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Sample records for chronic inhalation study

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

    International Nuclear Information System (INIS)

    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

  2. Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD). TECEPOC: study protocol for a partially randomized controlled trial (preference trial)

    OpenAIRE

    Leiva-Fernández Francisca; Leiva-Fernández José; Zubeldia-Santoyo Fernando; García-Ruiz Antonio; Prados-Torres Daniel; Barnestein-Fonseca Pilar

    2012-01-01

    Abstract Background Drugs for inhalation are the cornerstone of therapy in obstructive lung disease. We have observed that up to 75 % of patients do not perform a correct inhalation technique. The inability of patients to correctly use their inhaler device may be a direct consequence of insufficient or poor inhaler technique instruction. The objective of this study is to test the efficacy of two educational interventions to improve the inhalation techniques in patients with Chronic Obstructiv...

  3. Chronic inhalation studies of two types of stone wool fibers in rats.

    Science.gov (United States)

    Kamstrup, O; Ellehauge, A; Chevalier, J; Davis, J M; McConnell, E E; Thévenaz, P

    2001-07-01

    A summary is given of the pathology results after long-term inhalation in rats of insulation wool representing the new biosoluble types. The pathology results are compared with previously conducted long-term inhalation study with MMVF21 (traditional stone wool). The biosoluble fiber MMVF34/HT (HT) is characterized by a relatively high content of aluminum and a relatively low content of silica compared to the older MMVF21. HT has a high in vitro dissolution rate at pH 4.5, and a relatively low dissolution rate at pH 7.5. Male Fischer 344 rats were exposed at one exposure level of 30 mg/m(3) by nose-only inhalation of a well-characterized fiber test atmosphere. The fibers had been size selected to be largely rat respirable. The negative control group was exposed to filtered air. The exposure duration was 6 h/day, 5 days/wk for 104 wk, with a subsequent nonexposure period lasting until approximately 20% survival in the air control group. Interim sacrifices were performed at wk 13, 26, 52, 78, and 104 to monitor the progression of pulmonary change and fiber numbers. Effectively the main protocol for the previously conducted chronic study with MMVF21 was the same, except that there were three concentration levels (3, 16, and 30 mg/m(3)). In addition to the endpoints measured in the previous study, slides from both studies were evaluated for collagen deposition using a quantitative morphometric method. The results of the comparative study clearly showed a marked difference in the pulmonary pathogenicity of the MMVF21 and HT in terms of their fibrogenic potential. MMVF21 caused pulmonary fibrosis, but the HT fiber did not. The incidence of tumors for both the HT and the MMVF21 fiber was comparable to the control groups. PMID:11452357

  4. Effect of inhaled drugs on anxiety and depression in patients with chronic obstructive pulmonary disease: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hyun MK

    2016-04-01

    Full Text Available Min Kyung Hyun,1 Na Rae Lee,2 Eun Jin Jang,3 Jae-Joon Yim,4 Chang-Hoon Lee4 1Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea; 2National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea; 3Department of Information Statistics, College of Natural Science, Andong National University, Andong, Republic of Korea; 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea Objective: We investigated the effect of treatment with inhaled drugs on changes in mood, focusing on depression and anxiety during treatment in patients with newly diagnosed chronic obstructive pulmonary disease (COPD.Methods: We prospectively selected new COPD patients from three Seoul National Hospitals. Participants underwent face-to-face interviews to evaluate clinical characteristics and drug use, and completed questionnaires using the Hospital Anxiety and Depression Scale (HADS at the start of the project, the 4th week, and the 12th week. We compared changes in HADS scores both between inhaled corticosteroid (ICS/long-acting β2 agonist (LABA users and non-ICS/LABA users, as well as between long-acting muscarinic antagonist (LAMA users and non-LAMA users. The general linear mixed model was applied for multivariate analysis.Results: Ninety new COPD patients participated in the study. Of these 90 patients, 84 completed face-to-face interviews. In the univariate analysis, those who were treated by ICS/LABA or LAMA showed a significant increase in HADS-A at the 4-week evaluation (0.73±2.56, P=0.038, but the statistical significance was lost in the multivariable analysis. No significant difference was found in the change in HADS scores between ICS/LABA users and non-ICS/LABA users, or between LAMA users and non-LAMA users in multivariate general linear mixed model

  5. Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD. TECEPOC: study protocol for a partially randomized controlled trial (preference trial

    Directory of Open Access Journals (Sweden)

    Leiva-Fernández Francisca

    2012-05-01

    Full Text Available Abstract Background Drugs for inhalation are the cornerstone of therapy in obstructive lung disease. We have observed that up to 75 % of patients do not perform a correct inhalation technique. The inability of patients to correctly use their inhaler device may be a direct consequence of insufficient or poor inhaler technique instruction. The objective of this study is to test the efficacy of two educational interventions to improve the inhalation techniques in patients with Chronic Obstructive Pulmonary Disease (COPD. Methods This study uses both a multicenter patients´ preference trial and a comprehensive cohort design with 495 COPD-diagnosed patients selected by a non-probabilistic method of sampling from seven Primary Care Centers. The participants will be divided into two groups and five arms. The two groups are: 1 the patients´ preference group with two arms and 2 the randomized group with three arms. In the preference group, the two arms correspond to the two educational interventions (Intervention A and Intervention B designed for this study. In the randomized group the three arms comprise: intervention A, intervention B and a control arm. Intervention A is written information (a leaflet describing the correct inhalation techniques. Intervention B is written information about inhalation techniques plus training by an instructor. Every patient in each group will be visited six times during the year of the study at health care center. Discussion Our hypothesis is that the application of two educational interventions in patients with COPD who are treated with inhaled therapy will increase the number of patients who perform a correct inhalation technique by at least 25 %. We will evaluate the effectiveness of these interventions on patient inhalation technique improvement, considering that it will be adequate and feasible within the context of clinical practice. Trial registration Current Controlled Trials ISRTCTN15106246

  6. The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: a phase 1a study.

    Science.gov (United States)

    Eisenberg, Elon; Ogintz, Miri; Almog, Shlomo

    2014-09-01

    Chronic neuropathic pain is often refractory to standard pharmacological treatments. Although growing evidence supports the use of inhaled cannabis for neuropathic pain, the lack of standard inhaled dosing plays a major obstacle in cannabis becoming a "main stream" pharmacological treatment for neuropathic pain. The objective of this study was to explore the pharmacokinetics, safety, tolerability, efficacy, and ease of use of a novel portable thermal-metered-dose inhaler (tMDI) for cannabis in a cohort of eight patients suffering from chronic neuropathic pain and on a stable analgesic regimen including medicinal cannabis. In a single-dose, open-label study, patients inhaled a single 15.1 ± 0.1 mg dose of cannabis using the Syqe Inhaler device. Blood samples for Δ(9)-tetrahydrocannabinol (THC) and 11-hydroxy-Δ(9)-THC were taken at baseline and up to 120 minutes. Pain intensity (0-10 VAS), adverse events, and satisfaction score were monitored following the inhalation. A uniform pharmacokinetic profile was exhibited across all participants (Δ(9)-THC plasma Cmax ± SD was 38 ± 10 ng/mL, Tmax ± SD was 3 ± 1 minutes, AUC₀→infinity ± SD was 607 ± 200 ng·min/mL). Higher plasma Cmax increase per mg Δ(9)-THC administered (12.3 ng/mL/mg THC) and lower interindividual variability of Cmax (25.3%), compared with reported alternative modes of THC delivery, were measured. A significant 45% reduction in pain intensity was noted 20 minutes post inhalation (P = .001), turning back to baseline within 90 minutes. Tolerable, lightheadedness, lasting 15-30 minutes and requiring no intervention, was the only reported adverse event. This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a Δ(9)-THC pharmacokinetic profile with low interindividual variation of Cmax, achieving pharmaceutical standards for inhaled drugs. PMID:25118789

  7. Study protocol for a randomized, controlled trial comparing the efficacy of two educational interventions to improve inhalation techniques in patients with chronic obstructive pulmonary disease (COPD): TIEPOC Study

    OpenAIRE

    Leiva-Fernández, José; Leiva-Fernández, Francisca; Vázquez-Alarcón, Rubén L; García-Ruiz, Antonio; Prados-Torres, Daniel; Barnestein-Fonseca, Pilar

    2014-01-01

    Background: An appropriate inhalation technique and adherence to treatment are both critical determinants of the success of chronic obstructive pulmonary disease (COPD) management. We have observed that up to 75% of patients do not use a successful inhalation technique. Knowledge evaluation and frequent reassessment of inhaler use, together with education of patients and healthcare professionals, can significantly improve the benefits that patients with COPD will derive from inhaler therapy. ...

  8. A chronic inhalation toxicity/oncogenicity study of methylethylketoxime in rats and mice.

    Science.gov (United States)

    Newton, P E; Wooding, W L; Bolte, H F; Derelanko, M J; Hardisty, J F; Rinehart, W E

    2001-12-01

    To evaluate the oncogenic potential of methylethylketoxime (MEKO), CD-1 mice (50/sex/group) and F-344 rats (50/sex/group) were coexposed 6 h/day, 5 days/wk for 18 mo (mice) or 26 mo (rats) via whole-body inhalation exposures to target vapor concentrations of 0, 15, 75, and 375 ppm (actual concentrations of 0, 15 +/- 1, 75 +/- 2, or 374 +/- 10 ppm). Satellite groups of rats and mice (10/sex/group/interval) were exposed for 12 mo (mice) and 3, 12, or 18 mo (rats) to evaluate chronic toxicity. Methyl ethyl ketone (MEK), a possible hydrolysis product of MEKO, was present at less than 1%. Treatment-related effects included increased body weight (male rats only), methemoglobin formation, hematology and clinical chemistry changes, increased liver weight, and increased spleen and testes weights (rats only). A high incidence of cataracts and corneal dystrophy occurred in both control and MEKO-exposed rats, with an earlier appearance and slightly higher incidence for these ocular lesions in MEKO-exposed animals compared to controls. Degenerative and reparative changes of the olfactory epithelium in the nasal turbinates, primarily limited to the dorsal meatus, occurred in both rats (75 and 374 ppm) and mice (15, 75, and 374 ppm). In addition, in the mice, liver changes included increased incidences of pigment in reticuloendothelial cells, centilobular hypertrophy, granulomatous inflammation, and a slightly increased incidence of necrosis (75 and 374 ppm). An increase in hepatocellular carcinomas occurred in male mice at 374 ppm. Additional MEKO-related findings in the rat included congestion of the spleen with pigment in reticuloendothelial cells and extramedullary hematopoiesis and a decreased incidence of lymphoreticular mononuclear cell leukemia. Effects observed in the liver of the rats included decreases in the incidence of both peribiliary fibrosis and hyperplasia/proliferation of the biliary duct, an increase of spongiosis hepatis in males, and an increase in the

  9. Chronic inhalation toxicity and carcinogenicity studies on β-chloroprene in rats and hamsters

    NARCIS (Netherlands)

    Trochimowicz, H.J.; Löser, E.; Feron, V.J.; Clary, J.J.; Valentine, R.

    1998-01-01

    Three groups of 100 Wistar rats and Syrian golden hamsters of each sex were exposed by inhalation to 0, 10, or 50 ppm (v/v) β-chloroprene for 6 h/day, 5 days a week for up to 24 and 18 too, respectively. To maintain the chemical integrity of this highly reactive material in the exposure chambers, β-

  10. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  11. Inhaled corticosteroids for abnormal pulmonary function in children with a history of Chronic Lung Disease of Infancy: study protocol [ISRCTN55153521

    Directory of Open Access Journals (Sweden)

    Sauve Reginald

    2005-04-01

    Full Text Available Abstract Background There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD. Methods Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD. Discussion We propose that Beclomethasone Dipropionate (QVAR will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.

  12. Outcomes and costs of treating chronic obstructive pulmonary disease with inhaled fixed combinations: the Italian perspective of the PATHOS study

    Directory of Open Access Journals (Sweden)

    Roggeri A

    2014-06-01

    Full Text Available Alessandro Roggeri,1 Claudio Micheletto,2 Daniela Paola Roggeri11ProCure Solutions, Bergamo, Italy; 2Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, ItalyPurpose: Fixed-dose combinations of inhaled corticosteroids and long-acting ß2-agonists have proven to prevent and reduce chronic obstructive pulmonary disease (COPD exacerbations. The aim of this analysis was to explore the clinical consequences and direct health care costs of applying the findings of the PATHOS (An Investigation of the Past 10 Years Health Care for Primary Care Patients with Chronic Obstructive Pulmonary Disease study to the Italian context.Patients and methods: Effectiveness data from the PATHOS study, a population-based, retrospective, observational registry study conducted in Sweden, in terms of reduction in COPD and pneumonia-related hospitalizations, were considered, in order to estimate the differences in resource consumption between patients treated with budesonide/formoterol and fluticasone/salmeterol. The base case considers the average dosages of the two drugs reported in the PATHOS study and the actual public price in charges to the Italian National Health Service, while the difference in hospitalization rates reported in the PATHOS study was costed based on Italian real-world data.Results: The PATHOS study demonstrated a significant reduction in COPD hospitalizations and pneumonia-related hospitalizations in patients treated with budesonide/formoterol versus fluticasone/salmeterol (-29.1% and -42%, respectively. In the base case, the treatment of a patient for 1 year with budesonide/formoterol led to a saving of €499.90 (€195.10 for drugs, €193.10 for COPD hospitalizations, and €111.70 for pneumonia hospitalizations corresponding to a -27.6% difference compared with fluticasone/salmeterol treatment.Conclusion: Treatment of COPD with budesonide/formoterol compared with fluticasone/salmeterol could lead to a reduction in direct health care costs

  13. Patient preferences for inhaler devices in chronic obstructive pulmonary disease: experience with Respimat® Soft Mist™ Inhaler

    Directory of Open Access Journals (Sweden)

    Richard Hodder

    2009-10-01

    Full Text Available Richard Hodder,1 David Price21Divisions of Pulmonary and Critical Care, University of Ottawa, Ottawa, Ontario, Canada; 2Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, ScotlandAbstract: Current guidelines for the management of chronic obstructive pulmonary disease (COPD recommend the regular use of inhaled bronchodilator therapy in order to relieve symptoms and prevent exacerbations. A variety of inhaler devices are currently available to COPD patients, and the choice of device is an important consideration because it can influence patients’ adherence to treatment, and thus potentially affect the long-term outcome. The Respimat® Soft Mist™ Inhaler (SMI generates a slow-moving aerosol with a high fine particle fraction, resulting in deposition of a higher proportion of the dose in the lungs than pressurized metered-dose inhalers (pMDIs or some dry powder inhalers (DPIs. We review clinical studies of inhaler satisfaction and preference comparing Respimat® SMI against other inhalers in COPD patients. Using objective and validated patient satisfaction instruments, Respimat® SMI was consistently shown to be well accepted by COPD patients, largely due to its inhalation and handling characteristics. In comparative studies with pMDIs, the patient total satisfaction score with Respimat® SMI was statistically and clinically significantly higher than with the pMDI. In comparative studies with DPIs, the total satisfaction score was statistically significantly higher than for the Turbuhaler® DPI, but only the performance domain of satisfaction was clinically significantly higher for Respimat® SMI. Whether the observed higher levels of patient satisfaction reported with Respimat® SMI might be expected to result in improved adherence to therapy and thus provide benefits consistent with those recently shown to be associated with sustained bronchodilator treatment in patients with COPD remains to be proven

  14. Study of gas exchange in the bronchopulmonary system after inhalation administration of 133Xe in patients with chronic nonspecific pulmonary diseases

    International Nuclear Information System (INIS)

    Results of a comparative study of pulmonary ventilation, perfusion and alveolar gas exchange in 155 patients with chronic nonspecific pulmonary diseases are presented. In view of the shortcomings of conventional radiopulmonography with 133Xe the discrepancy between clinicoroentgenological findings and ventilation indices was 38%, that between the former and perfusion was 20%. It was concluded that a study of gas exchange in the bronchopulmonary system during inhalation administration of 133Xe provided an opportunity for objective diagnosis of a pathological process in the lung parenchyma, to outline a further adequate plan of the patient's examination and to assess the efficacy of his treatment

  15. Historical cohort study examining comparative effectiveness of albuterol inhalers with and without integrated dose counter for patients with asthma or chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Price DB

    2016-08-01

    Full Text Available David B Price,1,2 Anna Rigazio,2 Mary Buatti Small,3 Thomas J Ferro,3 1Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; 2Research in Real-Life Ltd, Cambridge, UK; 3Teva Pharmaceuticals, Frazer, PA, USA Background: Using a metered-dose inhaler (MDI beyond the labeled number of actuations may result in inadequate dosing of medication, which can lead to poor clinical outcomes. This study compared respiratory-related emergency department (ED visit rates in patients with asthma, chronic obstructive pulmonary disease, or both when they used albuterol MDIs with versus without dose counters. Methods: This retrospective study used US claims data to identify patients (ages 4–64 years with asthma, chronic obstructive pulmonary disease, or both, using albuterol MDIs with or without an integrated dose counter. The study comprised a 1-year baseline period for patient characterization and confounder definition and a 1-year outcome period following the first albuterol prescription. The primary end point was the incidence rate of respiratory-related ED visits, compared using a reduced zero-inflated Poisson regression model. We also compared severe exacerbation rates and rescue medication use. Results: A total of 93,980 patients were studied, including 67,251 (72% in the dose counter cohort and 26,729 (28% in the non-dose-counter cohort. The cohorts were broadly similar at baseline (55,069 [59%] female patients; median age, 37 years. The incidence rate of respiratory-related ED visits during the outcome year was 45% lower in the dose counter cohort than in the non-dose-counter cohort (adjusted rate ratio: 0.55; 95% confidence interval: 0.47–0.64. Exacerbation rates and short-acting β-agonist use were similar between cohorts. Conclusion: These findings suggest that dose counter integration into albuterol MDIs is associated with decreased ED visit rates. The presence of integrated dose counters on rescue

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

    Institute of Scientific and Technical Information of China (English)

    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

  17. A CHRONIC INHALATION STUDY OF METHYL BROMIDE TOXICITY IN B6C3F1 MICE. (FINAL REPORT TO THE NATIONAL TOXICOLOGY PROGRAM)

    Energy Technology Data Exchange (ETDEWEB)

    HABER, S.B.

    1987-06-26

    This report provides a detailed account of a two year chronic inhalation study of methyl bromide toxicity in B6C3Fl mice conducted for the National Toxicology Program. Mice were randomized into three dose groups (10, 33 and 100 ppm methyl bromide) and one control group (0 ppm) per sex and exposed 5 days/week, 6 hours/day, for a total of 103 weeks. Endpoints included body weight; clinical signs and mortality, and at 6, 15 and 24 months of exposure, animals were sacrificed for organ weights, hematology and histopathology. In addition, a subgroup of animals in each dosage group was monitored for neurobehavioral and neuropathological changes. After only 20 weeks of exposure, 48% of the males and 12% of the females in the 100 ppm group had died. Exposures were terminated in that group and the surviving mice were observed for the duration of the study. Exposure of B6C3Fl mice to methyl bromide, even for only 20 weeks, produced significant changes in growth rate, mortality, organ weights and neurobehavioral functioning. These changes occurred in both males and females, but were more pronounced in males.

  18. Pulmonary and Systemic Immune Response to Chronic Lunar Dust Inhalation

    Science.gov (United States)

    Crucian, Brian; Quiriarte, Heather; Nelman, Mayra; Lam, Chiu-wing; James, John T.; Sams, Clarence

    2014-01-01

    Background: Due to millennia of meteorite impact with virtually no erosive effects, the surface of the Moon is covered by a layer of ultra-fine, reactive Lunar dust. Very little is known regarding the toxicity of Lunar dust on human physiology. Given the size and electrostatic characteristics of Lunar dust, countermeasures to ensure non-exposure of astronauts will be difficult. To ensure astronaut safety during any future prolonged Lunar missions, it is necessary to establish the effect of chronic pulmonary Lunar dust exposure on all physiological systems. Methods: This study assessed the toxicity of airborne lunar dust exposure in rats on pulmonary and system immune system parameters. Rats were exposed to 0, 20.8, or 60.8 mg/m3 of lunar dust (6h/d; 5d/wk) for up to 13 weeks. Sacrifices occurred after exposure durations of 1day, 7 days, 4 weeks and 13 weeks post-exposure, when both blood and lung lavage fluid were collected for analysis. Lavage and blood assays included leukocyte distribution by flow cytometry, electron/fluorescent microscopy, and cytokine concentration. Cytokine production profiles following mitogenic stimulation were performed on whole blood only. Results: Untreated lavage fluid was comprised primarily of pulmonary macrophages. Lunar dust inhalation resulted in an influx of neutrophils and lymphocytes. Although the percentage of lymphocytes increased, the T cell CD4:CD8 ratio was unchanged. Cytokine analysis of the lavage fluid showed increased levels of IL-1b and TNFa. These alterations generally persisted through the 13 week sampling. Blood analysis showed few systemic effects from the lunar dust inhalation. By week 4, the peripheral granulocyte percentage was elevated in the treated rats. Plasma cytokine levels were unchanged in all treated rats compared to controls. Peripheral blood analysis showed an increased granulocyte percentage and altered cytokine production profiles consisting of increased in IL-1b and IL-6, and decreased IL-2

  19. Randomised crossover trial of salbutamol aerosol delivered by metered dose inhaler, jet nebuliser, and ultrasonic nebuliser in chronic lung disease

    OpenAIRE

    Fok, T; Lam, K.; Ng, P; So, H.; Cheung, K; Wong, Van W.; So, K

    1998-01-01

    AIMS—To compare the efficacy of salbutamol delivered by metered dose inhaler (MDI), jet nebuliser, and ultrasonic nebuliser in ventilated infants with chronic lung disease.
METHODS—Twenty preterm ventilated infants with chronic lung disease were enrolled in two studies. In study 1 (n=10), each infant was given 200 µg of salbutamol at 4 hour intervals and in random sequence from a metered dose inhaler-spacer device, a jet nebuliser, and an ultrasonic nebuliser with a small me...

  20. Controlled trial of inhaled budesonide in patients with cystic fibrosis and chronic bronchopulmonary Psuedomonas aeruginosa infection

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S S; Nielsen, K G;

    1997-01-01

    The efficacy and safety of anti-inflammatory treatment with inhaled glucocorticosteroids in patients with cystic fibrosis (CF) and complicating chronic Pseudomonas aeruginosa (P.a.) lung infection was studied in a placebo-controlled, parallel, double-blind single center trial. Active treatment...

  1. Effects of combined exposure of F344 rats to radiation and chronically inhaled cigarette smoke

    Energy Technology Data Exchange (ETDEWEB)

    Finch, G.L.; Nikula, K.J.; Barr, E.B. [and others

    1995-12-01

    Nuclear workers may be exposed to radiation in various forms, such as low-LET {gamma}-irradiation or {alpha}-irradiation from inhaled {sup 239}PuO{sub 2} particles. These workers may then have increased risk for lung cancer compared to the general population. Of additional concern is the possibility that interactions between radiation and other carcinogens may increase the risk of cancer induction, compared to the risks from either type of agent alone. An important and common lung carcinogen is cigarette smoke. The purpose of this project is to better determine the combined effects of chronically inhaled cigarette smoke and either inhaled {sup 239}PuO{sub 2} or external, thoracic X-irradiation on the induction of lung cancer in rats. Histologic and dosimetric evaluations of rats in the CS + {sup 239}PuO{sub 2} study continue, and the study of CS + X rays is beginning.

  2. Cough sensitivity and extrathoracic airway responsiveness to inhaled capsaicin in chronic cough patients.

    OpenAIRE

    Cho, You Sook; Lee, Chang-Keun; Yoo, Bin; Moon, Hee-Bom

    2002-01-01

    Enhanced cough response has been frequently observed in chronic cough. Recently, extrathoracic airway constriction to inhaled histamine was demonstrated in some chronic cough patients. However, relation between extrathoracic airway hyperresponsiveness (EAHR) and cough sensitivity determined by capsaicin inhalation is unclear in each etiological entity of chronic cough. Seventy-seven patients, with dry cough persisting for 3 or more weeks, normal spirometry and chest radiography, and 15 contro...

  3. Clinical effectiveness of the Respimat® inhaler device in managing chronic obstructive pulmonary disease: evidence when compared with other handheld inhaler devices

    Directory of Open Access Journals (Sweden)

    et al

    2011-02-01

    Full Text Available Felix SF Ram1, Celso R Carvallho2, John White31School of Health and Social Services, Massey University, Auckland, New Zealand; 2Department of Physical Therapy, School of Medicine, University of São Paulo, Brazil; 3York Hospitals NHS Foundation Trust, York Hospital, York, UKObjectives: Medication for the management of chronic obstructive pulmonary disease (COPD may be delivered by a number of different inhaler devices. This study was undertaken to determine the clinical effectiveness of the Respimat® handheld inhaler device compared with other handheld inhaler devices for the delivery of medication in stable COPD.Methodology: A systematic review of high-quality randomized controlled clinical trials comparing Respimat with other inhaler devices using the same medication was performed. Studies were searched for in the Cochrane Central Register of Controlled Trials as well as other relevant electronic databases. Manufacturers of inhaled COPD medication were also contacted for potential trials.Results: Seven studies of high methodological quality with 3813 participants were included in the review. Three trials used Handihaler® as the comparator inhaler, three used a chlorofluorocarbon metered-dose inhaler (CFC-MDI, and one trial used a hydroflouroalkane (HFA-MDI. When Respimat was compared with Handihaler, the following reported outcomes were not significantly different: trough forced expiratory volume in 1 second (FEV1 (weighted mean difference [WMD] 0.01 L; P = 0.14, trough forced vital capacity (FVC (WMD 0.001 L: P = 0.88, peak FEV1 (WMD 0.01 L: P = 0.08, peak FVC (WMD 0.01 L: P = 0.55, morning peak expiratory flow rate (PEFR (WMD 5.06 L/min: P = 0.08, and evening PEFR (WMD 4.39 L/min: P = 0.15. Furthermore, there were no differences when Respimat was compared with Handihaler for risk of exacerbations (relative risk [RR] 0.94: P = 0.81, dry mouth (RR 1.57: P = 0.34, or nasopharyngitis (RR 1.42: P = 0.22. For Respimat compared with CFC-MDI, the

  4. Efficacy and Tolerability of Budesonide/Formoterol in One Hydrofluoroalkane Pressurized Metered-Dose Inhaler in Patients with Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Rennard, Stephen I; Tashkin, Donald P.; McElhattan, Jennifer; Goldman, Mitchell; Ramachandran, Sulabha; Martin, Ubaldo J.; Silkoff, Philip E.

    2012-01-01

    Background: Combination therapy with a long-acting bronchodilator and an inhaled corticosteroid (ICS) is recommended in patients with chronic obstructive pulmonary disease (COPD) who have frequent exacerbations. The efficacy and tolerability of the combination of budesonide/formoterol have been demonstrated in patients with COPD when administered via the dry powder inhaler (DPI) in a 1-year study and when administered via the hydrofluoroalkane (HFA) pressurized metered-dose inhaler (pMDI) in ...

  5. Inhaler Costs and Medication Nonadherence Among Seniors With Chronic Pulmonary Disease

    Science.gov (United States)

    Rogers, William H.; Safran, Dana Gelb; Wilson, Ira B.

    2010-01-01

    Background: Chronic pulmonary diseases (CPDs) such as asthma and COPD are associated with particularly high rates of cost-related medication nonadherence (CRN), but the degree to which inhaler costs contribute to this is not known. Here, we examine the relationship between inhaler-specific out-of-pocket costs and CRN in CPD. Methods: Using data obtained in 2006 in a national stratified random sample (N = 16,072) of community-dwelling Medicare beneficiaries aged ≥ 65 years, we used logistic regression to examine the relationship between inhaled medications, various types of out-of-pocket costs, and CRN in persons with CPD. Results: The prevalence of CRN in Medicare recipients with CPD using inhalers was 31%. In multivariate models, the odds that respondents with CPD using inhalers would report CRN was 1.43 (95% CI, 1.21-1.69) compared with respondents without CPD who were not using inhalers. Adjustment for out-of-pocket inhaler costs—but not adjustment for total medication costs or non-inhaler costs—eliminated this excess risk of CRN (OR, 0.95; 95% CI, 0.71-1.28). Patients paying > $20 per month for inhalers were at significantly higher risk for CRN compared with those who had no out-of-pocket inhaler costs. Conclusions: Individuals with CPD and high out-of-pocket inhaler costs are at increased risk for CRN relative to individuals on other medications. Physicians should be aware that inhalers can pose a particularly high risk of medication nonadherence for some patients. PMID:20418367

  6. Inhalants

    Science.gov (United States)

    ... 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 ...

  7. Inhalants

    Science.gov (United States)

    ... 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 ...

  8. A comparative study to evaluate the role of inhaled steroid versus low-dose oral steroid in patients of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Surya Kant

    2015-04-01

    Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was first described. Although, overall steroid in any form is beneficial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids. [Int J Basic Clin Pharmacol 2015; 4(2.000: 240-244

  9. Optimising Inhaled Pharmacotherapy for Elderly Patients with Chronic Obstructive Pulmonary Disease: The Importance of Delivery Devices.

    Science.gov (United States)

    Lavorini, Federico; Mannini, Claudia; Chellini, Elisa; Fontana, Giovanni A

    2016-07-01

    Chronic obstructive pulmonary disease (COPD) is common in older people. Inhaled medications are the mainstay of pharmacological treatment of COPD, and are typically administered by handheld inhalers, such as pressurised metered-dose inhalers and dry powder inhalers, or by nebulisers. For each of the three major categories of aerosol delivery devices, several new inhalers have recently been launched, each with their own particularities, advantages and disadvantages. Consequently, broader availability of new drug-device combinations will increase prescription opportunities. Despite this, however, there is limited guidance available in published guidelines on the choice of inhalers, and still less consideration is given to elderly patients with COPD. The aim of this article is to provide a guide for healthcare professionals on device selection and factors to be considered for effective inhaled drug delivery in elderly COPD patients, including device factors (device type and complexity of use), patient factors (inspiratory capabilities, manual dexterity and hand strength, cognitive ability, co-morbidities) and considerations for healthcare professionals (proper education of patients in device use). PMID:27216613

  10. The role of the methacholine inhalation challenge in adult patients presenting with chronic cough.

    Science.gov (United States)

    Wongtim, S; Mogmeud, S; Limthongkul, S; Chareonlap, P; Udompanich, V; Nuchprayoon, C; Chochaipanichnont, L

    1997-03-01

    One hundred and twenty two patients who were presenting with chronic persistent cough for more than 3-4 weeks were studied. Using anatomical and stepwise approach, we could identify the cause of chronic cough in 96% of the patients. The most common causes were due to postnasal drip syndrome (PND) (45%) and bronchial asthma (26%). We also demonstrated the important role of methacholine inhalation challenge in the diagnostic work up. The procedure could identify the patients who had bronchial hyperresponsiveness (BHR) in 52% of the cases. The severity degree of the BHR was classified into three levels. Mild or nonspecific BHR was defined as PC20 16-25 mg/ml. This could be found in many diseases such as PND and bronchiectasis. Moderate degree of BHR (PC20 8-16 mg/ml) was found in patients with PND and asthma. PC20 of less than 8 mg/ml was considered to be the most severe degree and it seemed to be specific for the diagnosis of asthma (positive predictive value 100%). Other condition that caused chronic cough were drug-induced, especially angiotensin-converting enzyme inhibitors, gastroesophageal reflux disease (GERD), idiopathic pulmonary fibrosis, subgottic cancer and idiopathic cough. These conditions may require invasive diagnostic work up, such as fiberoptic bronchoscopy and tissue biopsy. The treatment of chronic cough was according to the etiology. Thus, the patients presenting with chronic cough should be investigated to identify the cause, and it was not just only the administration of cough suppressant drugs in these patients. PMID:9251842

  11. 46. Micronuclei induced by chronical treatment of SO2 inhalation in mouse bone marrow cells

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In the chronical experiment of treating with sulfur dioxide(SO2) inhalation, Micronuclei(MN) frequencies in the polychromatophilic erythroblasts(PCE) of mouse bone marrow and the frequencies of cells with MN were significantly increased in dose-dependent manner. There is a significant difference between the male and the female animals. The results also showed that SO2 inhibited urethone-induced MN formation, it is a antagonistic joint action to Urethone. These results furtherly confirm that SO2 inhalation is a clastogenetic and genotoxic agent to mammalian cells, and the combination roles of SO2 and other mutagens are complexity.

  12. Tobramycin Inhalation Powder™: a novel drug delivery system for treating chronic Pseudomonas aeruginosa infection in cystic fibrosis.

    Science.gov (United States)

    Parkins, Michael D; Elborn, J Stuart

    2011-10-01

    Lung disease in cystic fibrosis (CF) is typified by the development of chronic airways infection culminating in bronchiectasis and progression to end-stage respiratory disease. Pseudomonas aeruginosa, a ubiquitous gram-negative bacteria, is the archetypical CF pathogen and is associated with an accelerated clinical decline. The development and widespread use of chronic suppressive aerosolized antibacterial therapies, in particular Tobramycin Inhalation Solution (TIS), in CF has contributed to reduced lung function decline and improved survival. However, the requirement for the aerosolization of these agents through nebulizers has been associated with increased treatment burden, reduced quality of life and remain a barrier to broader uptake. Tobramycin Inhalation Powder (TIP™) has been developed by Novartis with the express purpose of delivering the same benefits as TIS in a time-effective manner. Administered via the T-326™ (Novartis) Inhaler in four individual 28-mg capsules, TIP can be administered in a quarter of the time of traditional nebulizers and is inherently portable. In clinical studies, TIP has been shown to be safe, result in equivalent or superior reductions in P. aeruginosa sputum density and produce similar improvements in pulmonary function. TIP offers significant advantages in time saving, portability and convenience over traditional nebulized TIS with comparable clinical outcomes for individuals with CF.

  13. Inhalation carcinogenicity study with nickel metal powder in Wistar rats

    International Nuclear Information System (INIS)

    Epidemiological studies of nickel refinery workers have demonstrated an association between increased respiratory cancer risk and exposure to certain nickel compounds (later confirmed in animal studies). However, the lack of an association found in epidemiological analyses for nickel metal remained unconfirmed for lack of robust animal inhalation studies. In the present study, Wistar rats were exposed by whole-body inhalation to 0, 0.1, 0.4, and 1.0 mg Ni/m3 nickel metal powder (MMAD = 1.8 μm, GSD = 2.4 μm) for 6 h/day, 5 days/week for up to 24 months. A subsequent six-month period without exposures preceded the final euthanasia. High mortality among rats exposed to 1.0 mg Ni/m3 nickel metal resulted in the earlier termination of exposures in this group. The exposure level of 0.4 mg Ni/m3 was established as the MTD for the study. Lung alterations associated with nickel metal exposure included alveolar proteinosis, alveolar histiocytosis, chronic inflammation, and bronchiolar-alveolar hyperplasia. No increased incidence of neoplasm of the respiratory tract was observed. Adrenal gland pheochromocytomas (benign and malignant) in males and combined cortical adenomas/carcinomas in females were induced in a dose-dependent manner by the nickel metal exposure. The incidence of pheochromocytomas was statistically increased in the 0.4 mg Ni/m3 male group. Pheochromocytomas appear to be secondary to the lung toxicity associated with the exposure rather than being related to a direct nickel effect on the adrenal glands. The incidence of cortical tumors among 0.4 mg Ni/m3 females, although statistically higher compared to the concurrent controls, falls within the historical control range; therefore, in the present study, this tumor is of uncertain relationship to nickel metal exposure. The lack of respiratory tumors in the present animal study is consistent with the findings of the epidemiological studies

  14. Inhalants

    Science.gov (United States)

    ... 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 ...

  15. Study on the deposition patterns of aerosol inhalation scintigraphy, 1

    International Nuclear Information System (INIS)

    The deposition patterns of aerosol inhalation scintigraphies and lung function tests were studied in 102 cases; 64 cases of obstructive pulmonary diseases (19 pulmonary emphysema, 27 diffuse panbronchiolitis, 18 chronic bronchitis) and 38 restrictive pulmonary disease (15 idiopathic interstitial pneumonia, 16 pulmonary asbestosis, 7 interstitial pneumonia due to collagen vascular disease). The deposition patterns were classified into 5 patterns (Type A:normal homogenous distribution; Type B: mildly unhomogenous distribution; Type C: severely unhomogenous distribution mingled with hot spots; Type D: non-hilar hot spots; and Type E: hilar hot spots). The deposition patterns of restrictive pulmonary diseases were markedly abnormal as well as obstructive pulmonary diseases. The deposition patterns showed mainly Types C, D and E in obstructive pulmonary diseases, Type B in restrictive pulmonary diseases. The deposition patterns showed mainly Type E in pulmonary emphysema, Types C and D in diffuse panbronchiolitis, Types A, B and C in chronic bronchitis, Type B in idiopathic interstitial pneumonia interstitial pneumonia due to collagen vascular disease, Types B and C in pulmonary asbestosis. The deposition patterns correlated well with %FEV1.0 which was a good indicator of the severity of obstructive pulmonary diseases and restrictive pulmonary diseases. Furthermore, the mean %FEV1.0 in obstructive pulmonary diseases was nearly equal to the mean %FEV1.0 in restrictive pulmonary diseases in each type of the deposition patterns. (J.P.N.)

  16. Comparison of the systemic bioavailability of mometasone furoate after oral inhalation from a mometasone furoate/formoterol fumarate metered-dose inhaler versus a mometasone furoate dry-powder inhaler in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kosoglou T

    2013-03-01

    Full Text Available Teddy Kosoglou,1 James Hubbell,2 Fengjuan Xuan,3 David L Cutler,1 Alan G Meehan,4 Bhavna Kantesaria,5 Bret A Wittmer6,† 1Clinical Pharmacology, 2Exploratory Drug Metabolism, 3Early Development Statistics, 4Medical Communications, 5Drug Metabolism/Pharmacokinetics, Merck Sharp & Dohme Corp, Whitehouse Station, NJ, USA; 6Commonwealth Biomedical Research, LLC, Madisonville, KY, USA†Dr Bret A Wittmer passed away on May 9, 2012.Background: Coadministration of mometasone furoate (MF and formoterol fumarate (F produces additive effects for improving symptoms and lung function and reduces exacerbations in patients with asthma and chronic obstructive pulmonary disease (COPD. The present study assessed the relative systemic exposure to MF and characterized the pharmacokinetics of MF and formoterol in patients with COPD.Methods: This was a single-center, randomized, open-label, multiple-dose, three-period, three-treatment crossover study. The following three treatments were self-administered by patients (n = 14 with moderate-to-severe COPD: MF 400 µg/F 10 µg via a metered-dose inhaler (MF/F MDI; DULERA®/ZENHALE® without a spacer device, MF/F MDI with a spacer, or MF 400 µg via a dry-powder inhaler (DPI; ASMANEX® TWISTHALER® twice daily for 5 days. Plasma samples for MF and formoterol assay were obtained predose and at prespecified time points after the last (morning dose on day 5 of each period of the crossover. The geometric mean ratio (GMR as a percent and the corresponding 90% confidence intervals (CI were calculated for treatment comparisons.Results: Systemic MF exposure was lower (GMR 77%; 90% CI 58, 102 following administration by MF/F MDI compared to MF DPI. Additionally, least squares geometric mean systemic exposures of MF and formoterol were lower (GMR 72%; 90% CI 61, 84 and (GMR 62%; 90% CI 52, 74, respectively, following administration by MF/F MDI in conjunction with a spacer compared to MF/F MDI without a spacer. MF/F MDI had a

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

    International Nuclear Information System (INIS)

    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

  18. Evaluation of the tracheobronchial clearance in patients with chronic bronchial infections by an integrated system using radioactive aerosol inhalation scintigraphy

    International Nuclear Information System (INIS)

    The relationship between impairment of tracheobronchial clearance and chronic bronchial infection was determined by radioactive aerosol inhalation scintigraphy with Tc-99m human serum albumin. The study population consisted of 11 with bronchiectasis, 9 with diffuse panbronchiolitis, and 3 with primary ciliary dyskinesia. Nine healthy persons served as controls. According to cough control for the first 2 hours after scintigraphy, a total of 23 patients were divided into cough-controlled group (n=19) and cough-uncontrolled group (n=4). According to the ratio of initial bronchial deposition (Br0) to initial lung deposition (L0), the cough-controlled group was subdivided into group A of ≤47.9% of Br0/L0 and group B of >47.9% of Br0/L0. The ratio of bronchial deposition at 2 hours after inhalation to the L0 was significantly increased in the cough-controlled group. There was no difference in the ratio of bronchial deposition at 6 hours to the L0 among the all groups. This suggests that cough may play an important role in eliminating airway fluid in chronic bronchial infection and that impaired mucociliary clearance may be partially compensated by cough effect. Tracheal mucus velocity (TMV) was significantly decreased in evaluable 14 patients than the control group. The remaining 9 patients, in whom no bolus for measuring TMV was detected on the tracheal mucosa for the first 2 hours, seemed to have severely impaired mucociliary clearance. The present integrated system using radioactive aerosol inhalation scintigraphy was very useful for evaluating the mucociliary clearance and cough effect individually. (N.K.)

  19. Impact of inhalation therapy on oral health

    Directory of Open Access Journals (Sweden)

    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.

  20. Toxicity studies of inhaled beta-emitting radionuclides: status report

    International Nuclear Information System (INIS)

    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

  1. Toxicity studies of inhaled beta-emitting radionuclides - status report

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Elastolytic activity and alveolar epithelial type-1 cell damage after chronic LPS inhalation: Effects of dexamethasone and rolipram

    International Nuclear Information System (INIS)

    This study investigated whether a correlation between leukocyte-derived elastolytic activity, alveolar epithelial type-1 cell damage, and leukocyte infiltration of the airways existed in guinea-pigs chronically exposed to inhaled lipopolysaccharide (LPS). The airway pathology of this model, notably the neutrophilia, resembles chronic obstructive pulmonary disease (COPD). The effect of the corticosteroid, dexamethasone, or the phosphodiesterase-4 (PDE4)-inhibitor, rolipram, on these features was studied. Conscious guinea-pigs were exposed for 1 h to single or repeated (nine) doses of LPS (30 μg ml-1). Dexamethasone (20 mg kg-1, ip) or rolipram (1 mg kg-1, ip) was administered 24 and 0.5 h before the first exposure and daily thereafter. Bronchoalveolar lavage fluid (BALF) was removed and elastolytic activity determined as the elastase-like release of Congo Red from impregnated elastin. The presence of the specific epithelial cell type-1 protein (40-42 kDa) RT140 in BALF was identified by Western blotting using a rat monoclonal antibody and semi-quantified by dot-blot analysis. The antibody was found to identify guinea-pig RT140. BALF inflammatory cells, particularly neutrophils and macrophages, and elastolytic activity were increased in chronic LPS-exposed guinea-pigs, the latter by 90%. Chronic LPS exposure also increased (10.5-fold) RT140 levels, indicating significant alveolar epithelial type-1 cell damage. Dexamethasone or rolipram treatment reduced the influx of inflammatory cells, the elastolytic activity (by 40% and 38%, respectively), and RT140 levels (by 50% and 57%, respectively). In conclusion, chronic LPS-exposed guinea-pigs, like COPD, exhibit elastolytic lung damage. This was prevented by a PDE4 inhibitor and supports their development for suppressing this leukocyte-mediated pathology

  4. Inhalation Injury

    OpenAIRE

    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...

  5. Origanum vulgar inhaler in the treatment of chronic rhinosinositis, a double blind placebo controlled randomized clinical trial

    Directory of Open Access Journals (Sweden)

    K. Rabie

    2007-01-01

    Full Text Available AbstractBackground and purpose: Symptoms of chronic rhinisinositis (CRS are cumbersome and refractory to most systemic medications and even after surgical intervention, the recurrence of symptoms are frequent. In order to study the beneficial effects of Origanum vulgar inhaler in relaxing the symptoms, this study was conducted in Boo Ali Sina Hospital, Sari, Iran.Materials and Methods: The study was a randomized double blind placebo controlled clinical trial carried out from April to December 2005. The diagnosis of CRS was made by an ENT specialist upon clinical and CT scan findings and or signs during functional endoscopy sinuses surgery (FESS. Patients younger than 15 years old, with a history of allergic eye disease and symptoms of infections were excluded. Patients were randomized in case and control groups (32 in each according to age, sex and disease chronicity. After verbal explanation of the trial, an informed consent form was signed by each patient. The study was approved by the medical ethics committee of the Mazandaran University of Medical Sciences, Iran. Origanum vulgar was gathered from local mountains (Kojor area, Nour, Mazandaran, Iran, and identified by an experienced botanist. The airial organs of the herb were dried, macerated followed by 75% hydroalcoholic extraction and standardized by Emerson method. The active ingredient and placebo in the same bottles were administered to the patients and they were asked to add 5 ml of the liquid to boiling water and inhale it for 15 minutes, three times a day for two weeks. A telephone contact was made to the patients, to increase the compliance to treatment. A questionnaire was filled in for each patient before and after the intervention by a doctor blind to groups. Chi square test was used for comparing the differences in symptoms and P< 0.05 was considered statistically significant.Results: Sixty four patients were recruited and allocated equally in case and control groups matched for

  6. Tobramycin Inhalation Powder (TIP): An Efficient Treatment Strategy for the Management of Chronic Pseudomonas Aeruginosa Infection in Cystic Fibrosis.

    Science.gov (United States)

    Lam, John; Vaughan, Steven; Parkins, Michael D

    2013-11-13

    Repeated bouts of acute and chronic lung infections are responsible for progressive pulmonary function decline in individuals with cystic fibrosis (CF), ultimately leading to respiratory failure and death. Pseudomonas aeruginosa is the archetypical CF pathogen, causes chronic infection in 70% of individuals, and is associated with an accelerated clinical decline. The management of P. aeruginosa in CF has been revolutionized with the development and widespread use of inhaled antibiotics. Aerosol delivery of antimicrobial compounds in CF enables extremely high concentrations of antibiotics to be reached directly at the site of infection potentially overcoming adaptive resistance and avoiding the potential for cumulative systemic toxicities. Tobramycin inhalation powder (TIP) represents the first dry powder inhaled (DPI) antibiotic available for use in CF. DPIs are notable for a markedly reduced time for administration, ease of portability, and increased compliance. TIP has been developed as a therapeutic alternative to tobramycin inhalation solution (TIS), the standard of care for the past 20 years within CF. Relative to TIS 300 mg nebulized twice daily in on-and-off cycles of 28 days duration, TIP 112 mg twice daily via the T-326 inhaler administered on the same schedule is associated with marked time savings, increased patient satisfaction, and comparable clinical end points. TIP represents an innovative treatment strategy for those individuals with CF and holds the promise of increased patient compliance and thus the potential for improved clinical outcomes.

  7. Inhaled antibiotics for the treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis patients: challenges to treatment adherence and strategies to improve outcomes

    Directory of Open Access Journals (Sweden)

    Bodnár R

    2016-02-01

    Full Text Available Réka Bodnár,1,2 Ágnes Mészáros,2 Máté Oláh,2 Tamás Ágh3 1Department of Pediatric Pulmonology, Heim Pál Children’s Hospital, Budapest, Hungary; 2University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary; 3Syreon Research Institute, Budapest, Hungary Background: Inhaled antibiotics (ABs are recommended for use in the therapy of chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF. The aim of this systematic literature review was to identify level of adherence to inhaled ABs and to determine predictors and consequences of nonadherence in CF. Methods: A systematic literature search of English-language articles was conducted in April 2015 using Medline and Embase. No publication date limit was applied. The literature screening was conducted by two independent reviewers. All of the included studies were assessed for quality. Results: The search yielded 193 publications, of which ten met the inclusion criteria and underwent data extraction. Seven studies focused on inhaled tobramycin, one on inhaled colistimethate, one on inhaled levofloxacin, and one on inhaled aztreonam lysine. Medication adherence to inhaled ABs was analyzed by pharmacy refill history, daily phone diary, parent and child self-reports, vials counting, or electronic monitoring. In randomized controlled trials (n=3, proportion of adherent patients (>75%–80% of required doses taken ranged from 86% to 97%; in prospective cohort studies (n=3, adherence rates ranged between 36% and 92%, and in retrospective studies (n=4 it ranged between 60% and 70%. The adherence to inhaled ABs in CF was found to be associated with the complexity of treatment, time of drug administration, age of patients, treatment burden (adverse events, taste, and patient satisfaction. Conclusion: The high diversity of adherence data was because of the different study designs (randomized controlled trials vs real-world studies and the lack

  8. Inhalants in Peru.

    Science.gov (United States)

    Lerner, R; Ferrando, D

    1995-01-01

    In Peru, the prevalence and consequences of inhalant abuse appear to be low in the general population and high among marginalized children. Inhalant use ranks third in lifetime prevalence after alcohol and tobacco. Most of the use appears to be infrequent. Among marginalized children, that is, children working in the streets but living at home or children living in the street, the problem of inhalant abuse is a serious problem. Among children working in the streets but living at home, the lifetime prevalence rate for inhalant abuse is high, ranging from 15 to 45 percent depending on the study being cited. For children living in the streets, the use of inhalant is even more severe. As mentioned earlier in this chapter, most of these street children use inhalants on a daily basis. The lack of research on the problem of inhalant abuse is a serious impediment to development of intervention programs and strategies to address this problem in Peru. Epidemiologic and ethnographic research on the nature and extent of inhalant abuse are obvious prerequisites to targeted treatment and preventive intervention programs. The urgent need for current and valid data is underscored by the unique vulnerability of the youthful population at risk and the undisputed harm that results from chronic abuse of inhalants. Nonetheless, it is important to mention several programs that work with street children. Some, such as the Information and Education Center for the Prevention of Drug Abuse, Generation, and Centro Integracion de Menores en Abandono have shelters where street children are offered transition to a less marginal lifestyle. Teams of street educators provide the children with practical solutions and gain their confidence, as well as offer them alternative socialization experiences to help them survive the streets and avoid the often repressive and counterproductive environments typical of many institutions. Most of the children who go through these programs tend to abandon

  9. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD

    Science.gov (United States)

    Miravitlles, Marc; Montero-Caballero, Jéssica; Richard, Frank; Santos, Salud; Garcia-Rivero, Juan Luis; Ortega, Francisco; Ribera, Xavier

    2016-01-01

    Delivery of inhaled medications via an inhaler device underpins the effectiveness of treatment for patients with chronic obstructive pulmonary disease (COPD). Correct inhaler technique among patients is also a predictor of achieving treatment compliance and adherence. Reporting of patient satisfaction with inhalers is therefore gaining increasing attention and is now recognized as an important patient-reported outcome in clinical trials involving patients with COPD or asthma. In this cross-sectional study, we use the validated Patient Satisfaction and Preference Questionnaire (PASAPQ) to assess the handling and satisfaction for Respimat® Soft Mist™ Inhaler (SMI) compared with the Breezhaler® dry powder inhaler (DPI) among patients with COPD in Spain. Patients were already assigned to therapy with either SPIRIVA® (tiotropium) Respimat® or with Hirobriz®/Onbrez®/Oslif® (indacaterol) Breezhaler® for at least 3 but not more than 6 months before completing the PASAPQ at a single visit to the study site. The primary endpoint of the trial was the mean total PASAPQ score. Secondary endpoints were the performance score domain of the PASAPQ, the convenience score domain of the PASAPQ, and the overall satisfaction score of the PASAPQ. For the primary endpoint, the mean PASAPQ total score in the Respimat® and Breezhaler® groups was 80.7 and 79.9, respectively (difference of 0.8, 95% confidence interval [CI] −2.9 to 4.5; P=0.67). The mean total performance scores were 82.5 and 78.2 (difference of 4.3, 95% CI −0.3 to 8.9; P=0.06), and the mean total convenience scores were 78.6 and 81.9 (difference of −3.3, 95% CI −7.0 to 0.4; P=0.08) for the Respimat® and Breezhaler® groups, respectively. Patients gave the Respimat® SMI and the Breezhaler® DPI overall satisfaction PASAPQ scores of 6.0 and 5.9, respectively, which shows that patients were satisfied with these inhalers. PMID:27013871

  10. Toxicogenomic analysis of susceptibility to inhaled urban particulate matter in mice with chronic lung inflammation

    Directory of Open Access Journals (Sweden)

    Yauk Carole L

    2009-03-01

    Full Text Available Abstract Background Individuals with chronic lung disease are at increased risk of adverse health effects from airborne particulate matter. Characterization of underlying pollutant-phenotype interactions may require comprehensive strategies. Here, a toxicogenomic approach was used to investigate how inflammation modifies the pulmonary response to urban particulate matter. Results Transgenic mice with constitutive pulmonary overexpression of tumour necrosis factor (TNF-α under the control of the surfactant protein C promoter and wildtype littermates (C57BL/6 background were exposed by inhalation for 4 h to particulate matter (0 or 42 mg/m3 EHC-6802 and euthanized 0 or 24 h post-exposure. The low alveolar dose of particles (16 μg did not provoke an inflammatory response in the lungs of wildtype mice, nor exacerbate the chronic inflammation in TNF animals. Real-time PCR confirmed particle-dependent increases of CYP1A1 (30–100%, endothelin-1 (20–40%, and metallothionein-II (20–40% mRNA in wildtype and TNF mice (p Conclusion Our data support the hypothesis that health effects of acute exposure to urban particles are dominated by activation of specific physiological response cascades rather than widespread changes in gene expression.

  11. Gold nanoparticle aerosols for rodent inhalation and translocation studies

    International Nuclear Information System (INIS)

    The intensive use of nano-sized particles in many different applications necessitates studies on their risk assessment as there are still open questions on their safe handling and utilization. For reliable risk assessment, the interaction of nanoparticles (NP) with biological systems after various routes of exposure needs to be investigated using well-characterized NP. We report here on the generation of gold-NP (Au-NP) aerosols for inhalation studies with the spark ignition technique, and their characterization in terms of chemical composition, physical structure, morphology, and specific surface area, and on interaction with lung tissues and lung cells after 1 h inhalation by mice. The originally generated agglomerated Au-NP were converted into compact spherical Au-NP by thermal annealing at 600 °C, providing particles of similar mass, but different size and specific surface area. Since there are currently no translocation data available on inhaled Au-NP in the 10–50 nm diameter range, the emphasis was to generate NP as small as 20 nm for inhalation in rodents. For anticipated in vivo systemic translocation and dosimetry analyses, radiolabeled Au-NP were created by proton irradiating the gold electrodes of the spark generator, thus forming gamma ray emitting 195Au with 186 days half-life, allowing long-term biokinetic studies. The dissolution rate of 195Au from the NP was below detection limits. The highly concentrated, polydisperse Au-NP aerosol (1–2 × 107 NP/cm3) proved to be constant over several hours in terms of its count median mobility diameter, its geometric standard deviation and number concentration. After collection on filters particles can be re-suspended and used for instillation or ingestion studies.

  12. Olodaterol Oral Inhalation

    Science.gov (United States)

    ... 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 ...

  13. Radioaerosol inhalation lung imaging for the diagnosis of chronic obstructive pulmonary diseases in Thailand. Final report for the period 10 December 1987 - 15 December 1993

    International Nuclear Information System (INIS)

    The radionuclide pulmonary function studies such as aerosol inhalation lung imaging, mucociliary clearance and pulmonary epithelial were developed and studied in normal and chronic obstructive pulmonary disease. The results of the aerosol inhalation lung imaging in 71 cases of COPD revealed that the aerosol inhalation lung scan was the most sensitive test for the diagnosis of early COPD as compared to the chest X-ray, vascular perfusion lung scan and spirometric test (% FEVI). The aerosol and perfusion lung scan were also performed in 21 cases of carcinoma of lung who had been treated with external radiation or chemotherapy. The result of study revealed 5 patients died during treatment, 5 patients were slightly improved, no significant change was detected in 10 cases and deterioration was found in one patient. The lung scintigraphy was studied in 15 cases of well differentiated carcinoma of thyroid with pulmonary metastasis who had I-131 treatment. The study showed that the radioactive iodine treatment dose had minimal effect on the post treatment lung imaging study. The perfusion and aerosol study in 15 cases of operated patients revealed no evidence of pulmonary embolism in post operative study. Abnormal vascular disease or pulmonary embolism was observed in one patient preoperatively. 12 refs, 13 figs, 13 tabs

  14. Regional study of ventilation with inhaled xenon 133 in children

    International Nuclear Information System (INIS)

    A regional exploration of pulmonary ventilation in a population of 104 infants and children by a study of distribution and washout of xenon 133 inhaled with rebreathing is carried out. The results are expressed by photographs (gamma-camera) and time-activity curves. The indications for regional exploration were oriented by the existence on the straight X-ray film of a localised ventilation disorder (a hyperlucent area or an opacity). This study permitted physiopathological analysis and guided endobronchial examinations. The functional results obtained, complete and explain other methods of exploration of lung function by spirography, ventilatory mechanics, transthoracic electrical measurements and study of lung perfusion with technetium 99m

  15. Chronic immobilization stress occludes in vivo cortical activation in an animal model of panic induced by carbon dioxide inhalation

    Directory of Open Access Journals (Sweden)

    Mohammed Mostafizur eRahman

    2014-09-01

    Full Text Available Breathing high concentrations of carbon dioxide (CO2 can trigger panic and anxiety in humans. CO2 inhalation has been hypothesized to activate neural systems similar to those underlying fear learning, especially those involving the amygdala. Amygdala activity is also upregulated by stress. Recently, however, a separate pathway has been proposed for interoceptive panic and anxiety signals, as patients exhibited CO2-inhalation induced panic responses despite bilateral lesions of the amygdala. This paradoxical observation has raised the possibility that cortical circuits may underlie these responses. We sought to examine these divergent models by comparing in vivo brain activation in unstressed and chronically-stressed rats breathing CO2. Regional cerebral blood flow measurements using functional Magnetic Resonance Imaging (fMRI in lightly-anaesthetized rats showed especially strong activation of the somatosensory cortex by CO2 inhalation in the unstressed group. Strikingly, prior exposure to chronic stress occluded this effect on cortical activity. This lends support to recent clinical observations and highlights the importance of looking beyond the traditional focus on limbic structures, such as the hippocampus and amygdala, to investigate a role for cortical areas in panic and anxiety in humans.

  16. [The combined application of yellow turpentine bathtubs and bronchodilators inhalations for the treatment of the patients presenting with chronic obstructive pulmonary disease].

