there were significant increase in RV SV (P=0.014, RV EF (P=0.009 and %RVAC (P=0.006. RV CO had no significant difference before and after inhalation (P=0.851. Conclusions Inhalation of iloprost can immediately improve RV function in patients with PAH, and noninvasive evaluation of the acute response with CMRI is feasibility.

  20. Acute effects of inhalable particles on the frog palate mucociliary epithelium.

    M. Macchione; Oliveira, A. P.; Gallafrio, C T; Muchão, F P; Obara, M T; Guimarães, E T; Artaxo, P.; King, M.; G. Lorenzi-Filho; Junqueira, V C; Saldiva, P H

    1999-01-01

    This work was designed to evaluate the toxicity of inhalable particles [less than/equal to] 10 microm in aerodynamic diameter (PM(10)) collected from the urban air in São Paulo, Brazil, to the mucociliary apparatus using the frog palate preparation. Seven groups of frog palates were immersed in different concentrations of PM(10) diluted in Ringer's solution during 120 min: 0 (control, n = 31); 50 (n = 10); 100 (n = 9); 500 (n = 28); 1,000 (n = 10); 5,000 (n = 11); and 10,000 microg/m(3) (n = ...

  1. Long-term follow-up of HAN-1, an acute plutonium oxide inhalation case

    The International Commission on Radiation Protection (ICRP) has recommended that plutonium oxide be designated an inhalation class Y material, indicating that a 500-day clearance half-time from the lung is adequate for radiation protection purposes. Based on extensive data obtained from one particular inhalation case (referred to here as HAN-1), and supported by somewhat less detailed data in nine other cases, an argument has been put forth that substantially longer clearance half-times may not be uncommon for Pu oxide. This has led to the tentative identification of a ''super class Y'' form of Pu which has been factored into worker monitoring programs at the US Department of Energy's Hanford Site. In addition, the United States Transuranium Registry autopsy work has indicted evidence to support the super class Y case. The particular case described in this paper was the key case which caused the Hanford internal dosimetry staff to seriously consider super class Y material. This paper includes data from long-term follow up monitoring as well as early data for calculating intakes for comparisons with secondary limits. 13 refs, 2 figs., 1 tab

  2. Acute symptoms during non-inhalation exposure to combinations of toluene, trichloroethylene, and n-hexane

    Bælum, Jesper

    1999-01-01

    To study the acute effect of exposure to a mixture of three commonly used solvents in humans using a route of exposure not involving the nose and lungs, in this case a gastrointestinal application....

  3. ESTIMATED RATE OF FATAL AUTOMOBILE ACCIDENTS ATTRIBUTABLE TO ACUTE SOLVENT EXPOSURE AT LOW INHALED CONCENTRATIONS

    Acute solvent exposures may contribute to automobile accidents because they increase reaction time and decrease attention, in addition to impairing other behaviors. These effects resemble those of ethanol consumption, both with respect to behavioral effects and neurological mecha...

  4. Derivation of plutonium-239 materials disposition categories

    At this time, the Office of Fissile Materials Disposition within the DOE, is assessing alternatives for the disposition of excess fissile materials. To facilitate the assessment, the Plutonium-Bearing Materials Feed Report for the DOE Fissile Materials Disposition Program Alternatives report was written. The development of the material categories and the derivation of the inventory quantities associated with those categories is documented in this report

  5. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults

    Gebistorf, Fabienne; Karam, Oliver; Wetterslev, Jørn;

    2016-01-01

    of INO on mortality at 28 days: 202/587 deaths (34.4%) in the INO group compared with 166/518 deaths (32.0%) in the control group (RR 1.08, 95% CI 0.92 to 1.27; I² statistic = 0%; moderate quality of evidence). In children, there was no statistically significant effects of INO on mortality: 25...... used to improve oxygenation, but its role remains controversial. This Cochrane review was originally published in 2003, and has been updated in 2010 and 2016. OBJECTIVES: The primary objective was to examine the effects of administration of inhaled nitric oxide on mortality in adults and children with...... data and resolved disagreements by discussion. Our primary outcome measure was all-cause mortality. We performed several subgroup and sensitivity analyses to assess the effects of INO in adults and children and on various clinical and physiological outcomes. We presented pooled estimates of the effects...

  6. Ethylene Oxide: Acute Four-Hour and One-Hour Inhalation Toxicity Testing in Rats

    William M. Snellings

    2011-01-01

    Full Text Available Ethylene oxide was tested on groups of rats for either 4-hour or 1-hour inhalation exposure, followed by 14 days of observation. Groups of five Sprague-Dawley rats/sex were exposed, and clinical signs and mortality were recorded. Clinical signs noted included irregular breathing, absence of certain reflexes, and tremors. Rats that died had moderate to severe pulmonary congestion. The calculated LC50 values, reported as ppm by volume (with 95% confidence limits, were as follows. 4-hour LC50 values were 1972 (1887 to 2061 ppm for males; 1537 (1391 to 1698 ppm for females; 1741 (1655 to 1831 ppm for the combined sexes. The 1-hour LC50 values were 5748 (5276 to 6262 ppm for males; 4439 (4034 to 4884 ppm for females; 5029 (4634 to 5459 ppm for the combined sexes.

  7. Computed tomographic criteria as expected effect to inhaled nitric oxide in patients with severe acute respiratory distress syndrome

    Purpose: inhaled nitric oxide (iNO) is an effective therapy for severe hypoxemia in most patients with acute respiratory distress syndrome (ARDS). For unknown reason, a subset of ARDS patients does not respond favorably to iNO therapy. We hypothesized that radiological manifestation of lung injury may be related to iNO response. Materials and methods: we retrospectively analyzed data from n = 25 ARDS patients who received iNO, and underwent chest CT within 72 h prior to inhaled treatment. The morphology of coherently pathologic lung tissue was characterized by the length of the borderline between consolidated, infiltrated and atelectatic lung tissue and radiologically normal lung tissue. This quantity was expressed as relative fraction of the visceral pleural circumference and averaged over all CT slices. Furthermore we semiquantitatively determined the total volume of consolidated lung tissue as part of the whole lung. Results: in n = 6 non-responders to iNO (ΔPaO2 10%), we found significantly less coherently consolidated lung tissue evidenced by an increased relative borderline when compared to iNO non-responders (0.09 ± 0.02 vs. 0.1 ± 0.01; P < 0.05). Moreover, there was a moderate and significant correlation between ΔPaO2 induced by iNO and the relative borderline in all patients studied (R = 0.59; P < 0.05). Total fraction of consolidated lung tissue volume was not different between iNO non-responders and responders (60 ± 3% vs. 54 ± 2% n. s.). Conclusion: our data demonstrate that the gross morphological distribution of pathological lung tissue influences iNO response in ARDS. Inhaled NO was most beneficial in injured lungs characterized by many small consolidated areas surrounded by normal lung tissue. The increased borderline between pathologic and normal lung tissue offers additional possibility for iNO to divert blood flow from shunt areas to ventilated lung regions, which consequently improves arterial oxygenation. (orig.)

  8. INHALATION OF OZONE AND DIESEL EXHAUST PARTICLES (DEP) INDUCES ACUTE AND REVERSIBLE CARDIAC GENE EXPRESSION CHANGES

    We have recently shown that episodic but not acute exposure to ozone or DEP induces vascular effects that are associated with the loss of cardiac mitochondrial phospholipid fatty acids (DEP 2.0 mg/m3 > ozone, 0.4 ppm). In this study we determined ozone and DEP-induced cardiac gen...

  9. Acute relief of exercise-induced bronchoconstriction by inhaled formoterol in children with persistent asthma

    Hermansen, Mette Northman; Nielsen, Kim Gjerum; Buchvald, Frederik;

    2006-01-01

    STUDY OBJECTIVE: To compare the acute bronchodilatory effect of the long-acting beta2-agonist formoterol against the short-acting beta2-agonist (SABA) terbutaline during exercise-induced bronchoconstriction (EIB) in children with asthma. DESIGN: A randomized, double-blind, placebo-controlled, cro......STUDY OBJECTIVE: To compare the acute bronchodilatory effect of the long-acting beta2-agonist formoterol against the short-acting beta2-agonist (SABA) terbutaline during exercise-induced bronchoconstriction (EIB) in children with asthma. DESIGN: A randomized, double-blind, placebo......-controlled, crossover study of the immediate effect of formoterol, 9 microg, vs terbutaline, 0.5 mg, and placebo administered as dry powder at different study days. Exercise challenge test was used as a model of acute bronchoconstriction. PATIENTS: Twenty-four 7- to 15-year-old children with persistent asthma...... dose. RESULTS: Formoterol and terbutaline offered a significant acute bronchodilatory effect from 3 min after dosecompared with placebo (p < 0.001). There was no difference between formoterol and terbutaline in FEV1 5 min after dose (p = 0.15), with a mean increase from each predrug baseline of 62% of...

  10. Adjustment of a direct method for the determination of man body burden in Pu-239 on by X-ray detection of U-235; Mise au point d'une methode directe de determination de la charge corporelle en plutonium 239 chez l'homme par detection X de l'uranium 235

    Boulay, P. [Commissariat a l' Energie Atomique, Bruyeres-le-Chatel (France). Centre d' Etudes

    1968-04-01

    The use of Pu-239 on a larger scale sets a problem about the contamination measurement by aerosol at lung level. A method of direct measurement of Pu-239 lung burden is possible, thanks to the use of a large area window proportional counter. A counter of such pattern, has been especially carried out for this purpose. The adjustment of the apparatus allows an adequate sensibility to detect a contamination at the maximum permissible body burden level. Besides, a method for individual 'internal calibration', with a plutonium mock: the protactinium-233, is reported. (author) [French] L'utilisation a une echelle de plus en plus large du plutonium-239 pose un probleme de la mesure de la contamination par aerosol au niveau du poumon. Une methode de mesure directe de la charge pulmonaire en plutonium-239 est possible grace a l'utilisation d'un compteur proportionnel a fenetre de grande surface. Un compteur de ce type a specialement ete realise dans ce but. La mise au point de l'appareillage permet une sensibilite suffisante pour deceler une contamination au niveau de la Q.M.A (quantite maximale admissible). D'autre part, une methode 'd'etalonnage interne' de l'individu a l'aide d'un simulateur de plutonium, le protactinium-233, est decrite. (auteur)

  11. Acute inhalation of ozone stimulates bronchial C-fibers and rapidly adapting receptors in dogs

    Coleridge, J.C.G.; Coleridge, H.M.; Schelegle, E.S.; Green, J.F. (Univ. of California, Davis (United States) Univ. of California, San Francisco (United States))

    1993-05-01

    To identify the afferents responsible for initiating the vagally mediated respiratory changes evoked by acute exposure to ozone, the authors recorded vagal impulses in anesthetized, open-chest, artificially ventilated dogs and examined the pulmonary afferent response to ozone (2--3 ppM in air) delivered to the lower trachea for 20--60 min. Bronchial C-fibers (BrCs) were the lung afferents most susceptible to ozone, the activity of 10 of 11 BrCs increasing from 0.2 [+-] 0.2 to 4.6 [+-] 1.3 impulses/s within 1--7 min of ozone exposure. Ten of 15 rapidly adapting receptors (RARs) were stimulated by ozone, their activity increasing from 1.5 [+-] 0.4 to 4.7 [+-] 0.7 impulses/s. Stimulation of RARs (but not of BrCs) appeared secondary to the ozone-induced reduction of lung compliance because it was abolished by hyperinflation of the lungs. Ozone had little effect on pulmonary C-fibers or slowly adapting pulmonary stretch receptors. The authors' results suggest that both BrCs and RARs contribute to the tachypnea and bronchoconstriction evoked by acute exposure to ozone when vagal conduction is intact and that BrCs alone are responsible for the vagally mediated tachypnea that survives vagal cooling to 7[degrees]C. 23 refs., 5 figs.

  12. Mimicking exposures to acute and lifetime concentrations of inhaled silver nanoparticles by two different in vitro approaches

    Fabian Herzog

    2014-08-01

    Full Text Available In the emerging market of nano-sized products, silver nanoparticles (Ag NPs are widely used due to their antimicrobial properties. Human interaction with Ag NPs can occur through the lung, skin, gastrointestinal tract, and bloodstream. However, the inhalation of Ag NP aerosols is a primary concern. To study the possible effects of inhaled Ag NPs, an in vitro triple cell co-culture model of the human alveolar/airway barrier (A549 epithelial cells, human peripheral blood monocyte derived dendritic and macrophage cells together with an air–liquid interface cell exposure (ALICE system was used in order to reflect a real-life exposure scenario. Cells were exposed at the air–liquid interface (ALI to 0.03, 0.3, and 3 µg Ag/cm2 of Ag NPs (diameter 100 nm; coated with polyvinylpyrrolidone: PVP. Ag NPs were found to be highly aggregated within ALI exposed cells with no impairment of cell morphology. Furthermore, a significant increase in release of cytotoxic (LDH, oxidative stress (SOD-1, HMOX-1 or pro-inflammatory markers (TNF-α, IL-8 was absent. As a comparison, cells were exposed to Ag NPs in submerged conditions to 10, 20, and 30 µg Ag/mL. The deposited dose per surface area was estimated by using a dosimetry model (ISDD to directly compare submerged vs ALI exposure concentrations after 4 and 24 h. Unlike ALI exposures, the two highest concentrations under submerged conditions promoted a cytotoxic and pro-inflammatory response after 24 h. Interestingly, when cell cultures were co-incubated with lipopolysaccharide (LPS, no synergistic inflammatory effects were observed. By using two different exposure scenarios it has been shown that the ALI as well as the suspension conditions for the lower concentrations after 4 h, reflecting real-life concentrations of an acute 24 h exposure, did not induce any adverse effects in a complex 3D model mimicking the human alveolar/airway barrier. However, the highest concentrations used in the ALI setup, as well

  13. Inhaled hyaluronic acid as ancillary treatment in children with bacterial acute rhinopharyngitis.

    Varricchio, A; Capasso, M; Avvisati, F; Varricchio, A M; De Lucia, A; Brunese, F P; Ciprandi, G

    2014-01-01

    Acute rhinopharyngitis (ARP) is the most common upper respiratory infection in children and represents a social problem for both the pharmaco-economic impact and a burden for the family. Topical antibiotic therapy is usually effective in bacterial ARP, but ancillary treatment might improve its efficacy. Hyaluronic acid (HA) is a promising molecule that has been recently proposed in upper respiratory disorders. Therefore, the purpose of this study was to evaluate the effects of ancillary HA treatment in children with bacterial ARP. Globally, 51 children (27 males, mean age 5.9 ± 2.1 years) with bacterial ARP were enrolled in the study. At baseline, children were randomly assigned to the treatment with: 125 mg of thiamphenicol diluted in 4 mL of saline isotonic solution twice daily (group A) or with 125 mg of thiamphenicol plus 4 ml of sodium hyaluronate 0.2% plus xylitol 5% (Aluneb, Sakura Italia) twice daily (group B) administered by the nasal device Rinowash (Airliquide Medical System, Italy) and connected to an aerosol nebulizer with pneumatic compressor (1.5 bar per 5 L/min) Nebula (Airliquide Medical System, Italy), for 10 days. sVAS, nasopharyngeal spotting, neutrophils and bacteria were assessed at baseline and after the treatment. Both treatments induced significant reduction of symptom perception, spotting, neutrophil and bacteria count. However, thiamphenicol plus HA was able to significantly induce a greater effect on sVAS (p=0.006), neutrophil count (p=0.01), and bacteria count (p=0.0003) than thiamphenicol alone. In conclusion, this study provides the first evidence that intranasal HA, as ancillary treatment, may be able to improve topical antibiotic efficacy in children with bacterial ARP. PMID:25316142

  14. Successful use of inhaled nitric oxide to decrease intracranial pressure in a patient with severe traumatic brain injury complicated by acute respiratory distress syndrome: a role for an anti-inflammatory mechanism?

    Medhkour Azedine; Papadimos Thomas J; Yermal Sooraj

    2009-01-01

    Abstract Use of inhaled nitric oxide in humans with traumatic brain injury and acute respiratory distress syndrome has twice previously been reported to be beneficial. Here we report a third case. We propose that INO may decrease the inflammatory response in patients with increased intracranial pressure caused by traumatic brain injury accompanied by acute respiratory distress syndrome thereby contributing to improved outcomes.

  15. A critical role of acute bronchoconstriction in the mortality associated with high-dose sarin inhalation: Effects of epinephrine and oxygen therapies

    Sarin is an organophosphate nerve agent that is among the most lethal chemical toxins known to mankind. Because of its vaporization properties and ease and low cost of production, sarin is the nerve agent with a strong potential for use by terrorists and rouge nations. The primary route of sarin exposure is through inhalation and, depending on the dose, sarin leads to acute respiratory failure and death. The mechanism(s) of sarin-induced respiratory failure is poorly understood. Sarin irreversibly inhibits acetylcholine esterase, leading to excessive synaptic levels of acetylcholine and, we have previously shown that sarin causes marked ventilatory changes including weakened response to hypoxia. We now show that LD50 sarin inhalation causes severe bronchoconstriction in rats, leading to airway resistance, increased hypoxia-induced factor-1α, and severe lung epithelium injury. Transferring animals into 60% oxygen chambers after sarin exposure improved the survival from about 50% to 75% at 24 h; however, many animals died within hours after removal from the oxygen chambers. On the other hand, if LD50 sarin-exposed animals were administered the bronchodilator epinephrine, > 90% of the animals survived. Moreover, while both epinephrine and oxygen treatments moderated cardiorespiratory parameters, the proinflammatory cytokine surge, and elevated expression of hypoxia-induced factor-1α, only epinephrine consistently reduced the sarin-induced bronchoconstriction. These data suggest that severe bronchoconstriction is a critical factor in the mortality induced by LD50 sarin inhalation, and epinephrine may limit the ventilatory, inflammatory, and lethal effects of sarin. - Highlights: • Inhalation exposure of rats to LD50 sarin causes death through respiratory failure. • Severe bronchoconstriction is the major cause of sarin-induced respiratory failure. • Transfer of sarin exposed rats to 60% oxygen improves the mortality temporarily. • Epinephrine improves

  16. Inhalation Injury

    Coşkun Araz; Arash Pirat

    2011-01-01

    Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three...

  17. 40 CFR 798.2450 - Inhalation toxicity.

    2010-07-01

    ... CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Subchronic Exposure § 798.2450 Inhalation... initial information on toxicity has been obtained by acute testing. The subchronic inhalation study has... daily exposure of experimental animals to a chemical by inhalation for part (approximately 10...

  18. Inhalant Abuse

    ... she is likely to try other kinds of drugs, especially alcohol and marijuana. Symptoms How can I tell if my child is abusing inhalants? It can be hard to recognize the signs of inhalant abuse. Teenagers who use inhalants may have some of the ...

  19. NMR-based metabolomics to determine acute inhalation effects of nano- and fine-sized ZnO particles in the rat lung.

    Lee, Sheng-Han; Wang, Ting-Yi; Hong, Jia-Huei; Cheng, Tsun-Jen; Lin, Ching-Yu

    2016-09-01

    Zinc oxide (ZnO) particles induce acute occupational inhalation illness in humans and rats. However, the possible molecular mechanisms of ZnO particles on the respiratory system remain unclear. In this study, metabolic responses of the respiratory system of rats inhaled ZnO particles were investigated by a nuclear magnetic resonance (NMR)-based metabolomic approach. Male Sprague-Dawley rats were treated with a series of doses of nano-sized (35 nm) or fine-sized (250 nm) ZnO particles. The corresponding control groups inhaled filtered air. After 24 h, bronchoalveolar lavage fluid (BALF) and lung tissues were collected, extracted and prepared for (1)H and J-resolved NMR analysis, followed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). PCA and PLSDA models from analysis of BALF and hydrophilic lung NMR spectra demonstrated that dose response trends were restricted to the 250 nm ZnO particle exposure group and were not observed in the 35 nm ZnO particle exposure group. Increased isoleucine and valine, as well as decreased acetate, trimethylamine n-oxide, taurine, glycine, formate, ascorbate and glycerophosphocholine, were recorded in the BALF of rats treated with moderate and high dose 250 nm ZnO exposures. Decreases in taurine and glucose, as well as an increase of phosphorylcholine-containing lipids and fatty acyl chains, were detected in the lung tissues from 250 nm ZnO-treated rats. These metabolic changes may be associated with cell anti-oxidation, energy metabolism, DNA damage and membrane stability. We also concluded that a metabolic approach provides more complete measurements and suggests potential molecular mechanisms of adverse effects. PMID:27245357

  20. Potentiated interaction between ineffective doses of budesonide and formoterol to control the inhaled cadmium-induced up-regulation of metalloproteinases and acute pulmonary inflammation in rats.

    Wenhui Zhang

    Full Text Available The anti-inflammatory properties of glucocorticoids are well known but their protective effects exerted with a low potency against heavy metals-induced pulmonary inflammation remain unclear. In this study, a model of acute pulmonary inflammation induced by a single inhalation of cadmium in male Sprague-Dawley rats was used to investigate whether formoterol can improve the anti-inflammatory effects of budesonide. The cadmium-related inflammatory responses, including matrix metalloproteinase-9 (MMP-9 activity, were evaluated. Compared to the values obtained in rats exposed to cadmium, pretreatment of inhaled budesonide (0.5 mg/15 ml elicited a significant decrease in total cell and neutrophil counts in bronchoalveolar lavage fluid (BALF associated with a significant reduction of MMP-9 activity which was highly correlated with the number of inflammatory cells in BALF. Additionally, cadmium-induced lung injuries characterized by inflammatory cell infiltration within alveoli and the interstitium were attenuated by the pre-treatment of budesonide. Though the low concentration of budesonide (0.25 mg/15 ml exerted a very limited inhibitory effects in the present rat model, its combination with an inefficient concentration of formoterol (0.5 mg/30 ml showed an enhanced inhibitory effect on neutrophil and total cell counts as well as on the histological lung injuries associated with a potentiation of inhibition on the MMP-9 activity. In conclusion, high concentration of budesonide alone could partially protect the lungs against cadmium exposure induced-acute neutrophilic pulmonary inflammation via the inhibition of MMP-9 activity. The combination with formoterol could enhance the protective effects of both drugs, suggesting a new therapeutic strategy for the treatment of heavy metals-induced lung diseases.

  1. Primary pulmonary sarcoma in a rhesus monkey after inhalation of plutonium dioxide

    A pulmonary fibrosarcoma of bronchial origin was discovered in a Rhesus monkey that died of pulmonary fibrosis 9 years after inhalation of plutonium-239 dioxide and with a radiation dose to lung of 1400 rad (14 Gy). It grew around the major bronchus of the right cardiac lung lobe and extended into the bronchial lumen and into surrounding pulmonary parenchyma. It also readily invaded muscular pulmonary arteries, resulting in infarction and scarring in the right cardiac lobe. Despite this aggressive growth, the tumor did not metastasize. The primary cause of death was severe pulmonary fibrosis involving the alveolar septa and and perivascular and peribronchial interstitium. Bullous or pericitrical emphysema was prominent. The initial lung burden of plutonium in this monkey was 270 nCi (10 kBq) which is equivalent to approximately 500 times the maximum permissible lung burden for man on a radioactivity per unit body weight basis. The time-dose relationship for survival is consistent with that of dogs and baboons that inhaled plutonium dioxide and died with lung tumors

  2. Pulmonary sarcoma in a Rhesus monkey after inhalation of plutonium dioxide

    A pulmonary fibrosarcoma of bronchial origin was discovered in a Rhesus monkey that died of pulmonary fibrosis nine years after inhalation of plutonium-239 dioxide. The tumor was well delineated but not encapsulated. It grew around the major bronchus of the right cardiac lung lobe and extended into the bronchial lumen and into surrounding pulmonary parenchyma. It also readily invaded muscular arteries, resulting in infarction and scarring in the right cardiac lobe. Despite this aggressive growth, the tumor did not metastasize. The primary cause of death was severe pulmonary fibrosis involving the alveolar septa and perivascular and peribronchial interstitium. Bullous or pericitrical emphysema was prominent. The initial lung burden of plutonium in this monkey was 270 nCi. This burden is equivalent to approx. 500 times the maximum permissible lung burden for man. The time-dose relationship for survival is consistent with that of dogs and baboons that inhaled plutonium dioxide, thus further strengthening the extrapolation of plutonium toxicity data from one species to another. 4 references, 3 figures, 1 table

  3. The effect of oxidation state on the absorption of ingested or inhaled plutonium

    The absorption of plutonium-239 either by gavage or inhalation was compared in fasting and nonfasting rats. It was shown that when Pu-239 in its hexavalent state was administered intragastrically, feeding reduced absorption from the gastrointestinal tract 18-fold and the combination of feeding and elimination of dichromate from the solution reduced it about 26-fold. Results obtained by exposing rats to aerosols of either Pu-239 in its quadrivalent state or in its hexavalent state indicated that there was increased retention of plutonium after exposure to hexavalent Pu-239 in comparison to quadrivalent Pu-239. The absence of food either before, or both before and after inhalation exposure had no effect on the amount of Pu-239 retained by the liver and carcass. Chlorine, at the concentrations found in municipal water supplies, can oxidize quadrivalent plutonium to its hexavalent state. Thus since the absorption of hexavalent Pu from the lung is higher than that of quadrivalent Pu, these facts should be taken into account in the calculation of the maximum permissible concentration of Pu-239 in drinking water. (U.K.)

  4. Comparação do corticoide inalatório e oral no tratamento da disfonia aguda Use of inhaled versus oral steroids for acute dysphonia

    Andréa Moreira Veiga de Souza

    2013-04-01

    Full Text Available A disfonia aguda é um quadro comum na prática clínica. Seu tratamento, principalmente em adultos, não é bem definido na literatura. O corticoide é o tratamento medicamentoso mais recomendado. Os estudos existentes, entretanto, não são suficientes para a determinação da superioridade entre diferentes corticoides e a melhor forma de administração. OBJETIVO: Este estudo clínico prospectivo teve como objetivo comparar o efeito do corticoide inalatório na forma de pó seco com o efeito do corticoide oral, no tratamento da disfonia aguda. MÉTODO: Foram avaliados 32 pacientes adultos, divididos em dois grupos de 16 pacientes para cada um dos tratamentos, antes e após sete dias do uso da medicação. Os pacientes foram submetidos à videolaringosocpia e avaliação perceptiva e acústica da voz. RESULTADOS: O tratamento inalatório e oral reduziram significativamente a hiperemia, o edema e melhorou o movimento muco-ondulatório; entretanto, a redução do edema foi estatisticamente mais significativa (p = 0,012 nos pacientes tratados com a forma inalatória. A comparação dos valores da análise perceptiva auditiva e das medidas acústicas após tratamento entre os grupos, entretanto, não apresentou significância estatística. CONCLUSÃO: Houve melhora significativa da laringite aguda nas avaliações realizadas, em todos os pacientes estudados, com os dois tratamentos. O tratamento com corticoide inalatório foi significativamente mais efetivo na redução do edema.Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. OBJECTIVE: This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to

  5. Lack of acute phase response in the livers of mice exposed to diesel exhaust particles or carbon black by inhalation

    Saber, Anne T; Halappanavar, Sabina; Folkmann, Janne K;

    2009-01-01

    phase responses, including C-reactive protein (CRP) and serum amyloid A (SAA) in humans. In this study we test the hypothesis that diesel exhaust particles (DEP) - or carbon black (CB)-induced lung inflammation initiates an acute phase response in the liver. RESULTS: Mice were exposed to filtered air...... pulmonary inflammation., Arch. Toxicol. 79 (2005) 177-182). As a positive control for the induction of an acute phase response, mice were exposed to 12.5 mg/kg of lipopolysaccharide (LPS) intraperitoneally. Quantitative real time RT-PCR was used to examine the hepatic mRNA expression of acute phase proteins......, serum amyloid P (Sap) (the murine homologue of Crp) and Saa1 and Saa3. While significant increases in the hepatic expression of Sap, Saa1 and Saa3 were observed in response to LPS, their levels did not change in response to DEP or CB. In a comprehensive search for markers of an acute phase response, we...

  6. Comparison of efficacy combination of inhaled phormoterol / budesonide turbuhaler vs. combination of nebulized salbutamol / ipratropium bromide on moderate asthma acute exacerbation in Persahabatan Hospital

    Zulkarnain Barasila

    2006-03-01

    Full Text Available The aim of this study was to compare efficacy combination of phormoterol/budesonide turbuhaler vs. salbutamol/ipratropium bromide nebulization. Main therapy for acute asthma is inhaled short acting β2-agonist. Asthma patients are using two drugs, controller and reliever. Recently there is device-containing combination of long-acting β2-agonist with rapid onset and corticosteroid. This combination can act as reliever and controller. An opened randomized clinical trial of 76 patients between the ages of 12 and 60 years presenting to Persahabatan Hospital with asthma score between 8-12 participated in this study. After initial evaluation, patients were divided into two groups. Thirty-eight patients were administered combination of formoterol/budesonide 4.5/160 µg via turbuhaler (T-group every 20 minutes, total of three doses, and another 38 of salbutamol/ipratropium bromide 2.5/0.25 mg via nebulizer (N-group also with the same manner. There were no statistical difference in sex, mean age, high, weight, initial PEFR, and asthma score between two groups. The significant increased of PEFR and decreased of asthma score were observed in both groups. However, there were no significant difference of PEFR and asthma score between the two groups within every time-interval. Adverse events were mild including hoarseness, tremor and palpitation. Of T-group, 1 subject was suffered from 3 adverse events simultaneously (hoarseness, tremor and palpitation, 5 subjects were only tremor. Of N-group, all 6 subjects were only suffered from tremor. A combination of formoterol/budesonide turbuhaler and a combination of nebulized salbutamol/ipratropium bromide are clinically equivalent for treatment moderate acute asthma. However, nebulized salbutamol/ipratropium bromide had less adverse effects. (Med J Indones 2006; 15:34-42Keywords: phormoterol, budesonide, salbutamol, ipratropium bromide, acute asthma

  7. Heliox as a driving gas to atomize inhaled drugs on acute exacerbation of chronic obstructive pulmonary disease: a prospective clinical study

    Xiao Yongjiu; Su Longxiang; Han Bingchao; Zhang Xin; Xie Lixin

    2014-01-01

    Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common condition,which affects not only the quality of life of patients but also their prognosis.The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.Methods Twenty-three patients with AECOPD were divided into a treatment group (He/O2=70%/30%) and a control group (N2/O2=70%/30%).The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days.Vital signs,arterial blood gas levels,pulmonary function and the levels of serum myostatin (sMSTN) were measured and lung vibration imaging was performed.Results We found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points (P >0.05).There were also no significant differences in any of the parameters of pulmonary function between the two groups.However,after baseline correction,the increase rate of the forced expiratory volume in one second (FEV1),the forced vital capacity (FVC),and the maximum minute ventilation (MW) appeared to be significantly increased at some time points compared with the baseline (before treatment) in both groups (P <0.05).Although the values of quantitative lung distribution (QLD) for different regions and the levels of sMSTN were slightly different between the two groups,the repeated measures analysis of variance (ANOVA) revealed that there were no significant differences between the two groups or within any group (P >0.05).Conclusion Although the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD,the heliox treatment group did not have significant differences in arterial blood gases,lung function,lung vibration response imaging or the levels of sMSTN compared with the control group.(Chinese Clinical Trial Register Center

  8. Acute inhalation of 2,2,4-trimethylpentane alters visual evoked potentials and signal detection behaviour of rats.

    The volatile organic compound 2,2,4-trimethylpentane (TMP, “isooctane”) is a primary constituent of gasoline for which the current health effects data are insufficient to permit EPA to conduct a risk assessment. We evaluated potential neurological impairment from acute inhalati...

  9. Acrolein Inhalation Suppresses Lipopolysaccharide-Induced Inflammatory Cytokine Production but Does Not Affect Acute Airways Neutrophilia1

    Kasahara, David Itiro; Poynter, Matthew E.; Othman, Ziryan; Hemenway, David; van der Vliet, Albert

    2008-01-01

    Acrolein is a reactive unsaturated aldehyde that is produced during endogenous oxidative processes and is a major bioactive component of environmental pollutants such as cigarette smoke. Because in vitro studies demonstrate that acrolein can inhibit neutrophil apoptosis, we evaluated the effects of in vivo acrolein exposure on acute lung inflammation induced by LPS. Male C57BL/6J mice received 300 μg/kg intratracheal LPS and were exposed to acrolein (5 parts per million, 6 h/day), either befo...

  10. Acute systemic accumulation of acrolein in mice by inhalation at a concentration similar to that in cigarette smoke

    Tully, Melissa; Zheng, Lingxing; Acosta, Glen; Tian, Ran; Shi, Riyi

    2014-01-01

    Cigarette smoke is an important environmental factor associated with a wide array of public health concerns. Acrolein, a component of tobacco smoke and a known toxin to various cell types, may be a key pathological factor mediating the adverse effects linked with tobacco smoke. Although acrolein is known to accumulate in the respiratory system after acute nasal exposure, it is not clear if it accumulates systemically, and less is known in the nervous system. The aim of this study was to asses...

  11. Lack of acute phase response in the livers of mice exposed to diesel exhaust particles or carbon black by inhalation

    Williams Andrew; Møller Peter; Boisen Anne; Bornholdt Jette; Folkmann Janne K; Halappanavar Sabina; Saber Anne T; Yauk Carole; Vogel Ulla; Loft Steffen; Wallin Håkan

    2009-01-01

    Abstract Background Epidemiologic and animal studies have shown that particulate air pollution is associated with increased risk of lung and cardiovascular diseases. Although the exact mechanisms by which particles induce cardiovascular diseases are not known, studies suggest involvement of systemic acute phase responses, including C-reactive protein (CRP) and serum amyloid A (SAA) in humans. In this study we test the hypothesis that diesel exhaust particles (DEP) – or carbon black (CB)-induc...

  12. Medical countermeasure against respiratory toxicity and acute lung injury following inhalation exposure to chemical warfare nerve agent VX

    To develop therapeutics against lung injury and respiratory toxicity following nerve agent VX exposure, we evaluated the protective efficacy of a number of potential pulmonary therapeutics. Guinea pigs were exposed to 27.03 mg/m3 of VX or saline using a microinstillation inhalation exposure technique for 4 min and then the toxicity was assessed. Exposure to this dose of VX resulted in a 24-h survival rate of 52%. There was a significant increase in bronchoalveolar lavage (BAL) protein, total cell number, and cell death. Surprisingly, direct pulmonary treatment with surfactant, liquivent, N-acetylcysteine, dexamethasone, or anti-sense syk oligonucleotides 2 min post-exposure did not significantly increase the survival rate of VX-exposed guinea pigs. Further blocking the nostrils, airway, and bronchioles, VX-induced viscous mucous secretions were exacerbated by these aerosolized treatments. To overcome these events, we developed a strategy to protect the animals by treatment with atropine. Atropine inhibits muscarinic stimulation and markedly reduces the copious airway secretion following nerve agent exposure. Indeed, post-exposure treatment with atropine methyl bromide, which does not cross the blood-brain barrier, resulted in 100% survival of VX-exposed animals. Bronchoalveolar lavage from VX-exposed and atropine-treated animals exhibited lower protein levels, cell number, and cell death compared to VX-exposed controls, indicating less lung injury. When pulmonary therapeutics were combined with atropine, significant protection to VX-exposure was observed. These results indicate that combinations of pulmonary therapeutics with atropine or drugs that inhibit mucous secretion are important for the treatment of respiratory toxicity and lung injury following VX exposure

  13. Inhalational Lung Disease

    S Kowsarian

    2010-01-01

    Full Text Available Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become apparent several years after exposure to the particles. However, for certain types of dusts, e.g., silicone dioxide crystal and beryllium, heavy exposure within a short period can cause an acute disease. Pulmonary involvement in asbestosis is usually in the lower lobes. On the contrary, in silicosis and coal worker pneumoconiosis, the upper lobes are involved predominantly. For imaging evaluation of pneumoconiosis, high-resolution computed tomography (CT is superior to conventional chest x-ray. Magnetic resonance imaging (MRI and positron emission tomography (PET scan are helpful in those with suspected tumoral lesions. In this essay, we reviewed the imaging aspects of inhalational lung disease.

  14. Inhalation Injury

    Coşkun Araz

    2011-07-01

    Full Text Available Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three types of injury: thermal injury, which is mostly restricted to the upper airway; chemical injury, which affects tracheobronchial tree; and systemic toxicity owing to toxic gases such as carbon monoxide. Inhalation injury increases the burn injury associated morbidity and mortality by causing airway problems and respiratory failure during the early phase and by contributing to the development of pneumonia and atelectasis during the late phase. Additionally, systemic effects of toxic gases such as carbon monoxide may also adversely affect the early and long-term outcome in burn victims. The early diagnosis and therapy of these problems plays a key role in improving the outcome of burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 37-45

  15. Nursing Experience of Acute and Chronic Pharyngitis Treated by Atomization Inhalation%雾化吸入治疗急慢性咽喉炎的护理体会

    许欢

    2016-01-01

    ObjectiveTo analyze the nursing experience of acute and chronic pharyngitis treated by aerosol inhalation.Methods32 cases of acute and chronic pharyngitis patients admitted to our hospital from May 2014 to May 2015 were selected as the study subjects. Al patients were given aerosol inhalation treatment and nursing intervention.Results After atomization inhalation treatment and nursing intervention,32 patients with acute and chronic pharyngitis were cured in 18 cases,markedly effective in 7 cases,effective in 5 cases,ineffective in 2 cases,the total effective rate was 93.75%. Conclusion In the treatment of patients with acute and chronic pharyngitis,using clinical nursing intervention can improve the effectiveness of treatment and promote the rehabilitation of patients.%目的:浅析雾化吸入治疗急慢性咽喉炎的护理体会。方法选取2014年5月~2015年5月我院收治的急慢性咽喉炎患者32例为本次研究对象,所有患者均给予雾化吸入治疗和护理干预,观察患者临床护理效果。结果经雾化吸入治疗和护理干预后,32例急慢性咽喉炎患者中痊愈18例,显效7例,有效5例,无效2例,总有效率为93.75%。结论针对采用雾化吸入治疗急慢性咽喉炎的患者,给予有效的临床护理干预,可提高治疗有效性,促进患者康复。

  16. Inhalation Injuries

    ... increase mortality 30% to 40% when patients with cutaneous burns and inhalation injury are compared with patients ... nasal hairs • Facial burns • Burns around the mouth • Mineral spirits – 104º F – paint thinner, brush cleaner. • Redness, ...

  17. Biological effect of plutonium 239 on Salmonella typhimurium

    Salmonella typhimurium cells were exposed in a 239Pu citrate solution. Cell death and induction of gene mutations were an exponential fucntion of γ-radiation dose. LD37 was 34.8 Gy; mutation doubling dose, 19 Gy

  18. The risk of bone sarcoma from plutonium-239

    It is postulated that the risk of bone sarcoma induction by 239Pu in humans can be quantitated from a consideration of the well-documented induction of bone sarcomas by sup(226,228)Ra. The basic assumption is that the risk of this malignancy is a function of the energy deposited by alpha particles in the layer of cells adjacent to bone surfaces. From calculations of the energy delivered to this cellular layer by bone-deposited 239Pu and 226Ra the ratio of the systemic intakes required to produce equal bone-cell doses is obtained. A dose-response relationship of the form I = βD2esup(-γD) was found to provide the best fit to the observed bone-sarcoma incidence for female radium dial workers, where I was the number of bone sarcomas per person x year of risk and D was the quantity of radium that entered the systemic circulation. It is proposed that such an expression, modified for the energy effectiveness of plutonium compared with radium, provides the best estimate of the risk of induction of bone sarcomas by 239Pu. The derived risk estimate is tested by comparing its predictions of bone sarcomas in two groups of people carrying known body burdens of plutonium. The predictions are not contradicted by the lack of any observed bone sarcomas in either the 27 workers exposed at Los Alamos during World War II, or in the 18 seriously ill cases injected with plutonium in 1945-47. Its form permits an immediate evaluation of the risk at any level of intake. (author)

  19. Fission yields in the thermal neutron fission of plutonium-239

    Fission yields for 27 mass numbers were determined in the thermal neutron fission of 239Pu using high resolution gamma ray spectrometry and radiochemical method. The results obtained using gamma ray spectrometry and from the investigations on the fission yield of 99Mo using radiochemical method were reported earlier. These data along with fission yields for 19 mass numbers determined using radiochemical method formed a part of Ph.D. thesis. The data given here are a compilation of all the results and are presented considering the neutron temperature correction to 239Pu fission cross-section which is used for calculating the total number of fissions in these studies. A comparison is made of the resulting fission yield values with the latest experimentally determined values and those given in two recent compilations. (author)

  20. A basic study on molecular hydrogen (H2 inhalation in acute cerebral ischemia patients for safety check with physiological parameters and measurement of blood H2 level

    Ono Hirohisa

    2012-08-01

    Full Text Available Abstract Background In animal experiments, use of molecular hydrogen ( H2 has been regarded as quite safe and effective, showing benefits in multiple pathological conditions such as ischemia-reperfusion injury of the brain, heart, kidney and transplanted tissues, traumatic and surgical injury of the brain and spinal cord, inflammation of intestine and lung , degenerative striatonigral tissue and also in many other situations. However, since cerebral ischemia patients are in old age group, the safety information needs to be confirmed. For the feasibility of H2 treatment in these patients, delivery of H2 by inhalation method needs to be checked for consistency. Methods Hydrogen concentration (HC in the arterial and venous blood was measured by gas chromatography on 3 patients, before, during and after 4% (case 1 and 3% (case2,3 H2 gas inhalation with simultaneous monitoring of physiological parameters. For a consistency study, HC in the venous blood of 10 patients were obtained on multiple occasions at the end of 30-min H2 inhalation treatment. Results The HC gradually reached a plateau level in 20 min after H2 inhalation in the blood, which was equivalent to the level reported by animal experiments. The HC rapidly decreased to 10% of the plateau level in about 6 min and 18 min in arterial and venous blood, respectively after H2 inhalation was discontinued. Physiological parameters on these 3 patients were essentially unchanged by use of hydrogen. The consistency study of 10 patients showed the HC at the end of 30-min inhalation treatment was quite variable but the inconsistency improved with more attention and encouragement. Conclusion H2 inhalation of at least 3% concentration for 30 min delivered enough HC, equivalent to the animal experiment levels, in the blood without compromising the safety. However, the consistency of H2 delivery by inhalation needs to be improved.

  1. Broncodilatadores en la crisis asmática: ¿Aerosol o nebulización? Bronchodilators in acute asthma: metered dose inhalers or wet nebulizations?

    Dora M. Lombardi

    2006-12-01

    Full Text Available El número de consultas por asma aguda en el Hospital María Ferrer ha aumentado de 3300 consultas anuales en 1980 a 15364 en 2002. Los broncodilatadores de acción corta (salbutamol-ipratropio en nebulizaciones, procedimiento que consume tiempo y recursos humanos, eran el tratamiento inicial en 2002. Para tratar de mejorar el cumplimiento del tratamiento frente al aumento de la demanda, se reemplazaron las nebulizaciones por aerosoles dosificadores. El objetivo de este estudio es evaluar el impacto de este cambio. Comparamos 90 pacientes con crisis asmática tratados con aerosoles en diciembre del 2003 con igual número tratados con nebulizaciones en diciembre del 2002 pareados por sexo, edad, altura, VEF1 teórico y de ingreso. Con aerosoles se observó una reducción significativa del tiempo de permanencia en el Departamento de Emergencia (mediana 3 h (2-4.75 versus 4 h (1-6 p=0.01 y un número mayor de altas en las primeras 2 horas (48% vs. 31% p=0.03. Los pacientes tratados con aerosol recibieron el 87% de las dosis prescriptas, mientras que el otro grupo recibió sólo el 38%. El VEF1 mostró una tendencia a ser mayor al egreso en el grupo que recibió aerosoles, pero la diferencia no fue estadísticamente significativa (78% ± 17% vs. 73% ± 17% p=0.09. El porcentaje de alta final fue similar en los dos grupos (96% vs. 93%. El tratamiento con aerosoles produjo una mejoría más rápida y mejor cumplimiento de las normas de tratamiento indicadas.The number of patients attending our Emergency Department (ED with acute asthma has increased from 3300 patient/year in 1980 to 15364 in 2003. Short acting bronchodilators (albuterol/ipratropium administered in wet nebulizations, a resource consuming procedure, were our main initial treatment in 2002. To improve treatment goals, we switched the method of bronchodilator delivery to metered dose inhalers (MDI in 2003. The purpose of this study is to evaluate the impact of this change in the

  2. Shu Pulmicort Order inhalation therapy in children with acute laryngeal-tracheal-bronchiolitis%普米克令舒雾化吸入治疗小儿急性喉-气管-支气管炎疗效观察

    李晓云

    2009-01-01

    Objective To observe the efficacy of Shu Pulmicort order inhalation therapy in children with acute laryngeal-tracheal-bronchitis treatment.Methods 48 cases of acute laryngeal-tracheal-bronchitis were randomly divided into two groups.Based on the comprehensive treatment,the treatment group was given the Shu pulmicort inhalation while in the control group given dexamethasone inhalation.The efficacy of the two groups was compared.Results Clinical control of the outcome of the treatment group and the total effective rate was superior to the control group (P<0.001).Conclusion Because of the direct effect of drugs partial airway disease,rapid effect,anti-inflammatory effects,and less adverse reactions,Shu inhalation pulmicort order treatment of children with acute laryngeal-tracheal-bronchitis can significandy promote the symptoms and shorten the course of disease.So it is worth to be applied.%目的 观察普米克令舒雾化吸入治疗小儿急性喉-气管-支气管炎的疗效.方法 将48例急性喉-气管-支气管炎患儿随机分成两组,两组均在综合治疗基础上,治疗组用普米克令舒雾化吸入,对照组给予地塞米松雾化吸入,比较两组疗效.结果 治疗组临床控制及总有效率明显优于对照组(P<0.001).结论 普米克令舒雾化吸入治疗小儿急性喉-气管-支气管炎,因药物直接作用气道病变局部,起效快、抗炎作用强、不良反应少,可明显促进症状缓解,缩短病程,值得推广应用.

  3. Therapeutic Effect of Budesonide Inhalation on Acute Infectious Laryngitis and Bronchitis%布地奈德吸入治疗急性喉炎、喉气管支气管炎疗效观察

    韩明达

    2015-01-01

    目的:分析探讨布地奈德吸入治疗急性喉炎、喉气管支气管炎症的临床效果。方法选取88例患有急性喉炎、喉气管支气管炎的患者作为研究对象,将其随机分成对照组和观察组,每组44例患者。对照组患者采用地塞米松静脉注射进行治疗,观察者则采取布地奈德雾化吸入进行治疗;治疗结束后,对比两组患者的治疗效果。结果采取布地奈德雾化吸入治疗的观察组患者在治疗效果及症状缓解上明显优于对照组,P<0.05,差异具有统计学意义。结论采用布地奈德雾化吸入治疗急性喉炎、喉气管支气管炎具有显著的治疗效果,患者症状能够得到迅速恢复。%Objective To explore the clinical effect analysis of budesonide inhalation in the treatment of acute laryngitis, bronchitis disease. Methods 88 cases with acute laryngitis, bronchitis of children as the research object, and were randomly separated into the observation group and the control group, 44 cases in each group of patients. The control group was treated with intravenous dexamethasone treatment, observers take budesonide inhalation treatment,in the end of the treatment, compared two groups of patients with treatment effect.Results Take budesonide atomization inhalation treatment observation group patients in the treatment and remission of symptoms signiifcantly better than the control group,P<0.05,with significant difference.Conclusion Inhalation in the treatment of acute laryngitis, bronchitis has signiifcant therapeutic effect of budesonide in children with symptoms, can be quickly restored.