    Science.gov (United States)

    Airapetova, N S; Polikanova, E B; Kulikova, O V; Nitchenko, O V; Sizyakova, L A; Derevnina, N A

    2015-01-01

    This paper was designed to report the results of comparative clinical and functional studies involving 89 patients who presented with moderately severe chronic obstructive pulmonary disease and were given the combined treatment with yellow turpentine bathtubs and bronchodilators inhalations with the use of a nebulizer. The patients comprising group 1 (n=29) were treated with yellow turpentine bathtubs and bronchodilators inhalations, those making up group 2 (n=30) received monotherapy with yellow turpentine bathtubs alone, and the patients included in group 3 (n=3) served as controls treated with the use of therapeutic physical exercises and symptomatic medications analogous to those given to the patients of the two former groups. The results of the study give evidence of the advantages of the rehabilitative complex including yellow turpentine bathtubs and atrovent inhalations over two alternative therapeutic modalities attributable to its pronounced anti-inflammatory and immune-corrective activity that resulted in the generalized improvement of bronchial patency, reduction of lung hypertension, and enhancement of physical tolerance; taken together, these effects ensured the best clinical results.

  17. A genome-wide analysis of the response to inhaled β2-agonists in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Hardin, M; Cho, M H; McDonald, M-L; Wan, E; Lomas, D A; Coxson, H O; MacNee, W; Vestbo, J; Yates, J C; Agusti, A; Calverley, P M A; Celli, B; Crim, C; Rennard, S; Wouters, E; Bakke, P; Bhatt, S P; Kim, V; Ramsdell, J; Regan, E A; Make, B J; Hokanson, J E; Crapo, J D; Beaty, T H; Hersh, C P

    2016-08-01

    Short-acting β2-agonist bronchodilators are the most common medications used in treating chronic obstructive pulmonary disease (COPD). Genetic variants determining bronchodilator responsiveness (BDR) in COPD have not been identified. We performed a genome-wide association study (GWAS) of BDR in 5789 current or former smokers with COPD in one African-American and four white populations. BDR was defined as the quantitative spirometric response to inhaled β2-agonists. We combined results in a meta-analysis. In the meta-analysis, single-nucleotide polymorphisms (SNPs) in the genes KCNK1 (P=2.02 × 10(-7)) and KCNJ2 (P=1.79 × 10(-7)) were the top associations with BDR. Among African Americans, SNPs in CDH13 were significantly associated with BDR (P=5.1 × 10(-9)). A nominal association with CDH13 was identified in a gene-based analysis in all subjects. We identified suggestive association with BDR among COPD subjects for variants near two potassium channel genes (KCNK1 and KCNJ2). SNPs in CDH13 were significantly associated with BDR in African Americans.The Pharmacogenomics Journal advance online publication, 27 October 2015; doi:10.1038/tpj.2015.65. PMID:26503814

  18. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD

    Directory of Open Access Journals (Sweden)

    Miravitlles M

    2016-02-01

    Full Text Available Marc Miravitlles,1 Jéssica Montero-Caballero,2 Frank Richard,2 Salud Santos,3 Juan Luis Garcia-Rivero,4 Francisco Ortega,5 Xavier Ribera61Pneumology Department, Hospital Universitari Vall d’Hebron, Ciber de Enfermedades Respiratorias (CIBERES, Barcelona, Spain; 2Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany; 3Pulmonology Department, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Ciber de Enfermedades Respiratorias (CIBERES, Barcelona, Spain; 4Pneumology Department, Hospital de Laredo, Cantabria, Spain; 5Pneumology Department, Hospital Virgen del Rocío, Sevilla, Spain; 6Boehringer Ingelheim Pharma GmbH & Co KG, Barcelona, Spain Abstract: Delivery of inhaled medications via an inhaler device underpins the effectiveness of treatment for patients with chronic obstructive pulmonary disease (COPD. Correct inhaler technique among patients is also a predictor of achieving treatment compliance and adherence. Reporting of patient satisfaction with inhalers is therefore gaining increasing attention and is now recognized as an important patient-reported outcome in clinical trials involving patients with COPD or asthma. In this cross-sectional study, we use the validated Patient Satisfaction and Preference Questionnaire (PASAPQ to assess the handling and satisfaction for Respimat® Soft Mist™ Inhaler (SMI compared with the Breezhaler® dry powder inhaler (DPI among patients with COPD in Spain. Patients were already assigned to therapy with either SPIRIVA® (tiotropium Respimat® or with Hirobriz®/Onbrez®/Oslif® (indacaterol Breezhaler® for at least 3 but not more than 6 months before completing the PASAPQ at a single visit to the study site. The primary endpoint of the trial was the mean total PASAPQ score. Secondary endpoints were the performance score domain of the PASAPQ, the convenience score domain of the PASAPQ, and the overall satisfaction score of the PASAPQ. For the primary endpoint, the mean PASAPQ

  19. NRPB volunteer study: deposition and clearance of inhaled particles

    International Nuclear Information System (INIS)

    At the Board Meeting of the National Radiological Protection Board held on 15 February 1996, approval was given for an experimental study of the deposition and clearance of inhaled particles in the human nasal passage. This is the latest in a series of volunteer biokinetic studies that have been conducted at NRPB since its formation. This article explains the purpose of the study, how ethical approval was obtained, how the study will be performed, what volunteers will be asked to do, and what doses they will receive. Doses will of course be carefully controlled, and will be well below the annual limits set for such experiments. The success of the study is of course crucially dependent on recruitment of a sufficient number of volunteers. The aim of this article is to provide information to anyone who might be interested in volunteering. (UK)

  20. Dry powder inhalation of antibiotics in cystic fibrosis therapy : Part 2. Inhalation of a novel colistin dry powder formulation: A feasibility study in healthy volunteers and patients

    NARCIS (Netherlands)

    Le Brun, P P H; de Boer, A H; Mannes, G P M; de Fraîture, D M I; Brimicombe, R W; Touw, Daan; Vinks, A A; Frijlink, H W; Heijerman, H G M

    2002-01-01

    The aim of the present study was to perform a proof of principle study with a new colistin dry powder inhalation system in six healthy volunteers and five patients with cystic fibrosis. All subjects were asked to inhale 25 mg colistin sulfate dry powder. The patients were also asked to nebulize 160

  1. Effects of Formoterol Inhaled Dry Powder on Exercise Performance in Chronic Obstructive Pulmonary Disease: A Single-Center, Randomized, Double-Blind, Placebo-Controlled, Crossover Study☆

    OpenAIRE

    Fuso, Leonello; Incalzi, Raffaele Antonelli; Basso, Salvatore; Spadaro, Salvatore; Tramaglino, Lorenzo M; Trové, Andrea; Boniello, Vincenzo; Pistelli, Riccardo

    2003-01-01

    Background: Inhaled bronchodilators commonly are used to reduce the work of breathing in patients with chronic obstructive pulmonary disease (COPD). The effects of bronchodilators are assessed in terms of symptom relief and/or improvements in spirometric indices. However, disability in COPD patients also is related to determinants such as exercise tolerance, which cannot be predicted on the basis of respiratory function. The effect of bronchodilators, such as inhaled beta2-agonists, on exerci...

  2. [Treatment of chronic inflammation of the upper respiratory airways by inhalation thermal therapy with sulfur-sulfate-bicarbonate- carbonate-alkaline earth mineral water: a study of nasal cytology].

    Science.gov (United States)

    Cristalli, G; Abramo, A; Pollastrini, L

    1996-12-01

    The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology. PMID:9381939

  3. Delayed effects of inhaled nitric acid aerosols in the rat: preliminary studies

    International Nuclear Information System (INIS)

    Rats that inhaled transuranic nitrate aerosols in a toxicology study were simultaneously exposed to aerosols of the suspending solution, nitric acid. Results indicated that exposure to nitric acid was associated with the finding of bone tumors. Other rats, exposed to low levels of inhaled Pu(NO3)4, showed one osteosarcoma in 79 rats examined

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

    Science.gov (United States)

    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...

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

    DEFF Research Database (Denmark)

    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...

  6. Inhaled Steroids

    Science.gov (United States)

    ... 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) ...

  7. Study of inhaler technique in asthma patients: differences between pediatric and adult patients

    Science.gov (United States)

    Manríquez, Pablo; Acuña, Ana María; Muñoz, Luis; Reyes, Alvaro

    2015-01-01

    Objective: Inhaler technique comprises a set of procedures for drug delivery to the respiratory system. The oral inhalation of medications is the first-line treatment for lung diseases. Using the proper inhaler technique ensures sufficient drug deposition in the distal airways, optimizing therapeutic effects and reducing side effects. The purposes of this study were to assess inhaler technique in pediatric and adult patients with asthma; to determine the most common errors in each group of patients; and to compare the results between the two groups. Methods: This was a descriptive cross-sectional study. Using a ten-step protocol, we assessed inhaler technique in 135 pediatric asthma patients and 128 adult asthma patients. Results: The most common error among the pediatric patients was failing to execute a 10-s breath-hold after inhalation, whereas the most common error among the adult patients was failing to exhale fully before using the inhaler. Conclusions: Pediatric asthma patients appear to perform most of the inhaler technique steps correctly. However, the same does not seem to be true for adult patients. PMID:26578130

  8. Genuair® in chronic obstructive pulmonary disease: a novel, user-friendly, multidose, dry-powder inhaler

    NARCIS (Netherlands)

    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

  9. Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Sørensen, T; Lange, Peter;

    1999-01-01

    . METHODS: We used a parallel-group, randomised, double-blind, placebo-controlled design in a singlecentre study, nested in a continuing epidemiological survey (the Copenhagen City Heart Study). Inclusion criteria were as follows: no asthma; a ratio of forced expiratory volume in 1 s (FEV1) and vital...... COPD patients recruited from the general population by screening. We question the role of long-term inhaled corticosteroids in the treatment of mild to moderate COPD....

  10. Inhalation developmental toxicology studies: Gallium arsenide in mice and rats

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Greenspan, B.J.; Dill, J.A.; Stoney, K.H.; Evanoff, J.J.; Rommereim, R.L.

    1990-12-01

    Gallium arsenide is a crystalline compound used extensively in the semiconductor industry. Workers preparing solar cells and gallium arsenide ingots and wafers are potentially at risk from the inhalation of gallium arsenide dust. The potential for gallium arsenide to cause developmental toxicity was assessed in Sprague- Dawley rats and CD-1 (Swiss) mice exposed to 0, 10, 37, or 75 mg/m{sup 3} gallium arsenide, 6 h/day, 7 days/week. Each of the four treatment groups consisted of 10 virgin females (for comparison), and {approx}30 positively mated rats or {approx}24 positively mated mice. Mice were exposed on 4--17 days of gestation (dg), and rats on 4--19 dg. The day of plug or sperm detection was designated as 0 dg. Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice (rats, 20 dg; mice, 18 dg). Implants were enumerated and their status recorded. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. Gallium and arsenic concentrations were determined in the maternal blood and uterine contents of the rats (3/group) at 7, 14, and 20 dg. 37 refs., 11 figs., 30 tabs.

  11. 吸入性损伤的研究进展%Advancement in study of inhalation injury

    Institute of Scientific and Technical Information of China (English)

    杨宗城

    2008-01-01

    Inhalation injury is a major contributor to the morbidity and mortality associated with serious burns. The improvement in the understanding of smoke inhalation injury had been obtained in the last half century in China. The models of steam and smoke inhalation injury had been reproduced and a series of experimental studies had been performed .It was found that chemical bronchotracheitis, pulmonary edema and alveolar collapse(atelectasis) were the primary pathologic findings after inhalation injury. The second inflammatory response would play an important role in the development of acute respiratory failure. The roles of some cytokines, inflammatory cells and pulmonary surfactants in the development of inhalation injury had been elucidated. The etologic factors and the pathophysiologic changes in inhalation injury had been illustrated clearly. These basic science investigations had led to the advances in protective strategies for the complications of inhalation injury. Now the morbidity and mortality of inhalation injury have decreased markedly in China.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Rodriguez-Roisin R

    2016-08-01

    Full Text Available Roberto Rodriguez-Roisin,1 Kay Tetzlaff,2,3 Henrik Watz,4 Emiel FM Wouters,5 Bernd Disse,2 Helen Finnigan,6 Helgo Magnussen,4 Peter MA Calverley7 1Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Barcelona, Spain; 2Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 3Department of Sports Medicine, University of Tübingen, Tübingen, Germany; 4Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; 5Department of Respiratory Medicine, University Hospital Maastricht, Maastricht University, Maastricht, the Netherlands; 6Department of Biostatistics and Data Sciences, Boehringer Ingelheim, Bracknell, UK; 7Institute of Ageing and Chronic Disease, Aintree University Hospital, Liverpool, UK Abstract: The WISDOM study (NCT00975195 reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume

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

    Science.gov (United States)

    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

  15. Long-term dose-response studies of inhaled or injected radionuclides

    International Nuclear Information System (INIS)

    This report describes the scientific progress in, and current status of, life-span studies of the long-term health risks in Beagle dogs of chronic irradiation from internally deposited radionuclides or from an external source. The reporting period for this document is the 2-year period from October 1, 1991 through September 30, 1993. Studies that were initiated at three different laboratories (Inhalation Toxicology Research Institute, ITRI, University of Utah, and Argonne National Laboratory, ANL) are presented here because they are being completed at ITRI. All living dogs in the Utah-initiated studies were transferred to the ITRI facility for the remainder of their life-span observations and measurements in September 1987. This report is the fourth in a series of reports dealing with the current status and progress of both the Utah and ITRI studies. Other life-span studies involving dogs exposed to gamma radiation from an external source were initiated and conducted for many years at ANL. In 1991, the decision was made to discontinue the chronic irradiation of the remaining living dogs and to transfer all remaining dogs to ITRI for care, clinical observations, and pathological observations at death or euthanasia. This report provides the current status of these dogs. Status reports on the Utah and ITRI studies comprise most of this report. The ITRI-related section presents brief statements of project objectives, the general procedures used in these studies, and some study-specific features for each of the 19 studies being conducted with either beta- or alpha-emitting radionuclides. Dose- and effect-modifying factors being addressed in these studies include total dose, dose rate, LET, solubility, nonuniformity of dose, species, age, sex, health status, and mode of exposure. Recent additions to experimental protocols for studies in which dogs are still alive involve the collection and analysis of tumor tissues using currently available molecular biology techniques

  16. The bronchodilator response from inhaled terbutaline is influenced by the mass of small particles: a study on a dry powder inhaler (Turbuhaler).

    Science.gov (United States)

    Persson, G; Wirén, J E

    1989-03-01

    This study was carried out to investigate if particles approximately less than 5 microns are optimal when delivered from a dry powder inhaler. It was performed as a cumulative dose response study of twelve asthmatic adults. Three different versions of a dry powder inhaler, Bricanyl Turbuhaler, were studied. Each inhaler delivered 0.5 mg of pure terbutaline sulphate with each dose. Out of this 0.5 mg, they delivered 90 micrograms, 40 micrograms and 5 micrograms, respectively, of particles approximately less than 5 microns with each dose at an inspiratory flow rate of 28 l.min-1. Terbutaline 0.5 mg, 0.5 mg, 1.0 mg and 2.0 mg was inhaled with a 30 min interval between the doses. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured 5 and 20 min after each dose. The bronchodilator response was greater with the inhaler delivering 90 micrograms of small particles with each dose than with the inhaler delivering 5 micrograms, thus confirming the importance of small (approximately less than 5 microns) particles. PMID:2731603

  17. Bronchoscopy-derived correlates of lung injury following inhalational injuries: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Samuel W Jones

    Full Text Available BACKGROUND: Acute lung injury (ALI is a major factor determining morbidity following burns and inhalational injury. In experimental models, factors potentially contributing to ALI risk include inhalation of toxins directly causing cell damage; inflammation; and infection. However, few studies have been done in humans. METHODS: We carried out a prospective observational study of patients admitted to the NC Jaycees Burn Center who were intubated and on mechanical ventilation for burns and suspected inhalational injury. Subjects were enrolled over an 8-month period and followed till discharge or death. Serial bronchial washings from clinically-indicated bronchoscopies were collected and analyzed for markers of cell injury and inflammation. These markers were compared with clinical markers of ALI. RESULTS: Forty-three consecutive patients were studied, with a spectrum of burn and inhalation injury severity. Visible soot at initial bronchoscopy and gram negative bacteria in the lower respiratory tract were associated with ALI in univariate analyses. Subsequent multivariate analysis also controlled for % body surface area burns, infection, and inhalation severity. Elevated IL-10 and reduced IL-12p70 in bronchial washings were statistically significantly associated with ALI. CONCLUSIONS: Independently of several factors including initial inhalational injury severity, infection, and extent of surface burns, high early levels of IL-10 and low levels of IL-12p70 in the central airways are associated with ALI in patients intubated after acute burn/inhalation injury. Lower airway secretions can be collected serially in critically ill burn/inhalation injury patients and may yield important clues to specific pathophysiologic pathways.

  18. Achieving therapeutic benefits of inhaled corticosteroids/beta2 agonist in chronic obstructive airway disease

    Institute of Scientific and Technical Information of China (English)

    WANG Zeng-li

    2007-01-01

    @@ Asthma and chronic obstructive pulmonary disease (COPD) are the two commonest causes of adult airflow obstruction. The fundamental differences and similarities between the pathological mechanisms of asthma and COPD are well recognized.1

  19. Perfusion, inhalation, and ventilation studies in patients with primary lung carcinoma

    International Nuclear Information System (INIS)

    To determine the relative roles of perfusion, inhalation, and ventilation lung scintigraphy, studies were done respectively in 48, 50, and 34 of 54 primary lung carcinoma patients (prior to thoracotomy and subsequent radical tumor resection). We observed the relationships between both the size of perfusion, inhalation, and ventilation defects observed scintigraphically, and the size of the mass lesion seen radiologically. We also estimated the correlation between those scintigraphic classifications and pTN. Although inhalation and perfusion images exhibited similar patterns, in hilar type lung carcinoma patients, the inhalation study showed superior mass lesion delineation. In peripheral type lung carcinoma, however, the incidence of negative inhalation defect (52%) differed significantly from that of negative perfusion defect (21%)(p<0.05). Xe-133 gas ventilation has limitations but is occasionally helpful in detecting obstructive airway disease. The coexistence ratio of COPD in lung carcinoma patients showed no significant difference from that of COPD in the controls. Perfusion and inhalation classification did not correlate with pTN factor. (author)

  20. Inhalation toxicity and carcinogenicity studies of cobalt sulfate.

    Science.gov (United States)

    Bucher, J R; Hailey, J R; Roycroft, J R; Haseman, J K; Sills, R C; Grumbein, S L; Mellick, P W; Chou, B J

    1999-05-01

    Cobalt sulfate is a water-soluble cobalt salt with a variety of industrial and agricultural uses. Several cobalt compounds have induced sarcomas at injection sites in animals, and reports have suggested that exposure to cobalt-containing materials may cause lung cancer in humans. The present studies were done because no adequate rodent carcinogenicity studies had been performed with a soluble cobalt salt using a route relevant to occupational exposures. Groups of 50 male and 50 female F344/N rats and B6C3F1 mice were exposed to aerosols containing 0, 0.3, 1.0, or 3.0 mg/m3 cobalt sulfate hexahydrate, 6 h/day, 5 days/week, for 104 weeks. Survival and body weights of exposed rats and mice were generally unaffected by the exposures. In rats, proteinosis, alveolar epithelial metaplasia, granulomatous alveolar inflammation, and interstitial fibrosis were observed in the lung in all exposed groups. Nonneoplastic lesions of the nose and larynx were also attributed to exposure to all concentrations of cobalt sulfate. In 3.0 mg/m3 male rats and in female rats exposed to 1.0 or 3.0 mg/m3, the incidences of alveolar/bronchiolar neoplasms were increased over those in the control groups. Lung tumors occurred with significant positive trends in both sexes. The incidences of adrenal pheochromocytoma in 1.0 mg/m3 male rats and in 3.0 mg/m3 female rats were increased. Nonneoplastic lesions of the respiratory tract were less severe in mice than in rats. In mice, alveolar/bronchiolar neoplasms in 3.0 mg/m3 males and females were greater than those in the controls, and lung tumors occurred with significantly positive trends. Male mice had liver lesions consistent with a Helicobacter hepaticus infection. Incidences of liver hemangiosarcomas were increased in exposed groups of male mice; however, because of the infection, no conclusion could be reached concerning an association between liver hemangiosarcomas and cobalt sulfate. In summary, exposure to cobalt sulfate by inhalation

  1. Efficacy and safety of eco-friendly inhalers: focus on combination ipratropium bromide and albuterol in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Panos RJ

    2013-04-01

    Full Text Available Ralph J Panos1,2 1Pulmonary, Critical Care, and Sleep Medicine Division, Cincinnati Veterans Affairs Medical Center, 2Pulmonary, Critical Care, and Sleep Medicine Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA Background: Chronic obstructive pulmonary disease (COPD is a major cause of morbidity and mortality and its treatment is critical to improve quality of life, reduce symptoms, and diminish the frequency of COPD exacerbations. Due to the harmful environmental effects of pressurized metered-dose inhalers (pMDIs containing chlorofluorocarbons (CFCs, newer systems for delivering respiratory medications have been developed. Methods: A search of the literature in the PubMed database was undertaken using the keywords “COPD,” “albuterol,” “ipratropium bromide,” and “Respimat® Soft Mist Inhaler™”; pertinent references within the identified citations were included. The environmental effect of CFC-pMDIs, the invention of the Respimat® Soft Mist Inhaler™ (SMI (Boehringer Ingelheim, Ingelheim, Germany, and its use to deliver the combination of albuterol and ipratropium bromide for the treatment of COPD were reviewed. Results: The adverse environmental effects of CFC-pMDIs stimulated the invention of novel delivery systems including the Respimat SMI. This review presents its development, internal mechanism, and use to deliver the combination of albuterol and ipratropium bromide. Conclusion: CFC-pMDIs contributed to the depletion of the ozone layer and the surge in disorders caused by harmful ultraviolet B radiation. The banning of CFCs spurred the development of novel delivery systems for respiratory medications. The Respimat SMI is an innovative device that produces a vapor of inhalable droplets with reduced velocity and prolonged aerosol duration that enhance deposition within the lower airway and is associated with improved patient satisfaction. Clinical trials have demonstrated that the Respimat SMI

  2. Arformoterol Oral Inhalation

    Science.gov (United States)

    ... 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 ...

  3. Inhalation Injury

    Directory of Open Access Journals (Sweden)

    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

  4. No relevant cardiac, pharmacokinetic or safety interactions between roflumilast and inhaled formoterol in healthy subjects: an open-label, randomised, actively controlled study

    OpenAIRE

    de Mey, Christian; Nassr, Nassr; Lahu, Gezim

    2011-01-01

    Background Roflumilast is an oral, selective phosphodiesterase 4 inhibitor with anti-inflammatory effects in chronic obstructive pulmonary disease (COPD). The addition of roflumilast to long-acting bronchodilators improves lung function in patients with moderate-to-severe COPD. The present study investigated drug-drug interaction effects between inhaled formoterol and oral roflumilast. Methods This was a single-centre (investigational clinic), open, randomised, multiple-dose, parallel-group s...

  5. Regulatory aspects of Phase 3 endpoints for new inhaled antibiotics for cystic fibrosis patients with chronic Pseudomonas aeruginosa infections.

    Science.gov (United States)

    Montgomery, Alan Bruce; Abuan, Tammy; Yeager, Melissa A

    2012-08-01

    Available regulatory guidelines for developing inhaled anti-infective therapies offer general advice, but specific guidance often provides conflicting and outdated advice in regard to clinical trial design. For instance, the availability of two approved drugs makes the conduct of placebo-controlled trials longer than 28 days problematic. Comparator drugs require use per the product label, making comparator trials difficult to blind as taste, foaming, regimen, device, and delivery time differences are present. Currently, there is no consensus on the most appropriate endpoints for evaluation of aerosolized antimicrobials. FEV(1) is a surrogate endpoint that it is a predictor of mortality--it is standardized, reproducible, noninvasive, simple, and inexpensive to perform but small statistically significant changes may not be clinically important. FEV(1) improvement also has a ceiling effect in patients with mild lung function impairment and spirometry cannot be reliably done in patients under the age of 6 years. A patient-reported outcome is a promising clinical endpoint. However, there is not currently an accepted tool that can be used as a primary endpoint for the FDA or the EMA, although the latter recognizes the CFQ-R as a validated secondary endpoint and the FDA grandfathered acceptance of the CFQ-R respiratory domain in the pivotal aztreonam for inhalation study. Exacerbations are an important clinical endpoint that reflects morbidity and are a major driver of cost of care, but they occur infrequently and a standardized definition has not been reached. Furthermore, an exacerbation endpoint may fail even with an otherwise effective antibiotic therapy. Regulatory authorities will have a difficult time approving any new inhaled antibiotic based on one clinical endpoint alone. PMID:22857271

  6. Sub-chronic inhalation of high concentrations of manganese sulfate induces lower airway pathology in rhesus monkeys

    Directory of Open Access Journals (Sweden)

    Wong Brian A

    2005-10-01

    Full Text Available Abstract Background Neurotoxicity and pulmonary dysfunction are well-recognized problems associated with prolonged human exposure to high concentrations of airborne manganese. Surprisingly, histological characterization of pulmonary responses induced by manganese remains incomplete. The primary objective of this study was to characterize histologic changes in the monkey respiratory tract following manganese inhalation. Methods Subchronic (6 hr/day, 5 days/week inhalation exposure of young male rhesus monkeys to manganese sulfate was performed. One cohort of monkeys (n = 4–6 animals/exposure concentration was exposed to air or manganese sulfate at 0.06, 0.3, or 1.5 mg Mn/m3 for 65 exposure days. Another eight monkeys were exposed to manganese sulfate at 1.5 mg Mn/m3 for 65 exposure days and held for 45 or 90 days before evaluation. A second cohort (n = 4 monkeys per time point was exposed to manganese sulfate at 1.5 mg Mn/m3 and evaluated after 15 or 33 exposure days. Evaluations included measurement of lung manganese concentrations and evaluation of respiratory histologic changes. Tissue manganese concentrations were compared for the exposure and control groups by tests for homogeneity of variance, analysis of variance, followed by Dunnett's multiple comparison. Histopathological findings were evaluated using a Pearson's Chi-Square test. Results Animals exposed to manganese sulfate at ≥0.3 mg Mn/m3 for 65 days had increased lung manganese concentrations. Exposure to manganese sulfate at 1.5 mg Mn/m3 for ≥15 exposure days resulted in increased lung manganese concentrations, mild subacute bronchiolitis, alveolar duct inflammation, and proliferation of bronchus-associated lymphoid tissue. Bronchiolitis and alveolar duct inflammatory changes were absent 45 days post-exposure, suggesting that these lesions are reversible upon cessation of subchronic high-dose manganese exposure. Conclusion High-dose subchronic manganese sulfate inhalation is

  7. The technology of metered-dose inhalers and treatment costs in asthma: a retrospective study of breath actuation versus traditional press-and-breathe inhalers.

    Science.gov (United States)

    Langley, P C

    1999-01-01

    This paper reviews the impact of the use of technologically dissimilar beta-agonist aerosols--the Maxair Autohaler (pirbuterol acetate) breath-actuated aerosol and the traditional albuterol press-and-breathe inhaler-on the treatment costs of asthma. If, as clinical evidence would suggest, the breath-actuated aerosol is not only as effective as an albuterol inhaler with a spacer, but is easier to use and results in more optimal beta-agonist use by patients, then one might consider the hypothesis that patients possessing a breath-actuated inhaler would, ceteris paribus, experience lower asthma-related treatment costs-principally, those medical costs associated with fewer emergency room visits and hospitalizations. This hypothesis is considered from the perspective of a retrospective claims database study of patients who used one or the other beta-agonist inhaler exclusively. At the descriptive level, costs of treatment for patients using the press-and-breathe inhaler are estimated to be 16.5% greater than costs for patients using the breath-actuated inhaler. In the multivariate analysis, the presence of the breath-actuated inhaler (in a dummy variable analysis) was not only statistically significant (P < 0.05), but entered with the expected negative sign. Estimated cost impacts under various model specifications are consistent with the magnitude of the cost differences reported in the descriptive analysis. Total cost savings with the Maxair Autohaler ranged from 8.7% to 11.7%, with medical cost savings estimated at 14.6%. PMID:10090438

  8. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  9. Challenges with current inhaled treatments for chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis.

    LENUS (Irish Health Repository)

    Greally, Peter

    2012-06-01

    Pseudomonas aeruginosa (Pa) is the predominant pathogen infecting the airways of patients with cystic fibrosis (CF). Initial colonization is usually transient and associated with non-mucoid strains, which can be eradicated if identified early. This strategy can prevent, or at least delay, chronic Pa infection, which eventually develops in the majority of patients by their late teens or early adulthood. This article discusses the management and latest treatment developments of Pa lung infection in patients with CF, with a focus on nebulized antibiotic therapy.

  10. Dose-effect studies with inhaled plutonium oxide in beagles

    International Nuclear Information System (INIS)

    Beagle dogs given single exposure to 239PuO2 or 238PuO2 aerosols are being observed for life-span dose-effect relationships. The 239Pu body burden of the nine dogs dying due to pulmonary fibrosis-induced insufficiency during the first 3 years after exposure was 1 to 12 μCi. One of these dogs had a pulmonary tumor. Three additional dogs with body burdens of 0.7 to 1.8 μCi died due to pulmonary neoplasia 4-1/2 years after exposure. None of the dogs exposed to 238Pu have died during the first two postexposure years. After inhalation of 239PuO2 or 238PuO2 lymphocytopenia was the earliest observed effect, occuring 0.5 to 2 years after deposition of greater than or equal to 80 nCi plutonium in the lungs

  11. [Advances in the experimental study of the use of mesenchy- mal stem cells for the treatment of inhalation injury].

    Science.gov (United States)

    Feng, Zhu; Guanghua, Guo

    2015-06-01

    Inhalation injury seriously threatens the survival and quality of life in burn and trauma patients. So far there is no breakthrough in the treatment of inhalation injury. A significant advance has been witnessed in the experimental study of the use of stem cells in the treatment of lung injury in recent years. In this paper, according to the results of our study in the systemic transplantation of bone marrow mesenchymal stem cells for the treatment of inhalation injury, the effect of mesenchymal stem cells on anti-inflammatory process and repair of lung tissues in inhalation injury, and its possible mechanisms are reviewed.

  12. Intermittent Oxygen Inhalation with Proper Frequency Improves Overall Health Conditions and Alleviates Symptoms in a Population at High Risk of Chronic Mountain Sickness with Severe Symptoms

    Institute of Scientific and Technical Information of China (English)

    Bin Feng; Wei-Hao Xu; Yu-Qi Gao; Fu-Yu Liu; Peng Li; Shan-Jun Zheng; Lu-Yue Gai

    2016-01-01

    Background:Oxygen inhalation therapy is essential for the treatment of patients with chronic mountain sickness (CMS),but the efficacy of oxygen inhalation for populations at high risk of CMS remains unknown.This research investigated whether oxygen inhalation therapy benefits populations at high risk of CMS.Methods:A total of 296 local residents living at an altitude of 3658 m were included;of which these were 25 diagnosed cases of CMS,8 cases dropped out of the study,and 263 cases were included in the analysis.The subjects were divided into high-risk (180 ≤ hemoglobin (Hb) <210 g/L,n =161) and low-risk (Hb <180 g/L,n =102) groups,and the cases in each group were divided into severe symptom (CMS score ≥6) and mild symptom (CMS score 0-5) subgroups.Severe symptomatic population of either high-or low-risk CMS was randomly assigned to no oxygen intake group (A group) or oxygen intake 7 times/week group (D group);mild symptomatic population of either high-or low-risk CMS was randomly assigned to no oxygen intake group (A group),oxygen intake 2 times/week group (B group),and 4 times/week group (C group).The courses for oxygen intake were all 30 days.The CMS symptoms,sleep quality,physiological biomarkers,biochemical markers,etc.,were recorded on the day before oxygen intake,on the 15th and 30th days of oxygen intake,and on the 15th day after terminating oxygen intake therapy.Results:A total of 263 residents were finally included in the analysis.Among these high-altitude residents,CMS symptom scores decreased for oxygen inhalation methods B,C,and D at 15 and 30 days after oxygen intake and 15 days after termination,including dyspnea,palpitation,and headache index,compared to those before oxygen intake (B group:Z =5.604,5.092,5.741;C group:Z =4.155,4.068,4.809;D group:Z =6.021,6.196,5.331,at the 3 time points respectively;all P < 0.05/3 vs.before intake).However,dyspnea/palpitation (A group:Z =5.003,5.428,5.493,both P < 0.05/3 vs.before intake) and headache (A

  13. Deposition-based passive monitors for assigning radon, thoron inhalation doses for epidemiological studies

    International Nuclear Information System (INIS)

    The International Commission on Radiological Protection dose limits for radiation protection have been based on linearly extrapolating the high-dose risk coefficients obtained from the Japanese A bomb survivor data to low doses. The validity of these extrapolations has been questioned from time to time. To overcome this, epidemiological studies have been undertaken across the world on populations chronically exposed to low-radiation levels. In the past decade, the results of these studies have yielded widely differing, and sometimes, contradictory, conclusions. While recent residential radon studies have shown statistically significant radon risks at low doses, high-level natural radiation (HLNR) studies in China and India have not shown any low-dose risks. Similar is the case of a congenital malformation study conducted among the HLNR area populations in Kerala (India)). It is thus necessary to make efforts at overcoming the uncertainties in epidemiological studies. In the context of HLNR studies, assigning radon and thoron doses has largely been an area of considerable uncertainty. Conventionally, dosimetry is carried out using radon concentration measurements, and doses have been assigned using assumed equilibrium factors for the progeny species. Gas-based dose assignment is somewhat inadequate due to variations in equilibrium factors and possibly due to significant thoron. In this context, passive, deposition-based progeny dosimetry appears to be a promising alternative method to assess inhalation doses directly. It has been deployed in various parts of India, including HBRAs and countries in Europe. This presentation discusses the method, the results obtained and their relevance to dose assignment in Indian epidemiological studies. (authors)

  14. Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD

    Directory of Open Access Journals (Sweden)

    Price D

    2011-04-01

    Full Text Available David Price1,2 John Haughney1, Erika Sims2, Muzammil Ali2, Julie von Ziegenweidt2, Elizabeth V Hillyer2, Amanda J Lee3, Alison Chisholm2, Neil Barnes41Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life Ltd, Cawston, Norwich, UK; 3Section of Population Health, University of Aberdeen, UK; 4Department of Respiratory Medicine, London Chest Hospital, Barts and The London NHS Trust, London, UKPurpose: Results of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI, breath-actuated MDI (BAI, and dry powder inhaler (DPI.Patients and methods: This retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5–60 years prescribed their first ICS (initiation population by pMDI (n = 39,746, BAI (n = 9809, or DPI (n = 6792, or their first ICS dose increase (step-up population by pMDI (n = 6245, BAI (n = 1388, or DPI (n = 1536. Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids. Outcomes were adjusted for potential confounding factors identified during a baseline year.Results: In the initiation population, adjusted odds ratios (95% confidence intervals [CI] for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02–1.14] and DPIs (1.13 [1.06–1.21], while adjusted exacerbation rate ratios (95% CI were 1.00 (0.93–1.08 and 0.88 (0.81–0.95, respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05–1.39 for

  15. Inhaled corticosteroid use in patients with chronic obstructive pulmonary disease and the risk of pneumonia: a retrospective claims data analysis

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-06-01

    Full Text Available Barbara P Yawn,1 Yunfeng Li,2 Haijun Tian,2 Jie Zhang,2 Steve Arcona,2 Kristijan H Kahler2 1Department of Research, Olmsted Medical Center, Rochester, MN, USA; 2Department of Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA Background: The use of inhaled corticosteroids in patients with chronic obstructive pulmonary disease (COPD has been associated with an increased risk of pneumonia in controlled clinical trials and case-control analyses. Objective: Using claims databases as a research model of real-world diagnosis and treatment, to determine if the use and dose of inhaled corticosteroids (ICS among patients with newly diagnosed COPD are associated with increased risk of pneumonia. Patients and methods: This was a retrospective cohort analysis of patients diagnosed with COPD between January 01, 2006 and September 30, 2010, drawn from databases (years 2006–2010. Patients (aged ≥45 years were followed until first pneumonia diagnosis, end of benefit enrollment, or December 31, 2010, whichever was earliest. A Cox proportional hazard model was used to assess the association of ICS use and risk of pneumonia, controlling for baseline characteristics. Daily ICS use was classified into low, medium, and high doses (1 µg–499 µg, 500 µg–999 µg, and ≥1000 µg fluticasone equivalents daily and was modeled as a time-dependent variable. Results: Among 135,445 qualifying patients with a total of 243,097 person-years, there were 1020 pneumonia incidences out of 5677 person-years on ICS (crude incidence rate, 0.180 per person-year, and 27,730 pneumonia incidences out of 237,420 person-years not on ICS (crude incidence rate, 0.117 per person-year. ICS use was associated with a dose-related increase in risk of pneumonia, with adjusted hazard ratios (versus no use; (95% confidence interval of 1.38 (1.27–1.49 for low-dose users, 1.69 (1.52–1.88 for medium-dose users, and 2.57 (1.98–3.33 for high

  16. Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study

    DEFF Research Database (Denmark)

    Sverrild, Asger; Porsbjerg, Celeste; Thomsen, Simon Francis;

    2009-01-01

    BACKGROUND: A new indirect bronchial provocation test measuring airway responsiveness by using inhaled mannitol was recently introduced. OBJECTIVE: The aim of this study was to examine the diagnostic properties of airway responsiveness to inhaled mannitol in the assessment of asthma...... operating characteristic curve was constructed, and the accuracy of the test, defined as the area under the curve, was computed. RESULTS: Fifty-one (21.4%) subjects had current asthma. Of 33 subjects with airway hyperresponsiveness to mannitol, 30 had current asthma. The specificity and sensitivity were 98...... in an unselected sample of young adults. METHODS: Two hundred thirty-eight young adults randomly drawn from the nationwide civil registration list were challenged with inhaled, dry-powder mannitol. A respiratory specialist, blind to the test results, classified all 238 subjects with respect to the presence...

  17. Inhalant Dependence and its Medical Consequences

    Directory of Open Access Journals (Sweden)

    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

  18. Asthma control in patients receiving inhaled corticosteroid and long-acting beta2-agonist fixed combinations. A real-life study comparing dry powder inhalers and a pressurized metered dose inhaler extrafine formulation

    Directory of Open Access Journals (Sweden)

    Nicolini Gabriele

    2011-07-01

    Full Text Available Abstract Background Although patients have more problems using metered dose inhalers, clinical comparisons suggest they provide similar control to dry powder inhalers. Using real-life situations this study was designed to evaluate asthma control in outpatients with moderate to severe persistent asthma and to compare efficacy of fixed combinations of inhaled corticosteroids (ICS and long acting beta-agonists (LABA. Methods This real-life study had a cross-sectional design. Patients using fixed combinations of ICS and LABA had their asthma control and spirometry assessed during regular visits. Results 111 patients were analyzed: 53 (47.7% received maintenance therapy of extrafine beclomethasone-formoterol (BDP/F pressurized metered dose inhaler (pMDI, 25 (22.5% fluticasone-salmeterol (FP/S dry powder inhaler (DPI, and 33 (29.7% budesonide-formoterol (BUD/F DPI. Severity of asthma at time of diagnosis, assessed by the treating physician, was comparable among groups. Asthma control was achieved by 45.9% of patients; 38.7% were partially controlled and 15.3% were uncontrolled. In the extrafine BDF/F group, asthma control total score, daytime symptom score and rescue medication use score were significantly better than those using fixed DPI combinations (5.8 ± 6.2 vs. 8.5 ± 6.8; 1.4 ± 1.8 vs. 2.3 ± 2.1; 1.8 ± 2.2 vs. 2.6 ± 2.2; p = 0.0160; p = 0.012 and p = 0.025, respectively and the mean daily ICS dose were significantly lower. Conclusions pMDI extrafine BDP/F combination demonstrated better asthma control compared to DPIs formulated with larger particles. This could be due to the improved lung deposition of the dose or less reliance on the optimal inhalation technique or both.

  19. Dose-effect studies with inhaled plutonium oxide in beagles

    International Nuclear Information System (INIS)

    Beagle dogs given a single exposure to 239PuO2 and 238PuO2 aerosols are being observed for life-span 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 12 μCi. One of these dogs had a pulmonary tumor; nine additional dogs with body burdens of 0.6 to 1.8 μCi died due to pulmonary neoplasia 3 to 6 yr after exposure. Two of the dogs exposed to 238Pu have died during the first 4 yr postexposure, due to bone and lung tumors, with body burdens at death of 10 μCi. Lymphocytopenia was the earliest observed effect after inhalation of 239PuO2 or 238PuO2, occurring 0.5 to 2 yr after deposition of equal to or greater than 80 nCi plutonium in the lungs

  20. Dose-effect studies with inhaled plutonium oxide in beagles

    International Nuclear Information System (INIS)

    Beagle dogs given a single exposure to 239PuO2 and 238PuO2 aerosols are being observed for life-span dose-effect relationships. The 239Pu body burden of the nine dogs that dies of pulmonary fibrosis-induced respiratory insufficiency during the first 3 yr after exposure was 1 to 12 μCi; one of these dogs had a pulmonary tumor. Eleven additional dogs with body burdens of 0.6 to 1.8 μCi died due to pulmonary neoplasia 3 to 7 yr after exposure. Four of the dogs exposed to 238Pu have died during the first 4 1/2 yr postexposure due to bone and/or lung tumors; the body burden at death ranged from 6 to 10 μCi. Lymphopenia was the earliest observed effect after inhalation of 239PuO2 or 238PuO2, occurring 0.5 to 2 yr after deposition of greater than or equal to 80 nCi plutonium in the lungs

  1. Dose-effect studies with inhaled plutonium oxide in beagles

    International Nuclear Information System (INIS)

    Beagle dogs given a single exposure to 239PuO2 and 238PuO2 aerosols are being observed for life-span 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 12 μCi; one of these dogs had a pulmonary tumor. Seventeen additional dogs, with body burdens of 0.2 to 1.8 μCi, died due to pulmonary neoplasia 3 to 8 yr after exposure. Ten of the dogs exposed to 238Pu have died during the first 5 1/2 yr postexposure due to bone and/or lung tumors; the body burden at death ranged from 1.5 to 10 μCi. Lymphopenia was the earliest observed effect after inhalation of 239PuO2 or 238PuO2, occurring 0.5 to 2 yr after deposition of >80 nCi plutonium in the lungs

  2. Synthesis and evaluation of inhaled [11C]butane and intravenously injected [11C]acetone as potential radiotracers for studying inhalant abuse.

    Science.gov (United States)

    Gerasimov, Madina R; Ferrieri, Richard A; Pareto, Deborah; Logan, Jean; Alexoff, David; Ding, Yu-Shin

    2005-02-01

    The phenomenon of inhalant abuse is a growing problem in the US and many countries around the world. Yet, relatively little is known about the pharmacokinetic properties of inhalants that underlie their abuse potential. While the synthesis of 11C-labeled toluene, acetone and butane has been proposed in the literature, none of these compounds has been developed as radiotracers for PET studies. In the present report we extend our previous studies with [11C]toluene to include [11C]acetone and [11C]butane with the goal of comparing the pharmacokinetic profiles of these three volatile abused substances. Both [11C]toluene and [11C]acetone were administered intravenously and [11C]butane was administered via inhalation to anesthesized baboons. Rapid and efficient uptake of radiolabeled toluene and acetone into the brain was followed by fast clearance in the case of toluene and slower kinetics in the case of acetone. [11C]Butane was detected in the blood and brain following inhalation, but the levels of radioactivity in both tissues dropped to half of the maximal values over the period of less than a minute. To our knowledge, this is the first reported study of the in vivo brain pharmacokinetics of labeled acetone and butane in nonhuman primates. These data provide insight into the pharmacokinetic features possibly associated with the abuse liability of toluene, acetone and butane.

  3. Synthesis and evaluation of inhaled [11C]butane and intravenously injected [11C]acetone as potential radiotracers for studying inhalant abuse

    International Nuclear Information System (INIS)

    The phenomenon of inhalant abuse is a growing problem in the US and many countries around the world. Yet, relatively little is known about the pharmacokinetic properties of inhalants that underlie their abuse potential. While the synthesis of 11C-labeled toluene, acetone and butane has been proposed in the literature, none of these compounds has been developed as radiotracers for PET studies. In the present report we extend our previous studies with [11C]toluene to include [11C]acetone and [11C]butane with the goal of comparing the pharmacokinetic profiles of these three volatile abused substances. Both [11C]toluene and [11C]acetone were administered intravenously and [11C]butane was administered via inhalation to anesthesized baboons. Rapid and efficient uptake of radiolabeled toluene and acetone into the brain was followed by fast clearance in the case of toluene and slower kinetics in the case of acetone. [11C]Butane was detected in the blood and brain following inhalation, but the levels of radioactivity in both tissues dropped to half of the maximal values over the period of less than a minute. To our knowledge, this is the first reported study of the in vivo brain pharmacokinetics of labeled acetone and butane in nonhuman primates. These data provide insight into the pharmacokinetic features possibly associated with the abuse liability of toluene, acetone and butane

  4. Evidence for the efficacy of aztreonam for inhalation solution in the management of Pseudomonas aeruginosa in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Hansen, Christine; Skov, Marianne

    2015-01-01

    Chronic airway infection in cystic fibrosis (CF) is a main cause of the increased morbidity and mortality found with this disease. The most common cause of Gram-negative infection is Pseudomonas aeruginosa. The introduction of inhaled antibiotics has changed the lives of affected patients...... and the clinical outcome of this infection; this article focuses on the use of inhaled antibiotics in chronic P. aeruginosa infection in CF, and specifically on studies including the use of inhaled aztreonam lysine in P. aeruginosa infection. Studies were identified using PubMed and ClinicalTrials.gov, searching...... for 'inhaled aztreonam' and 'cystic fibrosis'. Inhaled aztreonam is an important new treatment option for chronic P. aeruginosa infection in CF. Long-term studies have shown that the drug is safe and superior to inhaled tobramycin in these specific infections....

  5. A dynamic study of the mechanism of expectoration by coughing using aerosol inhalation cine-scintigraphy

    International Nuclear Information System (INIS)

    The mechanism of expectoration by coughing was studied using aerosol inhalation cine-scintigraphy which enables us to visualize the movements of inhaled aerosol in the airway of patients. The aerosol bolus (bolus) movements by coughing were observed in 26 cases, the analysis of which led to the following results. First, bolus movements of aerosol by coughing were classified into three groups: group 1, expectoration; group 2, cephalad movements that stopped halfway; and group 3, regurgitation. Expectoration by coughing was more effective when the bolus was in the distal part of the trachea. Patients with obstructive pulmonary disease had lower efficiency of expectoration by coughing. Second, a certain amount of mucus was required to generate coughing and expectoration. The bolus movements by intentional coughing were observed in 5 cases which suggests that abundant mechanical cough receptors existed in two areas: one area was from the larynx to the upper trachea, and the other from the lower trachea to the carina. Thus, aerosol inhalation cine-scintigraphy enabled the direct visualization of the fate of sputum in a non-invasive manner under the physiolosical condition. This report seems to be the first in which aerosol inhalation cine-scintigraphy was used to analyze the cough mechanism in humans. (author)

  6. Abused inhalants and central reward pathways: electrophysiological and behavioral studies in the rat.

    Science.gov (United States)

    Riegel, Arthur C; French, Edward D

    2002-06-01

    Inhalant abuse remains a significant health problem among the younger segment of society. In fact, the use of inhalants in this population trails only that of nicotine, alcohol, and marijuana. Toluene is a common ingredient in many of the substances sought out for inhalation abuse, apparently for its euphorigenic and hallucinogenic effects. Because drugs of abuse share the common property of altering the activity of mesolimbic dopamine neurons, it is reasonable to suspect that toluene-induced changes in this CNS pathway may underlie its abuse potential. Here we will provide in vivo and in vitro electrophysiological data and behavioral evidence linking toluene exposure in rats to activation of mesolimbic dopamine neurons. Exposure of rats to 11,000 ppm of inhaled toluene produced time-dependent activation of dopamine neurons within the midbrain ventral tegmental area (VTA). In the rat brain slice preparation, perfusion with toluene (23-822 microM) also evoked an increase in activity of both dopamine and nondopamine neurons within the VTA. These excitatory effects could not be found in adjacent non-VTA nuclei, nor were they sensitive to the glutamate antagonists CGS19755 or CNQX. In behavioral studies, systemic administration of toluene produced a dose-dependent locomotor hyperactivity that was attenuated by either pretreatment with the D2 dopamine receptor antagonist remoxipride or by 6-hydroxydopamine lesions of the nucleus accumbens. These findings show that toluene can activate dopamine neurons within the mesolimbic reward pathway, an effect that may underlie the abuse potential of inhaled substances containing toluene.

  7. Positron emission tomography in human hemispheric infarction: a study with 150 continuous inhalation technique

    International Nuclear Information System (INIS)

    Non-invasive tomographic imaging of cerebral blood flow and oxygen metabolism has now become possible with the 15O continuous inhalation technique coupled with positron emission tomography (PET). We have for the first time applied this procedure in a large scale study of human hemispheric infarction. From this study, it may be concluded that: various hitherto undescribed patterns of disturbances in the perfusion/metabolism couple that occur in cerebral infarction have been documented by PET imaging of CBF and EO2. The EO2 appears as an important physiological parameter in the study of recent cerebral infarction, and specific patterns of the CBF/EO2 relationship are now emerging that may have important pathophysiologic, prognostic and therapeutic implications. Despite some limitations, the non invasive 15O inhalation technique has a number of major specific advantages that make it particularly suited for the study of ischemic brain disorders

  8. Human hemispheric infarction studied by positron emission tomography and the 15O continuous inhalation technique

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) offers an entirely new approach to the study of the pathophysiology of cerebral ischemic disorders. For the first time it is possible to obtain functional tomographic images that represent cerebral perfusion and metabolism on a regional basis. We report here a study of cerebral blood flow and oxygen extraction by means of the 15O inhalation technique in a large number of human hemispheric infarctions. (orig.)

  9. Exposure to inhalable dust and endotoxin among Danish livestock farmers: results from the SUS cohort study

    OpenAIRE

    Basinas, I.; Sigsgaard, T.; Heederik, D; Takai, H.; Omland, O; Andersen, N. T.; Wouters, I.M.; Bonlokke, J.H.; Kromhout, H; V. Schlünssen

    2012-01-01

    Studies on personal dust and endotoxin concentrations among animal farmers have been either small or limited to a few sectors in their investigations. The present study aimed to provide comparable information on the levels and variability of exposure to personal dust and endotoxin in different types of animal farmers. 507 personal inhalable dust samples were collected from 327 farmers employed in 54 pig, 26 dairy, 3 poultry, and 3 mink farms in Denmark. Measurements in pig and dairy farmers w...

  10. Inflammogenic effect of well-characterized fullerenes in inhalation and intratracheal instillation studies

    Directory of Open Access Journals (Sweden)

    Yamamoto Kazuhiro

    2010-03-01

    Full Text Available Abstract Background We used fullerenes, whose dispersion at the nano-level was stabilized by grinding in nitrogen gas in an agitation mill, to conduct an intratracheal instillation study and an inhalation exposure study. Fullerenes were individually dispersed in distilled water including 0.1% Tween 80, and the diameter of the fullerenes was 33 nm. These suspensions were directly injected as a solution in the intratracheal instillation study. The reference material was nickel oxide in distilled water. Wistar male rats intratracheally received a dose of 0.1 mg, 0.2 mg, or 1 mg of fullerenes and were sacrificed after 3 days, 1 week, 1 month, 3 months, and 6 months. In the inhalation study, Wistar rats were exposed to fullerene agglomerates (diameter: 96 ± 5 nm; 0.12 ± 0.03 mg/m3; 6 hours/days for 5 days/week for 4 weeks and were sacrificed at 3 days, 1 month, and 3 months after the end of exposure. The inflammatory responses and gene expression of cytokine-induced neutrophil chemoattractants (CINCs were examined in rat lungs in both studies. Results In the intratracheal instillation study, both the 0.1 mg and 0.2 mg fullerene groups did not show a significant increase of the total cell and neutrophil count in BALF or in the expression of CINC-1,-2αβ and-3 in the lung, while the high-dose, 1 mg group only showed a transient significant increase of neutrophils and expression of CINC-1,-2αβ and -3. In the inhalation study, there were no increases of total cell and neutrophil count in BALF, CINC-1,-2αβ and-3 in the fullerene group. Conclusion These data in intratracheal instillation and inhalation studies suggested that well-dispersed fullerenes do not have strong potential of neutrophil inflammation.

  11. Studies on the spray dried lactose as carrier for dry powder inhalation

    OpenAIRE

    Linna Wu; Xu Miao; Ziyun Shan; Ying Huang; Lu Li; Xin Pan; Qinghe Yao; Ge Li; Chuanbin Wu

    2014-01-01

    The purpose of this study was to investigate the spray dried lactose as carrier for dry powder inhalation (DPI). The lactose particles were prepared by spray drying, then the particle size, shape and crystal form were characterized by laser diffraction, scanning electron microscopy (SEM), X-ray diffraction (XRD) and differential scanning calorimetry (DSC). The spray dried lactose particles were spherical and amorphous, but would transfer to crystal form when storage humidity was above 32%. Th...

  12. Effects of inhaled acid aerosols on lung mechanics: an analysis of human exposure studies.

    OpenAIRE

    Utell, M J

    1985-01-01

    There exist significant gaps in our understanding of human health effects from inhalation of pollutants associated with acid precipitation. Controlled clinical studies examine effects of criteria pollutants almost exclusively by assessing changes in lung mechanics. One constituent of acid precipitation, sulfuric acid aerosols, has been shown to induce bronchoconstriction in exercising extrinsic asthmatics at near ambient levels. These asthmatics may be an order of magnitude more sensitive to ...

  13. A multiple dose powder inhaler (Turbuhaler) compared with a conventional aerosol. An acceptance study in asthmatics.

    Science.gov (United States)

    Osterman, K; Norborg, A M; Stähl, E

    1989-05-01

    Nineteen patients with asthma completed an open, randomized, crossover study in which 0.5 mg terbutaline sulphate was administered either via Turbuhaler or via the metered dose inhaler (MDI) for 2-week periods. The clinical effect of the two treatment forms was comparable; both provided adequate bronchodilator therapy. Patients also considered Turbuhaler and MDI equally effective, with a small preference for the MDI. Turbuhaler seems to be a valuable alternative to bronchodilator MDI therapy. PMID:2735519

  14. Clinicomicrobiological study of chronic paronychia

    Directory of Open Access Journals (Sweden)

    Guha P

    1992-01-01

    Full Text Available A total of 261 digits affected in 100 patients of chronic paronychia were studied for clinical features. The bacteriological and mycological flora have been examined in 25 cases of the above 100 cases which were most severely affected. Aerobic bacteria were found in all cases. Staphylococcus aureus was seen in 60 percent. Klebsiella in 16 percent, Escherichia coli in 12 percent, Pseudomonas aeruginosa in 12 percent, Proteus mirabillis in 8 percent, Staphylococcus epidermidis in 4 percent and Streptococcus viridans in 4 percent. Culture for fungus revealed Candida albicans in 64 percent and other species such as C. krusei, C. stellatoides, C. viswanathi, C. parapsilosis and C. tropicalis were present in 1 case each. No fungus was detected in 4 cases(16percent. The present investigation was designed to compare the bacterial and mycotic flora of the nail folds of patients of chronic paronychia with that of western countries.

  15. Inhalant Abuse

    Science.gov (United States)

    ... 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 ...

  16. An observational study of inhaled-treprostinil respiratory-related safety in patients with pulmonary arterial hypertension.

    Science.gov (United States)

    Zamanian, R T; Levine, D J; Bourge, R C; De Souza, S A; Rosenzweig, E B; Alnuaimat, H; Burger, C; Mathai, S C; Leedom, N; DeAngelis, K; Lim, A; De Marco, T

    2016-09-01

    Inhaled treprostinil (Tyvaso) has been shown to be a safe and effective addition to pulmonary arterial hypertension (PAH) oral therapies; however, the respiratory-related safety profile of inhaled treprostinil required further elucidation in the setting of routine clinical care. The objectives of this study were to characterize respiratory-related adverse events (AEs) associated with current or recent treatment with inhaled treprostinil and to compare the incidence of respiratory-related AEs in PAH patients treated with inhaled treprostinil with that in patients treated with other Food and Drug Administration (FDA)-approved PAH therapies. This was a long-term, prospective, observational study. All respiratory-related AEs were recorded during the study. The number of PAH patients enrolled was 1,333, 666 treated with inhaled treprostinil and 667 controls (treated with an FDA-approved PAH therapy other than inhaled treprostinil), for a total of 958 and 1,094 patient-years of exposure, respectively. In the inhaled-treprostinil group, 1,281 respiratory-related AEs were reported in 403 patients (61%), and in the control group, 1,295 respiratory-related AEs were reported in 388 patients (58%). Cough, throat irritation, nasal discomfort, and hemoptysis were the most common respiratory-related AEs (occurring in ≥2% of patients in either treatment group) that demonstrated a higher number of events per patient-year of exposure in the inhaled-treprostinil group than in the control group (risk ratio [95% confidence interval]: 1.487 [1.172-1.887], 3.777 [2.050-6.956], 2.039 [1.072-3.879], and 1.957 [1.024-3.741], respectively). Overall, inhaled treprostinil was well tolerated by PAH patients in routine clinical care, with respiratory-related AEs consistent with the known safety profile (trial registration: clinicaltrials.gov identifier: NCT01266265). PMID:27683610

  17. Evaluation of cariogenic potential of dry powder inhalers: A case-control study

    Directory of Open Access Journals (Sweden)

    Navneet Godara

    2013-01-01

    Full Text Available Objective: Dry powder inhalers (DPIs are commonly employed in the management of asthma and other diseases with airway obstruction. A causal relationship of DPI use and occurrence of dental caries has been speculated. The present case-control study was therefore designed to examine the potential link between dental caries and specific use of dry powder inhalers in patients with bronchial asthma. Materials and Methods: The present study was conducted on 100 asthmatic patients aged between 10 and 45 years who were using DPIs for at least one year. The control group (n = 100 was selected from non-asthmatic individuals and were matched with the study group with respect to age, gender, and socio-economic status. Results: The results revealed that asthmatic subjects exhibited higher occurrence of dental caries in comparison to control group, but the difference was statistically non-significant. The mean decayed, missing, and filled teeth (DMFT indices scores in asthmatic and control group were found to be 1.71 ± 2.34 SD and 1.46 ± 1.89 SD (P = 0.408, respectively. Likewise, the mean decayed, missing, and filled surfaces (DMFS indices scores in both the groups were 2.41 ± 3.84 SD and 2.34 ± 4.48 SD (P = 0.90. However, increased frequency of DPI use was associated with significant risk of caries (P = 0.01. It has been observed that oral rinsing after an inhaler use limited the occurrence of dental caries to a certain extent although was non significant. Conclusions: Dry powder inhaler use in patients with bronchial asthma was not associated with significant risk of dental caries.