  4. [Inhalation of nitric oxide - dependence: case report

    Carvalho, W B; Matsumoto, T; Horita, S M; Almeida, N M; Martins, F R

    2000-01-01

    OBJECTIVE: Describe the hemodynamic response with rebound of pulmonary hypertension after withdrawal of inhaled nitric oxide (NO) in a pediatric patient with acute respiratory distress syndrome (ARDS). METHODS: Case report of a child with ARDS and pulmonary hypertension evaluated through ecocardiografic with dopller, receiving inhaled NO for a period of 21 days. RESULTS: There was a decrease of the pulmonary artery pressure (PAP) from 52 mmHg to 44 mmHg after the initial titulation of NO inhalation dose. After the withdrawal of inhaled NO an elevation of PAP was observed (55 mmHg). It was necessary to reinstall the inhaled NO to obtain a more appropriate value (34 mmHg). A new attempt of interruption of the inhaled NO after prolonged inhalation (20 days) resulted in a new clinic worsening and increase of PAP, with the indication to reinstall the inhaled NO. In the 24th day of permanence in the intensive care unit the patient died due to multiple organ dysfunction. CONCLUSIONS: The possibility of pulmonary hypertension rebound after withdrawal of inhaled NO is a complication that may have important clinical implications for patients who need a prolonged treatment with NO. This case report emphasizes these implications. PMID:14647690

  5. 3,5,4'-Tri-O-acetylresveratrol decreases seawater inhalation-induced acute lung injury by interfering with the NF-κB and i-NOS pathways.

    Ma, Lijie; Chen, Xiangjun; Wang, Ruixuan; Duan, Hongtao; Wang, Libin; Liang, Li; Nan, Yandong; Liu, Xueying; Liu, Ao; Jin, Faguang

    2016-01-01

    Drowning is a cause of accidental mortality. However, survival may result in acute lung injury. The aim of the present study was to evaluate the effects of 3,5,4'-tri-O-acetylresveratrol (AC-Res) on acute lung injury (ALI) induced by seawater inhalation in rats. ALI models were established by the tracheal instillation of artificial seawater with or without 50 mg/kg AC-Res pretreatment for 7 days. Lung samples from different groups were harvested 4 h after the model was established. Histological changes, blood vessel permeability, inflammatory factor secretion and expression states of the nuclear factor-κB (NF-κB) and inducible NOS (i-NOS) pathway were assessed to evaluate seawater‑induced lung injury and the protective effects of acetylated resveratrol. The results showed that seawater inspiration led to physiological structure changes and an increased permeability of blood vessels. In addition, seawater stimulation enhanced the expression levels of nitric oxide (NO), tumor necrosis factor α (TNF-α) and interleukin-1 β (IL-1β) secretion in vitro and in vivo. Notably, seawater inhalation increased NF-κB and i-NOS expression in lungs and cells. On the other hand, pretreatment of AC-Res inhibited the abnormal expression of the NF-κB and i-NOS pathways, followed by decreased NO, TNF-α and IL-1β secretion, protein and cell content in bronchoalveolar lavage fluid (BALF) and Evans blue, protein and cell infiltration from blood vessels into lung tissues. The results therefore suggest that AC-Res attenuated seawater inhalation induced‑ALI by interfering with the NF-κB and i-NOS pathways. PMID:26573555

  6. Inalação contínua com fenoterol na criança com asma aguda grave: efeitos clínicos imediatos Continuous fenoterol inhalation by children with severe acute asthma: immediate clinical effects

    Lourdes Z. Zanoni

    2002-09-01

    Full Text Available Objetivos: avaliar as alterações da freqüência cardíaca, da pressão arterial, do psiquismo e da saturação arterial de oxigênio, após a inalação contínua com fenoterol, na criança com asma aguda grave. Casuística e Métodos: foram estudados 30 pacientes com asma aguda grave, atendidos no PAM-Pediatria do Hospital Universitário - UFMS. Os pacientes receberam inalação contínua durante uma hora, com 0,5 mg/kg (2 gotas/kg de fenoterol. O psiquismo, a saturação arterial de oxigênio, a freqüência cardíaca e a pressão arterial foram avaliados antes, imediatamente após, e uma hora após a inalação com fenoterol. Resultados: 17 crianças eram do sexo masculino (56,6%, e 13 do sexo feminino (43,4%. Foi observado sonolência em 16 (53,3%, agitação psicomotora em 1 (3,3%, náusea e vômito em 12 pacientes (40%. A média da saturação arterial de oxigênio aumentou de 90,9 2,8% para 92,7 2,5% (pObjective: to evaluate the alterations of heart rate, blood pressure, psychological aspects and oxygen saturation after continuous fenoterol inhalation (0.5 mg/Kg by children with severe acute asthma. Methods: we studied 30 patients with severe acute asthma who were treated at the pediatric ward of Hospital Universitário - UFMS. The patients inhaled 0.5 mg/Kg of fenoterol (two drops/Kg during one hour. Psychological aspects, oxygen arterial saturation, heart rate and blood pressure were evaluated at three different moments: before, after and one hour after the fenoterol inhalation. Results: there were 17 males (56.6% and 13 females (43.4%. Sleepiness was observed in 16 (53.3%, psychomotor agitation in one (33% and nausea and vomiting in 12 patients (40%. The average of oxygen arterial saturation increased from 90.9 ± 2.8% to 92.7 ± 2.5% (P<0.05 after inhalation. There was statistically significant increase in the average heart rate before and after inhalation (139.5 ± 13.5 beats/min, 166.5 ± 11.1 beats/min, respectively, P<0.05. A

  7. Inhaling to mitigate exhaled bioaerosols

    Edwards, David A.; Man, Jonathan C.; Brand, Peter; Katstra, Jeffrey P.; Sommerer, K.; Stone, Howard A.; Nardell, Edward; Scheuch, Gerhard

    2004-01-01

    Humans commonly exhale aerosols comprised of small droplets of airway-lining fluid during normal breathing. These “exhaled bioaerosols” may carry airborne pathogens and thereby magnify the spread of certain infectious diseases, such as influenza, tuberculosis, and severe acute respiratory syndrome. We hypothesize that, by altering lung airway surface properties through an inhaled nontoxic aerosol, we might substantially diminish the number of exhaled bioaerosol droplets and thereby provide a ...

  8. Inhaled Therapies for Pulmonary Hypertension.

    Hill, Nicholas S; Preston, Ioana R; Roberts, Kari E

    2015-06-01

    The inhaled route has a number of attractive features for treatment of pulmonary hypertension, including delivery of drug directly to the target organ, thus enhancing pulmonary specificity and reducing systemic adverse effects. It can also improve ventilation/perfusion matching by dilating vessels supplying ventilated regions, thus improving gas exchange. Furthermore, it can achieve higher local drug concentrations at a lower overall dose, potentially reducing drug cost. Accordingly, a number of inhaled agents have been developed to treat pulmonary hypertension. Most in current use are prostacyclins, including epoprostenol, which has been cleared for intravenous applications but is used off-label in acute care settings as a continuously nebulized medication. Aerosolized iloprost and treprostinil are both prostacyclins that have been cleared by the FDA to treat pulmonary arterial hypertension (PAH). Both require frequent administration (6 and 4 times daily, respectively), and both have a tendency to cause airway symptoms, including cough and wheeze, which can lead to intolerance. These agents cannot be used to substitute for the infused routes of prostacyclin because they do not permit delivery of medication at high doses. Inhaled nitric oxide (INO) is cleared for the treatment of primary pulmonary hypertension in newborns. It is also used off-label to test acute vasoreactivity in PAH during right-heart catheterization and to treat acute right-heart failure in hospitalized patients. In addition, some studies on long-term application of INO either have been recently completed with results pending or are under consideration. In the future, because of its inherent advantages in targeting the lung, the inhaled route is likely to be tested using a variety of small molecules that show promise as PAH therapies. PMID:26070575

  9. Guidelines for the safe administration of inhaled nitric oxide.

    Miller, O I; Celermajer, D S; Deanfield, J. E.; MacRae, D. J.

    1994-01-01

    Inhaled nitric oxide (NO) is a selective pulmonary vasodilator, potentially useful in the treatment of pulmonary hypertension and ventilation-perfusion mismatch. High doses of inhaled NO and its oxidative product nitrogen dioxide (NO2) may cause acute lung injury. Using a standard infant ventilator, ventilator circuit and test lung, an administration and monitoring strategy has been defined for inhaled NO and these observations validated in eight ventilated infants. In 90% oxygen, doses of in...

  10. The Association of Inbreeding With Lung Fibrosis Incidence in Beagle Dogs That Inhaled 238PuO2 or 239PuO2.

    Wilson, Dulaney A.; Brigantic, Andrea M.; Morgan, William F.

    2011-09-12

    Studies of health effects in animals after exposure to internally deposited radionuclides were intended to supplement observational studies in humans. Both nuclear workers and Beagle dogs have exhibited plutonium associated lung fibrosis; however, the dogs smaller gene pool may limit the applicability of findings to humans. Data on Beagles that inhaled either plutonium-238 dioxide (238PuO2) or plutonium-239 dioxide (239PuO2) were analyzed. Wright's Coefficient of Inbreeding was used to measure genetic or familial susceptibility and was assessed as an explanatory variable when modeling the association between lung fibrosis incidence and plutonium exposure. Lung fibrosis was diagnosed in approximately 80% of the exposed dogs compared with 23.7% of the control dogs. The maximum degree of inbreeding was 9.4%. Regardless of isotope, the addition of inbreeding significantly improved the model in female dogs but not in males. In female dogs an increased inbreeding coefficient predicted decreased hazard of a lung fibrosis diagnosis. Lung fibrosis was common in these dogs with inbreeding affecting models of lung fibrosis incidence in females but not in males. The apparent protective effect in females predicted by these models of lung fibrosis incidence is likely to be minimal given the small degree of inbreeding in these groups.

  11. PBPK modeling/Monte Carlo simulation of methylene chloride kinetic changes in mice in relation to age and acute, subchronic, and chronic inhalation exposure.

    Thomas, R S; Yang, R S; Morgan, D G; Moorman, M P; Kermani, H R; Sloane, R A; O'Connor, R W; Adkins, B; Gargas, M L; Andersen, M E

    1996-01-01

    During a 2-year chronic inhalation study on methylene chloride (2000 or 0 ppm; 6 hr/day, 5 days/week), gas-uptake pharmacokinetic studies and tissue partition coefficient determinations were conducted on female B6C3F1, mice after 1 day, 1 month, 1 year, and 2 years of exposure. Using physiologically based pharmacokinetic (PBPK) modeling coupled with Monte Carlo simulation and bootstrap resampling for data analyses, a significant induction in the mixed function oxidase (MFO) rate constant (Vma...

  12. Substance use -- inhalants

    ... get through daily life. Addiction can lead to tolerance. Tolerance means that more and more of the inhalant ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Inhalants Browse the Encyclopedia ...

  13. Fluticasone Oral Inhalation

    ... medications a certain amount of time before and after you inhale fluticasone inhalation. If you were taking an ... your steroid dose starting at least 1 week after you begin to use fluticasone.Fluticasone helps to prevent ...

  14. Olodaterol Oral Inhalation

    ... inhalation is used to control wheezing, shortness of breath, coughing, and chest tightness caused by chronic obstructive ... bottom of the clear base. Fill in the expiration date on the inhaler label, which is 3 ...

  15. Sarcoidosis-associated pulmonary hypertension: acute vasoresponsiveness to inhaled nitric oxide and the relation to long-term effect of sildenafil

    Milman, Nils; Svendsen, Claus Bo; Iversen, Martin; Videbæk, Regitze; Carlsen, Jørn

    2009-01-01

    Abstract Background: Severe pulmonary sarcoidosis is often complicated by pulmonary hypertension (PH) caused by different pathophysiological mechanisms. Objectives: To assess the acute vasoresponsiveness in patients with sarcoidosis and PH and the relation to the therapeutic effect of sildenafil...

  16. Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose–response study

    Mourgeon, Eric; Puybasset, Louis; Law-Koune, Jean-Dominique; Lu, Qin; Abdennour, Lamine; Gallart, Lluis; Malassine, Patrick; Rao, GS Umamaheswara; Cluzel, Philippe; Bennani, Abdelhai; Coriat, Pierre; Rouby, Jean-Jacques

    1997-01-01

    Background: The aim of this prospective study was to assess whether the presence of septic shock could influence the dose response to inhaled nitric oxide (NO) in NO-responding patients with adult respiratory distress syndrome (ARDS). Results: Eight patients with ARDS and without septic shock (PaO2 = 95 ± 16 mmHg, PEEP = 0, FiO2 = 1.0), and eight patients with ARDS and septic shock (PaO2 = 88 ± 11 mmHg, PEEP = 0, FiO2 = 1.0) receiving exclusively norepinephrine were studied. All responded to 15 ppm inhaled NO with an increase in PaO2 of at least 40 mmHg, at FiO2 1.0 and PEEP 10 cmH2O. Inspiratory intratracheal NO concentrations were recorded continuously using a fast response time chemiluminescence apparatus. Seven inspiratory NO concentrations were randomly administered: 0.15, 0.45, 1.5, 4.5, 15, 45 and 150 ppm. In both groups, NO induced a dose-dependent decrease in mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI), and venous admixture (QVA/QT), and a dose-dependent increase in PaO2/FiO2 (P ≤ 0.012). Dose-response of MPAP and PVRI were similar in both groups with a plateau effect at 4.5 ppm. Dose-response of PaO2/FiO2 was influenced by the presence of septic shock. No plateau effect was observed in patients with septic shock and PaO2/FiO2 increased by 173 ± 37% at 150 ppm. In patients without septic shock, an 82 ± 26% increase in PaO2/FiO2 was observed with a plateau effect obtained at 15 ppm. In both groups, dose-response curves demonstrated a marked interindividual variability and in five patients pulmonary vascular effect and improvement in arterial oxygenation were dissociated. Conclusion: For similar NOinduced decreases in MPAP and PVRI in both groups, the increase in arterial oxygenation was more marked in patients with septic shock. PMID:11056694

  17. Bronchitis (acute)

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  18. Retention, distribution, and excretion of 239PuO2 particles labeled with 169Yb in the Rhesus monkey after a single acute inhalation exposure

    Sixteen Rhesus monkeys were exposed to a high fired 239PuO2 aerosol labeled with 169Yb, and retention, distribution, and excretion patterns were determined. After an early rapid clearance phase, which had a half-life of less than one day, the remaining plutonium was retained in the lungs with a half-life that appeared to be greater than 500 days. By 30 days after exposure, 99 percent of the 239Pu in the body was in the lungs. At this time, 6 to 10 percent of the 169Yb burden was in the carcass and skeleton suggesting that there was dissociation of some 169Yb from the particles. The remaining 169Yb activity was in the lungs. There was little 239Pu in the liver, bone, or lymph nodes. The particulate material was cleared rapidly from the gastrointestinal and upper respiratory tracts and appeared in feces over the first four days. The level of 239Pu in feces returned to background by six days. Urinary excretion of 239Pu reached a peak by 8 to 10 days and then remained at a constant rate throughout the remainder of the experiment. These data are useful in calculating radiation dose to a variety of organs and relating this dose to the appearance of late effects from inhaled alpha-emitting particles. (U.S.)

  19. Combined effect of low-dose nitric oxide gas inhalation with partial liquid ventilation on hemodynamics, pulmonary function, and gas exchange in acute lung injury of newborn piglets.

    Choi, Chang Won; Hwang, Jong Hee; Chang, Yun Sil; Park, Won Soon

    2003-01-01

    We conducted a randomized animal study to determine whether there is a cumulative effect on hemodynamics, pulmonary function, and gas exchange when low-dose nitric oxide (NO) is added to partial liquid ventilation (PLV) in acute lung injury. Eighteen newborn piglets were saline-lavaged repeatedly, and randomly divided into two groups: PLV with perfluorocarbon group (n=8) and lavage only (control) group (n=10). Perfluorodecalin (30 mL/kg) was instilled into the endotracheal tube for 30 min, fo...

  20. [Inhaled therapy in asthma].

    Plaza Moral, Vicente; Giner Donaire, Jordi

    2016-04-01

    Because of its advantages, inhaled administration of aerosolized drugs is the administration route of choice for the treatment of asthma and COPD. Numerous technological advances in the devices used in inhaled therapy in recent decades have boosted the appearance of multiple inhalers and aerosolized drugs. However, this variety also requires that the prescribing physician is aware of their characteristics. The main objective of the present review is to summarize the current state of knowledge on inhalers and inhaled drugs commonly used in the treatment of asthma. The review ranges from theoretical aspects (fundamentals and available devices and drugs) to practical and relevant aspects for asthma care in the clinical setting (therapeutic strategies, education, and adherence to inhalers). PMID:26683076

  1. Inhaled transuranics in rodents

    The purpose of this project is to examine, in small animals, the fate and effects of inhaled transuranic compounds including plutonium dioxide, americium oxides, americium nitrates and curium oxides. This project should provide data for hazard evaluation and establishment of permissible exposure limits to man for inhaled transuranics, particularly with respect to the effects of radiation dose and dose distribution. Inhalation carcinogenesis was the primary effect evaluated

  2. Inhalational Lung Disease

    S Kowsarian; Farzaneh; F Jamshidiha

    2010-01-01

    Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become ...

  3. Inhalant Abuse and Dextromethorphan.

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. PMID:27338970

  4. Formoterol Oral Inhalation

    Bevespi Aerosphere® (as a combination product containing Glycopyrrolate, Formoterol) ... Formoterol inhalation powder (Foradil) and nebulizer solution (Perforomist) are used to treat wheezing, shortness of breath, and ...

  5. Comparison of the acute effect of tiotropium versus a combination therapy with single inhaler budesonide/formoterol on the degree of resting pulmonary hyperinflation.

    Santus, P; Centanni, S; Verga, M; Di Marco, F; Matera, M G; Cazzola, M

    2006-07-01

    In 20 COPD patients (FEV(1) TGV between the two treatments were significant (P<0.05), at least after 120 min, whereas those in RV were not significant. The documentation that tiotropium is able to modify IC even after an acute administration indicates its capacity of influencing expiratory flow limitation in a very fast manner and this is an important finding. In fact, changes in IC after bronchodilators in patients with COPD with expiratory flow limitation at rest may represent an objective tool for prescribing these drugs to attain symptomatic improvement and better quality of life, even in the absence of a significant increase in FEV(1). PMID:16337781

  6. 沐舒坦雾化吸入治疗老年慢性支气管炎急性发作临床观察%Clinical observation of mucosolvan atomizing inhalation in the treatment of acute exacerbations of chronic bronchitis in eldly patients

    孟蕾; 朱剑

    2015-01-01

    目的:观察沐舒坦雾化吸入治疗老年慢性支气管炎急性发作患者的临床疗效。方法:收治老年慢性支气管炎急性发作患者106例,分为雾化吸入组和静脉滴注组,雾化吸入组给予沐舒坦雾化吸入治疗,静脉滴注组给予沐舒坦静脉滴注治疗,比较两组疗效。结果:雾化吸入组的临床治疗总有效率明显高于静脉滴注组,咳嗽缓解时间、喘息缓解时间明显早于静脉滴注组,住院时间明显短于静脉滴注组(P<0.05)。结论:沐舒坦雾化吸入治疗老年慢性支气管炎急性发作患者起效更快,临床治疗效果更确切。%Objective:To explore the clinical effect of mucosolvan aerosol inhalation in the treatment of acute exacerbations of chronic bronchitis in eldly patients.Methods:106 elderly patients with acute exacerbation of chronic bronchitis patients were selected.They were divided into the atomizing inhalation group and intravenous infusion group.The atomizing inhalation group was given mucosolvan aerosol inhalation.The intravenous infusion group was given ambroxol intravenous drip treatment.We compared the efficacy of two groups.Results:In the atomizing inhalation group,the total efficiency of clinical treatment was significantly higher than that of intravenous infusion group;the remission time of cough,the remission time of breathing were significantly earlier than the intravenous infusion group;the hospitalization time was significantly shorter than the intravenous infusion group(P<0.05).Conclusion:The onset of mucosolvan aerosol inhalation in the treatment of acute exacerbations of chronic bronchitis in eldly patients was faster.Clinical therapeutic effect was more precise.

  7. Effects of inhaled acids on respiratory tract defense mechanisms.

    Schlesinger, R B

    1985-01-01

    The respiratory tract is endowed with an interlocking array of nonspecific and specific defense mechanisms which protect it from the effects of inhaled microbes and toxicants, and reduce the risk of absorption of materials into the bloodstream, with subsequent systemic translocation. Ambient acids may compromise these defenses, perhaps providing a link between exposure and development of chronic and acute pulmonary disease. This paper reviews the effects of inhaled acids upon the nonspecific ...

  8. Inhaled Surfactant in the treatment of accidental Talc Powder inhalation: a new case report

    Lo Piparo Caterina

    2011-09-01

    Full Text Available Abstract The use of talcum powder is incorrectly part of the traditional care of infants. Its acute aspiration is a very dangerous condition in childhood. Although the use of baby powder has been discouraged from many authors and the reports of its accidental inhalation have been ever more rare, sometimes new cases with several fatalities have been reported. We report on a patient in which accidental inhalation of baby powder induced severe respiratory difficulties. We also point out the benefits of surfactant administration. Surfactant contributed to the rapid improvement of the medical and radiological condition, preventing severe early and late complications and avoiding invasive approaches.

  9. Insulin Human Inhalation

    ... is a short-acting, man-made version of human insulin. Insulin inhalation works by replacing the insulin ... and selegiline (Eldepryl, Emsam, Zelapar); niacin; oral contraceptives (birth control pills); oral medications for diabetes such as pioglitazone ( ...

  10. Nicotine Microaerosol Inhaler

    Paul G Andrus

    1999-01-01

    Full Text Available OBJECTIVE: To measure the droplet size distribution of a nicotine pressurized metered-dose inhaler using a nicotine in ethanol solution formulation with hydrofluoroalkane as propellant.

  11. Arformoterol Oral Inhalation

    ... inhalation is used to control wheezing, shortness of breath, coughing, and chest tightness caused by chronic obstructive ... store the medication in the refrigerator until the expiration date printed on the package has passed, or ...

  12. Prostacyclin-Inhalation in Kombination mit Almitrine zur Therapie des akuten Lungenversagens

    Kurth, Roland

    2003-01-01

    The aim of this prospective controlled animal study was to investigate a possible additive effect of combined inhaled prostacycline and intravenous almitrine bismesylate (ALM) on pulmonary ventilation-perfusion ratio in acute lung injury (ALI) compared to inhaled prostacycline or intravenous ALM alone. Experimental ALI was established in all 24 pigs (weighing 30+/-3 kg) by repeated lung lavage. Animals were randomly assigned to receive either 25 ng/kg/min inhaled prostacycline alone, 1 µg/kg/...

  13. Inhaled histamine increases human lung mucociliary transport

    Histamine, a mediator of airways constriction, alters ciliary beat frequency, bronchial mucus production, and epithelial ion transport; and in dogs, increases mucociliary transport. To evaluate the effect of inhaled histamine on human tracheobronchial mucociliary clearance, the authors measured lung mucociliary clearance (LMC) and tracheal mucociliary transport rate (TMTR) in 5 healthy, nonsmoking subjects in a randomized, double-blind, cross-over study. The concentration of inhaled histamine which produced a 20% fall in FEV1 was established for each subject. On a separate day the subjects inhaled a 9 μm MMAD /sup 99m/Tc-Fe2O3 aerosol. LMC and TMTR were then measured for 2.5h using a gamma camera and a tracheal multidetector probe. Simultaneously, the subjects were challenged every 26 +/- 4 min with either PBS or histamine in PBS. The Fe2O3 retained after 24h for histamine (14.4 +/- 7.6%) and PBS studies (13.1 +/- 8.6%) indicated no difference in deposition of Fe2O3 (ANOVA). Fe2O3 clearance at 30 min was increased in the histamine studies (61 +/- 21% compared to the PBS studies (44 +/- 29%; p < 0.02, ANOVA)). TMTR was also increased with histamine (7.6 +/- 3.4 mm/min) compared to PBS (4.6 +/- 1.7 mm/min; p < 0.001, ANOVA). Results indicate an acute stimulatory effect of inhaled histamine on mucous transport in humans

  14. STOP-EXPOSURE STUDIES OF INHALED CHLORINE PROVIDE IMPORTANT INSIGHTS ON PATHOGENESIS

    As part of a project to inform approaches for risk assessment of inhaled irritants of interest to homeland security, a set of acute (Peay et aI., SOT 2010) and subacute (George et aI., SOT 2010) studies of inhaled chlorine (CI2) in female F344 rats was performed. The exposure des...

  15. Inhaled americium dioxide

    This project includes experiments to determine the effects of Zn-DTPA therapy on the retention, translocation and biological effects of inhaled 241AmO2. Beagle dogs that received inhalation exposure to 241AmO2 developed leukopenia, clincial chemistry changes associated with hepatocellular damage, and were euthanized due to respiratory insufficiency caused by radiation pneumonitis 120 to 131 days after pulmonary deposition of 22 to 65 μCi 241Am. Another group of dogs that received inhalation exposure to 241AmO2 and were treated daily with Zn-DTPA had initial pulmonary deposition of 19 to 26 μCi 241Am. These dogs did not develop respiratory insufficiency, and hematologic and clinical chemistry changes were less severe than in the non-DTPA-treated dogs

  16. Albuterol and Ipratropium Oral Inhalation

    ... sure it is inserted correctly. Replace the clear plastic base on the inhaler. Hold the inhaler upright ... face mask. Connect the nebulizer reservoir to the compressor. Put the mouthpiece in your mouth or put ...

  17. 应用雾化吸入利多卡因治疗慢性喘息型支气管炎急性发作的临床效果探讨%Application Clinical Effect on Atomizing Inhalation of Lidocaine for the Treatment of Chronic Wheezing Bronchitis Acute Episodes

    芦万杰

    2015-01-01

    Objective To explore the clinical effect on atomization inhalation of lidocaine for the treatment of chronic wheezing bronchitis acute. Methods Selected 56 cases of chronic wheezing bronchitis acute episodes in our hospital as the observation group, patients with retrospective analysis of early departments of the clinical data of 55 patients with conditions similar to the control group. Control group patients received routine western medicine treatment, give atomization inhalation of lidocaine treatment group patients. To investigate the clinical therapeutic effect in both groups and contrast. Results Atomization inhalation of lidocaine treatment in the observation group of patients clinical treatment the total effective rate was 91.07%, significantly higher than the 78.18% of the control group treated with conventional treatment, compare the differences between groups,χ2=7.775, P<0.05,had statistically signiifcance. Conclusion The type of chronic wheezing bronchitis acute clinical treatment process, atomization inhalation of lidocaine therapy has good clinical effect, the recurrence rate is low.%目的:探讨雾化吸入利多卡因治疗慢性喘息型支气管炎急性发作的临床效果。方法选取在我院接诊的56例慢性喘息型支气管炎急性发作患者为观察组,回顾性分析早期我院接诊的55例条件相似的患者的临床资料,设为对照组。对照组患者接受常规西医治疗,给予观察组患者雾化吸入利多卡因治疗。对两组患者临床治疗效果进行调查和对比。结果接受雾化吸入利多卡因治疗的观察组患者临床治疗总有效率为91.07%,高于接受常规治疗的对照组患者的78.18%,χ2=7.775,P<0.05,差异具有统计学意义。结论在慢性喘息型支气管炎急性发作的临床治疗过程中,雾化吸入利多卡因治疗具有较好的临床效果,复发率较低。

  18. Liposomal formulations for inhalation.

    Cipolla, David; Gonda, Igor; Chan, Hak-Kim

    2013-08-01

    No marketed inhaled products currently use sustained release formulations such as liposomes to enhance drug disposition in the lung, but that may soon change. This review focuses on the interaction between liposomal formulations and the inhalation technology used to deliver them as aerosols. There have been a number of dated reviews evaluating nebulization of liposomes. While the information they shared is still accurate, this paper incorporates data from more recent publications to review the factors that affect aerosol performance. Recent reviews have comprehensively covered the development of dry powder liposomes for aerosolization and only the key aspects of those technologies will be summarized. There are now at least two inhaled liposomal products in late-stage clinical development: ARIKACE(®) (Insmed, NJ, USA), a liposomal amikacin, and Pulmaquin™ (Aradigm Corp., CA, USA), a liposomal ciprofloxacin, both of which treat a variety of patient populations with lung infections. This review also highlights the safety of inhaled liposomes and summarizes the clinical experience with liposomal formulations for pulmonary application. PMID:23919478

  19. Inhalants. Specialized Information Service.

    Do It Now Foundation, Phoenix, AZ.

    The document presents a collection of articles about inhalant abuse. Article 1 presents findings on the psychophysiological effects related to the use of amyl or butyl nitrate as a "recreational drug." Article 2 suggests a strong association between chronic sniffing of the solvent toulene and irreversible brain damage. Article 3 warns about the…

  20. [Acute and subacute chemical pneumonitis].

    Andujar, P; Nemery, B

    2009-10-01

    Acute or subacute chemical-induced lung injury is rarely compound specific and is most often caused by an accidental occupational, domestic or environmental exposure to an inhaled chemical agent. The industrial disaster that happened in Bhopal in 1984, accidental poisoning with chlorine and petroleum hydrocarbons and also vesicant gases used during conflicts, are specific examples. Rarely, a chemical agent can cause lung damage by being ingested and reaching the lung through the systemic circulation (for example accidental or deliberate paraquat ingestion). Household accidents should not be underestimated. An important cause of household accidents is chlorine inhalation resulting from mixing bleach with acids such as the scale removers used to clean toilets. Chemical agents can provoke direct and/or indirect damage to the respiratory tract. The acute or subacute clinical manifestations resulting from inhalation of chemical agents are very varied and include inhalation fevers, acute non-cardiogenic pulmonary oedema, adult respiratory distress syndrome, reactive airways dysfunction syndrome and acute or subacute pneumonitis. The site and the severity of chemical-induced respiratory damage caused by inhaled chemical agents depend mainly on the nature and the amount of the agent inhaled. The immediate and long-term prognosis and possible sequelae are also variable. This review excludes infectious or immunologically induced acute respiratory diseases. PMID:19953031

  1. Inhaled transuranics in rodents

    This project examines the interactions of external and internal radiation from mixtures of radionuclides present within the nuclear fuel inventory. The objective of the project is to evaluate the effects of mixed radiation insults, using key radiation sources as indicative of overall processes that may occur following release of nuclear fuel into the air. Previously initiated studies of immunological effects of plutonium inhalation are also being completed as part of this project

  2. Inhalation exposure methodology.

    Phalen, R F; Mannix, R C; Drew, R T

    1984-01-01

    Modern man is being confronted with an ever-increasing inventory of potentially toxic airborne substances. Exposures to these atmospheric contaminants occur in residential and commercial settings, as well as in the workplace. In order to study the toxicity of such materials, a special technology relating to inhalation exposure systems has evolved. The purpose of this paper is to provide a description of the techniques which are used in exposing laboratory subjects to airborne particles and ga...

  3. Clinical observation of ICS combined with Salbutamol atomization inhalation to control infants'acute episoded asthma%ICS联合沙丁胺醇雾化吸入对控制婴幼儿哮喘急性发作的临床观察

    徐玲; 赵顺英

    2012-01-01

    Objective To observe and study clinical curative effects of Budesonide combined with Salbutamol atomization inhalation to control infants' acute episoded asthma. Methods 160 infants with acute episoded asthma were divided into two groups randomly, each group had 80 patients. The control group was given conventional fighting infection, fighting virus and cough eliminating phlegm to smooth wheezing and oxygen uptake as treatment; the study group was given Budesonide combined with Salbutamol atomization inhalation on the basis of conventional treatment as treatment. The two groups' suppression and cough conditions, and the disappearing situation of lung moist rale and lung wheezing rale after taking the medicine were observed and compared, and the two groups' total effective rate was compared. Results The disappearing time of symptoms and signs in study group was obviously shorter than control group, and its total effective rate was higher than control group, the differences were all statistically significant (P < 0.01). Conclusion ICS combined with Salbutamol atomization inhalation can control infants' acute episoded asthma rapidly, and it has few untoward effects, it has evident treatment effects.%目的 观察研究布地奈德联合沙丁胺醇雾化吸入对控制婴幼儿哮喘急性发作的临床疗效.方法 将160例哮喘急性发作的婴幼儿随机分为两组,每组80例.对照组给予常规抗感染、抗病毒、止咳化痰平喘以及吸氧治疗.研究组在常规治疗的基础上给予布地奈德与硫酸沙丁胺醇雾化吸人治疗.用药后观察比较两组患者喘憋、咳嗽等症状以及肺部湿啰音和肺部哮鸣音等体征消失情况,并比较两组治疗后的总有效率.结果 研究组症状和体征消失时间明显短于对照组,总有效率高于对照组,差异均有高度统计意义(P<0.01).结论 吸入性糖皮质激素(ICS)联合沙丁胺醇雾化吸入能快速控制婴幼儿哮喘急性发作,不良反应少,治疗效果显著.

  4. 异丙托溴铵、布地奈德雾化吸入加用口服急支糖浆辅助治疗小儿肺炎支原体肺炎的临床观察%Ipratropium Bromide Nebulized Budesonide Inhalation Plus Oral Acute Bronchitis Syrup Auxiliary Treatment of Mycoplasma Pneumoniae Pneumonia Clinical Observation

    王丽珍; 李飞平; 罗芳; 张梅娟

    2012-01-01

    Objective; To study the budesonide, ipratropium bromide Stock aerosol inhalation plus oral acute bronchitis syrup efficacy of mycoplasma pneumonia in children. Method; from May 2011 to May 2012 in our hospital diagnosed with pneumonia, mycoplasma pneumonia, aged 3 to 14 years old, 69 cases of hospitalized children, 35 cases were randomly divided into a control group and a test group of 34 patients. Test group application budesonide, ipratropium bromide atomizing inhalation plus oral acute bronchitis syrup, observation and comparison of the two groups on the basis of given antibiotics. Experimental group, children with cough disappeared time, of pulmonary rales disappear and hospitalization time there was significantly shorter (P<0.01) than the control group, the total effective rate in the test group than the control group (P<0. 01). Conclusion:Budesonide, ipratropium bromide oxygen drive to the aerosol inhalation plus oral acute bronchitis syrup can be used as auxiliary treatment of mycoplasma pneumonia treatment.%目的:研究布地奈德、异丙托溴铵联合雾化吸入加用口服急支糖浆对小儿支原体肺炎的疗效.方法:将2011年5月-2012年5月在我院诊断为肺炎支原体肺炎,年龄3~14岁的69例住院患儿,随机分为对照组35例与试验组34例.在给予抗感染的基础上试验组应用布地奈德、异丙托溴铵氧气驱动雾化吸入加用口服急支糖浆,观察比较两组疗效.结果:试验组患儿咳嗽消失时间、肺部罗音消失时间及住院时间均比对照组有极显著缩短(P<0.01),试验组总有效率比对照组高(P<0.01).结论:布地奈德、异丙托溴铵氧气驱动雾化吸入加用口服急支糖浆可以作为治疗小儿支原体肺炎的辅助治疗方式.

  5. Emergency presentation and management of acute severe asthma in children

    Øymar Knut; Halvorsen Thomas

    2009-01-01

    Abstract Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronc...

  6. A mathematical model for predicting the probability of acute mortality in a human population exposed to accidentally released airborne radionuclides. Final report for Phase I of the project: early effects of inhaled radionuclides

    The report presents a mathematical model for the purpose of predicting the fraction of human population which would die within 1 year of an accidental exposure to airborne radionuclides. The model is based on data from laboratory experiments with rats, dogs and baboons, and from human epidemiological data. Doses from external, whole-body irradiation and from inhaled, alpha- and beta-emitting radionuclides are calculated for several organs. The probabilities of death from radiation pneumonitis and from bone marrow irradiation are predicted from doses accumulated within 30 days of exposure to the radioactive aerosol. The model is compared with existing similar models under hypothetical exposure conditions. Suggestions for further experiments with inhaled radionuclides are included

  7. Know How to Use Your Asthma Inhaler

    Full Text Available ... metered dose inhaler one to two inches from mouth Your browser does not support iframes Using a ... KB] Using a metered dose inhaler (inhaler in mouth) Your browser does not support iframes Using a ...

  8. Determination of ultratrace amounts of plutonium-239 in bioassay samples for alpha dosimetry

    Potential alpha contamination in PHWRs is of concern when working with materials which may contain fuel debris, such as around fueling machines and feeders which are cut open. Traditional screening methods use alpha spectrometry of fecal samples. It is highly desirable to use less invasive methods. Screening of urine samples is well accepted in the industry for a variety of purposes. However, various solubility models and known biological throughputs indicate that it is only practical to measure 239Pu/240Pu in urine and that these must be measured at very low concentrations in order to be a practical screening tool. It is necessary to achieve a detection limit of about 5 uBq in a daily urine output to correspond to a dose of 0.1 mSv/annum. This corresponds to about 2 femtograms (10-15 g) of 239Pu and 0.5 fg 240Pu in daily urine output. If the daily urine output is concentrated to 1 g, then the desired detection limit is 2 fg/g or 2 pg/kg for 239Pu, for example. Although alpha spectrometry would provide information on multiple isotopes of interest, its practical detection limit is about 100 to 300 uBq. The currently available methods for measuring uBq amounts of 239Pu/240Pu (the only alpha emitters in urine suitable for screening measurements) are all mass spectrometry based and vary in the means by which the analyte is presented to the mass spectrometer

  9. The uptake of plutonium-239, 240, americium-241, strontium-90 into plants

    This report describes the results of measurements on the uptake of plutonium, americium, strontium-90 and caesium-137 into peas, beet, oats, sweet corn, tomatoes and vegetable marrow grown in tubs containing radioactively-contaminated silts. The silts had been taken from an area of West Cumbria commonly referred to as the Ravenglass estuary. The experiments are categorised as being carried out under non-standard conditions because of the manner in which the radioactivity came to be incorporated into the growth medium. The growth medium was representative of conditions which could arise when the estuarine silt moves inland under the influence of wind and tide and mixes with the adjacent farm land. The silt had been contaminated by radioactive effluents from the nuclear fuels reprocessing plant at Sellafield and this contamination had been brought about by natural means. (Auth.)

  10. A multiwire proportional counter for the detection of plutonium-239 in vivo

    Work is in progress on developing counters to detect plutonium in the human lungs. The need for a low background counter for such work is discussed and the design and construction of a multiwire gas proportional counter described. The performance of the counter with different gas fillings is considered and results obtained on background, resolution, field of view and efficiency are given. Future work will consist of using the counter in conjunction with a realistic chest phantom. An estimate of the limit of detection is derived. (author)

  11. Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure-Prone Rats

    Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance...

  12. 吸入用布地奈德混悬液和硫酸特布他林雾化液雾化吸入治疗慢性阻塞性肺疾病急性加重期疗效分析%Combined therapy of nebulized budesonide suspension plus terbutaline sulphateaerosol inhalation for chronic obstructive disease at acute exacerbation phase

    秦永明

    2009-01-01

    Objective:To evaluate the therapy of inhaling nebulized budesonide suspension combined with terbutaline sulphate for treatment of chronic obstructive pulmonary disease (AECOPD)at acute exacerbations phase.Methods:Sixty-five patients with AECOPD were randomly divided into observed group (33 cases)and control group (32 cases).Both groups were administered the therapy of oxygen inhalation,anti-infection and intravenous aminophylline.On the basis of routine therapy,the patients in the observed group were given nebulized budesonide suspension inhalation and terbutaline sulphate,and the control group were ministered only terbutaline sulphate inhalation;then the clinical manifestation,blood gas analysis,and FEVl%at baseline and 7-10 days after treatment were determined.Results:The PaO2,PaCO2 and FEV1%were significantly different in the treatment group before and after the therapy(P<0.01).The response rate was 90.9% and 68.8% in the observed group and the control group respectively (P>0.05).The difference was not significant.Conclusions:The therapy of inhaling nebulized budesonide suspension combing with terbutaline sulphate aerosol may effectively relieve the symptoms of AECOPD.It′s the choice therapy for AECOPD.%目的:探讨吸入用布地奈德混悬液与硫酸特布他林雾化液雾化吸入治疗慢性阻塞性肺疾病急性加重期(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)的疗效.方法:将65例AECOPD患者随机分为2组,观察组33例,对照组32例,两组均予吸氧、抗感染、静脉氨茶碱及对症等治疗.在常规治疗的基础上观察组给予吸入用布地奈德混悬液和硫酸特布他林雾化液雾化吸入,对照组单用硫酸特布他林雾化液雾化吸入,对两组患者用药7~10天后的临床疗效、血气分析及第一秒用力呼气容积占预计值百分比(FEVl%)变化情况进行对照分析.结果:观察组治疗前后相比PaO2、PaCO2、FEVl%均有显著改善(P<0.01),两组间各

  13. 布地奈德雾化吸入治疗小儿急性喉-气管-支气管炎的疗效观察及护理%Curative Effect Observation and Nursing of Budesonide Aerosol Inhalation Treatment of Infantile Acute Laryngeal Airway-bronchitis

    韩春芳

    2015-01-01

    Objective To observe the budesonide suspension liquid atomization inhalation treatment of infantile acute laryngeal airway-bronchitis curative effect and nursing.Methods To observe the group of 60 cases, given budesonide suspension liquid oxygen gas atomization inhalation; the control group of 60 cases of intravenous drip given dexamethasone. Two groups adopt corresponding nursing measures, observation of symptoms in both groups.Results Observation group suction throat singing disappear time, barking cough time, loss of hearing time is shorter than the control group, and difference was statistically signiifcant (P<0.05).Conclusion Budesonide aerosol inhalation treatment of infantile acute laryngeal airway-bronchitis, good curative effect, the small dose of drug, can signiifcantly shorten the duration of symptoms, side effects.%目的:观察布地奈德混悬液(普米克令舒)雾化吸入治疗小儿急性喉-气管-支气管炎的疗效及护理。方法观察组60例患儿给予布地奈德混悬液氧气驱动雾化吸入;对照组60例患儿给予地塞米松静脉滴注。两组均采用相应地护理措施,观察两组患者症状缓解时间。结果观察组吸气喉鸣消失时间、犬吠样咳嗽消失时间、声嘶消失时间均短于对照组,差异有统计学意义P<0.05。结论布地奈德雾化吸入治疗小儿急性喉-气管-支气管炎,疗效好,所用药物剂量小,能明显缩短病程,不良反应小。

  14. Insulin inhalation: NN 1998.

    2004-01-01

    Aradigm Corporation has developed an inhaled form of insulin using its proprietary AERx drug delivery system. The system uses liquid insulin that is converted into an aerosol containing very small particles (1-3 micro in diameter), and an electronic device suitable for either the rapid transfer of molecules of insulin into the bloodstream or localised delivery within the lung. The AERx insulin Diabetes Management System (iDMS), AERx iDMS, instructs the user on breathing technique to achieve the best results. Aradigm Corporation and Novo Nordisk have signed an agreement to jointly develop a pulmonary delivery system for insulin [AERx iDMS, NN 1998]. Under the terms of the agreement, Novo Nordisk has exclusive rights for worldwide marketing of any products resulting from the development programme. Aradigm Corporation will initially manufacture the product covered by the agreement, and in return will receive a share of the overall gross profits from Novo Nordisk's sales. Novo Nordisk will cover all development costs incurred by Aradigm Corporation while both parties will co-fund final development of the AERx device. Both companies will explore the possibilities of the AERx platform to deliver other compounds for the regulation of blood glucose levels. Additionally, the agreement gives Novo Nordisk an option to develop the technology for delivery of agents outside the diabetes area. In April 2001, Aradigm Corporation received a milestone payment from Novo Nordisk related to the completion of certain clinical and product development stages of the AERx drug delivery system. Profil, a CRO in Germany, is cooperating with Aradigm and Novo Nordisk in the development of inhaled insulin. Aradigm and Novo Nordisk initiated a pivotal phase III study with inhaled insulin formulation in September 2002. This 24-month, 300-patient trial is evaluating inhaled insulin in comparison with insulin aspart. Both medications will be given three times daily before meals in addition to basal

  15. Acute bronchial asthma.

    Grover, Sudhanshu; Jindal, Atul; Bansal, Arun; Singhi, Sunit C

    2011-11-01

    Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support. PMID:21769523

  16. Inhaled plutonium nitrate in dogs

    Beagle dogs given a single inhalation exposure to 239Pu(NO3)4 are being observed for life-span dose-effect relationships. Lymphopenia occurred at the two highest dosage levels as early as 1 mo following exposure and was associated with neutropenia and reduction in numbers of circulatory monocytes by 4 mo postexposure. Radiation pneumonitis developed in one dog at the highest dosage level at 14 mo postexposure. More rapid translocation to skeleton and liver occurred following inhalation of 238Pu(NO3)4 than after 239Pu(NO3)4 inhalation

  17. Clinical Effect of Atomization Inhalation of Lidocaine for Treatment of Acute Attack of Chronic Asthmatic Bronchitis%雾化吸入利多卡因治疗慢性喘息型支气管炎急性发作的临床疗效

    张欢

    2015-01-01

    ObjectiveTo discuss and study the clinical effect and significance of atomization inhalation of lidocaine for treatment of acute attack of chronic asthmatic bronchitis.MethodRandomly selected patients in pediatric acute episode of chronic asthmatic bronchitis in 100 cases and divided into combination group and common group both with 50 cases. Common group was given routine treatment and combination group was given atomization inhalation of lidocaine on basis of routine treatment. After different treatments, total effective rate and blood gas analysis of the 2 groups were compared. ResultTotal effective rate of combination group was 100% obviously higher than common group 78%(P<0.05). Changes of blood gas analysis of combination group were obvious superior to common group (P<0.05).ConclusionAtomization inhalation of lidocaine for treatment of acute attack of chronic asthmatic bronchitis has signiifcant clinical effect. It can effectively restrain smooth muscle contraction, reduce bronchial hyperresponsiveness and obviously relieve breathing phenomenon of patients within a short time. Besides, it can also relieve edema and inlfammatory reaction, and effectively control acute attack of bronchitis.%目的:研究利多卡因雾化吸入用于治疗慢性喘息型支气管炎发作的临床疗效与意义。方法随机选取就诊于我院儿科慢性喘息型支气管炎急性发作患儿100例。分组为联合组、普通组,各50例。其中为普通组患者进行常规治疗;联合组给在常规治疗基础上联合雾化吸入利多卡因。比较两组患者经过不同治疗后总有效率、血气分析等指标。结果两组患者不同治疗后总有效率的比较,显示治疗后联合利多卡因雾化吸入患者总有效率为100%,显著优于常规治疗组78%(P<0.05),联合组治疗效果较好;治疗前后血气分析值比较显示联合组与普通组治疗前血气分析值无显著差异(P>0.05)。治疗后联合组血

  18. Combined therapy of inhalation for chronic obstructive disease at acute exacerbation phase%慢性阻塞性肺疾病急性加重期联合吸入药物治疗的临床研究

    包明红; 梅晓冬

    2011-01-01

    目的 探讨吸入布地奈德混悬液与硫酸特布他林、异丙托溴铵雾化液联合雾化吸入对慢性阻塞性肺疾病急性加重期(acuteexacerbations of chronic obstructive pulmonary disease,AECOPD)的疗效.方法 将82例AECOPD 患者随机分为两组,治疗组42例,对照组40例,两组均予吸氧、抗感染、静脉茶碱类及对症等治疗.在此基础上治疗组给予吸入布地奈德、硫酸特布他林和异丙托溴铵混悬液雾化吸入,对照组单用硫酸特布他林雾化液雾化吸入,对两组患者用药7 d后的呼吸困难、血气分析及第1秒用力呼气容积占预计值百分比( FEV1% ) 变化情况进行对照分析.同时比较两组的平均住院日.结果 治疗组与对照组相比,治疗组在呼吸困难、PaO2、PaCO2、FEV1%、平均住院日均较对照组改善明显,两组差异具有显著性( P <0.01).结论 采用布地奈德、硫酸特布他林和异丙托溴铵混悬液雾化吸入的多靶点抗炎治疗对AECOPD能够迅速缓解病情,改善肺功能,是治疗AECOPD的有效选择.%Objective To eva luate the therapy of inha ling nebulized budesonide suspension comb ined with terbuta line and ipratropium sulphate fo rtreatment of chronic obstructive pulmonary disease atacu te exacerbations phase(AECOPD). Methods eighitytwo patients with AECOPD w ere random ly div ided into observ ed g roup(42 cases) and control group(40 cases). Both groups were administered the therapy of oxygen inhalation, anti-infection and intravenous am inophylline. On the basis of routine the rapy, the patients in the observed group were given nebulized budeson ide suspension inhalation and terbuta line and ipratropium sulphate, and the control group were administered on ly terbutaline sulphate inhalation; then the clinical manifestation, despanish blood gasanalysis and FEV1 % at base line and 7 days after treatment were determined. Results The despanish PaO2 , PaCO2 and FEV1 % were sign ifican tly different in

  19. Inhalant Dependence and its Medical Consequences

    Mehmet Hamid Boztaş

    2010-01-01

    The term of inhalants is used for matters easily vapors. Inhalants are preferred for rapid, positive reinforcement and mild high effects. Products including inhalants are cheap, accessible, legal substances and are prevalently used in community. The prevalence of inhalant use in secondary schools in Turkey is about 5.1%. Inhalant substance dependence is generally observed within 14-15 age group. Age at first use could be as low as 5 to 6 years of age. Substance dependence is more probable in ...

  20. Biological effects of inhaled radionuclides

    This report focuses on various types of radionuclides that may be inhaled and deposited in the respiratory tract. One of the primary goals of this ICRP Task Group is to assess specifically the biological implications of inhaled plutonium. Because other transuranics are becoming more abundant, information on americium, curium and einsteinium is included. Data are also included from studies of polonium and of several beta-gamma emitting isotopes. The Task Group evaluated most of the data on the biological effects of inhaled radionuclides in experimental animals to identify the tissues at risk and to assess possible dose-response relationships. Few data from human cases of inhaled radionuclides are available for this assessment. The biological effects of nonradioactive air pollutants were also considered to provide the perspective that all air pollutants can have a deleterious effect on human life and to emphasize the possibility for combined or synergistic effects of nonradioactive and radioactive substances on the respiratory tract. (orig./HP)

  1. Exubera. Inhale therapeutic systems.

    Bindra, Sanjit; Cefalu, William T

    2002-05-01

    Inhale, in colaboration with Pfizer and Aventis Pharma (formerly Hoechst Marion Roussel; HMR), is developing an insulin formulation utilizing its pulmonary delivery technology for macromolecules for the potential treatment of type I and II diabetes. By July 2001, the phase III program had been completed and the companies had begun to assemble data for MAA and NDA filings; however, it was already clear at this time that additional data might be required for filing. By December 2001, it had been decided that the NDA should include an increased level of controlled, long-term pulmonary safety data in diabetic patients and a major study was planned to be completed in 2002, with the NDA filed thereafter (during 2002). US-05997848 was issued to Inhale Therapeutic Systems in December 1999, and corresponds to WO-09524183, filed in February 1995. Equivalent applications have appeared to date in Australia, Brazil, Canada, China, Czech Republic, Europe, Finland, Hungary, Japan, Norway, New Zealand, Poland and South Africa. This family of applications is specific to pulmonary delivery of insulin. In February 1999, Lehman Brothers gave this inhaled insulin a 60% probability of reaching market, with a possible launch date of 2001. The analysts estimated peak sales at $3 billion in 2011. In May 2000, Aventis predicted that estimated peak sales would be in excess of $1 billion. In February 2000, Merrill Lynch expected product launch in 2002 and predicted that it would be a multibillion-dollar product. Analysts Merril Lynch predicted, in September and November 2000, that the product would be launched by 2002, with sales in that year of e75 million, rising to euro 500 million in 2004. In April 2001, Merrill Lynch predicted that filing for this drug would occur in 2001. Following the report of the potential delay in regulatory filing, issued in July 2001, Deutsche Banc Alex Brown predicted a filing would take place in the fourth quarter of 2002 and launch would take place in the first

  2. Acute Response of Right Ventricular Function to Iloprost Inhalations in Patients with Pulmonary Arterial Hypertension:Preliminary Evaluation with Cardiac Magnetic Resonance Imaging%吸入伊洛前列素对肺动脉高压患者右心室功能改善的即刻效应:心脏MRI初步研究

    陆青青; 李东; 杨振文; 韩艳; 崔倩; 张璋; 于铁链

    2015-01-01

    Background and objective Pulmonary arterial hypertension (PAH) is a progressive disorder character-ized by abnormally elevated blood pressure of the pulmonary circulation. Without treatment, PAH progresses rapidly to right ventricular (RV) failure and even death. Cardiac magnetic resonance imaging (CMRI) has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PAH. e aim of this study is to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMRI. Method From March 2012 to March 2014, 48 patients with PAH underwent CMRI before and immediately aer inhalation of iloprost with a single dose of 20 μg over 15 min-20 min. RV function parameters derived from CMRI images were analyzed before and aer iloprost inhalation, including end-diastolic volume (EDV), end-diastolic area (EDA), end-systolic volume (ESV), end-systolic area (ESA), stroke volume (SV), ejection fraction (EF) and cardiac output (CO). Percentage of RV area change was also calculated [%RVAC=(EDA-ESA)/EDA×100%]. Wilcoxon's Sign Rank Test or Paired Samples t-Test was used to compare the dierences of RV function parameters before and aer inhalation. Results Aer iloprost inhalation, all patients showed significant decrease in RV EDV and RV ESV (P=0.007, P<0.001 respectively). Whereas, there were significant increase in RV SV (P=0.014), RV EF (P=0.009) and %RVAC (P=0.006). RV CO had no significant dierence before and aer inhalation (P=0.851). Conclusions Inhalation of iloprost can immediately improve RV function in patients with PAH, and noninvasive evaluation of the acute response with CMRI is feasibility.%背景与目的肺动脉高压(pulmonary arterial hypertension, PAH)是以肺循环压力异常增高为特征的进展性疾病,可引起右心室(right ventricle, RV)功能进行性衰竭,最终导致死亡。因此RV功能的评估

  3. 1006-0698(2011)08-0388-03Observation of Budesonide and Formoterol Fumarate Powder for Inhalation in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease%布地奈德福莫特罗用于慢阻肺急性加重期观察

    蔡丽秋; 杨丽雄

    2011-01-01

    Objective;To observe the clinical efficacy and security of budesonide and formoterol fumarate powder for inhalation (symbicort turbuhaler) in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Method :0 cases of AECOPD were randomly divided into the observation group and controlled group with 40 cases of each group. Both groups received the conventional treatment. The observation group were additionally treated with budesonide and formoterol fumarate powder for inhalation. The clinical efficacy, time of symptoms, obvious alleviation and adverse drug reactions were compared between two groups. Result: The total effective rate was 95.0% for the observationgroup and 80.0% for the controlled group, the clinical efficacy of the observation group was better than that of the controlled group (P<0.05) and the time of cough alleviation,expectorate alleviation and asthma alleviation in the observation group were obviously shorter than those in the controlled group (P < 0.05). There was no severe adverse drug reaction side in two groups. Conclusion: Budesonide and formoterol fumarate powder for inhalation were obviously effective for AECOPD with slight adverse drug reaction.%目的 观察布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效和安全性.方法 80例AECOPD患者随机分为观察组和对照组各40例,两组均采用常规治疗,观察组加用布地奈德福英特罗粉吸入剂,比较两组临床疗效、症状明显缓解时间、不良反应.结果 观察组总有效率95.0%,对照组总有效率80.0%,观察组疗效优于对照组(P<0.05),观察组咳嗽、咳痰、气喘症状明显缓解时间较对照组显著缩短(P<0.05);两组均未见明显不良反应.结论 布地奈德福莫特罗粉吸入剂治疗AECOPD疗效确切,安全性好.

  4. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the life-span dose-effect relationships of inhaled 239PuO2 and 238PuO2 in beagles. The data will be used to estimate the health effects of inhaled transuranics. The tissue distribution of plutonium, radiation effects in the lung and hematologic changes in plutonium-exposed beagles with lung tumors were evaluated

  5. Effect observation of budesonide combined with ambroxol atomization inhalation in the treatment of patients with a-cute exacerbation of chronic obstructive pulmonary disease%布地奈德联合氨溴索雾化吸入治疗慢性阻塞性肺疾病急性加重期疗效观察

    张卫伟; 吴亮

    2015-01-01

    目的:探讨布地奈德混悬液联合氨溴索雾化吸入治疗慢性阻塞性肺疾病(COPD)急性加重期患者的临床疗效。方法选择急性加重期的 COPD 患者80例,分为观察组和对照组各40例。对照组给予持续低流量吸氧、抗感染、平喘、止咳化痰及维持水电解质酸碱平衡等常规治疗。观察组在常规治疗的基础上,给予布地奈德混悬液联合氨溴索雾化吸入。观察比较2组各项临床疗效指标。结果观察组呼吸困难程度总有效率为97.5%高于对照组的80.0%,差异有统计学意义(P <0.05)。观察组肺部啰音总有效率为95.0%高于对照组的75.0%,差异有统计学意义(P <0.05)。观察组无明显不良反应发生。结论布地奈德联合氨溴索雾化吸入治疗 COPD 急性加重期疗效好,无明显不良反应,值得临床推广。%Objective To investigate the efficacy of nebulized budesonide combined with ambroxol atomization inhala-tion in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods 80 ca-ses of patients with acute exacerbations of COPD were divided into the observation group and control group,each of 40 cases. The control group was given continuous low flow oxygen,anti infection,bronchodilators,cough suppressant and expectorant, maintaining water electrolyte and acid-base balance and other conventional treatment. The observation group was given nebuliz-ed budesonide and ambroxol atomization inhalation on the basis of the conventional therapy. The clinical variable of 2 groups were observed and compared. Results The total effective rate of expiratory dyspnea in the observation group was 97. 5% , which was higher than 80. 0% of the control group,the difference was statistically significant(P<0. 05). The total effective rate of pulmonary rales in the observation group was 95. 0% ,which was higher than 75. 0% of the control group,the difference was

  6. 氨溴索、布地奈德雾化吸入联合治疗慢支急性发作的临床疗效%Ambroxol and Budesonide Aerosol Inhalation in Treatment of Acute Exacerbation of Chronic Bronchitis

    董凤霞

    2015-01-01

    目的:探讨氨溴索、布地奈德雾化吸入联合治疗慢支急性发作的临床疗效。方法选取2012年10月~2014年9月在我院接受治疗的慢支急性发作患者108例,并根据患者具体情况分为观察组和对照组各54例,对照组采用常规综合方法进行治疗,观察组在对照组基础上加用氨溴索、布地奈德雾化吸入联合治疗,观察并比较两组的治疗效果。结果观察组患者治疗总有效率为94.5%,对照组为85.2%,观察组明显高于对照组,P<0.05,具有统计学意义;治疗前两组患者体温、C反应蛋白、白细胞、血沉、中性粒细胞均值无明显差异,治疗后均下降,下降幅度观察组明显高于对照组,P<0.05,具有统计学意义。结论氨溴索、布地奈德雾化吸入联合治疗慢支急性发作疗效显著,安全稳定。%ObjectiveTo study the effect of Ambroxol and Budesonide aerosol inhalation in treatment of acute exacerbation of chronic bronchitis. MethodsFrom October 2012 to September 2014 in our hospital, 108 cases of patients with acute attack of chronic bronchitis were divided into observation group and control group 54 cases, control group was treated with the conventional synthesis methods, observation group in the control group on the basis of the total ammonia bromine rope, combination treatment with budesonide atomization inhalation, observed and compared the therapeutic effect of two groups.Results The observation group of patients treatment the total effective rate was 94.5%, control group was 85.2%, the observation group is signiifcantly higher than the control group,P<0.05, there was statistically signiifcant. Two groups of patients before treatment temperature, c-reactive protein, white blood cells, blood sedimentation, neutrophils mean no signiifcant difference, decreased after treatment, the decline in observation group is significantly higher than the control group,P<0.05, with statistical

  7. Effect observation of salmeterol xinafoate and fluticasone propionate pow-der for inhalation in the treatment of acute attack of chronic bronchitis%沙美特罗替卡松粉吸入剂治疗慢性支气管炎急性发作的效果观察

    肖亮

    2014-01-01

    目的:观察沙美特罗替卡松粉吸入剂治疗慢性支气管炎急性发作的临床效果。方法选取本院2012年2月~2014年2月收治的68例慢性支气管炎急性发作患者为研究对象,按照随机数字表法将其分为两组,各34例。对照组采取吸氧、平喘、抗感染、吸痰等常规治疗,实验组在对照组基础上加用沙美特罗替卡松粉吸入剂治疗,比较两组的治疗效果及不良反应情况。结果实验组中临床治愈19例(55.88%),显效8例(23.53%),好转5例(14.71%),总有效率为94.12%,对照组临床治愈14例(41.18%),显效8例(23.53%),好转3例(8.82%),总有效率为73.53%,实验组的总有效率明显高于对照组(P0.05)。结论沙美特罗替卡松粉吸入剂能明显改善临床症状,且不良反应少,值得在慢性支气管炎急性发作患者中进一步应用。%Objective To observe the clinical effect of salmeterol xinafoate and fluticasone propionate powder for in-halation in the treatment of acute attack of chronic bronchitis. Methods From February 2012 to February 2014,68 pa-tients with acute attack of chronic bronchitis admitted into our hospital were selected as research objects and they were evenly divided into two groups according to the random number table method.In the control group,regular treatment in-cluding oxygen uptake,anti-asthma,anti-infection,and aspiration of sputum were provided, while in the experimental group,on the basis of treatment the control group, salmeterol xinafoate and fluticasone propionate powder for inhalation was added. The clinical effect and adverse reaction in the two groups were compared. Results In the experimental group,19 cases (55.88%) were cured clinically,8 cases were markedly efective (23.53%),5 cases (14.71%) were improved, the total effective rate was 94.12%,while in the control group,14 cases (41.18%) were clinically cured,8 cases (23.53%) were markedly efective,3 cases (8.82%) were improved

  8. Development of a long-term ovine model of cutaneous burn and smoke inhalation injury and the effects of early excision and skin autografting

    Yamamoto, Yusuke; Enkhbaatar, Perenlei; Sakurai, Hiroyuki; Rehberg, Sebastian; Asmussen, Sven; Ito, Hiroshi; Sousse, Linda E.; Cox, Robert A.; Deyo, Donald J.; Traber, Lillian D.; TRABER, MARET G.; Herndon, David N.; Traber, Daniel L.

    2012-01-01

    Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal e...

  9. Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices

    Pierre Ernst

    1998-01-01

    Full Text Available Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI; its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.

  10. Pneumoconiosis after sericite inhalation

    Algranti, E; Handar, A; Dumortier, P; Mendonca, E; Rodrigues, G; Santos, A; Mauad, T; Dolhnikoff, M; De Vuyst, P; Saldiva, P; Bussacos, M

    2005-01-01

    Aims: To investigate and describe the radiological, clinical, and pathological changes in miners and millers exposed to sericite dust with mineralogical characteristics of inhaled dust. Methods: The working premises were visited to examine the sericite processing and to classify the jobs according to make qualitative evaluation. Respirable dust was collected and the amount of crystalline silica and particle size distribution were measured. Forty four workers were examined by a standard questionnaire for respiratory symptoms, spirometry, and chest x ray. Material from an open lung biopsy was reviewed for histopathological and mineralogical analysis, together with sericite samples from the work site to compare the mineral characteristics in lung lesions and work area. Results: Respirable dust contained 4.5–10.0% crystalline silica. Particle size distribution showed a heavy burden of very fine particles (23–55%) with a mean diameter of <0.5 µm. Mean age of sericite miners was 41.0 (11.9) and mean number of years of exposure was 13.5 (10.1). In 52.3% of workers (23/44), chest radiographs presented a median category of 1/0 or above, and 18.2% (8/44) had a reduced FEV1. There was a significant association between exposure indices and x ray category. Histological studies of the lung biopsy showed lesions compatible with mixed dust fibrosis with no silicotic nodules. x Ray diffraction analysis of the lung dust residue and the bulk samples collected from work area showed similar mineralogical characteristics. Muscovite and kaolinite were the major mineral particle inclusions in the lung. Conclusion: Exposure to fine sericite particles is associated with the development of functional and radiological changes in workers inducing mixed dust lesions, which are distinct histologically from silicosis. PMID:15723874

  11. [Impact of inhaled NO on developing lung and brain].

    Baud, O; Olivier, P; Vottier, G; Pham, H; Mercier, J-C; Loron, G

    2009-09-01

    With the advent of prenatal steroids, postnatal exogenous surfactant and less aggressive respiratory support, premature infants can develop chronic lung disease without even acute respiratory distress. This "new bronchopulmonary dysplasia" could be the result of impaired postnatal growth. Several experimental studies have suggested a possible role of the vascular endothelial growth factor/nitric oxide (VEGF/NO) pathway in restoring pulmonary angiogenesis and enhancing distal lung growth. The results of the clinical studies are, however, inconclusive, and it is currently unclear which subsets of premature infants might benefit from inhaled nitric oxide. Besides, severe intracranial haemorrhage and/or cystic periventricular leukomalacia may affect the most immature babies, many of whom are spared from severe initial respiratory disease. Recently, inhaled nitric oxide was shown to significantly decrease the incidence of these neurological events, and to improve the long-term outcome in a few clinical trials. At times neuroprotective, at times neurotoxic, nitric oxide is capable of divergent effects depending upon the extent of cerebral damage, the redox state of the cell, and the experimental model used. Recently, inhaled nitric oxide had recognized to have dramatic remote effects including angiogenesis and maturation on the developing brain in rodent pups. Therefore, the developmental consequences of inhaled NO should be further investigated to ensure its safety on the developing brain and to test its potential neurprotective effect. PMID:19836663

  12. Inhalant abuse: An exploratory study

    Rohit Verma

    2011-01-01

    Full Text Available Background: Inhalants are being abused by large numbers of people throughout the world, particularly children and adolescents. It is also an often overlooked form of ubstance abuse in adolescents. Aims: The current study explored the inhalant abuse among adolescents seeking treatment from a tertiary care drug de-addiction clinic. Settings and Design: The study was conducted at a tertiary level multispecialty hospital. Materials and Methods: The current study was a chart review of the cases with inhalant abuse/dependence presenting to the clinic over a 1-year period. All the treatment records of the de-addiction clinic were reviewed, and information was gathered regarding patients with inhalant abuse/dependence. Statistical Analysis: Descriptive statistics with frequency distribution was carried out by using SPSS version 10.0. Results: The mean age of the subjects was 16.24 years (SD±1.9 years; range 12-18 years. Twenty-two percent of the subjects were illiterate. Forty percent of the adolescents had a family history of alcohol use problems and 48% that of tobacco use. The mean age of the initiation of inhalant use was 11.6 years (SD±2.17 years. It varied from 9 to 18 years. Forty percent of the adolescents had made a previous abstinence attempt. Conclusions: The findings provide important information on an underresearched area in psychiatry.

  13. Zinc toxicology following particulate inhalation.

    Cooper, Ross G

    2008-04-01

    The current mini-review describes the toxic effects of zinc inhalation principally in the workplace and associated complications with breathing and respiration. The International Classification of Functioning, Disability and Health Criteria were used to specifically select articles. Most of the commercial production of zinc involves the galvanizing of iron and the manufacture of brass. The recommended daily allowance for adults is 15 mg zinc/day. Metal fume fever associated with inhalation of fumes of ZnO is characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste and salivation. ZnCl(2) inhalation results in edema in the alveolar surface and the protein therein the lavage fluid is elevated. Particular pathological changes associated with zinc intoxication include: pale mucous membranes; jaundice; numerous Heinz bodies; and marked anemia. Adequate ambient air monitors for permissible exposure limits, excellent ventilation and extraction systems, and approved respirators are all important in providing adequate protection. PMID:20040991

  14. Zinc toxicology following particulate inhalation

    Cooper Ross

    2008-01-01

    Full Text Available The current mini-review describes the toxic effects of zinc inhalation principally in the workplace and associated complications with breathing and respiration. The International Classification of Functioning, Disability and Health Criteria were used to specifically select articles. Most of the commercial production of zinc involves the galvanizing of iron and the manufacture of brass. The recommended daily allowance for adults is 15 mg zinc/day. Metal fume fever associated with inhalation of fumes of ZnO is characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste and salivation. ZnCl 2 inhalation results in edema in the alveolar surface and the protein therein the lavage fluid is elevated. Particular pathological changes associated with zinc intoxication include: pale mucous membranes; jaundice; numerous Heinz bodies; and marked anemia. Adequate ambient air monitors for permissible exposure limits, excellent ventilation and extraction systems, and approved respirators are all important in providing adequate protection.

  15. Managing diabetes with inhaled insulin

    Lucy D Mastrandrea

    2012-01-01

    Full Text Available The incidence of diabetes is increasing world-wide. Many individuals with diabetes require insulin to control their blood sugar and prevent both microvascular and macrovascular complications associated with this chronic disease. Current regimens involve delivery of subcutaneous insulin by injection or continuous insulin infusion. One area of research to advance diabetes care is aimed at developing alternate routes of insulin administration that will make daily management less invasive for patients. This review will focus on inhaled insulin, a novel formulation which takes advantage of drug delivery through the pulmonary system. The pharmacology, efficacy, and safety of inhaled insulin will be discussed. In addition, the status of inhaled insulin as a potential therapy for individuals with diabetes will be reviewed.

  16. Know How to Use Your Asthma Inhaler

    Full Text Available ... Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share ... to follow along with the correct way to use your metered dose inhaler. Print the step-by- ...

  17. Inhaled plutonium nitrate in dogs

    The major objective of this project is to determine dose-effect relationships of inhaled plutonium nitrate in dogs to aid in predicting health effects of accidental exposure in man. For lifespan dose-effect studies, beagle dogs were given a single inhalation exposure to 239Pu(NO3)4, in 1976 and 1977. The earliest biological effect was on the hematopoietic system; lymphopenia and neutropenia occurred at the two highest dose levels. The authors have also observed radiation pneumonitis, lung cancer, and bone cancer at the three highest dose levels. 1 figure, 4 tables

  18. Inhaled plutonium nitrate in dogs

    The major objective of this project is to determine dose-effect relationships of inhaled plutonium nitrate in dogs to aid in predicting health effects of accidental exposure in man. For lifespan dose-effect studies, beagle dogs were given a single inhalation exposure to 239Pu(NO3)4, in 1976 and 1977. The earliest biological effect was on the hematopoietic system; lymphopenia and neutropenia occurred at the two highest dose levels. They have also observed radiation pneumonitis, lung cancer, and bone cancer at the three highest dose levels. 1 figure, 3 tables

  19. Intermittent inhaled corticosteroids in infants with episodic wheezing

    Bisgaard, Hans; Hermansen, Mette Northman; Loland, Lotte; Halkjaer, Liselotte Brydensholt; Buchvald, Frederik

    2006-01-01

    BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one-month-old...... infants to treatment with two-week courses of inhaled budesonide (400 mug per day) or placebo, initiated after a three-day episode of wheezing, in this single-center, randomized, double-blind, prospective study of three years' duration. The primary outcome was the number of symptom-free days; key...... (hazard ratio, 1.22; 95 percent confidence interval, 0.71 to 2.13)--a finding that was unaffected by the presence or absence of atopic dermatitis. The mean duration of the acute episodes was 10 days in both groups and was independent of respiratory viral status. Height and bone mineral density were not...

  20. Age dependent systemic exposure to inhaled salbutamol

    Bønnelykke, Klaus; Jespersen, Jakob Jessing; Bisgaard, Hans

    2007-01-01

    AIMS: To determine the effect of age on systemic exposure to inhaled salbutamol in children. METHODS: Fifty-eight asthmatic children, aged 3-16 years, inhaled 400 microg of salbutamol from a pressurized metered dose inhaler with spacer. The 20 min serum profile was analyzed. RESULTS: Prescribing a...

  1. 沙丁胺醇雾化吸入联合沉香饮加减治疗慢性喘息性支气管炎急性发作的疗效观察%Efficacy observation on treating acute exacerbation of chronic asthmatic bronchitis with the albuterol inhalation joint the Chenxiang decoction

    潘君贤

    2012-01-01

      Objective:To analyze and investigate the clinical effect of treating acute exacerbation chronic asthmatic bronchitis with the albuterol inhalation of joint the Chenxiang decoction. Methods: Retrospective analyzing 20 patients with acute exacerbation of chronic asthmatic bronchitis in our hospital from January 2009 to December 2011, and plus salbutamol solution (1ml, 2 times a day) joint the Chenxiang decoction for treatment, in accordance with the evaluation standard, the analysis and observation of clinical efficacy in the treatment of this group of patients. Results: ①After treatment, markedly in 12 cases, effective in 7 cases, and ineffective in 1 case, the total effective rate of 95.0%. During treatment, symptoms of palpitations in 2 cases, 1 case of patient had symptoms of nausea, and adverse reactions disappear after medicine withdrawal. ②Pre-treatment lung function parameters (FEV1 and PEFR) were significantly lower than after treatment (2 weeks), and both showed a statistically significant difference. Conclusion:Treating acute exacerbation of chronic asthmatic bronchitis with the albuterol inhalation joint the Chenxiang decoction, its clinical efficacy, should be generalized and applied in clinical.%  目的:对沙丁胺醇雾化吸入联合沉香饮加减用于治疗慢性喘息性支气管炎的临床疗效进行分析与探究.方法:回顾性分析了2009年1月~2011年12月入住我院的20例慢性喘息性支气管炎急性发作的患者的临床资料,并向其加用沙丁胺醇雾化吸入溶液(1ml,每天2次)联合沉香饮加减饮进行治疗,按照相关的疗效评定标准,对本组患者在该种治疗方法下的临床疗效进行分析与观察.结果:①经过上述治疗方法的应用,显效例数12例,有效例数7例,无效例数为1例总有效率为95.0%.在治疗过程中,有2例出现心悸症状,1例出现恶心症状,停药之后不良反应均消失.②治疗前肺功能参数(FEV1与PEFR)要明显低

  2. Reproduction and evaluation of a rat model of inhalation lung injury caused by black gunpowder smog

    Yi-fan LIU

    2013-09-01

    Full Text Available Objective To reproduce and evaluate a rat model of inhalation lung injury caused by black gunpowder smog. Methods The smog composition was analyzed and a rat model of inhalation lung injury was reproduced. Forty two healthy male Wistar rats were randomly divided into normal control (NC group and 1h, 2h, 6h, 24h, 48h and 96h after inhalation group (n=6. The arterial blood gas, wet to dry weight ratio (W/D of lung, leukocyte count, and protein concentration in broncho-alveolar lavage fluid (BALF were determined. Macroscopic and microscopic changes in lung tissue were observed. Results The composition of black gunpowder smog was composed mainly of CO2 and CO, and their concentrations remained stable within 12 minutes. Smog inhalation caused a significant hypoxemia, the concentration of blood COHb reached a peak value 1h, and the W/D of lung reached peak value 2h after inhalation (P<0.05. The amount of leukocytes and content of protein in BALF increased significantly within 24h after inhalation (P<0.05. Histopathological observation showed diffuse hemorrhage, edema and inflammatory cell infiltration in lung tissue as manifestations of acute lung injury, and the injury did not recover at 96h after inhalation. Conclusion The rat model of inhalation lung injury can be reproduced using black gunpowder smog, and it has the advantages of its readiness for reproduction, reliability and stability, and it could be used for the experiment of inhalation injury in a battlefield environment.

  3. Respiratory irritation associated with inhalation of boron trifluoride and fluorosulfonic acid

    Rusch, G.M.; Bowden, A.M.; Muijser, H.; Arts, J.

    2008-01-01

    The objectives of this study were to examine the respiratory irritancy of boron trifluoride (BF3) and fluorosulfonic acid (FSA) following acute inhalation exposure. Testing was conducted using groups of 10 male and 10 female rats (BF3) or groups of 6 male rats (FSA). Rats were exposed for a single 4

  4. EFFECTS OF P-XYLENE INHALATION ON AXONAL TRANSPORT IN THE RAT RETINAL GANGLION CELLS

    Although the solvent xylene is suspected of producing nervous system dysfunction in animals and humans, little is known regarding the neurochemical consequences of xylene inhalation. he intent of this study was to determine the effect of intermittent, acute, and subchronic p-xyle...

  5. Activity and Safety of Inhaled Itraconazole Nanosuspension in a Model Pulmonary Aspergillus fumigatus Infection in Inoculated Young Quails

    Wlaź, Piotr; Knaga, Sebastian; Kasperek, Kornel; Wlaź, Aleksandra; Poleszak, Ewa; Jeżewska-Witkowska, Grażyna; Winiarczyk, Stanisław; Wyska, Elżbieta; Heinekamp, Thorsten; Rundfeldt, Chris

    2015-01-01

    Pulmonary aspergillosis is frequently reported in parrots, falcons, and other birds held in captivity. Inhalation is the main route of infection for Aspergillus fumigatus, resulting in both acute and chronic disease conditions. Itraconazole (ITRA) is an antifungal commonly used in birds, but its administration requires repeated oral dosing, and the safety margin is narrow. To investigate the efficacy of inhaled ITRA, six groups of ten young quails (Coturnix japonica) were inoculated intratrac...

  6. Impact of inhalation therapy on oral health

    Navneet Godara

    2011-01-01

    Full Text Available Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD. Beta-2 agonists, anticholinergic bronchodilators, inhaled corticosteroids, and sodium cromoglycate are often used alone or in combination in an inhaled form. Studies have shown that inhaled drugs used in the treatment have some adverse effects on the oral health based on their dosage, frequency, and duration of use. Several oral conditions such as xerostomia, dental caries, candidiasis, ulceration, gingivitis, periodontitis, and taste changes have been associated with inhalation therapy. Since the prevalence of chronic respiratory diseases is rising, it is important to provide optimal oral care to the individuals receiving inhalation therapy. This article will review the influence of inhaled drugs on the oral health of individuals and adequate management and prevention of the same.

  7. A rat model of smoke inhalation injury: Influence of combustion smoke on gene expression in the brain

    Acute smoke inhalation causes death and injury in victims of home and industrial fires as well as victims of combat situations. The lethal factors in combustion smoke inhalation are toxic gases and oxygen deficiency, with carbon monoxide (CO) as a primary cause of death. In survivors, inhalation of smoke can result in severe immediate and delayed neuropathologies. To gain insight into the progression of molecular events contributing to smoke inhalation sequelae in the brain, we developed a smoke inhalation rat model and conducted a genome-wide analysis of gene expression. Microarray analysis revealed a modified brain transcriptome with changes peaking at 24 h and subsiding within 7 days post-smoke. Overall, smoke inhalation downregulated genes associated with synaptic function, neurotransmission, and neurotrophic support, and upregulated genes associated with stress responses, including nitric oxide synthesis, antioxidant defenses, proteolysis, inflammatory response, and glial activation. Notably, among the affected genes, many have been previously implicated in other types of brain injury, demonstrating the usefulness of microarrays for analysis of changes in gene expression in complex insults. In accord with previously described modulations of nitric oxide homeostasis in CO poisoning, microarray analysis revealed increased brain expression of nitric oxide synthase (NOS) and NOS ligand after inhalation of smoke. Furthermore, immunostaining showed significant elevations in perivascular NOS and in protein nitration, corroborating the involvement of nitric oxide perturbations in post-smoke sequelae in the brain. Thus, the new rat model, in combination with microarray analyses, affords insight into the complex molecular pathophysiology of smoke inhalation in the brain

  8. Administration of cyclosporine by inhalation: A feasibility study in Beagle dogs

    Oral cyclosporine inhibits the primary,but-not the secondary immune responses in the lung. These findings suggest that the local administration of cyclosporine by inhalation could be a useful tool for increasing our understanding of lung immunity. Five dogs were each treated with inhaled, oral and intravenous cyclosporine, aerosol vehicle (ethyl alcohol), and no treatment, over a 5-wk period. One treatment per week was given to each dog. A radiolabel, 99mTc was included in the cyclosporine aerosol to allow visualization of lung distribution of the aerosol. Blood plasma concentrations of cyclosporine were approximately the same at 4 h and were essentially cleared by 24 h for all routes of administration. Aerosol distribution in the lung appeared uniform, based on 99mTc scintigrams. In a second study, two dogs inhaled cyclosporine once a day for five days, two dogs inhaled the aerosol vehicle, and one dog was not treated. No evidence of acute lung injury, based on cell counts, total protein, alkaline phosphatase, or lactic dehydrogenase levels in the bronchoalveolar lavage fluid, was found at 24 h after one or five administrations of cyclosporine. These data indicate that cyclosporine administered by aerosol either once or five times was distributed throughout the lung and was absorbed into the blood without producing an acute inflammatory reaction in the lung. Our results suggest that cyclosporine may be safely given by inhalation for studies of local immune responses in the lung. (author)

  9. Lung vasodilatory response to inhaled iloprost in experimental pulmonary hypertension: amplification by different type phosphodiesterase inhibitors

    Weissmann Norbert

    2005-07-01

    Full Text Available Abstract Inhaled prostanoids and phosphodiesterase (PDE inhibitors have been suggested for treatment of severe pulmonary hypertension. In catheterized rabbits with acute pulmonary hypertension induced by continuous infusion of the stable thromboxane analogue U46619, we asked whether sildenafil (PDE1/5/6 inhibitor, motapizone (PDE3 inhibitor or 8-Methoxymethyl-IBMX (PDE1 inhibitor synergize with inhaled iloprost. Inhalation of iloprost caused a transient pulmonary artery pressure decline, levelling off within per se ineffective dose of each PDE inhibitor (200 μg/kg × min 8-Methoxymethyl-IBMX, 1 μg/kg × min sildenafil, 5 μg/kg × min motapizone with subsequent iloprost nebulization, marked amplification of the prostanoid induced pulmonary vasodilatory response was noted and the area under the curve of PPA reduction was nearly threefold increased with all approaches, as compared to sole iloprost administration. Further amplification was achieved with the combination of inhaled iloprost with sildenafil plus motapizone, but not with sildenafil plus 8MM-IBMX. Systemic hemodynamics and gas exchange were not altered for all combinations. We conclude that co-administration of minute systemic doses of selective PDE inhibitors with inhaled iloprost markedly enhances and prolongs the pulmonary vasodilatory response to inhaled iloprost, with maintenance of pulmonary selectivity and ventilation perfusion matching. The prominent effect of sildenafil may be operative via both PDE1 and PDE5, and is further enhanced by co-application of a PDE3 inhibitor.

  10. A novel rapid - acting oral inhalation human insulin for diabetes mellitus: Afrezza

    Ravindra S. Beedimani

    2015-10-01

    Full Text Available Afrezza is rapid-acting oral inhalation insulin that is administered at the beginning of each meal. The U.S Food and Drug Administration has approved Afrezza (insulin human inhalation powder, a rapid-acting inhaled insulin to improve glycemic control in adults and #8805;18 years of age with Type 1 or Type 2 diabetes mellitus (T1DM or T2DM. Afrezza must be used in combination with long-acting insulin in patients with T1DM. Afrezza may be used with either oral anti-diabetic drugs or basal insulin in patients with T2DM. Afrezza should be administered via oral inhalation using Afrezza inhaler. Dosage adjustment is needed when switching from injection insulin to oral inhalation Afrezza. It is contraindicated in individuals with chronic lung disease and smokers because of the risk of the acute bronchospasm. Before initiating, Afrezza, a complete medical history, physical examination and spirometry (forced expiratory volume 1 sec results is required in all individuals to identify the potential lung disease. Common adverse reactions in individuals treated with Afrezza include hypoglycemia, cough, throat pain or irritation, headache, and diarrhea. [Int J Basic Clin Pharmacol 2015; 4(5.000: 1040-1042

  11. Passive inhalation of cannabis smoke

    Law, B.; Mason, P.A.; Moffat, A.C.; King, L.J.; Marks, V.

    1984-09-01

    Six volunteers each smoked simultaneously, in a small unventilated room (volume 27 950 liter), a cannabis cigarette containing 17.1 mg delta 9-tetrahydrocannabinol (THC). A further four subjects - passive inhalers - remained in the room during smoking and afterwards for a total of 3 h. Blood and urine samples were taken from all ten subjects and analyzed by radioimmunoassay for THC metabolites. The blood samples from the passive subjects taken up to 3 h after the start of exposure to cannabis smoke showed a complete absence of cannabinoids. In contrast, their urine samples taken up to 6 h after exposure showed significant concentrations of cannabinoid metabolites (less than or equal to 6.8 ng ml-1). These data, taken with the results of other workers, show passive inhalation of cannabis smoke to be possible. These results have important implications for forensic toxicologists who are frequently called upon to interpret cannabinoid levels in body fluids.

  12. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the lifespan dose-effect relationships of inhaled 239PuO2 and 238PuO2 in beagles. Beagle dogs given a single exposure to 239PuO2 or 238PuO2 aerosols are being observed for lifespan dose-effect relationships. The 239Pu body burden of the nine dogs that died of pulmonary-fibrosis-induced respiratory insufficiency during the first 3 yr after exposure was 1 to 12μCi. Nineteen of the dogs exposed to 238Pu haved died during the first 7-1/2 yr after exposure due to bone and/or lung tumors; their body burdens at death ranged from 0.7 to 10μCi. Chronic lymphopenia was the earliest observed effect after inhalation of 239PuO2 or 238PuO2

  13. Toxicological Assessment of Noxious Inhalants

    Kleinsasser, N. H.; Sassen, A. W.; Wallner, B. W.; Staudenmaier, R.; Harréus, U. A.; Richter, E

    2004-01-01

    In the past centuries mankind has been exposed to various forms of air pollution not only at his occupational but also in his social environment. He mainly gets exposed with these pollutants through the respiratory organs and partially absorbs them into the body. Many of these airborne substances can be harmful for humans and some of them may account for tumorigenic effects. The following essay describes the main features of toxicological assessment of inhalative environmental and workplace x...

  14. [Significance of inhaled environmental allergens].

    Zochert, J

    1983-01-01

    Whereas the importance of pollen as inhalative allergens has been largely investigated and is generally known, the experience in the frequency and the role of the sensibilization with air-borne fungi is relatively limited. In 720 patients with Asthma bronchiale the degree of sensitization has been tested with various extracts of air-borne fungi of SSW Dresden (mould mixture, aspergillin, mucor, cladosporium and penicillium and alternaria). The most frequent and also the strongest reactions were found with alternaria and the smallest part of positive skin reactions with penicillium. An isolated sensitization with mould has been demonstrated in 20 per cent of the cases. In 60 per cent of the tested patients a manifest mould allergy was shown by means of the Inhalative Allergen Test, the most favourable correlation between Intracutaneous Test (ICT) and Inhalative Test (IAT) was found with alternaria (76%). A conformance between ICT and basophils degranulation test (BDT) was stated in 69% of the cases. The aim should be comparable tests with allergen extracts without irritative effects and qualitative measurements of air-borne fungi. PMID:6649704

  15. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the lifespan dose-effect relationships of inhaled 239PuO2 and 238PuO2 in beagles. The data will be used to estimate the health effects of inhaled transuranics. Beagle dogs given a single exposure to 239PuO2 or 238PuO2 aerosols to obtain graded levels of initial lung burdens are being observed for lifespan dose-effect relationships. Mortality due to radiation pneumonitis and lung tumor increased in the four highest dose-level groups exposed to 239PuO2, during the 13-yr postexposure period. During the 10 1/2 years after exposure to 238PuO2, mortality due to lung and/or bone tumors increased in the three highest dose-level groups. Chronic lymphopenia, occurring 0.5 to 2 year after exposure, was the earliest observed effect after inhalation of either 239PuO2 or 238PuO2 in the four highest dose-level groups that had initial lung burdens greater than or equal to 80 nCi. 3 figures, 6 tables

  16. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the lifespan dose-effect relationships of inhaled 239PuO2 or 238PuO2 in beagles. The data will be used to estimate the health effects of inhaled transuranics. Beagle dogs given a single exposure to 239PuO2 or 238PuO2 aerosols to obtain graded levels of initial lung burdens (ILB) are being observed for lifespan dose-effect relationships. Mortality due to radiation pneumonitis and lung tumor increased in the four highest dose-level groups exposed to 239PuO2 during the 15-year postexposure period. During the 12 1/2 years after exposure to 238PuO2, mortality due to lung and/or bone tumors increased in the three highest dose-level groups. Chronic lymphopenia, occurring 0.5 to 2 years after exposure, was the earliest observed effect after inhalation of either 239PuO2 or 238PuO2 in the four highest dose-level groups that had ILB of ≥ 80 nCi. Other plutonium-exposure-related effects include sclerosis of the tracheobronchial lymph nodes, focal radiation pneumonitis, adenomatous hyperplasia of the liver, and dystrophic osteolytic lesions in the skeleton. 4 figures, 7 tables

  17. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the life span dose-effect relationships of inhaled 239PuO2 or 238PuO2 in beagles. The data will be used to estimate the health effects of inhaled transuranics. Beagle dogs given a single exposure to 239PuO2 or 238PuO2 aerosols to obtain graded levels of initial lung burdens (ILB) are being observed for life span dose-effect relationships. Mortality due to radiation pneumonitis and lung tumor increased in the four highest dose-level groups exposed to 239PuO2 during the 16-year post exposure period. During the 13 years after exposure to 238PuO2, mortality due to lung and/or bone tumors increased in the three highest dose-level groups. Chronic lymphopenia, occurring 0.5 to 2 years after exposure, was the earliest observed effect after inhalation of either 239PuO2 or 238PuO2 in the four highest dose-level groups that had ILB of ≥ 80 nCi. Other plutonium-exposure-related effects include sclerosis of the tracheobronchial lymph nodes, focal radiation pneumonitis, adenomatous hyperplasia of the liver, and dystrophic osteolytic lesions in the skeleton

  18. Inhaled plutonium oxide in dogs

    This project is concerned with long-term experiments to determine the lifespan dose-effect relationships of inhaled 239PuO2 and 238PuO2 in beagles. The data will be used to estimate the health effects of inhaled transuranics. Beagle dogs given a single exposure to 239PuO2 or 238PuO2 aerosols to obtain graded levels of initial lung burdens (ILB) are being observed for lifespan dose-effect relationships. Mortality due to radiation pnuemonitis and lung tumor increased in the four highest dose-level groups exposed to 239PuO2 during the 14-year postexposure period. During the 11 1/2 years after exposure to 238PuO2, mortality due to lung and/or bone tumors increased in the three highest dose-level groups. Chronic lymphopenia, occurring 0.5 to 2 years after exposure, was the earliest observed effect after inhalation of either 239PuO2 or 238PuO2 in the four highest dose-level groups that had ILB of greater than or equal to80 nCi. Other plutonium-exposure-related effects include sclerosis of the tracheobronchial lymph nodes, focal radiation pneumonitis, adenomatous hyperplasia of the liver, and dystrophic osteolytic lesions in the skeleton. 5 figures, 7 tables

  19. Cancer hazard from inhaled plutonium

    The best estimate of the lung cancer potential in humans for inhaled insoluble compounds of plutonium (such as PuO2 particles) has been grossly underestimated by such authoritative bodies as the International Commission on Radiological Protection and the British Medical Research Council. Calculations are presented of lung cancer induction by 239Pu as insoluble particles and for deposited reactor-grade Pu. The reason for the gross underestimate of the carcinogenic effects of Pu by ICRP or the British Medical Research Council (BMRC) is their use of a totally unrealistic idealized model for the clearance of deposited Pu from the lungs and bronchi plus their non-recognition of the bronchi as the true site for most human lung cancers. The erroneous model used by such organizations also fails totally to take into account the effect of cigarette-smoking upon the physiological function of human lungs. Plutonium nuclides, such as 239Pu, or other alpha particle-emitting nuclides, in an insoluble form represent an inhalation cancer hazard in a class some 100,000 times more potent than the potent chemical carcinogens, weight for weight. The already-existing lung cancer data for beagle dogs inhaling insoluble PuO2 particles is clearly in order of magnitude agreement with calculations for humans

  20. The Skeletal Effects of Inhaled Glucocorticoids.

    Sutter, Stephanie A; Stein, Emily M

    2016-06-01

    The skeletal effects of inhaled glucocorticoids are poorly understood. Children with asthma treated with inhaled glucocorticoids have lower growth velocity, bone density, and adult height. Studies of adults with asthma have reported variable effects on BMD, although prospective studies have demonstrated bone loss after initiation of inhaled glucocorticoids in premenopausal women. There is a dose-response relationship between inhaled glucocorticoids and fracture risk in asthmatics; the risk of vertebral and non-vertebral fractures is greater in subjects treated with the highest doses in the majority of studies. Patients with COPD have lower BMD and higher fracture rates compared to controls, however, the majority of studies have not found an additional detrimental effect of inhaled glucocorticoids on bone. While the evidence is not conclusive, it supports using the lowest possible dose of inhaled glucocorticoids to treat patients with asthma and COPD and highlights the need for further research on this topic. PMID:27091558

  1. Inhaled nitric oxide to prevent bronchopulmonary dysplasia in preterm neonates.

    Mercier, Jean-Christophe; Olivier, Paul; Loron, Gauthier; Fontaine, Romain; Maury, Laure; Baud, Olivier

    2009-02-01

    Bronchopulmonary dysplasia is a chronic lung disease that affects premature infants and contributes to their morbidity and mortality. With the advent of prenatal steroids and postnatal exogenous surfactant and less aggressive respiratory support, premature infants can develop chronic oxygen dependency without even acute respiratory distress. This 'new bronchopulmonary dysplasia' could be the result of impaired postnatal growth. Several experimental studies have suggested a possible role of the vascular endothelial growth factor/nitric oxide (VEGF/NO) pathway in restoring pulmonary angiogenesis and enhancing distal lung growth. The results of the clinical studies are, however, inconclusive, and it is currently unclear which subsets of premature infants might benefit from inhaled nitric oxide. Besides, severe intracranial haemorrhage and/or cystic periventricular leucomalacia may affect the most immature babies, many of whom are spared from severe initial respiratory disease. Recently, inhaled nitric oxide was shown to significantly decrease the incidence of these neurological events, and to improve the long-term outcome in a few clinical trials. At times neuroprotective, at times neurotoxic, nitric oxide is capable of divergent effects depending upon the extent of cerebral damage, the redox state of the cell, and the experimental model used. Recently, our group found that inhaled nitric oxide had remote effects including angiogenesis and maturation on the developing brain in rodent pups. Thus, we await the results of the recently completed randomised clinical trial of inhaled nitric oxide to prevent bronchopulmonary dysplasia (the European Nitric Oxide or 'EUNO' trial) where, besides the primary endpoint of chronic oxygen dependency reduction at 36 weeks' postconceptional age, long-term lung and brain will be followed-up until 7 years of age. PMID:18986855

  2. The Ozone Layer and Metered Dose Inhalers

    Louis-Philippe Boulet

    1998-01-01

    The stratospheric ozone layer plays a crucial role in protecting living organisms against ultraviolet radiation. Chlorofluorocarbons (CFC) contained in metered-dose inhalers (MDIs) contribute to ozone depletion and in accordance with the Montreal Protocol on Substances That Deplete the Ozone Layer established 10 years ago, phase-out strageies have been developed worldwide for this category of agents. Alternatives to CFC-containing inhalers have been developed, such as powder inhalers and thos...