  18. Clinical evaluation of Kr-81m inhalation study through a dead space

    International Nuclear Information System (INIS)

    A new inhalation technique of 81mKr gas was applied to evaluate the pathophysiological abnormality of ventilation. 81mKr gas (370 MBq) was continuously supplied into a mouth piece directly (without dead space), VE, or through a dead space of 500 ml, VL, in 110 subjects with various lung diseases. Subjects were divided in four groups by a combination of distribution patterns of 81mKr gas obtained by these two inhalation techniques. Group 1: No ventilatory defect in both techniques. Group 2: Defects larger in VE than VL. Group 3: Defects larger in VL than VE. Group 4: no remarkable difference in defects in both techniques. Cases of group 1 were normal in pulmonary function test and chest X-ray. Finding of group 2 reflects early airway closure. This group consisted of cases in remission of bronchial asthma, small air way disease and pulmonary congestion. In group 3, restrictive disease and obstructive disease, especially emphysema, were included. Patients with severe obstructive disease and organized change of pulmonary parenchyma were belonged in group 4. In ventilation study with 81mKr gas, a combined study of inhalation technique through a dead space and by direct infusion may be useful to evaluate a pathophysiological change of various pulmonary diseases. (author)

  19. Substance use - inhalants

    Science.gov (United States)

    Substance abuse - inhalants; Drug abuse - inhalants; Drug use - inhalants; Glue - inhalants ... consumered.org/learn/inhalant-abuse National Institute on Drug Abuse -- www.teens.drugabuse.gov/drug-facts/inhalants SMART ...

  20. A CLINICAL STUDY OF CHRONIC DEPRESSION

    OpenAIRE

    Singhal, S; Kumar, S.; Agarwal, A K

    1991-01-01

    SUMMARY Neurological status of chronic depressive states have not been resolved as yet. Recent classificatory systems ICD-X and DSM-III-R have included chronic depression under affective disorders and have done away with the category of neurotic depression. The present study was undertaken with the aims of (a) to study clinical variables associated with major subtypes of chronic depression (chronic major depression and dysthymia) and (b) to investigate personality characteristics and life eve...

  1. Human hemispheric infarction studied by positron emission tomography and the 150 continuous inhalation technique

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) offers an entirely new approach to the study of the pathophysiology of cerebral ischemic disorders. This is so because for the first time it is possible to obtain functional tomographic images that represent cerebral perfusion and metabolism in a regional basis. We report here a study of cerebral blood flow and oxygen extraction by means of the 15O inhalation technique in a large number of human hemispheric infarctions. PET imaging with this non-invasive technique has permitted the description of hitherto unreported focal patterns of changes in the CBF/EO2 couple that may have important pathophysiologic and prognostic implications

  2. Epidemiological Study of Respiratory Disorders Induced by Occupational Inhalation of Talc Powder in Rubber Factory Workers in Shiraz

    Directory of Open Access Journals (Sweden)

    M Neghab

    2006-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Talc powder is extensively used as a lubricant in rubber industry. However the nature of its respiratory effects, if any, has not been thoroughly investigated. The purpose of this study was to assess the pulmonary reactions associated with occupational exposure to talc dust. Materials & Methods: This is a analytical study in which 97 talc-exposed workers and 110 unexposed employees as the reference group were randomly selected from a local rubber industry. Standardized respiratory questionnaires were administered to the subjects. They underwent chest X-ray and were examined by a specialist for any possible respiratory abnormality to be diagnosed. Furthermore, Pulmonary Function Tests (PFTs were performed just before and after the work shift. Moreover, to assess the extent of exposure to talc dust, using standard methods, inhaleable and respirable dust concentrations were measured in different dusty worksites. The data were analyzed by standard statistical tests using SPSS software. Results: The average (mean ± SD age (years, weight (kg, height (cm and duration of exposure to talc dust (years for the exposed group were 35.8±6.75, 73.1±9.2, 173.2±5.9 and 11.79±5.3 respectively. The corresponding values for the non-exposed group were 36.1±6.87, 73.36±8.1, 172.2±5.7 and 0±0, respectively. Atmospheric concentrations of inhaleable and respirable talc dust were found to be 41.8±23.52 and 19.8±8.04 mg/m3, (mean ± SD, respectively. Talc exposed subjects had a significantly higher prevalence of respiratory symptoms. Similarly, PFTs revealed that exposure to this lubricating agent was associated with significant decreases in the mean percentage predicted of vital capacity (VC, forced vital capacity (FVC and forced expiratory volume in the first second (FEV1. Moreover, there was a sharp reduction in some parameters of pulmonary function such as VC, FVC and FEV1, over the work shift. Chest radiographs of

  3. Studies on the spray dried lactose as carrier for dry powder inhalation

    Directory of Open Access Journals (Sweden)

    Linna Wu

    2014-12-01

    Full Text Available The purpose of this study was to investigate the spray dried lactose as carrier for dry powder inhalation (DPI. The lactose particles were prepared by spray drying, then the particle size, shape and crystal form were characterized by laser diffraction, scanning electron microscopy (SEM, X-ray diffraction (XRD and differential scanning calorimetry (DSC. The spray dried lactose particles were spherical and amorphous, but would transfer to crystal form when storage humidity was above 32%. Thus, the humidity of the storage environment should be controlled below 30% strictly in order to maintain the amorphous nature of spray dried lactose which is a great benefit to DPI development.

  4. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe

    DEFF Research Database (Denmark)

    Burbach, G J; Heinzerling, L M; Edenharter, G;

    2009-01-01

    BACKGROUND: Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA(2)LEN) study with data on clinical relevance...... the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease. METHODS: Clinical relevance of skin prick tests was recorded with regard to patient history...

  5. Improved dispersion method of multi-wall carbon nanotube for inhalation toxicity studies of experimental animals.

    Science.gov (United States)

    Taquahashi, Yuhji; Ogawa, Yukio; Takagi, Atsuya; Tsuji, Masaki; Morita, Koichi; Kanno, Jun

    2013-01-01

    A multi-wall carbon nanotube (MWCNT) product Mitsui MWNT-7 is a mixture of dispersed single fibers and their agglomerates/aggregates. In rodents, installation of such mixture induces inflammatory lesions triggered predominantly by the aggregates/agglomerates at the level of terminal bronchiole of the lungs. In human, however, pulmonary toxicity induced by dispersed single fibers that reached the lung alveoli is most important to assess. Therefore, a method to generate aerosol predominantly consisting of dispersed single fibers without changing their length and width is needed for inhalation studies. Here, we report a method (designated as Taquann method) to effectively remove the aggregate/agglomerates and enrich the well-dispersed singler fibers in dry state without dispersant and without changing the length and width distribution of the single fibers. This method is base on two major concept; liquid-phase fine filtration and critical point drying to avoid re-aggregation by surface tension. MWNT-7 was suspended in Tert-butyl alcohol, freeze-and-thawed, filtered by a vibrating 25 µm mesh Metallic Sieve, snap-frozen by liquid nitrogen, and vacuum-sublimated (an alternative method to carbon dioxide critical point drying). A newly designed direct injection system generated well-dispersed aerosol in an inhalation chamber. The lung of mice exposed to the aerosol contained single fibers with a length distribution similar to the original and the Taquann-treated sample. Taquann method utilizes inexpensive materials and equipments mostly found in common biological laboratories, and prepares dry powder ready to make well-dispersed aerosol. This method and the chamber with direct injection system would facilitate the inhalation toxicity studies more relevant to human exposure. PMID:23824017

  6. Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Sørensen, T; Lange, Peter;

    1999-01-01

    for 36 months. The mean age of the participants was 59 years and the mean FEV1 2.37 L or 86% of predicted. The main outcome measure was rate of FEV1 decline. Analyses were by intention to treat. FINDINGS: The crude rates of FEV1 decline were slightly smaller than expected (placebo group 41.8 mL per year...... recruited from the general population by screening. We question the role of long-term inhaled corticosteroids in the treatment of mild to moderate COPD....

  7. Inhalation developmental toxicology studies: Teratology study of n-hexane in rats: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.

    1987-12-01

    The straight chain hydrocarbon, n-hexane, is a volatile, ubiquitous solvent used in industrial, academic, and smaller commercial environments. The significant opportunity for women of child-bearing age to be exposed to this chemical prompted the undertaking of a study to assess the developmental toxicity of n-hexane in an animal model. Timed-pregnant (30 animals per group) and virgin (10 animals per group) Sprague-Dawley rats were exposed to 0 (filtered air), 200, 1000, and 5000 ppM n-hexane (99.9% purity) vapor in inhalation chambers for 20 h/day for a period of 14 consecutive days. Sperm-positive females were exposed for 6 to 19 days of gestation (dg) and virgins were exposed concurrently for 14 consecutive days. The day of sperm detection was designated as 0 dg for mated females. Adult female body weights were monitored prior to, throughout the exposure period, and at sacrifice. Uterine, placental, and fetal body weights were obtained for gravid females at sacrifice. Implants were enumerated and their status recorded as live fetus, early or late resorption, or dead. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. 16 refs., 3 figs., 7 tabs.

  8. Effect of 4% lidocaine inhalation in bronchial asthma.

    Science.gov (United States)

    Prakash, G S; Sharma, S K; Pande, J N

    1990-01-01

    The effect of 4% lidocaine inhalation was studied in a single-blind fashion in 18 patients with chronic stable asthma. Inhalation of normal saline solution was used as placebo. None of the parameters except flow rate at 50% of vital capacity (V50) showed any statistically significant change from baseline values. V50 at 15 min was significantly lower (p less than 0.05) after 4% lidocaine inhalation. Considering more than 10% change from the baseline value as significant, 8 of 15 patients showed decrease in airway resistance (Raw) and 7 of the 15 patients showed an increase in specific airway conductance (SGaw) after 15 min of inhalation. However, V50 (8/18 patients), flow rate at 25% vital capacity [V25 (6/15 patients], and forced expiratory flow rate at 25-75% of the vital capacity (FEF25-75) (5/15 patients) showed a decrease after 15 min of 4% lidocaine inhalation. No change in pulmonary function was noted after 30 min of lidocaine inhalation. It is concluded from this study that lidocaine produces a small bronchodilatory effect on the large airways and a bronchoconstrictor effect on the small airways after 15 min of inhalation, but this effect is not statistically significant. It can be safely used as topical agent for bronchoscopy in patients with bronchial asthma.

  9. Living with Chronic Pancreatitis: A qualitative study.

    OpenAIRE

    CRONIN, PATRICIA; Begley, Cecily

    2013-01-01

    PUBLISHED OBJECTIVE: Recent literature acknowledges the impact of this progressive and debilitating disease on psychological and social well-being, but the plight of those with chronic pancreatitis remains unknown and hidden. The aim of this study was to develop an understanding of what it means to live with chronic pancreatitis. DESIGN: Qualitative study based on philosophical hermeneutics using multiple unstructured interviews. PARTICIPANTS: Fourteen people with chronic...

  10. 5-Day repeated inhalation and 28-day post-exposure study of graphene.

    Science.gov (United States)

    Shin, Jae Hoon; Han, Sung Gu; Kim, Jin Kwon; Kim, Boo Wook; Hwang, Joo Hwan; Lee, Jong Seong; Lee, Ji Hyun; Baek, Jin Ee; Kim, Tae Gyu; Kim, Keun Soo; Lee, Heon Sang; Song, Nam Woong; Ahn, Kangho; Yu, Il Je

    2015-01-01

    Graphene has recently been attracting increasing attention due to its unique electronic and chemical properties and many potential applications in such fields as semiconductors, energy storage, flexible electronics, biosensors and medical imaging. However, the toxicity of graphene in the case of human exposure has not yet been clarified. Thus, a 5-day repeated inhalation toxicity study of graphene was conducted using a nose-only inhalation system for male Sprague-Dawley rats. A total of three groups (20 rats per group) were compared: (1) control (ambient air), (2) low concentration (0.68 ± 0.14 mg/m(3) graphene) and (3) high concentration (3.86 ± 0.94 mg/m(3) graphene). The rats were exposed to graphene for 6 h/day for 5 days, followed by recovery for 1, 3, 7 or 28 days. The bioaccumulation and macrophage ingestion of the graphene were evaluated in the rat lungs. The exposure to graphene did not change the body weights or organ weights of the rats after the 5-day exposure and during the recovery period. No statistically significant difference was observed in the levels of lactate dehydrogenase, protein and albumin between the exposed and control groups. However, graphene ingestion by alveolar macrophages was observed in the exposed groups. Therefore, these results suggest that the 5-day repeated exposure to graphene only had a minimal toxic effect at the concentrations and time points used in this study.

  11. Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ahmed Fahim

    2012-01-01

    Conclusion: Inhaled budesonide and fluticasone have no significantly different effect on adrenal function in moderate to severe COPD. The adverse event profile of high-dose inhaled steroids should not influence the choice of medication.

  12. Development of a Zealand white rabbit deposition model to study inhalation anthrax.

    Science.gov (United States)

    Asgharian, Bahman; Price, Owen; Kabilan, Senthil; Jacob, Richard E; Einstein, Daniel R; Kuprat, Andrew P; Corley, Richard A

    2016-01-01

    Despite using rabbits in several inhalation exposure experiments to study diseases such as anthrax, there is a lack of understanding regarding deposition characteristics and fate of inhaled particles (bio-aerosols and viruses) in the respiratory tracts of rabbits. Such information allows dosimetric extrapolation to humans to inform human outcomes. The lung geometry of the New Zealand white rabbit (referred to simply as rabbits throughout the article) was constructed using recently acquired scanned images of the conducting airways of rabbits and available information on its acinar region. In addition, functional relationships were developed for the lung and breathing parameters of rabbits as a function of body weight. The lung geometry and breathing parameters were used to extend the existing deposition model for humans and several other species to rabbits. Evaluation of the deposition model for rabbits was made by comparing predictions with available measurements in the literature. Deposition predictions in the lungs of rabbits indicated smaller deposition fractions compared to those found in humans across various particle diameter ranges. The application of the deposition model for rabbits was demonstrated by extrapolating deposition predictions in rabbits to find equivalent human exposure concentrations assuming the same dose-response relationship between the two species. Human equivalent exposure concentration levels were found to be much smaller than those for rabbits.

  13. Clinical study of inhaled aerosols total deposition in healthy adults and children

    International Nuclear Information System (INIS)

    Inhalation is the first step towards respiratory tract intake of chemical and radioactive toxics. Particle deposition in human airways has been described by several authors as showing large individual variations. This study intends to contribute to assess this variability limits especially with reference to age. The method used is basically a measurement of retention, by difference between inhaled and exhaled air concentrations, of inert monodispersed aerosols, during controlled breathing. Particles of 1, 2, 3 μm MMAD (polystyrene latex) are measured in size and concentration by laser velocimetry. A Fleish pneumotachograph is used for controlling respiratory parameters. Healthy subjects, male and female, undergo the test at various tidal volumes, frequencies and flow rates, simulated resting and exercising ventilation; their respiratory function is also explored in a very complete way. 20 adults between 23 and 54 years have been tested in order to assess the laboratory reference values. 25 children, 8 under the age of 8 years, and 17 between 8 and 15 years, have been tested in a similar way. Compared to adults, children, especially under 8 years, have different total deposition mean values, higher for spontaneous and quiet controlled breathing, lower for exercising controlled breathing. Total deposition is dependent on particle size, higher for 2 than for 1 μm MMAD, but also, on lung volume, V.C., T.L.C., F.R.C., to which it is inversely proportional

  14. Aclidinium bromide inhalation powder for the long-term, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease including chronic bronchitis and emphysema.

    Science.gov (United States)

    Matera, Maria Gabriella; Sanduzzi, Alessandro; Alfano, Roberto; Cazzola, Mario

    2016-06-01

    Aclidinium is a twice-daily long-acting muscarinic receptor antagonist (LAMA) with an interesting pharmacological profile. Recent evidence indicates that this LAMA, in addition to causing a significant improvement in lung function and other important supportive outcomes, such as health related quality of life, dyspnea and nighttime/early morning symptoms in patients suffering from COPD, is also able to significantly reduce the rate of exacerbations of any severity, is extremely effective in controlling the COPD symptoms, is able to reduce lung hyperinflation, and has an excellent cardiovascular safety profile. Consequently, aclidinium should be considered a first-line approach at least for the symptomatic treatment of COPD although there are still few head-to-head studies comparing this LAMA with other bronchodilators. In any case, aclidinium can be taken into account in the treatment of different COPD phenotypes (emphysema, chronic bronchitis, exacerbators and patients with overlap COPD asthma). PMID:26998725

  15. Impairment of Coronary Arteriolar Endothelium-Dependent Dilation after Multi-Walled Carbon Nanotube Inhalation: A Time-Course Study

    Directory of Open Access Journals (Sweden)

    Timothy R. Nurkiewicz

    2012-10-01

    Full Text Available Engineered nanomaterials have been developed for widespread applications due to many highly unique and desirable characteristics. The purpose of this study was to assess pulmonary inflammation and subepicardial arteriolar reactivity in response to multi-walled carbon nanotube (MWCNT inhalation and evaluate the time course of vascular alterations. Rats were exposed to MWCNT aerosols producing pulmonary deposition. Pulmonary inflammation via bronchoalveolar lavage and MWCNT translocation from the lungs to systemic organs was evident 24 h post-inhalation. Coronary arterioles were evaluated 24–168 h post-exposure to determine microvascular response to changes in transmural pressure, endothelium-dependent and -independent reactivity. Myogenic responsiveness, vascular smooth muscle reactivity to nitric oxide, and α-adrenergic responses all remained intact. However, a severe impact on endothelium-dependent dilation was observed within 24 h after MWCNT inhalation, a condition which improved, but did not fully return to control after 168 h. In conclusion, results indicate that MWCNT inhalation not only leads to pulmonary inflammation and cytotoxicity at low lung burdens, but also a low level of particle translocation to systemic organs. MWCNT inhalation also leads to impairments of endothelium-dependent dilation in the coronary microcirculation within 24 h, a condition which does not fully dissipate within 168 h. The innovations within the field of nanotechnology, while exciting and novel, can only reach their full potential if toxicity is first properly assessed.

  16. Systemic activity of inhaled topical steroid in toddlers studied by knemometry

    DEFF Research Database (Denmark)

    Bisgaard, H

    1993-01-01

    -held knemometer. Eighteen toddlers aged 13-36 months (mean 27 months) with a history of recurrent wheezing requiring inhaled topical steroids, but without need of regular medication during the months prior to the study, were studied. The children were randomized blindly through three consecutive treatment periods...... of exacerbations and one because of non-compliance. The precision of the measurement procedure was 51 microns/day. The mean growth rate during placebo, low-dose and high-dose steroid treatment was 92 microns/day, 114 microns/day and 46 microns/day respectively. The growth rate during the high-dose treatment...... was suppressed significantly compared to placebo treatment (95% CI -76 microns/day to -17 microns/day), whereas the growth rate during low-dose steroid treatment was indistinguishable from placebo treatment (95% CI -7 to +52 microns/day). In conclusion, measurement of short-term linear growth rate by knemometry...

  17. Pilot Study of Inhaled Aerosols Targeted via Magnetic Alignment of High Aspect Ratio Particles in Rabbits

    Directory of Open Access Journals (Sweden)

    Gillian E. S. Redman

    2011-01-01

    Full Text Available Recently, inhaled pharmaceutical aerosols have seen increased investigation in the treatment of lung cancer, where the inability to deliver adequate therapeutic drug concentrations to tumour sites may be overcome with improved targeted delivery to the site of the tumour. In this study, the feasibility of magnetically targeted delivery of high aspect ratio particles loaded with iron oxide nanoparticles was studied in 19 New Zealand White rabbits. Half of the exposed rabbits had a magnetic field placed externally over their right lung. Iron sensitive magnetic resonance images of the lungs were acquired to determine the iron concentrations in the right and left lung of each animal. The right/left ratio increased in the middle and basal regions of the lung where, due to the morphology of the rabbit lung, this method of targeting is most effective. With further optimization, this technique could be an effective method for increasing the dose of drug delivered to a specific site within the lung.

  18. Dose assessment for inhalation intakes in complex, energetic environments: experience from the US Capstone study.

    Science.gov (United States)

    Guilmette, Raymond A; Parkhurst, Mary Ann

    2007-01-01

    Because of the lack of existing information needed to evaluate the risks from inhalation exposures to depleted uranium (DU) aerosols of US soldiers during the 1991 Persian Gulf War, the US Department of Defense funded an experimental study to measure the characteristics of DU aerosols created when Abrams tanks and Bradley fighting vehicles are struck with large-caliber DU penetrators, and a dose and risk assessment for individuals present in such vehicles. This paper describes some of the difficulties experienced in dose assessment modelling of the very complex DU aerosols created in the Capstone studies, e.g. high concentrations, heterogeneous aerosol properties, non-lognormal particle size distributions, triphasic in vitro dissolution and rapid time-varying functions of both DU air concentration and particle size. The approaches used to solve these problems along with example results are presented.

  19. Pilot Study of Inhaled Aerosols Targeted via Magnetic Alignment of High Aspect Ratio Particles in Rabbits

    International Nuclear Information System (INIS)

    Recently, inhaled pharmaceutical aerosols have seen increased investigation in the treatment of lung cancer, where the inability to deliver adequate therapeutic drug concentrations to tumour sites may be overcome with improved targeted delivery to the site of the tumour. In this study, the feasibility of magnetically targeted delivery of high aspect ratio particles loaded with iron oxide nanoparticles was studied in 19 New Zealand White rabbits. Half of the exposed rabbits had a magnetic field placed externally over their right lung. Iron sensitive magnetic resonance images of the lungs were acquired to determine the iron concentrations in the right and left lung of each animal. The right/left ratio increased in the middle and basal regions of the lung where, due to the morphology of the rabbit lung, this method of targeting is most effective. With further optimization, this technique could be an effective method for increasing the dose of drug delivered to a specific site within the lung.

  20. Effects of inhaled nitric oxide on hemostasis in healthy adults treated with heparin: a randomized, controlled, blinded crossover study

    Directory of Open Access Journals (Sweden)

    Goldstein Brahm

    2012-01-01

    Full Text Available Abstract Background Effects of nitric oxide (NO on hemostasis have been studied in various investigational settings, but data regarding inhaled NO on bleeding and platelet function are conflicting. It is not known if inhaled NO has an effect when administered with drugs that influence hemostasis. This trial evaluated effects of inhaled NO on hemostasis in the presence of heparin using aspirin as a positive control. Patients/Methods Twelve healthy adult males were enrolled in a single-center, randomized, single-blind, four-way crossover trial. Subjects received 80 ppm NO or medical air (placebo inhalation for 30 min with simultaneous injection of placebo or heparin. Aspirin capsules were used as a positive control. Parameters of hemostasis were measured before treatment and at post-treatment intervals. Results Activated clotting time (ACT, prothrombin time (PT and activated partial thromboplastin time (aPTT increased only in groups that received heparin. Areas under the curve for ACT in heparin groups receiving inhaled NO were judged to be equivalent to those receiving medical air for both 0- to 4-h (ratio: 1.00; 90% CI, 0.90-1.11 and 0- to 24-h time intervals (ratio: 1.01; 90% CI, 0.92-1.12. Changes in bleeding time and platelet aggregation were observed only in aspirin groups. No clinically significant changes in hemoglobin, red blood cell counts or haematocrit were observed in any group. Conclusions Inhaled NO, when administered with heparin, exhibited no significant additive effects on ACT, PT, aPTT, bleeding time or platelet aggregation.

  1. [Clinical application and experimental studies of the pulsed inhaled nitric oxide flow controlling instrument].

    Science.gov (United States)

    Mo, Xu-ming; Zhao, En-chun; Wang, Min-sheng; Gu, Xinglin; Wang, Zhenxi; Wang, Chunsheng

    2002-01-01

    A flow controlling system for pulsed inhaled nitric oxide has been developed and tested, and here its features and initial animal experiments and clinical applications are described. The physical characteristic test indicates that the practical released dose of NO gas is very close to the theoretical flow of NO gas at variant pressures. Animal experiments demonstrate that inhaled NO gas concentration is lower than the concentration of theoretical inhalation, but the variance is not remarkable (p>0.05). When sixteen cases with CHD and PH were chosen to inhale NO gas (15 ppm, 15 min) PAP and PVR of all cases were reduced after inhalation of NO gas from 617 +/-51.3 dyn x s x cm(-5), 54.4+/-13.1 mmHg to 417+/-36.9 dym x s x cm(-5), 33.8+/-12.3 mmHg (PVR, p<0.01; PAP, p<0.01) respectively. When gas inhalation was stopped, these values returned to their base lines after a short period of time. All these show that the pulsed inhaled NO flow controlling instrument in accordance with the requirements of the designing, can be widely used in clinical diagnoses and treatments and will be a new tool offered for the treatments of the patients with PH. PMID:16104155

  2. Regional cerebral blood flow in patients with transient ischemic attacks studied by Xenon-133 inhalation and emission tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Hemmingsen, R; Henriksen, L;

    1983-01-01

    Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...

  3. SENSITIVITY ANALYSIS FOR APPLICATION OF THE INHALATION EXPOSURE METHODOLOGY (IEM) TO STUDIES OF HAZARDOUS WASTE MANAGEMENT FACILITIES

    Science.gov (United States)

    The Inhalation Exposure Methodology (IEM) is an integrated system of computer programs that simulates the atmospheric transport of and the resulting human exposures to pollutants released from one or more sources at an industrial complex. The study was undertaken to determine the...

  4. Low-level inhaled-239PuO2 life-span studies in rats

    International Nuclear Information System (INIS)

    This study determined the dose-response curve for lung tumor incidence in rats after inhalation of high-fired 239PuO2, which gave radiation doses to the lung of from ∼5 to >1000 rads. Exposed rats were given a single, nose-only, inhalation exposure to 169Yb-239PuO2 aerosol (AMAD, 1.6 +- 0.11 μm). The effective half-time for 169Yb in the lung was 14 days, whereas ∼76% of 239Pu was cleared with a half-time of 20 days and 24%, with a half-time of 180 days. Whole-body counting for 169Yb at 14 days after exposure was an accurate method for determining 239Pu IAD in individual rats, even at IAD's as low as 0.60 nCi of 239Pu. The 239Pu lung-clearance curve and an equation describing changes in lung weight with body weight and age were used to determine lung radiation doses. The IAD's of exposure groups were 0.60 +- 0.15 nCi of 239Pu (1000 rats), 0.98 +- 0.25 (531 rats), 2.4 +- 0.69 (209 rats), 5.7 +- 1.2 (98 rats), and 7.5 +- 2.0 to 150 +- 37 nCi (300 rats); corresponding radiation doses to the lung estimated at 3 years after exposure were 8.3, 14, 33, 79, and 100 to 2100 rads, respectively. 71 refs., 5 figs., 4 tabs

  5. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

    DEFF Research Database (Denmark)

    Busse, William W; Pedersen, Søren; Pauwels, Romain A;

    2008-01-01

    BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open-l...

  6. Biological alterations resulting from chronic lung irradiation. I. The pulmonary lipid composition, physiology, and pathology after inhalation by beagle dogs of 144Ce-labeled fused clay aerosols

    International Nuclear Information System (INIS)

    Three groups of four beagle dogs inhaled a 144Ce-labeled fused clay aerosol; two additional dogs per group, exposed to a stable cerium-labeled fused clay aerosol, were used as controls. At monthly intervals, one diaphragmatic lobe of each of two dogs exposed to 144Ce and one control animal from each group was lavaged with isotonic saline. The recovered lavage solutions were centrifuged to isolate lung cells (mostly macrophages) and surfactant for lipid analyses. The groups were sacrificed at 2, 4, and 6 mo after exposure, when the lungs of the dogs exposed to 144Ce had average cumulative radiation doses of 23, 36, and 59 krad, respectively. Chronic irradiation of the lung resulted in a progressive radiation pneumonitis which was assessed clinically and pathologically at various intervals. At sacrifice, the lungs were analyzed for 144Ce and the right apical and diaphragmatic lobes were minced and lyophilized and the lipids were extracted. Total lipids from all lung samples were determined gravimetrically and individual compounds were identified, isolated, and quantitated. The quantities of lipid in lung tissue, in pulmonary cells, and in surfactant increased as a function of time and radiation dose. Neutral lipids (sterol esters and triglycerides) accounted for most of the increase. (U.S.)

  7. Withdrawal of inhaled glucocorticoids and exacerbations of COPD

    DEFF Research Database (Denmark)

    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...

  8. A cross-sectional questionnaire study of the rules governing pupils' carriage of inhalers for asthma treatment in secondary schools in North East England.

    Science.gov (United States)

    Funston, Wendy; Howard, Simon J

    2016-01-01

    Objectives. The primary objective of this study was to assess the rules governing secondary school pupils' carriage of inhalers for emergency treatment of asthma in the North East of England. Design. This study was based upon a postal questionnaire survey. Setting. The setting for this study was mainstream free-to-attend secondary schools which admit 16 year old pupils within the 12 Local Authority areas which make up the North East of England. Participants. All 153 schools meeting the inclusion criteria were invited to participate in the study, of which 106 (69%) took part. Main Outcome Measures. Our three main outcome measures were: whether pupils are permitted to carry inhalers on their person while at school; whether advance permission is required for pupils to carry inhalers, and from whom; and whether the school has an emergency 'standby' salbutamol inhaler for use in asthma emergencies, as permitted since October 2014 under recent amendments to The Human Medicines Regulations 2012. Results. Of 98 schools submitting valid responses to the question, 99% (n = 97) permitted pupils to carry inhalers on their person while at school; the remaining school stored pupils' inhalers in a central location within the school. A total of 22% of included schools (n = 22) required parental permission before pupils were permitted to carry inhalers. Of 102 schools submitting valid responses to the question, 44% (n = 45) had purchased a 'standby' salbutamol inhaler for use in asthma emergencies. Conclusions. Most secondary schools in North East England permit pupils to carry inhalers on their person. The requirement in a minority of schools for parental permission to be given possibly contravenes the standard ethical practices in clinical medicine for children of this age. Only a minority of schools hold a 'standby' salbutamol inhaler for use in asthma emergencies. Wider availability may improve outcomes for asthma emergencies occurring in schools.

  9. Study of indoor radon levels and inhalation dose estimate with dwelling size

    International Nuclear Information System (INIS)

    222Rn, 220Rn and their progeny levels were measured in dwellings in different parts of Bangalore city. Study was focused on the various types of houses with respect to ventilation characteristics. Seven categories of dwellings having room volumes varying from 30 m3 to 300 m3 were selected for the study. Integrated and long duration measurements of radon were carried out in the dwellings using twin cup dosimeters with Solid State Nuclear Track Detector (SSNTD) technique. Radon concentration in the category of houses is found to have a correlation with surface to volume ratio of the rooms. Results showed that concentrations of 222Rn. 220Rn in dwellings decreased with increase in room volume. However, the results from the study do not indicate a linear correlation with concentration of the gases and room volumes in totality. The annual effective inhalation dose due to 222Rn, 220Rn and their progenies from the study ranged between 0.27-4.45 mSv y-1 with a geometric mean of 1.34 mSv y-1 (GSD 2.1). (author)

  10. Fluticasone propionate-salmeterol versus inhaled corticosteroids plus montelukast: outcomes study in pediatric patients with asthma

    Directory of Open Access Journals (Sweden)

    Stanford RH

    2012-12-01

    Full Text Available Richard H Stanford,1 Manan Shah,2 Anna O D'Souza21GlaxoSmithKline, Research Triangle Park, Durham, NC, 2Xcenda, Palm Harbor, FL, USABackground: The purpose of this study (GSK ADA111194 was to compare asthma-related health care utilization and costs associated with fluticasone propionate (an inhaled corticosteroid [ICS] and salmeterol (a long-acting beta-agonist in a single inhalation device (fluticasone propionate-salmeterol versus the combination of ICS + montelukast in the treatment of pediatric patients with asthma.Methods: This was a retrospective, observational cohort study using a large health insurance claims database spanning January 1, 2000 to January 31, 2008. The target population was patients aged 4–11 years with at least one pharmacy claim for fluticasone propionate-salmeterol, any ICS, or montelukast during the study period. The date of first claim for the medication of interest was deemed the index date. Patients were required to be continuously eligible to receive health care services one year prior to and 30 days after the index date, and have at least one claim with an ICD-9-CM code for asthma (493.xx in the one-year pre-index period. Patients with prescriptions for fluticasone propionate-salmeterol, ICS + montelukast, or long-acting beta-agonists during the pre-index period were excluded. Patients were matched on a 1:1 basis according to three variables, ie, pre-index use of oral corticosteroids, ICS, and presence of pre-index respiratory-related hospitalizations/emergency department visits. The risk of asthma-related hospitalization, combined hospitalization/emergency department visit, and monthly asthma-related costs were assessed using multivariate methods.Results: Of the 3001 patients identified, 2231 patients were on fluticasone propionate-salmeterol and 770 were on ICS + montelukast. After matching, there were 747 pairs of fluticasone propionate-salmeterol and ICS + montelukast patients, which were well matched for

  11. Inhalation Injuries

    Science.gov (United States)

    ... 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, ...

  12. Inhalation cancer risk assessment of cobalt metal.

    Science.gov (United States)

    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

  13. Dry powder inhaler: influence of humidity on topology and adhesion studied by AFM.

    Science.gov (United States)

    Bérard, V; Lesniewska, E; Andrès, C; Pertuy, D; Laroche, C; Pourcelot, Y

    2002-01-31

    In the dry powder inhalers (DPIs), the adhesion results of the interactions between the active substance and the excipient. The carrier and the micronized drug particle morphologies are believed to affect the delivery of the drug. In this work, the couple studied was the lactose monohydrate and micronized zanamivir, used for the treatment of influenza. In a first approach, observations by scanning electron microscopy (SEM) have shown that the relative humidity (RH) greatly influenced the zanamivir amount fixed on the lactose monohydrate surface. This paper deals with the direct measurement in controlled atmosphere by atomic force microscopy (AFM) of the forces and the interaction ranges between a zanamivir probe and a lactose substrate. Selected zanamivir crystals were attached to the standard AFM probe. Different RH have been used in order to determine influent parameters permitting to identify the nature of adhesion forces between them. This study demonstrated that the increase of RH modified progressively the surface topology of the two components and increased the adhesion force.

  14. Acute effects of nitric oxide inhalation in ARDS: A dose finding study at steady state kinetics

    Directory of Open Access Journals (Sweden)

    Hari M

    2006-01-01

    Full Text Available Background: Inhaled Nitric oxide (INO decreases pulmonary artery pressures and improves oxygenation in patients with ARDS. Aim: To evaluate the dose response to 1-20 parts per million (ppm INO in ARDS, by noting changes in oxygenation, pulmonary artery systolic pressures (PASP and to determine optimum dose. Methodology and Design: Prospective study. Setting: 10 bed general intensive care unit. Patients: 13 consecutive patients with ARDS. Interventions: INO was given between 1-20 ppm with 15 minutes at each concentration via an insufflator from a high pressure source, to the inspiratory limb of the ventilator. Study had ascending and descending phase. Results and Conclusions: The optimum dose of INO to improve oxygenation was between 3 and 10 ppm. PaO2 improvement was independent of pulmonary haemodynamic changes. The pulmonary haemodynamic changes needed higher INO initially. Once stabilized, INO could be brought down to concentrations at which maximum improvement in PaO2 occurred. The ′responders′ had lesser duration of pre INO ventilation and lower PaO2/FiO2.

  15. Effects of an ethanol-gasoline mixture: results of a 4-week inhalation study in rats.

    Science.gov (United States)

    Chu, I; Poon, R; Valli, V; Yagminas, A; Bowers, W J; Seegal, R; Vincent, R

    2005-01-01

    The inhalation toxicity of an ethanol-gasoline mixture was investigated in rats. Groups of 15 male and 15 female rats were exposed by inhalation to 6130 ppm ethanol, 500 ppm gasoline or a mixture of 85% ethanol and 15% gasoline (by volume, 6130 ppm ethanol and 500 ppm gasoline), 6 h a day, 5 days per week for 4 weeks. Control rats of both genders received HEPA/charcoal-filtered room air. Ten males and ten females from each group were killed after 4 weeks of treatment and the remaining rats were exposed to filtered room air for an additional 4 weeks to determine the reversibility of toxic injuries. Female rats treated with the mixture showed growth suppression, which was reversed after 4 weeks of recovery. Increased kidney weight and elevated liver microsomal ethoxyresorufin-O-deethylase (EROD) activity, urinary ascorbic acid, hippuric acid and blood lymphocytes were observed and most of the effects were associated with gasoline exposure. Combined exposure to ethanol and gasoline appeared to exert an additive effect on growth suppression. Inflammation of the upper respiratory tract was observed only in the ethanol-gasoline mixture groups, and exposure to either ethanol and gasoline had no effect on the organ, suggesting that an irritating effect was produced when the two liquids were mixed. Morphology in the adrenal gland was characterized by vacuolation of the cortical area. Although histological changes were generally mild in male and female rats and were reversed after 4 weeks, the changes tended to be more severe in male rats. Brain biogenic amine levels were altered in ethanol- and gasoline-treated groups; their levels varied with respect to gender and brain region. Although no general interactions were observed in the brain neurotransmitters, gasoline appeared to suppress dopamine concentrations in the nucleus accumbens region co-exposed to ethanol. It was concluded that treatment with ethanol and gasoline, at the levels studied, produced mild, reversible

  16. Ease-of-use preference for the ELLIPTA® dry powder inhaler over a commonly used single-dose capsule dry powder inhaler by inhalation device-naïve Japanese volunteers aged 40 years or older

    Directory of Open Access Journals (Sweden)

    Komase Y

    2014-12-01

    Full Text Available Yuko Komase,1 Akimoto Asako,2 Akihiro Kobayashi,3 Raj Sharma4 1Department of Respiratory Internal Medicine, St Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan; 2MA Respiratory Department, Development and Medical Affairs Unit, GlaxoSmithKline KK, Tokyo, Japan; 3Biomedical Data Sciences Department, GlaxoSmithKline KK, Tokyo, Japan; 4Global Respiratory Franchise Medical Department, GSK, Stockley Park, UK Background: In patients receiving inhaled medication, dissatisfaction with and difficulty in using the inhaler can affect treatment adherence. The incidence of handling errors is typically higher in the elderly than in younger people. The aim of the study was to assess inhaler preference for and handling errors with the ELLIPTA® dry powder inhaler (DPI, (GSK, compared with the established BREEZHALER™, a single-dose capsule DPI (Novartis, in inhalation device-naïve Japanese volunteers aged ≥40 years. Methods: In this open-label, nondrug interventional, crossover DPI preference study comparing the ELLIPTA DPI and BREEZHALER, 150 subjects were randomized to handle the ELLIPTA or BREEZHALER DPIs until the point of inhalation, without receiving verbal or demonstrative instruction (first attempt. Subjects then crossed over to the other inhaler. Preference was assessed using a self-completed questionnaire. Inhaler handling was assessed by a trained assessor using a checklist. Subjects did not inhale any medication in the study, so efficacy and safety were not measured. Results: The ELLIPTA DPI was preferred to the BREEZHALER by 89% of subjects (odds ratio [OR] 70.14, 95% confidence interval [CI] 33.69–146.01; P-value not applicable for this inhaler for ease of use, by 63% of subjects (OR 2.98, CI 1.87–4.77; P<0.0001 for ease of determining the number of doses remaining in the inhaler, by 91% for number of steps required, and by 93% for time needed for handling the inhaler. The BREEZHALER was

  17. Chronic pain in Australia: a prevalence study.

    Science.gov (United States)

    Blyth, F M; March, L M; Brnabic, A J; Jorm, L R; Williamson, M; Cousins, M J

    2001-01-01

    This study reports chronic pain prevalence in a randomly selected sample of the adult Australian population. Data were collected by Computer-Assisted Telephone Interview (CATI) using randomly generated telephone numbers and a two-stage stratified sample design. Chronic pain was defined as pain experienced every day for three months in the six months prior to interview. There were 17,543 completed interviews (response rate=70.8%). Chronic pain was reported by 17.1% of males and 20.0% of females. For males, prevalence peaked at 27.0% in the 65--69 year age group and for females, prevalence peaked at 31.0% in the oldest age group (80--84 years). Having chronic pain was significantly associated with older age, female gender, lower levels of completed education, and not having private health insurance; it was also strongly associated with receiving a disability benefit (adjusted OR=3.89, Punemployment benefit (adjusted OR=1.99, Punemployed for health reasons (adjusted OR=6.41, Pinsurance. There were strong associations between having interfering chronic pain and receiving disability benefits (adjusted OR=3.31, Punemployed due to health reasons (adjusted OR=7.94, P<0.001, respectively). The results show that chronic pain impacts upon a large proportion of the adult Australian population, including the working age population, and is strongly associated with markers of social disadvantage. PMID:11166468

  18. Lovelace ITRI studies on the toxicity of inhaled radionuclides in beagle dogs

    International Nuclear Information System (INIS)

    This paper reviews 19 studies conducted by the Lovelace ITRI on the toxicity of inhaled radionuclides in beagle dogs. These studies provide information to estimate potential health effects in accidentally exposed people. Specific radionuclides (90Sr, 90Y, 91Y, 137Cs, 144Ce, 238Pu, and 239Pu), chemical forms, and particle sizes were selected for study because they are abundant in nuclear operations and deliver a wide range of radiation dose patterns. Depending upon the aerosol, one or more of the following organs or tissues received the significant irradiation: lung, nasal cavity, lung-associated lymph nodes, whole body, liver, or skeleton, with the radiation dose delivered over durations of time ranging from a few days to several years. In eight studies monodisperse particles of either 238PuO2 or 239PuO2 were used to evaluate the influence of particle number and total dose on lung cancer induction. Most studies involved single, brief exposures of young adult dogs, but two studies used immature dogs, two used aged dogs, and two studies involved repeated brief exposures. For each aerosol two types of studies were conducted. One was used to evaluate the time course of retention of radioactivity in various tissues of the body for calculating radiation doses. The second was used to determine health effects in animals exposed to achieve different initial lung burdens and observed for the remainder of their life spans. Initial lung burdens were selected to produce early morbidity and mortality at the highest levels and an excess of late-occurring diseases such as cancer at the lowest levels. The latter dogs have had an excess incidence of cancer, especially of the lung, lung-associated lymph nodes, nasal cavity, skeleton, and liver. Relationships between radiation doses to various tissues and effects have been evaluated for individual studies

  19. Transcending chronic liver disease: a qualitative study.

    Science.gov (United States)

    Wainwright, S P

    1997-01-01

    This study explores and describes experiences of chronic liver disease from the patient's perspective. No qualitative research studies appear to have examined the experiences of these patients. In-depth focused interviews and grounded theory data collection and data analysis methods were used. A two-stage theoretical framework (becoming ill, and not living) of the experience of transcending chronic liver disease is presented. Sociological and psychological literature on common sense models of health and illness are briefly reviewed. Several suggestions for further research are made. The way in which this qualitative research study is leading to a quantitative and qualitative appraisal of the psychological adjustment in end-stage chronic liver disease patients is outlined.

  20. STUDY ON INFLAMMATORY CELLS IN BALF OF SMOKE-INDUCED CHRONIC BRONCHITIS RAT MODEL

    Institute of Scientific and Technical Information of China (English)

    李庆云; 黄绍光; 吴华成; 程齐俭; 项轶; 万欢英

    2004-01-01

    Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the pathological change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lavage fluid (BALF) in various stages. Methods Chronic bronchitis sequential rat model was established by passively inhaling smoke mixture. Experiments were performed in 30 young male Sprague-Dawley rats, which comprised 5 groups in random, i.e.,4 chronic bronchitis model groups and I control group. After stained with hematoxylin and eosin, the specimens were studied by semi-quantitative method to evaluate the morphologic changes in various stages. Meanwhile, the inflammatory cells of the BALF and the activity of myeloperoxidase ( MPO ) of lung tissue were analysed. Results During the process of the chronic bronchitis, the pathologic score was increasing as time went on, and the typical morphologic changes of chronic bronchitis emerged in the group 7 weeks. The total number of inflammatory cells in BALF was increasing as time went on, correlated with the pathologic scores ( P < 0. 01 ).And the percentage of lymphocyte increased as well as positively correlated with pathologic scores ( P < 0. 05 ),whereas that of macrophage decreased and negatively correlated with pathologic scores (P <0. 05). The MPO lever of lung tissue was correlated with the pathologic scores ( P < 0. 01 ). But the percentage of the neutrophil in the BALF was just in a high level during the first week, then it maintained relatively lower. Conclusion Smoke-induced chronic bronchitis is a slowly progressive inflammation process. The model we established is convenient and simple for the longitudinal study on the inflammatory process of chronic bronchitis and the therapy in the early stage. The semi-quantitative evaluation for the pathological change is with much more value. During the inflammatory sequential process of early stage of chronic bronchitis, the cellular characteristics are

  1. Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats

    Directory of Open Access Journals (Sweden)

    Akamatsu Akinori

    2012-02-01

    Full Text Available Abstract Background Chlorine dioxide (CD gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio is judged as safe on the basis of a battery of toxicological examinations. Methods CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human.

  2. A STUDY OF INCID ENCE OF AWARENESS IN GENERAL AN ESTHESIA WITH INHALATIONAL AGENT (HALOTHANE

    Directory of Open Access Journals (Sweden)

    Sreeraghu

    2014-01-01

    Full Text Available BACKGROUND AND OBJECTIVES : A wareness during general anesthesia is a frightening experience , which may result in serious emotional injury and post - traumatic disorders. Awareness have been reported with many anesthetic techniques , particularly surgical patient populations such as thos e requiring anesthesia for Obstetrics , Major trauma , and cardiac surgery are known to experience a high incidence ( 7 - 43% of awareness. In our study we have made an attempt to evaluate the incidence of awareness in surgical patients under general anesthesi a using inhalational agent ( Halothane with Nitrous oxide . In this study we have evaluated the incidence of awareness by using Blood Pressure , Heart Rate , Sweating , Tears score intraoperatively and interviewing patients post - operatively by standard questio nnaire . MATERIALS AND METHODS : Hundred patients undergoing surgical procedures under general Anesthesia were randomly selected for the study . They were posted to undergo surgery from November 2011 to July 2013 . Parameters observed : Intra - operatively Blood Pressure , Heart Rate , Sweating , Tears scoring was done at 0 minutes in the operation theatre before induction and 10 minutes after intubation and monitored every 10 minutes till the end of surgery. All the patients were interviewed in the post - operative pe riod soon after complete recovery and 24 hours later again with a set of 10 questions ( Questionnaire method . RESULTS : In our study we have a standard interview questionnaire in the post operative period to study the incidence of awareness. We found that n one of the patients had conscious recall of the events during surgery. In our study of 100 patients none of the patients had awareness. Injection atropine 20 mcg/kg body weight and injection pethidine 1mg/kg body weight were given as premedication. Inducti on agent used was injection thiopental sodium 5mg/kg body weight and maintained with Nitrous oxide , Halothane as

  3. Assessment of satisfaction with different dry powder inhalation devices in Greek patients with COPD and asthma: the ANASA study

    Science.gov (United States)

    Zervas, Eleftherios; Samitas, Konstantinos; Gaga, Mina

    2016-01-01

    Background Poor adherence to inhaled therapy is common in patients with asthma and COPD. An inhaler selection based on patients’ preference could be beneficial to adherence and treatment effectiveness. Properly designed questionnaires can assess patients’ satisfaction with their medication devices. The aim of this study was to estimate, using the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire, the ease of use and satisfaction of patients regarding three different marketed dry powder inhalers (DPIs): Diskus® (DK), Elpenhaler® (EH), and Turbuhaler® (TH). The FSI-10 is a self-completed questionnaire to assess patients’ opinions regarding ease of use, portability, and usability of devices, irrespective of the drug used. Patients and methods We performed a 4-week, open, noninterventional, multicenter, parallel clinical study in 560 asthmatic and 561 COPD patients. During the first visit, patients were classified into three groups according to the DPI they were already using. Patients were regularly receiving their treatments (Seretide DK, Rolenium EH, and Symbicort TH) and agreed to complete the FSI-10 questionnaire in the second visit. Results A total of 517 COPD and 523 asthma patients completed the study. All DPIs tested received satisfactory results, while the EH obtained consistently higher scores in the FSI-10 in both COPD and asthma patients (44.7 and 44.1 vs 41.5 and 43 for TH, 40.8 and 41.4 for DK, P<0.001 and P<0.01, respectively). TH was rated better than DK by asthma patients. Patients suffering with severe COPD tended to express higher feeling of satisfaction than those with moderate or mild disease, irrespective of the device used. Conclusion All DPIs tested were highly acceptable by asthma and COPD patients of different ages; nevertheless, EH received significantly higher ratings in most of the questionnaire domains. COPD patients in advanced stages of the disease generally expressed higher level of satisfaction with their devices.

  4. Inhalation solutions--which ones may be mixed? Physico-chemical compatibility of drug solutions in nebulizers--update 2013.

    Science.gov (United States)

    Kamin, Wolfgang; Erdnüss, Frank; Krämer, Irene

    2014-05-01

    Many patients suffering from chronic respiratory diseases rely on inhalation therapy with nebulizers. About 25% of patients who need to inhale several different drugs per day save time by mixing them for simultaneous inhalation. This review presents a comprehensive overview of the available data concerning physico-chemical compatibility of commonly mixed nebulizer solutions and suspensions. Information is based on our in vitro studies and a thorough literature search. Results indicate that many nebulizer solutions/suspensions are mixable without provoking incompatibilities. However, certain excipients contained in some of the tested drug products could be identified as a reason for incompatibilities, e.g. impaired activity of dornase alfa. Studies assessing the aerosol characteristics of compatible mixtures nebulized with commonly used nebulizers are limited and should be encouraged. The clinical efficacy of simultaneous inhalation of duplicate, tripartite or quadripartite mixtures must be evaluated in clinical studies before final recommendations for the inhalation regimens can be made. PMID:24172851

  5. Inhalation developmental toxicology studies: Teratology study of 1,3-butadiene in mice: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hackett, P.L.; Sikov, M.R.; Mast, T.J.; Brown, M.G.; Buschbom, R.L.; Clark, M.L.; Decker, J.R.; Evanoff, J.J.; Rommereim, R.L.; Rowe, S.E.; Westerberg, R.B.

    1987-11-01

    Maternal toxicity, reproductive performance and developmental toxicology were evaluated in CD-1 mice following whole-body, inhalation exposures to 0, 40, 200 and 1000 ppM of 1,3-butadiene. The female mice, which had mated with unexposed males were exposed to the chemical for 6 hours/day on 6 through 15 dg and sacrificed on 18 dg. Maternal animals were weighed prior to mating and on 0, 6, 11 and 18 dg; the mice were observed for mortality, morbidity and signs of toxicity during exposure and examined for gross tissue abnormalities at necropsy. Live fetuses were weighed and subjected to external, visceral and skeletal examinations to detect growth retardation and morphologic anomalies. Significant concentration-related decreases were detected in a number of maternal body weight measures. There was a significant concentration-related depression of fetal body weights and placental weights. Body weights of male fetuses of all exposed groups were significantly lower than values for control fetuses; weights of female fetuses were significantly depressed in the mice exposed to 200 and 1000 ppM. In the 200- and 1000-ppM exposure groups, weights of placentas of male fetuses were significantly decreased, but placental weights of female fetuses were significantly affected only in litters exposed to the highest 1,3-butadiene concentration. This exposure regimen produced significant signs of maternal toxicity at concentrations of 200 and 1000 ppM 1,3-butadiene.

  6. A descriptive study of clinical, hematological, and biochemical parameters of inhalant users seeking treatment at a tertiary care center in India

    Directory of Open Access Journals (Sweden)

    Rizwana Quraishi

    2013-01-01

    Full Text Available Background: Inhalant (or solvent abuse is the purposeful inhalation of vapors or gases, intended to produce pleasurable psychoactive effects. There is a dearth of Indian studies on inhalant users. Aim: The present study aimed to describe the socio-demographic, clinical, and psychosocial characteristics of inhalant users visiting a Tertiary Care Center in North India. Materials and Methods: The study was a retrospective chart review for 50 inhalant users who sought treatment for the first time from the center over a period of 2 years. All patients seeking treatment for inhalant use at the center were evaluated by a psychiatrist. Results: Mean age of the sample was 17.16±4.09 years and majority comprised of children and adolescents (72.2%. There were only three girls (6%. Majority comprised of school drop-outs (82%, from lower socio-economic status (80%. Mean age of initiation of first substance was 14.13±4.27 years and inhalants were first drugs for 38%. Duration of inhalant use ranged between 1 month and 7.5 years. Use was mostly uninterrupted, and 88% were dependent users. Correction fluid was the commonest product, used by huffing or sniffing. A large majority (86% had used at least one other substance besides inhalants, and 8% reported involvement in high-risk sexual behaviors. Comorbid psychiatric disorder was seen in 8% of sample. Positive family history was observed in 30% of the sample. The mean hemoglobin of the sample was 11.88±0.60, with low hemoglobin in 25% of users. Neutrophils, lymphocytes, eosinophils, and monocytes were elevated beyond normal in 10.8%, 6.5%, 15.2%, and 7.5%, respectively. There was no evidence of leucopenia. Bilirubin and serum glutamic pyruvic transaminase was elevated in 6.6% and 13% of inhalant users, respectively. Conclusion: The study adds to the limited date available on the treatment-seeking inhalant users from Indian settings. There is a need to examine the pattern of inhalant use in larger samples

  7. INHALATION STUDIES OF MT. ST. HELENS VOLCANIC ASH IN ANIMALS: RESPIRATORY MECHANICS, AIRWAY REACTIVITY AND DEPOSITION

    Science.gov (United States)

    Effects of fine volcanic ash aerosol on pulmonary mechanical properties of awake guinea pigs were evaluated during exposure by inhalation. Ash penetration into the lungs as well as tissue response to ash were determined by transmission electron microscopy. The reactivity of airwa...

  8. Formoterol, a new long acting beta 2 agonist for inhalation twice daily, compared with salbutamol in the treatment of asthma.

    OpenAIRE

    Wallin, A; Melander, B; Rosenhall, L; Sandström, T; Wåhlander, L

    1990-01-01

    Sixteen patients with stable chronic asthma participated in a double blind crossover study comparing the new inhaled long acting beta 2 agonist formoterol with salbutamol. Inhaled (n = 15) and oral steroid (n = 1) treatment were maintained at the same daily dose throughout the study. For four weeks the patients received either formoterol 24 micrograms twice daily or salbutamol 400 micrograms twice daily, plus additional puffs (with the same drug) when needed. Asthma symptoms, additional puffs...

  9. A study on regional cerebral blood flow measurement by 133FXe inhalation method

    International Nuclear Information System (INIS)

    Fundamental and clinical investigations were performed on reliability of Fourier analysis of head clearance curves in regional cerebral blood flow measurement by 133Xe inhalation methods as compared with conventional Obrist analysis. Fourier analysis revealed better reproducibilities determined by computer simulated curves and repetitive measurements in man than Obrist analysis. In the studies of the changes of regional cerebral blood flow from the resting conditions to the conditions of finger movement, listening to verbal material or music and reading aloud in right-handed normal subjects, both F1 (a flow of the fast component of two compartmental model) and ISI (Initial Slope Index: calculated from the initial slope of the wash out curves corrected for recirculation) of Fourier analysis were more sensitive to detect significant changes than Obrist analysis. On the basis of the fact mentioned above, it was concluded that ISI of Fourier analysis was the best index of regional cerebral blood flow. Age-matched normal values of ISI of Fourier analysis were calculated from 132 measurements in 105 normal right-handed subjects, aged 19 to 80 years old (mean 42 years). Mean brain ISI showed significant negative correlation with advancing age (r = -0.70, p < 0.001). The regression line and 95% confidence interval were Y = -0.32X + 69.6 and +- 11.2, respectively. In comparison with the measured values of the patients with cerebrovascular disorders, this age-matched normal values were proved to be sufficient for practical use. Regional ISI also showed significant negative correlations with advancing age in the entire brain (p < 0.001). The regional reduction of ISI with advancing age was significantly greater in the regional distribution of the middle cerebral arteries bilaterally, compared with regions in the distributions of either the anterior cerebral, the posterior cerebral or vertebrobasilar arteries (p < 0.05). (J.P.N.)

  10. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Rodriguez-Roisin, Roberto; Tetzlaff, Kay; Watz, Henrik; Wouters, Emiel Fm; Disse, Bernd; Finnigan, Helen; Magnussen, Helgo; Calverley, Peter Ma

    2016-01-01

    The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland-Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of -0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis. PMID:27578972

  11. Long-term dose-response studies of inhaled or injected radionuclides. Biennial report, 1 October 1991--30 September 1993

    Energy Technology Data Exchange (ETDEWEB)

    Boecker, B.B.; Muggenburg, B.A.; Miller, S.C.; Bradley, P.L. [eds.