  3. Training Issues in the Use of Inhalers

    Martin Duerden; David Price

    2001-01-01

    Patient compliance and techniques used with inhalation devices can strongly influence the effectiveness of inhaled medications but these issues are often poorly recognized and may be neglected when these products are prescribed. The extent of these problems and the success of differing education and training programs designed to improve inhaler technique have been evaluated by a review of the literature using Medline, EMBASE and Biosis Database from 1985 to date. Drug delivery to the airways ...

  4. Inhalant abuse: youth at risk.

    Ahern, Nancy R; Falsafi, Nasrin

    2013-08-01

    Inhalant abuse is a significant problem affecting many people, particularly youth. The easy availability of products containing volatile substances (e.g., aerosol sprays, cleaning products, paint) provides opportunity for mind-altering experiences. Unfortunately, serious complications such as brain, cardiovascular, liver, and renal damage or even death may ensue. Adolescents perceive the risk as low, and parents may be unaware of the risks. Health care providers, particularly psychiatric nurses, should undertake strategies of prevention, assessment, and treatment of this challenging problem. PMID:23786241

  5. Inhalation anaesthetics and climate change

    Andersen, Mads Peter Sulbæk; Sander, S P; Nielsen, O J;

    2010-01-01

    Although the increasing abundance of CO(2) in our atmosphere is the main driver of the observed climate change, it is the cumulative effect of all forcing agents that dictate the direction and magnitude of the change, and many smaller contributors are also at play. Isoflurane, desflurane, and...... sevoflurane are widely used inhalation anaesthetics. Emissions of these compounds contribute to radiative forcing of climate change. To quantitatively assess the impact of the anaesthetics on the forcing of climate, detailed information on their properties of heat (infrared, IR) absorption and atmospheric...

  6. Toxicological Assessment of Noxious Inhalants

    Kleinsasser, N. H.

    2004-12-01

    Full Text Available In the past centuries mankind has been exposed to various forms of air pollution not only at his occupational but also in his social environment. He mainly gets exposed with these pollutants through the respiratory organs and partially absorbs them into the body. Many of these airborne substances can be harmful for humans and some of them may account for tumorigenic effects.The following essay describes the main features of toxicological assessment of inhalative environmental and workplace xenobiotics. The essay also explains relevant characteristics and limit values of noxious compounds and gases and depicts modern testing methods. To this end, emphasis is given on methods characterizing the different stages of tumorigenic processes. Various test systems have been developed which can be used in vivo, ex vivo or in vitro. They are to a great part based on the evidence of changes in DNA or particular genes of cells. Among others they have highlighted the impact of interindividual variability on enzymatic activation of xenobiotics and on susceptibility of the host to tumor diseases.Unfortunately, for many inhalative environmental noxious agents no sufficient risk profiles have been developed. The completion of these profiles should be the goal of toxicological assessment in order to allow reasonable socioeconomic or individual-based risk reduction.

  7. Toxicological assessment of noxious inhalants.

    Kleinsasser, N H; Sassen, A W; Wallner, B W; Staudenmaier, R; Harréus, U A; Richter, E

    2004-01-01

    In the past centuries mankind has been exposed to various forms of air pollution not only at his occupational but also in his social environment. He mainly gets exposed with these pollutants through the respiratory organs and partially absorbs them into the body. Many of these airborne substances can be harmful for humans and some of them may account for tumorigenic effects.The following essay describes the main features of toxicological assessment of inhalative environmental and workplace xenobiotics. The essay also explains relevant characteristics and limit values of noxious compounds and gases and depicts modern testing methods. To this end, emphasis is given on methods characterizing the different stages of tumorigenic processes. Various test systems have been developed which can be used in vivo, ex vivo or in vitro. They are to a great part based on the evidence of changes in DNA or particular genes of cells. Among others they have highlighted the impact of interindividual variability on enzymatic activation of xenobiotics and on susceptibility of the host to tumor diseases.Unfortunately, for many inhalative environmental noxious agents no sufficient risk profiles have been developed. The completion of these profiles should be the goal of toxicological assessment in order to allow reasonable socioeconomic or individual-based risk reduction. PMID:22073045

  8. Inhalants

    ... liquids that vaporize at room temperature Industrial or household products , including paint thinners or removers, degreasers, dry-cleaning ... oil sprays Gases —found in household or commercial products and used as medical anesthetics Household or commercial products , including butane lighters and propane ...

  9. Inhalants

    ... Science Adolescent Brain Comorbidity College-Age & Young Adults Criminal Justice Drugged Driving Drug Testing Drugs and the ... Health Effects Statistics and Trends Swipe left or right to scroll. Monitoring the Future Study: Trends in ...

  10. Efficacy comparison of nebulizator or spacer usage for acute bronchiolitis treatment in emergency department

    SAZ, Eylem Ulaş; MİDYAT, Levent; Duyu, Muhterem; OZANANAR, Yeliz; KARAPINAR, Bülent; ÖZÇETİN, Mustafa

    2009-01-01

    Acute bronchiolitis is one of the most common causes of lower respiratory tract infections in children. Nebulization of inhaled beta-2 agonists in emergency departments is time-consuming. In this study, effects of inhalation of appropriate dose of inhaled salbutamol by nebulization or by spacer are compared. Thirty-five patients between ages of 1-24 months old who were admitted in daytime to Ege University Faculty of Medicine Child Emergency Department for cough and/or wheezing and diagnosed ...

  11. Inhalant Dependence and its Medical Consequences

    Mehmet Hamid Boztaş

    2010-12-01

    Full Text Available The term of inhalants is used for matters easily vapors. Inhalants are preferred for rapid, positive reinforcement and mild high effects. Products including inhalants are cheap, accessible, legal substances and are prevalently used in community. The prevalence of inhalant use in secondary schools in Turkey is about 5.1%. Inhalant substance dependence is generally observed within 14-15 age group. Age at first use could be as low as 5 to 6 years of age. Substance dependence is more probable in adults working in substance existing places. Inhalant usage is common in disadvantaged groups, children living in street, people with history of crimes, prison, depression, suicide, antisocial attitudes and conflict of family, history of abuse, violence and any other drug dependence and isolated populations. Inhalants are absorbed from lungs, after performing their quick and short effect metabolized by cytochrom P450 enzyme system except inhalant nitrites group which has a depressing effect like alcohol. In chronic use general atrophy, ventricular dilatation and wide sulcus were shown in cerebrum, cerebellum and pons by monitoring brain. Defects are mostly in periventricular, subcortical regions and in white matter. Demyelinization, hyperintensity, callosal slimming and wearing off in white and gray matter margins was also found. Ravages of brain shown by brain monitorisation are more and serious in inhalant dependence than in other dependences. It is important to decrease use of inhalants. Different approaches should be used for subcultures and groups in prevention. Prohibiting all the matters including inhalant is not practical as there are too many substances including inhalants. Etiquettes showing harmful materials can be used but this approach can also lead the children and adolescents recognize these substances easily.. Despite determintal effects of inhalant dependence, there are not yet sufficient number of studies conducted on prevention and

  12. The Ozone Layer and Metered Dose Inhalers

    Louis-Philippe Boulet

    1998-01-01

    Full Text Available The stratospheric ozone layer plays a crucial role in protecting living organisms against ultraviolet radiation. Chlorofluorocarbons (CFC contained in metered-dose inhalers (MDIs contribute to ozone depletion and in accordance with the Montreal Protocol on Substances That Deplete the Ozone Layer established 10 years ago, phase-out strageies have been developed worldwide for this category of agents. Alternatives to CFC-containing inhalers have been developed, such as powder inhalers and those using hydrofluoroalkanes (HFAs as propellants, which have been shown to be as safe and effective as CFC-containing inhalers and even offer interesting advantages over older inhalers. The transition to non-CFC MDIs requires a major effort to make the new products available and to ensure adequate comparision with the previous ones. It also requires a harmonization of actions taken by industry, government, licencing bodies and patients or health professional associations to ensure adequate information and education to the public and respiratory care providers.

  13. An unusual foreign body producing acute laryngeal obstruction

    Kalan, A.; Tariqs, M.

    1999-01-01

    This paper present an unusual case of acute upper respiratory obstruction due to an inhaled grape necessitating acute surgical measures. Study of the literature proves laryngeal foreign bodies to be a rare occurrence but infinitely more dramatic and life-threatening than either oesophageal or bronchial foreign bodies. Successful management entails prompt surgical intervention coupled with at times, surgical ingenuity.

  14. Exposure to acrolein by inhalation causes platelet activation

    Acrolein is a common air pollutant that is present in high concentrations in wood, cotton, and tobacco smoke, automobile exhaust and industrial waste and emissions. Exposure to acrolein containing environmental pollutants such as tobacco smoke and automobile exhaust has been linked to the activation of the coagulation and hemostasis pathways and thereby to the predisposition of thrombotic events in human. To examine the effects of acrolein on platelets, adult male C57Bl/6 mice were subjected acute (5 ppm for 6 h) or sub-chronic (1 ppm, 6 h/day for 4 days) acrolein inhalation exposures. The acute exposure to acrolein did not cause pulmonary inflammation and oxidative stress, dyslipidemia or induce liver damage or muscle injury. Platelet GSH levels in acrolein-exposed mice were comparable to controls, but acrolein-exposure increased the abundance of protein-acrolein adducts in platelets. Platelets isolated from mice, exposed to both acute and sub-chronic acrolein levels, showed increased ADP-induced platelet aggregation. Exposure to acrolein also led to an increase in the indices of platelet activation such as the formation of platelet-leukocyte aggregates in the blood, plasma PF4 levels, and increased platelet-fibrinogen binding. The bleeding time was decreased in acrolein exposed mice. Plasma levels of PF4 were also increased in mice exposed to environmental tobacco smoke. Similar to inhalation exposure, acrolein feeding to mice also increased platelet activation and established a pro-thrombotic state in mice. Together, our data suggest that acrolein is an important contributing factor to the pro-thrombotic risk in human exposure to pollutants such as tobacco smoke or automobile exhaust, or through dietary consumption.

  15. High-flow oxygen therapy and other inhaled therapies in intensive care units.

    Levy, Sean D; Alladina, Jehan W; Hibbert, Kathryn A; Harris, R Scott; Bajwa, Ednan K; Hess, Dean R

    2016-04-30

    In this Series paper, we review the current evidence for the use of high-flow oxygen therapy, inhaled gases, and aerosols in the care of critically ill patients. The available evidence supports the use of high-flow nasal cannulae for selected patients with acute hypoxaemic respiratory failure. Heliox might prevent intubation or improve gas flow in mechanically ventilated patients with severe asthma. Additionally, it might improve the delivery of aerosolised bronchodilators in obstructive lung disease in general. Inhaled nitric oxide might improve outcomes in a subset of patients with postoperative pulmonary hypertension who had cardiac surgery; however, it has not been shown to provide long-term benefit in patients with acute respiratory distress syndrome (ARDS). Inhaled prostacyclins, similar to inhaled nitric oxide, are not recommended for routine use in patients with ARDS, but can be used to improve oxygenation in patients who are not adequately stabilised with traditional therapies. Aerosolised bronchodilators are useful in mechanically ventilated patients with asthma and chronic obstructive pulmonary disease, but are not recommended for those with ARDS. Use of aerosolised antibiotics for ventilator-associated pneumonia and ventilator-associated tracheobronchitis shows promise, but the delivered dose can be highly variable if proper attention is not paid to the delivery method. PMID:27203510

  16. Beneficial Effects of Concomitant Neuronal and Inducible Nitric Oxide Synthase Inhibition in Ovine Burn and Inhalation Injury

    Lange, Matthias; Hamahata, Atsumori; Enkhbaatar, Perenlei; Cox, Robert A.; Nakano, Yoshimitsu; Westphal, Martin; Traber, Lillian D.; Herndon, David N.; Traber, Daniel L.

    2011-01-01

    Different isoforms of nitric oxide synthase are critically involved in the development of pulmonary failure secondary to acute lung injury. Here we tested the hypothesis that simultaneous blockade of inducible and neuronal nitric oxide synthase effectively prevents the pulmonary lesions in an ovine model of acute respiratory distress syndrome (ARDS) induced by combined burn and smoke inhalation injury. Chronically instrumented sheep were allocated to a sham-injured group (n = 6), an injured a...

  17. Chlorine gas inhalation: human clinical evidence of toxicity and experience in animal models.

    White, Carl W; Martin, James G

    2010-07-01

    Humans can come into contact with chlorine gas during short-term, high-level exposures due to traffic or rail accidents, spills, or other disasters. By contrast, workplace and public (swimming pools, etc.) exposures are more frequently long-term, low-level exposures, occasionally punctuated by unintentional transient increases. Acute exposures can result in symptoms of acute airway obstruction including wheezing, cough, chest tightness, and/or dyspnea. These findings are fairly nonspecific, and might be present after exposures to a number of inhaled chemical irritants. Clinical signs, including hypoxemia, wheezes, rales, and/or abnormal chest radiographs may be present. More severely affected individuals may suffer acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS). Up to 1% of exposed individuals die. Humidified oxygen and inhaled beta-adrenergic agents are appropriate therapies for victims with respiratory symptoms while assessments are underway. Inhaled bicarbonate and systemic or inhaled glucocorticoids also have been reported anecdotally to be beneficial. Chronic sequelae may include increased airways reactivity, which tends to diminish over time. Airways hyperreactivity may be more of a problem among those survivors that are older, have smoked, and/or have pre-existing chronic lung disease. Individuals suffering from irritant-induced asthma (IIA) due to workplace exposures to chlorine also tend to have similar characteristics, such as airways hyperresponsiveness to methacholine, and to be older and to have smoked. Other workplace studies, however, have indicated that workers exposed to chlorine dioxide/sulfur dioxide have tended to have increased risk for chronic bronchitis and/or recurrent wheezing attacks (one or more episodes) but not asthma, while those exposed to ozone have a greater incidence of asthma. Specific biomarkers for acute and chronic exposures to chlorine gas are currently lacking. Animal models for chlorine gas

  18. 孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效研究%Clinical Efficacy of Montelukast Combined with Ipratropium Bromide and Budesonide Aerosol Inhalation on Acute Exac-erbation of Chronic Obstructive Pulmonary Disease

    杜飞; 贺刚; 李云飞; 陈代刚; 吾曼莉

    2014-01-01

    Objective To observe the clinical efficacy of Montelukast combined with Ipratropium bromide and Budes-onide aerosol inhalation on acute exacerbation of chronic obstructive pulmonary disease( COPD). Methods A total of 84 inpa-tients with acute exacerbation of COPD in our department were selected from January to October 2013,and they were divided into treatment group(n=42)and control groups(n=42)according to random number table. Both groups received comprehensive treatment,including oxygen inhalation,antibiotics,facilitating expectoration,suppressing cough and maintaining balance of water and electrolyte. Treatment group were additionally treated with Montelukast 10 mg,1 time per night,Ipratropium bromide 2. 5 ml and Budesonide suspension aerosols 2. 0 ml,twice a day,the treatment lasted for 1 week. The clinical efficacy and lung function changes in both groups were observed. Results The effective rate of treatment group was 95. 24%(40/42),was sig-nificantly higher than that of control group of 80. 95%(34/42)(P﹤0. 01). The differentials of FEV1%,FVC,FEV1/FVC, PEF,RV and RV/TLC before and after treatment were significantly higher of treatment group than those of control group( P﹤0. 05). Conclusion Montelukast combined with Ipratropium bromide and Budesonide aerosol inhalation can improve the clinical efficacy in COPD patients with acute exacerbation,and improve the lung function.%目的:观察孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病( COPD)急性加重期的临床疗效。方法选择我科2013年1-10月收治的COPD急性加重期患者84例,采用随机数字表法将所有患者分为对照组和治疗组,每组42例。对照组患者采用吸氧、抗感染、止咳化痰、维持水电解质平衡等综合治疗,治疗组患者在对照组基础上加用孟鲁司特10 mg口服,1次/晚;雾化吸入复方异丙托溴铵2.5 ml和布地奈德混悬液2 ml,2次/d,连用1周。观察两组

  19. Measurement of trace uranium-235 and plutonium-239, 240 in waste tank material at the Savannah River Site

    Mahannah, F.N.; Maxwell, S.L. III.

    1992-01-01

    At the Savannah River Site (SRS), large quantities of radioactive liquid waste are evaporated to reduce volume before eventual processing through the In-Tank Precipitation process. Actinides in the liquid waste are only slightly soluble in the highly alkaline waste solution. Since some of the actinide isotopes are fissionable, the quantities being processed through the evaporator system are of interest. To better quantify the concentration and mass of fissionable material entering the evaporator system and eventually deposited as salt, analysis of the actinide elements were necessary. The predominant fissionable actinide isotopes of interest are U{sup 235} and Pu{sup 239}. To enable the reliable measurement of these radionuclides, the Central Laboratory has developed high speed separation techniques to measure U{sup 235} content by Isotope Dilution Mass Spectrometry and Pu{sup 239,240} by alpha spectrometry. Due to the high radioactivity levels in the samples all separations are performed in shielded analytical cells. Uranium is purified and concentrated using a high speed extraction chromatography technique that employs applied vacuum and columns containing tri (2-ethylene) phosphate solvent coated on a small particle inert support. The uranium method enables measurement of U{sup 235} concentrations to 1 {times} 10{sup {minus}4} g/L. Plutonium is purified and concentrated using a high speed anion exchange technique. The Pu method enables measurements of Pu{sup 239,240} to 2 {times} 10{sup {minus}6} g/L.

  20. Measurement of trace uranium-235 and plutonium-239, 240 in waste tank material at the Savannah River Site

    Mahannah, F.N.; Maxwell, S.L. III

    1992-08-01

    At the Savannah River Site (SRS), large quantities of radioactive liquid waste are evaporated to reduce volume before eventual processing through the In-Tank Precipitation process. Actinides in the liquid waste are only slightly soluble in the highly alkaline waste solution. Since some of the actinide isotopes are fissionable, the quantities being processed through the evaporator system are of interest. To better quantify the concentration and mass of fissionable material entering the evaporator system and eventually deposited as salt, analysis of the actinide elements were necessary. The predominant fissionable actinide isotopes of interest are U{sup 235} and Pu{sup 239}. To enable the reliable measurement of these radionuclides, the Central Laboratory has developed high speed separation techniques to measure U{sup 235} content by Isotope Dilution Mass Spectrometry and Pu{sup 239,240} by alpha spectrometry. Due to the high radioactivity levels in the samples all separations are performed in shielded analytical cells. Uranium is purified and concentrated using a high speed extraction chromatography technique that employs applied vacuum and columns containing tri (2-ethylene) phosphate solvent coated on a small particle inert support. The uranium method enables measurement of U{sup 235} concentrations to 1 {times} 10{sup {minus}4} g/L. Plutonium is purified and concentrated using a high speed anion exchange technique. The Pu method enables measurements of Pu{sup 239,240} to 2 {times} 10{sup {minus}6} g/L.

  1. Measurement of trace uranium-235 and plutonium-239, 240 in waste tank material at the Savannah River Site

    At the Savannah River Site (SRS), large quantities of radioactive liquid waste are evaporated to reduce volume before eventual processing through the In-Tank Precipitation process. Actinides in the liquid waste are only slightly soluble in the highly alkaline waste solution. Since some of the actinide isotopes are fissionable, the quantities being processed through the evaporator system are of interest. To better quantify the concentration and mass of fissionable material entering the evaporator system and eventually deposited as salt, analysis of the actinide elements were necessary. The predominant fissionable actinide isotopes of interest are U235 and Pu239. To enable the reliable measurement of these radionuclides, the Central Laboratory has developed high speed separation techniques to measure U235 content by Isotope Dilution Mass Spectrometry and Pu239,240 by alpha spectrometry. Due to the high radioactivity levels in the samples all separations are performed in shielded analytical cells. Uranium is purified and concentrated using a high speed extraction chromatography technique that employs applied vacuum and columns containing tri (2-ethylene) phosphate solvent coated on a small particle inert support. The uranium method enables measurement of U235 concentrations to 1 x 10-4 g/L. Plutonium is purified and concentrated using a high speed anion exchange technique. The Pu method enables measurements of Pu239,240 to 2 x 10-6 g/L

  2. Expression of transforming growth factor alpha in plutonium-239-induced lung neoplasms in dogs: investigations of autocrine mechanisms of growth

    We have previously shown that 47% of radiation-induced lung neoplasms in dogs exhibit increased expression of epidermal growth factor receptor (EGFR). In this study, we investigated the expression of transforming growth factor alpha (TGF-alpha), a ligand for EGFR, to determine if an autocrine mechanism for growth stimulation was present in these tumors. As determined by immunohistochemistry, 59% (26/44) of the lung neoplasms examined had increased expression of TGF-alpha. Expression of TGF-alpha was not related to the etiology of the tumor, e.g., spontaneous or plutonium-induced; however, it was related to the phenotype of the tumor. Statistical analysis of the correlation of EGFR and TGF-alpha expression within the same tumor did not show a positive association; however, specific phenotypes did have statistically significant expression of EGFR or TGF-alpha, suggesting that overexpression of either the ligand or its receptor conferred a growth advantage to the neoplasm. Twenty-seven percent (32/117) of radiation-induced proliferative epithelial foci expressed TGF-alpha, and a portion of those foci (8/32) expressed both EGFR and TGF-alpha. This supports the hypothesis that these foci represent preneoplastic lesions, and suggests that those foci exhibiting increased expression of the growth factor or its receptor are at greater risk for progressing to neoplasia

  3. Potential of Vetiveria zizanoides L. Nash for phytoremediation of plutonium ((239)Pu): Chelate assisted uptake and translocation.

    Singh, Shraddha; Fulzele, D P; Kaushik, C P

    2016-10-01

    Plants have demonstrated a great potential to remove toxic elements from soils and solutions and been successfully used for phytoremediation of important radionuclides. Uptake potential of vetiver plants (V. zizanoides) for the remediation of (239)Pu in hydroponic and soil conditions was studied in the present work. High efficiency of V. zizanoides for the removal of (239)Pu was recorded with 66.2% being removed from the hydroponic solution after 30 days. However, remediation of (239)Pu from soil was limited. Remediation of (239)Pu from soil was increased with the addition of chelating agents citric acid (CA) and diethylenetriaminepentaacetic acid (DTPA). Accumulation of (239)Pu was recorded higher in roots than shoots, however its translocation from roots to shoots increased in the presence of chelators in hydroponic as well as soil conditions. DTPA was found more effective than CA showing higher translocation index (TI). Increase in TI was observed 8 and 6 times in the solution and soil respectively when plants were exposed to (239)Pu-DTPA in comparison to only (239)Pu. The present study demonstrates that V. zizanoides plant is a potential plant for phytoremediation of (239)Pu. PMID:27318195

  4. Study of α and triton particles emission in Uranium 235, Uranium 238, Plutonium 239 fast neutron fission

    Fast neutrons up to 2.5 MeV have been used to induce light particle accompanied fission in 235U, 238U and 239Pu targets. The energy spectra and relative intensities of 3H and 4He have been measured with a ΔE-E telescope. Absolute particle yields were derived from the number of 4He particle per 1000 binary fissions of 235U and 239Pu induced by thermal neutrons measured under the same geometrical conditions. We observe that all the energy distributions are well reproduced by gaussian lineshape, the mean energies of which remain constant while varying the neutron incident energy. (For all nuclei, the 4He mean energies lie close to 16 MeV and the corresponding energies for 3H particle at about 8-9 MeV). The production rates of 3H and 4He show a decrease of about 30% between thermal energy and En = 2 MeV with a small maximum at En = 1 MeV. Conversely the 3H and 4He particle yields obtained in fast neutron fission of 239U remain constant between En = 1.5 MeV and En = 2.5 MeV. Some possible explanation for these observations are briefly and qualitatively explored

  5. Handling of a glove box accident. Surgical treatment of a wound contaminated by a mixture of plutonium-239 and americium

    An employee of the Valduc Centre (France) suffered an injury to his right thumb when working in a glove-box on a pipeline which had contained a solution of 239Pu and Am. The lesion was slight but attempts at decontamination were fruitless. The contamination was deep-seated (activity of not less than 18nCi). DTPA was injected intravenously, and it was decided to excise the lesion surgically. Thanks to the quality of its physical facilities and the professional quality of its radiation medicine and surgery team, the Valduc Centre was able to carry out the operation successfully. The result was excellent, and the contamination was eliminated to the satisfaction of both the patient and the physician. (author)

  6. The distribution of plutonium-239 and americium-241 in the Syrian hamster following its intravenous administration as citrate

    Actinide distribution in various tissues and the skeleton of hamsters by liquid scintillation counting or isotope dilution. For plutonium 57% of activity was concentrated in the skeleton and more than 90% in the liver and skeleton after seven days. For americium the liver retained more than 50% of total activity and 25% was excreted in urine within seven days. (U.K.)

  7. Acute silicosis with bilateral pneumothorax.

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  8. A development of computer code for evaluating internal radiation dose through ingestion and inhalation pathways

    The computer codes were developed to evaluate internal radiation dose when radioactive isotopes released from nuclear facilities are taken through ingestion and inhalation pathways. Food chain models and relevant data base representing the agricultural and social environment of Korea are set up. An equilibrium model-KFOOD, which can deal with routine releases from a nuclear facility and a dynamic model-ECOREA, which is suitable for the description of acute radioactivity release following nuclear accident. (Author)

  9. Inhaled actinides: some safety issues and some research problems

    The following topics are discussed: limited research funds; risk coefficients for inhaled particles; the hot particle hypothesis; the Gofman-Martell contention; critical tissues for inhaled actinides inhalation hazards associated with future nuclear fuel cycles; and approach to be used by the inhalation panel

  10. Clinical efficacy and safety of beclomethasone dipropionate inhalation capsules inhaled by Cyclohaler compared with Becotide Rotacaps inhaled by Rotahaler.

    Vink-van Wijngaarden, T; Blom-Ross, M E; Lansdorp, D; Goedhart, D M; Eelhart, J; Guelen, P J; de Vos, D

    1998-09-01

    The study was undertaken to compare the efficacy and safety of beclomethasone dipropionate inhalation powder inhaled by Rotahaler (Becotide Rotacaps, Glaxo Wellcome) and by Cyclohaler (Beclomethasone Cyclocaps, Pharmachemie). Both the Cyclohaler and the Rotahaler are single-dose dry powder inhalation devices for inhalation capsules. 182 asthma patients stabilized on inhaled beclomethasone dipropionate 800 micrograms daily, were randomly assigned to treatment with 800 micrograms beclomethasone dipropionate inhaled by Rotahaler (91 patients) or Cyclohaler (91 patients) in a double-blind manner, using the double-dummy method. It was shown that the asthma remained stable during the 16-week study period with both preparations. There were no statistically significant differences in the pulmonary parameters (morning PEF, evening PEF, FEV1). The test/reference ratio of the morning PEF (99.5%, CI 93.0% - 106.5%) was well within the equivalence interval, which had been set a priori from 85% to 117.6%. There were no marked differences between the Cyclocaps and Rotacaps group in symptom scores and adverse events. A total of 12 patients had an asthma exacerbation: 8 exacerbations occurred in the Rotahaler group and 4 in the Cyclohaler group. The difference was not statistically significant. The use of rescue medication was somewhat higher in the Rotahaler group, but the difference did not reach statistical significance. Significantly more patients (17 patients) withdrew from the study in the Rotahaler group than in the Cyclohaler group (5 patients). In conclusion, there was no difference in asthma control of patients treated with Beclomethasone Cyclocaps inhaled by Cyclohaler and Becotide Rotacaps inhaled by Rotahaler. Both preparations are therapeutically equivalent. PMID:9760014

  11. Randomised controlled trial of aminophylline for severe acute asthma

    Yung, M; South, M

    1998-01-01

    OBJECTIVES—To determine whether children with severe acute asthma treated with large doses of inhaled salbutamol, inhaled ipratropium, and intravenous steroids are conferred any further benefits by the addition of aminophylline given intravenously.
STUDY DESIGN—Randomised, double blind, placebo controlled trial of 163 children admitted to hospital with asthma who were unresponsive to nebulised salbutamol.
RESULTS—The placebo and treatment groups of children were similar at b...

  12. [Acute paraffin oil pneumopathies. Apropos of a case in a fire-eater].

    Dominique, S; Lerebours Pigeonnière, G; Thiberville, L; Stain, J P; Genevois, A; Nouvet, G

    1988-01-01

    A case of acute paraffin oil-induced pneumonia due to accidental inhalation by a fire-eater of kerdane, a petroleum derivative is reported. The symptoms and course of respiratory manifestations of acute paraffin oil poisoning are reviewed. The physical properties of the petroleum derivative inhaled account for the pathogenesis of the pneumonia. Pulmonary lesions, usually fully reversible, result from the joint effects of an inflammatory phase with exudate and a proliferative phase. PMID:3406615

  13. Abused inhalants enhance GABA-mediated synaptic inhibition

    MacIver, M Bruce

    2009-01-01

    Abused inhalants are widely used, especially among school age children and teenagers, and are ‘gateway’ drugs leading to the abuse of alcohol and other addictive substances. In spite of this widespread use, little is known about the effects produced by inhalants on the central nervous system. The similarity in behavioral effects produced by inhalants and inhaled anesthetics, together with their common chemical features, prompted the present study of inhalant actions on a well characterized an...

  14. Know How to Use Your Asthma Inhaler

    Full Text Available ... Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent Asthma Data AsthmaStats Asthma-related Missed School Days among Children ...

  15. Know How to Use Your Asthma Inhaler

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Mixed Methods 5. Purpose Informs Design Other Evaluation Resources Multimedia ... HHS/Open USA.gov

  16. Know How to Use Your Asthma Inhaler

    Full Text Available ... Quick Links Asthma Action Plan America Breathing Easier [PDF - 1.1 MB] ASL Asthma Film Asthma Clinical ... Using a metered dose inhaler with a spacer [ PDF - 377 KB] Your browser does not support iframes ...

  17. Late effects of inhaled plutonium in dogs

    An overview is presented summarizing the effects of inhaled 239PuO2 and 238PuO2 in dogs with emphasis on dose-response relationships at low exposure levels. With the dose levels studied to date, pulmonary neoplasia was the primary cause of death in beagles 5 to 10 years after inhalation of 239PuO2. None of the dogs exposed to 239PuO2 developed bone tumors. Bone neoplasia was the primary cause of death 5 to 6 years after inhalation of 238PuO2; however, one of the dogs had pulmonary tumors in addition to bone tumors. The earliest indication of a biological effect after the inhalation of 239PuO2 or 238PuO2 was dose related lymphocytopenia

  18. Know How to Use Your Asthma Inhaler

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals ...

  19. Know How to Use Your Asthma Inhaler

    Full Text Available ... Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking your medicine ...

  20. About Steroids (Inhaled and Oral Corticosteroids)

    ... Medications > Long-Term Control Medications > About Steroids About Steroids (Inhaled and Oral Corticosteroids) What are corticosteroids (‘steroids’) ... considerations when your dosage changes? What are corticosteroids (‘steroids’)? Corticosteroids (steroids) are medicines that are used to ...

  1. Know How to Use Your Asthma Inhaler

    Full Text Available ... Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance ... gaining control over their asthma. Quick Links Asthma Action Plan America Breathing Easier [PDF - 1.1 MB] ...

  2. Know How to Use Your Asthma Inhaler

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Obesity Percentage of People with Asthma who Smoke Insurance coverage and barriers to care for people with ...

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    Full Text Available ... J K L M N O P Q R S T U V W X Y Z # Start ... Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent Asthma Data AsthmaStats Asthma- ...

  4. Know How to Use Your Asthma Inhaler

    Full Text Available ... avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you ... keep them with your Asthma Action Plan. Using a metered dose inhaler with a spacer Your browser ...

  5. Smoke inhalation injury during enclosed-space fires: an update

    Ana Carolina Pecanha Antonio

    2013-06-01

    Full Text Available In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection

  6. Inhaler devices - from theory to practice

    Sanchis, Joaquin; Corrigan, Chris; Levy, Mark L;

    2013-01-01

    This brief overview of the factors determining lung deposition of aerosols provides background information required by health care providers when instructing patients to use their prescribed inhalers. We discuss differences in the optimal inhalation manoeuvres for each type of aerosol generator a...... the difficulties patients face. Provision of short, clear instructions with demonstration of critical steps and checking technique during later clinical visits are necessary if these aerosolised medications are to be fully beneficial....

  7. Manganese Inhalation as a Parkinson Disease Model

    José Luis Ordoñez-Librado; Verónica Anaya-Martínez; Ana Luisa Gutierrez-Valdez; Laura Colín-Barenque; Enrique Montiel-Flores; Maria Rosa Avila-Costa

    2011-01-01

    The present study examines the effects of divalent and trivalent Manganese (Mn2+/Mn3+) mixture inhalation on mice to obtain a novel animal model of Parkinson disease (PD) inducing bilateral and progressive dopaminergic cell death, correlate those alterations with motor disturbances, and determine whether L-DOPA treatment improves the behavior, to ensure that the alterations are of dopaminergic origin. CD-1 male mice inhaled a mixture of Manganese chloride and Manganese acetate, one hour twice...

  8. Inhalation injury: epidemiology, pathology, treatment strategies

    Dries, David J; Endorf, Frederick W

    2013-01-01

    Lung injury resulting from inhalation of smoke or chemical products of combustion continues to be associated with significant morbidity and mortality. Combined with cutaneous burns, inhalation injury increases fluid resuscitation requirements, incidence of pulmonary complications and overall mortality of thermal injury. While many products and techniques have been developed to manage cutaneous thermal trauma, relatively few diagnosis-specific therapeutic options have been identified for patie...

  9. Clearance of inhaled particles in ankylosing spondylitis.

    Farquhar, D R; Chamberlain, M. J.; McCain, G A; Morgan, W K

    1989-01-01

    Patients with ankylosing spondylitis may uncommonly develop apical fibrobullous lung disease, the cause of which is unknown. It is postulated here that rigidity of the thoracic cage leads to reduced apical clearance of inhaled particles and may thereby predispose to chronic infection. Deposition and clearance of inhaled technetium-99m sulphur colloid particles were studied in eight male patients with ankylosing spondylitis who had chest wall rigidity (mean (SD) chest expansion 1.8 (1.07) cm) ...

  10. Amorphous powders for inhalation drug delivery.

    Chen, Lan; Okuda, Tomoyuki; Lu, Xiang-Yun; Chan, Hak-Kim

    2016-05-01

    For inhalation drug delivery, amorphous powder formulations offer the benefits of increased bioavailability for poorly soluble drugs, improved biochemical stability for biologics, and expanded options of using various drugs and their combinations. However, amorphous formulations usually have poor physicochemical stability. This review focuses on inhalable amorphous powders, including the production methods, the active pharmaceutical ingredients and the excipients with a highlight on stabilization of the particles. PMID:26780404

  11. Achieving consistent multiple daily low-dose Bacillus anthracis spore inhalation exposures in the rabbit model

    Roy E Barnewall

    2012-06-01

    Full Text Available Repeated low-level exposures to Bacillus anthracis could occur before or after the remediation of an environmental release. This is especially true for persistent agents such as Bacillus anthracis spores, the causative agent of anthrax. Studies were conducted to examine aerosol methods needed for consistent daily low aerosol concentrations to deliver a low-dose (less than 106 colony forming units (CFU of B. anthracis spores and included a pilot feasibility characterization study, acute exposure study, and a multiple fifteen day exposure study. This manuscript focuses on the state-of-the-science aerosol methodologies used to generate and aerosolize consistent daily low aerosol concentrations and resultant low inhalation doses. The pilot feasibility characterization study determined that the aerosol system was consistent and capable of producing very low aerosol concentrations. In the acute, single day exposure experiment, targeted inhaled doses of 1 x 102, 1 x 103, 1 x 104, and 1 x 105 CFU were used. In the multiple daily exposure experiment, rabbits were exposed multiple days to targeted inhaled doses of 1 x 102, 1 x 103, and 1 x 104 CFU. In all studies, targeted inhaled doses remained fairly consistent from rabbit to rabbit and day to day. The aerosol system produced aerosolized spores within the optimal mass median aerodynamic diameter particle size range to reach deep lung alveoli. Consistency of the inhaled dose was aided by monitoring and recording respiratory parameters during the exposure with real-time plethysmography. Overall, the presented results show that the animal aerosol system was stable and highly reproducible between different studies and multiple exposure days.

  12. Dynamics of airflow in a short inhalation

    Bates, Alister; Cetto, Raul; Calmet, Hadrien; Gambaruto, Alberto; Tolley, Neil; Houzeaux, Guillaume; Schroter, Robert

    2015-01-01

    During a rapid inhalation, such as a sniff, the flow in the airways accelerates and decays quickly. The consequences for flow development and convective trans- port of an inhaled gas were investigated in a subject geometry extending from the nose to the bronchi. The progress of flow transition and the advance of an inhaled non-absorbed gas were determined using highly resolved simulations of a sniff 0.5 s long, 1 litre per second peak flow, 364 ml inhaled volume. In the nose, the distribution of airflow evolved through three phases: (i) an initial transient of about 50 ms, roughly the filling time for a nasal volume, (ii) quasi-equilibrium over the majority of the inhalation, and (iii) a terminating phase. Flow transition commenced in the supraglottic region within 20ms, resulting in large- amplitude fluctuations persisting throughout the inhalation; in the nose, fluctuations that arose nearer peak flow were of much reduced intensity and diminished in the flow decay phase. Measures of gas concentration showed...

  13. Bronchodilatation effect of inhaled budesonide/formoterol and budesonide/salbutamol in treating children with acute asthma%吸入布地奈德/福莫特罗和布地奈德/沙丁胺醇对哮喘急性发作儿童支气管扩张的效果探讨

    吴俏桐; 吴博仪; 洪国强

    2014-01-01

    Objective To compare bronchodilation effects of inhaled budesonide/formoterol (dose:100 μ g and 6 μ g) and budesonide (100 μ g)/salbutamol (100 μ g) for the 5-15 year-old children with asthma exacerbation.Methods A double-blind randomized controlled trial was conducted each MDI intervals,children were administered two times,receiving formoterol or salbutamol,both groups received 100 μ g of budesonide.At 20-minute intervals,all children received three doses of the drug.Analysis and comparison of FEV1 (% predicted)and the amendments to the pulmonary index score (MPIS) were analyzed.Efficacies of 1,5,15,30,60 minutes were studied.Results FEV1(% predicted) and MPIS had no significant differences.From 1 minute to 60 minutes,one minute after administration,FEV1 (% predicted),formoterol and salbutamol from baseline were significantly improved.Peak expiratory flow rate (PEFR),percentage of predicted PEFR,forced expiratory flow 50 (FEF50) and percentage of predicted FEF50 were significantly improved.At different time points,the two groups were similar during the study and were not statistically significant.Conclusions In a certain inhaled dose,mild acute asthma among 5-15 years children,salbutamol or formoterol have a similar bronchodilator effect.%目的 比较吸入布地奈德(100μg)/福莫特罗(6μg)、布地奈德(100 μg)/沙丁胺醇(100 μg)组合在5~ 15岁儿童哮喘发作期对支气管扩张的效果.方法 采用双盲随机对照试验,研究组给予使用布地奈德100μg+福莫特罗6μg组合压力式定量气雾装置吸入(MDI),对照组给予布地奈德100μg+沙丁胺醇100μg组合MDI.所有的儿童接受三次剂量的药物,给药间隔时间在20分钟以内.分析比较FEV1(%预计值)以及修正的肺指标值(MPIS),研究两组在1、5、15、30、60分钟后的药效.结果 干预后两组之间1、5、15、30、60分钟FEV1(%预计值)的比较差异无统计学意义(P>0.05).而对照组、研究组自身的(FEV 1

  14. Intestinal circulation during inhalation anesthesia

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of 86Rb and 9-microns spheres labeled with 141Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO2) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines

  15. A comparison of Oral and Inhalant Corticosteroids in Treatment of Mild to Moderate Asthma Exacerbation in Children

    Nemat Bilan

    2015-04-01

    Full Text Available Introduction: Oral corticosteroids are the main treatment in asthma exacerbation. It has been reported that inhaled corticosteroids can be used instead of oral corticosteroids in asthma exacerbation. We aimed to evaluate the efficacy of inhaled fluticasone and oral prednisolone in children with mild to moderate asthma exacerbation. Materials and Methods: In this randomized clinical trial, 60 children with mild-to-moderate acute asthma exacerbation visiting emergency department were randomly assigned to receive oral prednisolone (2 mg/kg or fluticasone spray (2 puffs every 12 hours, each puff contains 250 microgram fluticasone using an spacer for one week. The first dose of the treatment was given in the emergency department.  Children were followed for seven days and signs and symptoms of exacerbation, as well as spirometry findings were evaluated.Results: On the days 1 and 3, symptoms including cough, sputum and need for salbutamol during day was more improved in oral prednisolone and symptoms at night was more improved in inhaled fluticasone. Patients were almost symptom free on the seventh day. Forced expiratory volume in 1 second, forced vital capacity and forced expiratory flow rate on the seventh day were significantly better with inhaled fluticasone compared to oral prednisolone.Conclusion: Both inhaled fluticasone and oral prednisolone improved symptoms during a week after exacerbation; however, better respiratory function in children treated with inhaled fluticasone is indicative of its further efficacy compared to oral prednisolone. Considering the low systemic effects of inhaled fluticasone, this treatment seems to be more appropriate in treatment of mild to moderate exacerbations. Keywords: Asthma exacerbation; Inhaled fluticasone; Prednisolone

  16. Protection against inhaled oxidants through scavenging of oxidized lipids by macrophage receptors MARCO and SR-AI/II

    Dahl, Morten; Bauer, Alison K; Arredouani, Mohamed; Soininen, Raija; Tryggvason, Karl; Kleeberger, Steven R; Kobzik, Lester

    2007-01-01

    Alveolar macrophages (AMs) express the class A scavenger receptors (SRAs) macrophage receptor with collagenous structure (MARCO) and scavenger receptor AI/II (SRA-I/II), which recognize oxidized lipids and provide innate defense against inhaled pathogens and particles. Increased MARCO expression in......, consistent with SRA function in binding oxidized lipids. SR-AI/II-/- mice showed similar enhanced acute lung inflammation after beta-epoxide or another inhaled oxidant (aerosolized leachate of residual oil fly ash). In contrast, subacute ozone exposure did not enhance inflammation in SR-AI/II-/- versus SR-AI...

  17. Assessing inhalation injury in the emergency room

    Tanizaki S

    2015-07-01

    Full Text Available Shinsuke Tanizaki Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan Abstract: Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care. Intubation should be considered if any of the following signs exist: respiratory distress, stridor, hypoventilation, use of accessory respiratory muscles, blistering or edema of the oropharynx, or deep burns to the face or neck. Any patients suspected to have inhalation injuries should receive a high concentration of supplemental oxygen to quickly reverse hypoxia and to displace carbon monoxide from protein binding sites. Management of carbon monoxide and cyanide exposure in smoke inhalation patients remains controversial. Absolute indications for hyperbaric oxygen therapy do not exist because there is a low correlation between carboxyhemoglobin levels and the severity of the clinical state. A cyanide antidote should be administered when cyanide poisoning is clinically suspected. Although an ideal approach for respiratory support of patients with inhalation injuries do not exist, it is important that they are supported using techniques that do not further exacerbate respiratory failure. A well-organized strategy for patients with inhalation injury is critical to reduce morbidity and mortality. Keywords: inhalation injury, burn, carbon monoxide poisoning, cyanide poisoning

  18. Biological effects of daily inhalation of radon and its short-lived daughters in experimental animals

    Syrian golden hamsters, C57BL mice, and specific-pathogen-free rats were exposed simultaneously in groups of 16 animals each for 90 hours per week to aerosols consisting of radon plus 3000--6000 Working Levels of radon-daughters with and without 18 mg/m3 carnotite uranium ore dust. Condensation nuclei concentrations ranged from 2000--4000 per ml and from 90,000--120,000 per ml in the chamber without and with uranium ore dust, respectively. At 4 months of exposure only one of the rodents remained alive. Histopathology of radon-daughter exposed mice includes acute interstitial pneumonitis, severe pulmonary congestion, and supperative rhinitis; mice inhaling radon-daughters with ore showed these lesions plus macrophage proliferation, alveolar septal cell hyperplasia, and bronchial epithelial hyperplasia. Hamsters inhaling radon-daughters showed proliferating lesions characterized by alveolar septal thickening, bronchiolar epithelial hyperplasia, septal fibrosis, and occasionally adenomatoid metaplasia and squamous metaplasia. Hamsters inhaling radon-daughters with ore dust showed similar effects plus granulomatous response and intense septal fibrosis. Rats inhaling radon-daughters showed lesions similar to those of hamsters but more focalized with classic radiation pneumonitis; rats exposed to radon-daughters with ore showed similar lesions, with greater consolidation and pneumoconiosis. These findings will be discussed in relation to pulmonary pathology in uranium miners

  19. CT and MR imaging of spongiform leukoencephalopathy after heroin vapor inhalation

    Objective: To summarize the CT and MRI features of spongiform leucoencephalopathy after heroin vapor inhalation. Methods: The clinical characteristic, CT and MRI of 5 cases and biopsy of 1 case with heroin vapor inhalation induced spongiform leukoencephalopathy were analyzed. Results: CT and MRI appearances of spongiform leucoencephalopathy after heroin vapor inhalation were as follow: (1) Brain CT and MRI showed extensive symmetrical white matter lesions within bilateral cerebral and cerebellar hemispheres, the brainstem, and posterior limbs of the internal capsule. The cerebellum was heavily impaired. The most outstanding characteristics of the lesion was ring-like or butterfly-like in shape with clear margin in cerebellar hemispheres. (2) The lesion was bilateral and symmetrical. The margin of the lesion was clear. (3) A computed tomographic scan showed hypointense lesions. T1-weighted magnetic resonance imaging (MRI) showed hypointense lesions and T2-weighted MRI showed hyperintense lesions. (4) No enhancement with Gd-DTPA was revealed. (5) Spongiform vacuoles degeneration of white matter was the main morphological change by biopsy. Conclusion: Spongiform leukoencephalopathy should be considered if a patient showed acute cerebellar signs who had a history of inhaling heroin pyrolysate. The imaging manifestation of this disease is typical and the diagnosis can be made by head CT or MRI

  20. Effects of inspiratory resistance, inhaled beta-agonists and histamine on canine tracheal blood flow

    Kelly, W.T.; Baile, E.M.; Brancatisano, A.; Pare, P.D.; Engel, L.A. (Dept. of Respiratory Medicine, Westmead Hospital, Westmead, NSW (Australia))

    1992-01-01

    Tracheobronchial blood flow is potentially important in asthma as it could either influence the clearance of mediators form the airways, thus affecting the duration and severity of bronchoispasm, or enhance oedema formation with a resultant increase in airflow obstruction. In anaesthetized dogs, spontaneously breathing via a tracheostomy, we investigated the effects of three interventions which are relevant to acute asthma attacks and could potentially influence blood flow and its distribution to the mucosa and remaining tissues of the trachea: (1) increased negative intrathoracic pressure swings (-25[+-]1 cmH[sub 2]O) induced by an inspiratory resistance; (2) variable inhaled doses of a beta-adrenoceptor-agonist (terbutaline); and (3) aerosolized histamine sufficient to produce a threefold increase in pulmonary resistance. Microspheres labelled with different radioisotopes were used to measure blood flow. Resistive breathing did not influence tracheobronchial blood flow. Following a large dose of terbutaline, mucosal blood flow (Qmb) increased by 50%. After inhaled histamine, Qmb reached 265% of the baseline value. We conclude that, whereas increased negative pressure swings do not influence tracheobronchial blood flow or its distribution, inhalation of aerosolized terbutaline, corresponding to a conventionally nebulized dose, increases mucosal blood flow. Our results also confirm that inhaled histamine, in a dose sufficient to produce moderate bronchoconstriction, increases tracheal mucosal blood flow in the area of deposition. (au).