    1994-01-01

    This report describes the scientific progress in, and current status of, life-span studies of the long-term health risks in Beagle dogs of chronic irradiation from internally deposited radionuclides or from an external source. The reporting period for this document is the 2-year period from October 1, 1991 through September 30, 1993. Studies that were initiated at three different laboratories (Inhalation Toxicology Research Institute, ITRI, University of Utah, and Argonne National Laboratory, ANL) are presented here because they are being completed at ITRI. All living dogs in the Utah-initiated studies were transferred to the ITRI facility for the remainder of their life-span observations and measurements in September 1987. This report is the fourth in a series of reports dealing with the current status and progress of both the Utah and ITRI studies. Other life-span studies involving dogs exposed to gamma radiation from an external source were initiated and conducted for many years at ANL. In 1991, the decision was made to discontinue the chronic irradiation of the remaining living dogs and to transfer all remaining dogs to ITRI for care, clinical observations, and pathological observations at death or euthanasia. This report provides the current status of these dogs. Status reports on the Utah and ITRI studies comprise most of this report. The ITRI-related section presents brief statements of project objectives, the general procedures used in these studies, and some study-specific features for each of the 19 studies being conducted with either beta- or alpha-emitting radionuclides. Dose- and effect-modifying factors being addressed in these studies include total dose, dose rate, LET, solubility, nonuniformity of dose, species, age, sex, health status, and mode of exposure. Recent additions to experimental protocols for studies in which dogs are still alive involve the collection and analysis of tumor tissues using currently available molecular biology techniques.

  12. Inhalation of honey reduces airway inflammation and histopathological changes in a rabbit model of ovalbumin-induced chronic asthma

    OpenAIRE

    Kamaruzaman, Nurfatin Asyikhin; Sulaiman, Siti Amrah; Kaur, Gurjeet; Yahaya, Badrul

    2014-01-01

    Background Honey is widely used in folk medicine to treat cough, fever, and inflammation. In this study, the effect of aerosolised honey on airway tissues in a rabbit model of ovalbumin (OVA)-induced asthma was investigated. The ability of honey to act either as a rescuing agent in alleviating asthma-related symptoms or as a preventive agent to preclude the occurrence of asthma was also assessed. Methods Forty New Zealand white rabbits were sensitized twice with mixture of OVA and aluminium h...

  13. Influence of inhaler technique on asthma and COPD control: a multicenter experience

    Science.gov (United States)

    Dudvarski Ilic, Aleksandra; Zugic, Vladimir; Zvezdin, Biljana; Kopitovic, Ivan; Cekerevac, Ivan; Cupurdija, Vojislav; Perhoc, Nela; Veljkovic, Vesna; Barac, Aleksandra

    2016-01-01

    Background The successful management of asthma and chronic obstructive pulmonary disease (COPD) mostly depends on adherence to inhalation drug therapy, the usage of which is commonly associated with many difficulties in real life. Improvement of patients’ adherence to inhalation technique could lead to a better outcome in the treatment of asthma and COPD. Objective The aim of this study was to assess the utility of inhalation technique in clinical and functional control of asthma and COPD during a 3-month follow-up. Methods A total of 312 patients with asthma or COPD who used dry powder Turbuhaler were enrolled in this observational study. During three visits (once a month), training in seven-step inhalation technique was given and it was practically demonstrated. Correctness of patients’ usage of inhaler was assessed in three visits by scoring each of the seven steps during administration of inhaler dose. Assessment of disease control was done at each visit and evaluated as: fully controlled, partially controlled, or uncontrolled. Patients’ subjective perception of the simplicity of inhalation technique, disease control, and quality of life were assessed by using specially designed questionnaires. Results Significant improvement in inhalation technique was achieved after the third visit compared to the first one, as measured by the seven-step inhaler usage score (5.94 and 6.82, respectively; Psuccessful respiratory disease treatment. Therefore, health care professionals should insist on educational programs aimed at improving patients’ inhalation technique with different devices, resulting in better long-term disease control and improved quality of life. PMID:27785007

  14. Soluble urokinase-type plasminogen activator receptor levels in patients with burn injuries and inhalation trauma requiring mechanical ventilation: an observational cohort study

    OpenAIRE

    Backes, Yara; van der Sluijs, Koenraad F; Tuip de Boer, Anita M; Hofstra, Jorrit Jan; Vlaar, Alexander PJ; Determann, Rogier M; Knape, Paul; David P Mackie; Schultz, Marcus J.

    2011-01-01

    Introduction Soluble urokinase-type plasminogen activator receptor (suPAR) has been proposed as a biologic marker of fibrinolysis and inflammation. The aim of this study was to investigate the diagnostic and prognostic value of systemic and pulmonary levels of suPAR in burn patients with inhalation trauma who need mechanical ventilation. Methods suPAR was measured in plasma and nondirected lung-lavage fluid of mechanically ventilated burn patients with inhalation trauma. The samples were obta...

  15. A randomized controlled trial of inhaled corticosteroids (ICS on markers of epithelial–mesenchymal transition (EMT in large airway samples in COPD: an exploratory proof of concept study

    Directory of Open Access Journals (Sweden)

    Sohal SS

    2014-05-01

    Full Text Available Sukhwinder Singh Sohal,1,* Amir Soltani,1,* David Reid,1,2 Chris Ward,1,3 Karen E Wills,1,4 H Konrad Muller,1 Eugene Haydn Walters1 1National Health and Medical Research Council Centre of Research Excellence for Chronic Respiratory Disease, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia; 2Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 3Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK; 4Department of Biostatistics, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia *These authors contributed equally to this workBackground: We recently reported that epithelial–mesenchymal transition (EMT is active in the airways in chronic obstructive pulmonary disease (COPD, suggesting presence of an active profibrotic and promalignant stroma. With no data available on potential treatment effects, we undertook a blinded analysis of inhaled corticosteroids (ICS effects versus placebo on EMT markers in previously obtained endobronchial biopsies in COPD patients, as a “proof of concept” study.Methods: Assessment of the effects of inhaled fluticasone propionate (FP; 500 µg twice daily for 6 months versus placebo in 34 COPD patients (23 on fluticasone propionate and eleven on placebo. The end points were epidermal growth factor receptor (EGFR; marker of epithelial activation and the biomarkers of EMT: reticular basement membrane (Rbm fragmentation (“hallmark” structural marker, matrix metalloproteinase-9 (MMP-9 cell expression, and S100A4 expression in basal epithelial and Rbm cells (mesenchymal transition markers.Results: Epithelial activation, “clefts/fragmentation” in the Rbm, and changes in the other biomarkers all regressed on ICS, at or close to conventional levels of statistical significance. From these data, we have been able to nominate primary and secondary end points and develop

  16. Increased use of inhaled corticosteroids among young Danish adult asthmatics: An observational study

    DEFF Research Database (Denmark)

    Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper;

    2010-01-01

    Product Statistics during 1997-2006. One year prevalences of ICS use were calculated in categories of gender, age, and annual consumption of inhaled beta-2-agonists (IBA) in defined daily doses (DDD) per year. Determinants of ICS use were estimated by logistic regression models. RESULTS: The one year.......96-1.01) compared to 1.12 (95% CI 1.09-1.15) in 2001, and 1.81 (95% CI 1.75-1.87) in 2006. Other determinants of high ICS use were female gender, young age, and high annual IBA consumption. Among those using at least 400 DDD of IBA per year (corresponding to 4.4 powder inhalations daily), nearly 20% had no ICS...

  17. Randomised controlled study of early use of inhaled corticosteroid in preterm infants with respiratory distress syndrome

    OpenAIRE

    Fok, T; Lam, K.; Dolovich, M.; Ng, P; Wong, Van W.; Cheung, K; So, K

    1999-01-01

    AIM—To investigate the therapeutic efficacy of inhaled fluticasone propionate, started on day 1 of age, on ventilated preterm infants with respiratory distress syndrome.
METHODS—Starting within 24 hours of age, ventilated preterm infants (gestation < 32 weeks, birthweight < 1.5 kg) with respiratory distress syndrome were given a 14 day course (two puffs, 12 hourly) of either fluticasone propionate (250 µg/puff) (group 1, n=27) or placebo (group 2, n=26) with a metered dose i...

  18. Effect of High Dose Inhaled Glucocorticoids on Quality of Life in Patients with Moderate to Severe Asthma

    OpenAIRE

    Choi, Jae-Sung; Jang, An-Soo; Lee, June-Hyuk; Park, Jong-Sook; Park, Sung Woo; Kim, Do-Jin; Park, Choon-Sik

    2005-01-01

    Asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients. Inhaled glucocorticoids (GCs) are the most effective controller therapy. The purpose of this study was to evaluate the effect of inhaled GCs on quality of life in patients with moderate to severe asthma. Patients completed the asthma quality of life questionnaire (AQLQ) and pulmonary function test at baseline and after 4 wks treatment of GCs. We enroll...

  19. 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

    Directory of Open Access Journals (Sweden)

    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.

  20. A method of estimating inspiratory flow rate and volume from an inhaler using acoustic measurements

    International Nuclear Information System (INIS)

    Inhalers are devices employed to deliver medication to the airways in the treatment of respiratory diseases such as asthma and chronic obstructive pulmonary disease. A dry powder inhaler (DPI) is a breath actuated inhaler that delivers medication in dry powder form. When used correctly, DPIs improve patients' clinical outcomes. However, some patients are unable to reach the peak inspiratory flow rate (PIFR) necessary to fully extract the medication. Presently clinicians have no reliable method of objectively measuring PIFR in inhalers. In this study, we propose a novel method of estimating PIFR and also the inspiratory capacity (IC) of patients' inhalations from a commonly used DPI, using acoustic measurements. With a recording device, the acoustic signal of 15 healthy subjects using a DPI over a range of varying PIFR and IC values was obtained. Temporal and spectral signal analysis revealed that the inhalation signal contains sufficient information that can be employed to estimate PIFR and IC. It was found that the average power (Pave) in the frequency band 300–600 Hz had the strongest correlation with PIFR (R2 = 0.9079), while the power in the same frequency band was also highly correlated with IC (R2 = 0.9245). This study has several clinical implications as it demonstrates the feasibility of using acoustics to objectively monitor inhaler use. (paper)

  1. Histological study of chronic pulmonary aspergillosis

    OpenAIRE

    Tochigi, Naobumi; Ishiwatari, Takao; Okubo, Yoichiro; Ando, Tsunehiro; Shinozaki, Minoru; Aki, Kyoko; GOCHO, KYOKO; Hata, Yoshinobu; Murayama, Somay Y.; Wakayama, Megumi; Nemoto, Tetsuo; Hori, Yasuhiro; SHIBUYA, KAZUTOSHI

    2015-01-01

    Background Chronic pulmonary aspergillosis (CPA) has been accepted the criteria for the diagnosis of pulmonary Aspergillus infection. Whereas, either pathophysiology or signs of CPA remains still controversial. Methods In this study, we histopathologically investigated 25 specimens of CPA, surgically resected. Results 21 (84 %) of that comprised male. There were 21 cases with mild impairment of the immune system and/or a scar mostly due to old tuberculosis. There is a tendency for a negative ...

  2. Evaluation of pN factors in patients with primary lung cancer by using perfusion, inhalation and ventilation studies

    International Nuclear Information System (INIS)

    The interpretation of scintigraphic patterns and the role of pathophysiological mechanisms in patients with primary lung cancer were investigated. To determine the relative roles of perfusion, inhalation and ventilation scintigraphy, the relationship between the count ratio of the affected side to the healthy side and the post-surgical histological lymph nodes factors were observed in this study. These scintigraphic count ratio's in patients with primary lung cancer did not reflect the pN factors except in the perfusion study in patients with hilar primary lung cancer. (author)

  3. AB034. Comparative effectiveness of prescribing similarversusdissimilar inhalers for COPD therapy

    Science.gov (United States)

    Bosnic-Anticevich, Sinthia; Chrystyn, Henry; Costello, Richard; Dolovich, Myrna; Fletcher, Monica; Lavorini, Federico; Rodríguez-Roisin, Roberto; Ryan, Dermot; Ming, Simon Wan Yau; Skinner, Derek; Price, David

    2016-01-01

    Background Prescription of different inhaler types for patients with chronic obstructive pulmonary disease (COPD) may lead to poorer outcomes through increased demands on patients to master dissimilar inhalation and dose preparation manoeuvres. To describe the demographic, co-morbidity, and clinical characteristics of patients with COPD prescribed ‘dissimilar’versus‘similar’ inhalers. Methods The study was a historical cohort observational design assessing a 1-year baseline period for patient characterization and categorisation of inhalers, and an index date to signal the last date of data extraction from the UK Optimum Patient Care Research Database (OPCRD). Patients had 1-year of continuous data between February 2008 and February 2015, a Quality and Outcomes Framework (QOF) coded diagnosis for COPD, were aged 40 and over, and had evidence of two or more inhaled respiratory treatments. Descriptive statistics included demographic, co-morbidity and clinical characteristics of patients, and comparison of patients prescribed similarversusdissimilar inhalers by GOLD group, FEV1, and number of exacerbations. Based on inhalation technique and dose preparation data in the OPCRD, two different categorisations were used to describe prescribed inhaler type: ‘similar inhalers’ included those patients prescribed either aerosols or similar dry-powder inhalers (DPIs), while ‘dissimilar inhalers’ included those prescribed both aerosols and DPIs. Results A total of 53,817 patients were selected [mean age of 71 years (SD 10.6); males: 51% in total population]. 13% were non-smokers, 30% current smokers, 52% ex-smokers and 5% with missing smoking status. In the baseline year, 39% received a QOF coded diagnosis for asthma, 36% for diabetes, 26% for ischaemic heart disease, 6% for actively treated rhinitis, and 1.3% for diagnosis for pneumonia. Patients prescribed dissimilar inhalers were of similar age to those prescribed similar inhalers (mean age of 71 in each cohort

  4. "Trying, But Failing" - The Role of Inhaler Technique and Mode of Delivery in Respiratory Medication Adherence.

    Science.gov (United States)

    Braido, Fulvio; Chrystyn, Henry; Baiardini, Ilaria; Bosnic-Anticevich, Sinthia; van der Molen, Thys; Dandurand, Ronald J; Chisholm, Alison; Carter, Victoria; Price, David

    2016-01-01

    Inhaled therapies are the backbone of asthma and chronic obstructive pulmonary disease management, helping to target therapy at the airways. Adherence to prescribed treatment is necessary to ensure achievement of the clinician's desired therapeutic effect. In the case of inhaled therapies, this requires patients' acceptance of their need for inhaled therapy together with successful mastery of the inhaler technique specific to their device(s). This article reviews a number of challenges and barriers that inhaled mode of delivery can pose to optimum adherence-to therapy initiation and, thereafter, to successful implementation and persistence. The potential effects on adherence of different categories of devices, their use in multiplicity, and the mixing of device categories are discussed. Common inhaler errors identified by the international Implementing Helping Asthma in Real People (iHARP) study are summarized, and adherence intervention opportunities for health care professionals are offered. Better knowledge of common errors can help practicing clinicians identify their occurrence among patients and prompt remedial actions, such as tailored education, inhaler technique retraining, and/or shared decision making with patients regarding suitable alternatives. Optimizing existing therapy delivery, or switching to a suitable alternative, can help avoid unnecessary escalation of treatment and health care resources. PMID:27587316

  5. Regional pulmonary ventilation and perfusion studies with sup(81m)Kr after acetylcholine inhalation in bronchial asthma

    International Nuclear Information System (INIS)

    sup(81m)Kr is a radioactive noble gas with an ultrashort halflife of 13 seconds, and can be produced in gaseous form or in solution from its parent, 81Rb(T1/2=4.7hours). Using sup(81m)Kr both regional pulmonary ventilation and perfusion were studied simultaneously in 32 asthmatic patients during remission just before and after acetylcholine inhalation. Twenty-five patients were studied in the sitting position and 7 patients supine : the former were examined once, the latter repeatedly after acetylcholine inhalation. The results were as follows : 1. Changes in regional ventilation 1) Ventilatory abnormalities after acetylcholine inhalation appeared to be localized. Their appearances were related to the percentage decrease in FEVsub(1.0). 2) The lower zones were involved most frequently and the upper zones least frequently. 3) On serial examination, the time courses of regional ventilatory function showed the same patterns as those of percentage decrease in FEVsub(1.0). in hypoventilated areas. But regional ventilatory recovery times were different in each area. 2. Regional ventilation and perfusion relationships 1) Hypoventilated areas generally showed hypoperfusion (similar distribution), but ventilatory abnormalities were greater than those of perfusion (low regional ventilation /perfusion ratio). These findings indicate that perfusion abnormalities are secondary to the ventilatory abnormalities. 2) Abnormalities of regional ventilation/perfusion ratios were related to the ventilatory abnormalities but almost never to the percentage decrease in FEVsub(1.0). 3) In upper (middle) zones, there were some cases with increased perfusion in spite of decreased ventilation. 4) Hypoperfusion reached a maximum witnin 2-3 minutes after the start of the hypoventilated plateau. (author)

  6. The design, construction, and operation of a whole-body inhalation chamber for use in avian toxicity studies.

    Science.gov (United States)

    Olsgard, Mandy L; Smits, Judit E G

    2008-01-01

    Environmental risk assessments are broadening to include evaluations of avian species exposed to gaseous and particulate materials (Mineau, 2002b; Irvine, 2004; Carmalt, 2005). Since the avian respiratory tract is fundamentally different from the respiratory tract of rodents, the effects of gaseous materials on birds cannot validly be extrapolated from data derived from rodent exposure studies (Briant & Driver, 1992; Brown et al., 1997). To address the lack of avian-specific lowest observable effect levels used to calculate reference concentrations for airborne pollutants, a system was designed to facilitate research on inhalation toxicology in small birds. Birds have long been used as early indicators of poor air quality (Brown et al., 1997), and various chambers have been designed for head only exposures of larger birds (Briant & Driver, 1992). Smaller birds with short tracheal lengths and hooked beaks however require less restrictive exposure apparatus, thus warranting the proposed design. The chamber described in this article was designed to accommodate a small falcon, the American kestrel, a species frequently used in toxicological risk assessments (Wiemeyer & Lincer, 1987a; Smits & Bortolotti, 2001; Bortolotti et al., 2003; Fisher et al., 2006). To accomplish this, a 41-L closed inhalation system capable of exposing 12 adult American kestrels was constructed primarily of galvanized steel, polyvinyl chloride, and copper tubing. Humidified air was passed over the birds and subsequently decontaminated by an activated carbon filter and released to a HEPA filtration system. The proposed inhalation chamber was successfully used in 2005 and 2006 to expose a total of 55 male American kestrels to benzene and toluene. Measurements of various biochemical endpoints associated with benzene and toluene toxicity allowed us to study the effects of airborne pollutants on small nondomesticated birds in a controlled laboratory setting.

  7. Factors influencing asthma control: results of a real-life prospective observational asthma inhaler treatment (ASIT study

    Directory of Open Access Journals (Sweden)

    Yıldız

    2013-07-01

    Full Text Available Füsun Yildiz, On behalf of the ASIT Study Group Department of Pulmonary Disease, Kocaeli University School of Medicine, Kocaeli, Turkey Background: Despite the availability of new pharmacological options and novel combinations of existing drug therapies, the rate of suboptimal asthma control is still high. Therefore, early identification of the clinical and behavioral factors responsible for poor asthma control, and interventions during routine outpatient visits to improve asthma trigger management, are strongly recommended. This study was designed to evaluate the profiles of asthmatic patients and their inhaler treatment devices in relation to asthma control in Turkey. Methods: A total of 572 patients with persistent asthma (mean [standard deviation] age: 42.7 [12.1] years; 76% female were included in this prospective observational study. A baseline visit (0 month, visit 1 and three follow-up visits (1, 3 and 6 months after enrolment were conducted to collect data on demographics, past medical and asthma history, and inhaler device use. Results: Asthma control was identified in 61.5% of patients at visit 1 and increased to 87.3% at visit 4 (P < 0.001, regardless of sociodemographics, asthma duration, body mass index or smoking status. The presence of asthma-related comorbidity had a significantly negative effect on asthma control (P = 0.004. A significant decrease was determined, in the rate of uncontrolled asthma, upon follow-up among patients who were using a variety of fixed dose combination inhalers (P < 0.001 for each. Logistic regression analysis was used to show that the presence of asthma-related comorbidity (odds ratio [OR], 0.602; 95% confidence interval [CI], 0.419; 0.863, P = 0.006 and active smoking (OR, 0.522; 95% CI, 0.330; 0.825, P = 0.005 were significant predictors of asthma control. Conclusion: Our findings indicate that, despite ongoing treatment, asthma control rate was 61.5% at visit 1 in adult outpatients with persistent

  8. Study of the thorium incorporation by inhalation in individuals occupationally exposed

    International Nuclear Information System (INIS)

    A mathematical model describing the metabolism of inhaled thorium in the human body was developed. Through this model theoretical limits of excretion were calculated for workers of a monazite plant (Usina Santo Amaro). This limits were based on International Commission on Radiological Protection publication 30, 1979. Excreta samples from twelve workers of Usina Santo Amaro were collected and analysed for thorium. All samples were bellow the theoretical limits of excretion indicating that Usina Santo Amaro workers are exposed to thorium levels bellow the Annual Limits of Intake recommended by ICRP, publication 30. (author)

  9. SUBCHRONIC TOXICITY OF INHALED TOLUENE IN RATS: IMMUNOLOGY, CARDIAC GENE EXPRESSION AND MARKERS OF OXIDATIVE STRESS.

    Science.gov (United States)

    The health effects of long-term exposure to volatile organic compounds (VOCs) are poorly understood, due primarily to insufficient human exposure data and inconsistent animal models. To develop a rodent model of long-term exposure to VOCs, a sub-chronic inhalation study with mult...

  10. Abused inhalants enhance GABA-mediated synaptic inhibition

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

  13. The risk and outcomes of pneumonia in patients on inhaled corticosteroids.

    Science.gov (United States)

    Sibila, Oriol; Soto-Gomez, Natalia; Restrepo, Marcos I

    2015-06-01

    Corticosteroids are frequently prescribed anti-inflammatory medications. Inhaled corticosteroids (ICS) are indicated for Chronic Obstructive Pulmonary Disease (COPD) and asthma. ICS are associated with a decrease in exacerbations and improved quality of life in COPD, however multiple studies have linked the chronic use of ICSs with an increased risk of developing pneumonia, though the effect on mortality is unclear. We review the association of ICS with the risk of pneumonia and the implications on clinical outcomes.

  14. Cerebral hemodynamics in normal-pressure hydrocephalus. Evaluation by 133Xe inhalation method and dynamic CT study

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, N.; Kusunoki, T.; Wakabayashi, T.; Matsumoto, S.

    1984-09-01

    Cerebral hemodynamics in 31 patients with suspected normal-pressure hydrocephalus were studied by means of the xenon-133 (133Xe) inhalation method and on dynamic computerized tomography (CT) scanning. Cerebral blood flow (CBF) is reduced in all patients with dementia. Hypoperfusion was noted in a frontal distribution in these patients compared with normal individuals. There was no difference in CBF patterns between patients with good and those with poor outcome. The CBF was increased following cerebrospinal fluid (CSF) shunting in patients who responded to that procedure: increase in flow correlated with clinical improvement, frontal and temporal lobe CBF was most markedly increased, and the CBF pattern became normal. In contrast, CBF was decreased after shunt placement in patients who were considered to have suffered from degenerative dementia, as evidenced by non-response to shunting. Dynamic computerized tomography studies demonstrated that patients with a good outcome showed a postoperative reduction in mean transit time of contrast material, most prominent in the frontal and temporal gray matter, and slight in the deep frontal structures, but not in the major cerebral vessels. Patients with poor outcome after shunting, however, had an increase in transit time in all regions. This corresponded well with the results as determined by the 133Xe inhalation method.

  15. Inhalation exposure methodology.

    OpenAIRE

    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...

  16. Toxicology and Carcinogenesis Studies of Furfuryl Alcohol (CAS No. 98-00-0) in F344/N Rats and B6C3F1 Mice (Inhalation Studies).

    Science.gov (United States)

    1999-02-01

    14. Mean body weights of male and female mice exposed to 63 or 125 ppm were significantly less than those of the chamber control groups. All exposed animals except one 16 ppm male developed lesions in the nasal respiratory epithelium and/or olfactory epithelium, and the severities of these lesions generally increased with increasing exposure concentration. 14-WEEK STUDY IN RATS: Groups of 10 male and 10 female rats were exposed to furfuryl alcohol at concentrations of 0, 2, 4, 8, 16, or 32 ppm, 6 hours per day, 5 days per week for 14 weeks. All rats survived to the end of the study. The mean body weight gain of females exposed to 32 ppm was less than that of the chamber control group. Exposure-related increases in the incidences of squamous metaplasia of the respiratory and transitional epithelium, goblet cell hyperplasia of the respiratory epithelium, and hypertrophy of the respiratory epithelium lining the nasopharyngeal duct were observed in the nose of male and female rats. The incidences of degeneration, hyperplasia, metaplasia, and surface exudate of the olfactory epithelium generally increased with increasing exposure concentration in males and females. 14-WEEK STUDY IN MICE: Groups of 10 male and 10 female mice were exposed to furfuryl alcohol at concentrations of 0, 2, 4, 8, 16, or 32 ppm, 6 hours per day, 5 days per week for 14 weeks. All mice survived to the end of the study. Heart weights of 32 ppm males were significantly less than those of the chamber controls. Exposure-related histologic changes included degeneration, metaplasia, and chronic inflammation of the olfactory epithelium; hyaline droplets of the respiratory epithelium; and squamous metaplasia of the submucosal gland of the cuboidal epithelium in males and females. 2-YEAR STUDY IN RATS: Groups of 50 male and 50 female rats were exposed to furfuryl alcohol by inhalation, 6 hours per day, 5 days per week for 105 weeks, at concentrations of 0, 2, 8, or 32 ppm. Survival and Body Weights All male

  17. Cost-effectiveness analysis of three different combinations of inhalers for severe and very severe chronic obstructive pulmonary disease patients at a tertiary care teaching hospital of South India

    Directory of Open Access Journals (Sweden)

    Mohammed Altaf

    2015-01-01

    Rs. 661/- per SFD. Conclusion: This study highlights the favorable therapeutic performance of combined inhaled bronchodilators and corticosteroids (SF/FB/FF, thus suggesting that healthcare costs would be also affected positively. Results from our study showed that SF and FB were the most effective strategies in the treatment of COPD, with a slight clinical superiority of SF. The FF strategy was not much effective (i.e. associated with fewer outcomes and higher costs.

  18. Inhalation developmental toxicology studies: Teratology study of tetrahydrofuran in mice and rats: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Evanoff, J.J.; Stoney, K.H.; Westerberg, R.B.; Rommereim, R.L.; Weigel, R.J.

    1988-08-01

    Tetrahydrofuran (THF), a four-carbon cyclic ether, is widely used as an industrial solvent. Although it has been used in large quantities for many years, few long-term toxicology studies, and no reproductive or developmental studies, have been conducted on THF. This study addresses the potential for THF to cause developmental toxicity in rodents by exposing Sprague-Dawley rats and Swiss (CD-1) mice to 0, 600, 1800, or 5000 ppm tetrahydrofuran (THF) vapors, 6 h/day, 7 dy/wk. Each treatment group consisted of 10 virgin females (for comparison), and approx.33 positively mated rats or mice. Positively mated mice were exposed on days 6--17 of gestation (dg), and rats on 6--19 dg. The day of plug or sperm detection was designated as O dg. Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice (rats, 20 dg; mice, 18 dg). Implants were enumerated and their status recorded and live fetuses were examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. 27 refs., 6 figs., 23 tabs.

  19. Inhalation developmental toxicology studies: Teratology study of isoprene in mice and rats: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Evanoff, J.J.; Stoney, K.H.; Westerberg, R.B.; Rommereim, R.L.; Weigel, R.J.

    1989-01-01

    Isoprene, a reactive, branched diene, is used in large quantities in the manufacture of polyisoprene and as a copolymer in the synthesis of butyl rubber. The potential for isoprene to cause developmental toxicity was assessed in rodents, by exposing four groups each of Sprague-Dawley rats and Swiss (CD-1) mice to 0, 280, 1400, or 7000 ppM isoprene vapors, 6 h/day, 7 day/wk. Each treatment group consisted of 10 virgin females (for comparison), and approx.30 positively mated rats or mice. Positively mated mice were exposed on days 6-17 of gestation (dg), and rats on 6-19 dg. The day of plug or sperm detection was designated as 0 dg. Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice (rats, 20 dg; mice, 18 dg). Implants were enumerated and their status recorded. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. 31 refs., 6 figs., 19 tabs.

  20. Inhalation developmental toxicology studies: Teratology study of methyl ethyl ketone in mice: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Dill, J.A.; Evanoff, J.J.; Rommereim, R.L.; Weigel, R.J.; Westerberg, R.B.

    1989-02-01

    Methyl ethyl ketone (MEK) is a widely used industrial solvent which results in considerable human exposure. In order to assess the potential for MEK to cause developmental toxicity in rodents, four groups of Swiss (CD-1) mice were exposed to 0, 400, 1000 or 3000 ppM MEK vapors, 7 h/day, 7 dy/wk. Ten virgin females and approx.30 plug-positive females per group were exposed concurrently for 10 consecutive days (6--15 dg for mated mice). Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice on 18 dg. Uterine implants were enumerated and their status recorded. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. Exposure of pregnant mice to these concentrations of MEK did not result in apparent maternal toxicity, although there was a slight, treatment-correlated increase in liver to body weight ratios which was significant for the 3000-ppM group. Mild developmental toxicity was evident at 3000-ppM as a reduction in mean fetal body weight. This reduction was statistically significant for the males only, although the relative decrease in mean fetal body weight was the same for both sexes. 17 refs., 4 figs., 10 tabs.

  1. Inhalation developmental toxicology studies: Teratology study of methyl ethyl ketone in mice: Final report

    International Nuclear Information System (INIS)

    Methyl ethyl ketone (MEK) is a widely used industrial solvent which results in considerable human exposure. In order to assess the potential for MEK to cause developmental toxicity in rodents, four groups of Swiss (CD-1) mice were exposed to 0, 400, 1000 or 3000 ppM MEK vapors, 7 h/day, 7 dy/wk. Ten virgin females and ∼30 plug-positive females per group were exposed concurrently for 10 consecutive days (6--15 dg for mated mice). Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice on 18 dg. Uterine implants were enumerated and their status recorded. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. Exposure of pregnant mice to these concentrations of MEK did not result in apparent maternal toxicity, although there was a slight, treatment-correlated increase in liver to body weight ratios which was significant for the 3000-ppM group. Mild developmental toxicity was evident at 3000-ppM as a reduction in mean fetal body weight. This reduction was statistically significant for the males only, although the relative decrease in mean fetal body weight was the same for both sexes. 17 refs., 4 figs., 10 tabs

  2. Inhalation developmental toxicology studies: Teratology study of acetone in mice and rats: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Evanoff, J.J.; Rommereim, R.L.; Stoney, K.H.; Weigel, R.J.; Westerberg, R.B.

    1988-11-01

    Acetone, an aliphatic ketone, is a ubiquitous industrial solvent and chemical intermediate; consequently, the opportunity for human exposure is high. The potential for acetone to cause developmental toxicity was assessed in Sprague-Dawley rats exposed to 0, 440, 2200, or 11000 ppm, and in Swiss (CD-1) mice exposed to 0, 440, 2200, and 6600 ppm acetone vapors, 6 h/day, 7 days/week. Each of the four treatment groups consisted of 10 virgin females (for comparison), and approx.32 positively mated rats or mice. Positively mated mice were exposed on days 6-17 of gestation (dg), and rats on 6-19 dg. The day of plug or sperm detection was designated as 0 dg. Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice (rats, 20 dg; mice, 18 dg). Implants were enumerated and their status recorded. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. 46 refs., 6 figs., 27 tabs.

  3. Fluticasone Oral Inhalation

    Science.gov (United States)

    ... 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 ...

  4. The deposition, distribution and retention of inhaled 239PuO2 in the lungs of rats with pulmonary emphysema

    International Nuclear Information System (INIS)

    Individuals with chronic obstructive lung disease, such as emphysema, may be more susceptible to injury from other inhaled pollutants. However, dose-response studies of inhaled radionuclides conducted to aid in estimating the biological effects of inhaled radionuclides in man have typically used healthy laboratory animals. Changes in radionuclide deposition, distribution and retention in the lungs as the result of pre-existing lung diseases could alter the radiation dose or the resulting biological effects. An experimental animal model for human emphysema, in which emphysema is induced by the intratracheal instillation of either elastase or papain, has been reviewed. This model was used to study the effects of pulmonary emphysema on the deposition, distribution and retention of inhaled 239PuO2 in rats. (author)

  5. Status of Chronic Oxidation Studies of Graphite

    Energy Technology Data Exchange (ETDEWEB)

    Contescu, Cristian I. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Mee, Robert W. [Univ. of Tennessee, Knoxville, TN (United States)

    2016-05-01

    Graphite will undergo extremely slow, but continuous oxidation by traces of moisture that will be present, albeit at very low levels, in the helium coolant of HTGR. This chronic oxidation may cause degradation of mechanical strength and thermal properties of graphite components if a porous oxidation layer penetrates deep enough in the bulk of graphite components during the lifetime of the reactor. The current research on graphite chronic oxidation is motivated by the acute need to understand the behavior of each graphite grade during prolonged exposure to high temperature chemical attack by moisture. The goal is to provide the elements needed to develop predictive models for long-time oxidation behavior of graphite components in the cooling helium of HTGR. The tasks derived from this goal are: (1) Oxidation rate measurements in order to determine and validate a comprehensive kinetic model suitable for prediction of intrinsic oxidation rates as a function of temperature and oxidant gas composition; (2) Characterization of effective diffusivity of water vapor in the graphite pore system in order to account for the in-pore transport of moisture; and (3) Development and validation of a predictive model for the penetration depth of the oxidized layer, in order to assess the risk of oxidation caused damage of particular graphite grades after prolonged exposure to the environment of helium coolant in HTGR. The most important and most time consuming of these tasks is the measurement of oxidation rates in accelerated oxidation tests (but still under kinetic control) and the development of a reliable kinetic model. This report summarizes the status of chronic oxidation studies on graphite, and then focuses on model development activities, progress of kinetic measurements, validation of results, and improvement of the kinetic models. Analysis of current and past results obtained with three grades of showed that the classical Langmuir-Hinshelwood model cannot reproduce all

  6. Erratum to: Safety Considerations of Inhaled Corticosteroids in the Elderly.

    Science.gov (United States)

    Battaglia, Salvatore; Cardillo, Irene; Lavorini, Federico; Spatafora, Mario; Scichilone, Nicola

    2015-12-01

    Inhaled corticosteroids (ICSs) are widely used in the treatment of patients with chronic obstructive pulmonary diseases. However, high-dose regimens and long-term use of ICSs have the potential to cause a variety of local and systemic side effects such as candidiasis, cataracts, glaucoma, and osteoporosis. The use of ICSs can also be associated with the risk of bone fractures, diabetes mellitus and pneumonia. These ICS-related side effects are of particular importance in elderly patients due to the presence of comorbidities and age-related behavioral, cognitive, and psychological problems, which can all interact with inhaled treatment. We reviewed the available literature on the clinically relevant side effects of ICSs in the elderly to provide practical measures to properly monitor and manage the risk of ICSs in the geriatric population. Inspection of the mouth, monitoring of ocular pressure, and use of bone-protective drugs may be necessary in patients on prolonged ICS therapy. Above all, the use of the lowest possible ICS dose and a careful re-assessment of the inhalation procedure should be recommended. Taken together, these observations suggest that physicians should use ICSs appropriately for those patients in whom the benefit will outweigh the risk, especially chronic obstructive pulmonary disease (COPD) patients with previous frequent exacerbations. Given the paucity of information on the topic and the need to extrapolate the results from studies with broader age ranges, we strongly encourage the design of specifically tailored clinical studies in the elderly. PMID:26578157

  7. Safety considerations of inhaled corticosteroids in the elderly.

    Science.gov (United States)

    Battaglia, Salvatore; Cardillo, Irene; Lavorini, Federico; Spatafora, Mario; Scichilone, Nicola

    2014-11-01

    Inhaled corticosteroids (ICSs) are widely used in the treatment of patients with chronic obstructive pulmonary diseases. However, high-dose regimens and long-term use of ICSs have the potential to cause a variety of local and systemic side effects such as candidiasis, cataracts, glaucoma, and osteoporosis. The use of ICSs can also be associated with the risk of bone fractures, diabetes mellitus and pneumonia. These ICS-related side effects are of particular importance in elderly patients due to the presence of comorbidities and age-related behavioral, cognitive, and psychological problems, which can all interact with inhaled treatment. We reviewed the available literature on the clinically relevant side effects of ICSs in the elderly to provide practical measures to properly monitor and manage the risk of ICSs in the geriatric population. Inspection of the mouth, monitoring of ocular pressure, and use of bone-protective drugs may be necessary in patients on prolonged ICS therapy. Above all, the use of the lowest possible ICS dose and a careful re-assessment of the inhalation procedure should be recommended. Taken together, these observations suggest that physicians should use ICSs appropriately for those patients in whom the benefit will outweigh the risk, especially chronic obstructive pulmonary disease (COPD) patients with previous frequent exacerbations. Given the paucity of information on the topic and the need to extrapolate the results from studies with broader age ranges, we strongly encourage the design of specifically tailored clinical studies in the elderly. PMID:25212953

  8. Dominant lethal study in CD-1 mice following inhalation exposure to 1,3-butadiene: Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Hackett, P.L.; Mast, T.J.; Brown, M.G.; Clark, M.L.; Evanoff, J.J.; Rowe, S.E.; McClanahan, B.J.; Buschbom, R.L.; Decker, J.R.; Rommereim, R.L.; Westerberg, R.B.

    1988-04-01

    The effects of whole-body inhalation exposures to 1,3-butadiene on the reproductive system was evaluated. The results of dominant lethality in CD-1 male mice that were exposed to 1,3-butadiene are described. Subsequent to exposure, males were mated with two unexposed females. Mating was continued for 8 weeks with replacement of two females each week. Gravid uteri were removed, and the total number, position and status of implantations were determined. The mice were weighed prior to exposure and at 0, 1, 2, 3, 4, 5, 6, 7, and 8 weeks after exposure and at sacrifice. The animals were observed for mortality, morbidity and signs of toxicity throughout the study. 19 refs., 5 figs., 9 tabs.

  9. No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide

    Directory of Open Access Journals (Sweden)

    Lars Hållström

    2014-01-01

    Full Text Available Nitric oxide donors and inhaled nitric oxide (iNO may decrease ischemia/reperfusion injury as reported in animal and human models. We investigated whether the attenuation of reperfusion injury, seen by others, in patients undergoing knee arthroplasty could be reproduced when patients had spinal anesthesia. 45 consecutive patients were randomized into three groups (n=15. Groups 1 and 3 were receiving iNO 80 ppm or placebo (nitrogen, N2 throughout the entire operation, and group 2 only received iNO in the beginning and at the end of the operation. Blood samples were collected before surgery, at the end of the surgery, and 2 hours postoperatively. Muscle biopsies were taken from quadriceps femoris muscle before and after ischemia. There were no increases in plasma levels of soluble adhesion molecules: ICAM, VCAM, P-selectin, E-selectin, or of HMGB1, in any of the groups. There were low numbers of CD68+ macrophages and of endothelial cells expression of ICAM, VCAM, and P-selectin in the muscle analyzed by immunohistochemistry, prior to and after ischemia. No signs of endothelial cell activation or inflammatory response neither systemically nor locally could be detected. The absence of inflammatory response questions this model of ischemia/reperfusion, but may also be related to the choice of anesthetic method EudraCTnr.

  10. Study the effects of radon inhalation on biomechanical properties of blood in rats

    Directory of Open Access Journals (Sweden)

    Mostafa Fawzy Eissa

    2015-09-01

    Full Text Available Purpose: To investigate the effect of inhalation radon gas (Rn on the biomechanical properties of red blood cell of rats. Methods: 20 young healthy adult male albino rats were divided into equally 4 groups. The first group (0 served as control group, while the other three groups (I, II and III were exposed to Rn gas inside a chamber for 3, 5 and 7 weeks. The biomechanical properties of red blood cell of rats was performed by determine the rheological properties of blood and the osmotic fragility of red blood cells (RBCs. Results: The Rn doses received by every group of rats were found to 34.84, 58.07 and 81.30 mSv for 3, 5 and 7 weeks respectively (based on 12 exposure hours per week. The obtained results indicate that the viscosity, consistency index, yield stress and aggregation index increase with Rn doses. The osmotic fragility curves of irradiated groups shift toward lower values of NaCl concentration. The dispersion of hemolysis (S increased, at the same time an average osmotic fragility (H50% decreased. Conclusion: The results indicates that the exposure to radon alters the mechanical properties of red blood cells membrane (permeability and elasticity reflecting a change in its physiological properties. This mean that low levels of Rn gas are harmful to biological systems and the degree of damage was dose-dependent.

  11. Conference report: 2nd Medicon Valley Inhalation Symposium.

    Science.gov (United States)

    Lastow, Orest

    2014-02-01

    2nd Medicon Valley Inhalation Symposium 16 October 2013, Lund, Sweden The 2nd Medicon Valley Inhalation Symposium was arranged by the Medicon Valley Inhalation Consortium. It was held at the Medicon Village, which is the former AstraZeneca site in Lund, Sweden. It was a 1 day symposium focused on inhaled drug delivery and inhalation product development. 120 delegates listened to 11 speakers. The program was organized to follow the value chain of an inhalation product development. This year there was a focus on inhaled biomolecules. The inhaled delivery of insulin was covered by two presentations and a panel discussion. The future of inhaled drug delivery was discussed together with an overview of the current market situation. Two of the inhalation platforms, capsule inhalers and metered-dose inhalers, were discussed in terms of the present situation and the future opportunities. Much focus was on the regulatory and intellectual aspects of developing inhalation products. The manufacturing of a dry powder inhaler requires precision filling of powder, and the various techniques were presented. The benefits of nebulization and nasal delivery were illustrated with some case studies and examples. The eternal challenge of poor compliance was addressed from an industrial design perspective and some new approaches were introduced.

  12. Toxicity of divinylbenzene-55 for B6C3F1 mice in a two-week inhalation study.

    Science.gov (United States)

    Morgan, D L; Mahler, J F; Wilson, R E; Moorman, M P; Price, H C; O'connor, R W

    1997-10-01

    Divinylbenzene (DVB) is a crosslinking monomer used primarily for copolymerization with styrene to produce ion-exchange resins. The toxicity of inhaled DVB was investigated because of the potential for worker exposure and the structural similarity of DVB to styrene, a potential carcinogen. Male and female B6C3F1 mice were exposed to 0, 25, 50, or 75 ppm DVB for 6 hr/day, 5 days/week for up to 2 weeks. Six mice/sex/dose group were killed after 3, 5, and 10 exposures and six mice/sex in the 75 ppm group were killed 7 days after 10 exposures. The most severe effects occurred in the nasal cavity and liver, with less severe effects occurring in the kidneys. In the nasal cavity olfactory epithelium acute necrosis and inflammation were present at early time points followed by regeneration, architectural reorganization, and focal respiratory metaplasia by 7 days after the last exposure. Olfactory epithelial changes were concentration-dependent with extensive involvement at 75 ppm and peripheral sparing at 25 ppm. There was also necrosis and regeneration of olfactory-associated Bowman's glands as well as the lateral nasal (Steno's) glands. Hepatocellular centrilobular (CL) necrosis was observed only in the 75 ppm dose group and was similar to that caused by styrene. A time-dependent progression was observed, characterized by CL degeneration after 1 exposure, necrosis after 3 and 5 exposures, and chronic inflammation with CL karyomegaly after 10 exposures and 7 days after the 10th exposure. Hepatic GSH levels were decreased in a dose-dependent manner. In the kidneys, transient tubular damage was observed in some male mice exposed to 75 ppm, and appeared to be a response to DVB-induced tubular epithelial injury.

  13. Inhaled plutonium oxide in dogs

    International Nuclear Information System (INIS)

    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

  14. Inhalation developmental toxicology studies of 1,3-butadiene in the rat: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hackett, P.L.; Sikov, M.R.; Mast, T.J.; Brown, M.G.; Buschbom, R.L.; Clark, M.L.; Decker, J.R.; Evanoff, J.J.; Rommereim, R.L.; Rowe, S.E.; Westerberg, R.B.

    1987-11-01

    Maternal toxicity, reproductive performance and developmental toxicology were evaluated in Sprague-Dawley-derived rats during and following 6 hours/day, whole-body, inhalation exposures to 0, 40, 200, and 1000 ppM of 1,3-butadiene. The female rats (Ns = 24 to 28), which had mated with unexposed males, were exposed to the chemical from 6 through 15 dg and sacrificed on 20 dg. Maternal animals were weighed prior to mating and on 0, 6, 11, 16 and 20 dg; the rats were observed for mortality, morbidity and signs of toxicity during exposure and examined for gross tissue abnormalities at necropsy. Live fetuses were weighed and subjected to external, visceral and skeletal examinations to detect growth retardation and morphologic anomalies. There were no significant differences among treatment groups in maternal body weights or extragestational weights of rats exposed to 1,3-butadiene concentrations of 40 or 200 ppM, but, in animals exposed to 1000 ppM, significantly depressed body weight gains were observed during the first 5 days of exposure and extragestational weight gains tended to be lower than control values. These results, and the absence of clinical signs of toxicity, were considered to indicate that there was no maternal toxicity at exposure levels of 200 ppM or lower. The percentage of pregnant animals and the number of litters with live fetuses were unaffected by treatment. Under the conditions of this exposure regimen, there was no evidence for a teratogenic response to 1,3-butadiene exposure.

  15. Cost Effectiveness of Budesonide/Formoterol in a Single Inhaler for COPD Compared with Each Monocomponent Used Alone

    OpenAIRE

    Claes-Goran Lofdahl; Asa Ericsson; Klas Svensson; Emma Andreasson

    2005-01-01

    Objective: To compare the healthcare costs and effects of budesonide/formoterol in a single inhaler with those of budesonide and formoterol monotherapies, and placebo, in a multinational study in patients with chronic obstructive pulmonary disease (COPD), National Heart, Lung and Blood Institute (NHLBI)/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III or IV. Previous analysis of the clinical data from the study had shown that budesonide/formoterol was associated wi...

  16. Studies on chronic effect on radiation

    International Nuclear Information System (INIS)

    This experiment was carried out to evaluate the chronic harzard of Co-60 low dose irradiation on ICR mice. There is now considerable evidence from human studies that age, both at exposure to radiation and at observation for risk, can be a major determinant of radiation induced cancer risk. For this reason, ICR mice at different ages as specified below were exposed to 60 m rads/week, 500 m rads/biweek of whole body Co-60 radiation at a dose rate of 3.6 rads/min. ICR mice were irradiated during pregnant period and each period from the 1st week to the 3rd week to the 52nd week, from the 6th week to the 52nd week and from the 22nd week to the 52nd week after the birth. All the experimental mice were autopsied immediately after sacrificed at the 52nd week. And all of their major organs were examined grossly and weighed. After fixation histo-pathological preparations were made for microscopical study. Blood cells-W.B.C., R.B.C., Hb-from eye's vein were counted by hemocytometer and hemometer. (Author)

  17. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    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...

  18. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    Bisgaard, H

    1997-01-01

    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...

  19. Comparing the effects of two inhaled glucocorticoids on allergen-induced bronchoconstriction and markers of systemic effects, a randomised cross-over double-blind study

    Directory of Open Access Journals (Sweden)

    Lötvall Jan

    2011-10-01

    Full Text Available Abstract Background Inhaled glucocorticoids are efficient in protecting against asthma exacerbations, but methods to compare their efficacy vs systemic effects have only been attempted in larger multi-centre studies. The aim of the current study was therefore to directly compare the effects of two separate inhaled glucocorticoids, mometasone and budesonide, to compare the effects on the early and late asthmatic responses to inhaled allergen in patients with mild allergic asthma, and sputum eosinophils, and to relate the clinical positive effects to any systemic effects observed. Methods Twelve patients with documented early and late asthmatic responses (EAR and LAR to inhaled allergen at a screening visit were randomized in a double-blind fashion to treatment with mometasone (200 μg × 2 or 400 μg × 2, budesonide (400 μg × 2 or placebo in a double-blind crossover fashion for a period of seven days. Challenge with the total allergen dose causing both an EAR and LAR was given on the last day of treatment taken in the morning. Lung function was assessed using FEV1, and systemic glucocorticoid activity was quantified using 24 h urinary cortisol. Results Mometasone and budesonide attenuate both EAR and LAR to allergen to a similar degree. No significant dose-related effects on the lung function parameters were observed. Both treatments reduced the relative amount of sputum eosinophils (% after allergen. At the dose of 800 μg daily, mometasone reduced 24 h urinary cortisol by approximately 35%. Both drugs were well tolerated. Conclusions Mometasone and budesonide are equieffective in reducing early and late asthmatic responses induced by inhaled allergen challenge. Mometasone 800 μg given for seven days partially affects the HPA axis.

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

  1. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

    DEFF Research Database (Denmark)

    Mäkelä, Mika J; Backer, Vibeke; Hedegaard, Morten;

    2013-01-01

    , adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD...... and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation......Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age...

  2. Is low dose inhaled corticosteroid therapy as effective for inflammation and remodeling in asthma? A randomized, parallel group study

    Directory of Open Access Journals (Sweden)

    Baraket Melissa

    2012-02-01

    Full Text Available Abstract Background While most of the clinical benefits of inhaled corticosteroid (ICS therapy may occur at low doses, results of dose-ranging studies are inconsistent. Although symptom/lung function response to low and high dose ICS medication is comparable, it is uncertain whether low dose ICSs are as effective as high dose in the treatment of inflammation and remodeling. Methods 22 mild or moderate asthmatic adult subjects (corticosteroid free for > 2 months participated in a randomized, parallel group study to compare effects of fluticasone propionate (FP 200 mcg/day and 1000 mcg/day. Alveolar macrophage (AM-derived cytokines and basement membrane thickness (BMT were measured at baseline and after 7 weeks treatment while symptoms, spirometry, exhaled nitric oxide (eNO and airway hyperresponsiveness (AHR to mannitol at baseline and 6 weeks. Results FP improved spirometry, eNO, symptoms and AHR with no difference between low and high dose FP. Both high and low dose FP reduced GM-CSF, TNF-alpha and IL-1ra, with no change in BMT and with no differences between low and high dose FP. Conclusions 200 μg/day of FP was as effective as 1000 μg/day in improving asthma control, airway inflammation, lung function and AHR in adults in the short term. Future studies should examine potential differential effects between low and high dose combination therapy (ICS/long acting beta agonist on inflammation and airway remodeling over longer treatment periods.

  3. Presentation of chronic daily headache : A clinical study

    NARCIS (Netherlands)

    Spierings, E L H; Schroevers, M.; Honkoop, P.C.; Sorbi, M.

    1998-01-01

    We studied the presentation of chronic daily headache in 258 patients from a private headache practice, 50 men and 208 women. Chronic daily headache was defined as headaches, occurring at least 5 days per week for at least 1 year. Seventy-seven percent of the patients experienced the onset of headac

  4. Imaging studies in chronic low back pain

    International Nuclear Information System (INIS)

    Imaging brings to difficult problems in chronic low back pain incomplete data showing that it will need a lot of time to find therapeutic solutions. Some comparisons are made between tomodensitometry, nuclear magnetic imaging, the disco-scanner, these technologies allow to find small lesions but the problem is complete when it is not possible to find anything with persistent pains. 125 refs

  5. Efficacy and safety of a multifactor intervention to improve therapeutic adherence in patients with chronic obstructive pulmonary disease (COPD: protocol for the ICEPOC study

    Directory of Open Access Journals (Sweden)

    Prados-Torres Daniel

    2011-02-01

    Full Text Available Abstract Background Low therapeutic adherence to medication is very common. Clinical effectiveness is related to dose rate and route of administration and so poor therapeutic adherence can reduce the clinical benefit of treatment. The therapeutic adherence of patients with chronic obstructive pulmonary disease (COPD is extremely poor according to most studies. The research about COPD adherence has mainly focussed on quantifying its effect, and few studies have researched factors that affect non-adherence. Our study will evaluate the effectiveness of a multifactor intervention to improve the therapeutic adherence of COPD patients. Methods/Design A randomized controlled clinical trial with 140 COPD diagnosed patients selected by a non-probabilistic method of sampling. Subjects will be randomly allocated into two groups, using the block randomization technique. Every patient in each group will be visited four times during the year of the study. Intervention: Motivational aspects related to adherence (beliefs and behaviour: group and individual interviews; cognitive aspects: information about illness; skills: inhaled technique training. Reinforcement of the cognitive-emotional aspects and inhaled technique training will be carried out in all visits of the intervention group. Discussion Adherence to a prescribed treatment involves a behavioural change. Cognitive, emotional and motivational aspects influence this change and so we consider the best intervention procedure to improve adherence would be a cognitive and emotional strategy which could be applied in daily clinical practice. Our hypothesis is that the application of a multifactor intervention (COPD information, dose reminders and reinforcing audiovisual material, motivational aspects and inhalation technique training to COPD patients taking inhaled treatment will give a 25% increase in the number of patients showing therapeutic adherence in this group compared to the control group. We will

  6. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Yunes Panahi

    2013-12-01

    Full Text Available Background: Theophylline may reverse steroid resistance and decrease inflammation in patients with chronic pulmonary disease and sulfur mustard (SM induced bronchiolitis. This study was designed to assess the effects of low-dose theophylline on improvement of pulmonary function tests (PFTs of SM exposed patients.Methods: In this comparative observational study, a group of SM-exposed victims during the Iraq-Iran war who were treated with oral slow releasing (SR theophylline, salmetrol, fluxitide, omeprazole and NAC (study group were compared to a group of age and gender matched SM-exposed patients who received same medications except oral SR theophylline (historical control group. PFTs were measured at the beginning of the study and after 8 weeks of the treatment.Results: In total, 33 subjects in the study group and 27 subjects in the control group were studied. Mean (SD age of all subjects was 51 (14.1 years. In the study group, on the 8th week post-treatment, PFTs decreased, though the differences of tests between before and after treatment were not significant. In the control group, all the tests decreased in the same period and these reductions were not also significant. However, the changes in PFTs were significantly different between the two groups. The results of most PFTs in the controls decreased in greater extents compared to theophylline treated patients. This shows that despite theophylline was unable to improve the patients; it was partially able to decelerate the reductions in PFTs.Conclusion: Theophylline may not improve PFTs of SM exposed patients but it may decelerate the progress of the underlying respiratory disease. Further studies in this setting with higher doses of theophylline and longer term of evaluation are needed to better understand the pathophysiological mechanism of SM induced bronchiolitis and the effectiveness of the treatment with theophylline.   How to cite this article: Panahi Y, Poursaleh Z, Amini-Harandi A

  7. Inhalational Lung Disease

    OpenAIRE

    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 ...

  8. Inhalation Exposures to Particulate Matter and Carbon Monoxide during Ethiopian Coffee Ceremonies in Addis Ababa: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Chris Keil

    2010-01-01

    Full Text Available The unique Ethiopian cultural tradition of the coffee ceremony increases inhalation exposures to combustion byproducts. This pilot study evaluated exposures to particulate matter and carbon monoxide in ten Addis Ababa homes during coffee ceremonies. For coffee preparers the geometric mean (57 μg/m3 and median (72 μg/m3 contributions to an increase in a 24-hour time-weighted average exposure were above World Health Organization (WHO guidelines. At 40% of the study sites the contribution to the 24-hour average exposure was greater than twice the WHO guideline. Similar exposure increases existed for ceremony participants. Particulate matter concentrations may be related to the use of incense during the ceremony. In nearly all homes the WHO guideline for a 60-minute exposure to carbon monoxide was exceeded. Finding control measures to reduce these exposures will be challenging due to the deeply engrained nature of this cultural practice and the lack of availability of alternative fuels.

  9. Human volunteer study on the inhalational and dermal absorption of N-methyl-2-pyrrolidone (NMP) from the vapour phase.

    Science.gov (United States)

    Bader, Michael; Wrbitzky, Renate; Blaszkewicz, Meinolf; Schäper, Michael; van Thriel, Christoph

    2008-01-01

    N-Methyl-2-pyrrolidone (NMP) is a versatile organic solvent frequently used for surface cleaning such as paint stripping or graffiti removal. Liquid NMP is rapidly absorbed through the skin but dermal vapour phase absorption might also play an important role for the uptake of the solvent. This particular aspect was investigated in an experimental study with 16 volunteers exposed to 80 mg/m(3) NMP for 8 h under either whole-body, i.e. inhalational plus dermal, or dermal-only conditions. Additionally, the influence of moderate physical workload on the uptake of NMP was studied. The urinary concentrations of NMP and its metabolites 5-hydroxy-N-methyl-2-pyrrolidone (5-HNMP) and 2-hydroxy-N-methylsuccinimide (2-HMSI) were followed for 48 h and analysed by gas chromatography-mass spectrometry (GC-MS). Percutaneous uptake delayed the elimination peak times and the apparent biological half-lives of NMP and 5-HNMP. Under resting conditions, dermal-only exposure resulted in the elimination of 71 +/- 8 mg NMP equivalents as compared to 169 +/- 15 mg for whole-body exposure. Moderate workload yielded 79 +/- 8 mg NMP (dermal-only) and 238 +/- 18 mg (whole-body). Thus, dermal absorption from the vapour phase may contribute significantly to the total uptake of NMP, e.g. from workplace atmospheres. As the concentration of airborne NMP does not reflect the body dose, biomonitoring should be carried out for surveillance purposes. PMID:17721780

  10. Bioaccessibility, bioavailability and toxicity of commercially relevant iron- and chromium-based particles: in vitro studies with an inhalation perspective

    Directory of Open Access Journals (Sweden)

    Hedberg Yolanda

    2010-09-01

    Full Text Available Abstract Background Production of ferrochromium alloys (FeCr, master alloys for stainless steel manufacture, involves casting and crushing processes where particles inevitably become airborne and potentially inhaled. The aim of this study was to assess potential health hazards induced by inhalation of different well-characterized iron- and chromium-based particles, i.e. ferrochromium (FeCr, ferrosiliconchromium (FeSiCr, stainless steel (316L, iron (Fe, chromium (Cr, and chromium(IIIoxide (Cr2O3, in different size fractions using in vitro methods. This was done by assessing the extent and speciation of released metals in synthetic biological medium and by analyzing particle reactivity and toxicity towards cultured human lung cells (A549. Results The amount of released metals normalized to the particle surface area increased with decreasing particle size for all alloy particles, whereas the opposite situation was valid for particles of the pure metals. These effects were evident in artificial lysosomal fluid (ALF of pH 4.5 containing complexing agents, but not in neutral or weakly alkaline biological media. Chromium, iron and nickel were released to very low extent from all alloy particles, and from particles of Cr due to the presence of a Cr(III-rich protective surface oxide. Released elements were neither proportional to the bulk nor to the surface composition after the investigated 168 hours of exposure. Due to a surface oxide with less protective properties, significantly more iron was released from pure iron particles compared with the alloys. Cr was predominantly released as Cr(III from all particles investigated and was strongly complexed by organic species of ALF. Cr2O3 particles showed hemolytic activity, but none of the alloy particles did. Fine-sized particles of stainless steel caused however DNA damage, measured with the comet assay after 4 h exposure. None of the particles revealed any significant cytotoxicity in terms of cell death

  11. Study Suggests Brain Is Hard-Wired for Chronic Pain

    Science.gov (United States)

    ... News Release Tuesday, September 17, 2013 NIH-funded study suggests brain is hard-wired for chronic pain ... Apkarian, Ph.D., a senior author of the study and professor of physiology at Northwestern University Feinberg ...

  12. Inhalant Abuse and Dextromethorphan.

    Science.gov (United States)

    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

  13. Formoterol Oral Inhalation

    Science.gov (United States)

    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 ...

  14. Evaluation of the efficacy and safety of tiotropium bromide (5 μg) inhaled via Respimat in Chinese patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    TANG Yan; Dan Massey; ZHONG Nan-shan

    2013-01-01

    Background A pharmacokinetic study in an Asian population showed that tiotropium 5 μg via Respimat leads to the same plasma levels compared to 18 μg via HandiHaler.The objective of the trial was to compare the efficacy and safety of longterm treatment (1 year) with tiotropium bromide (5 μg) via Respimat(R) with placebo in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 3991 patients were randomized in this double-blind,placebo controlled,parallel group study,while in China 338 patients (309 males,29 females) received either tiotropium bromide (n=167) or placebo (n=171).Tiotropium bromide solution or matching placebo was delivered via Respimat(R) at a dosage of 5 μg (2 x 2.5 μg/puff) once daily for 48 weeks.Co-primary endpoints were trough forced expiratory volume in one second (FEV1) and the time to first exacerbation.Results Statistically significant improvements in trough FEV1 and trough forced vital capacity (FVC) in the tiotropium group were achieved at weeks 4,24,and 48 compared with those in the placebo group.A statistically significant difference (P=0.0027) in favour of tiotropium was also observed for the time to first exacerbation.The total numbers of exacerbations during treatment were 90 and 128 in the tiotropium and placebo groups,respectively,with a rate ratio of 0.69 (P=0.0164).The difference between the treatment groups in the adjusted mean changes from baseline of St.George Respiratory Questionnaire (SGRQ) total score was-3.9 (95% Cl:-7.5,-0.2) and was of statistical significance (P=0.0367).The incidences of serious adverse events (SAEs) in the tiotropium and placebo groups were 16.2% and 17.0%,respectively.Seven deaths occurred whilst patients were on treatment,four in the tiotropium group and three in the placebo group,all of which were assessed as non-related study drugs by the investigators.Conclusions Tiotropium significantly improved lung function and quality of life,delayed the time to first

  15. Experimental studies of chronic pneumonia of sheep.

    Science.gov (United States)

    Gilmour, J S; Jones, G E; Rae, A G

    1979-01-01

    Strains of Mycoplasma ovipneumoniae and Pasteurella haemolytica isolated from sheep affected with chronic pneumonia were inoculated by endobronchial route to conventionally-reared and SPF (Specific Pathogen-Free) lambs. Changes resembling those of the naturally-occurring disease were produced in most lambs given the organisms in combination and in some given M. ovipneumoniae alone. Similar but less extensive changes were seen in SPF lambs and fewer animals were affected. Different strains of M. ovipneumoniae did not affect the extent of changes produced in SPF lambs. M. ovipneumoniae became established in the lungs of both types of sheep; P. haemolytica did so less readily. It was concluded that chronic pneumonia may be reproduced in conventional animals by combined inoculation of M. ovipneumoniae and P. haemolytica. Age and status of immunity to mycoplasmas may account for the different responses of conventional and SPF lambs.

  16. Biological effects of short-term, high-concentration exposure to methyl isocyanate. I. Study objectives and inhalation exposure design

    Energy Technology Data Exchange (ETDEWEB)

    Dodd, D.E.; Frank, F.R.; Fowler, E.H.; Troup, C.M.; Milton, R.M.

    1987-06-01

    Early reports from India indicated that humans were dying within minutes to a few hours from exposure to methyl isocyanate (MIC). Attempts to explain the cause(s) of these rapid mortalities is where Union Carbide Corporation concentrated its post-Bhopal toxicologic investigations. The MIC studies involving rats and guinea pigs focused primarily on the consequences of acute pulmonary damage. All MIC inhalation exposures were acute, of short duration (mainly 15 min), and high in concentration. MIC vapors were statically generated in a double chamber exposure design. Precautionary measures taken during exposures are discussed. Guinea pigs were more susceptible than rats to MIC exposure-related early mortality. A greater than one order of magnitude difference was observed between an MIC concentration that caused no early mortality in rats (3506 ppm) and an MIC concentration that caused partial (6%) early mortality in guinea pigs (225 ppm) for exposures of 10 to 15 min duration. For both species, the most noteworthy clinical signs during exposure were lacrimation, blepharospasm, and mouth breathing. Fifteen minute LC/sub 50/ tests with 14-day postexposure follow-up were conducted, and the LC/sub 50/ (95% confidence limit) values were 171 (114-256) ppm for rats and 112 (61-204) ppm for guinea pigs. Target exposure concentrations for the toxicologic investigations of MIC-induced early mortality were established. A short summary of pertinent results of Union Carbide Corporation's post-Bhopal toxicologic investigations is presented.

  17. Bone mineral density in children treated with daily or periodical inhaled budesonide: the Helsinki Early Intervention Childhood Asthma study.

    Science.gov (United States)

    Turpeinen, Markku; Pelkonen, Anna S; Nikander, Kurt; Sorva, Ritva; Selroos, Olof; Juntunen-Backman, Kaisu; Haahtela, Tari

    2010-08-01

    In a double-blind, randomized study, 136 children, 5-10-y-old, with newly detected persistent asthma received budesonide (BUD) 400 microg twice daily for 1 mo and thereafter 200 microg twice daily for 5 mo. Thereafter, 50 children were treated with BUD 100 microg twice daily, whereas 44 children used BUD as needed for 1 y; an additional 42 children received disodium cromoglycate (DSCG). Asthma exacerbations were treated with BUD for 2 wk in a dose of 400 microg twice daily in all groups. In this secondary analysis, bone mineral density (BMD) of the lumbar vertebrae was measured before and after the 18-mo treatment. Compared with DSCG, regular BUD treatment resulted in a significantly smaller increase in BMD (0.023 versus 0.034 g/cm; p = 0.023) and height (7.75 versus 8.80 cm; p = 0.001). Periodic treatment did not affect BMD. No intergroup differences were observed when BMD data were adjusted for changes in height. Daily BUD treatment in prepubertal children may slow down the increment in BMD and standing height. This was not observed in children receiving BUD periodically after the initial regular BUD treatment. The correlation between height and BMD suggests that following children's height might afford an estimation of inhaled corticosteroid effects on bone. PMID:20485203

  18. Remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management: an open-group, short-term pilot study of the impact on asthma control.

    Directory of Open Access Journals (Sweden)

    David Van Sickle

    Full Text Available OBJECTIVE: Adequate symptom control is a problem for many people with asthma. We asked whether weekly email reports on monitored use of inhaled, short-acting bronchodilators might improve scores on composite asthma-control measures. METHODS: Through an investigational electronic medication sensor attached to each participant's inhaler, we monitored 4 months' use of inhaled, short-acting bronchodilators. Participants completed surveys, including the Asthma Control Test(TM (ACT, to assess asthma control at entry and monthly thereafter. After the first month, participants received weekly email reports for 3 months. The reports summarized inhaled bronchodilator use during the preceding week and provided suggestions derived from National Asthma Education and Prevention Program (NAEPP guidelines. Paired t-tests and random-effects mixed models were implemented to assess changes in primary asthma endpoints. RESULTS: Thirty individuals participated in the 4-month study; 29 provided complete asthma control information. Mean age was 36.8 years (range: 19-74 years; 52% of respondents were female. Mean ACT scores were 17.6 (Standard Deviation [SD]  = 3.35 at entry and 18.4 (SD = 3.60 at completion of the first month. No significant difference appeared between ACT values at entry and completion of the first month (p = 0.66; however, after participants began receiving email reports and online information about their inhaler use, mean ACT scores increased 1.40 points (95% CI: 0.61, 2.18 for each subsequent study month. Significant decreases occurred in 2-week histories of daytime symptoms (β = -1.35, 95% CI: -2.65, -0.04 and nighttime symptoms (β = -0.84, 95% CI: -1.25, -0.44; no significant change in activity limitation (β = -0.21, 95% CI: -0.69, 0.26 was observed. Participants reported increased awareness and understanding of asthma patterns, level of control, bronchodilator use (timing, location and triggers, and improved

  19. Ventilatory-perfusion relationships and respiratory drive in chronic obstructive pulmanory disease : With special reference to hypoxaemia, sleep quality and treatment with inhaled corticisteroid

    OpenAIRE

    Sandek, Karin

    2002-01-01

    By measuring retention in blood and excretion in exhaled air of six infused inert gases using multiple inert gas technique (MIGET), it is possible to obtain detailed assessment of the ventilation-perfusion (VA/Q) relationships in patients with chronic obstructive pulmonary disease. Stable, non-bronchitic COPD patients show a substantial perfusion of hyper-ventilated lung regions. For individuals with exclusively nocturnal hypoxaemia, when the nocturnal arterial oxygen satur...

  20. GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe

    DEFF Research Database (Denmark)

    Heinzerling, L M; Burbach, G J; Edenharter, G;

    2009-01-01

    . This could partly be related to changes in mobility of patients, vegetation or climate in Europe. CONCLUSION: The results of this large pan-European study demonstrate for the first time sensitization patterns for different inhalant allergens in patients across Europe. The standardized skin prick test...... with the standardized allergen battery should be recommended for clinical use and research. Further EU-wide monitoring of sensitization patterns is urgently needed....

  1. Ambient carbon monoxide and the risk of hospitalization due to chronic obstructive pulmonary disease

    OpenAIRE

    Tian, L.; Ho, KF; Wang, T.; Qiu, H.; Pun, VC; Chan, CS; Louie, PKK; Yu, ITS

    2014-01-01

    Data from recent experimental and clinical studies have indicated that lower concentrations of inhaled carbon monoxide might have beneficial antiinflammatory effects. Inhaled carbon monoxide has the potential to be a therapeutic agent for chronic obstructive pulmonary diseases (COPD). However, population-based epidemiologic studies of environmentally relevant carbon monoxide exposure have generated mixed findings. We conducted a time-series study in Hong Kong to estimate the association of sh...

  2. Chronic urticaria. Clinical and pathogenetic studies in 141 patients

    NARCIS (Netherlands)

    Doeglas, Hendrik Maarten George

    1975-01-01

    This study describes a combined clinical, laboratory and experimental approach of the problems of 141 patients with chronic urticaria, collected over a three-year period in a Dermatology department. ... Zie: Summary

  3. Assessment of inhalation dose sensitivity by physicochemical properties of airborne particulates containing naturally occurring radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Si Young; Choi, Cheol Kyu; Kim, Yong Geon; Choi, Won Chul; Kim, Kwang Pyo [Kyung Hee University, Seoul (Korea, Republic of)

    2015-12-15

    Facilities processing raw materials containing naturally occurring radioactive materials (NORM) may give rise to enhanced radiation dose to workers due to chronic inhalation of airborne particulates. Internal radiation dose due to particulate inhalation varies depending on particulate properties, including size, shape, density, and absorption type. The objective of the present study was to assess inhalation dose sensitivity to physicochemical properties of airborne particulates. Committed effective doses to workers resulting from inhalation of airborne particulates were calculated based on International Commission on Radiological Protection 66 human respiratory tract model. Inhalation dose generally increased with decreasing particulate size. Committed effective doses due to inhalation of 0.01μm sized particulates were higher than doses due to 100μm sized particulates by factors of about 100 and 50 for {sup 238}U and {sup 230}Th, respectively. Inhalation dose increased with decreasing shape factor. Shape factors of 1 and 2 resulted in dose difference by about 18 %. Inhalation dose increased with particulate mass density. Particulate mass densities of 11 g·cm{sup -3} and 0.7 g·cm{sup -3} resulted in dose difference by about 60 %. For {sup 238}U, inhalation doses were higher for absorption type of S, M, and F in that sequence. Committed effective dose for absorption type S of {sup 238}U was about 9 times higher than dose for absorption F. For {sup 230}Th, inhalation doses were higher for absorption type of F, M, and S in that sequence. Committed effective dose for absorption type F of {sup 230}Th was about 16 times higher than dose for absorption S. Consequently, use of default values for particulate properties without consideration of site specific physiochemical properties may potentially skew radiation dose estimates to unrealistic values up to 1-2 orders of magnitude. For this reason, it is highly recommended to consider site specific working materials and

  4. Toxicological assessment of a prototype e-cigaret device and three flavor formulations: a 90-day inhalation study in rats.

    Science.gov (United States)

    Werley, Michael S; Kirkpatrick, Dan J; Oldham, Michael J; Jerome, Ann M; Langston, Timothy B; Lilly, Patrick D; Smith, Donna C; Mckinney, Willie J

    2016-01-01

    A prototype electronic cigaret device and three formulations were evaluated in a 90-day rat inhalation study followed by a 42-day recovery period. Animals were randomly assigned to groups for exposure to low-, mid- and high-dose levels of aerosols composed of vehicle (glycerin and propylene glycol mixture); vehicle and 2.0% nicotine; or vehicle, 2.0% nicotine and flavor mixture. Daily targeted aerosol total particulate matter (TPM) doses of 3.2, 9.6 and 32.0 mg/kg/day were achieved by exposure to 1 mg/L aerosol for 16, 48 and 160 min, respectively. Pre-study evaluations included indirect ophthalmoscopy, virology and bacteriological screening. Body weights, clinical observations and food consumption were monitored weekly. Plasma nicotine and cotinine and carboxyhemoglobin levels were measured at days 28 and 90. After days 28, 56 and 90, lung function measurements were obtained. Biological endpoints after 90-day exposure and 42-day recovery period included clinical pathology, urinalysis, bronchoalveolar fluid (BALF) analysis, necropsy and histopathology. Treatment-related effects following 90 days of exposure included changes in body weight, food consumption and respiratory rate. Dose-related decreases in thymus and spleen weights, and increased BALF lactate dehydrogenase, total protein, alveolar macrophages, neutrophils and lung weights were observed. Histopathology evaluations revealed sporadic increases in nasal section 1-4 epithelial hyperplasia and vacuolization. Following the recovery period, effects in the nose and BALF were persistent while other effects were resolved. The no observed effect level based upon body weight decreases is considered to be the mid-dose level for each formulation, equivalent to a daily TPM exposure dose of approximately 9.6 mg/kg/day. PMID:26787428

  5. Inhalation devices and patient interface: human factors.

    Science.gov (United States)

    Leiner, Stefan; Parkins, David; Lastow, Orest

    2015-03-01

    The development of any inhalation product that does not consider the patient needs will fail. The needs of the patients must be identified and aligned with engineering options and physical laws to achieve a robust and intuitive-to-use inhaler. A close interaction between development disciplines and real-use evaluations in clinical studies or in human factor studies is suggested. The same holds true when a marketed product needs to be changed. Caution is warranted if an inhaler change leads to a change in the way the patient handles the device. Finally, the article points out potential problems if many inhaler designs are available. Do they confuse the patients? Can patients recall the correct handling of each inhaler they use? How large is the risk that different inhaler designs pose to the public health? The presentations were given at the Orlando Inhalation Conference: Approaches in International Regulation co-organised by the University of Florida and the International Pharmaceutical Aerosol Consortium on Regulation & Science (IPAC-RS) in March 2014.

  6. A study of the ventilation-perfusion process in the lungs during 133Xe inhalation

    International Nuclear Information System (INIS)

    A study of the ventilation-perfusion process in 33 patients with various pulmonary diseases has shown the adVantages of 133Xe administration by inhalatjon over intravenoUs administration. This method for the study of the ventilation-perfusion process in the lungs adequately reflects pathological changes in them; it is not traumatic, easy to perform and permits one to considerably lessen the radiation exposure of the patient and the staff

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

    Science.gov (United States)

    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…

  8. Radioaerosol Inhalation Lung Scan in Pulmonary Emphysema

    International Nuclear Information System (INIS)

    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

  9. Inhalation developmental toxicology studies: Developmental toxicity of chloroprene vapors in New Zealand white rabbits. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Evanoff, J.J.; Westerberg, R.B.; Rommereim, R.L.; Weigel, R.J.

    1994-04-01

    Chloroprene, 2-chloro-1,3-butadiene, is a colorless liquid with a pungent ethereal odor that is primarily used as an intermediate in the manufacture of neoprene rubber, and has been used as such since about 1930. This study addressed the potential for chloroprene to cause developmental toxicity in New Zealand white rabbits following gestational exposure to 0, 10, 40, or 175 ppm chloroprene vapors, 6h/dy, 7dy/wk. Each treatment group consisted of 15 artificially inseminated females exposed on 6 through 28 days of gestation (dg). Body weights were obtained throughout the study period, and uterine and fetal body weights were obtained at sacrifice on 29 dg. Implants were enumerated and their status recorded and live fetuses were examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. There were no overt signs of maternal toxicity and the change in maternal body weight over the course of the study was not affected. Exposure of pregnant rabbits to chloroprene vapors on 6-28 dg had no effect on the number of implantation, the mean percent of live pups per litter, or on the incidence of resorptions per litter. The incidence of fetal malformations was not increased by exposure to chloroprene. Results of this study indicate that gestational exposure of New Zealand white rabbits to 10, 40, or 175 ppm chloroprene did not result in observable toxicity to either the dam or the offspring.

  10. Cognitive impairment in patients with chronic fatigue: a preliminary study.

    OpenAIRE

    McDonald, E; Cope, H; David, A

    1993-01-01

    Subjective impairment of memory and concentration is a frequent complaint in sufferers from chronic fatigue. To study this, 65 general practice attenders identified as having chronic fatigue were administered a structured psychiatric interview and a brief screening battery of cognitive tests. Subjective cognitive impairment was strongly related to psychiatric disorder, especially depressed mood, but not fatigue, anxiety, or objective performance. Simple tests of attention and concentration sh...

  11. Dry Powder Inhalers: Study of the Parameters Influencing Adhesion and Dispersion of Fluticasone Propionate

    OpenAIRE

    Le, V. N. P.; Thi, T. H. Hoang; Robins, E.; Flament, M. P.

    2012-01-01

    Interactions between particles are dependent on the physicochemical characteristics of the interacting particles but it is also important to consider the manufacturing process. Blending active pharmaceutical ingredient (API) with carrier is a critical stage that determines the blend homogeneity and is the first step towards obtaining the final quality of the powder blend. The aim of this work was to study parameters that influence the interactions between API and carrier in adhesive mixtures ...

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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

  14. Dry powder inhalers: study of the parameters influencing adhesion and dispersion of fluticasone propionate.

    Science.gov (United States)

    Le, V N P; Hoang Thi, T H; Robins, E; Flament, M P

    2012-06-01

    Interactions between particles are dependent on the physicochemical characteristics of the interacting particles but it is also important to consider the manufacturing process. Blending active pharmaceutical ingredient (API) with carrier is a critical stage that determines the blend homogeneity and is the first step towards obtaining the final quality of the powder blend. The aim of this work was to study parameters that influence the interactions between API and carrier in adhesive mixtures used in DPI and their effect on API dispersion. The study was done with fluticasone propionate blended with lactose 'Lactohale 200'. The study was based on the influence of the operating conditions (speed, mixing time, resting steps during mixing), the size of the carrier and the storage conditions on the blend properties and on the API dispersion. The quality of the blends was examined by analysing the API content uniformity. Adhesion characteristics were evaluated by submitting mixtures to a sieving action by air depression with the Alpine air-jet sieve. Aerodynamic evaluation of fine particle fraction (FPF) was obtained using a Twin Stage Impinger; the FPF being defined as the mass percentage of API below 6.4 μm. For good dispersion and therefore good homogeneity of the API in the carrier particles, speed and powder blending time have to be sufficient, but not too long to prevent the appearance of static electricity, which is not favourable to homogeneity and stability. The FPF increases with the decrease in the carrier size. The storage conditions have also to be taken into consideration. Higher humidity favours the adhesion of API on the carrier and decreases the FPF.

  15. Human health issues for plutonium inhalation: Perspectives from laboratory animal studies

    International Nuclear Information System (INIS)

    Since the first production of plutonium in the 1940s, potential health effects from plutonium have been a concern for humans. The few people exposed to plutonium and the relatively small intakes that have occurred, at least in the Western world, have resulted in very little direct information from human population studies. The Manhattan Project workers have been followed for decades, and few health effects have been observed. The situation is similar for the population of workers at the Rocky Flats facility. Some information is now being released from the former Soviet Union on selected worker populations who show biological effects, primarily pulmonary fibrosis and some increase in lung cancers

  16. Use of animal studies for assessing intakes of inhaled actinide-bearing dusts

    International Nuclear Information System (INIS)

    This paper reviews the methodology used in the execution and interpretation of animal studies (mostly conducted at NRPB) designed to provide guidance on limits of intake and the effectiveness of chest monitoring for persons exposed to various uranium, plutonium, americium, and thorium bearing dusts. The lung retention and transportability characteristics of the actinides in humans have been predicted by combining the absorption rates into blood calculated from the animal studies with particle transport rates from the alveolar region of the human lung. This approach is compatible with the application of the new ICRP respiratory tract model. The results of the animal experiments demonstrate the diversity of the absorption rates for the different chemical forms of the actinides and their disparity from the default values proposed by ICRP for Type F, M, and S compounds in the absence of specific data. The predicted lung retention kinetics of the actinides in humans provide the basis for assessing the validity of chest monitoring; for this purpose the most recent ICRP values for doses per unit intake and deposition in the alveolar region of the lungs have been taken into account. The results show that for some dusts, the data can be interpreted with confidence, while for others the method is impracticable or has considerable uncertainty. Overall, the results support the ICRP recommendation that material specific information is to be preferred for setting limits on intake and interpreting monitoring data. The paper concludes with suggestions for further work. (author). 44 refs., 4 figs., 6 tabs

  17. Clinical application of radioaerosol studies - pulmonary embolism, inhalation burns and glue-sniffers and COPD

    International Nuclear Information System (INIS)

    The alveolar epithelium and the capillary endothelium together form the alveolar capillary membrane. Fluid exchange occurs across this membrane, and is dependent on intravascular and interstitial hydrostatic and oncotic pressures, and on permeability of this membrane. Damage to either the alveolar or capillary component can result in a high permeability pulmonary oedema, even though the alveolar epithelium forms an extremely tight membrane which is ten times less permeable than the capillary endothelium. Nuclear medicine methods can be used to observe changes in integrity of pulmonary capillary endothelium (with first pass dual-indicator dilution technique using successive injections of radiotracer), and of alveolar epithelium, and it is important that the damage should be detected before patients develop clinical pulmonary oedema so that intensive therapy can be instituted early. We have used 99mTc DTPA radioaerosol to measure alteration in pulmonary epithelial permeability and to image the distribution of ventilation in normal and some pathological states. In some clinical studies Tc-99m (tin) colloid radioaerosol has been used to obtain the ventilation images

  18. Acute toxicity when concentration varies with time: A case study with carbon monoxide inhalation by rats.

    Science.gov (United States)

    Sweeney, Lisa M; Sommerville, Douglas R; Goodwin, Michelle R; James, R Arden; Channel, Stephen R

    2016-10-01

    Exposure to time-varying concentrations of toxic compounds is the norm in both occupational settings and daily human life, but little has been done to investigate the impact of variations in concentration on toxic outcomes; this case study with carbon monoxide helps fill that gap. Median acute lethality of 10-, 20-, 40-, and 60-min continuous exposures of rats to carbon monoxide was well described by the toxic load model (k = C(n) × t; k is constant, C = test concentration, n = toxic load exponent, and t = exposure duration) with n = 1.74. Dose response-relationships for 1-h exposures including a recovery period between 10- or 20-min pulses showed greater similarity (in both median lethality and steepness of dose-response curve) to continuous exposures with equivalent pulse duration and concentration, rather than a 60-min exposure with equivalent time-weighted average concentrations or toxic load. When pulses were of unequal concentration (3:1 ratio), only the high concentration pulse contributed to lethality. These findings show that fluctuations or interruptions in exposure over a short time scale (60 min or less) can have a substantial impact on outcomes (when n > 1), and thus high-resolution monitoring data are needed to aid interpretation of resulting outcomes.

  19. Sleep characteristics of individuals with chronic stroke: a pilot study

    Directory of Open Access Journals (Sweden)

    Al-Dughmi M

    2015-10-01

    Full Text Available Mayis Al-Dughmi,1 Alham Al-Sharman,2 Suzanne Stevens,3 Catherine F Siengsukon1 1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA; 2Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA Abstract: Changes in sleep characteristics in individuals with chronic stroke are not well described, particularly compared with healthy individuals. Therefore, the aim of this pilot study was to explore the sleep characteristics in individuals with chronic stroke compared to age- and sex-matched controls. Sixteen individuals with chronic stroke and ten age- and sex-matched controls underwent two nights of polysomnographic recording. The sleep characteristics of interest included total sleep time, sleep efficiency, and percent time, as well as time in minutes spent in stages N1, N2, and N3 and stage R sleep. The individuals with chronic stroke spent less percent time in stage N3 compared with controls (P=0.048. No significant differences in the other sleep characteristics were found between the stroke and control groups. Individuals with chronic stroke present with altered stage N3 sleep compared with healthy controls. These alterations in stage N3 sleep might be a sign of neuronal dysfunction and may impact recovery following stroke. A larger scale study is needed to confirm these findings. Keywords: sleep characteristics, sleep, chronic stroke, polysomnography

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Studies on the biological behaviour of uranium-plutonium mixed oxide aerosols: Inhalation experiments with rats and in vitro studies with alveolar macrophages

    International Nuclear Information System (INIS)

    The retention of spherical and of irregularly shaped (U, Pu) mixed oxides in rat lung was analyzed after inhalation and intratracheal instillation. Their biological behaviour was relatively independent of particle shape and application route with only a few percent of radioactivity being transferred to other organs. In vivo and in vitro uptake and intracellular distribution in rat and bovine alveolar macrophages were analyzed as dependent on various parameters. In addition, detailed electron microscopic studies were performed demonstrating particles within membrane limited vacuoles as well as lying free in the cytoplasm. Under in vitro conditions the uptake process was finished after a few hours. After differential centrifugation of lung or macrophage homogenates the particles sedimented in the first (1000 g) fraction. (orig.)

  2. Bronchial brush biopsies for studies of epithelial inflammation in stable asthma and nonobstructive chronic bronchitis.

    Science.gov (United States)

    Riise, G C; Andersson, B; Ahlstedt, S; Enander, I; Söderberg, M; Löwhagen, O; Larsson, S

    1996-08-01

    Recently, bronchial brush biopsy (BBB) has been introduced as a complimentary method to bronchial forceps biopsy for the study of bronchial epithelial cells. We wanted to determine whether epithelial inflammatory cells in bronchial brush biopsies can reflect mucosal inflammation assessed indirectly by levels of cellular activation markers in bronchial lavage fluid. We studied 15 healthy controls, 11 asthmatics with regular steroid inhalation therapy, 13 asthmatics without steroids, and 10 smokers with nonobstructive chronic bronchitis. Differential counts of epithelial and inflammatory cells were made from the BBB material. Bronchial lavage levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), tryptase, hyaluronan and interleukin-8 (IL-8) were measured as indirect markers for inflammatory cell activation. We found an increased percentage of eosinophil granulocytes in the BBB from the steroid-untreated asthmatic patients (1.16%) in comparison to the other groups (0.11%, 0.09% and 0.02%, respectively; pairways disease. These changes appear to relate to the degree of inflammatory activity and disease severity in asthma. PMID:8866592

  3. Levalbuterol Oral Inhalation

    Science.gov (United States)

    ... a concentrated solution to be mixed with normal saline and inhaled by mouth using a nebulizer, and ... the concentrated solution, add the amount of normal saline that your doctor told you to use to ...

  4. Insulin Human Inhalation

    Science.gov (United States)

    ... control pills); oral medications for diabetes such as pioglitazone (Actos, in Actoplus Met, in Duetact, in Oseni) or ... or lower legs sudden weight gain extreme drowsiness confusion dizziness Insulin inhalation may increase the risk that ...

  5. Nicotine Microaerosol Inhaler

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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. ...

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

    Science.gov (United States)

    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

  9. Inflammatory and Remodeling Events in Asthma with Chronic Exposure to House Dust Mites: A Murine Model

    OpenAIRE

    Ahn, Joong Hyun; Kim, Chi Hong; Kim, Yong Hyun; Kim, Seung Joon; Lee, Sook-Young; Kim, Young Kyoon; Kim, Kwan Hyoung; Moon, Hwa Sik; Song, Jeong Sup; Park, Sung Hak; Kwon, Soon Seog

    2007-01-01

    Although animal models with ovalbumin have been used to study chronic asthma, there are difficulties in inducing recurrence as well as in maintaining chronic inflammation in this system. Using a murine model of house dust mite (HDM)-induced bronchial asthma, we examined the airway remodeling process in response to the chronic exposure to HDM. During the seventh and twelfth weeks of study, HDM were inhaled through the nose for three consecutive days and airway responsiveness was measured. Twen...

  10. Switching patients from other inhaled corticosteroid devices to the Easyhaler®: historical, matched-cohort study of real-life asthma patients

    Directory of Open Access Journals (Sweden)

    Price D

    2014-04-01

    Full Text Available David Price,1,2 Vicky Thomas,2 Julie von Ziegenweidt,2 Shuna Gould,2 Catherine Hutton,2 Christine King2 1Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life, Oakington, Cambridge, UK Purpose: To investigate the clinical and cost effectiveness of switching real-life asthma patients from other types of inhalers to the Easyhaler® (EH for the administration of inhaled corticosteroids (ICS. Patients and methods: Historical, matched-cohort study of 1,958 asthma patients (children and adults treated in UK primary-care practices, using data obtained from the Optimum Patient Care Research Database and Clinical Practice Research Datalink. Other inhalers (OH included pressurized metered-dose inhalers, breath-actuated inhalers, and dry-powder inhalers, delivering beclomethasone, budesonide, fluticasone, or ciclesonide. Patients remaining on OH unchanged (same drug, dosage, and device; n=979 were matched 1:1 with those switched to the EH (beclomethasone or budesonide at the same or lower ICS dosage (n=979, based on age, sex, year of index patient review/switch, most recent ICS drug, dosage, and device, and the number of severe exacerbations and average daily short-acting β2 agonist (SABA dosage in the preceding year. Clinical outcomes and health care costs were compared between groups for 12 months before and after the switch. Co-primary clinical outcomes were: 1 risk domain asthma control (RDAC – no asthma-related hospitalization, acute oral steroid use, or lower respiratory tract infection (LRTI; 2 exacerbation rate (American Thoracic Society [ATS] definition – where exacerbation is asthma-related hospitalization or acute oral steroid use; 3 exacerbation rate (clinical definition – where exacerbation is ATS exacerbation or LRTI; and 4 overall asthma control (OAC – RDAC plus average salbutamol-equivalent SABA dosage ≤200 μg/day. Non-inferiority (at least equivalence of EH was tested against OH for the

  11. Multicenter clinical study on the efficacy and safety of inhalable insulin aerosol in the treatment of type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    LIAO Zhi-hong; WENG Jian-ping; CHEN Ying-li; LI Fang-ping; YAN Xiang; LU Hai; YAN Li; ZHOU Zhi-guang; ZHU Da-long; JI Li-nong

    2008-01-01

    Background A new inhalable insulin aerosoI(Inh-Ins)was developed in China.The aim of this multicenter clinical study was to evaluate the efficacy and safety of this new Inh-Ins as a treatment of type 2 diabetes.Regular porcine insulin(RI)was used as a control.Methods This study is a prospective,randomized,open-label,parallel-group multicenter clinical trial in which 253 qualified patients with type 2 diabetes received the insulin Glargine daily at bedtime plus either a pre-meal Inh-Ins or a pre-meal subcutaneous RI for 12 weeks.HbA1c,fasting plasma glucose(FPG),the 1-hour-postprandial blood glucose(1hPBG)and the 2-hour-postprandial blood glucose(2hPBG)were measured.Events were monitored for adverse effects.Results After 12 weeks,the HbA1c decreased significantly from baseline in both treatment groups,with no significant difference between the two regimens.In the Inh-Ins group,FPG,both 1hPBG and 2hPBG significantly declined from baseline after the 8th-and 12th-weeks of treatment.The reduced values of FPG or 1hPBG between the two groups showed a more significant hypoglycemic effect with the Inh-Ins than the RI.After 12 weeks,the pulmonary carbon monoxide diffusing capacity(DLco)was significantly lower in Inh-Ins group than in the RI.The main side effects of Inh-Ins were coughing,excessive sputum,and hypoglycemia.Conclusions Inh-Ins was effective in decreasing HbA1c like the RI.It was better in lowering the FPG and the 1hPBG than the RI.Its main side effects were coughing,excessive sputum,and hypoglycemia.Also,Inh-Ins slightly impaired DLco.

  12. Manganese Inhalation as a Parkinson Disease Model

    OpenAIRE

    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...

  13. Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic [Rouen University Hospital, Service de Cardiologie, Rouen (France); Loriot, Stephane; Henry, Jean-Paul; Thuillez, Christian; Morin, Jean-Paul [University of Rouen France, INSERM U644, School of Medicine-Pharmacy, Rouen, Cedex (France); Dionnet, Frederic [Centre d' Etudes et de Recherches Technologiques en Aerothermique et Moteurs, Saint Etienne du Rouvray (France); Napoleoni, Jean-Gerard [EMKA Technologies, Paris (France)

    2007-04-15

    Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestraint and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 {+-} 2.62 vs. 4.89 {+-} 1.67 ms, P < 0.05) and CHF rats (8.01 {+-} 0.89 vs. 6.6 {+-} 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact. (orig.)

  14. Efficacy and safety of inhaled formoterol 4.5 and 9 μg twice daily in Japanese and European COPD patients: Phase III study results

    OpenAIRE

    Bogdan Miron A; Aizawa Hisamichi; Fukuchi Yoshinosuke; Mishima Michiaki; Nishimura Masaharu; Ichinose Masakazu

    2011-01-01

    Abstract Background This study evaluated the efficacy and safety of the long-acting β2-agonist formoterol in patients with moderate-to-severe COPD. Methods This double-blind, placebo-controlled, parallel-group, multinational phase III study randomized patients ≥ 40 years of age with moderate-to-severe COPD to inhaled formoterol 4.5 or 9 μg twice daily (bid) via Turbuhaler® or placebo for 12 weeks. Salbutamol 100 μg/actuation via pMDI was permitted as reliever medication. The primary outcome v...

  15. Determinants of depression in chronic stroke : A prospective cohort study

    NARCIS (Netherlands)

    van de Port, Ingrid G. L.; Kwakkel, Gert; Bruin, Margje; Lindeman, Eline

    2007-01-01

    Purpose. The aim of the study was to identify factors that are significantly related to depression in chronic stroke patients. Methods. Prospective cohort study of stroke patients admitted for rehabilitation. A total of 165 first ever stroke patients over 18 years of age were assessed at one and thr

  16. An incident study about acute and chronic human exposure to uranium by high-resolution inductively coupled plasma mass spectrometry (HR-ICPMS).

    Science.gov (United States)

    Krystek, Petra; Ritsema, Rob

    2009-01-01

    From the year 2003 to 2005 around 1700 Dutch soldiers made a part of the international stabilisation force in Iraq. An incident happened as a group of four Dutch soldiers found a 30mm bullet identified as containing depleted uranium (DU). The main pathway of the acute exposure is via inhalation of small uranium containing particles, e.g. from a bullet during its explosion. To develop a method for acute exposure investigations were carried out about finding an efficient and suitable way to sample nasal mucus as medium of inhalation. Generally, in human exposure studies with regard to natural uranium (NU) or DU, urine is the matrix for analysis. Uranium concentrations in urine are based on daily ingestion depending on the composition of drinking water and food. A second possibility is the acute exposure to uranium after an incident, either through inhalation or impact. Nevertheless, the results deliver only interpretations in respect to chronic/long-term exposure. For the acute exposure procedures like sniffling out into cleansing tissues and rinsing the nose were tested with real-life samples from four soldiers involved in an incident with possibly acute exposure to uranium. For the quantification of uranium high-resolution inductively coupled plasma mass spectrometry (HR-ICPMS) was applied. PMID:18187363

  17. Emerging inhaled bronchodilators: an update.

    Science.gov (United States)

    Cazzola, M; Matera, M G

    2009-09-01

    Bronchodilators remain central to the symptomatic management of chronic obstructive pulmonary disease and asthma, and, for this reason and also because the patent protection of many bronchodilators has expired, several companies have reinitiated research into the field. The only limits set for the development of a long-lasting bronchodilator with a new product profile are medical needs and marketing opportunities. The incorporation of once-daily dose administration is an important strategy for improving adherence and is a regimen preferred by most patients. A variety of beta(2)-agonists and antimuscarinic agents with longer half-lives and inhalers containing a combination of several classes of long-acting bronchodilator are currently under development. The present article reviews all of the most important compounds under development, describing what has been done and discussing their genuine advantage.

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

    Science.gov (United States)

    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

  19. Use of sulfur hexafluoride airflow studies to determine the appropriate number and placement of air monitors in an alpha inhalation exposure laboratory

    International Nuclear Information System (INIS)

    Determination of the appropriate number and placement of air monitors in the workplace is quite subjective and is generally one of the more difficult tasks in radiation protection. General guidance for determining the number and placement of air sampling and monitoring instruments has been provided by technical reports such as Mishima, J. These two documents and other published guidelines suggest that some insight into sampler placement can be obtained by conducting airflow studies involving the dilution and clearance of the relatively inert tracer gas sulfur hexafluoride (SF6) in sampler placement studies and describes the results of a study done within the ITRI alpha inhalation exposure laboratories. The objectives of the study were to document an appropriate method for conducting SF6 dispersion studies, and to confirm the appropriate number and placement of air monitors and air samplers within a typical ITRI inhalation exposure laboratory. The results of this study have become part of the technical bases for air sampling and monitoring in the test room

  20. Use of sulfur hexafluoride airflow studies to determine the appropriate number and placement of air monitors in an alpha inhalation exposure laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Newton, G.J.; Hoover, M.D.

    1995-12-01

    Determination of the appropriate number and placement of air monitors in the workplace is quite subjective and is generally one of the more difficult tasks in radiation protection. General guidance for determining the number and placement of air sampling and monitoring instruments has been provided by technical reports such as Mishima, J. These two documents and other published guidelines suggest that some insight into sampler placement can be obtained by conducting airflow studies involving the dilution and clearance of the relatively inert tracer gas sulfur hexafluoride (SF{sub 6}) in sampler placement studies and describes the results of a study done within the ITRI alpha inhalation exposure laboratories. The objectives of the study were to document an appropriate method for conducting SF{sub 6} dispersion studies, and to confirm the appropriate number and placement of air monitors and air samplers within a typical ITRI inhalation exposure laboratory. The results of this study have become part of the technical bases for air sampling and monitoring in the test room.

  1. Objective Assessment of Adherence to Inhalers by COPD Patients.

    OpenAIRE

    Sulaiman, Imran; Cushen, Breda; Greene, Garrett; Seheult, Jansen; Seow, Dexter; Rawat, Fiona; MacHale, Elaine; Mokoka, Matshediso; Moran, Catherine Nora; Bhreathnach, Aoife Sartini; MacHale, Philippa; Tappuni, Shahed; Deering, Brenda; Jackson, Mandy; McCarthy, Hannah

    2016-01-01

    RATIONALE: Objective adherence to inhaled therapy by patients with COPD has not been reported. OBJECTIVES: The aim of this study was to objectively quantify adherence to preventer DiskusTM inhaler therapy by patients with COPD with an electronic audio recording device (INCATM). METHODS: This was a prospective observational study. On discharge from hospital patients were given a salmeterol/fluticasone inhaler with an INCATM device attached. Analysis of this audio quantified the frequency...

  2. Breath-synchronized plume-control inhaler for pulmonary delivery of fluticasone propionate.

    Science.gov (United States)

    Shrewsbury, Stephen B; Armer, Thomas A; Newman, Stephen P; Pitcairn, Gary

    2008-05-22

    A novel breath-synchronized, plume-control inhaler (Tempo inhaler) was developed to overcome limitations of a pressurized metered-dose inhaler. This report compared the Tempo inhaler and a commercial inhaler for fine particle distribution and lung deposition of fluticasone propionate. In vitro fine particle distribution was determined using the Andersen Cascade Impactor at inspiration rates of 28.3 and 45L/min. In vivo lung deposition was assessed in a randomized, two-arm, crossover study of (99m)Tc-radiolabeled fluticasone propionate in 12 healthy adult subjects, analyzed by gamma scintigraphy. In vitro: fine particle fractions at 28.3 and 45L/min were 88.6+/-3.6% and 89.2+/-3.0% (Tempo inhaler) versus 40.4+/-4.7% and 43.1+/-4.4% (commercial inhaler). In vivo: lung deposition was 41.5+/-9.8% (Tempo inhaler) versus 13.8+/-7.4% (commercial inhaler) and oropharyngeal deposition was 18.3+/-7.7% (Tempo inhaler) versus 76.8+/-7.1% (commercial inhaler). Variability of lung deposition was reduced from 55% (commercial inhaler) to 24% (Tempo inhaler) of the delivered dose. The Tempo inhaler produced significantly higher fine particle fraction values, reduced oropharyngeal deposition by 75%, and increased whole, central, intermediate, and peripheral lung delivery by more than 200%. Thus, the Tempo inhaler enhances efficient drug delivery to the lungs.

  3. Impact of Inhaled Nitric Oxide on the Sulfatide Profile of Neonatal Rat Brain Studied by TOF-SIMS Imaging

    OpenAIRE

    Hanane Kadar; Hoa Pham; David Touboul; Alain Brunelle; Olivier Baud

    2014-01-01

    Despite advances in neonatal intensive care leading to an increased survival rate in preterm infants, brain lesions and subsequent neurological handicaps following preterm birth remain a critical issue. To prevent brain injury and/or enhance repair, one of the most promising therapies investigated in preclinical models is inhaled nitric oxide (iNO). We have assessed the effect of this therapy on brain lipid content in air- and iNO-exposed rat pups by mass spectrometry imaging using a time-of...

  4. Daily versus as-needed inhaled corticosteroid for mild persistent asthma (The Helsinki early intervention childhood asthma study)

    OpenAIRE

    Turpeinen, M.; Nikander, K; Pelkonen, A S; Syvänen, P; Sorva, R; Raitio, H; Malmberg, P; Juntunen-Backman, K; Haahtela, T

    2007-01-01

    Objective: To compare the effect of inhaled budesonide given daily or as-needed on mild persistent childhood asthma. Patients, design and interventions: 176 children aged 5–10 years with newly detected asthma were randomly assigned to three treatment groups: (1) continuous budesonide (400 μg twice daily for 1 month, 200 μg twice daily for months 2–6, 100 μg twice daily for months 7–18); (2) budesonide, identical treatment to group 1 during months 1–6, then budesonide for exacerbations as need...

  5. Modulation of Immune Response in Asthmatic Patients by Using Inhaled Tuberculin

    International Nuclear Information System (INIS)

    Bronchial asthma is a chronic immuno inflammatory reversible lung disease with airway responsiveness to various stimuli which relived by proper therapy using inhaled steroids or the highly expensive recombinant interferon gamma (IFN-gamma). This study undertaken to investigate for the first time a novel treatment method using inhaled tuberculin (PPD) to determine whether PPD inhalation could be safely and effectively delivered into the airways of bronchial asthmatic patients in attempt to bring immurite deviation away from atopy via inhaling an economic dose of tuberculin. Sixty patients suffering from mild atopic bronchial asthma along with twenty healthy volunteers were included in our study. Patients were randomly categorized into three equally-sized groups received 2, 5 and 10 PPD units respectively. Treatment doses taken every 72 hours for two weeks. Respiratory function tests were examined before and after treatment regime. Interleukin 2 (IL-2), IL-4 and immunoglobulin E (IgE)w ere measured by ELISA technique in serum and bronchoalveolar lavage fluid (BALF) samples before and after treatment regime. Eosinophil count in BALF was also examined. The results showed that PPD treatment doses caused a significant increase in lung function standards (FEV1 and FEV1/FVC ratio) as compared with before treatment values. Also, the different doses of PPD resulted in a highly significant increase in the levels of serum and BALF IL-2 with a concomitant significant decrease in BALF IL-4

  6. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group.

    Science.gov (United States)

    Fukuda, K; Straus, S E; Hickie, I; Sharpe, M C; Dobbins, J G; Komaroff, A

    1994-12-15

    The complexities of the chronic fatigue syndrome and the methodologic problems associated with its study indicate the need for a comprehensive, systematic, and integrated approach to the evaluation, classification, and study of persons with this condition and other fatiguing illnesses. We propose a conceptual framework and a set of guidelines that provide such an approach. Our guidelines include recommendations for the clinical evaluation of fatigued persons, a revised case definition of the chronic fatigue syndrome, and a strategy for subgrouping fatigued persons in formal investigations. PMID:7978722

  7. Doppler ultrasound study and venous mapping in chronic venous insufficiency.

    Science.gov (United States)

    García Carriazo, M; Gómez de las Heras, C; Mármol Vázquez, P; Ramos Solís, M F

    2016-01-01

    Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.

  8. Chronic liver disease in Kuala Lumpur, Malaysia: a clinical study.

    Science.gov (United States)

    Kudva, M V; Zawawi, M M

    1990-08-01

    This study was undertaken to analyse the clinical spectrum of chronic liver disease (cirrhosis, and others with portal hypertension) in Kuala Lumpur. Eighty patients were diagnosed over a 6-year period. Twenty-two had biopsy proven cirrhosis while 58 others had portal hypertension with clinical and biochemical evidence of chronic liver disease. The commonest aetiology was alcohol (36%), followed by the idiopathic variety and hepatitis B. The male to female ratio was 4.4:1. Indians had a high prevalence of alcohol-associated chronic liver disease. Overall, ascites was the commonest presentation. Eight patients presented with hepatocellular carcinoma. Spontaneous bacterial peritonitis was diagnosed in 13% of patients undergoing abdominal paracentesis. Gallstones were detected in 37% of patients who underwent ultrasonography. Diabetes mellitus and peptic ulcer disease were noted in 22% and 31% of patients respectively.

  9. Inhaled Therapies for Pulmonary Hypertension.

    Science.gov (United States)

    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

  10. Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study

    OpenAIRE

    Kaiser, Daniela; Bolt, Isabel; Hofer, Michael; Relly, Christa; Berthet, Gerald; Bolz, Dieter; Saurenmann, Traudel

    2015-01-01

    Background To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. Methods Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. Result...

  11. Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study

    OpenAIRE

    Kaiser, Daniela; Bolt, Isabel; Hofer, Michael; Relly, Christa; Berthet, Gerald; Bolz, Dieter; Saurenmann, Traudel

    2015-01-01

    BACKGROUND: To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. METHODS: Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. ...

  12. Dutch transmural nurse clinics for chronic patients: a descriptive study.

    NARCIS (Netherlands)

    Temmink, D.; Francke, A.L.; Kerkstra, A.; Huyer Abu-Saad, H.

    2000-01-01

    'Transmural care' can be defined as patient-tailored care provided on the basis of close collaboration and joint responsibility between hospitals and home care organizations. One form of transmural care is transmural nurse clinics for chronically ill. This study describes 62 transmural nurse clinics

  13. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

    The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with...

  14. Review on Clinical and Mechanism Studies of Moxibustion Therapy for Chronic Gastritis

    Institute of Scientific and Technical Information of China (English)

    Zhu Hui-wen; Ruan Chun-xun; Cao Shu-fei; Wu Huan-gan; Li Jing

    2014-01-01

    By computer research, the literature of clinical and experimental studies on moxibustion therapy for chronic gastritis in the recent fifteen years was collected, sorted and analyzed, in order to understand the general situation about the clinical and experimental studies on moxibustion therapy for chronic gastritis, summarize the regularity of moxibustion therapy for chronic gastritis, so as to guide the treatment of chronic gastritis.

  15. Concentrations and size distribution of inhalable and respirable dust among sugar industry workers: a pilot study in Khon Kaen, Thailand.

    Science.gov (United States)

    Sakunkoo, Pornpun; Chaiear, Naesinee; Chaikittiporn, Chalermchai; Sadhra, Steven

    2011-11-01

    There has been very limited information regarding bagasse exposure among workers in sugar industries as well as on health outcomes. The authors determined the occupational exposure of sugar industry workers in Khon Kaen to airborne bagasse dust. The size of the bagasse dust ranged from 0.08 to 9 µm with the highest size concentration of 2.1 to 4.7 µm. The most common size had a geometric mean diameter of 5.2 µm, with a mass concentration of 6.89 mg/m(3)/log µm. The highest mean values of inhalable and respirable dust were found to be 9.29 mg/m(3) from February to April in bagasse storage, 5.12 mg/m(3) from May to September, and 4.12 mg/m(3) from October to January. Inhalable dust concentrations were 0.33, 0.47, and 0.41 mg/m(3), respectively. Workers are likely to be exposed to high concentrations of bagasse dust and are at risk of respiratory diseases. Preventive measures, both in the form of engineering designs and personal protective devices, should be implemented.

  16. Inhaled americium dioxide

    International Nuclear Information System (INIS)

    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

  17. NTP Toxicology and Carcinogenesis Studies of Nitromethane (CAS No. 75-52-5) in F344/N Rats and B6C3F1 Mice (Inhalation Studies).

    Science.gov (United States)

    1997-02-01

    Nitromethane is used as a rocket and engine fuel; as a synthesis intermediate for agricultural fumigants, biocides, and other products; as a solvent; and as an explosive in mining, oil-well drilling, and seismic exploration. It has been detected in air, in surface and drinking water, and in cigarette smoke. Nitromethane was studied because of the potential for widespread human exposure and because it is structurally related to the carcinogens 2-nitropropane and tetranitromethane. Male and female F344/N rats and B6C3F1 mice received nitromethane (purity 98% or greater) by inhalation for 16 days, 13 weeks, or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium, cultured Chinese hamster ovary cells, and peripheral blood erythrocytes of mice. 16-DAY STUDY IN RATS: Groups of five male and five female rats were exposed to 0, 94, 188, 375, 750, or 1,500 ppm nitromethane by inhalation, 6 hours per day, 5 days per week, for 16 days. All rats survived until the end of the study. The mean body weight gain of male rats in the 1,500 ppm group was slightly but significantly less than that of the controls; the final mean body weights and mean body weight gains of exposed females were similar to those of the controls. Clinical findings in all male and female rats in the 1,500 ppm groups included increased preening, rapid breathing, hyperactivity early in the study, and hypoactivity and loss of coordination in the hindlimbs near the end of the study. The relative liver weights of all exposed groups of male rats and the absolute and relative liver weights of females exposed to 375 ppm or greater were significantly greater than those of the controls. Minimal to mild degeneration of the olfactory epithelium was observed in the nose of males and females exposed to 375 ppm or greater. Sciatic nerve degeneration was present in all male and female rats exposed to 375 ppm or greater; rats exposed to 750 or 1,500 ppm also had reduced myelin around sciatic axons. 16

  18. Effect of high dose inhaled glucocorticoids on quality of life in patients with moderate to severe asthma.

    Science.gov (United States)

    Choi, Jae-Sung; Jang, An-Soo; Lee, June-Hyuk; Park, Jong-Sook; Park, Sung-Woo; Kim, Do-Jin; Park, Choon-Sik

    2005-08-01

    Asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients. Inhaled glucocorticoids (GCs) are the most effective controller therapy. The purpose of this study was to evaluate the effect of inhaled GCs on quality of life in patients with moderate to severe asthma. Patients completed the asthma quality of life questionnaire (AQLQ) and pulmonary function test at baseline and after 4 wks treatment of GCs. We enrolled 60 patients who had reversibility in FEV1 after 200 microgram of albuterol of 15% or more and/or positive methacholine provocation test, and initial FEV1% predicted less than 80%. All patients received inhaled GCs (fluticasone propionate 1,000 microgram/day) for 4 wks. The score of AQLQ was significantly improved following inhaled GCs (overall 51.9+/-14.3 vs. 67.5+/-12.1, presponsiveness. Quality of life was improved after inhaled GCs regardless of asthma severity and GCs responsiveness in patients with moderate to severe asthma. PMID:16100448

  19. Skin thickness in children treated with daily or periodical inhaled budesonide for mild persistent asthma. The Helsinki early intervention childhood asthma study.

    Science.gov (United States)

    Turpeinen, Markku; Raitio, Hanna; Pelkonen, Anna S; Nikander, Kurt; Sorva, Ritva; Selroos, Olof; Juntunen-Backman, Kaisu; Haahtela, Tari

    2010-02-01

    In adults, asthma treatment with high doses of inhaled corticosteroids has resulted in dermal thinning. The aim of this study was to investigate the skin thickness in children with asthma during budesonide treatment. In a double-blind study, 113 children, 5-10 y old, with persistent asthma received budesonide 400 microg twice daily for 1 mo and thereafter 200 microg twice daily for 5 mo. Thereafter, 56 children received 100 microg twice daily for 1 y, whereas 57 other children used budesonide periodically for exacerbations. An additional 54 children were treated with disodium cromoglycate (DSCG) for 18 mo. Skin thickness was measured on each forearm before and after treatment for 6, 12, and 18 mo using a 20-MHz high-resolution ultrasonic device. The initial 6-mo budesonide treatment resulted in a greater reduction in mean skin thickness in the forearms compared with DSCG (right: -35.9 versus -5.9 microm; p = 0.004; left: -30.6 versus -7.3 microm; p = 0.03). At month 18, the inter-group differences were no longer significant. Budesonide inhalations in daily doses of 400-800 microg in prepubertal children with newly detected asthma may cause minor dermal thinning. The changes were reversible during low dose or periodic treatment with budesonide. PMID:19858777

  20. Aortic PWV in Chronic Kidney Disease: A CRIC Ancillary Study

    Science.gov (United States)

    Townsend, Raymond R.; Wimmer, Neil J.; Chirinos, Julio A.; Parsa, Afshin; Weir, Matthew; Perumal, Kalyani; Lash, James P.; Chen, Jing; Steigerwalt, Susan P.; Flack, John; Go, Alan S.; Rafey, Mohammed; Rahman, Mahboob; Sheridan, Angela; Gadegbeku, Crystal A.; Robinson, Nancy A.; Joffe, Marshall

    2009-01-01

    Background Aortic PWV is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end stage renal disease receiving hemodialysis. Little data exist characterizing aortic stiffness in patients with chronic kidney disease who are not receiving dialysis, and in particular the effect of reduced kidney function on aortic PWV. Methods We performed measurements of aortic PWV in a cross-sectional cohort of participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased aortic PWV in chronic kidney disease. Results PWV measurements were obtained in 2564 participants. The tertiles of aortic PWV (adjusted for waist circumference) were 10.2 m/sec with an overall mean (± S.D.) value of 9.48 ± 3.03 m/sec [95% CI = 9.35–9.61 m/sec]. Multivariable regression identified significant independent positive associations of age, blood glucose concentrations, race, waist circumference, mean arterial blood pressure, gender, and presence of diabetes with aortic PWV and a significant negative association with the level of kidney function. Conclusions The large size of this unique cohort, and the targeted enrollment of chronic kidney disease participants provides an ideal situation to study the role of reduced kidney function as a determinant of arterial stiffness. Arterial stiffness may be a significant component of the enhanced cardiovascular risk associated with kidney failure. PMID:20019670

  1. NTP Toxicology and Carcinogenesis Studies of Tetrafluoroethylene (CAS No. 116-14-3) in F344 Rats and B6C3F1 Mice (Inhalation Studies).

    Science.gov (United States)

    1997-04-01

    Tetrafluoroethylene is used in the production of polytetrafluoroethylene (Teflon(R)) and other polymers. Tetrafluoroethylene was nominated by the National Cancer Institute for toxicity and carcinogenicity studies based on the potential for human exposure to the chemical due to the large production volume and on the lack of adequate data for tetrafluoroethylene in the literature. Male and female F344/N rats and B6C3F1 mice were exposed to tetrafluoroethylene (98% to 99% pure) by whole body inhalation exposure for 16 days, 13 weeks, or 2 years. Genetic toxicity studies were conducted in mouse peripheral blood erythrocytes. 16-DAY STUDY IN RATS: Groups of five male and five female F344/N rats were exposed to 0, 312, 625, 1,250, 2,500, or 5,000 ppm tetrafluoroethylene by inhalation for 6 hours per day, 5 days per week for a total of 12 exposures during a 16-day period. All rats survived to the end of the study. The final mean body weights and body weight gains of males and females exposed to 5,000 ppm were significantly less than those of the controls. The mean body weight gain of females exposed to 2,500 ppm was also significantly less than that of the controls. There were no exposure-related clinical findings in male or female rats. There were no significant differences in hematology parameters that were considered to be related to tetrafluoroethylene exposure. Absolute and relative kidney weights of all exposed groups of males were significantly greater than those of the controls, as were those of females in the 2,500 and 5,000 ppm groups. The absolute kidney weight of females exposed to 1,250 ppm was also significantly greater than that of the controls. The relative liver weights of all exposed groups of males and the absolute liver weights of males in the 625 and 2,500 ppm groups were significantly greater than those of the controls. Increased incidences of renal tubule degeneration occurred in males and females exposed to 625 ppm or greater; this lesion was

  2. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  3. Infrared spectroscopy study of the influence of inhaled vapors/smoke produced by cigarettes of active smokers

    Science.gov (United States)

    Popa, Cristina

    2015-05-01

    While much is known about the effect of smoke and vapors on the composition of blood, little is known about their impact on the composition of breath. When tobacco from traditional cigarettes (T) is burned, it produces harmful smoke compared with the vapor produced when using electronic cigarettes (E). Using a noninvasive, safe, and rapid CO2 laser-photoacoustic method, this study aimed to examine the ethylene changes at different time intervals in the exhaled breath composition of E-cigarette smokers and T-cigarette smokers, before and after the consecutive exposures to cigarettes. Oxidative stress from exposure to tobacco smoke has a role in the pathogenic process, leading to chronic obstructive pulmonary disease. The evidence on the mechanisms by which T-smoking causes damage indicates that there is no risk-free level of exposure to tobacco smoke. The study revealed that the ethylene level (in the E-cigarette smoker's case) was found to be in smaller concentrations (compared with T-cigarette smoker's case) and that E-cigarettes may provide an alternative to T-cigarette smoking.