  1. Effects of inspiratory resistance, inhaled beta-agonists and histamine on canine tracheal blood flow

    Tracheobronchial blood flow is potentially important in asthma as it could either influence the clearance of mediators form the airways, thus affecting the duration and severity of bronchoispasm, or enhance oedema formation with a resultant increase in airflow obstruction. In anaesthetized dogs, spontaneously breathing via a tracheostomy, we investigated the effects of three interventions which are relevant to acute asthma attacks and could potentially influence blood flow and its distribution to the mucosa and remaining tissues of the trachea: 1) increased negative intrathoracic pressure swings (-25±1 cmH2O) induced by an inspiratory resistance; 2) variable inhaled doses of a beta-adrenoceptor-agonist (terbutaline); and 3) aerosolized histamine sufficient to produce a threefold increase in pulmonary resistance. Microspheres labelled with different radioisotopes were used to measure blood flow. Resistive breathing did not influence tracheobronchial blood flow. Following a large dose of terbutaline, mucosal blood flow (Qmb) increased by 50%. After inhaled histamine, Qmb reached 265% of the baseline value. We conclude that, whereas increased negative pressure swings do not influence tracheobronchial blood flow or its distribution, inhalation of aerosolized terbutaline, corresponding to a conventionally nebulized dose, increases mucosal blood flow. Our results also confirm that inhaled histamine, in a dose sufficient to produce moderate bronchoconstriction, increases tracheal mucosal blood flow in the area of deposition. (au)

  2. Calculations of loads and doses delivered, from radiochemistry and human spectrometry experimental results in a case of internal contamination in man. (Validity of Morrow's test and retention equations)

    The results of a previous study giving fecal and urinary excretion curves of five radioelements (cesium 137, cobalt 60, cerium 144, strontium 90, and plutonium 239) after radioactive aerosol inhalation by a man were interpreted. It is tried to draw conclusions on the validity of the theoretical parameters needed for calculating the load and the dose in man

  3. Use of inhaled corticosteroids in pediatric asthma

    Bisgaard, H

    1997-01-01

    Inhaled corticosteroids reduce asthma symptoms and exacerbations, improve lung function, and reduce airway inflammation and bronchial hyperreactivity more effectively than other treatments. However, inhaled corticosteroids may be unable to return lung function and bronchial hyperreactivity to...... normal when introduced for moderately severe asthma. This finding highlights the need to improve treatment strategy in pediatric asthma. The natural progression of persistent asthma may lead to loss of lung function and chronic bronchial hyperreactivity for children and adults. There is evidence to...... suggest that asthma acts via a chronic inflammatory process that causes remodeling of the airways with mucosal thickening and smooth muscle hypertrophy. An optimal treatment strategy would be one aimed at reducing the ongoing airway inflammation. Inhaled steroids ameliorate the inflammation, whereas this...

  4. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    Gauglitz, Gerd G; Finnerty, Celeste C; Herndon, David N; Mlcak, Ronald P; Jeschke, Marc G

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different serum cytokine profile compared with burn patients with inhalation injury who survived. Early identification followed by appropriate management of these high-risk patients may lead to improved clinical outcome. Methods Thirteen severely burned children with inhalation injury who did not survive and 15 severely burned pediatric patients with inhalation injury who survived were enrolled in the study. Blood was collected within 24 hours of admission and 5 to 7 days later. Cytokine levels were profiled using multiplex antibody coated beads. Inhalation injury was diagnosed by bronchoscopy during the initial surgery. The number of days on the ventilator, peak inspiratory pressure rates, arterial oxygen tension (PaO2)/fraction of inspired oxygen (FiO2) ratio and incidence of acute respiratory distress syndrome were recorded for those patients. Results Significantly altered levels of IL-4, IL-6, IL-7, IL-10, and IL-13 were detected within the first 7 days after admission in serum from burn pediatric patients with concomitant inhalation injury who did not survive when compared with similar patients who did (P < 0.05). Alterations in these cytokines were associated with increased incidence of acute respiratory distress syndrome, number of days under ventilation, increased peak inspiratory pressure, and lower PaO2/FiO2 ratio in this patient population. Multiple logistic regression analysis revealed that patients with increased IL-6 and IL-10 as well as decreased IL-7 serum levels had a

  5. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  6. Activity and Safety of Inhaled Itraconazole Nanosuspension in a Model Pulmonary Aspergillus fumigatus Infection in Inoculated Young Quails.

    Wlaź, Piotr; Knaga, Sebastian; Kasperek, Kornel; Wlaź, Aleksandra; Poleszak, Ewa; Jeżewska-Witkowska, Grażyna; Winiarczyk, Stanisław; Wyska, Elżbieta; Heinekamp, Thorsten; Rundfeldt, Chris

    2015-08-01

    Pulmonary aspergillosis is frequently reported in parrots, falcons, and other birds held in captivity. Inhalation is the main route of infection for Aspergillus fumigatus, resulting in both acute and chronic disease conditions. Itraconazole (ITRA) is an antifungal commonly used in birds, but its administration requires repeated oral dosing, and the safety margin is narrow. To investigate the efficacy of inhaled ITRA, six groups of ten young quails (Coturnix japonica) were inoculated intratracheally with 5 × 10(6) spores (3 groups) or 5 × 10(7) spores (3 groups). Animals were exposed to nebulized ITRA nanosuspension as 10 % suspension or 4 % suspension, once daily for 30 min, starting 2 h after inoculation for 6 days. Control groups were exposed to nebulized saline for the same period of time. Survival and clinical scores were evaluated, and animals were subjected to gross pathology. In control animals, aspergillosis resulted in systemic disease without pulmonary or air sac granulomas. Animals died from multiple organ failure. Inhalation of 10 % ITRA nanosuspension blocked lethality and prevented disease-related symptoms in the quails exposed to the low dose of spores, while the disease course in quails inoculated with the high-spore dose was retarded. Inhalation of 4 % ITRA nanosuspension was less effective. Both inhalations were well tolerated, and gross pathology did not reveal signs of local toxicity. The data indicate that inhaled administration of 10 % ITRA nanosuspension is capable of alleviating an acute A. fumigatus infection in quails. A lower ITRA concentration may be only active in chronic pulmonary aspergillosis. PMID:25790942

  7. [Inhaled corticosteroids: Which regimens are appropriate?].

    Giovannini-Chami, L; Piccini-Bailly, C; Albertini, M

    2016-06-01

    Inhaled corticosteroids are the cornerstone of asthma management. Inhaled corticosteroid regimens differ slightly in various international guidelines on asthma management but are based on the principles of continuous treatment and titration to the lowest effective dose. Several recent studies, nevertheless, appear to demonstrate the potential value of preemptive or "pro re nata" regimens in infants and children. These studies were included in GINA 2015 for children 5 years of age and younger in whom discontinuous treatment is proposed as a second-line option. Should we change our practices after a critical reading of these studies? PMID:27133372

  8. Fine particle mass from the Diskus inhaler and Turbuhaler inhaler in children with asthma

    Bisgaard, H; Klug, B; Sumby, B S;

    1998-01-01

    in an inhalation profile simulator to assess drug delivery from both a Diskus inhaler and a Turbuhaler inhaler, and in particular to assess the proportion of drug emitted in the coarse (>4.7 microm) and fine (... represents the changes in flow rate over time through the device than the constant flow rate usually applied with an impactor alone. The aerosol cloud was released before the peak inspiratory effort had been achieved and accordingly the early part and not the peak of the inspiratory performance...... is a determinant of the quality of the aerosol. The mean (SD) amount of drug in large particles (>4.7 microm), fine particles (

  9. Microscopic distribution patterns of microspheres deposited by inhalation in lungs of rats, guinea pigs, and dogs

    Snipes, M.B.; Guilmette, R.A.; Nikula, K.J.

    1995-12-01

    Acute inhalation exposures of mammalian species to small amounts of poorly soluble particles result in deposition of the particles in the head airways, tracheobronchial region, and pulmonary region of the respiratory tract. Most of the particles that deposit in the head airways and tracheobronchial region are believed to clear rapidly, but some as yet undefined fraction of the particles is retained in the airway epithelium or subepithelial interstitium for extended times. This long-term retention has important implications for the new respiratory tract dosimetry model of the International Commission on Radiological Protection because particles retained within the region can result in long-term exposure of airway epithelial cells. Preliminary results from this study demonstrate that a substantial fraction of the PSL microspheres inhaled by these rats, guinea pigs, and dogs was incorporated into the epithelium and interstitium of the tracheobronchial region.

  10. Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.

    Jordi Almirall

    Full Text Available BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP. We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. METHODS: Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality. RESULTS: Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%. In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002 in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787. This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542, with COPD alone (OR=4.68, p=0.194, but a protective effect was observed in CB patients (OR=0.15, p=0.027. Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. CONCLUSIONS: Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis.

  11. Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

    Jose Chacko

    2012-01-01

    Full Text Available Background and Aims: Although smoke inhalation is well known to cause acute lung injury, there are few reports in literature that study the evolution, clinical course and outcomes of isolated inhalational lung injury in a modern intensive care setting. A major fire disaster provided us the opportunity to study victims of isolated inhalational injury admitted to our Multidisciplinary Intensive Care Unit (MICU. Materials and Methods: We studied the clinical course, ICU and hospital outcomes of 13 victims of a fire disaster who required mechanical ventilation for isolated inhalational lung injury. All patients were followed up at regular intervals, and their functional status was assessed at 8 months after hospital discharge. Results: The Lung Injury Scores (LIS worsened to reach a nadir on Day 3 of injury. There was a significant correlation between the LIS on Day 3 and duration of mechanical ventilation (r = 0.8; P = 0.003, ICU (r = 0.8; P = 0.002 and hospital (r = 0.6; P = 0.02 days. Late-onset airway complications were encountered in four patients. Three of them required long-term artificial airways - two with a tracheostomy while the third patient required surgical insertion of a "T" tube. Persistent problems with phonation occurred in two patients. At 8 months postdischarge, all patients were independent with activities of daily living; all were back to work, except for two who continued to need artificial airways. Conclusions: Inhalational lung injury progresses over the first few days and is worst after 72 h. Late-onset airway complications may manifest after several weeks and require repeated intervention.

  12. 49 CFR 172.429 - POISON INHALATION HAZARD label.

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD label. 172.429 Section... REQUIREMENTS, AND SECURITY PLANS Labeling § 172.429 POISON INHALATION HAZARD label. (a) Except for size and color, the POISON INHALATION HAZARD label must be as follows: ER22JY97.023 (b) In addition to...

  13. 49 CFR 172.555 - POISON INHALATION HAZARD placard.

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD placard. 172.555 Section... REQUIREMENTS, AND SECURITY PLANS Placarding § 172.555 POISON INHALATION HAZARD placard. (a) Except for size and color, the POISON INHALATION HAZARD placard must be as follows: ER22JY97.025 (b) In addition...

  14. 42 CFR 84.90 - Breathing resistance test; inhalation.

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; inhalation. 84.90...-Contained Breathing Apparatus § 84.90 Breathing resistance test; inhalation. (a) Resistance to inhalation airflow will be measured in the facepiece or mouthpiece while the apparatus is operated by a...

  15. Pulmonary toxicity of well-dispersed cerium oxide nanoparticles following intratracheal instillation and inhalation

    Morimoto, Yasuo, E-mail: yasuom@med.uoeh-u.ac.jp; Izumi, Hiroto; Yoshiura, Yukiko; Tomonaga, Taisuke; Oyabu, Takako; Myojo, Toshihiko; Kawai, Kazuaki; Yatera, Kazuhiro [University of Occupational and Environmental Health (Japan); Shimada, Manabu; Kubo, Masaru [Hiroshima University (Japan); Yamamoto, Kazuhiro [National Institute of Advanced Industrial Science and Technology (AIST) (Japan); Kitajima, Shinichi [National Sanatorium Hoshizuka Keiaien (Japan); Kuroda, Etsushi [Osaka University, Laboratory of Vaccine Science, WPI Immunology Frontier Research Center (Japan); Kawaguchi, Kenji; Sasaki, Takeshi [National Institute of Advanced Industrial Science and Technology (AIST) (Japan)

    2015-11-15

    We performed inhalation and intratracheal instillation studies of cerium dioxide (CeO{sub 2}) nanoparticles in order to investigate their pulmonary toxicity, and observed pulmonary inflammation not only in the acute and but also in the chronic phases. In the intratracheal instillation study, F344 rats were exposed to 0.2 mg or 1 mg of CeO{sub 2} nanoparticles. Cell analysis and chemokines in bronchoalveolar lavage fluid (BALF) were analyzed from 3 days to 6 months following the instillation. In the inhalation study, rats were exposed to the maximum concentration of inhaled CeO{sub 2} nanoparticles (2, 10 mg/m{sup 3}, respectively) for 4 weeks (6 h/day, 5 days/week). The same endpoints as in the intratracheal instillation study were examined from 3 days to 3 months after the end of the exposure. The intratracheal instillation of CeO{sub 2} nanoparticles caused a persistent increase in the total and neutrophil number in BALF and in the concentration of cytokine-induced neutrophil chemoattractant (CINC)-1, CINC-2, chemokine for neutrophil, and heme oxygenase-1 (HO-1), an oxidative stress marker, in BALF during the observation time. The inhalation of CeO{sub 2} nanoparticles also induced a persistent influx of neutrophils and expression of CINC-1, CINC-2, and HO-1 in BALF. Pathological features revealed that inflammatory cells, including macrophages and neutrophils, invaded the alveolar space in both studies. Taken together, the CeO{sub 2} nanoparticles induced not only acute but also chronic inflammation in the lung, suggesting that CeO{sub 2} nanoparticles have a pulmonary toxicity that can lead to irreversible lesions.

  16. Dose-dependent pulmonary effects of inhaled endotoxin in guinea pigs.

    Gordon, T

    1992-12-01

    As a cell wall component of gram-negative bacteria, endotoxin is thought to play a significant role in the respiratory effects of inhaled organic dusts which are microbially contaminated. Assessment of occupational survey data and clinical studies suggests that few measureable, acute functional changes occur below 30-50 ng/m3 endotoxin (as sampled in airborne dust with a vertical elutriator). Little information is available on the inflammatory effects of inhaled endotoxin at these low concentrations. The present study examined the dose-response relationship between inhaled endotoxin and functional, biochemical, and histological endpoints in the lungs of guinea pigs. Animals were exposed to 0.03 to 50.5 micrograms/m3 aerosolized endotoxin or the vehicle water for 4 hr. At 2 hr into exposure, significant decreases in specific airway conductance were observed only in animals exposed to 9.6 and 50.5 micrograms/m3 endotoxin (17.3 +/- 1.2 and 35.5 +/- 0.5% decreases from baseline values, respectively (mean +/- SE)). Total cell count and lactate dehydrogenase levels in bronchoalveolar lavage fluid were significantly elevated at 24 hr after exposure in all endotoxin-exposed groups except the lowest dose, 0.03 micrograms/m3 (P endotoxin. Thus, LDH activity, a biochemical marker of cell injury, and total cell counts and polymorphonuclear leukocytes, markers of inflammation, were more sensitive indices of adverse pulmonary effects from inhaled endotoxin than a functional measurement. These results suggest that subtle inflammatory changes may occur at airborne endotoxin concentrations which may produce no acute respiratory symptoms. PMID:1464292

  17. Pulmonary toxicity of well-dispersed cerium oxide nanoparticles following intratracheal instillation and inhalation

    We performed inhalation and intratracheal instillation studies of cerium dioxide (CeO2) nanoparticles in order to investigate their pulmonary toxicity, and observed pulmonary inflammation not only in the acute and but also in the chronic phases. In the intratracheal instillation study, F344 rats were exposed to 0.2 mg or 1 mg of CeO2 nanoparticles. Cell analysis and chemokines in bronchoalveolar lavage fluid (BALF) were analyzed from 3 days to 6 months following the instillation. In the inhalation study, rats were exposed to the maximum concentration of inhaled CeO2 nanoparticles (2, 10 mg/m3, respectively) for 4 weeks (6 h/day, 5 days/week). The same endpoints as in the intratracheal instillation study were examined from 3 days to 3 months after the end of the exposure. The intratracheal instillation of CeO2 nanoparticles caused a persistent increase in the total and neutrophil number in BALF and in the concentration of cytokine-induced neutrophil chemoattractant (CINC)-1, CINC-2, chemokine for neutrophil, and heme oxygenase-1 (HO-1), an oxidative stress marker, in BALF during the observation time. The inhalation of CeO2 nanoparticles also induced a persistent influx of neutrophils and expression of CINC-1, CINC-2, and HO-1 in BALF. Pathological features revealed that inflammatory cells, including macrophages and neutrophils, invaded the alveolar space in both studies. Taken together, the CeO2 nanoparticles induced not only acute but also chronic inflammation in the lung, suggesting that CeO2 nanoparticles have a pulmonary toxicity that can lead to irreversible lesions

  18. 5% CO2 is a potent, fast acting inhalation anticonvulsant

    Tolner, Else A.; Hochman, Daryl W.; Hassinen, Pekka; Otáhal, Jakub; Gaily, Eija; Haglund, Michael M.; Kubová, Hana; Schuchmann, Sebastian; Vanhatalo, Sampsa; Kaila, Kai

    2010-01-01

    Purpose CO2 has been long recognized for its anticonvulsant properties. We aimed to determine whether inhaling 5% CO2 can be used to suppress seizures in epilepsy patients. The effect of CO2 on cortical epileptic activity accompanying behavioral seizures was studied in rats and a non-human primate and based on these data, preliminary tests were carried out in humans. Methods In freely moving rats, cortical afterdischarges paralleled by myoclonic convulsions were evoked by sensorimotor cortex stimulation. 5% CO2 was applied for 5 minutes, 3 minutes before stimulation. In macaque monkeys, hypercarbia was induced by hypoventilation while seizure activity was electrically or chemically evoked in the sensorimotor cortex. Seven patients with drug-resistant partial epilepsy were examined with video-EEG and received 5% CO2 in medical carbogen shortly after electrographic seizure onset. Results In rats, 5% CO2 strongly suppressed cortical afterdischarges, by ca. 75%, while responses to single-pulse stimulation were reduced by about 15% only. In macaques, increasing pCO2 from 37 to 44-45 mmHg (corresponding to inhalation of 5% CO2 or less) suppressed stimulation-induced cortical afterdischarges by about 70% and single, bicuculline-induced epileptiform spikes by ca. 25%. In a pilot trial carried out in 7 patients, a rapid termination of electrographic seizures was seen despite the fact that the application of 5% CO2 was started after seizure generalization. Conclusions 5% CO2 has a fast and potent anticonvulsant action. The present data suggest that medical carbogen with 5% CO2 can be used for acute treatment to suppress seizures in epilepsy patients. PMID:20887367

  19. Pneumonitis after Inhalation of Mercury Vapours

    JD Glezos

    2006-01-01

    Full Text Available A 43-year-old man presented to hospital with pneumonia but only after discharge from hospital did he admit to deliberate prior inhalation of mercury. His pulmonary involvement appeared to resolve almost completely with antibiotics and supportive care. Nevertheless, persisting elevated urinary excretion of mercury required two courses of chelation therapy. No serious systemic sequelae were observed.

  20. Inhalant Use in Latina Early Adolescent Girls

    Guzmán, Bianca L.; Kouyoumdjian, Claudia

    2016-01-01

    The purpose of the current study was to examine how lifetime use and extent of use of inhalants by Latina girls is impacted by age, acculturation, grades, ditching, sexual behaviors (light petting, heavy petting, and going all the way) and sexual agency. A total of 273 females who self-identified as being Latina whose mean age was 13.94 completed…

  1. Report of the panel on inhaled actinides

    Some topics discussed are as follows: assessment of risks to man of inhaling actinides; use of estimates for developing protection standards; epidemiology of lung cancer in exposed human populations; development of respiratory tract models; and effects in animals: dose- and effect-modifying factors

  2. Inhalation of antibiotics in cystic fibrosis

    Touw, D J; Brimicombe, R W; Hodson, M E; Heijerman, H G; Bakker, W

    1995-01-01

    Aerosol administration of antipseudomonal antibiotics is commonly used in cystic fibrosis. However, its contribution to the improvement of lung function, infection and quality of life is not well-established. All articles published from 1965 until the present time concerning the inhalation of antibi

  3. Manganese Inhalation as a Parkinson Disease Model

    José Luis Ordoñez-Librado

    2011-01-01

    Full Text Available The present study examines the effects of divalent and trivalent Manganese (Mn2+/Mn3+ mixture inhalation on mice to obtain a novel animal model of Parkinson disease (PD inducing bilateral and progressive dopaminergic cell death, correlate those alterations with motor disturbances, and determine whether L-DOPA treatment improves the behavior, to ensure that the alterations are of dopaminergic origin. CD-1 male mice inhaled a mixture of Manganese chloride and Manganese acetate, one hour twice a week for five months. Before Mn exposure, animals were trained to perform motor function tests and were evaluated each week after the exposure. By the end of Mn exposure, 10 mice were orally treated with 7.5 mg/kg L-DOPA. After 5 months of Mn mixture inhalation, striatal dopamine content decreased 71%, the SNc showed important reduction in the number of TH-immunopositive neurons, mice developed akinesia, postural instability, and action tremor; these motor alterations were reverted with L-DOPA treatment. Our data provide evidence that Mn2+/Mn3+ mixture inhalation produces similar morphological, neurochemical, and behavioral alterations to those observed in PD providing a useful experimental model for the study of this neurodegenerative disease.

  4. THE METABOLISM OF NALED INHALED BY RATS

    Naled (Dibrom) was prepared with a (14)carbon label in the 1-ethyl position. The labeled compound was administered in appropriate formulation vehicles to female rats by the inhalation, oral or intraperitoneal routes. Treated animals were either placed in metabolism cages and thei...

  5. DEVELOPMENTAL NEUROTOXICITY OF INHALED METHANOL IN RATS

    Dr. Weiss and his colleagues conducted a controlled series of experiments in which they exposed pregnant rats and their newborn offspring to 4,500 parts per million (ppm) methanol by inhalation, and then submitted them to tests of behavioral function. Exposure to 4,500...

  6. Health risks associated with inhaled nasal toxicants

    Feron, V.J.; Arts, J.H.E.; Kuper, C.F.; Slootweg, P.J.; Woutersen, R.A.

    2001-01-01

    Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and me

  7. Know How to Use Your Asthma Inhaler

    Full Text Available ... Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent Asthma Data AsthmaStats Asthma- ... 4. Gathering and Using Data 4A. Focus On: Data Collection Choices 4B. Focus on Using Mixed Methods 5. ...

  8. Inhalation drug delivery devices: technology update

    Ibrahim M

    2015-02-01

    Full Text Available Mariam Ibrahim, Rahul Verma, Lucila Garcia-ContrerasDepartment of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: The pulmonary route of administration has proven to be effective in local and systemic delivery of miscellaneous drugs and biopharmaceuticals to treat pulmonary and non-pulmonary diseases. A successful pulmonary administration requires a harmonic interaction between the drug formulation, the inhaler device, and the patient. However, the biggest single problem that accounts for the lack of desired effect or adverse outcomes is the incorrect use of the device due to lack of training in how to use the device or how to coordinate actuation and aerosol inhalation. This review summarizes the structural and mechanical features of aerosol delivery devices with respect to mechanisms of aerosol generation, their use with different formulations, and their advantages and limitations. A technological update of the current state-of-the-art designs proposed to overcome current challenges of existing devices is also provided.Keywords: pulmonary delivery, asthma, nebulizers, metered dose inhaler, dry powder inhaler

  9. Use of inhaled corticosteroids in pediatric asthma

    Bisgaard, H

    1997-01-01

    suggest that asthma acts via a chronic inflammatory process that causes remodeling of the airways with mucosal thickening and smooth muscle hypertrophy. An optimal treatment strategy would be one aimed at reducing the ongoing airway inflammation. Inhaled steroids ameliorate the inflammation, whereas this...

  10. Particle engineering of materials for oral inhalation by dry powder inhalers. II - sodium cromoglicate

    Healy, Anne Marie; Tajber, Lidia; Corrigan, Owen,

    2011-01-01

    Sodium cromoglicate is an antiasthmatic and antiallergenic drug used in inhalation therapy and commonly administered by a dry powder inhaler. In the present study we sought to examine the feasibility of producing nanoporous microparticles (NPMPs) of this hydrophilic material by adaptation of a spray drying process previously applied to hydrophobic drugs, and to examine the physicochemical and in vitro deposition properties of the spray dried particles in comparison to a commercial product....

  11. Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

    Claude Guerin

    2005-01-01

    Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

  12. Emergency presentation and management of acute severe asthma in children

    Øymar Knut

    2009-09-01

    Full Text Available Abstract Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronchodilators may include selective b2-agonists, adrenaline and anticholinergics. Additional treatment in selected cases may involve intravenous administration of theophylline, b2-agonists and magnesium sulphate. Both non-invasive and invasive ventilation may be options when medical treatment fails to prevent respiratory failure. It is important that relevant treatment algorithms exist, applicable to all levels of the treatment chain and reflecting local considerations and circumstances.

  13. Acute silicosis with bilateral pneumothorax

    Srivastava, G. N.; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of...

  14. Effects, side effects and plasma concentrations of terbutaline in adult asthmatics after inhaling from a dry powder inhaler device at different inhalation flows and volumes.

    Engel, T; Scharling, B; Skovsted, B; Heinig, J H

    1992-04-01

    1. The efficacy of a metered dose inhaler (MDI) is highly dependent on the mode of inhalation. The relatively high built-in resistance in the Turbohaler (TBH), a new dry powder inhaler device for inhalation of terbutaline sulphate and budesonide, reduces the flow during inhalation. We compared five different modes of inhalation using the terbutaline TBH in 10 stable asthmatic subjects, who were tested on 5 consecutive days. 2. Measurement of 10 different parameters of pulmonary function indicated that the full bronchodilatory effect of an inhaled dose was already achieved at 5 min after the inhalation. Inspiratory flows through the TBH varying from 34 to 88 l min-1 resulted in comparable bronchodilation, and a previous exhalation to residual volume proved of no value. However, if, prior to inhalation, an exhalation through the device was performed, a substantially reduced effect was seen. 3. Reducing the inspiratory flow to approximately 34 l min-1 produced slightly reduced side effects and lower plasma terbutaline concentrations. PMID:1576070

  15. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  16. Inhalation Anthrax: Dose Response and Risk Analysis

    Coleman, Margaret E.; Thran, Brandolyn; Morse, Stephen S.; Hugh-Jones, Martin; Massulik, Stacey

    2008-01-01

    The notion that inhalation of a single Bacillus anthracis spore is fatal has become entrenched nearly to the point of urban legend, in part because of incomplete articulation of the scientific basis for microbial risk assessment, particularly dose-response assessment. Risk analysis (ie, risk assessment, risk communication, risk management) necessitates transparency: distinguishing scientific facts, hypotheses, judgments, biases in interpretations, and potential misinformation. The difficulty ...

  17. Inhalation drug delivery devices: technology update

    Ibrahim M.; Verma R; Garcia-Contreras L

    2015-01-01

    Mariam Ibrahim, Rahul Verma, Lucila Garcia-ContrerasDepartment of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: The pulmonary route of administration has proven to be effective in local and systemic delivery of miscellaneous drugs and biopharmaceuticals to treat pulmonary and non-pulmonary diseases. A successful pulmonary administration requires a harmonic interaction between the drug formulation, the inhaler d...

  18. Inhaled Umeclidinium in COPD Patients: A Review and Meta-Analysis.

    Pleasants, Roy A; Wang, Tiansheng; Gao, Jinming; Tang, Huilin; Donohue, James F

    2016-03-01

    A number of new agents for the management of chronic obstructive pulmonary disease (COPD) are at different stages of development, including several inhaled long-acting antimuscarinics (LAMA). Long-acting bronchodilators are considered to be central to the management of COPD due to the evidence supporting their efficacy and safety. Umeclidinium, a LAMA, has recently been approved for the maintenance treatment of moderate to very severe COPD in a number of countries. This comprehensive review and pooled meta-analysis provides detailed information about the efficacy and safety of this agent. The pharmacokinetics and pharmacodynamics of umeclidinium observed in phase I and II studies support its once-daily administration. Umeclidinium is rapidly cleared from blood, and renal or hepatic impairment do not lead to significant changes in drug disposition. A pooled analysis of phase III and comparative studies of umeclidinium in patients with moderate to very severe COPD showed significant improvement in lung function measures, including trough forced expiratory volume in 1 s (FEV1), as well as in acute exacerbations of COPD, dyspnea, and quality of life. Adverse effects, including known anticholinergic effects, were uncommon with umeclidinium. Limited data suggest the efficacy of umeclidinium is similar to that of tiotropium. Umeclidinium is administered as a dry powder inhaler, provides adequate lung delivery in patients with moderate to very severe airflow obstruction, and appears to be easily used by patients. Umeclidinium provides a safe and effective option as an inhaled LAMA for the management of COPD. PMID:26755180

  19. Inhalation dose assessment for Maralinga and Emu

    Dose assessments for the inhalation of artificial radionuclides are presented for all types of contaminated areas at Maralinga and Emu. These enable Committed Effective Dose Equivalent (CEDE), to be estimated by scaling at any area of interest where activity concentrations are known. In the case of Aborigines, these dose are estimated assuming respirable dust loadings of 1 mg/m3 for adults and 1.5 mg/m3 for children and infants. Details of the calculations are presented in the appendix. The model of the respiratory system used in this assessment is that described in Interantional Commission on Radiological Protection (ICRP) Publication 30 (ICRP, 1979a). With the exception of Kuli, which is contaminated with uranium, at all other sites it is only the inhalation of plutonium and americium that contributes significantly to the dose, and of these 239Pu is the largest contributor. Therefore, considering the long half lives of the radionuclides concerned, it appears that the inhalation problems highlighted by this dose assessment will not diminish significantly within any reasonable period of time and hence management strategies must be developed to deal with such problems. 32 refs., 5 tabs., 1 fig

  20. Inhalation cancer risk assessment of cobalt metal.

    Suh, Mina; Thompson, Chad M; Brorby, Gregory P; Mittal, Liz; Proctor, Deborah M

    2016-08-01

    Cobalt compounds (metal, salts, hard metals, oxides, and alloys) are used widely in various industrial, medical and military applications. Chronic inhalation exposure to cobalt metal and cobalt sulfate has caused lung cancer in rats and mice, as well as systemic tumors in rats. Cobalt compounds are listed as probable or possible human carcinogens by some agencies, and there is a need for quantitative cancer toxicity criteria. The U.S. Environmental Protection Agency has derived a provisional inhalation unit risk (IUR) of 0.009 per μg/m(3) based on a chronic inhalation study of soluble cobalt sulfate heptahydrate; however, a recent 2-year cancer bioassay affords the opportunity to derive IURs specifically for cobalt metal. The mechanistic data support that the carcinogenic mode of action (MOA) is likely to involve oxidative stress, and thus, non-linear/threshold mechanisms. However, the lack of a detailed MOA and use of high, toxic exposure concentrations in the bioassay (≥1.25 mg/m(3)) preclude derivation of a reference concentration (RfC) protective of cancer. Several analyses resulted in an IUR of 0.003 per μg/m(3) for cobalt metal, which is ∼3-fold less potent than the provisional IUR. Future research should focus on establishing the exposure-response for key precursor events to improve cobalt metal risk assessment. PMID:27177823

  1. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  2. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  3. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  4. Inhaled tolafentrine reverses pulmonary vascular remodeling via inhibition of smooth muscle cell migration

    Weissmann Norbert

    2005-11-01

    Full Text Available Abstract Background The aim of the study was to assess the chronic effects of combined phosphodiesterase 3/4 inhibitor tolafentrine, administered by inhalation, during monocrotaline-induced pulmonary arterial hypertension (PAH in rats. Methods CD rats were given a single subcutaneous injection of monocrotaline to induce PAH. Four weeks after, rats were subjected to inhalation of tolafentrine or sham nebulization in an unrestrained, whole body aerosol exposure system. In these animals (i the acute pulmonary vasodilatory efficacy of inhaled tolafentrine (ii the anti-remodeling effect of long-term inhalation of tolafentrine (iii the effects of tolafentrine on the expression profile of 96 genes encoding cell adhesion and extracellular matrix regulation were examined. In addition, the inhibitory effect of tolafentrine on ex vivo isolated pulmonary artery SMC cell migration was also investigated. Results Monocrotaline injection provoked severe PAH (right ventricular systolic pressure increased from 25.9 ± 4.0 to 68.9 ± 3.2 after 4 weeks and 74.9 ± 5.1 mmHg after 6 weeks, cardiac output depression and right heart hypertrophy. The media thickness of the pulmonary arteries and the proportion of muscularization of small precapillary resistance vessels increased dramatically, and the migratory response of ex-vivo isolated pulmonary artery smooth muscle cells (PASMC was increased. Micro-arrays and subsequent confirmation with real time PCR demonstrated upregulation of several extracellular matrix regulation and adhesion genes, such as matrixmetalloproteases (MMP 2, 8, 9, 10, 11, 12, 20, Icam, Itgax, Plat and serpinb2. When chronically nebulized from day 28 to 42 (12 daily aerosol maneuvers, after full establishment of severe pulmonary hypertension, tolafentrine reversed about 60% of all hemodynamic abnormalities, right heart hypertrophy and monocrotaline-induced structural lung vascular changes, including the proportion of pulmonary artery

  5. Whole-body nanoparticle aerosol inhalation exposures.

    Yi, Jinghai; Chen, Bean T; Schwegler-Berry, Diane; Frazer, Dave; Castranova, Vince; McBride, Carroll; Knuckles, Travis L; Stapleton, Phoebe A; Minarchick, Valerie C; Nurkiewicz, Timothy R

    2013-01-01

    Inhalation is the most likely exposure route for individuals working with aerosolizable engineered nano-materials (ENM). To properly perform nanoparticle inhalation toxicology studies, the aerosols in a chamber housing the experimental animals must have: 1) a steady concentration maintained at a desired level for the entire exposure period; 2) a homogenous composition free of contaminants; and 3) a stable size distribution with a geometric mean diameter generation of aerosols containing nanoparticles is quite challenging because nanoparticles easily agglomerate. This is largely due to very strong inter-particle forces and the formation of large fractal structures in tens or hundreds of microns in size (6), which are difficult to be broken up. Several common aerosol generators, including nebulizers, fluidized beds, Venturi aspirators and the Wright dust feed, were tested; however, none were able to produce nanoparticle aerosols which satisfy all criteria (5). A whole-body nanoparticle aerosol inhalation exposure system was fabricated, validated and utilized for nano-TiO2 inhalation toxicology studies. Critical components: 1) novel nano-TiO2 aerosol generator; 2) 0.5 m(3) whole-body inhalation exposure chamber; and 3) monitor and control system. Nano-TiO2 aerosols generated from bulk dry nano-TiO2 powders (primary diameter of 21 nm, bulk density of 3.8 g/cm(3)) were delivered into the exposure chamber at a flow rate of 90 LPM (10.8 air changes/hr). Particle size distribution and mass concentration profiles were measured continuously with a scanning mobility particle sizer (SMPS), and an electric low pressure impactor (ELPI). The aerosol mass concentration (C) was verified gravimetrically (mg/m(3)). The mass (M) of the collected particles was determined as M = (Mpost-Mpre), where Mpre and Mpost are masses of the filter before and after sampling (mg). The mass concentration was calculated as C = M/(Q*t), where Q is sampling flowrate (m(3)/min), and t is the sampling

  6. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  7. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  8. Corpus callosum size and shape alterations in adolescent inhalant users.

    Takagi, Michael; Lubman, Dan I; Walterfang, Mark; Barton, Sarah; Reutens, David; Wood, Amanda; Yücel, Murat

    2013-09-01

    Inhalants, frequently abused during adolescence, are neurotoxic to white matter. We investigated the impact of inhalant misuse on the morphology of the corpus callosum (CC), the largest white matter bundle in the brain, in an adolescent sample of inhalant users [n = 14; mean age = 17.3; standard deviation (SD) = 1.7], cannabis users (n = 11; mean age = 19.7; SD = 1.7) and community controls (n = 9; mean age = 19.5; SD = 2.6). We identified significant morphological differences in the CC among inhalant users compared with community controls. There were no morphological differences between inhalant and cannabis users. Our findings may represent the early stages of neurobiological damage associated with chronic inhalant misuse. PMID:21955104

  9. Inhalant abuse by adolescents: A new challenge for Indian physicians

    Basu Debasish

    2004-06-01

    Full Text Available Inhalant abuse has been commonly reported especially in the young during the last decades globally. The reason for the relative paucity of literature from India may be attributed to a lack of knowledge about this growing problem among health professionals. A series of five cases of inhalant abuse is described in order to understand this growing public health concern. Most of the cases started inhalant abuse during adolescence. All patients except one abused typewriter erasing fluid and thinner which contains toluene. All the patients reported using inhalants as addictive substance because of their easy accessibility, cheap price, their faster onset of action and the regular ′high′ that it provided. Whereas several features of inhalant dependence were fulfilled, no physical withdrawal signs were observed. The diagnosis of inhalant abuse can be difficult and relies almost entirely on clinical judgment. Treatment is generally supportive.

  10. Effects of p-xylene inhalation on axonal transport in the rat retinal ganglion cells

    Although the solvent xylene is suspected of producing nervous system dysfunction in animals and humans, little is known regarding the neurochemical consequences of xylene inhalation. The intent of this study was to determine the effect of intermittent, acute, and subchronic p-xylene exposure on the axonal transport of proteins and glycoproteins within the rat retinofugal tract. A number of different exposure regimens were tested ranging from 50 ppm for a single 6-hr exposure to 1600 ppm 6 hr/day, 5 days/week, for a total of 8 exposure days. Immediately following removal from the inhalation chambers rats were injected intraocularly with [35S]methionine and [3H]fucose (to label retinal proteins and glycoproteins, respectively) and the axonal transport of labeled macromolecules to axons (optic nerve and optic tract) and nerve endings (lateral geniculate body and superior colliculus) was examined 20 hr after precursor injection. Only relatively severe exposure regimens (i.e., 800 or 1600 ppm 6 hr/day, 5 days/week, for 1.5 weeks) produced significant reductions in axonal transport; there was a moderate reduction in the axonal transport of 35S-labeled proteins in the 800-ppm-treated group which was more widespread in the 1600 ppm-treated group. Transport of 3H-labeled glycoproteins was less affected. Assessment of retinal metabolism immediately after isotope injection indicated that the rate of precursor uptake was not reduced in either treatment group. Furthermore, rapid transport was still substantially reduced in animals exposed to 1600 ppm p-xylene and allowed a 13-day withdrawal period. These data indicate that p-xylene inhalation decreases rapid axonal transport supplied to the projections of the rat retinal ganglion cells immediately after cessation of inhalation exposure and that this decreased transport is still apparent 13 days after the last exposure

  11. Chapter 14: Acute severe asthma (status asthmaticus).

    Shah, Rachna; Saltoun, Carol A

    2012-01-01

    Acute severe asthma, formerly known as status asthmaticus, is defined as severe asthma unresponsive to repeated courses of beta-agonist therapy such as inhaled albuterol, levalbuterol, or subcutaneous epinephrine. It is a medical emergency that requires immediate recognition and treatment. Oral or parenteral corticosteroids should be administered to all patients with acute severe asthma as early as possible because clinical benefits may not occur for a minimum of 6-12 hours. Approximately 50% of episodes are attributable to upper respiratory infections, and other causes include medical nonadherence, nonsteroidal anti-inflammatory exposure in aspirin-allergic patients, allergen exposure (especially pets) in severely atopic individuals, irritant inhalation (smoke, paint, etc.), exercise, and insufficient use of inhaled or oral corticosteroids. The patient history should be focused on acute severe asthma including current use of oral or inhaled corticosteroids, number of hospitalizations, emergency room visits, intensive-care unit admissions and intubations, the frequency of albuterol use, the presence of nighttime symptoms, exercise intolerance, current medications or illicit drug use, exposure to allergens, and other significant medical conditions. Severe airflow obstruction may be predicted by accessory muscle use, pulsus paradoxus, refusal to recline below 30°, a pulse >120 beats/min, and decreased breath sounds. Physicians' subjective assessments of airway obstruction are often inaccurate. More objective measures of airway obstruction via peak flow (or forced expiratory volume in 1 second) and pulse oximetry before oxygen administration usually are helpful. Pulse oximetry values >90% are less commonly associated with problems although CO(2) retention and a low Pao(2) may be missed. PMID:22794687

  12. Defence System of Respiratory Tract and Clearence of Inhalation Agents

    Nesrin Ocal

    2016-01-01

    It is well known that inhaled urban air contains many particles and gases. On the other hand, the anesthetic agents used in respiratory diseases comprise pharmaceutical particles. Deposition and cleaning processes of both the inhaled foreign particles and gases from room air, and inhalation agents from respiratory tract are very important clinically. These processes are carried out by the defense mechanisms of the respiratory system. In this review, the defence system of respiratory tract and...

  13. Adolescent inhalant use prevention, assessment, and treatment: A literature synthesis.

    Nguyen, Jacqueline; O'Brien, Casey; Schapp, Salena

    2016-05-01

    Inhalant use refers to the use of substances such as gases, glues, and aerosols in order to achieve intoxication, while inhalant use disorder (IUD) encompasses both DSM-IV-TR criteria for inhalant abuse and dependence. Inhalant use among adolescents is an international public health concern considering the severe medical and cognitive consequences and biopsychosocial correlates. In this paper, we summarize the current state of the literature on inhalant use among adolescents focusing on social context, prevention, assessment, and treatment strategies. Psychoeducation, skills training, and environmental supply reduction are helpful strategies for preventing adolescent inhalant use, while parent and adolescent self-report as well as physician report of medical signs and symptoms can aid in assessment and diagnosis. Although research has only begun to explore the treatment of inhalant use, preliminary findings suggest that a multimodal approach involving individual counselling (i.e., CBT brief intervention), family therapy, and activity and engagement programs is the first-line treatment, with residential treatment programs indicated for more severe presentations. The limited nature of treatments developed specifically for inhalant use combined with high prevalence rates and potential for significant impairment within the adolescent population indicate the need for further research. Research should focus on understanding the social context of use, establishing the efficacy of current adolescent substance use treatments adapted for inhalant use, and exploring long-term outcomes. PMID:26969125

  14. Effect of inhaled yttrium-90 in fused clay particles on the pulmonary clearance of inhaled Staphylococcus aureus in mice

    The effect of 90Y inhaled in fused clay particles on the pulmonary clearance of inhaled Staphylococcus aurcus in mice was investigated to provide an improved understanding of the influence of localized irradiation from inhaled radionuclides on infectious processes. Pulmonary clearance of inhaled S. aurcus was suppressed in mice with initial lung burdens of 20 μCi 90Y or greater at 2, 3, and 4 weeks after inhalation exposure to 90Y. Suppressed clearance rates were accompanied by radiation-induced lifespan shortening, retarded increases in average body wieght, suppression of blood lymphocyte count, and pulmonary lesions. Only equivocal suppression of bacterial clearance was observed in mice with initial lung burdens of less than 20 μCi 90Y that were tested from 1 through 52 weeks after inhalation exposure. An initial lung burden of 1 μCi 90Y was estimated to result in 400 rad to the lung delivered within 24 days after exposure

  15. Effects of 7.5% Carbon Dioxide Inhalation on Anxiety and Mood in Cigarette Smokers

    Attwood, Angela S.; Ataya, Alia F.; Bailey, Jayne E.; Lightman, Stafford L.; Munafò, Marcus R.

    2016-01-01

    Cigarette smoking is associated with elevated risk of anxiety and mood disorder. Using the 7.5% carbon dioxide (CO2) inhalation model of anxiety induction, we examined the effects of smoking status and abstinence from smoking on anxiety responses. Physiological and subjective responses to CO2 and medical air were compared in smokers and non-smokers (Experiment One) and in overnight abstinent and non-abstinent smokers (Experiment Two). CO2 induced greater increases in blood pressure in non-smokers compared with smokers (ps < 0.043), and greater increases in anxiety (p = 0.005) and negative affect (p = 0.054) in non-abstinent compared with abstinent smokers. CO2 increased physiological and subjective indices of anxiety. There were differences across smoking groups indicating that the CO2 inhalation model is a useful tool for examining the relationship between smoking and anxiety. The findings suggested that both acute smoking and acute abstinence may protect against anxious responding. Further investigation is needed in long-term heavy smokers. PMID:24763184

  16. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  17. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  18. A new multiple dose powder inhaler, (Turbuhaler), compared with a pressurized inhaler in a study of terbutaline in asthmatics.

    Persson, G; Gruvstad, E; Ståhl, E

    1988-08-01

    Twelve adult asthmatic patients participated in an open, randomized, cross-over comparison between cumulatively increasing doses of terbutaline sulphate administered via the multiple dose powder inhaler (Turbuhaler) or via a pressurized inhaler. Turbuhaler and the pressurized inhaler showed equipotency both with respect to bronchodilatation and side effects. Both treatments produced a significant increase in pulmonary function measurements, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). No increase in pulse rate was seen with either treatment but there was an increase in tremor at higher doses with both treatments. Inhalation of beta-agonists via Turbuhaler seems to be an effective way of treating asthma. PMID:3234516

  19. Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus

    Heijerman, Harry; Westerman, Elsbeth; Conway, Steven;

    2009-01-01

    In cystic fibrosis inhalation of drugs for the treatment of CF related lung disease has been proven to be highly effective. Consequently, an increasing number of drugs and devices have been developed for CF lung disease or are currently under development. In this European consensus document we...

  20. Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis : A European consensus

    Heijerman, Harry; Westerman, Elsbeth; Conway, Steven; Touw, Daan; Döring, Gerd; Frijlink, Henderik

    2009-01-01

    In cystic fibrosis inhalation of drugs for the treatment of CF related lung disease has been proven to be highly effective. Consequently, an increasing number of drugs and devices have been developed for CF lung disease or are currently under development. In this European consensus document we revie

  1. PROCESS VALIDATION OF DRY POWDER INHALERS (GENERALIZED APPROACH, THEORY AND PRACTICES): A REVIEW

    Pandita Rachna; Rana A. C.; Seth Nimrata; Bala Rajni

    2011-01-01

    Drugs can be delivered to the lungs by inhalation, oral, parenteral routes. Different types of devices such as pressurised metered dose inhalers (p-MDI's), nebulizers or dry powder inhalers (DPI's) are used for the pulmonary delivery of drugs .This present review article focus on the process validation of dry powder inhalers. Dry powder inhaler is a device that deliver medication to the lungs in the form of dry powder. Validation of dry powder inhaler is done to ensure that a specific manufac...

  2. Emitted dose and lung deposition of inhaled terbutaline from Turbuhaler at different conditions.

    Abdelrahim, Mohamed E

    2010-05-01

    Turbuhaler has a very high resistance hence patient inhalation flow when using it would be low. The total emitted dose (TED) of 500microg terbutaline sulphate from a Bricanyl Turbuhaler was determined using a range of inhalation flows (10-60L min(-1)) with inhalation volume of 2 and 4L using a DPI sampling apparatus after one and two inhalations. The relative lung and systemic bioavailability of terbutaline from Bricanyl Turbuhaler when used by healthy subjects and COPD patients were determined after one and two inhalations at slow and fast inhalation flows using a novel urinary terbutaline pharmacokinetic method. The TED resulted from the one and two inhalations increased significantly (p<0.05) with the increase of the inhalation flow at both 2 and 4L inhalation volumes. The relative lung and systemic bioavailability after one inhalation at fast inhalation flow were significantly higher (p<0.01) than at slow inhalation flow in both healthy subjects and patients. Also the healthy subjects results were significantly higher (p<0.05) than the COPD patients after one inhalation. However after two inhalations there was no significant difference between slow and fast inhalation flow or healthy subjects and COPD patients. Hence it is essential to inhale twice and as deep and hard as possible from each dose of Turbuhaler for patients with low inspiratory flow and limited inhalation volume as they may not receive much benefit from one inhalation. PMID:20004090

  3. Inhalant Abuse and Dependence among Adolescents in the United States

    Wu, Li-Tzy; Pilowsky, Daniel J.; Schlenger, William E.

    2004-01-01

    Objective: To examine the patterns of inhalant use and correlates of the progression from inhalant use to abuse and dependence among adolescents aged 12 to 17. Method: Study data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse. Multinominal logistic regression was used to identify the characteristics associated with…

  4. IMPROVED STREET SWEEPERS FOR CONTROLLING URBAN INHALABLE PARTICULATE MATTER

    The report gives results of an experimental program to develop design modifications that can be used to improve the ability of municipal street sweepers to remove inhalable dust particles from streets. (Dust emissions from paved roads are a major source of urban inhalable particu...

  5. Inhaled Anesthetic Potency in Aged Alzheimer Mice

    Bianchi, Shannon L.; Caltagarone, Breanna M.; LaFerla, Frank M.; Eckenhoff, Roderic G.; Kelz, Max B.

    2016-01-01

    BACKGROUND The number of elderly patients with frank or incipient Alzheimer’s disease (AD) requiring surgery is growing as the population ages. General anesthesia may exacerbate symptoms of and the pathology underlying AD, so minimizing anesthetic exposure may be important. This requires knowledge of whether the continuing AD pathogenesis alters anesthetic potency. METHODS We determined the induction potency and emergence time for isoflurane, halothane, and sevoflurane using the minimum alveolar anesthetic concentration for loss of righting reflex as an end point in 12- to 14-mo-old triple transgenic Alzheimer (3xTgAD) mice and wild type C57BL6 controls. 3xTgAD mice model AD by harboring three distinct mutations: the APPSwe, Tau, and PS1 human transgenes, each of which has been associated with familial forms of human AD. RESULTS The 3xTgAD mice exhibited mild resistance (from 8% to 30%) to volatile anesthetics but displayed indistinguishable emergence patterns from all three inhaled anesthetics. CONCLUSIONS These results show that the genetic vulnerabilities and neuropathology associated with AD produce a small but significant decrease in sensitivity to the hypnotic actions of three inhaled anesthetics. Emergence times were not altered. PMID:19820240

  6. Hematologic effects of inhaled plutonium in beagles

    Beagle dogs were exposed, by inhalation, 5 to 11 years ago, to aerosols of 239PuO2, 238PuO2, or 239Pu(NO3)4, at six dose levels resulting in initial lung burdens ranging from ∼2 to ∼5500 nCi. Translocation of the plutonium to extrapulmonary sites was related to the physical-chemical characteristics of the plutonium compound. The highly insoluble 239PuO2 was retained primarily in the lung and associated lymph nodes, whereas 239Pu(NO3)4 was much more soluble and translocated relatively rapidly to the skeleton and other extrapulmonary tissues. The 238PuO2 was intermediate in solubility and translocation characteristics. The hematologic effects of plutonium inhalation were most pronounced on lymphocyte populations. Evidence suggests that these effects result from irradiation of lymphocytes via the pulmonary lymph nodes with insoluble 239PuO2, and via these same lymph nodes, extrapulmonary lymph nodes, and bone marrow lymphocytes with the more soluble forms, i.e., 238PuO2 and 239Pu(NO3)4. There is no evidence suggesting that these exposures increase the risk of developing myeloid or lymphoid neoplasia. 8 refs., 4 figs., 3 tabs

  7. Effect of inhaled steroids on laryngeal microflora.

    Turan, Mahfuz; Ekin, Selami; Ucler, Rıfkı; Arısoy, Ahmet; Bayram, Yasemin; Yalınkılıç, Abdulaziz; Bozan, Nazım; Garca, Mehmet Fatih; Çankaya, Hakan

    2016-07-01

    Conclusions As is known, this study is the first study to evaluate the effect of inhaled steroids on laryngeal microflora. The data support that ICS usage causes changes in the larynx microflora. Purpose The aim of this study was to determine the alteration in larynx microbial flora of the patients treated with ICS comparing the culture results of a control group. In addition, laryngeal microflora was compared to the smears obtained from the vallecula and pharynx. Materials and methods The study included 39 patients (mean age = 45.56 ± 12.76 years) who had been using a corticosteroid inhaler and control group consisting of 27 persons (mean age = 43.07 ± 13.23 years). Culture samples were obtained from the pharynx, larynx, and vallecula in the patient and control groups, and they were evaluated in the microbiology laboratory. Obtained culture results were named by the same microbiologist according to the basic microorganism classification method. Results Coagulase-negative staphylococci (CNS), Streptococcus viridians (VGS) and candida albicans were detected to grow significantly more in the patient group in all three anatomic localizations compared to the control group. Neisseria spp, basillus spp, and Non-viridans alpha-hemolytic streptococcus were detected to grow significantly more in the control group in all three anatomic localizations compared to the patient group. PMID:26901427

  8. Inhalational anaesthesia with low fresh gas flow

    Christian Hönemann

    2013-01-01

    Full Text Available During the inhalation of anaesthesia use of low fresh gas flow (0.35-1 L/min has some important advantages. There are three areas of benefit: pulmonary - anaesthesia with low fresh gas flow improves the dynamics of inhaled anaesthesia gas, increases mucociliary clearance, maintains body temperature and reduces water loss. Economic - reduction of anaesthesia gas consumption resulting in significant savings of > 75% and Ecological - reduction in nitrous oxide consumption, which is an important ozone-depleting and heat-trapping greenhouse gas that is emitted. Nevertheless, anaesthesia with high fresh gas flows of 2-6 L/min is still performed, a technique in which rebreathing is practically negligible. This special article describes the clinical use of conventional plenum vaporizers, connected to the fresh gas supply to easily perform low (1 L/min, minimal (0.5 L/min or metabolic flow anaesthesia (0.35 L/min with conventional Primus Draeger® anaesthesia machines in routine clinical practice.

  9. Whole-Body Nanoparticle Aerosol Inhalation Exposures

    Yi, Jinghai; Chen, Bean T.; Schwegler-Berry, Diane; Frazer, Dave; Castranova, Vince; McBride, Carroll; Knuckles, Travis L.; Stapleton, Phoebe A.; Minarchick, Valerie C.; Nurkiewicz, Timothy R.

    2013-01-01

    Inhalation is the most likely exposure route for individuals working with aerosolizable engineered nano-materials (ENM). To properly perform nanoparticle inhalation toxicology studies, the aerosols in a chamber housing the experimental animals must have: 1) a steady concentration maintained at a desired level for the entire exposure period; 2) a homogenous composition free of contaminants; and 3) a stable size distribution with a geometric mean diameter < 200 nm and a geometric standard deviation σg < 2.5 5. The generation of aerosols containing nanoparticles is quite challenging because nanoparticles easily agglomerate. This is largely due to very strong inter-particle forces and the formation of large fractal structures in tens or hundreds of microns in size 6, which are difficult to be broken up. Several common aerosol generators, including nebulizers, fluidized beds, Venturi aspirators and the Wright dust feed, were tested; however, none were able to produce nanoparticle aerosols which satisfy all criteria 5. A whole-body nanoparticle aerosol inhalation exposure system was fabricated, validated and utilized for nano-TiO2 inhalation toxicology studies. Critical components: 1) novel nano-TiO2 aerosol generator; 2) 0.5 m3 whole-body inhalation exposure chamber; and 3) monitor and control system. Nano-TiO2 aerosols generated from bulk dry nano-TiO2 powders (primary diameter of 21 nm, bulk density of 3.8 g/cm3) were delivered into the exposure chamber at a flow rate of 90 LPM (10.8 air changes/hr). Particle size distribution and mass concentration profiles were measured continuously with a scanning mobility particle sizer (SMPS), and an electric low pressure impactor (ELPI). The aerosol mass concentration (C) was verified gravimetrically (mg/m3). The mass (M) of the collected particles was determined as M = (Mpost-Mpre), where Mpreand Mpost are masses of the filter before and after sampling (mg). The mass concentration was calculated as C = M/(Q*t), where Q is

  10. Design and evaluation of a new dry powder inhaler

    "Rouholamini Najafabadi AH

    2001-08-01

    Full Text Available Three versions of a new dry powder inhaler (DPI, RG-haler, were designed using two kinds of grid inserts. Salbutamol sulfate/lactose blend (Ventolin Rotacaps® was selected as a model formulation to analyze the performance of all inhalers and compare their efficiency with three marketed devices (Rotahaler®, Spinhaler® and ISF inhalator® using the twin impinger (TI. Deposition of the drug in device was significantly (P<0.05 lower for ISF inhalator® and all kinds of RG-halers in comparison with those of Rotahaler® and Spinhaler®. The amount of drug deposited in the stage 2 and the respirable dose for RG-halers were similar to those of ISF inhalator® and significantly (P<0.05 higher than those of Rotahaler® and Spinhaler®. The results suggest efficient aerosol generating capability of the RG-haler.

  11. Disposition and safety of inhaled biodegradable nanomedicines: Opportunities and challenges.

    Haque, Shadabul; Whittaker, Michael R; McIntosh, Michelle P; Pouton, Colin W; Kaminskas, Lisa M

    2016-08-01

    The inhaled delivery of nanomedicines can provide a novel, non-invasive therapeutic strategy for the more localised treatment of lung-resident diseases and potentially also enable the systemic delivery of therapeutics that are otherwise administered via injection alone. However, the clinical translation of inhalable nanomedicine is being hampered by our lack of understanding about their disposition and clearance from the lungs. This review provides a comprehensive overview of the biodegradable nanomaterials that are currently being explored as inhalable drug delivery systems and our current understanding of their disposition within, and clearance from the lungs. The safety of biodegradable nanomaterials in the lungs is discussed and latest updates are provided on the impact of inflammation on the pulmonary pharmacokinetics of inhaled nanomaterials. Overall, the review provides an in-depth and critical assessment of the lung clearance mechanisms for inhaled biodegradable nanomedicines and highlights the opportunities and challenges for their translation into the clinic. PMID:27033834

  12. Inhaled antibiotics for gram-negative respiratory infections.

    Hudson, Ryan; Olson Blair, Brooke

    2011-10-01

    Several disease states create conditions that lead to opportunistic Gram-negative respiratory infections. Inhalation is the most direct and, until recently, underutilized means of antimicrobial drug targeting for respiratory tract infections. All approved antimicrobial agents for administration by inhalation are indicated for Pseudomonas aeruginosa infections in patients with cystic fibrosis. These inhaled therapies have directly contributed to a significant reduction in exacerbations and hospitalizations in this patient population over the last few decades. The relentless adaptation of pathogenic organisms to current treatment options demands that the pharmaceutical industry continue designing next-generation antimicrobial agents over 70 years after they were first introduced. Recent technological advances in inhalation devices and drug formulation techniques have broadened the scope of antimicrobial structural classes that can be investigated by inhalation; however, there is an urgent need to discover novel compounds with improved resistance profiles relative to those drugs that are already marketed. PMID:21942255

  13. Acute pneumonia in a fire-eater.

    Dell' Omo, M; Murgia, N; Chiodi, M; Giovenali, P; Cecati, A; Gambelunghe, A

    2010-01-01

    Fire-eater's lung, an acute exogenous lipoid pneumonia, is caused when street performers accidentally inhale pyrofluids. We report the case of a young fire-eater who, 12 hours after inhaling an iso-alkanebased pyrofluid, developed fever, dyspnoea, dry cough and intense right chest pain. Radiographic signs of pneumonia emerged two days later. Computed tomography (CT) scans visualized an irregular area of parenchymal consolidation with an air bronchiologram and peripheral ground-glass opacities in the right middle lobe. The diagnostic work-up included microbiological and lung function tests, optic fibre bronchoscopy and an in-depth cyto-immunological analysis of bronchoalveolar lavage fluid. Symptoms gradually improved over a few days. A CT scan one month later showed the thickened parenchymal area in the right middle lobe had almost completely disappeared. PMID:21244782

  14. Effects of early bronchoalveolar lavage fluid collected from dogs with smoke inhalation injury on the lungs of rats

    NIE Fa-chuan; SU Dong; YANG Zong-cheng; BI Min; HUANG Yue-sheng

    2004-01-01

    Objective: Whether early massive bronchoalveolar lavage can remove the harmful substances from the lungs injured with smoke inhalation remains uncertain. This study was designed to observe the effects of early massive bronchoalveolar lavage fluid (BALF) on the healthy lungs in rats. Methods: Mongrel dogs were inflicted with severe smoke inhalation injury. The injured lungs were lavaged with large amount of normal saline in the first hour after injury and the BALF was collected. The BALF was injected into the healthy lungs of 30 rats (group C) in the dosage of 5 ml/kg. The functions and pathological changes of the lungs were observed 24 h after perfusion with the BALF. The data were compared with those of 23 rats (group B) whose lungs were perfused with the BALF collected from normal dogs and those of 21 rats (group A)whose lungs were perfused with normal saline. Results: The mortality rate 24 h after lung perfusion was higher in group C than in groups A and B. The survivors of group C exhibited fluctuation of respiratory rate (RR), remarkable decrease of PaO2, significantly higher content of lung water, decrease of total static pulmonary compliance and pulmonary expansion index, and increasse of inflammatory cytokines in the tissues of lungs. Only slight mechanic obstructive effect on the airway was observed in rats of group A and B. The pathological changes of the lungs of the rats in group C were similar to those of the dogs with actual smoke inhalation injury. Conclusion: Our findings indicate that the BALF collected from dogs with acute severe smoke inhalation injury in the early stage after injury injured the normal lungs of rats with the bioactive substances in the BALF. These findings show us that it is a valuable therapeutic procedure to apply massive bronchoalveolar fluid lavage in the early stage after inhalation injury.

  15. Insulin inhalation--Pfizer/Nektar Therapeutics: HMR 4006, inhaled PEG-insulin--Nektar, PEGylated insulin--Nektar.

    2004-01-01

    Nektar Therapeutics (formerly Inhale Therapeutic Systems) has developed a pulmonary drug delivery system for insulin [HMR 4006, Exubera]. The rationale behind developing a pulmonary drug delivery system is to ensure that insulin powder is delivered deep into the lungs, where it is easily absorbed into the bloodstream, in a hand-held inhalation device. The device converts the insulin powder particles into an aerosol cloud for the patient to inhale. No propellants are used. The inhaler requires no power source and the clear chamber ensures that the patient knows immediately when all the insulin has been inhaled. Nektar Therapeutics, developers of the inhalation device and formulation process, has licensed the system to Pfizer. Under the terms of the agreement, Pfizer will lead the clinical development of inhaled insulin, while working with Nektar Therapeutics to develop the technology required for packaging the product. Pfizer has an agreement with Hoechst Marion Roussel (now Aventis Pharma) for developing, manufacturing and promoting inhaled insulin. Under the terms of the collaboration, Aventis Pharma will supply recombinant insulin to Nektar Therapeutics to process it into dry powder for incorporation into the inhaler device. Nektar Therapeutics will receive royalties on sales of inhaled insulin marketed by Pfizer and Aventis Pharma, and milestone payments and research support from Pfizer. Aventis Pharma's codename for the product is HMR 4006.Profil, a CRO in Germany, is cooperating with Pfizer/Aventis Pharma in the development of inhaled insulin. In March 2004, Pfizer and Aventis announced that the European Medicines Evaluation Agency (EMEA) accepted the filing of the MAA for inhaled insulin (Exubera) for the treatment of type 1 and type 2 diabetes mellitus. The two companies are working with the US FDA to determine the timing for the submission of the NDA in the US. Pfizer completed five pivotal phase III clinical trials with inhaled insulin in patients with

  16. Biokinetics and dosimetry of inhaled tritiated aerosols

    Trivedi, A. [Radiation Biology and Health Physics Branch, Atomic Energy of Canada Limited, Chalk River, Ontario (Canada); Cheng, Y.S. [Lovelace Respiratory Research Institute, Albuquerque, New Mexico (United States)

    2000-05-01

    Inhalation of tritiated pump oils and metal tritides is a potential radiological protection problem in some situations in tritium facilities. At present, the biokinetic data and validated dose models do not generally exist for chemical forms of tritium other than tritiated water and tritium gas. This situation calls for improving our radiobiological and dosimetric understanding for inhalation of tritiated aerosols. When tritiated pump oils or metal tritides were instilled into the lung, tritium was biotransformed to organically bound tritium (OBT) and tritiated water (HTO) in the body. The biokinetics of tritium-in-urine exhibited a sum of two exponential functions for OBT and HTO: short and long-term clearance components. For tritiated pump oils, 68% of the instilled activity was excreted in feces and less than 10% in urine. More than 90% of the applied activity was retained in the lung up to 5 d post-exposure, this declined to 40% and 5% of the instilled activity 7 d and 28 d post-exposure, respectively. No major long-term storage of OBT was observed in the body. For metal tritides (i.e., titanium tritide), 37% of instilled activity was eliminated via urine, 29% via feces, and 16% through exhaled air. The results on distribution and dynamics of tritium in the body were remarkably similar with our earlier studies on percutaneous absorption of tritiated pump oils or skin-contact exposure to tritium-gas-contaminated metal surfaces. Urinary excretion bioassay data from workers exposed to metal tritides or pump oils were analyzed using the MS-Windows 95 PC version of GENMOD{sup TM} internal dosimetry code. (GENMOD implements the ICRP Publication 66 respiratory tract model and compartment models rather than retention functions of tritium compounds as describes by ICRP Publication 67). The simulated tritium urinary excretion data for exposed workers indicated that Type S solubility classification is more appropriate that Type M default as prescribed ICRP Publication 66

  17. Effect of compression pressure on inhalation grade lactose as carrier for dry powder inhalations

    Raut, Neha Sureshrao; Jamaiwar, Swapnil; Umekar, Milind Janrao; Kotagale, Nandkishor Ramdas

    2016-01-01

    Introduction: This study focused on the potential effects of compression forces experienced during lactose (InhaLac 70, 120, and 230) storage and transport on the flowability and aerosol performance in dry powder inhaler formulation. Materials and Methods: Lactose was subjected to typical compression forces 4, 10, and 20 N/cm2. Powder flowability and particle size distribution analysis of un-compressed and compressed lactose was evaluated by Carr's index, Hausner's ratio, the angle of repose ...

  18. Pathology associated with inhaled plutonium in beagles

    The pathology associated with the inhalation of plutonium was studied in beagle dogs given a single exposure to aerosols of 239PuO2, 238PuO2, or 239Pu(NO3)4. The temporal-spatial relationships between plutonium deposition and the development of lesions in dogs were evaluated up to 11 years, 8 years, or 5 years, respectively, after exposures, resulting in initial lung burdens ranging from ∼2 to ∼5500 nCi. Exposure of the lung to high dose levels produced a spectrum of progressively more severe morphological changes, ranging from radiation pneumonitis to fibrosis. Lung tumors occurred at exposure levels that did not result in early death from radiation pneumonitis or fibrosis. Bronchiolar-alveolar carcinomas, papillary adenocarcinomas, epidermoid carcinomas, and combined epidermoid and adenocarcinomas were observed. Sclerosing tracheobronchial lymphadenitis, radiation osteodystrophy, osteosarcoma, and hepatic adenomatous hyperplasia were the principal extrapulmonary lesions resulting from translocation of plutonium. 15 refs., 2 tabs

  19. Human biokinetics of inhaled terbium oxide

    Four healthy men inhaled a monodisperse aerosol of 160Tb-labelled terbium oxide particles. The behaviour of the tracer was studied through measurements of body radioactivity and of its urinary and faecal excretion. Estimated early faecal losses in the four subjects ranged from 3% to 31% of the initial respiratory-tract deposit; most of the residue had become systemic within a year, with the principal deposit apparently in bone. Interference from this systemic deposit prevented accurate determination of the long-term pulmonary clearance kinetics, but the pattern was broadly what would be expected for Type M materials in the ICRP's Human Respiratory Tract Model. Averaged trends in the whole-body residue after ∼ 1 year suggest a clearance half-life of about 5 y. (author)

  20. Toxic spongiform leucoencephalopathy after inhaling heroin vapour

    This is a report of clinical, CT and MRI findings in a patient with toxic spongiform leucoencephalopathy after heroin ingestion. The disease is observed in drug addicts who inhale pre-heated heroin. The clinical onset, which usually occurs some days or even longer after the last heroin consumption, is characterized by a cerebellar syndrome. The cerebellar hemispheres, the cerebellar and cerebral peduncles and the pyramidal tract may be affected. Spongiform demyelination is the morphological substrate of the lesions, which are not contrast enhancing, hypodense on CT and hyperintense on T2-weighted MRI. The frequently perfect symmetry of the affection of functional systems points to a toxic and/or metabolic pathophysiological mechanism. (orig.)

  1. Toxic spongiform leucoencephalopathy after inhaling heroin vapour

    Weber, W.; Henkes, H.; Kuehne, D. [Klinik fuer Allgemeine Roentgendiagnostik und Neuroradiologie, Alfried-Krupp-Krankenhaus, Alfried Krupp Strasse 21, D-45117, Essen (Germany); Moeller, P.; Bade, K. [Neurologische Klinik, Knappschafts-Krankenhaus, D-45657 Recklinghausen (Germany)

    1998-06-02

    This is a report of clinical, CT and MRI findings in a patient with toxic spongiform leucoencephalopathy after heroin ingestion. The disease is observed in drug addicts who inhale pre-heated heroin. The clinical onset, which usually occurs some days or even longer after the last heroin consumption, is characterized by a cerebellar syndrome. The cerebellar hemispheres, the cerebellar and cerebral peduncles and the pyramidal tract may be affected. Spongiform demyelination is the morphological substrate of the lesions, which are not contrast enhancing, hypodense on CT and hyperintense on T2-weighted MRI. The frequently perfect symmetry of the affection of functional systems points to a toxic and/or metabolic pathophysiological mechanism. (orig.) With 2 figs., 2 tabs., 26 refs.

  2. Asthma and Adherence to Inhaled Corticosteroids

    Bårnes, Camilla Boslev; Ulrik, Charlotte Suppli

    2015-01-01

    Inhaled corticosteroids (ICS) are the cornerstone of maintenance asthma therapy. However, in spite of this, adherence to ICS remains low. The aim of this systematic literature review was to provide an overview of the current knowledge of adherence to ICS, effects of poor adherence, and means to...... was found to be between 22 and 63%, with improvement up to and after an exacerbation. Poor adherence was associated with youth, being African-American, having mild asthma, < 12 y of formal education, and poor communication with the health-care provider, whereas improved adherence was associated with...... asthma-related hospitalizations could be attributed to poor adherence. Most studies have reported an increase in adherence following focused interventions, followed by an improvement in quality of life, symptoms, FEV1, and oral corticosteroid use. However, 2 studies found no difference in health...

  3. Radioaerosol inhalation lung scintigraphy in bronchial asthma

    A study on obstructive changes in airways and mucociliary clearance in children and youth with bronchial asthma was performed. Radioaerosol inhalation lung scintigraphies using 99Tc-human serum albumin (HSA) were applied to 50 children and youth with bronchial asthma. The deposition patterns of the radioaerosol and aerosol clearance curves were evaluated. Abnormal deposition patterns, which consisted of non-homogeneous distribution and/or hot spot formation, were likely to be seen in patients with asthmatic attacks at the time of measurements. However, a few asymptomatic patients also revealed abnormal deposition patterns. The deposition patterns were related to FEV1.0%, MMF, V50 and V25, but especially to FEV1.0%. As an index of mucociliary clearance, β, the rate constant of the 99mTc-HSA aerosol clearance curve, was introduced. β was significantly lower in patients with abnormal aerosol deposition patterns than in normal persons. β was also significantly lower in patients undergoing asthmatic attack at the time of the measurements than in asymptomatic patients. β correlated negatively with FEV1.0%, MMF, V50 and V25, but especially with FEV1.0%. Although patients with long term affection or moderate-to-severe asthma tended to reveal abnormal deposition patterns and had low β values, these differences were not statistically significant. Radioaerosol inhalation lung scintigraphy with 99mTc-HSA is useful for evaluating not only obstructive changes in the airways but also for evaluating mucociliary clearance in children with bronchial asthma. (author)

  4. Inhaled /sup 147/Pm and/or total-body gamma radiation: Early mortality and morbidity in rats

    Filipy, R.E.; Lauhala, K.E.; McGee, D.R.; Cannon, W.C.; Buschbom, R.L.; Decker, J.R.; Kuffel, E.G.; Park, J.F.; Ragan, H.A.; Yaniv, S.S.; Scott, B.R.

    1989-05-01

    Rats were given doses of /sup 60/Co gamma radiation and/or lung burdens of /sup 147/Pm (in fused aluminosilicate particles) within lethal ranges in an experiment to determine and compare morbidity and mortality responses for the radiation insults within 1 year after exposure. Radiation-induced morbidity was assessed by measuring changes in body weights, hematologic parameters, and pulmonary-function parameters. Acute mortality and morbidity from inhaled promethium were caused primarily by radiation pneumonitis and pulmonary fibrosis that occurred more than 53 days after exposure. Acute mortality and morbidity from total-body gamma irradiation occurred within 30 days of exposure and resulted from the bone-marrow radiation syndrome. Gamma radiation caused transient morbidity, reflected by immediately depressed blood cell levels and by reduced body weight gain in animals that survived the acute gamma radiation syndrome. Inhaled promethium caused a loss of body weight and diminished pulmonary function, but its only effect on blood cell levels was lymphocytopenia. Combined gamma irradiation and promethium lung burdens were synergistic, in that animals receiving both radiation insults had higher morbidity and mortality rates than would be predicted based on the effect of either kind of radiation alone. Promethium lung burdens enhanced the effect of gamma radiation in rats within the first 30 days of exposure, and gamma radiation enhanced the later effect of promethium lung burdens. 70 refs., 68 figs., 21 tabs.

  5. Some pathophysiological and biochemical changes in dogs with different forms of lesions induced by inhalation of /sup 239/Pu and /sup 241/Am nitrates

    Kalmykova, Z.I.; Tokarskaya, Z.B.; Buldakov, L.A.; Nifatov, A.P.; Vedeneev, V.S.

    Dogs were acutely, subacutely and chronically inhaled with polymeric /sup 239/Pu and monomeric /sup 241/Am nitrates. Distinctly directed changes were observed in the protein fraction and glycoproteins, as well as in transaminases and sorbitoldehydrogenase of the blood serum, which were attributed to unequal radiation loads to the lungs and the organs of the secondary deposition of nuclides, and also to different degree of the respiratory distress.

  6. Inhalation Toxicology Research Institute annual report 1987-1988

    The mission of the Inhalation Toxicology Research Institute is to investigate the magnitude of human health effects that result from the inhalation of airborne materials at home, in the work place, or in the general environment. Diseases of the respiratory tract are major causes of suffering and death, and many of these diseases are directly related to the materials that people breath. The Institute's research is directed toward obtaining a better understanding of the basic biology of the respiratory tract and the mechanisms by which inhaled materials produce respiratory disease. Special attention is focused on studying the airborne materials released by various energy technologies, as well as those associated with national defense activities. The research uses a wide-ranging, comprehensive array of investigative approaches that are directed toward characterizing the source of the airborne material, following the material through its potential transformation in the air, identifying the mechanisms that govern its inhalation and deposition in the respiratory tract, and determining the fate of these inhaled materials in the body and the health effects they produce. The ultimate objectives are to determine the roles played by inhaled materials in the development of disease processes adn to estimate the risk they pose by inhaled materials in the development of disease processes and to estimate the risk they pose to humans who may be exposed to them. This report contains brief research papers that reflect the scope and recent findings of the Institute's research funded by the U.S. Department of Energy, principally through the Office of Health and Environmental Research. The papers are divided into topical sections. The first section, Characterization of Airborne Materials and Generation of Experimental Exposure Atmospheres, reflects the Institute's capabilities for fundamental aerosol research and the application of that expertise to toxicological studies. The second

  7. Budesonide–formoterol (inhalation powder) in the treatment of COPD

    Ceylan, Erkan

    2006-01-01

    The budesonide–formoterol dry powder inhaler (Symbicort® Turbuhaler® 160/4.5–640/18 μg/day) contains the long-acting β2-adrenoreceptor agonist formoterol and the inhaled corticosteroid budesonide. Two large, 12-month trials examined the effect of budesonide–formoterol 160/4.5 μg twice daily in COPD patients who met these criteria. The studies were identical, except one in which the patients had received oral prednisolone 30 mg/day and had inhaled formoterol 4.5 μg twice daily for 2 weeks befo...

  8. Measurements and prediction of inhaled air quality with personalized ventilation

    Cermak, Radim; Majer, M.; Melikov, Arsen Krikor

    2002-01-01

    This paper examines the performance of five different air terminal devices for personalized ventilation in relation to the quality of air inhaled by a breathing thermal manikin in a climate chamber. The personalized air was supplied either isothermally or non-isothermally (6 deg.C cooler than...... the room air) at flow rates ranging from less than 5 L/s up to 23 L/s. The air quality assessment was based on temperature measurements of the inhaled air and on the portion of the personalized air inhaled. The percentage of dissatisfied with the air quality was predicted. The results suggest...

  9. Improvement of Brain Tissue Oxygenation by Inhalation of Carbogen

    Ashkanian, M.; Borghammer, P.; Gjedde, A.; Ostergaard, L.; Vafaee, M.

    2008-01-01

    confirmed by statistical cluster analysis. Oxygen and carbogen were equally potent in increasing oxygen saturation of arterial blood (Sa(O2)). The present data demonstrate that inhalation of carbogen increases both CBF and Sa(O2) in healthy adults. In conclusion we speculate that carbogen inhalation is...... sufficient for optimal oxygenation of healthy brain tissue, whereas carbogen induces concomitant increases of CBF and Sa(O2).......Hyperoxic therapy for cerebral ischemia is suspected to reduce cerebral blood flow (CBF), due to the vasoconstrictive effect of oxygen on cerebral arterioles. We hypothesized that vasodilation predominates when 5% CO(2) is added to the inhaled oxygen (carbogen). Therefore, we used positron emission...

  10. Metabolomic changes in murine serum following inhalation exposure to gasoline and diesel engine emissions.

    Brower, Jeremy B; Doyle-Eisele, Melanie; Moeller, Benjamin; Stirdivant, Steven; McDonald, Jacob D; Campen, Matthew J

    2016-04-01

    The adverse health effects of environmental exposure to gaseous and particulate components of vehicular emissions are a major concern among urban populations. A link has been established between respiratory exposure to vehicular emissions and the development of cardiovascular disease (CVD), but the mechanisms driving this interaction remain unknown. Chronic inhalation exposure to mixed vehicle emissions has been linked to CVD in animal models. This study evaluated the temporal effects of acute exposure to mixed vehicle emissions (MVE; mixed gasoline and diesel emissions) on potentially active metabolites in the serum of exposed mice. C57Bl/6 mice were exposed to a single 6-hour exposure to filtered air (FA) or MVE (100 or 300 μg/m(3)) by whole body inhalation. Immediately after and 18 hours after the end of the exposure period, animals were sacrificed for serum and tissue collection. Serum was analyzed for metabolites that were differentially present between treatment groups and time points. Changes in metabolite levels suggestive of increased oxidative stress (oxidized glutathione, cysteine disulfide, taurine), lipid peroxidation (13-HODE, 9-HODE), energy metabolism (lactate, glycerate, branched chain amino acid catabolites, butrylcarnitine, fatty acids), and inflammation (DiHOME, palmitoyl ethanolamide) were observed immediately after the end of exposure in the serum of animals exposed to MVE relative to those exposed to FA. By 18 hours post exposure, serum metabolite differences between animals exposed to MVE versus those exposed to FA were less pronounced. These findings highlight complex metabolomics alterations in the circulation following inhalation exposure to a common source of combustion emissions. PMID:27017952

  11. Community exposures to airborne agricultural pesticides in California: ranking of inhalation risks.

    Lee, Sharon; McLaughlin, Robert; Harnly, Martha; Gunier, Robert; Kreutzer, Richard

    2002-12-01

    We assessed inhalation risks to California communities from airborne agricultural pesticides by probability distribution analysis using ambient air data provided by the California Air Resources Board and the California Department of Pesticide Regulation. The pesticides evaluated include chloropicrin, chlorothalonil, chlorpyrifos, S,S,S-tributyl phosphorotrithioate, diazinon, 1,3-dichloropropene, dichlorvos (naled breakdown product), endosulfan, eptam, methidathion, methyl bromide, methyl isothiocyanate (MITC; metam sodium breakdown product), molinate, propargite, and simazine. Risks were estimated for the median and 75th and 95th percentiles of probability (50, 25, and 5% of the exposed populations). Exposure estimates greater than or equal to noncancer reference values occurred for 50% of the exposed populations (adults and children) for MITC subchronic and chronic exposures, methyl bromide subchronic exposures (year 2000 monitoring), and 1,3-dichloropropene subchronic exposures (1990 monitoring). Short-term chlorpyrifos exposure estimates exceeded the acute reference value for 50% of children (not adults) in the exposed population. Noncancer risks were uniformly higher for children due to a proportionately greater inhalation rate-to-body weight ratio compared to adults and other factors. Target health effects of potential concern for these exposures include neurologic effects (methyl bromide and chlorpyrifos) and respiratory effects (1,3-dichloropropene and MITC). The lowest noncancer risks occurred for simazine and chlorothalonil. Lifetime cancer risks of one-in-a-million or greater were estimated for 50% of the exposed population for 1,3-dichloropropene (1990 monitoring) and 25% of the exposed populations for methidathion and molinate. Pesticide vapor pressure was found to be a better predictor of inhalation risk compared to other methods of ranking pesticides as potential toxic air contaminants. PMID:12460795

  12. Inhalant Use, Abuse, and Dependence among Adolescent Patients: Commonly Comorbid Problems.

    Sakai, Joseph T.; Hall, Shannon K.; Mikulich-Gilbertson, Susan K.; Crowley, Thomas J.

    2004-01-01

    Objective: Little is known about adolescents with DSM-IV-defined inhalant abuse and dependence. The aim of this study was to compare comorbidity among (1) adolescents with inhalant use disorders, (2) adolescents who reported using inhalants without inhalant use disorder, and (3) other adolescent patients drawn from an adolescent drug and alcohol…

  13. Age of Inhalant First Time Use and Its Association to the Use of Other Drugs

    Ding, Kele; Chang, G. Andy; Southerland, Ron

    2009-01-01

    Inhalants are the 4th most commonly abused drugs after alcohol, tobacco, and marijuana. Although inhalants are often referred as Gateway Drugs this hypothesis is less examined. Using the 2003 National Survey on Drug Use and Health data, age of first time inhalant use was compared with the age of onset of other drugs among 6466 inhalant users who…

  14. Acute pancreatitis

    ... page: //medlineplus.gov/ency/article/000287.htm Acute pancreatitis To use the sharing features on this page, ... fatty foods after the attack has improved. Outlook (Prognosis) Most cases go away in a week. However, ...

  15. Acute Pericarditis

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... cancer, or heart surgery, the fluid is blood. Causes Acute pericarditis usually results from infection or other ...

  16. CT and MR imaging of Spongiform leukoencephalopathy after heroin vapor inhalation: analysis of 13 cases

    ZHOU Liang; WU Yong-ming; LIU Ji-yuan; LU Bing-xun; YIN Jia; PAN Su-yue; JI Zhong; LUO Yi-feng; LIU Xiao-jia; WANG Qun; GUAN Yu-qing

    2001-01-01

    To study the CT and MR imaging features of spongiform leukoencephalopathy after heroin vapor inhalation. Methods: The CT and MR imaging features and pathologic findings of 13 patients with heroin-induced spongiform leukoencephalopathy were analyzed. Results: CT scanning and MRI of all the patients showed diffuse,symmetric lesion in the cerebellar and cerebral white matter, and the cerebellum was invariably involved in all cases.Symmetric round or butterfly-like lesions lateral to the midline of the cerebellum with clear border was the most distinct feature in CT and MRI examination. The lesions were not found in the anterior limbs of the internal capsules. CT scanning showed low-density changes while MRI T1WI imaging presented low-signal and T2WI high-signal lesions without space-occupying mass. The pathologic findings showed spongiform degeneration of the white matter in the central nervous system, but necrotic lesions were not observed. Conclusions: Spongiform leukoencephalopathy should be considered when acute. Cerebellar signs are present in patients who admitted a history of heroin inhalation. The CT and MRI manifestation of this disease is typical and the diagnosis can thus be made.

  17. Carbon dioxide inhalation induces dose-dependent and age-related negative affectivity.

    Eric J Griez

    Full Text Available BACKGROUND: Carbon dioxide inhalation is known to induce an emotion similar to spontaneous panic in Panic Disorder patients. The affective response to carbon dioxide in healthy subjects was not clearly characterized yet. METHODOLOGY/PRINCIPAL FINDINGS: Sixty-four healthy subjects underwent a double inhalation of four mixtures containing respectively 0, 9, 17.5 and 35% CO(2 in compressed air, following a double blind, cross-over, randomized design. Affective responses were assessed according to DSM IV criteria for panic, using an Electronic Visual Analogue Scale and the Panic Symptom List. It was demonstrated that carbon dioxide challenges induced a dose dependent negative affect (p<0.0001. This affect was semantically identical to the DSM IV definition of panic. Older individuals were subjectively less sensitive to Carbon Dioxide (p<0.05. CONCLUSIONS/SIGNIFICANCE: CO(2 induced affectivity may lay on a continuum with pathological panic attacks. Consistent with earlier suggestions that panic is a false biological alarm, the affective response to CO(2 may be part of a protective system triggered by suffocation and acute metabolic distress.

  18. Acute dyspnea

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  19. Nuclear data and measurements series: Ratio of the prompt-fission-neutron spectrum of plutonium 239 to that of uranium 235

    The prompt-fission-neutron spectrum resulting from 239Pu fission induced by 0.55 MeV incident neutrons is measured from 1.0 to 10.0 MeV relative to that of 235U fission induced by the same incident-energy neutrons. The measurements employ the time-of-flight technique. Energy-dependent ratios of the two spectra are deduced from the measured values over the energy range 1.0 to 10.0 MeV. The experimentally-derived ratio results are compared with those calculated from ENDF/B-V, revision-2, and with results of recent microscopic measurements. Using the ENDF/B-V 235U Watt parameters for the 235U spectrum, the experimental measurements imply a ratio of average fission-spectrum energies of 239Pu/235U = 1.045 +- 0.003, compared to the value 1.046 calculated from ENDF/B-V, revision 2. 12 refs., 2 figs., 2 tabs

  20. An intercomparison experiment on isotope dilution thermal ionisation mass spectrometry using plutonium-239 spike for the determination of plutonium concentration in dissolver solution of irradiated fuel

    Determination of plutonium concentration in the dissolver solution of irradiated fuel is one of the key measurements in the nuclear fuel cycle. This report presents the results of an intercomparison experiment performed between Fuel Chemistry Division (FCD) at BARC and PREFRE, Tarapur for determining plutonium concentration in dissolver solution of irradiated fuel using 239Pu spike in isotope dilution thermal ionisation mass spectrometry (ID-TIMS). The 239Pu spike method was previously established at FCD as viable alternative to the imported enriched 242Pu or 244Pu; the spike used internationally for plutonium concentration determination by IDMS in dissolver solution of irradiated fuel. Precision and accuracy achievable for determining plutonium concentration are compared under the laboratory and the plant conditions using 239Pu spike in IDMS. For this purpose, two different dissolver solutions with 240Pu/239Pu atom ratios of about 0.3 and 0.07 corresponding, respectively, to high and low burn-up fuels, were used. The results of the intercomparison experiment demonstrate that there is no difference in the precision values obtained under the laboratory and the plant conditions; with mean precision values of better than 0.2%. Further, the plutonium concentration values determined by the two laboratories agreed within 0.3%. This exercise, therefore, demonstrates that ID-TIMS method using 239Pu spike can be used for determining plutonium concentration in dissolver solution of irradiated fuel, under the plant conditions. 7 refs., 8 tabs

  1. Alkaline phosphatase and transaminase activity in rat liver and blood serum at delayed periods following external γ-irradiation combined with internal exposure to plutonium 239

    A study was made of activity of alkaline phosphatase and alanine- and aspartate aminotransferase in rat liver and blood serum at remote times after external γ-irradiation combined with internal exposure to 239Pu nitrate delivered in two chronically effective doses. The radionuclide was shown to be mainly responsible for the changes observed in activity of the enzymes under study. The degree to which the changes were manifest depended upon dose of plutonium administered

  2. The effects of inhaled isoparaffins on locomotor activity and operant performance in mice.

    Bowen, S E; Balster, R L

    1998-11-01

    Very little is known qualitatively or quantitatively about the acute central nervous system effects of isoparaffin solvents that are widely used in household and commercial applications. Four isoparaffinic hydrocarbon solvent products differing in predominant carbon number and volatility (ISOPAR-C, -E -G, -H) were tested for their acute effects on locomotor activity and operant performance after inhalation exposure in mice. For both measures, concentration-effect curves were obtained for 30-min exposures using a within-subject design. The more volatile products, ISOPAR-C and -E, were as easily vaporized under our conditions as vapors such as toluene and TCE, which have acute effects on human behavior and are abused. ISOPAR-G was slowly volatilized and ISOPAR-H could not be completely volatilized within our 30-min exposures, suggesting that acute human exposures may be less likely and that it may be more difficult to abuse them. ISOPAR-C, -E, and -G produced reversible increases in locomotor activity of mice at 4000 and 6000 ppm while ISOPAR-C and -E produced reversible concentration-dependent decreases in rates of schedule-controlled operant behavior in approximately the same concentration range as they affected locomotor activity. The fact that only locomotor activity increases were observed with these isoparaffins provides evidence that they produce a different pattern of effects than those reported for abused solvents such as toluene and TCE. Further research will be needed to determine if this different pattern of effects on animal behavior between isoparaffins and abused solvents is correlated with a different pattern of acute intoxication and abuse potential in humans. PMID:9768561

  3. Use of Respimat® Soft Mist™ Inhaler in COPD patients

    Anderson, Paula

    2006-01-01

    Events of the past decade have stimulated development of new drug formulations and delivery devices that have improved the efficiency, ease of use, and environmental impact of inhaled drug therapy. Respimat® Soft Mist™ Inhaler is a novel, multidose, propellant-free, hand-held, liquid inhaler that represents a new category of inhaler devices. The aerosol cloud generated by Respimat contains a higher fraction of fine particles than most pressurized metered dose inhalers (pMDIs) and dry powder i...

  4. Reliability of Use, Abuse, and Dependence of Four Types of Inhalants in Adolescents and Young Adults

    Ridenour, Ty A.; Bray, Bethany C.; Cottler, Linda B.

    2007-01-01

    Inhalants, as a class of drugs, consists of heterogeneous substances that include some of the most dangerous drugs on a per use basis. Research on inhalant abuse has lagged behind other drugs partly because of the need for a diagnostic instrument of different types of inhalants. This study was conducted to obtain reliability estimates for the new Substance Abuse Module DSM-IV inhalants diagnoses for four types of inhalants: aerosols, gases, nitrites, and solvents as well as different diagnost...

  5. The use of inhaled corticosteroids in pediatric asthma: update.

    Hossny, Elham; Rosario, Nelson; Lee, Bee Wah; Singh, Meenu; El-Ghoneimy, Dalia; Soh, Jian Yi; Le Souef, Peter

    2016-01-01

    Despite the availability of several formulations of inhaled corticosteroids (ICS) and delivery devices for treatment of childhood asthma and despite the development of evidence-based guidelines, childhood asthma control remains suboptimal. Improving uptake of asthma management plans, both by families and practitioners, is needed. Adherence to daily ICS therapy is a key determinant of asthma control and this mandates that asthma education follow a repetitive pattern and involve literal explanation and physical demonstration of the optimal use of inhaler devices. The potential adverse effects of ICS need to be weighed against the benefit of these drugs to control persistent asthma especially that its safety profile is markedly better than oral glucocorticoids. This article reviews the key mechanisms of inhaled corticosteroid action; recommendations on dosage and therapeutic regimens; potential optimization of effectiveness by addressing inhaler technique and adherence to therapy; and updated knowledge on the real magnitude of adverse events. PMID:27551328

  6. Inhaled medical gases: more to breathe than oxygen.

    Gentile, Michael A

    2011-09-01

    The mixture of oxygen and nitrogen is usually sufficient to achieve the therapeutic objective of supporting adequate gas exchange. Pediatric and neonatal patients have an assortment of physiologic conditions that may require adjunctive inhaled gases to treat the wide variety of diseases seen in this heterogeneous population. Inhaled nitric oxide, helium oxygen mixtures, inhaled anesthetics, hypercarbic mixtures, hypoxic mixtures, inhaled carbon monoxide, and hydrogen sulfide have been used to alter physiology in an attempt to improve patient outcomes. Balancing the therapeutic potential, possible adverse effects, and the complexity of the technical aspects of gas delivery, it is essential that clinicians thoroughly understand the application of medical gas therapy beyond the traditional nitrogen/oxygen mixture. PMID:21944684

  7. Inhalation of Simulated Smog Affects Cardiac Function in Mice

    Rationale: The health effects of individual criteria air pollutants have been well investigated. Little is known about health effects of inhaled multi-pollutant mixtures that more realistically represent environmental exposures. The present study was designed to evaluate the card...

  8. Mexican-American Adolescent Inhalant Abuse: A Proposed Model.

    Dworkin, A. Gary; Stephens, Richard C.

    1980-01-01

    Drawing from literature on differences between the Mexican American experience and that of other groups, offers a model to explain the higher rates of inhalant abuse among Mexican American youth. Considers cultural, ecological, structural, and economic factors. (Author/GC)

  9. Urine and serum concentrations of inhaled and oral terbutaline

    Elers, Jimmi; Hostrup, Morten; Pedersen, Lars;

    2012-01-01

    We examined urine and serum concentrations after therapeutic use of single and repetitive doses of inhaled and supratherapeutic oral use of terbutaline. We compared the concentrations in 10 asthmatics and 10 healthy subjects in an open-label, cross-over study with 2 mg inhaled and 10 mg oral....... Median (IQR) urine concentrations peaked in the period 0-4 h after inhalation with Cmax 472 (324) ng/mL in asthmatics and 661 (517) ng/mL in healthy subjects, and 4-8 h after oral use with Cmax 666 (877) ng/mL in asthmatic and 402 (663) ng/mL in healthy subjects. In conclusion we found no significant...... differences in urine and serum concentrations between asthmatic and healthy subjects. We compared urine and serum concentrations after therapeutic inhaled doses and supratherapeutic oral doses and observed significant statistical differences in both groups but found it impossible to distinguish between...