  4. Contribution to the study of tracheobronchial and pulmonary deposits in 52 subjects after inhalation of radioactive particles

    International Nuclear Information System (INIS)

    Particle deposits in the bronchopulmonary system can lead to three main types of disorder: pneumoconioses, bronchial cancers and most chronic bronchopulmonary diseases. The study of deposition is useful for the prevention, diagnosis and treatment of these illnesses. The air-borne contaminants laid down are cleared by different mechanisms corresponding roughly to distinct anatomical regions. Short-term clearance, known as tracheobronchial (TB) takes place in a few hours, while long-term clearance from the deep lung is much slower: according to the International Radiological Protection Commission, 60% of particles deposited in the bronchiolo-alveolar region take more than 500 days to eliminate. It is useful therefore to known in what proportions the particles are fixed in the tracheobronchial region and on the deep lung. This was the purpose of the present work. The distribution of the deposit between these two regions was measured in 52 subjects having breathed in radioactive particles (indium 111). A functional respiratory study was conducted at the same time to find out whether the two sets of experimental data are related in any way

  5. Inhaled insulin: overview of a novel route of insulin administration

    Directory of Open Access Journals (Sweden)

    Lucy D Mastrandrea

    2010-01-01

    Full Text Available Lucy D MastrandreaDepartment of Pediatrics, School of Medicine and Biochemical Sciences, University at Buffalo, Buffalo, NY, USAAbstract: Diabetes is a chronic disease characterized by inadequate insulin secretion with resulting hyperglycemia. Diabetes complications include both microvascular and macrovascular disease, both of which are affected by optimal diabetes control. Many individuals with diabetes rely on subcutaneous insulin administration by injection or continuous infusion to control glucose levels. Novel routes of insulin administration are an area of interest in the diabetes field, given that insulin injection therapy is burdensome for many patients. This review will discuss pulmonary delivery of insulin via inhalation. The safety of inhaled insulin as well as the efficacy in comparison to subcutaneous insulin in the various populations with diabetes are covered. In addition, the experience and pitfalls that face the development and marketing of inhaled insulin are discussed.Keywords: glycemic control, hemoglobin A1c, inhalation, insulin, type 1 diabetes, type 2 diabetes

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Liposomal formulations for inhalation.

    Science.gov (United States)

    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

  9. Inhalational Lung Disease

    Directory of Open Access Journals (Sweden)

    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.

  10. Experimental studies of the early effects of inhaled beta-emitting radionuclides for nuclear accident risk assessment: Phase 2 report

    International Nuclear Information System (INIS)

    This report summarizes a series of experiments concerning the effect of linear energy transfer and temporal radiation dose pattern to the lung from inhaled beta-emitting radionuclides. The results were used to test the validity of a hazard-function mathematical model for predicting death from radiation pneumonitis. Both morbidity and mortality within 18 months after exposure were examined in rats exposed to beta-emitting radionuclides, giving brief or protracted irradiation of the lung or having weak or strong beta emissions. Protraction of the radiation dose to the lung from a half-time in the lung of less than three days to a half-time with a long-term component of about 150 days has a sparing effect. The median lethal dose for the protracted irradiation is about 1.7 times the median lethal dose for the brief irradiation. Low energy beta emissions from 147Pm have a similar effectiveness in producing lethal injury as high energy beta emissions from 90Sr. Changes in three parameters of morbidity were measured: body weight, hematology and pulmonary function; only changes in pulmonary function correlated well with pulmonary radiation injury. The doses of radiation required to produce impaired function, however, were not significantly different from those that produced death. The hazard-function model for predicting death from radiation pneumonitis, which was developed from previously obtained data for inhalation exposures of dogs to beta-emitting radionuclides, adequately predicted the median lethal doses for rats receiving one of several different beta dose rate patterns to the lung, thus strengthening the validity of the mathematical model. 23 refs., 41 figs., 12 tabs

  11. Comparison of efficacy of high dose inhaled corticosteroids with a combination of low dose inhaled corticosteroids and long acting AND#946;2 agonists in patients of moderate persistent asthma : a randomised prospective comparative study

    OpenAIRE

    Vivek Sood; Parveen Sharma; Rekha Bansal; Dinesh Kansal

    2016-01-01

    Background: Asthma has global prevalence varying from 2-25%. Among various subtypes, moderate persistent asthma is a subtype currently managed by a combination therapy of low dose inhaled corticosteroids and LABA (long acting beta2 agonists). Search is on for LABA free regime because of safety concerns and increased risk of exacerbations as reported in meta-analysis conducted by FDA in 2008. Methods: Patients (new and old) of either sex and age having moderate persistent asthma as per GINA...

  12. Role of Inhaled Steroids in Vascular Airway Remodelling in Asthma and COPD

    Directory of Open Access Journals (Sweden)

    Alfredo Chetta

    2012-01-01

    Full Text Available In chronic obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD, changes in bronchial microvasculature are present in response to inflammatory stimuli. Vascular changes may significantly contribute to airway wall remodelling. Angiogenesis and vascular leakage are prevalent in asthma, while vasodilation and vascular leakage dominate in COPD. An endothelial dysfunction may be present both in asthma and in COPD. Vascular changes may occur simultaneously with the thickening of the airway wall and the narrowing of the bronchial lumen. Consequently, pharmacological control of bronchial vascular remodelling may be crucial for symptom control in asthma and COPD. In asthmatic airways, inhaled steroids can downregulate vascular remodelling by acting on proangiogenic factors. Additionally, studies on combination therapy with long-acting β2-agonists and inhaled steroids have provided evidence of a possible synergistic action on components of vascular remodelling in asthma. In COPD, there is less experimental evidence on the effect of inhaled steroids on airway microvascular changes. Importantly, vascular endothelial growth factor (VEGF, the most specific growth factor for vascular endothelium, is crucially involved in the pathophysiology of airway vascular remodelling, both in asthma and COPD. The inhibition of VEGF and its receptor may be useful in the treatment of the vascular changes in the airway wall.

  13. Effects of the inhaled treatment of liriope radix on an asthmatic mouse model.

    Science.gov (United States)

    Kim, Ki-Suk; Cho, Dong-Hyuk; Yang, Hea Jung; Choi, Eun-Kyeong; Shin, Min Hee; Kim, Kang-Hoon; Ahn, Kwang Seok; Ha, In Jin; Na, Yun-Cheol; Um, Jae Young; Chung, Won Seok; Jung, Hee-Jae; Jung, Sung-Ki; Jang, Hyeung-Jin

    2015-01-01

    As a treatment for allergic asthma, inhaled treatments such as bronchodilators that contain β2-agonists have an immediate effect, which attenuates airway obstructions and decreases airway hypersensitivity. However, bronchodilators only perform on a one off basis, but not consistently. Asthma is defined as a chronic inflammatory disease of the airways accompanying the overproduction of mucus, airway wall remodeling, bronchial hyperreactivity and airway obstruction. Liriope platyphylla radix extract (LPP), a traditional Korean medicine, has been thoroughly studied and found to be an effective anti-inflammatory medicine. Here, we demonstrate that an inhaled treatment of LPP can attenuate airway hyperresponsiveness (AHR) in an ovalbumin-induced asthmatic mouse model, compared to the saline-treated group (p < 0.01). Moreover, LPP decreases inflammatory cytokine levels, such as eotaxin (p < 0.05), IL-5 (p < 0.05), IL-13 (p < 0.001), RANTES (p < 0.01), and TNF-α (p < 0.05) in the bronchoalveolar lavage (BAL) fluid of asthmatic mice. A histopathological study was carried out to determine the effects of LPP inhalation on mice lung tissue. We performed UPLC/ESI-QTOF-MS, LC/MS, and GC/MS analyses to analyze the chemical constituents of LPP, finding that these are ophiopogonin D, spicatoside A, spicatoside B, benzyl alcohol, and 5-hydroxymethylfurfural. This study demonstrates the effect of an inhaled LPP treatment both on airway AHR and on the inflammatory response in an asthmatic mouse model. Hence, LPP holds significant promise as a nasal inhalant for the treatment of asthmatic airway disease. PMID:25967662

  14. Inhalation exposure systems: design, methods and operation.

    Science.gov (United States)

    Wong, Brian A

    2007-01-01

    The respiratory system, the major route for entry of oxygen into the body, provides entry for external compounds, including pharmaceutic and toxic materials. These compounds (that might be inhaled under environmental, occupational, medical, or other situations) can be administered under controlled conditions during laboratory inhalation studies. Inhalation study results may be controlled or adversely affected by variability in four key factors: animal environment; exposure atmosphere; inhaled dose; and individual animal biological response. Three of these four factors can be managed through engineering processes. Variability in the animal environment is reduced by engineering control of temperature, humidity, oxygen content, waste gas content, and noise in the exposure facility. Exposure atmospheres are monitored and adjusted to assure a consistent and known exposure for each animal dose group. The inhaled dose, affected by changes in respiration physiology, may be controlled by exposure-specific monitoring of respiration. Selection of techniques and methods for the three factors affected by engineering allows the toxicologic pathologist to study the reproducibility of the fourth factor, the biological response of the animal. PMID:17325967

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

    OpenAIRE

    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....

  16. 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

    Directory of Open Access Journals (Sweden)

    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

  17. Discovery of unique and ENM- specific pathophysiologic pathways: Comparison of the translocation of inhaled iridium nanoparticles from nasal epithelium versus alveolar epithelium towards the brain of rats.

    Science.gov (United States)

    Kreyling, Wolfgang G

    2016-05-15

    The biokinetics of inhaled nanoparticles (NP) is more complex than that of larger particles since NP may NP deposited on the nasal mucosa of the upper respiratory tract (URT) may translocate to the olfactory bulb of the brain and also via the trigeminus (URT neuronal route); and (b) NP deposited in the lower respiratory tract (LRT) may cross the ABB into blood and enter the brain across the blood-brain-barrier (BBB) or take a neuronal route from enervated tracheo-bronchial epithelia via the vagus nerve. Translocation from both - the URT and the LRT - are quantified during the first 24h after a 1-hour aerosol inhalation of 20nm-sized, (192)Ir radiolabeled iridium NP by healthy adult rats using differential exposures: (I) nose-only exposure of the entire respiratory tract or (II) intratracheal (IT) inhalation of intubated and ventilated rats, thereby bypassing the URT and extrathoracic nasal passages. After nose-only exposure brain accumulation (BrAcc) is significantly nine-fold higher than after IT inhalation since the former results from both pathways (a+b) while the latter exposure comes only from pathway (b). Interestingly, there are significantly more circulating NP in blood 24h after nose-only inhalation than after IT inhalation. Distinguishing translocation from URT versus LRT estimated from the differential inhalation exposures, the former is significantly higher (8-fold) than from the LRT. Although the BrAcc fraction is rather low compared to total NP deposition after this short-term exposure, this study proofs that inhaled insoluble NP can accumulate in the brain from both - URT and LRT which may trigger and/or modulate adverse health effects in the central nervous system (CNS) during chronic exposure.

  18. Emotional suppression in chronic fatigue syndrome (CFS): Experimental study

    OpenAIRE

    Rimes, Katharine Amber.; Ashcroft, Joanna Caroline; Bryan, Lauren; Chalder, Trudie

    2016-01-01

    Objective: Emotional processing differences in chronic fatigue syndrome (CFS) have been reported but have rarely been investigated experimentally. This study used self-report, observer ratings, and electrodermal responses to test hypotheses about emotion suppression and autonomic reactivity.Methods: Eighty adults with CFS and 80 healthy controls (HC) watched a distressing film clip. Half of each group were instructed to suppress their emotions and half were told to express their feelings as t...

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    The study aimed to investigate dose consistency and particle distribution from the dry powder inhalers Diskus and Turbuhaler. Full profiles of inhalation pressure versus time were recorded in 18 4 yr old and 18 8 yr old asthmatic children through Diskus and Turbuhaler inhalers. These data were used...... is a determinant of the quality of the aerosol. The mean (SD) amount of drug in large particles (>4.7 microm), fine particles (children and 71 (3), 18 (2) and 2...... (1) from the 8 yr old children, respectively. Similar particle fractions from the Budesonide Turbuhaler were 35 (9), 21 (10) and 7 (5) from 4 yr old children and 30 (7), 32 (9) and 12 (6) from 8 yr old children. In conclusion, the Diskus inhaler provides an improved dose consistency through...

  20. Risks of pneumonia in patients with asthma taking inhaled corticosteroids

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Soren; Carlsson, Lars-Göran;

    2011-01-01

    Rationale: Inhaled corticosteroids (ICS) are the mainstay of asthma treatment. Studies in chronic obstructive pulmonary disease reported increased rates of pneumonia with ICS. Concerns exist about an increased pneumonia risk in patients with asthma taking ICS. Objectives: To evaluate the risks...... of pneumonia in patients with asthma taking ICS. Methods: A retrospective analysis evaluated studies of the ICS budesonide in asthma. The primary data set were all double-blind, placebo-controlled trials lasting at least 3 months, involving budesonide (26 trials, n = 9,067 for budesonide; n = 5...... effect of ICS on pneumonia adverse events (AEs) or serious adverse events (SAEs). Measurements and Main Results: In the primary data set, the occurrence of pneumonia AEs was 0.5% (rate 10.0 events/1,000 patient-years [TPY]) for budesonide and 1.2% (19.3 per TPY) for placebo (hazard ratio, 0.52; 95...

  1. The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes

    OpenAIRE

    Faul, John L.; Wilson, Sandra R.; Chu, James W.; Canfield, James; Kuschner, Ware G.

    2009-01-01

    Objective: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD).

  2. Comparing the effectiveness of small-particle versus large-particle inhaled corticosteroid in COPD

    NARCIS (Netherlands)

    Postma, Dirkje S.; Roche, Nicolas; Colice, Gene; Israel, Elliot; Martin, Richard J.; van Aalderen, Willem M. C.; Grigg, Jonathan; Burden, Anne; Hillyer, Elizabeth V.; von Ziegenweidt, Julie; Gopalan, Gokul; Price, David

    2014-01-01

    Purpose: Small airway changes and dysfunction contribute importantly to airway obstruction in chronic obstructive pulmonary disease (COPD), which is currently treated with inhaled corticosteroids (ICS) and long-acting bronchodilators at Global initiative for Obstructive Lung Disease (GOLD) grades 2-

  3. Qigong Ameliorates Symptoms of Chronic Fatigue: A Pilot Uncontrolled Study

    Directory of Open Access Journals (Sweden)

    Naropa J. Mike Craske

    2009-01-01

    Full Text Available Traditional Chinese Medicine practitioners consider that chronic fatigue reflects a disharmony and depletion in the supply of qi in the body. Qigong is one of the traditional complementary interventions used to strengthen qi through self-practice, and to manage the state of qi to prevent and cure disease. The aim of this study is to assess whether qigong could be used to manage the symptoms of chronic fatigue. Eighteen Caucasian, British female participants were recruited, taught a qigong routine during weekly classes over 6 months, and asked to practice it daily for 15 min. Participants completed the core set of the RAND Medical Outcomes Study questionnaire (RAND MOS and a sleep diary during the 2-week baseline control period, and at 3 and 6 months following the start of the trial. The qigong intervention resulted in significant changes in sleep rate score and in the following subscales of the RAND MOS: SF36 Vitality, Sleep Problems, Social Activity, Social Activity Limitation due to Health, Health Distress, Mental Health Index and Psychological Well-being. Qigong seems to improve factors related to chronic fatigue such as sleep, pain, mental attitude and general mobility after 3 and 6 months. Qigong's positive effects indicate that it represents a potentially safe method of treatment for chronic fatigued patients. However, we cannot completely discount the possible influence of placebo effects, and more objective clinical measures are needed to reproduce our findings with long-term follow-up in a randomized, controlled study involving a larger number of subjects.

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  5. Respiratory muscle pacing with chronically implanted intramuscular Permaloc electrodes: A feasibility study

    Directory of Open Access Journals (Sweden)

    James S. Walter, PhD

    2011-02-01

    Full Text Available We tested the feasibility of stimulating upper-intercostal and abdominal muscles plus the diaphragm by using chronically implanted intramuscular electrodes. During two survival surgeries with six dogs, intramuscular electrodes were implanted bilaterally in the three respiratory muscles. Standard stimulation of the diaphragm was conducted. The dorsolateral and ventrolateral abdominal wall areas were stimulated with a 25 mA current. The second to fourth intercostal spaces were stimulated to elicit the largest tidal volume associated with the least coactivation of the serratus and latissimus muscles. Lone diaphragm and upper-intercostal muscle pacing produced inhaled tidal volumes (mean +/- standard error of the mean of 293 +/- 36 mL and 59 +/- 17 mL, respectively. Lone abdominal muscle pacing produced an exhaled volume of 55 +/- 17 mL. Combined pacing of diaphragm and intercostal muscles increased the inhaled volume to 389 +/- 39 mL. The addition of abdominal pacing following the combined stimulation of diaphragm and intercostals increased the exhaled volume to 472 +/- 54 mL. During autopsy, dislodgement of the electrodes overlying the ribs was a concern and probably resulted from loose animal jackets. Chronic intramuscular Permaloc electrodes can be implanted in several respiratory muscles and increase tidal volumes more than diaphragm stimulation alone.

  6. GALEN skin test study III: Minimum battery of test inhalent allergens needed in epidemiological studies in patients

    DEFF Research Database (Denmark)

    Bousquet, P-J; Burbach, G; Heinzerling, L M;

    2009-01-01

    Background: The number of allergens to be tested in order to identify sensitized patients is important in order to have the most cost-effective approach in epidemiological studies. Objective: To define the minimal number and the type of skin prick test (SPT) allergens required to identify a patient...... as sensitized using results of the new Pan-European GA(2)LEN skin prick test study. Method: In a large Pan-European multicenter (17 centers in 14 countries) patient based study, a standardized panel of 18 allergens has been prick tested using a standardized procedure. Conditional approach allowed to determine...... or Alternaria]). According to country, up to 13 allergens were needed to identify all sensitized subjects. Conclusion: Eight to ten allergens allowed the identification of the majority of sensitized subjects. For clinical care of individual patients, the whole battery of 18 allergens is needed to appropriately...

  7. Inhalation reproductive toxicology studies: Male dominant lethal study of n-hexane in Swiss (CD-1) mice: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mast, T.J.; Rommereim, R.L.; Evanoff, J.J.; Sasser, L.B.; Decker, J.R.; Stoney, K.H.; Weigel, R.J.; Westerberg, R.B.

    1988-08-01

    The straight-chain hydrocarbon, n-hexane, is a volatile, ubiquitous solvent routinely used in industrial environments; consequently, the opportunity for industrial, environmental or accidental exposure to hexane vapors is significant. Although myelinated nerve tissue is the primary target organ of hexane, the testes have also been identified as being sensitive to hexacarbon exposure. The objective of this study was to evaluate male dominant lethal effects in Swiss (CD-1) mice after exposure to 0, 200, 1000, or 5000 ppM n-hexane, 20 h/day for 5 consecutive days. Each exposure concentration consisted of 30 randomly selected, proven male breeders; 4 groups. The mice were weighed just prior to the first day of exposure and at weekly intervals until sacrifice. Ten males in each dose group were sacrificed one day after the cessation of exposure, and their testes and epididymides were removed for evaluation of the germinal epithelium. The remaining male mice, 20 per group, were individually housed in hanging wire-mesh breeding cages where they were mated with unexposed, virgin females for eight weekly intervals; new females were provided each week. The mated females were sacrificed 12 days after the last day of cohabitation and their reproductive status and the number and viability of the implants were recorded. The appearance and behavior of the male mice were unremarkable throughout the study period and no evidence of n-hexane toxicity was observed. 18 refs., 3 figs., 11 tabs.

  8. Inhalation toxicity studies with 1,3-butadiene 3 two year toxicity/carcinogenicity study in rats

    Energy Technology Data Exchange (ETDEWEB)

    Owen, P.E.; Glaister, J.R.; Gaunt, I.F.; Pullinger, D.H.

    1987-05-01

    Groups of 110 male and 110 female CD (Sprague-Dawley) rats were exposed to atmospheres containing 0 (control), 1000 or 8000 ppm v/v butadiene for 6 hr/day and 5 days/week. Ten of each sex from each group were killed at 52 weeks. The study was terminated when it was predicted that survival would drop to 20% to 25%. High dose rats had wet, ruffled fur and showed slight incoordination during the first exposure each week. During the second year, mortality in both treated female groups was increased because of humanitarian sacrifice of animals with large subcutaneous masses, while increased mortality in the high dose males was accompanied by an increase of the severity of nephropathy. Body weight was slightly lower than controls in both sexes at the high dose, but statistically significant only over the first 12 weeks. There were no effects in hematological analyses or tests of neuromuscular function that definitely could be associated with treatment. Liver weights at both doses were increased in both sexes with no associated pathological change. Kidney weight was increased in males at the high dose, together with an increase in the severity of nephrosis. There were increases in the incidences of pancreatic exocrine adenoma; uterine sarcoma; Zymbal gland carcinoma; mammary tumors; thyroid follicular cell tumors; and testis Leydig-cell tumors. These data suggest the butadiene is a weak oncogen to the rat under the conditions of exposure used in this study.

  9. Inhalation reproductive toxicology studies: Male dominant lethal study of n-hexane in Swiss (CD-1) mice: Final report

    International Nuclear Information System (INIS)

    The straight-chain hydrocarbon, n-hexane, is a volatile, ubiquitous solvent routinely used in industrial environments; consequently, the opportunity for industrial, environmental or accidental exposure to hexane vapors is significant. Although myelinated nerve tissue is the primary target organ of hexane, the testes have also been identified as being sensitive to hexacarbon exposure. The objective of this study was to evaluate male dominant lethal effects in Swiss (CD-1) mice after exposure to 0, 200, 1000, or 5000 ppM n-hexane, 20 h/day for 5 consecutive days. Each exposure concentration consisted of 30 randomly selected, proven male breeders; 4 groups. The mice were weighed just prior to the first day of exposure and at weekly intervals until sacrifice. Ten males in each dose group were sacrificed one day after the cessation of exposure, and their testes and epididymides were removed for evaluation of the germinal epithelium. The remaining male mice, 20 per group, were individually housed in hanging wire-mesh breeding cages where they were mated with unexposed, virgin females for eight weekly intervals; new females were provided each week. The mated females were sacrificed 12 days after the last day of cohabitation and their reproductive status and the number and viability of the implants were recorded. The appearance and behavior of the male mice were unremarkable throughout the study period and no evidence of n-hexane toxicity was observed. 18 refs., 3 figs., 11 tabs

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

    Science.gov (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…

  11. A DESCRIPTIVE STUDY OF FUNGAL INFECTIONS IN CHRONICALLY DISCHARGING EARS

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-08-01

    Full Text Available BACKGROUND : Chronic Suppurative Otitis Media (CSOM is a disease of multiple aetiology and well known for its persis tence and recurrence inspite of treatment and are the bearbug of otologist, paediatrician and general practitioner. One of the reason s for the refractoriness to treatment and chronicity is coexist ing fungal infection of the ear. OBJECTIVES: Are to find out the prevalence of fungal infections in chronic discharging ears and to identify and isolate the type of fungus prevalent in these ears . MATERIALS AND METHOD S: Tertiary care hospital level descrip tive study was conducted in 50 cases of CSOM with actively discharging ears for a period of one year starting from February 2013. For all the cases aural swabs were collected from the diseased ear and were used for direct microscopic examination in potassi um hydroxide wet mount. Ear swab was cultured on Sabouraud’s dextrose agar plate for fungal cultures. The patient characteristics were prospectively recorded and results were analysed. CONCLUSION : There is high prevalence of coexisting fungal infection in actively discharging ears of CSOM patients

  12. Impact of inhaled nitric oxide on the sulfatide profile of neonatal rat brain studied by TOF-SIMS imaging.

    Science.gov (United States)

    Kadar, Hanane; Pham, Hoa; Touboul, David; Brunelle, Alain; Baud, Olivier

    2014-01-01

    Despite advances in neonatal intensive care leading to an increased survival rate in preterm infants, brain lesions and subsequent neurological handicaps following preterm birth remain a critical issue. To prevent brain injury and/or enhance repair, one of the most promising therapies investigated in preclinical models is inhaled nitric oxide (iNO). We have assessed the effect of this therapy on brain lipid content in air- and iNO-exposed rat pups by mass spectrometry imaging using a time-of-flight secondary ion mass spectrometry (TOF-SIMS) method. This technique was used to map the variations in lipid composition of the rat brain and, particularly, of the white matter. Triplicate analysis showed a significant increase of sulfatides (25%-50%) in the white matter on Day 10 of life in iNO-exposed animals from Day 0-7 of life. These robust, repeatable and semi-quantitative data demonstrate a potent effect of iNO at the molecular level. PMID:24670476

  13. Impact of Inhaled Nitric Oxide on the Sulfatide Profile of Neonatal Rat Brain Studied by TOF-SIMS Imaging

    Directory of Open Access Journals (Sweden)

    Hanane Kadar

    2014-03-01

    Full Text Available Despite advances in neonatal intensive care leading to an increased survival rate in preterm infants, brain lesions and subsequent neurological handicaps following preterm birth remain a critical issue. To prevent brain injury and/or enhance repair, one of the most promising therapies investigated in preclinical models is inhaled nitric oxide (iNO. We have assessed the effect of this therapy on brain lipid content in air- and iNO-exposed rat pups by mass spectrometry imaging using a time-of-flight secondary ion mass spectrometry (TOF-SIMS method. This technique was used to map the variations in lipid composition of the rat brain and, particularly, of the white matter. Triplicate analysis showed a significant increase of sulfatides (25%–50% in the white matter on Day 10 of life in iNO-exposed animals from Day 0–7 of life. These robust, repeatable and semi-quantitative data demonstrate a potent effect of iNO at the molecular level.

  14. Comparison of resource use by COPD patients on inhaled therapies with long-acting bronchodilators: a database study

    Directory of Open Access Journals (Sweden)

    Kozma Chris M

    2011-12-01

    Full Text Available Abstract Background The purpose of this analysis was to compare health care costs and utilization among COPD patients who had long-acting beta-2 agonist (LABA OR long-acting muscarinic antagonist (LAMA; LABA AND LAMA; or LABA, LAMA, AND inhaled corticosteroid (ICS prescription claims. Methods This was a 12 month pre-post, retrospective analysis using COPD patients in a national administrative insurance database. Propensity score and exact matching were used to match patients 1:1:1 between the LABA or LAMA (formoterol, salmeterol, or tiotropium, LABA and LAMA (tiotropium/formoterol or tiotropium/salmeterol, and LABA, LAMA and ICS (bronchodilators plus steroid groups. Post-period comparisons were evaluated with analysis of covariance. Costs were evaluated from a commercial payer perspective. Results A total of 523 patients were matched using 29 pre-period variables (e.g., demographics, medication exposure. Post-match assessments indicated balance among the cohorts. COPD-related costs differed among groups (LABA or LAMA $2,051 SE = 91; LABA and LAMA $2,823 SE = 62; LABA, LAMA and ICS $3,546 SE = 89; all p Conclusions Significant cost differences driven mainly by pharmaceuticals were observed among LABA or LAMA, LABA and LAMA and LABA, LAMA and ICS therapies. A COPD-related cost offset was observed from single bronchodilator to two bronchodilators. Addition of an ICS with two bronchodilators resulted in higher treatment costs without reduction in other COPD-related costs compared with two bronchodilators.

  15. [Interaction between benzene and toluene in long term inhalation exposure in rats (author's transl)].

    Science.gov (United States)

    Gradiski, D; Bonnet, P; Duprat, P; Zissu, D; Magadur, J L; Guenier, J P

    1981-07-01

    Industrial chemicals are seldom used as pure substances; hazards resulting from exposure to mixtures have, however not been solved. Our study deals with chronic inhalation toxicity of a mixture of benzene and toluene; few studies have been completed on this subject. Our results show: - leucopenia with benzene alone, at a concentration of 50 p.p.m., that is not detectable in the presence of toluene; - metabolic variations consisting in: a decrease in the phenol urinary rate versus time with benzene alone; a sharp decrease of this rate from the third month of exposure on, in presence of toluene.

  16. Twelve-week efficacy and safety study of mometasone furoate/formoterol 200/10 microg and 400/10 microg combination treatments in patients with persistent asthma previously receiving high-dose inhaled corticosteroids

    DEFF Research Database (Denmark)

    Weinstein, Steven F; Corren, Jonathan; Murphy, Kevin;

    2010-01-01

    A significant unmet medical need exists in patients with uncontrolled asthma. The purpose of this study was to evaluate the efficacy and safety of mometasone furoate/formoterol (MF/F) 400/10 microg versus MF 400 microg administered twice-daily (b.i.d.) via metered-dose inhaler in patients with...

  17. Urine and serum concentrations of inhaled and oral terbutaline

    DEFF Research Database (Denmark)

    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 terb...... therapeutic and prohibited use based on doping tests with urine and blood samples....... terbutaline on 2 study days. Further, 10 healthy subjects were administrated 1 mg inhaled terbutaline in 4 repetive doses with total 4 mg. Blood samples were collected at baseline and during 6 h after the first inhalations. Urine samples were collected at baseline and during 12 h after the first inhalations...

  18. Influence of pollution control on lead inhalation bioaccessibility in PM2.5: A case study of 2014 Youth Olympic Games in Nanjing.

    Science.gov (United States)

    Li, Shi-Wei; Li, Hong-Bo; Luo, Jun; Li, Hui-Ming; Qian, Xin; Liu, Miao-Miao; Bi, Jun; Cui, Xin-Yi; Ma, Lena Q

    2016-09-01

    Pollution controls were implemented to improve the air quality for the 2014 Youth Olympic Games (YOG) in Nanjing. To investigate the influence of pollution control on Pb inhalation bioaccessibility in PM2.5, samples were collected before, during, and after YOG. The objectives were to identify Pb sources in PM2.5 using stable isotope fingerprinting technique and compare Pb inhalation bioaccessibility in PM2.5 using two simulated lung fluids. While artificial lysosomal fluid (ALF) simulates interstitial fluid at pH 7.4, Gamble's solution simulates fluid in alveolar macrophages at pH 4.5. The Pb concentration in PM2.5 samples during YOG (88.2ngm(-3)) was 44-48% lower than that in non-YOG samples. Based on stable Pb isotope ratios, Pb in YOG samples was mainly from coal combustion while Pb in non-YOG samples was from coal combustion and smelting activities. While Pb bioaccessibility in YOG samples was lower than those in non-YOG samples (59-79% vs. 55-87%) by ALF, it was higher than those in non-YOG samples (11-29% vs. 5.3-21%) based on Gamble's solution, attributing to the lower pH and organic acids in ALF. Different Pb bioaccessibility in PM2.5 between samples resulted from changes in Pb species due to pollution control. PbSO4 was the main Pb species in PM2.5 from coal combustion, which was less soluble in ALF than PbO from smelting activities, but more soluble in Gamble's solution. This study showed it is important to consider Pb bioaccessibility during pollution control as source control not only reduced Pb contamination in PM2.5 but also influenced Pb bioaccessibility. PMID:27209002

  19. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    OpenAIRE

    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...

  20. [Significance of field epidemiologic study to identification of chronic arsenic poisoning].

    Science.gov (United States)

    Su, Li-Qin; Jin, Yin-Long

    2005-09-01

    Chronic arsenic poisoning has serious and extensive impact on human health, which attracts wide attention worldwide. Bases on vast public survey, this article introduces recent field studies on chronic arsenic poisoning from three aspects: exposure history, clinical symptoms and laboratory evidences, and also explains the meaning of each index to the determination of chronic arsenic poisoning, then bring forward some considerations on further epidemiological studies on chronic arsenic poisoning.

  1. Inhalation or instillation of steroids for the prevention of bronchopulmonary dysplasia.

    Science.gov (United States)

    Bassler, Dirk

    2015-01-01

    Survival of extremely preterm infants has increased over recent years, but bronchopulmonary dysplasia (BPD) remains a major cause of morbidity. In the USA, BPD is the most common chronic respiratory disorder of infancy and affects the pulmonary and overall health of 10,000 preterm infants annually. Preclinical and clinical studies suggest a crucial role for lung inflammation and host immune response in the pathogenesis of BPD. Inflammation may result from, amongst others, chorioamnionitis, postnatal infection, ventilation, and the administration of oxygen. Infants with BPD have worse long-term outcomes than those without chronic lung disease. They are more than twice as likely to be readmitted to hospital in their first year of life and, having survived their primary hospitalizations, they are more likely to die than very preterm infants without chronic lung disease. Survivors with BPD have an increased risk of neurodevelopmental impairment and their respiratory function remains compromised well into adolescence. As the first generations of extremely low birth weight (ELBW) survivors have not yet reached retirement age, there are currently no reliable data addressing the association between BPD and pulmonary diseases of the elderly such as chronic obstructive pulmonary disease. Although BPD is quite common in ELBW infants, there are infants who do not develop BPD, which supports the argument that BPD is a preventable disease, emphasizing the need for high-quality safety and efficacy prevention studies. However, according to an Institute of Medicine statement regarding pediatric drug studies, the therapeutic area that has the fewest drugs indicated for neonates is BPD. As inflammation seems to be a primary mediator of injury in the pathogenesis of BPD, anti-inflammatory agents such as steroids have long been the focus of preventive research activities. However, systemic steroids, although reducing BPD, have frequently been linked to adverse neurodevelopmental

  2. Inhalation solutions: which one are allowed to be mixed? Physico-chemical compatibility of drug solutions in nebulizers.

    Science.gov (United States)

    Kamin, Wolfgang; Schwabe, Astrid; Krämer, Irene

    2006-12-01

    Therapy of chronic respiratory diseases often involves inhalation therapy with nebulizers. Patients often attempt to shorten the time consuming administration procedure by mixing drug solutions/suspensions for simultaneous inhalation. This article considers the issue of physico-chemical compatibility of admixtures of drug solutions/suspensions in nebulizers. A search of databases, prescribing information and primary literature was conducted to locate literature concerning the physico-chemical compatibility of inhalation solutions/suspensions. This was supplemented by telephone interviews. Admixtures of albuterol with ipratropium and/or cromolyn, of albuterol and budesonide, or tobramycin, or colistin are physico-chemically compatible. Physico-chemical compatibility has been demonstrated for admixtures of cromolyn with albuterol and/or ipratropium and for admixtures of cromolyn and budesonide. Admixtures of budesonide with ipratropium and/or fenoterol, and admixtures of budesonide and albuterol, or cromolyn are physico-chemically compatible. Both cromolyn and colistin are incompatible with benzalkonium chloride. Admixtures should be prepared from inhalation solutions/suspensions formulated without preservatives. Besides studies of the physico-chemical compatibility, the aerodynamic behaviour of physico-chemical mixtures needs to be studied before a final recommendation of simultaneous nebulization of compatible admixtures can be made. PMID:16678502

  3. Species difference in metabolism of inhaled butadiene

    International Nuclear Information System (INIS)

    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. Inhalant Use in Latina Early Adolescent Girls

    Science.gov (United States)

    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…

  5. 40 CFR 798.2450 - Inhalation toxicity.

    Science.gov (United States)

    2010-07-01

    ... selection. (ii) Age. Young adult animals shall be used. At the commencement of the study the weight...) Definitions. (1) Subchronic inhalation toxicity is the adverse effects occurring as a result of the repeated... Practice Standards, 40 CFR part 792, subpart J, the following specific information shall be reported:...

  6. Use of inhaled anticholinergic agents in obstructive airway disease.

    Science.gov (United States)

    Restrepo, Ruben D

    2007-07-01

    In the last 2 decades, anticholinergic agents have been generally regarded as the first-choice bronchodilator therapy in the routine management of stable chronic obstructive pulmonary disease (COPD) and, to a lesser extent, asthma. Anticholinergics are particularly important bronchodilators in COPD, because the vagal tone appears to be the only reversible component of airflow limitation in COPD. The inhaled anticholinergics approved for clinical use are synthetic quaternary ammonium congeners of atropine, and include ipratropium bromide, oxitropium bromide, and tiotropium bromide. This article reviews the most current evidence for inhaled anticholinergics in obstructive airway disease and summarizes outcomes reported in randomized controlled trials.

  7. Pilot study: bone marrow stem cells as a treatment for dogs with chronic spinal cord injury

    OpenAIRE

    Sarmento, Carlos Alberto Palmeira; Rodrigues, Marcio Nogueira; Bocabello, Renato Zonzini; Mess, Andrea Maria; Miglino, Maria Angelica

    2014-01-01

    Background Chronic Spinal Cord injury is a common, severe, and medically untreatable disease. Since the functional outcomes of acute and experimental chronic spinal cord injury have been shown to improve with stem cell therapy, a case study was conducted to test if the application of stem cell also regenerates chronic SCI dysfunction. Transplantation of foetal bone marrow stem cells was applied in seven dogs with chronic spinal cord injury. Magnetic resonance images and assessments of symptom...

  8. Observation of curative effect by budesonide/formoterol powder inhalation in the treatment of chronic obstructive pulmonary disease patients%布地奈德/福莫特罗粉吸入治疗慢性阻塞性肺疾病患者的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄欢; 陈锦萍

    2015-01-01

    Objective To observe the curative effect by budesonide/formoterol powder inhalation in the treatment of moderate and severe chronic obstructive pulmonary disease (COPD) patients. Methods A total of 80 patients with moderate and severe chronic obstructive pulmonary disease were randomly divided into control group and treatment group, and each group contained 40 cases. The control group received conventional treatment, and the treatment group received additional budesonide/formoterol powder inhalation for treatment. Changes of pulmonary function, arterial blood gases, and clinical symptoms score of the two groups were observed. Results The treatment group had better pulmonary function, arterial blood gases, and clinical symptoms score than those of the control group (P<0.05). Conclusion Implement of budesonide/formoterol powder inhalation in the treatment of moderate and severe chronic obstructive pulmonary disease patients can improve their pulmonary function and relieve clinical symptoms.%目的:观察布地奈德/福莫特罗粉吸入剂吸入治疗中、重度慢性阻塞性肺疾病(COPD)患者的疗效。方法将80例中、重度慢性阻塞性肺疾病患者随机分为对照组和治疗组,各40例。对照组进行常规治疗。治疗组在常规治疗的基础上加布地奈德/福莫特罗粉吸入剂治疗。观察两组患者肺功能、动脉血气、临床症状评分变化。结果治疗组患者肺功能、动脉血气分析、临床症状评分均优于对照组(P<0.05)。结论中、重度慢性阻塞性肺疾病患者使用布地奈德/福莫特罗粉吸入治疗,能够改善其肺功能,并缓解临床症状。

  9. Tumorigenic responses from single or repeated inhalation exposures to relatively insoluble aerosols of Ce-144

    International Nuclear Information System (INIS)

    Human occupational or environmental inhalation exposures may involve repeated or chronic exposures, but most laboratory studies of inhaled radionuclides have involved single exposures. This study was designed to compare the biological effects of repeated inhalation exposures of dogs to a relatively insoluble form of 144Ce with existing data for singly-exposed dogs that had the same cumulative dose to the lungs two years after exposure. To date, the biological effects observed in these repeatedly-exposed dogs have been substantially different from those seen in singly-exposed dogs, particularly during the first 5 years after the initial exposure. Although pulmonary hemangiosarcoma was the prominent biological effect seen in singly-exposed dogs between 2 and 4 years after exposure, no lung tumors were seen during the 5 years after the first of the repeated exposures. This response plus other clinical observations are discussed in relation to the patterns of dose rate and cumulative dose for the different exposure conditions. (H.K.)

  10. Impact of gasoline inhalation on some neurobehavioural characteristics of male rats

    Directory of Open Access Journals (Sweden)

    Kinawy Amal A

    2009-11-01

    Full Text Available Abstract Background This paper examines closely and compares the potential hazards of inhalation of two types of gasoline (car fuel. The first type is the commonly use leaded gasoline and the second is the unleaded type enriched with oxygenate additives as lead substituent in order to raise the octane number. The impacts of gasoline exposure on Na+, K+-ATPase, superoxide dismutase (SOD, acetylcholinesterase (AChE, total protein, reduced glutathione (GSH, and lipid peroxidation (TBARS in the cerebral cortex, and monoamine neurotransmitters dopamine (DA, norepinephrine (NE and serotonin (5-HT in the cerebral cortex, hippocampus, cerebellum and hypothalamus were evaluated. The effect of gasoline exposure on the aggressive behaviour tests was also studied. Results The present results revealed that gasoline inhalation induced significant fluctuations in the levels of the monoamine neurotransmitters in the studied brain regions. This was concomitant with a decrease in Na+, K+-ATPase activity and total protein content. Moreover, the group exposed to the unleaded gasoline exhibited an increase in lipid peroxidation and a decrease in AChE and superoxide dismutase activities. These physiological impairments were accompanied with a higher tendency towards aggressive behaviour as a consequence to gasoline inhalation. Conclusion It is concluded from the present work that chronic exposure to either the leaded or the unleaded gasoline vapours impaired the levels of monoamine neurotransmitters and other biochemical parameters in different brain areas and modulated several behavioural aspects related to aggression in rats.

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

    Science.gov (United States)

    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

  12. Chinese cohort study of chronic kidney disease: design and methods

    Institute of Scientific and Technical Information of China (English)

    Gao Bixia; Zhang Luxia; Wang Haiyan; Zhao Minghui

    2014-01-01

    Background Chronic kidney disease (CKD) is a common disorder associated with multiple adverse clinical consequences,especially cardiovascular risk and end-stage renal disease.A recent national survey demonstrated that CKD has become a leading health problem in China.There is an urgent need to implement an in-depth investigation of the CKD burden and also to explore underlying mechanisms of CKD progression and it association with adverse consequences.Methods The Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is the first national CKD cohort in China.It will enroll approximately 3 000 pre-dialysis CKD patients aged between 18 and 74 years and follow-up for at least 5 years.Questionnaires,anthropometric measures,laboratory tests,and biomaterials will be collected at baseline and annually.The principal clinical outcomes of the C-STRIDE consist of renal disease events,cardiovascular events,and death.Based on the longitudinal clinical data and biomaterials,the risk factors with CKD progression and other outcomes will be analyzed,and candidate markers and predicted models will be established.Conclusion The C-STRIDE would provide important evidence for underlying mechanisms of CKD progression,valuable information for clinical guidelines,and healthcare policies in China.

  13. Longitudinal study of leptin levels in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Averbukh Zhan

    2011-06-01

    Full Text Available Abstract Background The influence of serum leptin levels on nutritional status and survival in chronic hemodialysis patients remained to be elucidated. We conducted a prospective longitudinal study of leptin levels and nutritional parameters to determine whether changes of serum leptin levels modify nutritional status and survival in a cohort of prevalent hemodialysis patients. Methods Leptin, dietary energy and protein intake, biochemical markers of nutrition and body composition (anthropometry and bioimpedance analysis were measured at baseline and at 6, 12, 18 and 24 months following enrollment, in 101 prevalent hemodialysis patients (37% women with a mean age of 64.6 ± 11.5 years. Observation of this cohort was continued over 2 additional years. Changes in repeated measures were evaluated, with adjustment for baseline differences in demographic and clinical parameters. Results Significant reduction of leptin levels with time were observed (linear estimate: -2.5010 ± 0.57 ng/ml/2y; p Conclusions Thus leptin levels reflect fat mass depots, rather than independently contributing to uremic anorexia or modifying nutritional status and/or survival in chronic hemodialysis patients. The importance of such information is high if leptin is contemplated as a potential therapeutic target in hemodialysis patients.

  14. Manganese Inhalation as a Parkinson Disease Model

    Directory of Open Access Journals (Sweden)

    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.

  15. Efficacy and safety of inhaled formoterol 4.5 and 9 μg twice daily in Japanese and European COPD patients: Phase III study results

    Directory of Open Access Journals (Sweden)

    Bogdan Miron A

    2011-11-01

    Full Text Available Abstract Background This study evaluated the efficacy and safety of the long-acting β2-agonist formoterol in patients with moderate-to-severe COPD. Methods This double-blind, placebo-controlled, parallel-group, multinational phase III study randomized patients ≥ 40 years of age with moderate-to-severe COPD to inhaled formoterol 4.5 or 9 μg twice daily (bid via Turbuhaler® or placebo for 12 weeks. Salbutamol 100 μg/actuation via pMDI was permitted as reliever medication. The primary outcome variable was change (ratio from baseline to treatment period in FEV1 60-min post-dose. Results 613 patients received treatment (formoterol 4.5 μg n = 206; 9 μg n = 199; placebo n = 208; 539 (87.9% male; 324 (52.9% Japanese and 289 (47.1% European. End of study increases in FEV1 60-min post-dose were significantly greater (p Conclusions Formoterol 4.5 μg and 9 μg bid was effective and well tolerated in patients with COPD; there was no difference between formoterol doses for the primary endpoint; however, an added value of formoterol 9 μg over 4.5 μg bid was observed for some secondary endpoints. Trial registration NCT00628862 (ClinicalTrials.gov; D5122C00001 (AstraZeneca Study code.

  16. The improving of ventilometric indices using Airway Clearance Techniques Asociated with Inhalation Therapy applied to adolescents with cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Bogdan Almăjan-Guţă

    2010-12-01

    Full Text Available Introduction: this study gave particular attention to respiratory damage, lung disease being the main target for developingtherapies in MV. The purpose of this study was to demonstrate the efficiency of Classical Respiratory clearance techniquescombined with Inhalation Therapy and to compare the results of using acetylcysteine with those of using Pulmozyme Therapy.Aerosol (inhalation therapy is, along with exercise and respiratory clearance techniques, the third component in thephysiotherapy of patients with CF. Material and method: the study was developed during a period of six months, in TheNational Center of Cystic Fibrosis, Clinic II of Pediatrics in the Emergency County Hospital, Timisoara. The study group consistedof 12 children with MV . This group was divided into two groups of 6 patients (group 1 and group 2. Group 1 followedinhalation treatment with acetylcysteine, and group 2 with Pulmozyme. Results: The evaluation of the results was done after 2months and 6 months since the study started, by measuring the FEV, and FVC. For the first group, that used acetylcysteine inthe inhalation therapy, we observed, after 6 months, an increase of FEV with an average of 2.08% and of FVC with 2.13%.Thegrowth of ventilometric indices were relatively accelerated in the first two months and later there was a slower growth,achieving final value. For the second group, that used Pulmozyme, the growth of ventilometric indices was significantly higher.Discussion: considering the two relatively homogeneous groups, in what concerns the values of ventilometric indices andsuperimposed infection, we believe that inhaled Pulmozyme therapy proved to be superior to acetylcysteine. Conclusions:inhalation therapy is an important part of physiotherapy for patients with cystic fibrosis. A consistent physiotherapy is probablythe most important element in preventing chronic pulmonary infection and, along with antibiotherapy, improves significantlythe prognosis and helps

  17. Chronic pain, perceived stress, and cellular aging: an exploratory study

    Directory of Open Access Journals (Sweden)

    Sibille Kimberly T

    2012-02-01

    Full Text Available Abstract Background Chronic pain conditions are characterized by significant individual variability complicating the identification of pathophysiological markers. Leukocyte telomere length (TL, a measure of cellular aging, is associated with age-related disease onset, psychosocial stress, and health-related functional decline. Psychosocial stress has been associated with the onset of chronic pain and chronic pain is experienced as a physical and psychosocial stressor. However, the utility of TL as a biological marker reflecting the burden of chronic pain and psychosocial stress has not yet been explored. Findings The relationship between chronic pain, stress, and TL was analyzed in 36 ethnically diverse, older adults, half of whom reported no chronic pain and the other half had chronic knee osteoarthritis (OA pain. Subjects completed a physical exam, radiographs, health history, and psychosocial questionnaires. Blood samples were collected and TL was measured by quantitative polymerase chain reaction (qPCR. Four groups were identified characterized by pain status and the Perceived Stress Scale scores: 1 no pain/low stress, 2 no pain/high stress, chronic pain/low stress, and 4 chronic pain/high stress. TL differed between the pain/stress groups (p = 0.01, controlling for relevant covariates. Specifically, the chronic pain/high stress group had significantly shorter TL compared to the no pain/low stress group. Age was negatively correlated with TL, particularly in the chronic pain/high stress group (p = 0.03. Conclusions Although preliminary in nature and based on a modest sample size, these findings indicate that cellular aging may be more pronounced in older adults experiencing high levels of perceived stress and chronic pain.

  18. Self-reported osteoporosis prevention in inhaled corticosteroid users in community pharmacy setting

    Directory of Open Access Journals (Sweden)

    Valerie Chan

    2015-05-01

    Full Text Available Objectives: The use of inhaled corticosteroids is the standard maintenance therapy in asthma therapy and as adjunct therapy in moderate to severe chronic obstructive pulmonary disease. A dose-related increase in fracture risk is associated with inhaled corticosteroid use; there is an inverse relationship between bone mineral density and duration and cumulative dose of inhaled corticosteroid. Adequate intake of calcium and vitamin D are cornerstones of osteoporosis prevention. The objectives are to assess whether the proportion of patients receiving inhaled corticosteroids are taking calcium and vitamin D; the association between long-term inhaled corticosteroid use and abnormal bone mineral density or fractures; and how many qualified patients received bone mineral density scans. Methods: Patients who filled a prescription for inhaled corticosteroids at selected community pharmacies across Alberta were recruited for a survey of their osteoporosis prevention activities. Results: A total of 256 patients from 12 community pharmacies were included. The average age was 60 ± 17.4 years with 65% female. There were 21%, 51%, and 28% of patients on high, medium, and low dose inhaled corticosteroids, respectively. Only 17% of patients >50 years old received recommended calcium and vitamin D supplementation and 87 (73% of the qualified patients received bone mineral density scan. Conclusion: Osteoporosis prevention in inhaled corticosteroid users is currently poorly addressed. More promotion is needed to raise pharmacist awareness of the risks of inhaled corticosteroids.

  19. Behavioral changes in mice following benzene inhalation.

    Science.gov (United States)

    Evans, H L; Dempster, A M; Snyder, C A

    1981-01-01

    Although benzene is an important occupational health hazard and a carcinogen, the possibility that behavioral changes may forewarn of the later-occurring hematological changes has not been investigated. A time-sampling protocol was used to quantify the occurrence of 7 categories of behavior in the homecage following daily 6-hr exposures to two strains of adult mice (CD1 and C57BL/6J). The behavioral categories were stereotypic behavior, sleeping, resting, eating, grooming, locomotion, and fighting. The inhalation exposures were designed to reflect occupational exposure. Dynamic vapor exposure techniques in standard inhalation chambers were employed. Exposure to 300 or 900 ppm benzene increased the occurrence of eating and grooming and reduced the number of mice that were sleeping or resting. The responses to benzene of both the CD1 and the C57 strains were similar. The positive findings with benzene inhalation indicate the utility of behavioral investigations into the toxicology of inhaled organic solvents. The methods described herein illustrate an objective observation of animal behavior that is capable of documenting toxicity and of guiding detailed follow-up studies aimed at mechanism of action.

  20. A randomised, crossover study on an electronic vapour product, a nicotine inhalator and a conventional cigarette. Part B: Safety and subjective effects.

    Science.gov (United States)

    Walele, Tanvir; Sharma, Girish; Savioz, Rebecca; Martin, Claire; Williams, Josie

    2016-02-01

    An Electronic Vapour Product (EVP) has been evaluated for short-term safety parameters and subjective effects in a 2-part study, in smokers. Part 1 compared the EVP with unflavoured (UF) and flavoured (FL) e-liquid at 2.0% nicotine to a conventional cigarette (CC; JPS Silver King Size, 0.6 mg) and a licensed nicotine inhalator (Nicorette(®), 15 mg). Part 2 assessed the effect of increasing concentrations of nicotine in the e-liquid used with the EVP (0%, 0.4%, 0.9%, 2.0%). The study was designed as a randomised, controlled, crossover trial. Outcomes included adverse events (AEs), vital signs, exhaled carbon monoxide (CO), clinical laboratory parameters, smoking urges and withdrawal symptoms. In both study parts, only mild non-serious AEs were reported. No major differences were observed in AEs between the EVPs and Nicorette(®). Exhaled CO levels only increased for CC. All products appeared to decrease smoking urges and nicotine withdrawal symptom scores to a similar extent. The EVP had a similar short-term safety profile to Nicorette(®) and relieved smoking urges and nicotine withdrawal symptoms to a similar extent as Nicorette(®) and CC. Unlike nicotine replacement therapies, the EVP may offer an alternative for those finding it difficult to quit the behavioural and sensorial aspects of smoking.

  1. Design, assembly, and validation of a nose-only inhalation exposure system for studies of aerosolized viable influenza H5N1 virus in ferrets

    Directory of Open Access Journals (Sweden)

    Hamilton Sara B

    2010-06-01

    Full Text Available Abstract Background The routes by which humans acquire influenza H5N1 infections have not been fully elucidated. Based on the known biology of influenza viruses, four modes of transmission are most likely in humans: aerosol transmission, ingestion of undercooked contaminated infected poultry, transmission by large droplets and self-inoculation of the nasal mucosa by contaminated hands. In preparation of a study to resolve whether H5N1 viruses are transmissible by aerosol in an animal model that is a surrogate for humans, an inhalation exposure system for studies of aerosolized H5N1 viruses in ferrets was designed, assembled, and validated. Particular attention was paid towards system safety, efficacy of dissemination, the viability of aerosolized virus, and sampling methodology. Results An aerosol generation and delivery system, referred to as a Nose-Only Bioaerosol Exposure System (NBIES, was assembled and function tested. The NBIES passed all safety tests, met expected engineering parameters, required relatively small quantities of material to obtain the desired aerosol concentrations of influenza virus, and delivered doses with high-efficacy. Ferrets withstood a mock exposure trial without signs of stress. Conclusions The NBIES delivers doses of aerosolized influenza viruses with high efficacy, and uses less starting material than other similar designs. Influenza H5N1 and H3N2 viruses remain stable under the conditions used for aerosol generation and sample collection. The NBIES is qualified for studies of aerosolized H5N1 virus.

  2. Inhaled fluticasone propionate impairs pulmonary clearance of Klebsiella Pneumoniae in mice

    Directory of Open Access Journals (Sweden)

    Patterson Craig M

    2012-05-01

    Full Text Available Abstract Background Recent trials demonstrate increased pneumonia risk in chronic obstructive pulmonary disease patients treated with the inhaled corticosteroid (ICS fluticasone propionate (FP. There is limited work describing FP effects on host defenses against bacterial pneumonia. Methods C57BL/6 mice received daily, nose-only exposure to nebulized FP or vehicle for 8 days, followed by pulmonary challenge with Klebsiella pneumoniae. Bacterial burden, phagocytosis, leukocyte recruitment, cytokine expression, nitric oxide release, and survival were measured. Results Inhaled FP increased bacterial burden in lungs and blood 48 h after infection but affected neither in vivo phagocytosis of bacteria by alveolar macrophages (AM nor alveolar neutrophil recruitment. AM from FP-treated mice showed impaired expression of infection induced TNF-alpha, IP-10 (CXCL-10, and interleukin 6 (IL-6, and AM also showed a trend towards impaired intracellular pathogen control following in vivo infection. In vitro FP treatment resulted in a dose-dependent impairment of cytokine expression by AM. Furthermore, infection-induced nitric oxide (but not hydrogen peroxide production was impaired by FP in vivo and in vitro. FP decreased survival in this model. Conclusions Exposure to inhaled FP impairs pulmonary clearance of K. pneumoniae in mice, an effect associated with greater systemic bacteremia and death. Decreased AM cytokine and nitric oxide expression parallel the failure to control infection. These results support the study of ICS effects on human pulmonary host defenses.

  3. Liver fibrosis in chronic viral hepatitis: An ultrasonographic study

    Institute of Scientific and Technical Information of China (English)

    Rong-Qin Zheng; Qing-Hui Wang; Ming-De Lu; Shi-Bin Xie; Jie Ren; Zhong-Zhen Su; Yin-Ke Cai; Ji-Lu Yao

    2003-01-01

    AIM: To select valuable ultrasonographic predictors for the evaluation of hepatic inflammation and fibrosis degree in chronic hepatitis, and to study the value of ultrasonography in the evaluation of liver fibrosis and compensated liver cirrhosis in comparison with serology and histology.METHODS: Forty-four ultrasonographic variables were analyzed and screened using color Doppler ultrasound system in 225 patients with chronic viral hepatitis and compensated liver cirrhosis. The valuable ultrasonographic predictors were selected on the basis of a comparison with histopathological findings. The value of ultrasonography and serology in the evaluation of liver fibrosis degree and the diagnosis of compensated liver cirrhosis was also studied and compared. Meanwhile, the influencing factors on ultrasonographic diagnosis of compensated liver cirrhosis were also analyzed.RESULTS: By statistical analysis, the maximum velocity of portal vein and the degree of gall-bladder wall smoothness were selected as the valuable predictors for the inflammation grade (G), while liver surface, hepatic parenchymal echo pattern, and the wall thickness of gall-bladder were selected as the valuable predictors for the fibrosis stage (S). Three S-related independent ultrasonographyic predictors and three routine serum fibrosis markers (HA, HPCIII and CIV) were used to discriminate variables for the comparison of ultrasonography with serology. The diagnostic accuracy of ultrasonography in moderate fibrosis was higher than that of serology (P<0.01), while there were no significant differences in the general diagnostic accuracy of fibrosis as well as between mild and severe fibrosis (P<0.05). There were no significant differences between ultrasonography and serology in the diagnosis of compensated liver cirrhosis.However, the diagnostic accuracy of ultrasonography was higher in inactive liver cirrhosis and lower in active cirrhosis than that of serology (both P<0.05). False positive and false

  4. Clinical effect and safety of budesonide and formoterol inhalant combined with tiotropium bromide in the ;treatment of chronic obstructive pulmonary disease%布地奈德福莫特罗粉吸入剂联合噻托溴铵治疗慢性阻塞性肺疾病的临床疗效和安全性

    Institute of Scientific and Technical Information of China (English)

    林茂华; 唐雨晴; 王智辉; 钟志超

    2015-01-01

    目的:研究布地奈德福莫特罗粉吸入剂联合噻托溴铵治疗慢性阻塞性肺疾病(COPD)的临床疗效和安全性。方法90例慢性阻塞性肺疾病患者,随机分为观察组和对照A、B组,每组30例。对照A组接受噻托溴铵治疗,对照B组接受布地奈德/福莫特罗治疗,观察组采用噻托溴铵联合布地奈德/福莫特罗治疗。观察三组治疗效果。结果观察组的一秒用力呼气容积(FEV1)、最大呼气流速(PEF)和FEV1预计百分比,明显优于对照A、B组,差异均具有统计学意义(P<0.05);观察组临床指标较治疗前和对照A、B组更优(P<0.05)。三组患者未见明显不良反应。结论布地奈德/福莫特罗联合噻托溴铵吸入治疗慢性阻塞性肺疾病有利于控制临床症状,改善患者肺功能与生活质量,安全性高。%Objective To study the clinical effect and safety of budesonide/formoterol inhalant combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease (COPD). Methods A total of 90 COPD patients were randomly divided into observation group, control A group, and control B group, with 30 cases in each group. The control A group received tiotropium bromide for treatment, and control B group received budesonide/formoterol for treatment, while the observation group was treated by budesonide/formoterol combined with tiotropium bromide. Curative effects of the three groups were observed. Results The observation group had remarkably better forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and FEV1 predicted percentage than control A and B groups. The difference had statistical significance (P<0.05). The observation group had better clinical indexes than that before treatment and control A and B groups, and the difference had statistical significance (P<0.05). No obvious adverse reactions were found in all three groups. Conclusion Budesonide/formoterol combined with tiotropium bromide

  5. Genome-wide association studies in pediatric chronic kidney disease.

    Science.gov (United States)

    Gupta, Jayanta; Kanetsky, Peter A; Wuttke, Matthias; Köttgen, Anna; Schaefer, Franz; Wong, Craig S

    2016-08-01

    The genome-wide association study (GWAS) has become an established scientific method that provides an unbiased screen for genetic loci potentially associated with phenotypes of clinical interest, such as chronic kidney disease (CKD). Thus, GWAS provides opportunities to gain new perspectives regarding the genetic architecture of CKD progression by identifying new candidate genes and targets for intervention. As such, it has become an important arm of translational science providing a complementary line of investigation to identify novel therapeutics to treat CKD. In this review, we describe the method and the challenges of performing GWAS in the pediatric CKD population. We also provide an overview of successful GWAS for kidney disease, and we discuss the established pediatric CKD cohorts in North America and Europe that are poised to identify genetic risk variants associated with CKD progression.

  6. Prospective study of chronic pain after groin hernia repair

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    1999-01-01

    BACKGROUND: The aim was to provide a detailed description of any residual pain 1 year after elective day-case open groin hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study by questionnaire of 500 consecutive operations in 466 unselected adult...... severe pain 4 weeks after operation (24 versus 3 per cent; P < 0.001). CONCLUSION: Chronic pain is a significant problem after open groin hernia repair. It may be worse after surgery for a recurrent hernia and may be predicted by the intensity of early postoperative pain....... severe pain was higher after repair of recurrent than primary hernias (14 versus 3 per cent; P < 0.001). The risk of developing moderate or severe pain was increased in patients who had a high pain score 1 week after operation (9 versus 3 per cent; P < 0.05) and also in patients who had moderate or...

  7. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  8. Chronic toxicity study of Hyptis suaveolens (L. Poit in rats

    Directory of Open Access Journals (Sweden)

    Bunjong Chaorai

    2005-09-01

    Full Text Available The effect of water extract of Hyptis suaveolens (H. suaveolens was evaluated for 6-month chronic toxicity in Wistar rats. Control group received distilled water orally 10 ml/kg/day. The extract was orally given to five treatment groups at the doses of 5, 50, 250, 500 and 500 mg/kg/day for 6 months. The last group was served as the recovery group. Changes in the body weights, actual and relative organ weights were not significantly demonstrated in all groups throughout the study. The results of hematological, biochemical parameters and histopathological lesions showed that the extract did not produce any significant doserelated changes. Therefore, it may be concluded that the extract of H. suaveolens at the given doses did not produce any significant toxic effect in rats during 6-month period of the treatment.

  9. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    Science.gov (United States)

    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

  10. Advantage of impulse oscillometry over spirometry to diagnose chronic obstructive pulmonary disease and monitor pulmonary responses to bronchodilators: An observational study

    Directory of Open Access Journals (Sweden)

    Constantine Saadeh

    2015-04-01

    Full Text Available Objectives: This retrospective study was a comparative analysis of sensitivity of impulse oscillometry and spirometry techniques for use in a mixed chronic obstructive pulmonary disease group for assessing disease severity and inhalation therapy. Methods: A total of 30 patients with mild-to-moderate chronic obstructive pulmonary disease were monitored by impulse oscillometry, followed by spirometry. Lung function was measured at baseline after bronchodilation and at follow-up (3–18 months. The impulse oscillometry parameters were resistance in the small and large airways at 5 Hz (R5, resistance in the large airways at 15 Hz (R15, and lung reactance (area under the curve X; AX. Results: After the bronchodilator therapy, forced expiratory volume in 1 second (FEV1 readings evaluated by spirometry were unaffected at baseline and at follow-up, while impulse oscillometry detected an immediate improvement in lung function, in terms of AX (p = 0.043. All impulse oscillometry parameters significantly improved at follow-up, with a decrease in AX by 37% (p = 0.0008, R5 by 20% (p = 0.0011, and R15 by 12% (p = 0.0097. Discussion: Impulse oscillometry parameters demonstrated greater sensitivity compared with spirometry for monitoring reversibility of airway obstruction and the effect of maintenance therapy. Impulse oscillometry may facilitate early treatment dose optimization and personalized medicine for chronic obstructive pulmonary disease patients.

  11. CHRONIC DIARRHOEA : AN ETIOLOGICAL AND EPIDEMIOLOGICAL STUDY AT A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Lokesh

    2015-10-01

    Full Text Available BACKGROUND : The etiology of malabsorption syndrome varies according to the geographical location and age of the patients. Scare data is available regarding the etiology of chronic diarrhoea in India. AIMS AND OBJECTIVES: To study etiology and epidemiological profile of chronic diarrhoea at a tert iary care center. MATERIAL AND METHODS: 100 patients of chronic diarrhoea were evaluated. RESULTS: Celiac sprue ( 54% remains the commonest cause of chronic diarrhoea followed by Tropical sprue (32%. Crohn’s disease, Intestinal tuberculosis, AIDS, Amyloid osis and Giardiasis. CONCLUSION: Celiac disease, Tropical sprue and Crohn’s disease are common causes of chronic diarrhoea

  12. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis

    OpenAIRE

    Yunes Panahi; Zohreh Poursaleh; Ali Amini-Harandi; Amin Saburi; Majid Shohrati; Mostafa Ghanei

    2013-01-01

    Background: Theophylline may reverse steroid resistance and decrease inflammation in patients with chronic pulmonary disease and sulfur mustard (SM) induced bronchiolitis. This study was designed to assess the effects of low-dose theophylline on improvement of pulmonary function tests (PFTs) of SM exposed patients.Methods: In this comparative observational study, a group of SM-exposed victims during the Iraq-Iran war who were treated with oral slow releasing (SR) theophylline, salmetrol, flux...

  13. Dietary and inhalation exposure to polycyclic aromatic hydrocarbons and urinary excretion of monohydroxy metabolites – A controlled case study in Beijing, China

    International Nuclear Information System (INIS)

    Daily dietary and inhalation exposures to 16 parent polycyclic aromatic hydrocarbons (PAHs) and urinary excretion of 13 monohydroxy metabolites (OHPAHs) were monitored for 12 non-smoking university students in Beijing, China, during a controlled feeding experiment. The relationship between the urinary excretion of OHPAHs and the uptake of PAHs was investigated. The results suggest severe exposure of the subjects to PAHs via both dietary and inhalation pathways. Large increase of most urinary OHPAHs occurred after the ingestion of lamb kabob. Higher concentrations of OHPAHs were observed for female subjects, with the intakes of parent PAHs lower than those by males, likely due to the gender differences in metabolism. It appears that besides 1-PYR, metabolites of PHE could also be used as biomarkers to indicate the short-term dietary exposure to PAHs and urinary 3-BaA may serve as the biomarker for inhalation intake of high molecular weight PAHs. Highlights: • The dependence of urinary OHPAHs on PAH intake was explored. • Consumption of lamb kabob resulted in large increase of most urinary OHPAHs. • Gender differences in PAH metabolism was observed. • Urinary metabolites of PHE and PYR can be used as biomarkers for dietary PAH intake. • Urinary 3-BaA may serve as the indicator for the inhalation exposure to BaPeq. -- Severe exposure to PAHs via dietary and inhalation pathways indicated by the intake of parent PAHs as well as the urinary excretion of OHPAHs, was observed for students in Beijing

  14. Real-life use of budesonide/formoterol in clinical practice: a 12-month follow-up assessment in a multi-national study of asthma patients established on single-inhaler maintenance and reliever therapy

    OpenAIRE

    Ställberg, Björn; Naya, Ian; Ekelund, Jan; Eckerwall, Göran

    2015-01-01

    Objective: The efficacy and safety of budesonide/formoterol maintenance and reliever therapy (MRT) has been demonstrated in phase III clinical studies, but limited data are available in a real-life setting. We examined the pattern of maintenance and as-needed inhaler use in routine clinical practice among patients with asthma receiving budesonide/formoterol MRT (NCT00505388). Methods: This 12-month European observational study enrolled patients prescribed budesonide/formoterol MRT and grouped...

  15. Patient preference for and satisfaction with inhaler devices

    OpenAIRE

    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...

  16. Novolizer: how does it fit into inhalation therapy?

    Science.gov (United States)

    Magnussen, Helgo

    2005-01-01

    Inhalation therapy is the preferred route of administration of anti-asthmatic drugs to the lungs. However, the vast majority of patients cannot use their inhalers correctly, particularly pressurised metered dose inhalers (pMDIs). The actual proportion of patients who do not use their inhalers correctly may even be under-estimated as GPs tend to over-estimate correct inhalation technique. Dry powder inhalers (DPIs) have many advantages over pMDIs. Unlike pMDIs, they are environmentally-friendly, contain no propellant gases and, more importantly, they are breath-activated, so that the patient does not need to coordinate actuation of the inhaler with inspiration. Three key parameters for correct inhaler use should be considered when evaluating existing or future DPI devices and especially when choosing the appropriate device for the patient: (1) usability, (2) particle size distribution of the emitted drug and (3) intrinsic airflow resistance of the device. The Novolizer is a breath-activated, multidose, refillable DPI. It is easy to use correctly, has multiple feedback and control mechanisms which guide the patient through the correct inhalation manoeuvre. In addition, the Novolizer has an intelligent dose counter, which resets only after a correct inhalation and may help to monitor patient compliance. The Novolizer has a comparable or better lung deposition than the Turbuhaler at similar or higher peak inspiratory flow (PIF) rates. A flow trigger valve system ensures a clinically effective fine particle fraction (FPF) and sufficient drug delivery, which is important for a good lung deposition. The FPF produced through the Novolizer is also relatively independent of flow rate and the device shows better reproducibility of metering and delivery performance compared to the Turbuhaler. The low-to-medium airflow resistance means that the Novolizer is easy for patients to use correctly. Even children, patients with severe asthma and patients with moderate

  17. Chronic pain in children and adolescents: observational studies

    NARCIS (Netherlands)

    C.W. Perquin (Christel)

    2002-01-01

    textabstractIn adults, chronic pain is by most people involved considered to be a serious disorder. Although chronic pain in adults is in general not life-threatening, a considerable amount of literature elucidates the large number of sufferers, the high cost to the person in question and to the soc

  18. 喘可治注射液联合布地奈德福莫特罗治疗慢性阻塞性肺疾病的疗效观察%Curative Effect of Chuankezhi Injection Combined with Budesonide and Formoterol Fumarate Powder for Inhalation in the Treatment of Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    姜晶; 周秀梅

    2015-01-01

    Objective:To observe the efficacy of Chuankezhi injection combined with budesonide and formoterol fumarate powder for inhalation in the treatment of chronic obstructive pulmonary disease ( COPD) . Methods:Totally 120 patients with COPD were ran-domly divided into two groups:the observation group inhaled budesonide and formoterol fumarate powder for inhalation combined with intramuscular injection of Chuankezhi injection, and the control group inhaled budesonide and formoterol fumarate powder for inhala-tion. The treatment course was 28 days. The pulmonary function indices [ FEV1% expected value, FEV1 /FVC, 6 min walking dis-tance (6MWD)], the times of acute exacerbation and the adverse drug reactions during the treatment were observed and compared be-tween the two groups. Results:After the treatment, the lung function and 6MWD were improved in the two groups, and the improve-ment of FEV1% expected value in the treatment group was more obvious than that in the control group [(59. 7+12. 1)% vs (49. 8+11. 3)%, P<0. 05]. The number of patients with at least once of acute exacerbation was significantly reduced in the treatment group when compared with that in the control group (35% vs 62%, P<0. 01). The incidence of adverse drug reactions in the two groups showed no significant difference. Conclusion:Chuankezhi injection combined with budesonide and formoterol fumarate powder for in-halation can notably improve the lung function in the patients with COPD and reduce the times of acute exacerbation without effect on the incidence of adverse drug reactions.%目的::观察喘可治注射液联合布地奈德福莫特罗治疗慢性阻塞性肺疾病( COPD)的疗效。方法:120例COPD患者随机分为2组,观察组予布地奈德福莫特罗吸入同时肌注喘可治注射液,对照组单纯给予布地奈德福莫特罗吸入。治疗28 d,比较两组FEV1%预计值、FEV1/FVC、6 min 步行距离(6MWD)等肺功能指标变化和急性加重次数,同时观察治

  19. 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

    Institute of Scientific and Technical Information of China (English)

    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

  20. An aetiopathological study of chronic bronchopneumonia in lambs in Ireland.

    Science.gov (United States)

    Sheehan, Maresa; Cassidy, Joseph P; Brady, Joseph; Ball, Hywel; Doherty, Michael L; Quinn, Patrick J; Nicholas, Robin A J; Markey, Bryan K

    2007-05-01

    Chronic bronchopneumonia in lambs, also known as 'atypical' or 'chronic, non-progressive' pneumonia is a common, frequently sub-clinical disease affecting animals under 12-months-old in intensive production systems. Infection with both Mycoplasma ovipneumoniae and Mannheimia haemolytica have been implicated in the aetiology of this condition and a variety of pulmonary lesions can result. In this study, detailed laboratory examination of 30 abattoir-derived lungs with the characteristic gross features of atypical pneumonia (AP) was carried out with a view to refining and correlating the histopathological and microbiological criteria required for the diagnosis of this disease. For the first time a broad range of laboratory detection techniques including bacterial and virus isolation, fluorescent antibody tests and immunohistochemistry were used in parallel to identify potential causative pathogens such as M. ovipneumoniae, M. haemolytica, parainfluenza type-3 (PI3) virus and respiratory syncytial virus (RSV) in AP lesions. The most consistent finding was the association of gross AP lesions with M. ovipneumoniae, identified by either culture or immunohistochemistry in 27 (90%) of the 30 cases. However the presence M. ovipneumoniae organisms or antigen did not consistently correlate with particular histopathological changes. Furthermore, peri-airway lymphoid hyperplasia, intra-alveolar exudation and nodular 'hyaline scars', which are all previously reported microscopic lesions of AP, were not identified in 12 (40%) of the cases and isolation of M. haemolytica was over-represented in lungs exhibiting suppurative lesions. These findings illustrate the complex aetiopathogenesis of this disease and highlight the requirement to use a combination of diagnostic criteria in its laboratory diagnosis.

  1. Inhalation Toxicology Research Institute annual report 1987-1988

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

  3. A pilot study to assess effects of long-term inhalation of airborne particulate matter on early Alzheimer-like changes in the mouse brain.

    Science.gov (United States)

    Bhatt, Dhaval P; Puig, Kendra L; Gorr, Matthew W; Wold, Loren E; Combs, Colin K

    2015-01-01

    Exposure to air pollutants, including particulate matter, results in activation of the brain inflammatory response and Alzheimer disease (AD)-like pathology in dogs and humans. However, the length of time required for inhalation of ambient particulate matter to influence brain inflammation and AD pathology is less clear. Here, we studied the effect of 3 and 9 months of air particulate matter (PM2.5) exposure on brain inflammatory phenotype and pathological hallmarks of AD in C57BL/6 mice. Using western blot, ELISA, and cytokine array analysis we quantified brain APP, beta-site APP cleaving enzyme (BACE), oligomeric protein, total Aβ 1-40 and Aβ 1-42 levels, inducible nitric oxide synthase (iNOS), nitrotyrosine-modified proteins, HNE-Michael adducts, vascular cell adhesion molecule 1 (VCAM-1), glial markers (GFAP, Iba-1), pre- and post- synaptic markers (synaptophysin and PSD-95), cyclooxygenase (COX-1, COX-2) levels, and the cytokine profile in PM2.5 exposed and filtered air control mice. Only 9 month PM2.5 exposure increased BACE protein levels, APP processing, and Aβ 1-40 levels. This correlated with a concomitant increase in COX-1 and COX-2 protein levels and a modest alteration in the cytokine profile. These data support the hypothesis that prolonged exposure to airborne particulate matter has the potential to alter brain inflammatory phenotype and promote development of early AD-like pathology.

  4. A pilot study to assess effects of long-term inhalation of airborne particulate matter on early Alzheimer-like changes in the mouse brain.

    Directory of Open Access Journals (Sweden)

    Dhaval P Bhatt

    Full Text Available Exposure to air pollutants, including particulate matter, results in activation of the brain inflammatory response and Alzheimer disease (AD-like pathology in dogs and humans. However, the length of time required for inhalation of ambient particulate matter to influence brain inflammation and AD pathology is less clear. Here, we studied the effect of 3 and 9 months of air particulate matter (<2.5 μm diameter, PM2.5 exposure on brain inflammatory phenotype and pathological hallmarks of AD in C57BL/6 mice. Using western blot, ELISA, and cytokine array analysis we quantified brain APP, beta-site APP cleaving enzyme (BACE, oligomeric protein, total Aβ 1-40 and Aβ 1-42 levels, inducible nitric oxide synthase (iNOS, nitrotyrosine-modified proteins, HNE-Michael adducts, vascular cell adhesion molecule 1 (VCAM-1, glial markers (GFAP, Iba-1, pre- and post- synaptic markers (synaptophysin and PSD-95, cyclooxygenase (COX-1, COX-2 levels, and the cytokine profile in PM2.5 exposed and filtered air control mice. Only 9 month PM2.5 exposure increased BACE protein levels, APP processing, and Aβ 1-40 levels. This correlated with a concomitant increase in COX-1 and COX-2 protein levels and a modest alteration in the cytokine profile. These data support the hypothesis that prolonged exposure to airborne particulate matter has the potential to alter brain inflammatory phenotype and promote development of early AD-like pathology.

  5. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    Directory of Open Access Journals (Sweden)

    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  6. SURGICAL TREATMENT OF PAIN IN CHRONIC PANCREATITIS:STUDIES OF 111 PATIENTS

    Institute of Scientific and Technical Information of China (English)

    D. Guinier; P. Mathieu; B. Heyd; G. Mantion

    2004-01-01

    Objective Evaluation of the efficacy of pancreatic resections for the treatment of chronic pains during chronic pancreatitis. Methods Retrospective study of inpatients for chronic pancreatitis between 1982 to 2000. Purpose of admission, morphological changes, treatments and results were evaluated. Results 142 patients were admitted for chronic pancreatitis. 111 patients suffered from chronic pains, due to morphological changes such as pseudocysts, inflammatory masses in the head, dilated pancreatic ducts, biliary or duodenal compressions. Denervations were never efficient, pancreatic resections achieved relief of pain in up to 75% of cases and drainages were efficient in 52% of cases. Conclusions Pancreatic resections during chronic pancreatitis seem to be the most efficient treatment of chronic pains. New techniques such as duodenum-preserving head resection or total pancreatectomy with islet autotransplantation should improve these results.

  7. Inhalation delivery of asthma drugs.

    Science.gov (United States)

    Matthys, H

    1990-01-01

    In the immediate future, metered-dose inhalers (MDIs) with spacers remain the aerosol application of choice for topical steroids, mainly to reduce side effects. For beta 2-agonist, anticholinergics and prophylactic drugs, MDI (with or without demand valve), dry powder inhalers (multidose inhalers), ultrasonic or jet aerosol generators (with or without mechanical breathing assistance [IPPB]) are chosen according to the preference or the ability of the patients to perform the necessary breathing maneuvers as well as the availability of different products in different countries.

  8. Inhaled plutonium nitrate in dogs

    International Nuclear Information System (INIS)

    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

  9. Health hazards due to the inhalation of amorphous silica.

    Science.gov (United States)

    Merget, R; Bauer, T; Küpper, H U; Philippou, S; Bauer, H D; Breitstadt, R; Bruening, T

    2002-01-01

    Occupational exposure to crystalline silica dust is associated with an increased risk for pulmonary diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and lung cancer. This review summarizes the current knowledge about the health effects of amorphous (non-crystalline) forms of silica. The major problem in the assessment of health effects of amorphous silica is its contamination with crystalline silica. This applies particularly to well-documented pneumoconiosis among diatomaceous earth workers. Intentionally manufactured synthetic amorphous silicas are without contamination of crystalline silica. These synthetic forms may be classified as (1) wet process silica, (2) pyrogenic ("thermal" or "fumed") silica, and (3) chemically or physically modified silica. According to the different physicochemical properties, the major classes of synthetic amorphous silica are used in a variety of products, e.g. as fillers in the rubber industry, in tyre compounds, as free-flow and anti-caking agents in powder materials, and as liquid carriers, particularly in the manufacture of animal feed and agrochemicals; other uses are found in toothpaste additives, paints, silicon rubber, insulation material, liquid systems in coatings, adhesives, printing inks, plastisol car undercoats, and cosmetics. Animal inhalation studies with intentionally manufactured synthetic amorphous silica showed at least partially reversible inflammation, granuloma formation and emphysema, but no progressive fibrosis of the lungs. Epidemiological studies do not support the hypothesis that amorphous silicas have any relevant potential to induce fibrosis in workers with high occupational exposure to these substances, although one study disclosed four cases with silicosis among subjects exposed to apparently non-contaminated amorphous silica. Since the data have been limited, a risk of chronic bronchitis, COPD or emphysema cannot be excluded. There is no study

  10. Health hazards due to the inhalation of amorphous silica

    International Nuclear Information System (INIS)

    Occupational exposure to crystalline silica dust is associated with an increased risk for pulmonary diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and lung cancer. This review summarizes the current knowledge about the health effects of amorphous (non-crystalline) forms of silica. The major problem in the assessment of health effects of amorphous silica is its contamination with crystalline silica. This applies particularly to well-documented pneumoconiosis among diatomaceous earth workers. Intentionally manufactured synthetic amorphous silicas are without contamination of crystalline silica. These synthetic forms may be classified as (1) wet process silica, (2) pyrogenic (''thermal'' or ''fumed'') silica, and (3) chemically or physically modified silica. According to the different physico-chemical properties, the major classes of synthetic amorphous silica are used in a variety of products, e.g. as fillers in the rubber industry, in tyre compounds, as free-flow and anti-caking agents in powder materials, and as liquid carriers, particularly in the manufacture of animal feed and agrochemicals; other uses are found in toothpaste additives, paints, silicon rubber, insulation material, liquid systems in coatings, adhesives, printing inks, plastisol car undercoats, and cosmetics. Animal inhalation studies with intentionally manufactured synthetic amorphous silica showed at least partially reversible inflammation, granuloma formation and emphysema, but no progressive fibrosis of the lungs. Epidemiological studies do not support the hypothesis that amorphous silicas have any relevant potential to induce fibrosis in workers with high occupational exposure to these substances, although one study disclosed four cases with silicosis among subjects exposed to apparently non-contaminated amorphous silica. Since the data have been limited, a risk of chronic bronchitis, COPD or emphysema cannot be excluded. There is no

  11. Sinonasal inhalation of tobramycin vibrating aerosol in cystic fibrosis patients with upper airway Pseudomonas aeruginosa colonization: results of a randomized, double-blind, placebo-controlled pilot study

    Science.gov (United States)

    Mainz, Jochen G; Schädlich, Katja; Schien, Claudia; Michl, Ruth; Schelhorn-Neise, Petra; Koitschev, Assen; Koitschev, Christiane; Keller, Peter M; Riethmüller, Joachim; Wiedemann, Baerbel; Beck, James F

    2014-01-01

    Rationale In cystic fibrosis (CF), the paranasal sinuses are sites of first and persistent colonization by pathogens such as Pseudomonas aeruginosa. Pathogens subsequently descend to the lower airways, with P. aeruginosa remaining the primary cause of premature death in patients with the inherited disease. Unlike conventional aerosols, vibrating aerosols applied with the PARI Sinus™ nebulizer deposit drugs into the paranasal sinuses. This trial assessed the effects of vibrating sinonasal inhalation of the antibiotic tobramycin in CF patients positive for P. aeruginosa in nasal lavage. Objectives To evaluate the effects of sinonasal inhalation of tobramycin on P. aeruginosa quantification in nasal lavage; and on patient quality of life, measured with the Sino-Nasal Outcome Test (SNOT-20), and otologic and renal safety and tolerability. Methods Patients were randomized to inhalation of tobramycin (80 mg/2 mL) or placebo (2 mL isotonic saline) once daily (4 minutes/nostril) with the PARI Sinus™ nebulizer over 28 days, with all patients eligible for a subsequent course of open-label inhalation of tobramycin for 28 days. Nasal lavage was obtained before starting and 2 days after the end of each treatment period by rinsing each nostril with 10 mL of isotonic saline. Results Nine patients participated, six initially receiving tobramycin and three placebo. Sinonasal inhalation was well tolerated, with serum tobramycin <0.5 mg/L and stable creatinine. P. aeruginosa quantity decreased in four of six (67%) patients given tobramycin, compared with zero of three given placebo (non-significant). SNOT-20 scores were significantly lower in the tobramycin than in the placebo group (P=0.033). Conclusion Sinonasal inhalation of vibrating antibiotic aerosols appears promising for reducing pathogen colonization of paranasal sinuses and for control of symptoms in patients with CF. PMID:24596456

  12. The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.

    LENUS (Irish Health Repository)

    Faul, John L

    2009-06-01

    OBJECTIVE: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. SETTING: A United States Department of Veterans Affairs Health Care System outpatient setting. PARTICIPANTS: Adults with type 2 diabetes and asthma or COPD. METHODS: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 microg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg\\/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. RESULTS: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and -0.14, respectively). CONCLUSION: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS, especially with higher dosages.

  13. Engineering of an Inhalable DDA/TDB Liposomal Adjuvant

    DEFF Research Database (Denmark)

    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)....

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

    OpenAIRE

    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...

  15. Chronic pain following total hip arthroplasty: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; Brandsborg, Birgitte; Lucht, Ulf;

    2006-01-01

    of chronic pain after THA in relation to pre-operative pain and early post-operative pain. METHODS: A questionnaire was sent to 1231 consecutive patients who had undergone THA 12-18 months previously, and whose operations had been reported to the Danish Hip Arthroplasty Registry. RESULTS: The response rate...... was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post...

  16. Diffusion Tensor Imaging Study of White Matter Damage in Chronic Meningitis

    OpenAIRE

    Lin, Wei-Che; Chen, Pei-Chin; Wang, Hung-Chen; Tsai, Nai-Wen; Chou, Kun-Hsien; Chen, Hsiu-Ling; Su, Yu-Jih; Lin, Ching-Po; Li, Shau-Hsuan; Chang, Wen-Neng; Lu, Cheng-Hsien

    2014-01-01

    Tuberculous meningitis (TBM) and cryptococcal meningitis (CM) are two of the most common types of chronic meningitis. This study aimed to assess whether chronic neuro-psychological sequelae are associated with micro-structure white matter (WM) damage in HIV-negative chronic meningitis. Nineteen HIV-negative TBM patients, 13 HIV-negative CM patients, and 32 sex- and age-matched healthy volunteers were evaluated and compared. The clinical relevance of WM integrity was studied using voxel-based ...

  17. Genetic studies in chronic kidney disease: interpretation and clinical applicability.

    Science.gov (United States)

    Witasp, Anna; Nordfors, Louise; Carrero, Juan Jesus; Luttropp, Karin; Lindholm, Bengt; Schalling, Martin; Stenvinkel, Peter

    2012-01-01

    The tools of modern molecular biology are evolving rapidly, resulting in vastly more efficient approaches to illuminating human genetic variations and their effects on common multifactorial disorders such as chronic kidney disease (CKD). Indeed, candidate gene association studies and genome-wide association studies (GWASs) have generated novel genetic variants in previously unrecognized biological pathways, highlighting disease mechanisms with a potential role in CKD etiology, morbidity and mortality. Nephrologists now need to find ways to make use of these advancements and meet the increasingly stringent requirements for valid study design, data handling and interpretation of genetic studies. Adding to our prior article in this journal, which introduced the basics of genotype-phenotype association studies in CKD, this second article focuses on how to ascertain robust and reproducible findings by applying adequate methodological and statistical approaches to genotype-phenotype studies in CKD populations. Moreover, this review will briefly discuss genotype-based risk prediction, pharmacotherapy, drug target identification and individualized treatment solutions, specifically highlighting potentially important findings in CKD patients. This increased knowledge will hopefully facilitate the exciting transition from conventional clinical medicine to gene-based medicine. However, before this can be accomplished, unsolved issues regarding the complex human genetic architecture as well technical and clinically oriented obstacles will have to be overcome. Additionally, new policies and standardized risk evaluations for genetic testing in the clinical setting will have to be established to guarantee that CKD patients are provided with high-quality genotype-guided counseling that will help to improve their poor outcomes.

  18. Prevalence and diagnosis of chronic respiratory symptoms in adults.

    OpenAIRE

    Littlejohns, P; Ebrahim, S; Anderson, R

    1989-01-01

    OBJECTIVE--To investigate the prevalence and diagnosis of chronic respiratory disease in adults. DESIGN--Screening questionnaire was sent to all patients aged 40-70 on the register of a group general practice; those responding positively were sent a detailed questionnaire and invited for assessment of respiratory function by forced expiratory volume in one second, forced vital capacity, peak flow rate, and reversibility studies with a beta adrenergic inhaler. SETTING--Group general practice i...

  19. Genetic influences on Chronic Obstructive Pulmonary Disease - a twin study

    DEFF Research Database (Denmark)

    Ingebrigtsen, Truls; Thomsen, Simon F; Vestbo, Jørgen;

    2010-01-01

    Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted....

  20. Inhalant Dependence and its Medical Consequences

    OpenAIRE

    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 ...

  1. Lack of paradoxical bronchoconstriction after administration of tiotropium via Respimat® Soft Mist™ Inhaler in COPD

    Directory of Open Access Journals (Sweden)

    Hodder R

    2011-04-01

    Full Text Available Rick Hodder1, Demetri Pavia2, Angela Lee2, Eric Bateman31Divisions of Pulmonary and Critical Care, University of Ottawa, Ottawa, ON, Canada; 2Boehringer Ingelheim Limited, Bracknell, England, UK; 3Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South AfricaAbstract: Bronchoconstriction has been reported in asthma and chronic obstructive pulmonary disease (COPD patients after administration of some aqueous inhalation solutions. We investigated the incidence of this event during long-term clinical trials of tiotropium delivered via Respimat® Soft Mist™ Inhaler (SMI. We retrospectively analyzed pooled data from two identical Phase III clinical trials, in which 1990 patients with COPD received 48 weeks' treatment with once-daily tiotropium (5 or 10 µg or placebo inhaled via Respimat® SMI. We recorded the incidence of bronchospasm and of a range of respiratory events that could suggest bronchoconstriction during the first 30 minutes after inhalation of study treatment on each of the eight test days. No patients reported bronchospasm. Six patients (0.3% reported a combination of at least two events suggestive of bronchoconstriction, and 21 (1.1% reported either rescue medication use or a respiratory adverse event. Asymptomatic falls in forced expiratory volume in one second (FEV1 of ≥15% were recorded on all test days, with no change in incidence over time, and affected 8.2% of those in the tiotropium groups and 14.5% of those on placebo. In COPD patients receiving long-term treatment with tiotropium 5 or 10 µg via Respimat® SMI, no bronchospasm was recorded, and the number of events possibly indicative of paradoxical bronchoconstriction was very low.Keywords: inhalation device, bronchoconstriction, COPD, tiotropium

  2. A STUDY OF LIPID PROFILE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    OpenAIRE

    Modini Venkata; Srikanti; Surya Kiran; Hanumanth Rao

    2015-01-01

    BACKGROUND : Chronic obstructive pulmonary disease (COPD) the third leading cause of death in the world , represents an important public health challenge that is both preventable and treatable. According to Global Initiative f or Chronic Obstructiv e Lung Disease (GOLD) , Spirometric tests , Forced Expiratory Volume in first second (FEV1) less than 80% of the expected value and forced expiratory volume in first second to the forced vital capa...

  3. Pharmacokinetic and pharmacodynamic characterization of inhaled β2 - agonists using the isolated human lung perfusion model

    OpenAIRE

    Gnadt, Mirjam

    2011-01-01

    The inhaled pharmacotherapy is fundamental in the management of obstructive lung diseases such as asthma bronchiale or chronic obstructive pulmonary disease. In this context short- and long-acting β2-agonists play a prominent role as relieve and control medication. Regarding the risk-benefit profile of an inhaled drug, the pattern of pulmonary deposition and the rate and extent of absorption into systemic circulation are essential parameters. New developments of drugs are characterized by hig...

  4. Obstructive lung diseases and inhaler treatment: results from a national public pragmatic survey

    OpenAIRE

    Braido, Fulvio; Baiardini, Ilaria; Sumberesi, Massimo; Blasi, Francesco; Canonica, Giorgio Walter

    2013-01-01

    Background The opinions held by the general population on obstructive lung disease and inhaler devices could influence asthma and chronic obstructive pulmonary disorder (COPD) management and treatment adherence. The aim of the present public pragmatic survey was to evaluate the opinions, beliefs and perceptions of Italian people with respect to respiratory diseases as well as their perspectives on the use of inhaler devices. Methods This survey was conducted on a group of 2,008 individuals fo...

  5. Time trends of period prevalence rates of patients with inhaled long-acting beta-2-agonists-containing prescriptions: a European comparative database study.

    Directory of Open Access Journals (Sweden)

    Marietta Rottenkolber

    Full Text Available Inhaled, long-acting beta-2-adrenoceptor agonists (LABA have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology.A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2, and the UK (2 to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs of LABA-containing prescriptions from 2002-2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD.From 2002-2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%-185.1%. Highest PPRs were found in men ≥ 80 years old and women 70-79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with "asthma and COPD" but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age.Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries.

  6. Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus: Two Nested Case-Control Studies.

    Science.gov (United States)

    Lee, Chang-Hoon; Kim, Jimin; Jang, Eun Jin; Lee, Joon-Ho; Kim, Yun Jung; Choi, Seongmi; Kim, Deog Kyeom; Yim, Jae-Joon; Yoon, Ho Il

    2016-05-01

    There have been concerns that systemic corticosteroid use is associated with pregnancy-induced hypertension (PIH) and diabetes mellitus. However, the relationship between inhaled corticosteroids (ICSs) and the risk of PIH has not been fully examined, and there was no study investigating the association between ICS use and the development of gestational diabetes mellitus (GDM). The aims of the study are to determine whether the use of ICSs during pregnancy increases the risk of PIH and GDM in women.We conducted 2 nested case-control studies utilizing the nationwide insurance claims database of the Health Insurance Review and Assessment Service (Seoul, Republic of Korea), in which 1,306,281 pregnant women who delivered between January 1, 2009 and December 31, 2011 were included. Among them, PIH cases and GDM cases were identified and matched controls were included. Conditional logistic regression analyses adjusted by other concomitant drugs use during and before pregnancy and confounding covariates including comorbidities were performed.Total 43,908 PIH cases and 219,534 controls, and 34,190 GDM cases and 170,934 control subjects were identified. When other concomitant drugs use during pregnancy was adjusted, ICS use was associated with an increased rate of PIH (adjusted odds ratio, 1.40 [95% CI, 1.05-1.87]). ICS medication possession ratios and cumulative doses were associated with an increased risk of PIH. However, the statistical significance was not found in other models. In both unadjusted and adjusted multivariable models, ICSs use was not associated with increase in the risk of GDM.ICSs use is not associated with an increased risk of PIH and GDM. PMID:27258493

  7. Potent Inhalational Anesthetics for Dentistry.

    Science.gov (United States)

    Satuito, Mary; Tom, James

    2016-01-01

    Nitrous oxide and the volatile inhalational anesthetics have defined anxiety and pain control in both dentistry and medicine for over a century. From curious experimentation to spectacular public demonstrations, the initial work of 2 dentists, Horace Wells and William T. G. Morton, persists to this day in modern surgery and anesthesia. This article reviews the history, similarities, differences, and clinical applications of the most popular inhalational agents used in contemporary dental surgical settings.

  8. Inhaled plutonium oxide in dogs

    International Nuclear Information System (INIS)

    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

  9. Eine Re-Analyse der Blue Mountains Eye Study zum Kataraktrisiko durch inhalative Kortikoide: Ein Beitrag zur Objektivierung der Diskussion

    OpenAIRE

    Hartung, Joachim; Knapp, Guido

    1999-01-01

    In einer Re-Analyse der Blue Mountains Eye Study von Cumming, Mitchell und Leeder (1997) wird gezeigt, daß diese Studie keinen Beitrag zur Klärung des Kataraktrisikos von inhalativen Kortikoiden leistet. Akzeptiert man die Schlußweisen der Studie, so ergibt sich ein diffuses und zugleich aber auch interessantes Bild von diversen Aussagen zu Kataraktrisiken bei inhalativen Kortikoiden, systemisch verabreichten Kortikoiden bzw. einer Kombination von inhalativen und systemisch verabreichten Kort...

  10. Biological effects of inhaled cigarette smoke in beagle dogs

    International Nuclear Information System (INIS)

    A group of twenty dogs has received up to 7 yr of daily cigarette smoking (10 cigarettes per day, 5 days per week), using realistic methods of oral inhalation and nose-plus-mouth exhalation. Three dogs that received 20 cigarettes per day over 9 mo developed respiratory tract lesions, including pleural thickening, alveolar septal fibrosis, vesicular emphysema, and chronic bronchitis, more rapidly than dogs receiving 10 cigarettes per day

  11. Progress on Clinical Study of Acupuncture Treatment for Chronic Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wen-jie; HUANG Guo-qi

    2008-01-01

    @@ Chronic pelvic inflammation is mostly caused byincomplete treatment of acute pelvic inflammation orby transference from pathologic condition due to poorbody constitution, including chronic endometritis,chronic salpingo-oophoritis and chronic inflammationof connective tissue, and is a commonly andfrequently encountered disease in the gynecologydepartment. Due to long duration, intractablecondition and high recurrent rate, it is also acommonly encountered reason to induce heterotopicpregnancy, sterility, pelvic pain and pelvic adhesivediseases. In the investigative study on the domesticliterature about acupuncture treatment of chronicpelvic inflammation in the recent five years, theauthor hopes to summarize the information forreference in the clinical treatment and to point outsome issues existing in the current clinical study.

  12. Use of novel inhalation kinetic studies to refine physiologically-based-pharmacokinetic models for ethanol in non-pregnant and pregnant rats

    Science.gov (United States)

    Ethanol (EtOH) exposure induces a variety of concentration-dependent neurological and developmental effects in the rat. Physiologically-based pharmacokinetic (PBPK) models have been used to predict the inhalation exposure concentrations necessary to produce blood EtOH concentrat...

  13. Inhalational drug delivery from seven different spacer devices.

    OpenAIRE

    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...

  14. Clinical and electrophysiological study of chronic inflammatory demyelinating polyneuropathy

    Institute of Scientific and Technical Information of China (English)

    秦绍森; 玛依努尔; 王湘

    2001-01-01

    Objective To investigate the clinical and electrophysiological features of chronic inflammatory demyelinating polyneuropathy (CIDP) . Methods The clinical symptoms and signs of 11 patients with CIDP were studied, motor conduction velocity( MCV), sensory con-duction velocity (SCV) and Electromyography (EMG) were also respectively carried out on 54 motor nerves, 28 sensory nerves and 21 musclesof these 11 cases. The amplitudes of compound muscle action potential(CAMP) obtained from distal and proximal ends were compared to as-certain the presence of conduction block (CB) by stimulating the segments starting from the distal ends. Results More than 3 nerves werefound involved in 10 out of 11 cases, slow MCV were found in 52%, prolongation of the distal latency in 64%, reduction of the amplitudes ofCAMP in 68%, CB in 26%, slow SCV in 85. 7%. EMG revealed neurogenic damage in 81%. Conclusion CIDP is a peripheral de- myelinating neuropathy involving not only the prox imal and distal segments but also the sensory and motor nerves. If there were no conditionsto perform nerve biopsy, testing of protein in CSF and electrophysiology mightbe of important diagnostic value for CIDP.

  15. Chronic actinic dermatitis - A study of clinical features

    Directory of Open Access Journals (Sweden)

    Somani Vijay

    2005-01-01

    Full Text Available Background: Chronic actinic dermatitis (CAD, one of the immune mediated photo-dermatoses, comprises a spectrum of conditions including persistent light reactivity, photosensitive eczema and actinic reticuloid. Diagnostic criteria were laid down about 20 years back, but clinical features are the mainstay in diagnosis. In addition to extreme sensitivity to UVB, UVA and/or visible light, about three quarters of patients exhibit contact sensitivity to several allergens, which may contribute to the etiopathogenesis of CAD. This study was undertaken to examine the clinical features of CAD in India and to evaluate the relevance of patch testing and photo-aggravation testing in the diagnosis of CAD. Methods: The clinical data of nine patients with CAD were analyzed. Histopathology, patch testing and photo-aggravation testing were also performed. Results: All the patients were males. The average age of onset was 57 years. The first episode was usually noticed in the beginning of summer. Later the disease gradually tended to be perennial, without any seasonal variations. The areas affected were mainly the photo-exposed areas in all patients, and the back in three patients. Erythroderma was the presenting feature in two patients. The palms and soles were involved in five patients. Patch testing was positive in seven of nine patients. Conclusions: The diagnosis of CAD mainly depended upon the history and clinical features. The incidence of erythroderma and palmoplantar eczema was high in our series. Occupation seems to play a role in the etiopathogenesis of CAD.

  16. Inhaled corticosteroids do not reduce initial high activity of matrix metalloproteinase (MMP)-9 in exhaled breath condensates of children with asthma exacerbation: a proof of concept study

    Science.gov (United States)

    Grzela, Katarzyna; Zagórska, Wioletta; Krejner, Alicja; Banaszkiewicz, Aleksandra; Litwiniuk, Małgorzata; Kulus, Marek

    2016-01-01

    Inhaled corticosteroids (ICS) are the key component of asthma treatment. However, it is unclear whether they could control the activity and level of matrix metalloproteinase (MMP)-9, which is an important factor in asthma-associated inflammation and airway remodeling. Therefore, the aim of this proof of concept study was to analyze the influence of increased doses of ICS on MMP-9 in exhaled breath condensates (EBC) of patients with allergic asthma exacerbation. Apart from MMP-9, the assessment concerned selected inflammation markers – exhaled nitric oxide (eNO) and cytokines (IL-8 and TNF). The study involved a small group (n = 4) of individuals with asthma exacerbation. The intervention concerned increased doses of ICS with β-mimetics for 4 weeks. In addition to clinical evaluation, eNO measurements and EBC collections were done before and after 4 weeks of intense ICS treatment. The biochemical assessment of EBC concerned MMP-9, IL-8 and TNF. The data were compared to results of healthy controls (n = 6). The initial levels of eNO, MMP-9 and TNF in EBC were higher in the asthma group than in controls. In all subjects IL-8 levels were below the detection limit. After 4 weeks of ICS treatment in all patients we observed improvement of clinical and laboratory parameters. Interestingly, despite reduction of eNO and TNF, the activity of MMP-9/EBC remained on the initial level. Practical relevance of our results is limited by a small group. Nevertheless, our data suggest that ICS, although sufficient to control symptoms and inflammatory markers, may be ineffective to reduce MMP-9/EBC activity in asthma exacerbation and, possibly, airway remodeling. PMID:27536209

  17. Ethylene glycol monomethyl ether (EGME) and propylene glycol monomethyl ether (PGME): inhalation fertility and teratogenicity studies in rats, mice and rabbits.

    Science.gov (United States)

    Hanley, T R; Young, J T; John, J A; Rao, K S

    1984-08-01

    A combined dominant lethal-fertility study was conducted in which male and female Sprague-Dawley (CD) rats were exposed to 0, 30, 100 or 300 ppm of ethylene glycol monomethyl ether (EGME) vapor for 6 hr/day, 5 days/week for 13 weeks and then mated to untreated counterparts. Among males, fertility was completely suppressed after exposure to 300 ppm. A partial restoration of reproductive function was evident following 13 weeks of recovery. No treatment-related reproductive effects were observed among males exposed subchronically to 100 ppm, or among females exposed to 300 ppm or below of EGME. Studies to assess the effects of inhaled EGME on embryonal and fetal development were also conducted in Fischer 344 rats, CF-1 mice, and New Zealand White rabbits. Rats and rabbits were exposed to concentrations of 0, 3, 10 or 50 ppm for 6 hr/day on days 6-15 or 6-18 of gestation, respectively. Exposure of rabbits to 50 ppm resulted in significant teratologic effects, an increased resorption rate, and decreased fetal body weight. Slight fetotoxicity in the form of skeletal variations were observed among rats exposed to 50 ppm. Exposure of pregnant mice to 0, 10, or 50 ppm for 6 hr/day on days 6-15 of gestation resulted in slight fetotoxicity at 50 ppm. No significant treatment-related effects were observed at 10 ppm of EGME or below in any of the species tested. Separate groups of pregnant rats and rabbits were exposed to 0, 500, 1500 or 3000 ppm of propylene glycol monomethyl ether (PGME) during organogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Ethylene glycol monomethyl ether (EGME) and propylene glycol monomethyl ether (PGME): inhalation fertility and teratogenicity studies in rats, mice and rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Hanley, T.R. Jr.; Young, J.T.; John, J.A.; Rao, K.S.

    1984-08-01

    A combined dominant lethal-fertility study was conducted in which male and female Sprague-Dawley (CD) rats were exposed to 0, 30, 100, or 300 ppm of ethylene glycol monomethyl ether (EGME) vapor for 6 hr/day, 5 days/week for 13 weeks and then mated to untreated counterparts. Among males, fertility was completely suppressed after exposure to 300 ppm. A partial restoration of reproductive function was evident following 13 weeks of recovery. No treatment-related reproductive effects were observed among males exposed subchronically to 100 ppm, or among females exposed to 300 ppm or below of EGME. Studies to assess the effects of inhaled EGME on embryonal and fetal development were also conducted in Fischer 344 rats. CF-1 mice, and New Zealand White rabbits. Rats and rabbits were exposed to concentrations of 0, 3, 10, or 50 ppm for 6 hr/day on days 6-15 or 6-18 of gestation, respectively. Exposure of rabbits to 50 ppm resulted in significant teratologic effects, an increased resorption rate, and decreased fetal body weight. Slight fetotoxicity in the form of skeletal variations were observed among rats exposed to 50 ppm. Separate groups of pregnant rats and rabbits were exposed to 0, 500, 1500, or 3000 ppm of propylene glycol monomethyl ether (PGME) during organogenesis. Mild CNS depression was observed among rats and rabbits exposed to 3000 ppm of PGME. Fetal examination revealed no embryotoxic or teratogenic effects among either species. Thus, it was concluded that PGME was not teratogenic at exposure levels up to 3000 ppm.

  19. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

    OpenAIRE

    Sevgi Akarsu; Turna İlknur; Özlem Özbağçıvan; Emel Fetil

    2015-01-01

    Background and Design: Chronic spontaneous urticaria (CSU), the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV) is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patie...

  20. Acute myocardial involvement after heroin inhalation

    Directory of Open Access Journals (Sweden)

    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.

  1. Acute myocardial involvement after heroin inhalation

    OpenAIRE

    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.

  2. Susceptibility to Chronic Mucus Hypersecretion, a Genome Wide Association Study

    Science.gov (United States)

    Dijkstra, Akkelies E.; Smolonska, Joanna; van den Berge, Maarten; Wijmenga, Ciska; Zanen, Pieter; Luinge, Marjan A.; Platteel, Mathieu; Lammers, Jan-Willem; Dahlback, Magnus; Tosh, Kerrie; Hiemstra, Pieter S.; Sterk, Peter J.; Spira, Avi; Vestbo, Jorgen; Nordestgaard, Borge G.; Benn, Marianne; Nielsen, Sune F.; Dahl, Morten; Verschuren, W. Monique; Picavet, H. Susan J.; Smit, Henriette A.; Owsijewitsch, Michael; Kauczor, Hans U.; de Koning, Harry J.; Nizankowska-Mogilnicka, Eva; Mejza, Filip; Nastalek, Pawel; van Diemen, Cleo C.; Cho, Michael H.; Silverman, Edwin K.; Crapo, James D.; Beaty, Terri H.; Lomas, David A.; Bakke, Per; Gulsvik, Amund; Bossé, Yohan; Obeidat, M. A.; Loth, Daan W.; Lahousse, Lies; Rivadeneira, Fernando; Uitterlinden, Andre G.; Hofman, Andre; Stricker, Bruno H.; Brusselle, Guy G.; van Duijn, Cornelia M.; Brouwer, Uilke; Koppelman, Gerard H.; Vonk, Judith M.; Nawijn, Martijn C.; Groen, Harry J. M.; Timens, Wim; Boezen, H. Marike; Postma, Dirkje S.

    2014-01-01

    Background Chronic mucus hypersecretion (CMH) is associated with an increased frequency of respiratory infections, excess lung function decline, and increased hospitalisation and mortality rates in the general population. It is associated with smoking, but it is unknown why only a minority of smokers develops CMH. A plausible explanation for this phenomenon is a predisposing genetic constitution. Therefore, we performed a genome wide association (GWA) study of CMH in Caucasian populations. Methods GWA analysis was performed in the NELSON-study using the Illumina 610 array, followed by replication and meta-analysis in 11 additional cohorts. In total 2,704 subjects with, and 7,624 subjects without CMH were included, all current or former heavy smokers (≥20 pack-years). Additional studies were performed to test the functional relevance of the most significant single nucleotide polymorphism (SNP). Results A strong association with CMH, consistent across all cohorts, was observed with rs6577641 (p = 4.25×10−6, OR = 1.17), located in intron 9 of the special AT-rich sequence-binding protein 1 locus (SATB1) on chromosome 3. The risk allele (G) was associated with higher mRNA expression of SATB1 (4.3×10−9) in lung tissue. Presence of CMH was associated with increased SATB1 mRNA expression in bronchial biopsies from COPD patients. SATB1 expression was induced during differentiation of primary human bronchial epithelial cells in culture. Conclusions Our findings, that SNP rs6577641 is associated with CMH in multiple cohorts and is a cis-eQTL for SATB1, together with our additional observation that SATB1 expression increases during epithelial differentiation provide suggestive evidence that SATB1 is a gene that affects CMH. PMID:24714607

  3. Susceptibility to chronic mucus hypersecretion, a genome wide association study.

    Directory of Open Access Journals (Sweden)

    Akkelies E Dijkstra

    Full Text Available BACKGROUND: Chronic mucus hypersecretion (CMH is associated with an increased frequency of respiratory infections, excess lung function decline, and increased hospitalisation and mortality rates in the general population. It is associated with smoking, but it is unknown why only a minority of smokers develops CMH. A plausible explanation for this phenomenon is a predisposing genetic constitution. Therefore, we performed a genome wide association (GWA study of CMH in Caucasian populations. METHODS: GWA analysis was performed in the NELSON-study using the Illumina 610 array, followed by replication and meta-analysis in 11 additional cohorts. In total 2,704 subjects with, and 7,624 subjects without CMH were included, all current or former heavy smokers (≥20 pack-years. Additional studies were performed to test the functional relevance of the most significant single nucleotide polymorphism (SNP. RESULTS: A strong association with CMH, consistent across all cohorts, was observed with rs6577641 (p = 4.25×10(-6, OR = 1.17, located in intron 9 of the special AT-rich sequence-binding protein 1 locus (SATB1 on chromosome 3. The risk allele (G was associated with higher mRNA expression of SATB1 (4.3×10(-9 in lung tissue. Presence of CMH was associated with increased SATB1 mRNA expression in bronchial biopsies from COPD patients. SATB1 expression was induced during differentiation of primary human bronchial epithelial cells in culture. CONCLUSIONS: Our findings, that SNP rs6577641 is associated with CMH in multiple cohorts and is a cis-eQTL for SATB1, together with our additional observation that SATB1 expression increases during epithelial differentiation provide suggestive evidence that SATB1 is a gene that affects CMH.

  4. Development of an intelligent adapter for metered dose inhalers

    Directory of Open Access Journals (Sweden)

    Zhang Mingrong

    2016-01-01

    Full Text Available To better coordinate the interaction of inhalation and aerosol release, an intelligent adapter (IA was developed for metered dose inhalers (MDIs. The adapter included three main units: a signal acquisition device, a micro-control-unit (MCU, and an actuation mechanism. To fully study the effectiveness of the intelligent adapter, an inhalation simulation experiment was done, and two bands of MDI were used for the experiment. The results indicated that, when inhalation, the intelligent adapter can press down the MDI automatically; moreover, this intelligent adapter could achieve an aerosol-release time Tr of 0.4 s for MDI A and 0.60 s for MDI B, which compares very well with the existing pure mechanical systems at 0.8 s and 1.0 s.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  6. Quantitative biokinetic analysis of radioactively labelled, inhaled Titanium dioxide Nanoparticles in a rat model

    Energy Technology Data Exchange (ETDEWEB)

    Kreyling, Wolfgang G.; Wenk, Alexander; Semmler-Behnke, Manuela [Helmholtz Zentrum Muenchen, Deutsches Forschungszentrum fuer Gesundheit und Umwelt GmbH (Germany). Inst. fuer Lungenbiologie und Erkrankungen, Netzwerk Nanopartikel und Gesundheit

    2010-09-15

    The aim of this project was the determination of the biokinetics of TiO{sub 2} nanoparticles (NP) in the whole body of healthy adult rats after NP administration to the respiratory tract - either via inhalation or instillation. We developed an own methodology to freshly synthesize and aerosolize TiO{sub 2}-NP in our lab for the use of inhalation studies. These NP underwent a detailed physical and chemical characterization providing pure polycrystalline anatase TiO{sub 2}-NP of about 20 nm (geometric standard deviation 1.6) and a specific surface area of 270 m{sup 2}/g. In addition, we developed techniques for sufficiently stable radioactive {sup 48}V labelling of the TiO{sub 2} NP. The kinetics of solubility of {sup 48}V was thoroughly determined. The methodology of quantitative biokinetics allows for a quantitative balance of the retained and excreted NP in control of the administered NP dose and provides a much more precise determination of NP fractions and concentrations of NP in organs and tissues of interest as compared to spotting biokinetics studies. Small fractions of TiO{sub 2}-NP translocate across the air-blood-barrier and accumulate in secondary target organs, soft tissue and skeleton. The amount of translocated TiO{sub 2}-NP is approximately 2% of TiO{sub 2}-NP deposited in the lungs. A prominent fraction of these translocated TiO{sub 2}-NP was found in the remainder. Smaller amounts of TiO{sub 2}-NP accumulate in secondary organs following particular kinetics. TiO{sub 2}-NP translocation was grossly accomplished within the first 2-4 hours after inhalation followed by retention in all organs and tissues studied without any detectable clearance of these biopersistent TiO{sub 2}-NP within 28 days. Therefore, our data suggest crossing of the air-blood-barrier of the lungs and subsequent accumulation in secondary organs and tissues depends on the NP material and its physico-chemical properties. Furthermore, we extrapolate that during repeated or chronic

  7. Quantitative biokinetic analysis of radioactively labelled, inhaled Titanium dioxide Nanoparticles in a rat model

    International Nuclear Information System (INIS)

    The aim of this project was the determination of the biokinetics of TiO2 nanoparticles (NP) in the whole body of healthy adult rats after NP administration to the respiratory tract - either via inhalation or instillation. We developed an own methodology to freshly synthesize and aerosolize TiO2-NP in our lab for the use of inhalation studies. These NP underwent a detailed physical and chemical characterization providing pure polycrystalline anatase TiO2-NP of about 20 nm (geometric standard deviation 1.6) and a specific surface area of 270 m2/g. In addition, we developed techniques for sufficiently stable radioactive 48V labelling of the TiO2 NP. The kinetics of solubility of 48V was thoroughly determined. The methodology of quantitative biokinetics allows for a quantitative balance of the retained and excreted NP in control of the administered NP dose and provides a much more precise determination of NP fractions and concentrations of NP in organs and tissues of interest as compared to spotting biokinetics studies. Small fractions of TiO2-NP translocate across the air-blood-barrier and accumulate in secondary target organs, soft tissue and skeleton. The amount of translocated TiO2-NP is approximately 2% of TiO2-NP deposited in the lungs. A prominent fraction of these translocated TiO2-NP was found in the remainder. Smaller amounts of TiO2-NP accumulate in secondary organs following particular kinetics. TiO2-NP translocation was grossly accomplished within the first 2-4 hours after inhalation followed by retention in all organs and tissues studied without any detectable clearance of these biopersistent TiO2-NP within 28 days. Therefore, our data suggest crossing of the air-blood-barrier of the lungs and subsequent accumulation in secondary organs and tissues depends on the NP material and its physico-chemical properties. Furthermore, we extrapolate that during repeated or chronic exposure to insoluble NP the translocated fraction of NP will accumulate in secondary

  8. The nasal distribution of metered dose inhalers.

    Science.gov (United States)

    Newman, S P; Morén, P F; Clarke, S W

    1987-02-01

    The intranasal distribution of aerosol from a metered dose inhaler has been assessed using a radiotracer technique. Inhalers were prepared by adding 99Tcm-labelled Teflon particles (simulating the drug particles) to chlorofluorocarbon propellants, and scans of the head (and chest) taken with a gamma camera. Ten healthy subjects (age range 19-29 years) each performed two radioaerosol studies with the inhaler held in two different ways: either in a single position (vial pointing upwards) or in two positions (vial pointing upwards and then tilted by 30 degrees in the sagittal plane). The vast majority of the dose (82.5 +/- 2.8 (mean +/- SEM) per cent and 80.7 +/- 3.1 per cent respectively for one-position and two-position studies) was deposited on a single localized area in the anterior one-third of the nose, the initial distribution pattern being identical for each study. No significant radioaerosol was detected in the lungs. Only 18.0 +/- 4.7 per cent and 15.4 +/- 4.1 per cent of the dose had been removed by mucociliary action after 30 minutes, and it is probable that the remainder had not penetrated initially beyond the vestibule. Since the deposition pattern was highly localized and more than half the dose probably failed to reach the turbinates it is possible that the overall effect of nasal MDIs is suboptimal for the treatment of generalized nasal disorders.