  10. Inhaled therapy for the management of perioperative pulmonary hypertension

    C A Thunberg

    2015-01-01

    Full Text Available Patients with pulmonary hypertension (PH are at high risk for complications in the perioperative setting and often receive vasodilators to control elevated pulmonary artery pressure (PAP. Administration of vasodilators via inhalation is an effective strategy for reducing PAP while avoiding systemic side effects, chiefly hypotension. The prototypical inhaled pulmonary-specific vasodilator, nitric oxide (NO, has a proven track record but is expensive and cumbersome to implement. Alternatives to NO, including prostanoids (such as epoprostenol, iloprost, and treprostinil, NO-donating drugs (sodium nitroprusside, nitroglycerin, and nitrite, and phosphodiesterase inhibitors (milrinone, sildenafil may be given via inhalation for the purpose of treating elevated PAP. This review will focus on the perioperative therapy of PH using inhaled vasodilators.

  11. Strategies to improve oxygenation in experimental acute lung injury

    Hartog, Arthur

    2000-01-01

    textabstractOne of the most important clinical syndromes, in which failure of oxygen uptake in the lung leads to severe hypoxia, is the so-called acute respiratory distress syndrome (ARDS). ARDS is a complex of clinical signs and symptoms which occur following diverse pulmonary or systemic insults, including sepsis. shock, pneumonia. trauma, liquid aspiration. hematological disorders, smoke inhalation, and many others, In ARDS, the treatments available are still inadequate and morbidity, mort...

  12. Effect of carbon dioxide in acute mountain sickness

    Harvey, T C; Raichle, M E; Winterborn, M H;

    1988-01-01

    The effect of adding CO2 to inhaled air in six subjects with acute mountain sickness was investigated during a medical expedition to 5400 m.3% CO2 in ambient air increased ventilation and resulted in a rise in PaO2 of between 24% and 40%. There was a 9-28% increase in PaCO2 and a reduction of the...

  13. FORMULATION AND QUALITY CONTROL OF METERED DOSE INHALER: A REVIEW

    Ramteke K.H.; Gunjal S.S; Sharma Y.P

    2012-01-01

    The MDI is now established as the principal dosage form of inhalation drug therapy for bronchial asthma and chronic obstructive pulmonary disease (COPD). Metered dose inhalers (MDIs) are pharmaceutical delivery systems designed for oral or nasal use, which deliver discrete doses of aerosolized medicament to the respiratory tract. The MDI contains the active substance, dissolved or suspended in a liquefied propellant system held in a pressurized container that is sealed with a metering valve. ...

  14. Patient preference for and satisfaction with inhaler devices

    Anderson, P

    2005-01-01

    Preference for and satisfaction with inhaler devices may be associated with improved clinical outcomes, but this has not been proven to date. A screened Medline search for papers on preference for inhaler devices produced 29 studies on a variety of devices, with Advair Diskus® and TurbuhalerTM featuring prominently. Of the 23 studies sponsored by the pharmaceutical industry, the sponsor's device was preferred in 19. Interpretation of results was made more difficult because only two studies us...

  15. Inhalational drug delivery from seven different spacer devices.

    Barry, P W; O Callaghan, C.

    1996-01-01

    BACKGROUND: A study was performed to determine in vitro the difference in drug output of seven currently available spacer devices when used with different inhaled medications. METHODS: A glass multistage liquid impinger (MSLI) was used to determine the amount of disodium cromoglycate (DSCG, 5 mg), salbutamol (100 micrograms), or budesonide (200 micrograms) obtained in various particle size ranges from metered dose inhalers (MDIs) actuated directly into the MSLI or via one of seven different s...

  16. Carbon nanotube dosimetry: from workplace exposure assessment to inhalation toxicology

    Erdely, Aaron; Dahm, Matthew; Chen, Bean T.; Zeidler-Erdely, Patti C.; Fernback, Joseph E.; Birch, M. Eileen; Evans, Douglas E.; Kashon, Michael L; Deddens, James A.; Hulderman, Tracy; Bilgesu, Suzan A; Battelli, Lori; Schwegler-Berry, Diane; Leonard, Howard D.; McKinney, Walter

    2013-01-01

    Background Dosimetry for toxicology studies involving carbon nanotubes (CNT) is challenging because of a lack of detailed occupational exposure assessments. Therefore, exposure assessment findings, measuring the mass concentration of elemental carbon from personal breathing zone (PBZ) samples, from 8 U.S.-based multi-walled CNT (MWCNT) manufacturers and users were extrapolated to results of an inhalation study in mice. Results Upon analysis, an inhalable elemental carbon mass concentration ar...

  17. Willingness to Pay for Inhaled Insulin: A Contingent Valuation Approach

    Hamid Sadri; MacKeigan, Linda D.; Leiter, Lawrence A.; Einarson, Thomas R

    2005-01-01

    Purpose: To determine the willingness to pay (WTP) of patients with diabetes mellitus for inhaled insulin. Methods: A contingent valuation survey was administered to 96 diabetic outpatients at St. Michael's Hospital, Toronto, Canada. Standardised information about inhaled insulin and subcutaneous rapid-acting insulin was provided via video. Participants' WTP for their preferred product was elicited in Canadian dollars ($Can) using a `payment-scale' method. Results: The mean age of participant...

  18. Engineering of an Inhalable DDA/TDB Liposomal Adjuvant

    Ingvarsson, Pall Thor; Yang, Mingshi; Mulvad, Helle;

    2013-01-01

    The purpose of this study was to identify and optimize spray drying parameters of importance for the design of an inhalable powder formulation of a cationic liposomal adjuvant composed of dimethyldioctadecylammonium (DDA) bromide and trehalose-6,6'-dibehenate (TDB).......The purpose of this study was to identify and optimize spray drying parameters of importance for the design of an inhalable powder formulation of a cationic liposomal adjuvant composed of dimethyldioctadecylammonium (DDA) bromide and trehalose-6,6'-dibehenate (TDB)....

  19. Subchronic inhalation toxicity of gold nanoparticles

    Chung Yong

    2011-05-01

    Full Text Available Abstract Background Gold nanoparticles are widely used in consumer products, including cosmetics, food packaging, beverages, toothpaste, automobiles, and lubricants. With this increase in consumer products containing gold nanoparticles, the potential for worker exposure to gold nanoparticles will also increase. Only a few studies have produced data on the in vivo toxicology of gold nanoparticles, meaning that the absorption, distribution, metabolism, and excretion (ADME of gold nanoparticles remain unclear. Results The toxicity of gold nanoparticles was studied in Sprague Dawley rats by inhalation. Seven-week-old rats, weighing approximately 200 g (males and 145 g (females, were divided into 4 groups (10 rats in each group: fresh-air control, low-dose (2.36 × 104 particle/cm3, 0.04 μg/m3, middle-dose (2.36 × 105 particle/cm3, 0.38 μg/m3, and high-dose (1.85 × 106 particle/cm3, 20.02 μg/m3. The animals were exposed to gold nanoparticles (average diameter 4-5 nm for 6 hours/day, 5 days/week, for 90-days in a whole-body inhalation chamber. In addition to mortality and clinical observations, body weight, food consumption, and lung function were recorded weekly. At the end of the study, the rats were subjected to a full necropsy, blood samples were collected for hematology and clinical chemistry tests, and organ weights were measured. Cellular differential counts and cytotoxicity measurements, such as albumin, lactate dehydrogenase (LDH, and total protein were also monitored in a cellular bronchoalveolar lavage (BAL fluid. Among lung function test measurements, tidal volume and minute volume showed a tendency to decrease comparing control and dose groups during the 90-days of exposure. Although no statistically significant differences were found in cellular differential counts, histopathologic examination showed minimal alveoli, an inflammatory infiltrate with a mixed cell type, and increased macrophages in the high-dose rats. Tissue

  20. Radioaerosol Inhalation Imaging in Bronchial Asthma

    Kim, Bum Soo; Park, Young Ha; Park, Jeong Mi; Chung, Myung Hee; Chung, Soo Kyo; Shinn, Kyung Sub; Bahk, Yong Whee [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a HARC(Bhabha Atomic Research Center, India) nebulizer with 15 mCi of {sup 99m}Tc-phytate. The scanning was performed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analysed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with {sup 99m}Tc-MAA. Follow-up scans were obtained in 5 patients after bronchodilator therapy. 1 he patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of hasal interstitial markings in 26 of the 31 patients. Chest radiographs were normal in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present

  1. Radioaerosol Inhalation Lung Scan in Pulmonary Emphysema

    Perfusion and ventilation imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonary emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebuliser with 15 mCi of 99mTc-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to 10-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with 99mTc-MAA was performed in 12 patients. In five patients, we performed follow-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was

  2. Radioaerosol Inhalation Imaging in Bronchial Asthma

    Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a HARC(Bhabha Atomic Research Center, India) nebulizer with 15 mCi of 99mTc-phytate. The scanning was performed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analysed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with 99mTc-MAA. Follow-up scans were obtained in 5 patients after bronchodilator therapy. 1 he patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of hasal interstitial markings in 26 of the 31 patients. Chest radiographs were normal in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 1.7 patients

  3. Sildenafil versus nitric oxide for acute vasodilator testing in pulmonary arterial hypertension

    Milger, Katrin; Felix, Janine F.; Voswinckel, Robert; Sommer, Natascha; Franco, Oscar H; Grimminger, Friedrich; Reichenberger, Frank; Seeger, Werner; Ghofrani, Hossein A; Gall, Henning

    2015-01-01

    Vasoreactivity testing with inhaled NO is recommended for pulmonary arterial hypertension (PAH) because of its therapeutic and prognostic value. Sildenafil has acute pulmonary vasodilating properties, but its diagnostic and prognostic impact in PAH is unknown. Our objective was to compare acute vasodilating responses to sildenafil and those to NO during right heart catheterization and also their prognostic values in patients with PAH. Ninety-nine patients with idiopathic PAH and 99 with assoc...

  4. Experimental investigation of design parameters on dry powder inhaler performance.

    Ngoc, Nguyen Thi Quynh; Chang, Lusi; Jia, Xinli; Lau, Raymond

    2013-11-30

    The study aims to investigate the impact of various design parameters of a dry powder inhaler on the turbulence intensities generated and the performance of the dry powder inhaler. The flow fields and turbulence intensities in the dry powder inhaler are measured using particle image velocimetry (PIV) techniques. In vitro aerosolization and deposition a blend of budesonide and lactose are measured using an Andersen Cascade Impactor. Design parameters such as inhaler grid hole diameter, grid voidage and chamber length are considered. The experimental results reveal that the hole diameter on the grid has negligible impact on the turbulence intensity generated in the chamber. On the other hand, hole diameters smaller than a critical size can lead to performance degradation due to excessive particle-grid collisions. An increase in grid voidage can improve the inhaler performance but the effect diminishes at high grid voidage. An increase in the chamber length can enhance the turbulence intensity generated but also increases the powder adhesion on the inhaler wall. PMID:24055597

  5. Inhalation of two putative Gulf War toxins by mice.

    Repine, John E; Wilson, Paul; Elkins, Nancy; Klawitter, Jelena; Christians, Uwe; Peters, Ben; Smith, Dwight M

    2016-06-01

    We employed our inhalation methodology to examine whether biomarkers of inflammation and oxidative stress would be produced in mice following inhalation of aerosols containing carbonaceous particles or the vapor of pesticides prevalent during the first Gulf War. Exposure to two putative Gulf War Illness toxins, fine airborne particles and the pesticide malathion, increased biomarkers of inflammation and oxidative stress in Friend virus B (FVB) female mice. Mice inhaling particles 24 h before had increased lung lavage and plasma Leukotriene B4 (LTB4) (a biomarker of inflammation) and PGF2α (a biomarker of oxidative stress) levels, lung lavage protein and lung lavage lactic dehydrogenase (LDH) levels. These changes were a function of particle density and exposure time. Compared to particle inhalation, mice inhaling malathion 24 h before had small increase in plasma LTB4 and PGF2α levels but no increase in lung lavage LTB4, lung lavage protein, lung lavage LDH, and lung lavage alveolar macrophage (AM) levels compared to unexposed control mice. AM from particle-exposed mice contained phagocytosed particles, while AM from malathion-exposed mice showed no abnormalities. Our results indicate that inhaling particles or malathion can alter inflammatory and oxidative biomarkers in mice and raise the possibility that these toxins may have altered inflammation and oxidative stress biomarkers in Gulf War-exposed individuals. PMID:26950528

  6. Hepatotoxic Alterations Induced by Inhalation of Trichloroethylene (TCE) in Rats

    2001-01-01

    Objective Trichloroethylene (TCE) is one of the most potent organic unsaturated solvents being used in dry cleaning, metal degreasing, thinner for paints varnishes and electroplating, etc. and has been reported to be a hepatotoxicant through oral and dermal exposure. However, its inhalation toxicity data is very limited in the literature due to the fact that the exposure levels associated with these effects were usually not reported. Hence, inhalation toxicity study was carried out for hepatotoxic studies. Method Inhalation toxicity studies was carried out by exposing rats to TCE for 8, 12 and 24 weeks in a dynamically operated whole body inhalation chamber. Sham treated control rats were exposed to compressed air in the inhalation chamber for the same period. Results Significant increase in liver weight (liver enlargement) appearance of necrotic lesions with fatty changes and marked necrosis were observed after longer duration (12 and 24 weeks) of TCE exposure. The lysosomal rupture resulted in increased activity of acid and alkaline phosphatase alongwith reduced glutathione content and total increased sulfhydryl content in liver tissue. Conclusion TCE exposure through Inhalation route induces hepatotoxicity in terms of marked necrosis with fatty changes and by modulating the lysosomal enzymes.

  7. From inhaler to lung: clinical implications of the formulations of ciclesonide and other inhaled corticosteroids

    Nave R

    2013-03-01

    Full Text Available Ruediger Nave, Helgert Mueller Nycomed: a Takeda Company, Nycomed GmbH, Konstanz, Germany Abstract: Asthma continues to be a global health problem and currently available treatments such as corticosteroids can cause unwanted side effects. Inhaled corticosteroids (ICS are recommended as first-line therapy for reducing airway inflammation and have a distinct advantage over oral preparations as they provide a direct route of delivery to the lungs. However, local deposition of ICS in the oropharynx can lead to oral candidiasis, dysphonia, and pharyngitis. The pharmaceutical quality is a primary concern of any ICS asthma treatment, with a higher quality product resulting in improved efficacy and safety profiles. The particle size distribution and the spray force velocity of an ICS may directly influence lung deposition, and the spray duration of a device is another important factor when coordinating inhalation. Recent advances in ICS device and formulation technology have resulted in significant improvements in the efficacy of available asthma treatments. In particular, hydrofluoroalkane (HFA solution technology and the development of smaller particle sizes have resulted in the production of new ICS formulations that have the ability to directly target drug delivery to the site of airway inflammation. Both the ICS formulation and the pressurized metered-dose inhaler device used to administer ciclesonide (CIC HFA have been developed to treat the underlying chronic inflammation associated with asthma. CIC is administered as a prodrug which is activated in the lungs, leading to minimal oropharyngeal deposition. The small particle size of CIC results in the delivery of a high fraction of respirable particles to the small airways of the lungs, resulting in high lung deposition and continual dose consistency. This review summarizes how CIC administered as an HFA formulation is an effective treatment for asthma. Keywords: ciclesonide, asthma, small airways

  8. Acute, rapidly progressive renal failure with simultaneous use of amphotericin B and pentamidine.

    Antoniskis, D.; Larsen, R.A.

    1990-01-01

    We report four cases of acute reversible renal failure in patients with acquired immune deficiency syndrome who received both amphotericin B (for systemic mycoses) and pentamidine isethionate (for Pneumocystis carinii pneumonia). The concurrent use of amphotericin B with either inhaled pentamidine or trimethoprim-sulfamethoxazole did not cause significant renal impairment.

  9. Inhaled corticosteroids in COPD: the clinical evidence.

    Ernst, Pierre; Saad, Nathalie; Suissa, Samy

    2015-02-01

    In this article, we focus on the scientific evidence from randomised trials supporting treatment with inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), including treatment with combinations of long-acting β-agonist (LABA) bronchodilators and ICS. Our emphasis is on the methodological strengths and limitations that guide the conclusions that may be drawn. The evidence of benefit of ICS and, therefore, of the LABA/ICS combinations in COPD is limited by major methodological problems. From the data reviewed herein, we conclude that there is no survival benefit independent of the effect of long-acting bronchodilation and no effect on FEV1 decline, and that the possible benefit on reducing severe exacerbations is unclear. Our interpretation of the data is that there are substantial adverse effects from the use of ICS in patients with COPD, most notably severe pneumonia resulting in excess deaths. Currently, the most reliable predictor of response to ICS in COPD is the presence of eosinophilic inflammation in the sputum. There is an urgent need for better markers of benefit and risk that can be tested in randomised trials for use in routine specialist practice. Given the overall safety and effectiveness of long-acting bronchodilators in subjects without an asthma component to their COPD, we believe use of such agents without an associated ICS should be favoured. PMID:25537556

  10. Lupine inhalation induced asthma in a child.

    Moreno-Ancillo, Alvaro; Gil-Adrados, Ana C; Domínguez-Noche, Carmen; Cosmes, Pedro M

    2005-09-01

    The ingestion of lupine seed flour has been reported as a cause of allergic reactions. There is some evidence of its allergenic potential after inhalation. An 8-year-old asthmatic child, who was allergic to peanut, was studied in our clinic with the suspicion of an adverse drug reaction due to salbutamol. He suffered an asthma attack while playing with his brother, who had been eating lupine seed as snack; surprisingly, the asthma attack worsened with salbutamol. The skin tests showed a positive result with Lupinus albus extract, peanut, garbanzo bean, navy bean, pea, green bean, lentil, soy, Olea europea pollen, grass pollen and Plantago lanceolata pollen. The prick-by-prick tests both from dried seeds and those preserved in salt and water were strongly positive. Serum specific IgE antibodies were positive to Lupine albus (1.43 kU/l), peanut (4.32 kU/l), soy (2.15 kU/l), lentil (3.12 kU/l) and garbanzo (0.7 kU/l). After informed consent salbutamol was well tolerated but the patient had asthma in 5 min of manipulation of the lupine seeds. In our case, reactivity with other legumes was also demonstrated, but only peanut allergy was relevant because boiled legumes were tolerated. It is also notorious that anamnesis is so important to assess the true etiological agents of asthma. PMID:16176404

  11. Introduction: Aerosol delivery of orally inhaled agents.

    Corcoran, Timothy E; Devadason, Sunalene G; Kuehl, Philip J

    2012-12-01

    Deposition scintigraphy methods have been used extensively to provide qualitative and quantitative data on aerosol drug deposition in the lungs. However, differences in methodology among the different centers performing these studies have limited the application of these techniques, especially in regulatory roles. As an introduction to the standardized techniques developed by the International Society for Aerosols in Medicine (ISAM) Regulatory Affairs Networking Group, we present potential advantages of the use of standard techniques for deposition scintigraphy. Specifically, we propose that standardized techniques would allow for better comparisons between labs and would facilitate multicenter studies. They would allow for improved methods of establishing equivalence and could be better utilized to establish dosing for new medications. They would allow for the performance of more accurate dose ranging or multidose studies and complement pharmacokinetic studies of new inhaled medications. Standardized techniques could help to establish the relationship between the deposition of drug in the lungs and clinical effect, and may also facilitate clinical measurements of deposited dose for medications with narrow therapeutic indices. In the sections that follow, we discuss the best techniques used to perform deposition scintigraphy through planar, single-photon emission computed tomography, and positron emission tomography modalities and propose a detailed set of standardized methods for each. These include methods for radiolabel validation, radiolabel accountability and mass balance, and imaging acquisition and analysis. PMID:23215846

  12. Newer insulin analogues and inhaled insulin

    Girish C

    2006-03-01

    Full Text Available Diabetes is a metabolic disease with high prevalence worldwide. Exogenous insulin is used in the management of this condition. The development of human insulin has provided tighter control of glycaemia in diabetic patients. Insulin analogues like insulin lispro and aspart were developed to closely match its profile with physiological secretion. The newer additions to this armamentarium are insulin glulisine, insulin detemir and albulin.Insulin glulisine is a short acting analogue with a rapid onset of action. The antiapoptotic property, mediated through insulin substrate receptor-2 has a favourable protective action on beta cells. Insulin detemir is a long acting analogue, soluble at neutral pH, which reversibly binds to albumin in plasma, prolonging its action. Its lower affinity for insulin receptors necessitates higher doses compared to human insulin. The reduction in body weight is an additional advantage of detemir. A major concern about all newer insulin analogues is their altered mitogenic properties and resultant risk of carcinogenicity on long term use. Albulin is a latest addition of insulin analogue which is under various in vitro and in vivo studies. Inhaled insulin in powder form (Exubera is recently approved by FDA and appears promising.

  13. Translocation pathways for inhaled asbestos fibers

    Mantegazza F

    2008-01-01

    Full Text Available Abstract We discuss the translocation of inhaled asbestos fibers based on pulmonary and pleuro-pulmonary interstitial fluid dynamics. Fibers can pass the alveolar barrier and reach the lung interstitium via the paracellular route down a mass water flow due to combined osmotic (active Na+ absorption and hydraulic (interstitial pressure is subatmospheric pressure gradient. Fibers can be dragged from the lung interstitium by pulmonary lymph flow (primary translocation wherefrom they can reach the blood stream and subsequently distribute to the whole body (secondary translocation. Primary translocation across the visceral pleura and towards pulmonary capillaries may also occur if the asbestos-induced lung inflammation increases pulmonary interstitial pressure so as to reverse the trans-mesothelial and trans-endothelial pressure gradients. Secondary translocation to the pleural space may occur via the physiological route of pleural fluid formation across the parietal pleura; fibers accumulation in parietal pleura stomata (black spots reflects the role of parietal lymphatics in draining pleural fluid. Asbestos fibers are found in all organs of subjects either occupationally exposed or not exposed to asbestos. Fibers concentration correlates with specific conditions of interstitial fluid dynamics, in line with the notion that in all organs microvascular filtration occurs from capillaries to the extravascular spaces. Concentration is high in the kidney (reflecting high perfusion pressure and flow and in the liver (reflecting high microvascular permeability while it is relatively low in the brain (due to low permeability of blood-brain barrier. Ultrafine fibers (length

  14. The biological behaviour of inhaled transuranic elements

    The biological behaviour of inhaled transuranic elements has been reviewed by focus on different points of present interest. Lung clearance and translocation are largely affected by the chemistry of transuranic elements. However, especially for plutonium, some examples show that the kinetics of some chemical reactions are function of the element concentration: extrapolation to the biological concentrations must therefore be cautious. The importance of the specific activity is stressed by different behaviours of plutonium 238 and 239 oxides. In the case of 238Pu, it is responsible of the fast dissolution of the oxide by formation of nanometric particles. Whatever the isotopes, these particules have a particularly important function since their biological fate seems to disturb the established models. Their origin is still to be determined since they have been identified both in the combustion of Pu-Na or Pu-Mg simultaneously, and plutonium only. The bronchial clearance of micronic particles does not seem to be fast for the whole of the fraction cleared. A residual compartment, indeed low, will remain at the level of the bronchial epithelium for a rather long time. This must be taken into account by dosimetric evaluations at the cellular levels. In spite of the few restrictions stated, the body of knowledge makes a fair estimation of risks possible

  15. Protective effect of budesonide/formoterol compared with formoterol, salbutamol and placebo on repeated provocations with inhaled AMP in patients with asthma: a randomised, double-blind, cross-over study

    van der Woude Hanneke J

    2010-05-01

    Full Text Available Abstract Background The budesonide/formoterol combination is successfully used for fast relief of asthma symptoms in addition to its use as maintenance therapy. The temporarily increased corticosteroid dose during increasing inhaler use for symptom relief is likely to suppress any temporary increase in airway inflammation and may mitigate or prevent asthma exacerbations. The relative contribution of the budesonide and formoterol components to the improved asthma control is unclear. Methods The acute protective effect of inhaled budesonide was tested in a model of temporarily increased airway inflammation with repeated indirect airway challenges, mimicking an acute asthma exacerbation. A randomised, double-blind, cross-over study design was used. Asthmatic patients (n = 17, mean FEV1 95% of predicted who previously demonstrated a ≥30% fall in forced expiratory volume in 1 second (FEV1 after inhaling adenosine 5'-monophosphate (AMP, were challenged on four consecutive test days, with the same dose of AMP (at 09:00, 12:00 and 16:00 hours. Within 1 minute of the maximal AMP-induced bronchoconstriction at 09:00 hours, the patients inhaled one dose of either budesonide/formoterol (160/4.5 μg, formoterol (4.5 μg, salbutamol (2 × 100 μg or placebo. The protective effects of the randomised treatments were assessed by serial lung function measurements over the test day. Results In the AMP provocations at 3 and 7 hours after inhalation, the budesonide/formoterol combination provided a greater protective effect against AMP-induced bronchoconstriction compared with formoterol alone, salbutamol and placebo. In addition all three active treatments significantly increased FEV1 within 3 minutes of administration, at a time when inhaled AMP had induced the 30% fall in FEV1. Conclusions A single dose of budesonide/formoterol provided a greater protective effect against inhaled AMP-induced bronchoconstriction than formoterol alone, both at 3 and at 7 hours

  16. Acute myelogenous leukemia (AML) - children

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  17. Inhalational anesthesia for organ procurement: potential indications for administering inhalational anesthesia in the brain-dead organ donor.

    Elkins, Laurie J

    2010-08-01

    Organs needed for transplantation far outweigh their availability. There is minimal research regarding perioperative care of the brain-dead organ donor during the procurement procedure. Current research attributes a great deal of organ damage to autonomic or sympathetic storm that occurs during brain death. Literature searches were performed with the terms brain death, organ donor, organ procurement, anesthesia and organ donor, anesthesia and brain death, anesthesia and organ procurement, inhalational anesthetics and organ procurement, and inhalational anesthetics and brain dead. Additional resources were obtained from reference lists of published articles. The literature review showed there is a lack of published studies researching the use of inhalational anesthetics in organ procurement. No studies have been published evaluating the effect of preconditioning with inhalational agents (administering 1.3 minimal alveolar concentration of an inhalational agent for the 20 minutes before periods of ischemia) in the brain-dead organ donor population. Further studies are required to determine if administration of inhalational anesthetics reduces catecholamine release occurring with surgical stimulation during the organ procurement procedure and whether this technique increases viability of transplanted organs. Anesthetic preconditioning before the ischemic period may reduce ischemia-reperfusion injury in transplanted organs, further increasing viability of transplanted organs. PMID:20879630

  18. Particle engineering of materials for oral inhalation by dry powder inhalers. II-Sodium cromoglicate.

    Nolan, Lorraine M; Li, Jianhe; Tajber, Lidia; Corrigan, Owen I; Healy, Anne Marie

    2011-02-28

    Sodium cromoglicate is an antiasthmatic and antiallergenic drug used in inhalation therapy and commonly administered by a dry powder inhaler. In the present study we sought to examine the feasibility of producing nanoporous microparticles (NPMPs) of this hydrophilic material by adaptation of a spray drying process previously applied to hydrophobic drugs, and to examine the physicochemical and in vitro deposition properties of the spray dried particles in comparison to a commercial product. The storage stability of successfully prepared NPMPs was assessed under a number of conditions (4°C with dessicant, 25°C at 60% relative humidity and 25°C with dessicant). Spray dried sodium cromoglicate was amorphous in nature. NPMPs of sodium cromoglicate displayed superior aerodynamic properties resulting in improved in vitro drug deposition, as assessed by Andersen Cascade Impactor and twin impinger studies, in comparison to the commercial product, Intal. Deposition studies indicated that porosity and sphericity were important factors in improving deposition properties. The optimum solvent system for NPMP production was water:methanol:n-butyl acetate, as spherical NPMPs spray dried from this solvent system had a higher respirable fraction than non-spherical NPMPs of sodium cromoglicate (spray dried from methanol:n-butyl acetate), non-porous sodium cromoglicate (spray dried from water) and micronised sodium cromoglicate (Intal). While particle morphology was altered by storage at high humidity (60% RH) and in vitro deposition performance deteriorated, it was possible to maintain NPMP morphology and aerosolisation performance by storing the powder with dessicant. PMID:21129460

  19. Towards the optimisation and adaptation of dry powder inhalers.

    Cui, Y; Schmalfuß, S; Zellnitz, S; Sommerfeld, M; Urbanetz, N

    2014-08-15

    Pulmonary drug delivery by dry powder inhalers is becoming more and more popular. Such an inhalation device must insure that during the inhalation process the drug powder is detached from the carrier due to fluid flow stresses. The goal of the project is the development of a drug powder detachment model to be used in numerical computations (CFD, computational fluid dynamics) of fluid flow and carrier particle motion through the inhaler and the resulting efficiency of drug delivery. This programme will be the basis for the optimisation of inhaler geometry and dry powder inhaler formulation. For this purpose a multi-scale approach is adopted. First the flow field through the inhaler is numerically calculated with OpenFOAM(®) and the flow stresses experienced by the carrier particles are recorded. This information is used for micro-scale simulations using the Lattice-Boltzmann method where only one carrier particle covered with drug powder is placed in cubic flow domain and exposed to the relevant flow situations, e.g. plug and shear flow with different Reynolds numbers. Therefrom the fluid forces on the drug particles are obtained. In order to allow the determination of the drug particle detachment possibility by lift-off, sliding or rolling, also measurements by AFM (atomic force microscope) were conducted for different carrier particle surface structures. The contact properties, such as van der Waals force, friction coefficient and adhesion surface energy were used to determine, from a force or moment balance (fluid forces versus contact forces), the detachment probability by the three mechanisms as a function of carrier particle Reynolds number. These results will be used for deriving the drug powder detachment model. PMID:24792975

  20. Potential doses at the Maralinga and Emu test sites

    A brief article presents the key points of an NRPB assessment of potential radiation doses to the local aboriginal population likely to result from the residual activity in the Maralinga and Emu nuclear testing areas. The main radionuclide contributing to dose is plutonium-239 although isotopes of uranium are significant in certain areas. Exposure pathways included inhalation of resuspended activity, ingestion of soil by infants and intake of activity into wounds. (UK)

  1. Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD A double-blind, randomised, non-inferiority, parallel-group, multicentre study

    Andersson Eva; Vogelmeier Claus; Selroos Olof; Ställberg Björn; Ekström Tommy; Larsson Kjell

    2009-01-01

    Abstract Background Oral corticosteroids and inhaled bronchodilators with or without antibiotics represent standard treatment of COPD exacerbations of moderate severity. Frequent courses of oral steroids may be a safety issue. We wanted to evaluate in an out-patient setting whether a 2-week course of inhaled budesonide/formoterol would be equally effective for treatment of acute COPD exacerbations as standard therapy in patients judged by the investigator not to require hospitalisation. Metho...

  2. Asbestos cement dust inhalation by hamsters

    Wehner, A.P.; Dagle, G.E.; Cannon, W.C.; Buschbom, R.L. (Pacific Northwest Laboratories, Richland, WA (USA))

    1978-12-01

    Two groups of 96 male Syrian golden hamsters were exposed to respirable asbestos cement aerosol at concentrations of approximately 1 and approximately 10 micrograms/liter, respectively, 3 hours/day, 5 days/week. Average fiber counts ranged from 5 to about 120 fibers/cm3. Each group was randomly divided into six subgroups of 16 animals. The first subgroup was sacrificed after 3 months of exposure, the second after 6 months, and the third after 15 months. The fourth subgroup was withdrawn from exposure after 3 months, observed for an additional 3 months, and then sacrificed. The fifth and sixth subgroups were withdrawn after 3 and 6 months of exposure, respectively, and maintained for observation up to the 15-month exposure point of the third subgroup at which time all surviving animals were sacrificed. All other experimental procedures were similar to those delineated in a previous publication describing the development of an animal model, techniques, and an exposure system for asbestos cement dust inhalation. The asbestos cement exposures had no significant effect on body weight and mortality of the animals. Higher aerosol concentration and longer exposure times increased the number of macrophages and ferruginous bodies found in the lungs of the exposed animals. Recovery periods had no effect on the incidence of macrophages and ferruginous bodies. The incidence of very slight to slight fibrosis in the animals sacrificed after 15 months of exposure shows a significant (P less than 0.01) trend when the untreated control group and the 1 and 10 microgram/liter dose level groups are compared, indicating a dose-response relationship. Development of minimal fibrosis continued in animals withdrawn from exposure. No primary carcinomas of the lung and respiratory tract and no mesotheliomas were found.

  3. Species difference in metabolism of inhaled butadiene

    Chronic exposure of B6C3F1 mice and Sprague-Dawley rats to butadiene (BD) produced a very high incidence of cancer in mice while the incidence in rats was much lower with different tissues affected. Studies at this institute indicate that for equivalent exposures, the blood BD epoxide concentrations in mice are 5-fold higher than in rats and > 10-fold higher than in Cynomolgus monkeys. In this study, the profiles of urinary metabolites of butadiene were determined in Cynomolgus monkeys, F344/N rats, Sprague Dawley rats, B6C3F1 mice and Syrian hamsters, species containing widely divergent hepatic epoxide hydrolase (EH) activities. Animals were exposed for 2 hr to 8,000 ppm [14C]BD and 24-hr urine samples were analyzed for metabolites. Two major urinary metabolites were identified, N-acetyl-S-(-1(or 2)-3-butene-2(or 1)-ol)cysteine (1) and N-acetyl-S-(-4-butane-1,2-diol)cysteine (2). Monkeys exposed by inhalation produced primarily metabolite 2, while rodent species produced 1-4 times as much of 1 compared to 2. The ratio of 2/1 formation was related to the hepatic epoxide hydrolase activity in different species. The high 2/1 ratio in monkeys was consistent with the lower blood epoxide levels in this species. If BD metabolism by humans is similar to that in the monkey, exposure of humans to BD may result in lower tissue concentrations of reactive metabolites than an equivalent exposure of rodents. This has important implications for assessing the risk to humans of BD exposure based on rodent studies

  4. [Atypical case of teenager fatal poisoning by butane as a result of gas for lighters inhalation against his will].

    Celiński, Rafał; Skowronek, Rafał; Uttecht-Pudełko, Anna

    2013-01-01

    Inhalatomania with volatile organic compounds is a still present phenomenon among Polish young adolescents. Conscious, voluntary exposition on such substances may result in serious health consequences, including sudden death in the course of acute intoxication. In this paper, atypical case of death of 16-year-old teenager as a result of complications of physically forced inhalation of gas for lighters is presented. According to testimonies of witnesses, the container was placed in the mouth of victim and the gas was introduced directly to his throat. Autopsy revealed small damage of tooth with corresponding bruising of lower lip; brain and lung oedma; single bruisings in the upper respiratory tract and subpleural. Chemical-toxicological analysis of blood, brain and lung samples taken during autopsy revealed in all of them the presence of n-butan--a component of gas for lighters (the greatest in brain and lung tissues). Additionally, in blood the presence of carboxyhemoglobin (COHb) in concentration 7% was confirmed. Based on the results of analyses, acute intoxication with n-butan was estimated as a cause of death; however the key role played the information obtained during the investigation. This case shows, that deaths resulting from gas for lighters inhalation may be a consequence of forced exposition--against victim's will. So medical staff should always check, if on the body of patient there are any signs of physical constraint (the presence of bruisings in the area of viscerocranium and oral cavity, teeth damages, etc.). PMID:24167951

  5. PROCESS VALIDATION OF METERED DOSE INHALER: A REVIEW

    Kaur Gaganpreet

    2012-03-01

    Full Text Available The purpose of this work is to present an introduction and general overview on process validation of Metered dose inhaler.The word validation simply means, “Assessment of validation or action of proving effectiveness”. The most common dosage form for inhalation is the metered-dose inhaler (MDI, by which the drug is delivered from a pressurized container using a liquefied gas propellant.Inhalation is the convenient way to deliver drugs to respiratory tract in treatment of respiratory disease like ASTHMA.The process validation process parameters are derived from the specifications for the device, component or other entity to be produced by the process. The process is developed in such a way that the required parameters are achieved and it ensures that the output of the process will consistently meet the required parameters during routine production, the process is validated. A manufacturer can assure through careful design of the device, processes, process controls and packaging that all manufactured units will meet specifications and have uniform quality. However, in-process and finished product testing still play an important role in assuring that products meet specifications Validation is defined as a collection and evaluation of data , from the process design stage through commercial production, which establishes scientific evidence that a process is capable of consistently delivering quality product. MDI is pocket-sized, hand-held, pressurise multiple-dose inhalation delivery system. It delivers small, precisely measured therapeutic doses, greatly minimizing the risk of adverse side effects. A metered dose inhaler (MDI is a device that delivers a specific amount of medication to the lungs in the form of a short burst of aerosolized medicine that is inhaled by the patient. Three consecutive batches of metered dose inhaler shall be taken up for process validation. Based on the results of all the 3 batches, suitable conclusions will be drawn

  6. Inhalability for aerosols at ultra-low windspeeds

    Most previous experimental studies of aerosol inhalability were conducted in wind tunnels for windspeeds greater than 0.5 ms-1. While that body of work was used to establish a convention for the inhalable fraction, results from studies in calm air chambers (for essentially zero windspeed) are being discussed as the basis of a modified criterion. However, information is lacking for windspeeds in the intermediate range, which - it so happens - pertain to most actual workplaces. With this in mind, we have developed a new experimental system to assess inhalability - and, ultimately, personal sampler performance - for aerosols with particle aerodynamic diameter within the range from about 9 to 90 μm for ultra-low windspeed environments from about 0.1 to 0.5 ms1. This new system contains an aerosol test facility, fully described elsewhere, that combines the physical attributes and performance characteristics of moving air wind tunnels and calm air chambers, both of which have featured individually in previous research. It also contains a specially-designed breathing, heated, life-sized mannequin that allows for accurate recovery of test particulate material that has been inhaled. Procedures have been developed that employ test aerosols of well-defined particle size distribution generated mechanically from narrowly-graded powders of fused alumina. Using this new system, we have conducted an extensive set of new experiments to measure the inhalability of a human subject (as represented by the mannequin), aimed at filling the current knowledge gap for conditions that are more realistic than those embodied in most previous research. These data reveal that inhalability throughout the range of interest is significantly different based on windspeed, indicating a rise in aspiration efficiency as windspeed decreases. Breathing flowrate and mode of breathing (i.e. nose versus mouth breathing) did not show significant differences for the inhalability of aerosols. On the whole

  7. Dry powder inhalable formulations for anti-tubercular therapy.

    Parumasivam, Thaigarajan; Chang, Rachel Yoon Kyung; Abdelghany, Sharif; Ye, Tian Tian; Britton, Warwick John; Chan, Hak-Kim

    2016-07-01

    Tuberculosis (TB) is an intracellular infectious disease caused by the airborne bacterium, Mycobacterium tuberculosis. Despite considerable research efforts, the treatment of TB continues to be a great challenge in part due to the requirement of prolonged therapy with multiple high-dose drugs and associated side effects. The delivery of pharmacological agents directly to the respiratory system, following the natural route of infection, represents a logical therapeutic approach for treatment or vaccination against TB. Pulmonary delivery is non-invasive, avoids first-pass metabolism in the liver and enables targeting of therapeutic agents to the infection site. Inhaled delivery also potentially reduces the dose requirement and the accompanying side effects. Dry powder is a stable formulation of drug that can be stored without refrigeration compared to liquids and suspensions. The dry powder inhalers are easy to use and suitable for high-dose formulations. This review focuses on the current innovations of inhalable dry powder formulations of drug and vaccine delivery for TB, including the powder production method, preclinical and clinical evaluations of inhaled dry powder over the last decade. Finally, the risks associated with pulmonary therapy are addressed. A novel dry powder formulation with high percentages of respirable particles coupled with a cost effective inhaler device is an appealing platform for TB drug delivery. PMID:27212477

  8. Rethinking the paradigm for the development of inhaled drugs.

    Pritchard, John N

    2015-12-30

    Nebulized treatment is an important delivery option for the young, elderly, and those with severe chronic respiratory disease, but there is a lack of new nebulized drug products being produced for these patients, leading to the potential for under-treatment. This communication describes a new drug development paradigm as a timely solution to this issue. Often, drug development is initiated with nebulizers in the early stages, to provide cheaper and faster drug development, and then switched to inhaler devices in later clinical trials to address the majority of patients. However, the waste of resource on parallel development of the inhaler can be large due to the high early attrition rate of new drug development. The new paradigm uses the nebulizer to continue drug development through to market, and initiates inhaler development after completion of the riskier early phase studies. New drug safety and efficacy can be assessed faster and more efficiently by using a nebulized formulation rather than developing an inhaler. The results of calculations of expected net present value showed that the new paradigm produced higher expected net present values than the conventional model over a range of economic scenarios. This new paradigm could therefore provide improved returns on investments, as well as more modern drugs in nebulized form for those patients unable to use inhalers. PMID:26475968

  9. Withdrawal of inhaled glucocorticoids and exacerbations of COPD

    Magnussen, Helgo; Disse, Bernd; Rodriguez-Roisin, Roberto;

    2014-01-01

    BACKGROUND: Treatment with inhaled glucocorticoids in combination with long-acting bronchodilators is recommended in patients with frequent exacerbations of severe chronic obstructive pulmonary disease (COPD). However, the benefit of inhaled glucocorticoids in addition to two long-acting bronchod......BACKGROUND: Treatment with inhaled glucocorticoids in combination with long-acting bronchodilators is recommended in patients with frequent exacerbations of severe chronic obstructive pulmonary disease (COPD). However, the benefit of inhaled glucocorticoids in addition to two long......-acting bronchodilators has not been fully explored. METHODS: In this 12-month, double-blind, parallel-group study, 2485 patients with a history of exacerbation of COPD received triple therapy consisting of tiotropium (at a dose of 18 μg once daily), salmeterol (50 μg twice daily), and the inhaled glucocorticoid...... fluticasone propionate (500 μg twice daily) during a 6-week run-in period. Patients were then randomly assigned to continued triple therapy or withdrawal of fluticasone in three steps over a 12-week period. The primary end point was the time to the first moderate or severe COPD exacerbation. Spirometric...

  10. Inhaled corticosteroids: hazardous effects on voice-an update.

    Gallivan, Gregory J; Gallivan, K Holly; Gallivan, Helen K

    2007-01-01

    Inhaled corticosteroids (ICS) have become the prevalent treatment in asthmatics. Hazards to voice are under-recognized. A total of 38 patients with voice complaints associated with the use of ICS were assessed by 79 strobovideolaryngoscopy (SVL) examinations, 24 single and 14 multiple SVL. Hoarseness and dysphonia were the primary reasons for referral. The ICS initially used most frequently was Advair Diskus (fluticasone propionate and salmeterol-inhalation powder-[IP]) in 22 patients, followed by Flovent (fluticasone propionate inhalation aerosol-pressurized metered-dose inhaler-[PMDI]) in 11. Duration of ICS usage varied from 2 weeks to 4-5 years. Higher dosage and frequency of use exacerbated problems. Hazards to voice previously unrecognized by real-time indirect mirror or fiberoptic laryngoscopy were identified by meticulous attention to SVL abnormalities. There was essentially no difference in occurrence of abnormalities whether analyzed from the perspective of the initial 38 or all 79 examinations. These included abnormal mucosal wave symmetry/periodicity (76-63%), phase closure (74-63%), glottic closure (63-59%), mucosal wave amplitude/magnitude (50-35%), supraglottic hyperactivity (39-25%), mucosal quality (34-34%), and glottic plane (10-5%). Candidiasis of the larynx was infrequently observed. Fluticasone ICS were a cause of steroid inhaler laryngitis, and the best treatment was their avoidance or cessation. Further prospective studies ideally might include SVL documented as a pretherapy baseline and then repeated in each ICS patient who developed hoarseness/dysphonia. PMID:16442776

  11. Biological effects of inhaled radionuclides: summary of ICRP report 31

    The ICRP Task Group charged with evaluating the hazards associated with inhalation of plutonium and other radionuclides, enumerated the biological responses to inhaled radionuclides, identified tissues and cells at risk, derived risk coefficients for inhaled radionuclides from animal experiments for comparison with human data, and determined an equal effectiveness ratio of alpha emitters relative to beta-gamma emitters. High lung burdens of inhaled radionuclides result in profound structural and functional changes in which the pulmonary capillary endothelial cells are the most prominent cells at risk. Linear and nonlinear models used to evaluate lung cancer data from animal experiments project to risk coefficients between 0.84 and 1600 cases/106 animals/rad. The report concludes that the animal data support the current ICRP lung cancer risk of 2 x 10-3 Sv-1 (400 x 10+H-+H6 rad-1). Comparison of risk coefficients for beta-gamma emitters with those for alpha emitters, obtained using the same models, gave an Equal Effectiveness Ratio of 30 for inhaled alpha-emitting radionuclides. Thus, the experimental data support the ICRP decision to change the quality factor from 10 to 20 for alpha radiation. (H.K.)

  12. Accidental Cutaneous Burns Secondary to Salbutamol Metered Dose Inhaler

    Ashutosh Kale

    2010-01-01

    Full Text Available We report a case of accidental cutaneous burns caused by salbutamol metered dose inhaler. A 9-year-old boy underwent dental extraction at a children's hospital and was incidentally noted to have burn injuries on dorsum of both hands. On questioning, the boy revealed that a few days ago his 14-year-old brother, who is an asthmatic, playfully sprayed his salbutamol metered dose inhaler on the back of both his hands with the inhaler's mouth piece being in direct contact with the patient's skin. On examination, there was a rectangular area of erythema with superficial peeling on the dorsum of both hands, the dimensions of which exactly matched those of the inhaler's mouthpiece. It is possible that the injury could have been a chemical burn from the pharmaceutical/preservative/propellant aerosol or due to the physical effect of severe cooling of the skin or mechanical abrasive effect of the aerosol blasts or a combination of some or all the above mechanisms. This case highlights the importance of informing children and parents of the potentially hazardous consequences of misusing a metered dose inhaler.

  13. Raxibacumab: potential role in the treatment of inhalational anthrax

    Kummerfeldt CE

    2014-04-01

    Full Text Available Carlos E KummerfeldtDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USAAbstract: Anthrax is a highly contagious and potentially fatal human disease caused by Bacillus anthracis, an aerobic, Gram-positive, spore-forming rod-shaped bacterium with worldwide distribution as a zoonotic infection in herbivore animals. Bioterrorist attacks with inhalational anthrax have prompted the development of more effective treatments. Antibodies against anthrax toxin have been shown to decrease mortality in animal studies. Raxibacumab is a recombinant human monoclonal antibody developed against inhalational anthrax. The drug received approval after human studies showed its safety and animal studies demonstrated its efficacy for treatment as well as prophylaxis against inhalational anthrax. It works by preventing binding of the protective antigen component of the anthrax toxin to its receptors in host cells, thereby blocking the toxin's deleterious effects. Recently updated therapy guidelines for Bacillus anthracis recommend the use of antitoxin treatment. Raxibacumab is the first monoclonal antitoxin antibody made available that can be used with the antibiotics recommended for treatment of the disease. When exposure is suspected, raxibacumab should be given with anthrax vaccination to augment immunity. Raxibacumab provides additional protection against inhalational anthrax via a mechanism different from that of either antibiotics or active immunization. In combination with currently available and recommended therapies, raxibacumab should reduce the morbidity and mortality of inhalational anthrax.Keywords: anthrax, monoclonal antibody, protective antigen, raxibacumab

  14. Pathobiology of acute respiratory distress syndrome.

    Sapru, Anil; Flori, Heidi; Quasney, Michael W; Dahmer, Mary K

    2015-06-01

    The unique characteristics of pulmonary circulation and alveolar-epithelial capillary-endothelial barrier allow for maintenance of the air-filled, fluid-free status of the alveoli essential for facilitating gas exchange, maintaining alveolar stability, and defending the lung against inhaled pathogens. The hallmark of pathophysiology in acute respiratory distress syndrome is the loss of the alveolar capillary permeability barrier and the presence of protein-rich edema fluid in the alveoli. This alteration in permeability and accumulation of fluid in the alveoli accompanies damage to the lung epithelium and vascular endothelium along with dysregulated inflammation and inappropriate activity of leukocytes and platelets. In addition, there is uncontrolled activation of coagulation along with suppression of fibrinolysis and loss of surfactant. These pathophysiological changes result in the clinical manifestations of acute respiratory distress syndrome, which include hypoxemia, radiographic opacities, decreased functional residual capacity, increased physiologic deadspace, and decreased lung compliance. Resolution of acute respiratory distress syndrome involves the migration of cells to the site of injury and re-establishment of the epithelium and endothelium with or without the development of fibrosis. Most of the data related to acute respiratory distress syndrome, however, originate from studies in adults or in mature animals with very few studies performed in children or juvenile animals. The lack of studies in children is particularly problematic because the lungs and immune system are still developing during childhood and consequently the pathophysiology of pediatric acute respiratory distress syndrome may differ in significant ways from that seen in acute respiratory distress syndrome in adults. This article describes what is known of the pathophysiologic processes of pediatric acute respiratory distress syndrome as we know it today while also presenting the much

  15. [Evaluations of a specified number of inhalations and how to assess the contents in metered-dose inhalers].

    Obata, T; Fujikawa, M; Obata, Y; Obata, J

    1996-10-01

    Many kinds of Metered-Dose Inhalers (MDI) have been clinically available for bronchial asthma. Although manufacturers demonstrate the specified number of inhalations per canister on an attached document or on a plastic bag, the information provided are usually inadequate and inconsistent. They provide no information on the problems of the Metered-Dose Inhalers beyond the maximum specified number of actuations and the time when to exchange for a new one. We examined the technique how to evaluate the contents of MDI and their accuracy. Patients and their parents depended on inaccurate methods, such as shaking the inhalers to listen to the sound of contents, estimating the weight of the canisters and the size of emissions, and only a half of them were able to distinguish between 1/3 and 2/ 3 of remaining doses. Three Metered-Dose Inhalers with anti-inflammatory drugs and one MDI with beta-stimulant supplied consistent doses until they reached the maximum specified number. The 4 MDIs floated in the water in different ways and provided information when to replace for new ones in some MDIs. PMID:8958655

  16. Limiting progressive hippocampal metabolic abnormalities after smoke inhalation injury.

    Tobe, Edward; Pradhan, Basant K

    2014-01-01

    A 46-year-old man had a smoke inhalation injury. Within 1 month, he developed neuropsychiatric problems including toxic encephalopathy, cognitive disorder, depression symptoms and personality change. From 3 to 14 years after the toxic inhalation injury, the patient received treatment with sertraline and methylphenidate. The (18)F-fluorodeoxyglucose positron emission tomography scan at 3 years after injury showed deterioration of glucose metabolism in the hippocampus and orbital frontal region; at 14 years after injury, the hippocampus had no significant change but the orbital frontal region had deterioration of glucose metabolism. It was hypothesised that sertraline may have provided selective hippocampal neuroprotection. Further study is justified to evaluate sertraline as a possible neuroprotective agent after smoke inhalation injury. PMID:24577174

  17. Adolescents and inhalant abuse: how huffing affects the myelin sheath.

    Baird, Carolyn A; Furek, Maxim W

    2012-05-01

    As concern grows over the impact that accidental chemical exposures may have on the long term health of individuals, our young people are deliberately exposing themselves to the effect of neurotoxic chemicals with the intent of feeling high. Over time the result of inhaling these chemicals is often the development of symptoms and behavior that may suggest serious physiological damage. Research is being conducted to examine what the exact nature of the damage might be, especially the impact of inhaled lipophilic chemicals on structures in the brain and other parts of the nervous system. Healthcare professionals responsible for assessing adolescents in all settings need to be aware of the prevalence of inhalant abuse, as well as the chemicals, terminology, and potential symptomatology in order to intervene in the behavior and provide diagnosis and treatment as indicated. Some implications for nursing are included. PMID:22471781

  18. Criteria for inhalation exposure systems utilizing concurrent flow spirometry

    Principles are given for the design and operation of a new class of inhalation exposure systems utilizing concurrent flow spirometry (CFS), a simple method for providing realtime measurement of respiratory volumes and rates during inhalation exposure by mouth or nose of individual experimental animals or man to aerosols or gases. This technique is especially useful for inhalation exposure of larger experimental animals, such as horses, where whole-body plethysmography is usually impractical. Difficulties encountered with conventional exposure systems in maintenance of uniform aerosol or gas concentrations and prevention of large pressure excursions in the exposure chamber during breathing are obviated by systems utilizing the principles of concurrent flow spirometry. For illustration, two exposure units with CFS are described, one for exposure of Beagle dogs and one for ponies. (U.S.)

  19. Contribution of inhalation by food animals to man's ingestion dose

    Animals' inhalation (AI) pathway was evaluated for 57 radionuclides using infant dose predictions from the food-chain model LIMCAL. With ingestion transfer coefficients fMi to define transfer from the respiratory tract to milk, the AI pathway appeared to be insignificant compared to animals' plant ingestion, as implicitly assumed in most environmental assessment models for nuclear installations. Using ICRP Publication 30 respiratory clearance models for man to adjust ingestion transfer coefficients, animals' inhalation appeared to be important, particularly for some actinide radionuclides. The AI pathway also appeared to be significant relative to man's inhalation, especially for infants. The importance of the AI pathway varied greatly between radionuclides, and results strongly suggest that it cannot be ignored in environmental assessments. Until better data become available to implement this pathway fully, adjusted ingestion transfer coefficient values can be used for transfer from animals' respiratory tract to milk and other food products

  20. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  1. Pneumonia risk with inhaled fluticasone furoate and vilanterol compared with vilanterol alone in patients with COPD

    Crim, Courtney; Dransfield, Mark T; Bourbeau, Jean; Jones, Paul W; Hanania, Nicola A; Mahler, Donald A; Vestbo, Jørgen; Wachtel, Andrew; Martinez, Fernando J; Barnhart, Frank; Lettis, Sally; Calverley, Peter M A

    2015-01-01

    RATIONALE: Radiographically confirmed pneumonia risk with inhaled corticosteroid use in chronic obstructive pulmonary disease (COPD) has not been assessed to date. OBJECTIVES: To determine the incidence of pneumonia, risk factors, and clinical attributes with inhaled fluticasone furoate (FF) in p...

  2. Asthma Patients in US Overuse Quick-Relief Inhalers, Underuse Control Medications

    ... overuse quick-relief inhalers, underuse control medications Share | Asthma patients in US overuse quick-relief inhalers, underuse control medications Published Online: December 13, 2013 Asthma exacerbations and uncontrolled asthma result in poor health ...

  3. Urine concentrations of repetitive doses of inhaled salbutamol

    Elers, J; Pedersen, Lars; Henninge, J;

    2011-01-01

    We examined blood and urine concentrations of repetitive doses of inhaled salbutamol in relation to the existing cut-off value used in routine doping control. We compared the concentrations in asthmatics with regular use of beta2-agonists prior to study and healthy controls with no previous use of...... beta2-agonists. We enrolled 10 asthmatics and 10 controls in an open-label study in which subjects inhaled repetitive doses of 400 microgram salbutamol every second hour (total 1600 microgram), which is the permitted daily dose by the World Anti-Doping Agency (WADA). Blood samples were collected at...

  4. Determination of hepatic blood flow following inhalation of xenon

    The 133Xe inhalation technique causes a long-lasting inflow of xenon to the liver after the end of inhalation because of the residual concentration in the lungs starting from the formula according to Kety and Schmidt. A mathematical solution is proposed to eliminate, the influence of the arterial concentration on the measured values and to determine the real flow values. On the basis of the least squares method an algorithm is proposed that yields values which are in good correlation (r = 0.90, n = 15) to the original method of arterial Xe injection. Factors influencing the mathematical model are discussed. (author)

  5. Toxicity studies of inhaled beta-emitting radionuclides: status report

    The influence of total dose and dose rate on the effects of inhaled beta-emitting radionuclides is being studied in laboratory animals. The radionuclides are inhaled either in a relatively soluble form (90SrCl2, 144CeCl3, 91YCl3 or 137CsCl) or in a relatively insoluble form in fused aluminosilicate particles. The organs affected depend on the solubility and chemical characteristics of the radio isotopes. Studies with young adult dogs are complemented with comparable studies in other species (mice, rats and Syrian hamsters), with animals of different ages and with animals repeatedly exposed to 144Ce

  6. Toxicity studies of inhaled beta-emitting radionuclides - status report

    The influence of total dose and dose rate pattern on the effects of inhaled β-emitting radionuclides is being studied in laboratory animals. The inhaled radionuclides were either in a relatively soluble form (90SrCl2, 144CeCl3, 91YCl3, or 137CsCl), or in a relatively insoluble form in fused aluminosilicate particles. The organs affected depend on the solubility and chemical characteristics of the radionuclides. Studies with young adult dogs are complemented by comparable studies in other species (mice, rats, and Syrian hamsters), with animals of different ages and animals repeatedly exposed to 144Ce. 12 references, 2 figures, 2 tables

  7. Subchronic Inhalation Toxicity Study of n-pentane in Rats

    Kim, Jong-Kyu; Cho, Hae-Won; Han, Jeong-Hee; Lee, Sung-Bae; Chung, Yong-Hyun; Rim, Kyung-Taek; Yang, Jeong-Sun

    2012-01-01

    Objectives This study was conducted in order to obtain information concerning the health hazards that may result from a 13 week inhalation exposure of n-pentane in Sprague-Dawley rats. Methods This study was conducted in accordance with the Organization for Economic Co-operation and Development (OECD) guidelines for the testing of chemicals No. 413 'Subchronic inhalation toxicity: 90-day study (as revised in 2009)'. The rats were divided into 4 groups (10 male and 10 female rats in each group...

  8. A Study on Subchronic Inhalation Toxicity of 1-Chloropropane

    Chung, Yong Hyun; HAN, Jeong Hee; Lee, Yong-Hoon

    2015-01-01

    This study was conducted to measure toxicity of 1-chloropropane (CAS No. : 540-54-5). According to the OECD Test Guideline 413 (Subchronic inhalation toxicity: 90-day study), SD rats were exposed to 0, 310, 1,250, and 5,000 ppm of 1-chloropropane for 6 h/day, 5 day/week for 13 weeks via whole-body inhalation. Mortality, clinical signs, body weights, food consumption, motor activity, ophthalmoscopy, hematology, serum chemistry, urinalysis, organ weights, gross and histopathological findings we...

  9. A perspective on the developmental toxicity of inhaled nanoparticles

    Hougaard, Karin Sørig; Campagnolo, Luisa; Chavatte-Palmer, Pascale; Tarrade, Anne; Rousseau-Ralliard, Delphine; Valentino, Sarah; Park, Margriet V. D. Z.; de Jong, Wim H.; Wolterink, Gerrit; Piersma, Aldert H.; Ross, Bryony L.; Hutchison, Gary R.; Hansen, Jitka Stilund; Vogel, Ulla Birgitte; Jackson, Petra; Slama, Rémy; Pietroiusti, Antonio; Cassee, Flemming R.

    This paper aimed to clarify whether maternal inhalation of engineered nanoparticles (NP) may constitute a hazard to pregnancy and fetal development, primarily based on experimental animal studies of NP and air pollution particles. Overall, it is plausible that NP may translocate from the respirat......This paper aimed to clarify whether maternal inhalation of engineered nanoparticles (NP) may constitute a hazard to pregnancy and fetal development, primarily based on experimental animal studies of NP and air pollution particles. Overall, it is plausible that NP may translocate from the......, significant amounts of groundwork are warranted for a testing strategy to be established on a sound scientific basis....

  10. Concept for motivating toddlers to accept inhalation therapy

    Anton Segarra, Rebeca

    2013-01-01

    This master thesis is conducted at the Institute of Product Design at NTNU. The subject of the assignment is “Concept for motivating toddlers to accept inhalation therapy”. The project aims at developing a concept for motivating hospitalized toddlers (2-3 years old) to accept inhalation therapy. The first part of the project was an investigation process to understand the situation: the disease, the children’s behaviour at 2-3 years age, the hospital environment, the treatment, etc. Secondly I...

  11. A double-blind comparison between a new multidose powder inhaler (Turbuhaler) and metered dose inhaler in children with asthma.

    Hultquist, C; Ahlström, H; Kjellman, N I; Malmqvist, L A; Svenonius, E; Melin, S

    1989-09-01

    Turbuhaler is a ready-loaded multiple dose inhaler which does not require co-ordination between release of dose and inhalation. 57 children with asthma participated in this clinical trial to compare the clinical effect and acceptance of terbutaline sulphate via Turbuhaler with that of metered dose inhaler (MDI). The trial consisted of two parts. In the first part of the study, which made use of a double-blind cross-over design, the clinical effect and number of treatment occasions with Turbuhaler were compared with those of MDI. In the second part, which was open, all patients were treated with Turbuhaler for 2 weeks. At the end of this period the patients were asked to make a subjective assessment of effect and to state their preference. There was no difference in clinical effect and number of treatment occasions between Turbuhaler and MDI. A majority of the patients thought Turbuhaler had the best effect and was easy to use. PMID:2683835

  12. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    Finnerty, Celeste C.; Herndon, David N; Jeschke, Marc G.

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in...

  13. Profile of inhalant users seeking treatment at a de-addiction centre in north India

    Sunil Gupta; Naresh Nebhinani; Debasish Basu; Surendra Kumar Mattoo

    2014-01-01

    Background & objectives: Inhalants are substances whose chemical vapors are inhaled to produce euphoric, disinhibiting, and exciting effects. Data on inhalant abuse in India are relatively scarce. We report the demographic and clinical profile of inhalant users among the treatment seekers at a Drug De-addiction and Treatment Centre in north India. Methods: The records of treatment seekers at the Drug De-addiction and Treatment Centre, over 10 years (2002-2011) were scanned to identify 92...

  14. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    Raka Jain; Arpita Verma

    2016-01-01

    The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clini...

  15. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    Raka Jain

    2016-01-01

    Full Text Available The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clinical care.

  16. Uso do óxido nítrico em pediatria Inhaled nitric oxide in pediatrics

    José R. Fioretto

    2003-11-01

    persistent pulmonary hypertension and hypoxia of the newborn, acute respiratory distress syndrome, primary pulmonary hypertension, heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease. CONCLUSIONS: Inhaled nitric oxide is a therapeutic approach with wide clinical applications in pediatrics. Its use is safe when administered in pediatric intensive care units under strict monitoring. As a pulmonary vasodilator, nitric oxide has beneficial effects on gas exchange and ventilation. Controlled trials, focusing on early gas administration should be performed under many clinical conditions, especially acute respiratory distress syndrome.

  17. TARGETED DELIVERY OF INHALED PHARMACEUTICALS USING AN IN SILICO DOSIMETRY MODEL

    We present an in silico dosimetry model which can be used for inhalation toxicology (risk assessment of inhaled air pollutants) and aerosol therapy ( targeted delivery of inhaled drugs). This work presents scientific and clinical advances beyond the development of the original in...

  18. Design and application of a new modular adapter for laser diffraction characterization of inhalation aerosols

    de Boer, Anne; Gjaltema, D; Hagedoorn, P; Schaller, M; Witt, W; Frijlink, H W

    2002-01-01

    An inhaler adapter has been designed for the characterization of the aerosol clouds from medical aerosol generators such as nebulizers, dry powder inhalers (dpis) and metered dose inhalers (mdis) with laser diffraction technology. The adapter has a pre-separator, for separation of large particles (i

  19. 21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Amyl nitrite inhalant as a prescription drug for... Prescription Status of Specific Drugs § 250.100 Amyl nitrite inhalant as a prescription drug for human use. (a) Amyl nitrite inhalant has been available over-the-counter for emergency use by the patient in...

  20. Timing of Emergency Department Visits for Childhood Asthma after Initial Inhaled Corticosteroid Use

    Zhang, Shun; Holloway, Kelvin; Tyler-Hill, Yasmin

    2015-01-01

    Abstract Inhaled corticosteroids can prevent acute exacerbations and emergency visits when used as part of a chronic care plan for long-term control of asthma, but low patient adherence and inadequate provider prescribing (clinical inertia) can limit these benefits. State Medicaid programs are a major source of insurance coverage for low-income children, paying for medications and preventive care, as well as bearing the cost of adverse outcomes for common chronic conditions in childhood, such as asthma. This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx) among 43,156 Medicaid-enrolled children with a diagnosis of asthma in 14 southern states in 2007. One in 5 children (19.6%) with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10% of these visits occurred within the first 48 hours, and 25% occurred within the first week. Continued ICS-Rx use was associated with lower risk of an ED visit. There were no racial differences in the ED visit rates. Initial ICS-Rx for Medicaid-enrolled children is a warning flag for short-term risk of asthma-related ED visits, whereas continued ICS-Rx use is protective for at least 90 days. Primary care follow-up may be needed within the first 2 days after initial ICS-Rx to prevent adverse outcomes. Medicaid programs could use claims data for surveillance of adherence to guideline-concordant therapy and for sentinel events marking windows of a higher risk for ED visits. Population Health Management 2015;18:54–60. PMID:25046059

  1. Applications of aerosol inhalation cine-scintigraphy for, clinical investigations of mucociliary transport

    Mucociliary transport and cough effect were studied in 10 healthy controls and 116 patients with respiratory diseases using aerosol inhalation cine-scintigraphy which permits visualization of the movement of inhaled aerosols. Additionally, the effectiveness of β-adrenergic stimulant on mucociliary transport was evaluated in 8 normal cases by this method. 1. In healthy controls, the aerosol-bolus moved to the cephalad side rapidly and smoothly in the main bronchus and the trachea, but in many cases of respiratory diseases, we recognized various abnormal patterns such as slow movement, spiral movement, regurgitation etc. We consider that the bolus movements can be used as an index of the mucociliary transport. 2. We found low grade abnormality of bolus movement in cases of atopic bronchial asthma, pulmonary emphysema, silicosis, interstitial pneumonia and asbestosis, but high grade abnormality in cases of bronchiectasis, pulmonary emphysema with chronic bronchitis, mixed or infectious bronchial asthma, chronic bronchitis and especially acute pulmonary infection and diffuse panbronchiolitis. Normal patterns were observed in atopic asthma patients in remission, but abnormal patterns in cases of attack. With larger daily volumes of sputum, the bolus movements showed higher greater abnormality. 3. Bolus movements by coughing were seen most frequently in patients who had produced moderate volumes of sputum and in whom the bolus had stopped at the first carina. Bolus movements by coughing were classified into three groups: expectoration, cephalad movement that stopped halfway, and regurgitation. When the bolus was in the trachea, especially located on the oral side, we observed that expectoration by coughing was more effective. Patients with obstructive pulmonary diseases had lower effciency of expectoration by coughing. 4. We confirmed that terbutaline (β-adrenergic stimulant) accelerated the mucociliary transport. (author)

  2. Acute mountain sickness

    ... works best when taken before reaching a high altitude. If you have fluid in your lungs (pulmonary edema), treatment may include: Oxygen A high blood pressure medicine called nifedipine Beta agonist inhalers to ...

  3. INDOOR AIR QUALITY AND INHALATION EXPOSURE - SIMULATION TOOL KIT

    A Microsoft Windows-based indoor air quality (IAQ) simulation software package is presented. Named Simulation Tool Kit for Indoor Air Quality and Inhalation Exposure, or IAQX for short, this package complements and supplements existing IAQ simulation programs and is desi...

  4. Inhaled budesonide for treatment of recurrent wheezing in early childhood

    Bisgaard, H; Munck, Susanne; Nielsen, J P; Petersen, W; Ohlsson, S V

    1990-01-01

    77 children, aged 11 to 36 months (mean 24) with moderately severe recurrent wheezing, were treated with budesonide pressurised aerosol 400 micrograms twice daily or placebo for 12 weeks in a double-blind, parallel-group trial. Aerosols were inhaled from a spacer with a facemask. Budesonide signi...

  5. Personal exposure to inhalable cement dust among construction workers.

    Peters, S.M.; Thomassen, Y.; Fechter-Rink, E.; Kromhout, H.

    2009-01-01

    Objective- A case study was carried out to assess cement dust exposure and its determinants among construction workers and for comparison among workers in cement and concrete production.Methods- Full-shift personal exposure measurements were performed and samples were analysed for inhalable dust and

  6. Airmax: a multi-dose dry powder inhaler.

    Keating, Gillian M; Faulds, Diana

    2002-01-01

    Airmax is a multi-dose dry powder inhaler. An internal pump measures out the drug dose using controlled air pressure. Inhalation transports the drug into a cyclone separator (where active drug is separated from the lactose carrier) and then into the patient airway. In vitro studies indicate that Airmax may be less dependent on airflow than Turbuhaler for drug delivery; greater dose consistency was seen with administration of budesonide via Airmax than via Turbuhaler. At a low flow rate, the lung deposition of budesonide administered via Airmax was greater than that of budesonide administered via Turbuhaler or a pressurised metered dose inhaler in patients with asthma. In cumulative-dose studies, the mean forced expiratory volume in 1 second (FEV(1)) achieved with salbutamol (albuterol) or formoterol administered via Airmax was equivalent to that achieved with twice the dose administered via dry powder inhalers. black triangle In randomised, double-blind studies, budesonide administration via Airmax was equivalent to administration via Turbuhaler with regards to FEV(1) and improvement in asthma symptoms in both adults and children with asthma. The concentration of adenosine monophosphate producing a 20% fall in FEV(1) increased from pretreatment levels by a greater extent with budesonide administered via Airmax, compared with Turbuhaler. Both adults and children preferred Airmax to Turbuhaler, and more found Airmax easier to use. In one study, the majority of children found learning how to use Airmax trade mark easier than learning how to use Turbuhaler. PMID:12215059

  7. Disposition and biological effect of inhaled 85Kr

    Half-lives of approximately 5, 30, and 100 min were obtained for whole-body clearance of inhaled 85Kr in beagle dogs. Analysis showed the highest partition coefficients in lungs, bone marrow, and fat. Circulating blood elements were not lowered permanently after 85Kr exposures

  8. Liposomal budesonide for dry powder inhaler: Preparation and stabilization

    Joshi, Mayank R.; Misra, Ambikanandhan

    2001-01-01

    The purpose of the study was to prepare stable liposomally entrapped budesonide (BUD) for a dry powder inhaler (DPI) formulation. BUD liposomes composed of egg phosphatidyl choline and cholesterol were prepared by lipid film hydration technique and sonicated to have the desired size (

  9. Drug interactions between inhaled corticosteroids and enzymatic inhibitors

    Daveluy, Amélie; Raignoux, Cécile; Miremont-Salamé, Ghada; Girodet, Pierre-Olivier; Moore, Nicholas; Haramburu, Françoise; Molimard, Mathieu

    2009-01-01

    Drug interactions between inhaled corticosteroids and enzymatic inhibitors phone: +33-557-571561 (Daveluy, Amelie) (Daveluy, Amelie) Centre Regional de Pharmacovigilance, Hopital Pellegrin - 33076 - Bordeaux Cedex - FRANCE (Daveluy, Amelie) Unite 657, INSERM - Bordeaux - FRANCE (Daveluy, Amelie) Departement de Pharmacologie, CHU de Bordeaux - Bordeaux - FRANCE (Daveluy, Amelie) Centre Regional de Pharmacovigilance, Hopital Pellegrin - 33076...

  10. Inhaled Antibiotics for Gram-Negative Respiratory Infections.

    Wenzler, Eric; Fraidenburg, Dustin R; Scardina, Tonya; Danziger, Larry H

    2016-07-01

    Gram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects, in vitro and microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena. PMID:27226088

  11. Physico-chemical characterisation of surface modified particles for inhalation.

    Stank, Katharina; Steckel, Hartwig

    2013-05-01

    Surface modification of drugs for inhalation is a possibility to influence interparticulate forces. This can be necessary to achieve a sufficient aerosolisation during powder inhalation as the cohesiveness of the micronised drug can be reduced. In addition, the interaction with propellants in pressurised metered dose inhaler can be changed. This can be used to improve the physical stability of the suspension based formulations. A dry particle coating process was used for the alteration of particle surfaces. The blending of micronised salbutamol sulphate (SBS) with different concentrations of magnesium stearate (Mgst) or glycerol monostearate (GMS) was followed by co-milling with an air jet mill. The powder properties were characterised by SEM, EDX, laser diffraction, BET and inverse gas chromatography. Physical mixtures generated by Turbula blending were compared to co-milled samples. A slight particle size reduction was determined. The Mgst deposition on SBS particles was detected by EDX measurements. The dispersive surface energy of SBS is lowered and the energy distribution is more homogenous for the co-milled samples. This study proves the application of co-milling for surface modification in the inhalation area. PMID:23518364

  12. FATE OF INHALED NITROGEN DIOXIDE IN ISOLATED PERFUSED RAT LUNG

    The fate of inhaled NO2 was studied with isolated perfused rat lungs. The isolated lungs were exposed to 5 ppm NO2 for 90 min at a ventilation rate of 45 ml/min. The NO2 exposure had no adverse effects on the lungs as judged from their weights, glucose uptake, or lactate producti...

  13. Inhaled Voriconazole for Prevention of Invasive Pulmonary Aspergillosis▿

    Tolman, Justin A; Wiederhold, Nathan P.; McConville, Jason T.; Najvar, Laura K.; Bocanegra, Rosie; Peters, Jay I.; Coalson, Jacqueline J.; Graybill, John R.; Patterson, Thomas F.; Williams, Robert O.

    2009-01-01

    Targeted airway delivery of antifungals as prophylaxis against invasive aspergillosis may lead to high lung drug concentrations while avoiding toxicities associated with systemically administered agents. We evaluated the effectiveness of aerosolizing the intravenous formulation of voriconazole as prophylaxis against invasive pulmonary aspergillosis caused by Aspergillus fumigatus in an established murine model. Inhaled voriconazole significantly improved survival and limited the extent of inv...

  14. NEW APPROACHES TO QUANTITATING THE PULMONARY EFFECTS OF INHALED POLLUTANTS

    The authors have developed a variety of non-invasive and other techniques to study effects of inhaled pollutants on the lung. In the area of airway mechanics they have developed and applied a diameter gauge to make continuous measurements of large airways caliber. The gauge provi...

  15. Brugada syndrome unmasked by accidental inhalation of gasoline vapors

    Kranjcec, Darko; Bergovec, Mijo; Rougier, Jean-Sébastien;

    2007-01-01

    Loss-of-function mutations in the gene SCN5A can cause Brugada syndrome (BrS), which is an inherited form of idiopathic ventricular fibrillation. We report the case of a 46-year-old patient, with no previous medical history, who had ventricular fibrillation after accidental inhalation of gasoline...

  16. Spontaneous pneumothorax associated with talc pulmonary granulomatosis after cocaine inhalation.

    Fiorelli, Alfonso; Accardo, Marina; Rossi, Francesco; Santini, Mario

    2016-03-01

    We report a case of recurrent spontaneous pneumothorax in a patient with cocaine abuse through inhalation alone. He underwent thoracoscopic apical lung resection with mechanical pleurodesis. Despite the lack of significant radiological features of talc induced pulmonary granulomatosis, pathological findings showed granulomas with foreign materials suggestive of being talc. Electronic microscopy showed that the size of talc particles were alveoli. PMID:24942102

  17. Infant with Altered Consciousness after Cannabis Passive Inhalation

    Zarfin, Yehoshua; Yefet, Enav; Abozaid, Said; Nasser, Wael; Mor, Tamer; Finkelstein, Yoram

    2012-01-01

    We report on an infant who was admitted to hospital with severe neurological symptoms following passive inhalation of cannabis. To date, cannabis abuse has been described almost entirely in adolescents and adults. In early childhood, however, cannabis effects were almost exclusively discussed in the context of maternal prenatal exposure, and the…

  18. Inhaled corticosteroids and Aspergillus fumigatus isolation in cystic fibrosis.

    Noni, Maria; Katelari, Anna; Dimopoulos, George; Kourlaba, Georgia; Spoulou, Vana; Alexandrou-Athanassoulis, Helen; Doudounakis, Stavros-Eleftherios; Tzoumaka-Bakoula, Chryssa

    2014-10-01

    Aspergillus fumigatus isolation in cultures from respiratory specimens of patients with cystic fibrosis (CF) is quite common; however, the role of A. fumigatus as a pathogen and whether its presence is associated with progression of pulmonary disease remain unclear. We investigated the association between inhaled corticosteroids and the recovery of A. fumigatus by performing a retrospective cohort study of CF patients born between 1988 and 1996. The patients' medical records from their first visit to the CF Center until December 2010 were reviewed. Outcomes were the occurrence of A. fumigatus first isolation, chronic colonization, or the last visit at the CF Center. A number of possible confounders were included in the multivariate logistic regression analysis in order to identify an independent association between inhaled corticosteroids and colonization status. A total of 121 patients were included in the study. Thirty-nine patients (32.2%) had at least one positive culture and 14 (11.6%) developed chronic colonization. Multivariate logistic regression analysis was used to determine the independent effect of inhaled corticosteroids on the odds of first isolation (odds ratio [OR], 1.165; 95% confidence interval [CI], 1.015-1.337; P = 0.029) and chronic colonization (OR, 1.180; 95% CI, 1.029-1.353; P = 0.018). In conclusion, A. fumigatus first isolation and chronic colonization are associated with the duration of inhaled corticosteroid treatment. PMID:25056962

  19. Evidence of Inhaled Tobramycin in Non-Cystic Fibrosis Bronchiectasis

    Vendrell, Montserrat; Muñoz, Gerard; de Gracia, Javier

    2015-01-01

    There is currently less experience with inhaled tobramycin in non-cystic fibrosis bronchiectasis than in cystic fibrosis (CF). Intravenous formulation and solution for inhalation (TSI) have been studied in non-CF bronchiectasis patients with chronic P. aeruginosa bronchial infection. An improvement in clinical parameters and a reduction in bacterial density have been shown with both inhaled solutions in these patients. However, further trials are needed to determine the most effective dose and administration protocol in these patients. Based on the current evidence, recommendations cannot be made regarding the use of TSI to treat exacerbations. Although no systemic toxicity has been reported in studies specifically investigating this treatment, patients with known kidney disease or ear disorders should be treated with caution. Adverse respiratory effects are reported to be more common in non-CF patients than in CF patients, who tend to be non-smokers and younger. Research is being conducted into the possibility of combining tobramycin with other antibiotics to increase its antibacterial activity. In this review we will present and discuss the published evidence regarding the use of inhaled tobramycin in non–CF bronchiectasis. PMID:25893022

  20. Acute toxicity testing of chemicals-Opportunities to avoid redundant testing and use alternative approaches.

    Creton, Stuart; Dewhurst, Ian C; Earl, Lesley K; Gehen, Sean C; Guest, Robert L; Hotchkiss, Jon A; Indans, Ian; Woolhiser, Michael R; Billington, Richard

    2010-01-01

    Assessment of the acute systemic oral, dermal, and inhalation toxicities, skin and eye irritancy, and skin sensitisation potential of chemicals is required under regulatory schemes worldwide. In vivo studies conducted to assess these endpoints can sometimes be associated with substantial adverse effects in the test animals, and their use should always be scientifically justified. It has been argued that while information obtained from such acute tests provides data needed to meet classification and labelling regulations, it is of limited value for hazard and risk assessments. Inconsistent application of in vitro replacements, protocol requirements across regions, and bridging principles also contribute to unnecessary and redundant animal testing. Assessment of data from acute oral and dermal toxicity testing demonstrates that acute dermal testing rarely provides value for hazard assessment purposes when an acute oral study has been conducted. Options to waive requirements for acute oral and inhalation toxicity testing should be employed to avoid unnecessary in vivo studies. In vitro irritation models should receive wider adoption and be used to meet regulatory needs. Global requirements for sensitisation testing need continued harmonisation for both substance and mixture assessments. This paper highlights where alternative approaches or elimination of tests can reduce and refine animal use for acute toxicity requirements. PMID:20144136

  1. Acute abdomen

    Acute abdomen may be connected with the injury of one of the internal organs, injury of large blood vessels, with the spreading of pains from some other area. It may also be a manifestation of systemic disease or poisoning. The main purposes of radiodiagnosis are: determination of the cause of clinical syndrome; determination of the localization and spreading of pathological changes in abdominal organs; finding out the character of complications. If the data of the ordinary roentgenological investiagtion and isn't complete, the computer tomography of abdominal and pelvic cavities is needed

  2. Evidence of validity of an inhalant-craving questionnaire.

    Alonso-Matías, Lizeth; Páez-Martínez, Nayeli; Reyes-Zamorano, Ernesto; González-Olvera, Jorge J

    2015-01-01

    Inhalants are substances widely used as recreational drugs: their addictive potential has been demonstrated by many studies. There is no reported measurable evidence of craving in inhalant users. The main goal of this study was to design and obtain evidence of validity of the score of a questionnaire for the evaluation of inhalant craving (ICQ) in a Mexican population sample. The ICQ is a type of visual analog scale with ten items. Face validity was evaluated by a group of experts in the addiction field. Reviewers considered the completeness, semantics, and sentence structure to guarantee a conceptual representation of the items. The final ICQ was applied to a sample of 520 Mexican high school students, 46% women and 54% men, between 12-19 years of age (M=15.18; SD=1.48), from 7th to 12th grades. The internal consistency of the ICQ showed a Cronbach's Alpha of 0.947. The 10 items were grouped into one single factor, with a factor loading above 0.74 for each of them. ROC analysis breakpoint was located at 18.5 mm with a sensitivity of 0.855 and specificity of 0.753. Thirty-three per cent (n= 172) of the student population evaluated reported the use of inhalants at some point in their lifetimes, with an average of misuse beginning at 13.6 years of age. The ICQ showed adequate psychometric properties, suggesting that the instrument may be considered a useful tool for screening for craving in young inhalant users. PMID:26706810

  3. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in the study. Inhalation injury was diagnosed by bronchoscopy during the first operation. Blood was collected within 24 hours of admission and again at five to seven days following admission. Cytokine expression was profiled using multi-plex antibody-coated beads. Significance was accepted at a p value of less than 0.05. Results The mean percentages of total body surface area burned were 67% ± 4% (56% ± 6%, third-degree burns) in the inhalation injury group and 60% ± 3% (45% ± 3%, third-degree burns) in the non-inhalation injury group (p value not significant [NS]). Mean age was 9 ± 1 years in the inhalation injury group and 8 ± 1 years in the non-inhalation injury group (p value NS). Time from burn to admission in the inhalation injury group was 2 ± 1 days compared to 3 ± 1 days in the non-inhalation injury group (p value NS). Mortalities were 40% in the inhalation injury group and 12% in the non-inhalation injury group (p < 0.05). At the time of admission, serum interleukin (IL)-7 was significantly increased in the non-inhalation injury group, whereas IL-12p70 was significantly increased in the inhalation injury group compared to the non-inhalation injury group (p < 0.05). There were no other significant differences between groups. Five to seven days following admission, all cytokines decreased with no differences between the inhalation injury and non-inhalation injury cohorts. Conclusion In the present study, we show that an inhalation injury causes alterations in IL-7

  4. Analytical method for internal dose determination caused by chronically radionuclides inhalation to respiration system

    Analytical method for internal dose determination caused by chronically radionuclides inhalation to respiratory system with the constant rate of radionuclide concentration inhaled has been developed. The dose calculation is solved solved analytically using distribution and accumulation of radionuklida model in respiratory system. A computer program was then made to calculate internal dose in respiratory system easily and quickly. Computer program is arranged using Borland C++ 4.5 language. The value of internal dose on time t after inhalation depend on the radionuclides, the half time ,radionuclides AMAD, radionuclides class, radiation type, energy absorbed by respiratory organ, organ mass, the radionuclides concentration inhaled, the inhalation period

  5. Inhalation Toxicology Research Institute annual report, October 1, 1993--September 30, 1994

    Belinsky, S. A.; Hoover, M. D.; Bradley, P. L. [eds.

    1994-11-01

    This document from the Inhalation Toxicology Research Institute includes annual reports in the following general areas: (I) Aerosol Technology and Characterization of Airborne Materials; (II) Deposition, transport, and clearance of inhaled Toxicants; (III) Metabolism and Markers of Inhaled Toxicants; (IV) Carcinogenic Responses to Toxicants; (V) Mechanisms of carcinogenic response to Toxicants; (VI) Non carcinogenic responses to inhaled toxicants; (VII) Mechanisms of noncarcinogenic Responses to Inhaled Toxicants; (VIII) The application of Mathematical Modeling to Risk Estimates. 9 appendices are also included. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  6. Inhalation Toxicology Research Institute annual report, October 1, 1993--September 30, 1994

    This document from the Inhalation Toxicology Research Institute includes annual reports in the following general areas: (I) Aerosol Technology and Characterization of Airborne Materials; (II) Deposition, transport, and clearance of inhaled Toxicants; (III) Metabolism and Markers of Inhaled Toxicants; (IV) Carcinogenic Responses to Toxicants; (V) Mechanisms of carcinogenic response to Toxicants; (VI) Non carcinogenic responses to inhaled toxicants; (VII) Mechanisms of noncarcinogenic Responses to Inhaled Toxicants; (VIII) The application of Mathematical Modeling to Risk Estimates. 9 appendices are also included. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database

  7. Acute effect of glucan-spiked office dust on nasal and pulmonary inflammation in guinea pigs

    Straszek, Sune; Adamcakova-Dodd, Andrea; Nervana, Metwali; Pedersen, Ole Finn; Sigsgaard, Torben; Thorne, Peter Sherman

    2007-01-01

    The acute effects of pure inhaled glucan on respiratory inflammation remain inconclusive and not sufficiently examined with regards to the simultaneous interaction of glucan, endotoxin (LPS) and house dust in airway inflammation. This study aims at determining effects of simultaneous exposure to...... by acoustic rhinometry (AR) and animals were exposed by inhalation for 4 hr to curdlan spiked dust, unspiked dust, purified air (negative controls) or LPS (positive controls). After exposure (+5 hr) or the following day (+18 hr) measurements were repeated by AR and followed by bronchoalveolar lavage...... (BAL). Total and differential cell counts, IL-8 in BAL fluid and change in nasal volume was compared between groups. A 5-10% increase in nasal volume was seen for all groups including clean air except for a significant 5% decrease for spiked-dust inhalation (+18 hr). No marked differences were observed...

  8. Plasma concentrations of fluticasone propionate and budesonide following inhalation from dry powder inhalers by healthy and asthmatic subjects

    Harrison, T; Tattersfield, A

    2003-01-01

    Methods: The area under the plasma concentration-time curves (AUC) and the maximum concentration (Cmax) of fluticasone propionate and budesonide after a single inhaled dose of each drug were compared in 12 healthy control subjects and 12 subjects with moderately severe asthma.

  9. Inhalable PEGylated Phospholipid Nanocarriers and PEGylated Therapeutics for Respiratory Delivery as Aerosolized Colloidal Dispersions and Dry Powder Inhalers

    Priya Muralidharan

    2014-06-01

    Full Text Available Nanomedicine is making groundbreaking achievements in drug delivery. The versatility of nanoparticles has given rise to its use in respiratory delivery that includes inhalation aerosol delivery by the nasal route and the pulmonary route. Due to the unique features of the respiratory route, research in exploring the respiratory route for delivery of poorly absorbed and systemically unstable drugs has been increasing. The respiratory route has been successfully used for the delivery of macromolecules like proteins, peptides, and vaccines, and continues to be examined for use with small molecules, DNA, siRNA, and gene therapy. Phospholipid nanocarriers are an attractive drug delivery system for inhalation aerosol delivery in particular. Protecting these phospholipid nanocarriers from pulmonary immune system attack by surface modification by polyethylene glycol (PEGylation, enhancing mucopenetration by PEGylation, and sustaining drug release for controlled drug delivery are some of the advantages of PEGylated liposomal and proliposomal inhalation aerosol delivery. This review discusses the advantages of using PEGylated phospholipid nanocarriers and PEGylated therapeutics for respiratory delivery through the nasal and pulmonary routes as inhalation aerosols.

  10. [Acute myocarditis].

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  11. Respiratory Effects of Inhaled Single-Walled Carbon Nanotubes: The Role of Particle Morphology and Iron Content

    Madl, Amy Kathleen

    Nanotechnology provides promise for significant advancements in a number of different fields including imaging, electronics, and therapeutics. With worldwide production of carbon nanotubes (CNTs) exceeding over 500 metric tons annually and industry growth expecting to double over the next 5 yr, there are concerns our understanding of the hazards of these nanomaterials may not be keeping pace with market demand. The physicochemical properties of CNTs may delineate the key features that determine either toxicity or biocompatibility and assist in evaluating the potential health risks posed in industrial and consumer product settings. We hypothesized that the iron content and morphology of inhaled single-walled carbon nanotubes (SWCNTs) influences the extent of cellular injury and alters homeostasis in the lung. To address this hypothesis, (1) an aerosol system was developed to deliver carbon-based nanomaterials in a manner of exposure that is physiologically and environmentally relevant (e.g., inhalation), (2) acute (1 d) and subacute (10 d) nose-only inhalation studies to a well-characterized aerosol of iron-containing (FeSWCNT) versus cleaned (iron removed, cSWCNTs) SWCNTs were conducted to evaluate the time-course patterns of possible injury through measurement of markers of cytotoxicity, inflammation, and cellular remodeling/homeostasis, and (3) the effects of SWCNTs were compared to other well-studied materials (e.g. non-fibrous, low-iron content ultrafine carbon black and fibrous, high-iron content, highly persistent, durable and potent carcinogen crocidolite) to offer insights into the relative toxicity of these nanomaterials as well as the possible mechanisms by which the effects occur. Rats (SD) were exposed to either aerosolized SWCNTs (raw FeSWCNT or purified cSWCNT), carbon black (CB), crocidolite, or fresh air via nose-only inhalation. Markers of inflammation and cytotoxicity in lung lavage, mucin in different airway generations, and collagen in the

  12. Protective effect of budesonide/formoterol compared with formoterol, salbutamol and placebo on repeated provocations with inhaled AMP in patients with asthma: a randomised, double-blind, cross-over study

    Aalbers, R.F.A.; Boorsma, M.; Woude, van der, C.J.; Jonkers, R. E.

    2010-01-01

    Background The budesonide/formoterol combination is successfully used for fast relief of asthma symptoms in addition to its use as maintenance therapy. The temporarily increased corticosteroid dose during increasing inhaler use for symptom relief is likely to suppress any temporary increase in airway inflammation and may mitigate or prevent asthma exacerbations. The relative contribution of the budesonide and formoterol components to the improved asthma control is unclear. Methods The acute p...

  13. RECURRENT SEASONAL ACUTE PSYCHOSIS

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  14. Acute cerebellar ataxia

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  15. Population pharmacokinetic and pharmacodynamic modeling of epinephrine administered using a mobile inhaler.

    Frechen, Sebastian; Suleiman, Ahmed Abbas; Mohammad Nejad Sigaroudi, Ali; Wachall, Bertil; Fuhr, Uwe

    2015-12-01

    Inhaled epinephrine is a potential alternative to self-administered intramuscular epinephrine in imminent anaphylactic reactions. The objective was to develop a pharmacokinetic-pharmacodynamic model describing exposure and effects on heart rate of inhaled epinephrine. Data from a 4-phase cross-over clinical trial in 9 healthy volunteers including 0.3 mg intramuscular epinephrine, two doses of inhaled epinephrine (4 mg/mL solution administered during [mean] 18 and 25 min, respectively) using a mobile pocket inhaler, and an inhaled placebo were analyzed using mixed-effects modeling. Inhaled epinephrine was available almost immediately and more rapidly than via the intramuscular route (absorption half-live 29 min). Epinephrine plasma concentrations declined rapidly after terminating inhalation (elimination half-life 4.1 min) offering the option to stop exposure in case of adverse events. While the expected maximum concentration was higher for inhaled epinephrine, this was not associated with safety concerns due to only moderate additional hemodynamic effects compared to intramuscular administration. Bioavailability after inhalation (4.7%) was subject to high interindividual and interoccasional variability highlighting that training of inhalation would be essential for patients. The proposed model suggests that the use of a highly concentrated epinephrine solution via inhalation may offer an effective treatment option in anaphylaxis, while efficacy in patients remains to be shown. PMID:26615448

  16. A method for determination of the absolute pulmonary bioavailability of inhaled drugs: Terbutaline

    Terbutaline sulfate (4 X 0.250 mg) was given to 11 healthy volunteers by inhalation from a metered dose inhaler (MDI), with and without oral administration of a charcoal slurry. Before the inhalations, the adsorbing capacity of the charcoal slurry was tested. Deuterated terbutaline, 0.125 mg, was given intravenously at the same time as the test doses. The charcoal slurry adsorbed 97% of an oral dose. The oral contribution to the overall systemic bioavailability after inhalation, when charcoal was coadministered, could thus be neglected. After inhalation of terbutaline, 9.1% of the dose was deposited in the lungs and an additional 6.7% was systemically available via the oral route. The method presented measures the absolute pulmonary bioavailability after inhalation from a MDI. Since a deuterated analogue is given intravenously together with the inhalations, fewer subjects are needed to obtain reliable data

  17. Inhaled Foreign Bodies In Pediatric Patients: Proven Management Techniques In The Emergency Department.

    Maraynes, Megan; Agoritsas, Konstantinos

    2015-10-01

    Foreign body inhalation affects thousands of children every year, and it remains a significant cause of morbidity and mortality in children. Inhaled organic or inorganic foreign bodies can become lodged in the posterior nasopharynx, larynx, trachea, or bronchi. Presentation of foreign body inhalation can range from nonspecific respiratory symptoms to respiratory failure associated with a choking episode. In this issue, an in-depth review of the etiology, pathophysiology, diagnosis, and treatment of inhaled foreign bodies is presented. Risk factors for foreign body inhalation and clinical clues to diagnosis, as well as emergent management of inhaled foreign bodies are reviewed. A systematic approach, as described in this issue, will aid in timely and accurate diagnosis and treatment of inhaled foreign bodies, thereby limiting future complications and morbidity. PMID:26510331

  18. Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation

    Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Methods: Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5 mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O2 saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin–antithrombin complex (TAT), active plasminogen activator inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Results: Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Conclusions: Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. - Highlights: • TFPI administration to rats after mustard inhalation reduces airway cast formation. • Inhibition of thrombin activation is the likely mechanism for limiting casts. • Rats given TFPI had

  19. Genuair® in chronic obstructive pulmonary disease: a novel, user-friendly, multidose, dry-powder inhaler

    Palen, van der Job

    2014-01-01

    Inhaled corticosteroids and bronchodilators, which are pivotal to the management of respiratory diseases, are delivered by numerous devices, including pressurized metered-dose inhalers and dry-powder inhalers. However, patient adherence to these medications is suboptimal and incorrect inhaler techni

  20. How to match the optimal currently available inhaler device to an individual child with asthma or recurrent wheeze

    van Aalderen, W. M.; Garcia-Marcos, L.; Gappa, M.;

    2015-01-01

    Inhaled medications are the cornerstone of treatment in early childhood wheezing and paediatric asthma. A match between patient and device and a correct inhalation technique are crucial for good asthma control. The aim of this paper is to propose an inhaler strategy that will facilitate an inhale...