  9. Smoking reduction and cessation reduce chronic cough in a general population: the Inter99 study

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Godtfredsen, Nina; Jørgensen, Torben

    2008-01-01

    also attended the 1-year follow-up. We investigated if SR or SC had improved the self-reported pulmonary symptoms, using logistic regression analyses. Results: Almost 34% of the smokers had chronic cough at baseline and 24.5% had chronic phlegm. Thirty-seven persons with cough at baseline and 24......% of daily tobacco consumption) or smoking cessation (SC) had an effect on chronic cough and phlegm. Methods: A total of 2408 daily smokers were included in a Danish population-based intervention study, Inter99. In the analyses, we included smokers with self-reported chronic cough or phlegm at baseline who...... compared with continuous smoking. Conclusion: SC significantly improved self-reported chronic cough and phlegm as expected. Substantial SR was achieved by few smokers but had a significantly positive effect on chronic cough Udgivelsesdato: 2008/1...

  10. [The effect of prostatilen on the hemostatic indices in chronic prostatitis (a clinical and experimental study)].

    Science.gov (United States)

    al-Shukri, S Kh; Petrishchev, N N; Gorbachev, A G; Mikhaĭlova, I A; Bobkov, Iu A; Kuz'min, I V; Borovets, S Iu; Savel'eva, I B; Korokhodkina, M V

    1997-01-01

    Prostatilen effects on hemostasis were studied in 120 intact and 240 chronic prostatitis rats, 34 patients with chronic prostatitis. Intact rats responded to prostatilen by inhibition of platelet-vascular and coagulation hemostatic mechanisms and activation of fibrinolysis. Experimental chronic prostatitis in rats induced hemostatic shifts to hypercoagulation. These parameters returned to normal after 5- and 10-day course of prostatilen administration. A single prostatilen dose was unable to produce the above action. As to patients with chronic prostatitis, there were also prostatilen-induced platelet-vascular hemostatic normalization and fibrinolysis activation. Hemocoagulation was affected in a less degree. Prostatilen effects were unrelated to the disease stage. Normalization of hemostasis seems to be one of the factors of prostatilen therapeutic efficacy in chronic prostatitis. This peptide is found effective as a pathogenetic treatment of chronic prostatitis.

  11. Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis:A comparative study

    Institute of Scientific and Technical Information of China (English)

    Ioan; Sporea; Roxana; Sirli; Alexandra; Deleanu; Adriana; Tudora; Alina; Popescu; Manuela; Curescu; Simona; Bota

    2010-01-01

    AIM:To assess the values of liver stiffness (LS) in pa-tients with hepatitis B virus (HBV) chronic hepatitis and to compare them with those in patients with hepatitis C virus (HCV) chronic hepatitis. METHODS: The study included 140 patients with HBV chronic hepatitis, and 317 patients with HCV chronic hepatitis, in which LS was measured (FibroScan-Echo-sens) and liver biopsy was performed in the same session (assessed according to the Metavir score). RESULTS:According to the Metavir score of the 140 HBV p...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Comparative study of budesonide as a nebulized suspension vs pressurized metered-dose inhaler in adult asthmatics

    DEFF Research Database (Denmark)

    Bisgaard, H; Nikander, K; Munch, E

    1998-01-01

    The study objective was to compare the effect of budesonide administered as a nebulized suspension as compared to a spray with a spacer in adult asthmatics. In a double-blind, double-dummy crossover study, 26 adult patients with moderately severe unstable asthma were randomized to three 4-week....... A consistent trend showed the nebulizer treatment to be at least as efficient as the pMDI plus spacer treatment. In actual fact, the apparent order of effect was: 4 mg nebulized suspension treatment > or = 1 mg nebulized suspension treatment > or = 0.8 mg pMDI with spacer treatment. Plasma budesonide....... These results attest to the efficiency of jet-nebulized budesonide suspension, and indicate nebulized budesonide to be equipotent to standard budesonide therapy delivered by pMDI with Nebuhaler, provided nebulization is synchronized with inspiration and no loss of aerosol occurs during expiration....

  14. 高压喷射氧雾化吸入沐舒坦对慢性阻塞性肺疾病急性加重期痰液性状的影响%The Effects of Ambroxol Mucosolvan Inhalated by High-pressure Jet Oxygen Atomization to Sputum Properties in Patients with Chronic Obstructive Pulmonary Disease During Acute Aggravating Period

    Institute of Scientific and Technical Information of China (English)

    杨玉平; 周向东

    2014-01-01

    Objective To observe the effects of Ambroxol mucosolvan inhalated by High-pressure jet oxygen atomization to the physical and chemical properties of sputum in patients with chronic obstructive pulmonary disease during acute aggravating period. Method 72 cases of COPD patients with acute aggravating period to give an easy high-pressure jet oxygen atomization inhalation,bathing separately col ected before detect atomization,1 hours after atomization sputum volume,wet/dry weight and viscosity. Results After oxygen atomization,oxygen atomization before amount of sputum,sputum viscosity,sputum dry/wet weight had significant dif erence (p<0.05), and inflammatory biomarkers of neutrophil (PMN) combined with elastic enzyme membrane(HLE) has no obvious change. Conclusion High-pressure jet oxygen atomization inhalation of Ambroxol mucosolvan with dilute sputum and increased sputum volume effect,so as to ease of airway obstruction caused by high mucus secretion,relieve the patient's clinical symptoms,but the inhibition effect of the inflammatory response in the airways of has yet to be further research.%目的:观察高压喷射氧雾化吸入沐舒坦对慢性阻塞性肺疾病(COPD)急性加重期患者痰液理化性质的作用。方法72例COPD急性加重期患者给予沐舒坦高压喷射氧雾化吸入,分别收集检测雾化前、雾化后1h痰液量、干/湿重及黏度。结果氧雾化前与雾化后的痰液量、痰液黏度、痰液干/湿重均有明显差异(P<0.05)。而炎症指标中性粒细胞(PMN)膜结合弹力酶(HLE)无明显改变。结论高压喷射氧雾化吸入沐舒坦有稀释痰液、增加排痰量的作用。从而缓解黏液高分泌所致的气道阻塞、减轻患者的临床症状,但抑制气道炎症反应的作用尚无明确证据。

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. Coal tar creosote abuse by vapour inhalation presenting with renal impairment and neurotoxicity: a case report

    Directory of Open Access Journals (Sweden)

    Hiemstra Thomas F

    2007-09-01

    Full Text Available Abstract A 56 year old aromatherapist presented with advanced renal failure following chronic coal tar creosote vapour inhalation, and a chronic tubulo-interstitial nephritis was identified on renal biopsy. Following dialysis dependence occult inhalation continued, resulting in seizures, ataxia, cognitive impairment and marked generalised cerebral atrophy. We describe for the first time a case of creosote abuse by chronic vapour inhalation, resulting in significant morbidity. Use of the polycyclic aromatic hydrocarbon-containing wood preservative coal tar creosote is restricted by many countries due to concerns over environmental contamination and carcinogenicity. This case demonstrates additional toxicities not previously reported with coal tar creosote, and emphasizes the health risks of polycyclic aromatic hydrocarbon exposure.

  17. Response of spontaneously hypertensive rats to inhalation of fine and ultrafine particles from traffic: experimental controlled study

    Directory of Open Access Journals (Sweden)

    Dormans Jan AMA

    2006-05-01

    Full Text Available Abstract Background Many epidemiological studies have shown that mass concentrations of ambient particulate matter (PM are associated with adverse health effects in the human population. Since PM is still a very crude measure, this experimental study has explored the role of two distinct size fractions: ultrafine (3 to 3613 μg/m3 for fCAP and from 269μg/m3 to 556 μg/m3 for u+fCAP. Results Ammonium, nitrate, and sulphate ions accounted for 56 ± 16% of the total fCAP mass concentrations, but only 17 ± 6% of the u+fCAP mass concentrations. Unambiguous particle uptake in alveolar macrophages was only seen after u+fCAP exposures. Neither fCAP nor u+fCAP induced significant changes of cytotoxicity or inflammation in the lung. However, markers of oxidative stress (heme oxygenase-1 and malondialdehyde were affected by both fCAP and u+fCAP exposure, although not always significantly. Additional analysis revealed heme oxygenase-1 (HO-1 levels that followed a nonmonotonic function with an optimum at around 600 μg/m3 for fCAP. As a systemic response, exposure to u+fCAP and fCAP resulted in significant decreases of the white blood cell concentrations. Conclusion Minor pulmonary and systemic effects are observed after both fine and ultrafine + fine PM exposure. These effects do not linearly correlate with the CAP mass. A greater component of traffic CAP and/or a larger proportion ultrafine PM does not strengthen the absolute effects.

  18. Simultaneous CT measurement of inspired and expired gas methods of Xe-inhalation CT 1CBF study

    International Nuclear Information System (INIS)

    Our new method of xenon (Xe) CT lCBF study and the clinical results are presented. In our technique, inspiratory and expiratory tubes are closely scanned, together with the patient's head, to ascertain the Xe concentration of the arterial blood and of the brain tissue. The lCBF is then calculated from the two time-density curves, (C(exp)t) for the former and (C(t)t) for the later. In this method, a mass spectrometer is not necessary in ascertaining the time-density curve of the Xe concentration of arterial blood (C(a)t), and alternating C(exp)t to C(a)t is done only by means of the patient's Ht (%), without any sampling of arterial blood. However, the C(exp)t is not accurately reflected in the Xe concentration of the endotidal expired gas (C(end)t), and so it is necessary to correct the C(exp)t to C(end)t. It was found, from the expiratory lung model and the theoretical simulations, that each point on the C(exp)t was situated at the middle point between C(end)t and the Xe concentration of the inspired tube (C(insp)t). Therefore, the calculation was done as follows: C(end)t = 2C(exp)t - C(insp)t. The K value obtained by this method well fit the K value calculated from the C(t)t and C(end)t obtained by means of a mass spectrometer. Our new method of Xe CT lCBF study is discussed with regard to the correction of C(exp)t to C(a)t, and some clinical cases are presented. (author)

  19. Sinonasal inhalation of tobramycin vibrating aerosol in cystic fibrosis patients with upper airway Pseudomonas aeruginosa colonization: results of a randomized, double-blind, placebo-controlled pilot study

    Directory of Open Access Journals (Sweden)

    Mainz JG

    2014-02-01

    Full Text Available Jochen G Mainz,1 Katja Schädlich,1 Claudia Schien,1 Ruth Michl,1 Petra Schelhorn-Neise,2 Assen Koitschev,3 Christiane Koitschev,4 Peter M Keller,5 Joachim Riethmüller,6 Baerbel Wiedemann,7 James F Beck1 1Cystic Fibrosis Centre, Department of Pediatrics, Jena University Hospital, Jena, Germany; 2Otorhinolaryngology Department, Jena University Hospital, Jena, Germany; 3Otorhinolaryngology Department, Klinikum Stuttgart, Germany; 4Otorhinolaryngology Department, University Hospital, Tübingen, Germany; 5Microbiology, Jena University Hospital, Jena, Germany; 6University Hospital, Pediatric CF-Centre, Tübingen, Germany; 7Technical University, Biometrics, Dresden, Germany Rationale: In cystic fibrosis (CF, the paranasal sinuses are sites of first and persistent colonization by pathogens such as Pseudomonas aeruginosa. Pathogens subsequently descend to the lower airways, with P. aeruginosa remaining the primary cause of premature death in patients with the inherited disease. Unlike conventional aerosols, vibrating aerosols applied with the PARI Sinus™ nebulizer deposit drugs into the paranasal sinuses. This trial assessed the effects of vibrating sinonasal inhalation of the antibiotic tobramycin in CF patients positive for P. aeruginosa in nasal lavage. Objectives: To evaluate the effects of sinonasal inhalation of tobramycin on P. aeruginosa quantification in nasal lavage; and on patient quality of life, measured with the Sino-Nasal Outcome Test (SNOT-20, and otologic and renal safety and tolerability. Methods: Patients were randomized to inhalation of tobramycin (80 mg/2 mL or placebo (2 mL isotonic saline once daily (4 minutes/nostril with the PARI Sinus™ nebulizer over 28 days, with all patients eligible for a subsequent course of open-label inhalation of tobramycin for 28 days. Nasal lavage was obtained before starting and 2 days after the end of each treatment period by rinsing each nostril with 10 mL of isotonic saline. Results: Nine

  20. 延长吸氧管对氧疗效果的影响%Study on effects of prolonged oxygen inhalation tube on oxygen therapy/

    Institute of Scientific and Technical Information of China (English)

    沈端端; 姜金莲; 胡聂

    2013-01-01

    Objective To explore the effects of prolonged oxygen inhalation tube on oxygen therapy. Methods Patients with persistent low flow oxygen therapy were treated with 2 m,3 m,4 m and 5 m oxygen inhalation tube for oxygen therapy respectively. The blood oxygen saturation,the time of oxygen inhalation tube filling with oxygen and the patient satisfaction with prolonged oxygen inhalation tube were compared among the four groups. Results The peripheral oxyen staturation in 5 and 10 minutes after oxygen therapy were higher than those before oxygen therapy within 4 groups comparisons ( P 0. 05). And the time of 2 m,3 m,4 m and 5 m oxygen tube filling with oxygen were 1.26 min, 1.88 min,2.51 min and 3. 14 min,respectively. All the patients applauded for the prolonged oxygen inhalation tube. Conclusion The appropriately prolonged oxygen inhalation tube has no adverse effects on oxygen therapy. And it not only meets the demands of oxygen therapy for patients, but also benefits for the bedside activities of patients and the rehabilitation of disease.%目的 探讨适当延长吸氧管长度对血氧饱和度的影响.方法 对持续低流量氧疗病人按应用2 m、3 m、4 m、5 m吸氧管吸氧分为4组,观察血氧饱和度,计算氧气充满吸氧管时间,并调查延长吸氧管吸氧病人满意度.结果 4组病人组内比较吸氧后5 min和吸氧后10 min,末梢血氧饱和度均高于吸氧前(P<0.01);组间比较吸氧前、吸氧后5 min和吸氧后10 min,末梢血氧饱和度差异无统计学意义(P>0.05).2 m、3 m、4m、5m吸氧管氧气充满管腔时间为1.26 min、1.88 min、2.51 min、3.14 min.病人均乐于接受延长吸氧管吸氧.结论 适当延长吸氧管长度对吸氧效果无不良影响,既满足了氧疗病人用氧需求,又利于病人床边活动,利于疾病的康复.

  1. A toxicological study of inhalable particulates in an industrial region of Lanzhou City, northwestern China: Results from plasmid scission assay

    Science.gov (United States)

    Xiao, Zhenghui; Shao, Longyi; Zhang, Ning; Wang, Jing; Chuang, Hsiao-Chi; Deng, Zhenzhen; Wang, Zhen; BéruBé, Kelly

    2014-09-01

    The city of Lanzhou in northwestern China experiences serious air pollution episodes in the form of PM10 that is characterized by having high levels of heavy metals. The Xigu District represents the industrial core area of Lanzhou City and is denoted by having the largest petrochemical bases in western China. This study investigates heavy metal compositions and oxidative potential of airborne PM10 (particulate matter with aerodynamic diameter of 10 μm or less) collected in Xigu District in the summer and winter of 2010. An in vitro plasmid scission assay (PSA) was employed to study the oxidative potential of airborne PM10 and inductively coupled plasma-mass spectrometry (ICP-MS) was used to examine heavy metal compositions. Transmission electron microscopy coupled with energy-dispersive X-ray spectrometry (TEM/EDX) was used to investigate elemental compositions and mixing states of PM10. The average mass concentrations of PM10 collected in Xigu District were generally higher than the national standard for daily PM10 (150 μg/m3). Cr, Zn, Pb and Mn were the most abundant metals in the intact whole particles of PM10. Zn, Mn and As was the most abundant metal in the water-soluble fraction, while Cr, Pb, and V existed primarily in insoluble forms. TD20 values (i.e. toxic dosage of PM10 causing 20% of plasmid DNA damage) varied considerably in both winter and summer (from 19 μg/mL to >1000 μg/mL) but were typically higher in summer, suggesting that the winter PM10 exhibited greater bioreactivity. In addition, the PM10 collected during a dust storm episode had a highest TD20 value and thus the least oxidative damage to supercoiled plasmid DNA, while the particles collected on a hazy day had a lowest TD20 value and thus the highest oxidative damage to supercoiled plasmid DNA. The particles collected on the first day after snow fall and on a day of cold air intrusion exhibited minor oxidative potential (i.e. caused limited DNA damage). The water-soluble Zn, Mn, As, and

  2. Influence of flow rate on aerosol particle size distributions from pressurized and breath-actuated inhalers.

    Science.gov (United States)

    Smith, K J; Chan, H K; Brown, K F

    1998-01-01

    Particle size distribution of delivered aerosols and the total mass of drug delivered from the inhaler are important determinants of pulmonary deposition and response to inhalation therapy. Inhalation flow rate may vary between patients and from dose to dose. The Andersen Sampler (AS) cascade impactor operated at flow rates of 30 and 55 L/min and the Marple-Miller Impactor (MMI) operated at flow rates of 30, 55, and 80 L/min were used in this study to investigate the influence of airflow rate on the particle size distributions of inhalation products. Total mass of drug delivered from the inhaler, fine particle mass, fine particle fraction, percentage of nonrespirable particles, and amount of formulation retained within the inhaler were determined by ultraviolet spectrophotometry for several commercial bronchodilator products purchased in the marketplace, including a pressurized metered-dose inhaler (pMDI), breath-actuated pressurized inhaler (BAMDI), and three dry powder inhalers (DPIs), two containing salbutamol sulphate and the other containing terbutaline sulphate. Varying the flow rate through the cascade impactor produced no significant change in performance of the pressurized inhalers. Increasing the flow rate produced a greater mass of drug delivered and an increase in respirable particle mass and fraction from all DPIs tested. PMID:10346666

  3. Challenges of Change: A Qualitative Study of Chronic Care Model Implementation

    OpenAIRE

    Hroscikoski, Mary C.; Solberg, Leif I.; Sperl-Hillen, JoAnn M.; Harper, Peter G.; McGrail, Michael P.; Crabtree, Benjamin F.

    2006-01-01

    PURPOSE The Chronic Care Model (CCM) provides a conceptual framework for transforming health care for patients with chronic conditions; however, little is known about how to best design and implement its specifics. One large health care organization that tried to implement the CCM in primary care provided an opportunity to study these issues.

  4. Prevalence of chronic diseases at the onset of inflammatory arthritis: a population-based study.

    NARCIS (Netherlands)

    Ursum, J.; Korevaar, J.C.; Twisk, J.W.R.; Peters, M.J.L.; Schellevis, F.G.; Nurmohamed, M.T.; Nielen, M.M.J.

    2013-01-01

    Objective. Little is known about the presence of chronic morbidity in inflammatory arthritis (IA) patients at disease onset. Previous studies have been mainly performed in established IA patients or they focus on isolated co-morbid diseases. Our aim was to determine the prevalence of chronic disease

  5. Schema therapy for patients with chronic depression: a single case series study

    NARCIS (Netherlands)

    I.A. Malogiannis; A. Arntz; A. Spyropoulou; E. Tsartsara; A. Aggeli; S. Karveli; M. Vlavianou; A. Pehlivanidis; G.N. Papadimitriou; I. Zervas

    2014-01-01

    Background and objectives: This study tested the effectiveness of schema therapy (ST) for patients with chronic depression. Methods: Twelve patients with a diagnosis of chronic depression participated. The treatment protocol consisted of 60 sessions, with the first 55 sessions offered weekly and the

  6. Melatonin Treatment in Individuals with Intellectual Disability and Chronic Insomnia: A Randomized Placebo-Controlled Study

    Science.gov (United States)

    Braam, W.; Didden, R.; Smits, M.; Curfs, L.

    2008-01-01

    Background: While several small-number or open-label studies suggest that melatonin improves sleep in individuals with intellectual disabilities (ID) with chronic sleep disturbance, a larger randomized control trial is necessary to validate these promising results. Methods: The effectiveness of melatonin for the treatment of chronic sleep…

  7. Across-sectional study of prescribing patterns in chronic psychiatric patients living in sheltered housing facilities

    NARCIS (Netherlands)

    Schorr, S.G.; Loonen, A.J.M.; Brouwers, J.R.B.J.; Taxis, K.

    2008-01-01

    Objective: To analyze prescribing patterns of chronic psychiatric patients living in sheltered housing facilities, to identify the extent of polypharmacy and to estimate associated risks in this patient group. Methods: In a retrospective cross-sectional study the prescription data of 323 chronic psy

  8. Occipital nerve stimulation in medically intractable, chronic cluster headache. The ICON study

    DEFF Research Database (Denmark)

    Wilbrink, Leopoldine A; Teernstra, Onno Pm; Haan, Joost;

    2013-01-01

    BACKGROUND: About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled neu...

  9. Association between Herpesviruses and Chronic Periodontitis: A Meta-Analysis Based on Case-Control Studies

    Science.gov (United States)

    Wong, May. Chun. Mei; Feng, Xi-Ping; Lu, Hai-Xia; Xu, Wei

    2015-01-01

    Objective Numerous studies have investigated the associations between herpesviruses and chronic periodontitis; however, the results remain controversial. To derive a more precise estimation, a meta-analysis on all available studies was performed to identify the association between herpesviruses and chronic periodontitis. Methods A computerized literature search was conducted in December 2014 to identify eligible case-control studies from the PUBMED and EMBASE databases according to inclusion and exclusion criteria. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were used to assess the association between herpesviruses and risk of chronic periodontitis. A fixed or random effects model was determined based on a heterogeneity test. Sensitivity analysis was conducted to investigate stability and reliability. Publication bias was investigated using the Begg rank correlation test and Egger's funnel plot. Results Ten eligible studies were included to investigate the association between Epstein–Barr virus (EBV) and chronic periodontitis. The results showed that EBV has a significant association with chronic periodontitis compared with periodontally healthy group (OR = 5.74, 95% CI = 2.53–13.00, Pherpesvirus 7 (HHV-7) and chronic periodontitis risk (OR = 1.00, 95% CI = 0.21–4.86). Conclusion The findings of this meta-analysis suggest that two members of the herpesvirus family, EBV and HCMV, are significantly associated with chronic periodontitis. There is insufficient evidence to support associations between HSV, HHV-7 and chronic periodontitis. PMID:26666412

  10. Chronic fatigue syndrome--a controlled cross sectional study

    DEFF Research Database (Denmark)

    Rasmussen, A K; Nielsen, H; Andersen, V;

    1994-01-01

    OBJECTIVE. To look for signs of immunodeficiencies and/or longstanding infections underlying chronic fatigue syndrome (CFS). METHODS. Twenty-one patients fulfilling the Centers for Disease Control criteria for CFS were compared to 21 age and sex matched controls. A number of viral antibodies...

  11. Susceptibility to chronic mucus hypersecretion, a genome wide association study

    NARCIS (Netherlands)

    A.E. Dijkstra (Akkelies); J. Smolonska (Joanna); M. van den Berge (Maarten); C. Wijmenga (Ciska); P. Zanen (Pieter); M.A. Luinge (Marjan); I. Platteel (Inge); J.-W.J. Lammers (Jan-Willem); M. Dahlback (Magnus); K. Tosh (Kerrie); P.S. Hiemstra (Pieter); P.J. Sterk (Peter); M.E. Spira (Micha); J. Vestbo (Jorgen); B.G. Nordestgaard (Børge); M. Benn (Marianne); S.F. Nielsen (Sune); M. Dahl (Morten); W.M.M. Verschuren (W. M. Monique); H.S.J. Picavet (Susan); H.A. Smit (Henriëtte); M. Owsijewitsch (Michael); H.U. Kauczor (Hans); H.J. de Koning (Harry); E. Nizankowska-Mogilnicka (Eva); F. Mejza (Filip); P. Nastalek (Pawel); C.C. van Diemen (Cleo); M.H. Cho (Michael); E.K. Silverman (Edwin); R.O. Crapo (Robert); T.H. Beaty (Terri); D.J. Lomas (David John); A.B. Bakke (Arnold B.); A. Gulsvik (Amund); Y. Bossé (Yohan); M. Obeidat; D.W. Loth (Daan); L. Lahousse (Lies); F. Rivadeneira Ramirez (Fernando); A.G. Uitterlinden (André); A. Hofman (Albert); B.H.Ch. Stricker (Bruno); G.G. Brusselle (Guy); C.M. van Duijn (Cock); U. Brouwer (Uilke); G.H. Koppelman (Gerard); J.M. Vonk (Judith); M.C. Nawijn (Martijn); H.J.M. Groen (Henk); W. Timens (Wim); H.M. Boezen (H. Marike); D.S. Postma (Dirkje); B.Z. Alizadeh (Behrooz); R.A. de Boer; M. Bruinenberg (M.); L. Franke (Lude); P. van der Harst (Pim); H.L. Hillege (Hans); M.M. van der Klauw (Melanie); G. Navis (Gerjan); J. Ormel (Johan); J. Rosmalen (Jgm); J.P.J. Slaets (Joris); H. Snieder (Harold); R.P. Stolk (Ronald); B. Wolffenbuttel (Bhr)

    2014-01-01

    textabstractBackground: Chronic mucus hypersecretion (CMH) is associated with an increased frequency of respiratory infections, excess lung function decline, and increased hospitalisation and mortality rates in the general population. It is associated with smoking, but it is unknown why only a minor

  12. Nilotinib 300 mg twice daily: an academic single-arm study of newly diagnosed chronic phase chronic myeloid leukemia patients

    Science.gov (United States)

    Castagnetti, Fausto; Breccia, Massimo; Gugliotta, Gabriele; Martino, Bruno; D’Adda, Mariella; Stagno, Fabio; Carella, Angelo Michele; Avanzini, Paolo; Tiribelli, Mario; Trabacchi, Elena; Visani, Giuseppe; Gobbi, Marco; Salvucci, Marzia; Levato, Luciano; Binotto, Gianni; Capalbo, Silvana Franca; Bochicchio, Maria Teresa; Soverini, Simona; Cavo, Michele; Martinelli, Giovanni; Alimena, Giuliana; Pane, Fabrizio; Saglio, Giuseppe; Rosti, Gianantonio; Baccarani, Michele

    2016-01-01

    The introduction and the extended clinical use of nilotinib in the first-line treatment of chronic myeloid leukemia have been based on company-sponsored trials. Independent confirmations are extremely important. We report an investigator-sponsored study of nilotinib 300 mg twice daily in 130 chronic myeloid leukemia patients in early chronic phase. A deep molecular response was achieved in 46% (MR4.0) and 17% (MR4.5) of patients at 2 years; 58% of the enrolled patients achieved a MR4.0 at least once, with a sustained MR4.0 in 52% of them. With a median observation of 29 months (range 24–37 months), 77% of patients were still on treatment with nilotinib. The reasons for permanent discontinuation were: 3% progression, 5% failure or suboptimal response, 8% adverse events, 1% treatment-free remission, and 5% other reasons. Thirteen thrombotic arterial events were reported in 12 patients. A prospective evaluation of metabolic effects showed an increase of fasting glucose without significant variations of glycated hemoglobin, an increase of total cholesterol (both low density lipoprotein and high density lipoprotein fractions) and a decrease of triglycerides. This study confirms a high and rapid efficacy of nilotinib 300 mg twice daily and provides detailed information on the type and incidence of non-hematologic and metabolic adverse events (clinicaltrials.gov identifier: 01535391). PMID:27470600

  13. Clinical study of acute and chronic pain after temporal craniotomy

    Directory of Open Access Journals (Sweden)

    WANG Cheng-wei

    2013-10-01

    Full Text Available Objective To investigate the correlation of chronic pain after surgery and acute pain within 48 h after temporal craniotomy. Methods One hundred and seventy-six patients who underwent surgery through temporal approach were divided into 3 groups and treated with morphine 30 mg (Group M, N = 57, tramadol 1000 mg (Group T, N = 60 and morphine 20 mg + flurbiprofen 200 mg (Group F, N = 59 by patient-controlled intravenous analgesia (PCIA. Postoperative acute pain (resting and movement was evaluated by Visual Analogue Scale (VAS at 4, 16, 24 and 48 h respectively. Chronic pain was measured by Short-Form McGill Pain Questionnaire (SF-MPQ 3 months after surgery. The characteristics of acute and chronic pain, the relationship between them and analgesic effect of 3 kinds of analgesic drugs were analyzed. Results The differences of observed indicators including gender, age, weight and operating time, which might affect the degree of postoperative pain between before and after surgery were not statistically significant (P > 0.05. VAS scores at different time points within 48 h after surgery in each group decreased gradually. The VAS scores in group T (2.91 ± 1.64 was significantly higher than group M (2.19 ± 1.68 and group F (1.71 ± 1.17, P 0.05. The overall incidence rate of chronic pain was 71.02% (125/176, with moderate and severe pain in 15.91% (28/176. Chronic pain and acute postoperative pain severity were positively correlated (resting: rs = 0.171, P = 0.012; movement: rs = 0.190, P = 0.006. The difference of the acute pain (VAS corresponding to SF-MPQ Ⅱ score > 0 and SF-MPQ Ⅱ score = 0 was statistically significant (P < 0.05. Conclusion The postoperative chronic pain following temporal craniotomy is related to acute pain within 48 h after operation. Effective treatment of early postoperative acute pain may reduce the incidence of chronic pain.

  14. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    Directory of Open Access Journals (Sweden)

    Bunker Jeremy M

    2012-09-01

    Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. Design A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD. The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate, smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities. The primary outcome measure is health-related quality of life, assessed with the St George’s Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related

  15. Clinical studies of chronic pulmonary emphysema on computed tomography

    International Nuclear Information System (INIS)

    In order to assess the usefulness of CT for the evaluation of chronic pulmonary emphysema (CPE), three studies were made as follows. Correlation between CT findings and pulmonary function tests (PFT's) was studied by a scoring method in 41 patients with clinically diagnosed CPE. CT visual score was best correlated with DLCO (r=-0.68) and %DLCO (r=-0.74). The coexistence of bronchial lesion was considered to be responsible for the discrepancy between CT findings and PFT's in patients with low visual score. Alteration ratios of lung field CT numbers in different respiratory phases were studied in 30 cases with CPE, 15 cases with s/o CPE, 7 cases with bronchial asthma and 20 cases with normal lung. Among three parameters we employed, %(I-E)/W, i.e., the alteration ratio of whole lung fields CT numbers between fully inspired and entirely expired state, was proved to be best parameter to separate the disease groups from each other. %(I-E)/W had good correlation with FEV1.0% (r=0.79), V25/H (r=0.80) and RV/TLC (r=-0.75), and this parameter was considered to be useful for the diagnosis of CPE. CT-functional images (CT-FI's) were created from Xe-dynamic CT data of 10 patients with CPE and 6 volunteers with normal lung. For each case, the distribution of ventilation dynamics was compared between outer and inner zone of lung fields. In CT-FI's of normal lungs, the values of washin and washout parameter of outer zone were larger than those of inner zone. In CT-FL's of CPE, the values of washin parameter of inner zone were larger than those of outer zone and the values of washout parameter of outer zone were larger than those of inner zone. CT-FI proved to be helpful in evaluating the distribution of ventilation dynamics in axial planes of the lung with CPE. (author) 83 refs

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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

  17. Alcoholic chronic pancreatitis: A quality of life study

    Directory of Open Access Journals (Sweden)

    Simone Carla BENINCÁ

    2016-02-01

    Full Text Available ABSTRACT Objective: To compare the quality of life between patients with alcoholic chronic pancreatitis and controls, and between diabetic and non-diabetic patients, correlating clinical, sociodemographic, and nutritional factors with their quality of life scores. Methods: Forty-three outpatients of the pancreas and biliary tract clinic diagnosed with alcoholic chronic pancreatitis were assessed. Quality of life was measured by the Brazilian version of the Short Form-36. The control group consisted of 43 healthy companions. Nutritional status was classified according to body mass index and triceps, biceps, suprailiac, and subscapular skinfold thicknesses, using the appropriate methods. The percentage of body fat was given by adding the four skinfold thicknesses and by bioelectrical impedance analysis. The statistical tests included the Chi-square, Mann-Whitney, and Spearman's correlation tests, with the significance level set at p<0.05. Results: The sociodemographic variables of the case and control groups did not differ. Quality of life was lower in alcoholic chronic pancreatitis patients than in controls. The only quality of life domain that differed between diabetics and non-diabetics was functional capacity, lower in diabetics (p=0.022. Smoking duration, alcohol intake in grams, and time since pancreatic surgery correlated negatively with the quality of life of alcoholic chronic pancreatitis patients. Old age, skinfold thicknesses, and percentage of body fat correlated positively with quality of life. Conclusion: Quality of life is low in alcoholic chronic pancreatitis patients because of the negative influence of certain factors, such as smoking duration, amount of alcohol consumed, and time since pancreatic surgery.

  18. Hypokalaemia and other non-bronchial effects of inhaled fenoterol and salbutamol: a placebo-controlled dose-response study in healthy volunteers.

    OpenAIRE

    Scheinin, M; Koulu, M.; Laurikainen, E.; Allonen, H

    1987-01-01

    1. The hypokalaemia-inducing effects of two widely used inhaled antiasthmatic beta 2-adrenoceptor agonists, fenoterol and salbutamol, were compared in six healthy male volunteers. 2. Each drug was administered in three different doses, 400, 600 and 800 micrograms, which were repeated three times with 30 min intervals (total doses 1200, 1800 and 2400 micrograms in 1 h). The treatments were given at 1 week intervals in random order in a single-blind fashion. 3. The concentration of potassium in...

  19. Prognosis of chronic low back pain: design of an inception cohort study

    Directory of Open Access Journals (Sweden)

    McAuley James H

    2007-02-01

    Full Text Available Abstract Background Although clinical guidelines generally portray chronic low back pain as a condition with a poor prognosis this portrayal is based on studies of potentially unrepresentative survival cohorts. The aim of this study is to describe the prognosis of an inception cohort of people with chronic low back pain presenting for primary care. Methods/Design The study will be an inception cohort study with one year follow-up. Participants are drawn from a cohort of consecutive patients presenting with acute low back pain (less than 2 weeks duration to primary care clinics in Sydney, Australia. Those patients who continue to experience pain at three months, and are therefore classified as having chronic back pain, are invited to participate in the current study. The cohort will be followed up by telephone at baseline, 9 months and 12 months after being diagnosed with chronic low back pain. Recovery from low back pain will be measured by sampling three different outcomes: pain intensity, interference with function due to pain, and work status. Life tables will be generated to determine the one year prognosis of chronic low back pain. Prognostic factors will be assessed using Cox regression. Discussion This study will determine the prognosis of chronic non-specific low back pain in a representative cohort of patients sourced from primary care. The results of this study will improve understanding of chronic low back pain, allowing clinicians to provide more accurate prognostic information to their patients.

  20. [Evoked potentials and inhalation anesthetics].

    Science.gov (United States)

    Thiel, A; Russ, W; Hempelmann, G

    1988-01-01

    Intraoperative monitoring of evoked potentials can be affected by various factors including volatile anaesthetics. These effects have to be considered in order to give correct interpretations of the obtained data. Visual evoked potentials (VEP) and auditory evoked potentials (AEP) will show strong alterations under general anaesthesia whereas brainstem auditory evoked potentials (BAEP) are slightly affected. The effects of nitrous oxide, halothane, enflurane, and isoflurane on somatosensory evoked potentials (SEP) after median nerve stimulation were studied in 35 healthy adult patients. pCO2 and tympanic membrane temperature were held constant. Simultaneous cervical and cortical SEP recording was performed using surface electrodes. After induction of anaesthesia SEP were recorded during normoventilation with 100% oxygen and after inhalation of 66.6% nitrous oxide. 10 patients received halothane at inspired concentrations of 0.5, 1.0, 1.5, and 2.0%. After nitrous oxide had been replaced by oxygen, halothane was reduced in steps of 0.5%. SEP were recorded at the end of each period (15 min). Equipotent doses of enflurane or isoflurane were administered to 15 and 10 patients, respectively. Nitrous oxide depressed early cortical SEP amplitude. Halothane, enflurane, and isoflurane caused dose dependent increases of latencies. Reduction of amplitude was most pronounced with isoflurane. Using high doses of enflurane in oxygen cortical SEP showed unusual high amplitudes associated with marked increases of latencies. Even under high concentrations of volatile anaesthetics cervical SEP were minimally affected. The effects of anaesthetic gases have to be considered when SEP are recorded intraoperatively.

  1. Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study.

    NARCIS (Netherlands)

    Wijnhoven, Hanneke A H; Vet, Henrica C W de; Smit, Henriëtte A; Picavet, H Susan J

    2006-01-01

    STUDY DESIGN: Cross-sectional study of 11,428 women aged 20-59 years who were included in a postal questionnaire survey in the Dutch general population. OBJECTIVE: To examine how hormonal and reproductive factors are associated with chronic low back pain (LBP) and chronic upper extremity pain (UEP)

  2. Zinc toxicology following particulate inhalation.

    Science.gov (United States)

    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

  3. Zinc toxicology following particulate inhalation

    Directory of Open Access Journals (Sweden)

    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.

  4. The effect of umeclidinium added to inhaled corticosteroid/long-acting β2-agonist in patients with symptomatic COPD: a randomised, double-blind, parallel-group study.

    Science.gov (United States)

    Sousa, Ana R; Riley, John H; Church, Alison; Zhu, Chang-Qing; Punekar, Yogesh S; Fahy, William A

    2016-01-01

    Benefits of triple therapy with a long-acting muscarinic antagonist (LAMA), added to inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA), have been demonstrated. Limited data assessing the efficacy of the LAMA umeclidinium (UMEC) added to ICS/LABA are available. The aim of this study is to evaluate the efficacy and safety of UMEC added to ICS/LABAs in patients with moderate-to-very-severe COPD. This is a multicentre, randomised, double-blind, parallel-group study. Patients were symptomatic (modified Medical Research Council Dyspnoea Scale score ⩾2), despite receiving ICS/LABA (fluticasone propionate/salmeterol (FP/SAL, branded) 500/50 mcg, budesonide/formoterol (BD/FOR, branded) 200/6 mcg or 400/12 mcg, or other ICS/LABAs) ⩾30 days before the run-in (7±2 days). Patients were randomised 1:1 to once-daily UMEC 62.5 mcg or placebo (PBO), added to twice-daily open-label ICS/LABA for 12 weeks. Primary end point was trough forced expiratory volume in 1 s (FEV1) at Day 85; secondary end point was weighted mean (WM) 0-6 h FEV1 at Day 84; other end points included COPD Assessment Test (CAT) score and Transition Dyspnoea Index (TDI) score. Adverse events (AEs) were investigated. In the UMEC+ICS/LABA and PBO+ICS/LABA groups, 119 and 117 patients were randomised, respectively. Patients received FP/SAL (40%), BD/FOR (43%) and other ICS/LABAs (17%). UMEC+ICS/LABA resulted in significant improvements in trough FEV1 (Day 85) and in WM 0-6 h FEV1 (Day 84) versus PBO+ICS/LABA (difference: 123 and 148 ml, respectively, both P<0.001). Change from baseline for UMEC+ICS/LABA versus PBO+ICS/LABA was significantly different for CAT score at Day 84 (-1.31, P<0.05), but not for TDI score (0.40, P=0.152). AE incidence was similar with UMEC+ICS/LABA (38%) and PBO+ICS/LABA (42%). UMEC+ICS/LABA improved lung function and CAT score in patients with symptomatic COPD versus PBO+ICS/LABA (ClinicalTrials.gov NCT02257372). PMID:27334739

  5. Wirksamkeit der Inhalation heißer, trockener Luft bei akuten Infekten der oberen Atemwege

    OpenAIRE

    Knöchel, Bettina

    2016-01-01

    Introduction: Traditionally, in the treatment of common colds a local application of heat is often used (inhaling hot steam, drinking hot fluids). The efficacy of local heating was evaluated just in a few trials which have had conflicting results. Objective: The aim of the present study was to evaluate whether inhaling 90°C hot dry air in a sauna reduces common cold symptoms greater than inhaling air at room temperature in patients with a newly acquired common cold. Methods: A randomise...

  6. Relation between the bronchial obstructive response to inhaled lipopolysaccharide and bronchial responsiveness to histamine.

    OpenAIRE

    Michel, O; Ginanni, R; Sergysels, R

    1992-01-01

    BACKGROUND: Bronchoconstriction has developed after inhalation of lipopolysaccharide in a dose of 20 micrograms in asthmatic patients and of 200 micrograms in normal subjects. This study set out to determine whether the bronchial response to lipopolysaccharide was related to non-specific bronchial responsiveness and atopy. METHODS: Sixteen subjects with a fall in specific airway conductance of 40% (PD40sGaw) after inhaling up to 900 micrograms histamine inhaled 20 micrograms lipopolysaccharid...

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

    OpenAIRE

    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/...

  8. Effects of the abused inhalant toluene on the mesolimbic dopamine system

    OpenAIRE

    Woodward, John J; Beckley, Jacob

    2014-01-01

    Toluene is a representative member of a class of inhaled solvents that are voluntarily used by adolescents and adults for their euphorigenic effects. Research into the mechanisms of action of inhaled solvents has lagged behind that of other drugs of abuse despite mounting evidence that these compounds exert profound neurobehavioral and neurotoxicological effects. Results from studies carried out by the authors and others suggest that the neural effects of inhalants arise from their interactio...

  9. The effect of respiratory manoeuvres and pharmacological agents on the pharmacokinetics of nedocromil sodium after inhalation.

    OpenAIRE

    Summers, Q. A.; Singh, S; Honeywell, R G; Renwick, A G; Holgate, S T

    1992-01-01

    1. Eight healthy subjects inhaled nedocromil sodium from a metered-dose inhaler using a standardised inspiratory technique. Blood samples were taken for up to 270 min after inhalation for radioimmunoassay of plasma nedocromil sodium concentrations. 2. To investigate the possibility that respiratory manoeuvres can alter the absorption of the drug from the lungs, on the first (control) study day at 70 min after dosing, subjects performed nine forced expiratory manoeuvres over a 3 min period. At...

  10. Whole-body nanoparticle aerosol inhalation exposures.

    Science.gov (United States)

    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

  11. Sleep characteristics of individuals with chronic stroke: a pilot study

    OpenAIRE

    Al-Dughmi M; Al-Sharman A; Stevens S; Siengsukon CF

    2015-01-01

    Mayis Al-Dughmi,1 Alham Al-Sharman,2 Suzanne Stevens,3 Catherine F Siengsukon1 1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA; 2Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA Abstract: Changes in sleep characteristics in individuals with chronic stroke are not well described, particularly...

  12. Study of inhaled radio-active pollutants: 1. Current data; II. Pathology; III. Validity of animal model. Dose-effect relations

    International Nuclear Information System (INIS)

    An attempt has been made to develop an animal for human industrial exposure to airradiation. That will give results applicable to man both qualitatively and quantitavely. Using over 2000 animals. The following studies were made. Radon, rat and occupationally exposed man; 239 plutonium oxide, rat and monkey; 12 different α and emitters, rat with different exposure media (aerosols particles) and exposure shcedules (acute chronic). Scrupulous pathological, microscopic, autoradiographic and ultrastructural analysis of animals followed their deaths. Acute changes are characterized by alveolaroedema, capillary and arteriolar thrombisus, and desquamation of type 1 pneumatocytes. There is interstitial pneumonia, hyaline membrane formation, and extensive bronchiolar and alveolar metaplasia. In a study of long-term effects a wide variety of both benign and malignant tumours was discovered. There are variations in species lateney and radiation sensitivity. The pathological changes, found in these studies are qualitatively very similar to changes found in man

  13. In Vitro Pharmacodynamics of Levofloxacin and Other Aerosolized Antibiotics under Multiple Conditions Relevant to Chronic Pulmonary Infection in Cystic Fibrosis ▿

    OpenAIRE

    King, Paula; Lomovskaya, Olga; Griffith, David C.; Burns, Jane L.; Dudley, Michael N.

    2009-01-01

    The inhalational administration of antibiotics can provide high concentrations locally in the lungs of cystic fibrosis patients and, thus, can be useful for the treatment of chronic bacterial infections. The present study evaluated the in vitro activities of levofloxacin, ciprofloxacin, tobramycin, amikacin, and aztreonam against clinical isolates of Pseudomonas aeruginosa, Burkholderia cepacia complex, Stenotrophomonas maltophilia, Alcaligenes xylosoxidans, and Staphylococcus aureus from cys...

  14. Association of chronic periodontitis with metabolic syndrome: A cross-sectional study

    OpenAIRE

    Naresh Kumar; Ashu Bhardwaj; Prakash Chand Negi; Pravesh Kumar Jhingta; Deepak Sharma; Vinay Kumar Bhardwaj

    2016-01-01

    Background: Prevalence of metabolic syndrome (MeS) is high among Asians, including Indians and is rising, particularly with the adoption of modernized lifestyle. Various studies have reported a significant relationship between periodontal status and MeS. The objective of this study is to investigate the association between periodontitis and MeS. Materials and Methods: The study included 259 subjects (130 cases with chronic periodontitis, 129 controls without chronic periodontitis) who underwe...

  15. [The influence of treatment with formoterol, formoterol with tiotropium, formoterol with inhaled glucocorticosteroid and tiotropium on lung functions, tolerance of exercise and simple, morning everyday activities in patients with chronic obstructive pulmonary disease (COPD)].

    Science.gov (United States)

    Szmidt, Mirosław

    2012-01-01

    Bronchodilators - long-acting b2-adrenergic agonists (formoterol and salmeterol) and a long-acting antimuscarinic drug (tiotropium), are the main drugs applied in symptomatic treatment of COPD. In patients with COPD, dyspnea is frequently associated with simple everyday activities. Two questionnaires have been published recently as a means of assessing the patients' ability to perform morning activities and symptoms. Dynamic hyperinflation is the pathophysiological disorder responsible for dyspnea and decreased exercise tolerance in COPD. Formoterol is faster than salmeterol in diminishing air-trapping. It has been shown that treatment with formoterol and tiotropium in COPD patients improves FEV(1), FVC, IC, symptoms score and quality of life in comparison with tiotropium applied alone. Among LABA and inhaled glucocorticosteroids combinations, those containing formoterol have a more beneficial effect on the ability to perform simple morning activities (budesonide/formoterol was better than fluticasone/salmeterol). Beclomethasone/formoterol - 400/24 mcg/die, in comparison with fluticasone/salmeterol - 500/100 mcg/die significantly reduced air-trapping and dyspnea in COPD patients. The comparison of budesonide/formoterol - 400/12 mcg 2 x die with beclomethasone/ /formoterol - 200/12 mcg 2 x die has shown similar influence of both combinations on FEV(1), dyspnea, 6-minute walk test, symptoms score and quality of life. The addition of budesonide and formoterol combination to tiotropium gives further benefits: reduces number of exacerbations, improves FEV1, symptoms score and performance of simple morning routines. Doctors should pay more attention to symptoms and limitations in simple activities in the morning and adequately adjust the treatment. PMID:22562275

  16. INHALATION EXPOSURE OF RATS TO LIBBY AMPHIBOLE (LA) AND AMOSITE ASBESTOS

    Science.gov (United States)

    Inhalation toxicology studies are being conducted to inform the risk assessment ofLibby amphibole. The overall purpose of these studies is to compare the toxicity of inhaled Libby amphibole fibers to a positive control fiber sample (UICC amosite). A 2-week study was conducted to ...

  17. Depleted uranium contamination by inhalation exposure and its detection after {approx} 20 years: Implications for human health assessment

    Energy Technology Data Exchange (ETDEWEB)

    Parrish, Randall R. [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); NERC Isotope Geosciences Laboratory, British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom)], E-mail: rrp@nigl.nerc.ac.uk; Horstwood, Matthew [NERC Isotope Geosciences Laboratory, British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Arnason, John G. [Department of Earth and Atmospheric Sciences, University at Albany, 1400 Washington Avenue, Albany NY 12222 (United States); Chenery, Simon [British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Brewer, Tim [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); Lloyd, Nicholas S. [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Carpenter, David O. [Institute for Health and the Environment, University at Albany, Five University Place, Room A217, Rensselaer, NY 12144-3456 (United States)

    2008-02-01

    Inhaled depleted uranium (DU) aerosols are recognised as a distinct human health hazard and DU has been suggested to be responsible in part for illness in both military and civilian populations that may have been exposed. This study aimed to develop and use a testing procedure capable of detecting an individual's historic milligram-quantity aerosol exposure to DU up to 20 years after the event. This method was applied to individuals associated with or living proximal to a DU munitions plant in Colonie New York that were likely to have had a significant DU aerosol inhalation exposure, in order to improve DU-exposure screening reliability and gain insight into the residence time of DU in humans. We show using sensitive mass spectrometric techniques that when exposure to aerosol has been unambiguous and in sufficient quantity, urinary excretion of DU can be detected more than 20 years after primary DU inhalation contamination ceased, even when DU constitutes only {approx} 1% of the total excreted uranium. It seems reasonable to conclude that a chronically DU-exposed population exists within the contamination 'footprint' of the munitions plant in Colonie, New York. The method allows even a modest DU exposure to be identified where other less sensitive methods would have failed entirely. This should allow better assessment of historical exposure incidence than currently exists.

  18. Retinopathy and the risk of cardiovascular disease in patients with chronic kidney disease (from the Chronic Renal Insufficiency Cohort study).

    Science.gov (United States)

    Grunwald, Juan E; Pistilli, Maxwell; Ying, Gui-Shuang; Maguire, Maureen; Daniel, Ebenezer; Whittock-Martin, Revell; Parker-Ostroff, Candace; Mohler, Emile; Lo, Joan C; Townsend, Raymond R; Gadegbeku, Crystal Ann; Lash, James Phillip; Fink, Jeffrey Craig; Rahman, Mahboob; Feldman, Harold; Kusek, John W; Xie, Dawei

    2015-11-15

    Patients with chronic kidney disease (CKD) experience other diseases such as cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess whether retinopathy predicts future CVD events in a subgroup of the participants of the Chronic Renal Insufficiency Cohort (CRIC) study. In this ancillary investigation, 2,605 participants of the CRIC study were invited to participate, and nonmydriatic fundus photographs were obtained in 1,936 subjects. Using standard protocols, presence and severity of retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed at a central photograph reading center by trained graders masked to study participant's information. Patients with a self-reported history of cardiovascular disease were excluded. Incident CVD events were adjudicated using medical records. Kidney function measurements, traditional and nontraditional risk factors, for CVD were obtained. Presence and severity of retinopathy were associated with increased risk of development of any CVD in this population of CKD patients, and these associations persisted after adjustment for traditional risk factors for CVD. We also found a direct relation between increased venular diameter and risk of development of CVD; however, the relation was not statistically significant after adjustment for traditional risk factors. In conclusion, the presence of retinopathy was associated with future CVD events, suggesting that retinovascular pathology may be indicative of macrovascular disease even after adjustment for renal dysfunction and traditional CVD risk factors. Assessment of retinal morphology may be valuable in assessing risk of CVD in patients with CKD, both clinically and in research settings.

  19. [A welder with chemical pneumonitis caused by inhalation of zinc fume].

    Science.gov (United States)

    Tojima, H; Ando, T; Kishikawa, H; Tokudome, T

    1998-04-01

    A 61-year-old man with a 32-year occupational history of welding developed malaise, cough, and dyspnea after inhalation of smoke while welding galvanized steel. On admission, peripheral leukocytosis, hypoxemia, and diffuse granular and linear opacities on a chest X-ray were present. The bronchioli were exaggerated in a chest high-resolution CT. Bronchoalveolar lavage revealed mild lymphocytosis and transbronchial lung biopsy showed siderosis and exudation of fibrin and neutrophils into alveolar spaces. The clinical and radiographic findings later improved except for an obstructive disorder on pulmonary function test. The respiratory health hazards associated with welding vary according to the materials and the concentration of inhaled substances. Acute chemical pneumonitis caused by inhalation of zinc fumes (zinc oxide) was accompanied by chronic siderosis in this case. It is well known that metal fume fever commonly occurs when inhaling zinc oxide fumes. However acute chemical pneumonitis after exposure to zinc oxide during welding has been only rarely reported.

  20. A stepwise approach to management of stable COPD with inhaled pharmacotherapy: a review.

    Science.gov (United States)

    Restrepo, Ruben D

    2009-08-01

    Although existing evidence confirms that no pharmacologic agent ameliorates the decline in the lung function or changes the prognosis of chronic obstructive pulmonary disease (COPD), inhaled pharmacotherapy is a critical component of the management for patients suffering with COPD. Inhaled agents are directed to provide immediate relief of symptoms and to restore functional capacity in treatment of stable COPD. While COPD may not be cured, knowledge and implementation of currently available guidelines provide the health-care provider alternatives to treat the disease effectively. Respiratory therapists play an important role in the implementation of these guidelines, since they are often responsible for educating patients on the correct use of the inhalers. This paper reviews current evidence regarding the use of inhaled pharmacotherapy in the treatment of COPD and provides a guided approach to the use of different agents in stable COPD.

  1. High-vs low-dose cytarabine combined with interferon alfa in patients with first chronic phase chronic myeloid leukemia. A prospective randomized phase III study

    NARCIS (Netherlands)

    Deenik, W.; van der Holt, B.; Verhoef, G. E. G.; Schattenberg, A. V. M. B.; Verdonck, L. F.; Daenen, S. M. G. J.; Zachee, P.; Westveer, P. H. M.; Smit, W. M.; Wittebol, S.; Schouten, H. C.; Lowenberg, B.; Ossenkoppele, G. J.; Cornelissen, J. J.

    2007-01-01

    A prospective randomized phase III study was performed to evaluate whether intensified cytarabine would induce a higher response rate and longer event-free interval as compared to low-dose cytarabine in chronic myeloid leukemia (CML). One hundred and eighteen patients with CML in early chronic phase

  2. High-vs low-dose cytarabine combined with interferon alfa in patients with first chronic phase chronic myeloid leukemia : A prospective randomized phase III study

    NARCIS (Netherlands)

    Deenik, W.; Holt, B. van der; Verhoef, G.E.; Schattenberg, A.V.M.B.; Verdonck, L.F.; Daenen, S.M.G.J.; Zachee, P.; Westveer, P.H.; Smit, W.M.; Wittebol, S.; Schouten, H.C.; Lowenberg, B.; Ossenkoppele, G.J.; Cornelissen, J.J.L.M.

    2007-01-01

    A prospective randomized phase III study was performed to evaluate whether intensified cytarabine would induce a higher response rate and longer event-free interval as compared to low-dose cytarabine in chronic myeloid leukemia (CML). One hundred and eighteen patients with CML in early chronic phase

  3. Factors related to the incorrect use of inhalers by asthma patients

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2014-01-01

    Full Text Available OBJECTIVE: To evaluate inhaler technique in outpatients with asthma and to determine associations between the correctness of that technique and the level of asthma control. METHODS: This was a cross-sectional study involving patients > 14 years of age with physician-diagnosed asthma. The patients were recruited from the Asthma Outpatient Clinic of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, Brazil. The patients completed two questionnaires (a general questionnaire and an asthma control questionnaire based on the 2011 Global Initiative for Asthma guidelines, demonstrated their inhaler technique, and performed pulmonary function tests. Incorrect inhaler technique was defined as the incorrect execution of at least two of the predefined steps. RESULTS: We included 268 patients. Of those, 81 (30.2% showed incorrect inhaler technique, which was associated with poor asthma control (p = 0.002. Logistic regression analysis identified the following factors associated with incorrect inhaler technique: being widowed (OR = 5.01; 95% CI, 1.74-14.41; p = 0.003; using metered dose inhalers (OR = 1.58; 95% CI, 1.35-1.85; p 2 comorbidities (OR = 3.80; 95% CI, 1.03-14.02; p = 0.045. CONCLUSIONS: In the sample studied, incorrect inhaler technique was associated with poor asthma control. Widowhood, use of metered dose inhalers, low socioeconomic level, and the presence of > 2 comorbidities were associated with incorrect inhaler technique.

  4. Quality of life in individuals with chronic foot conditions: a cross sectional observational study.

    LENUS (Irish Health Repository)

    Groarke, Patrick

    2012-06-01

    Chronic foot conditions have been reported to be a significant cause of impairment and disability to individuals affected. However, studies to date have particularly focussed on patient satisfaction with outcomes following surgery.

  5. A study on the change of autophagy in skeletal muscle of patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    黄娟

    2013-01-01

    Objective To study skeletal muscle atrophy and the change of autophagy in skeletal muscle of patients with chronic kidney disease.Methods Mean muscle cross sectional area,mRNA and protein expression of

  6. Clinical Study on Treatment of Chronic Renal Failure with Shenshuailing

    Institute of Scientific and Technical Information of China (English)

    鞠建伟; 郭亚玲; 梁延平; 孙世宁; 杨建华; 杨素云

    2001-01-01

    The therapeutic effects of Shenshuailing Kou Fu Ye (SKFY肾衰灵口服液, the Oral Liquid for Renal Failure) and Shenshuailing Guan Chang Ye (SGCY肾衰灵灌肠液, the Enema for Renal Failure) were evaluated in treatment of chronic renal failure, with coateg aldehyde oxystarch as the controls. The changes in the clinical symptoms, serum creatinine, blood urea nitrogen and creatinine clearance rate were observed. The total effective rate in the former was 90.46%, and the latter 60.43%.

  7. A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Stone Brian A

    2007-02-01

    Full Text Available Abstract Background The etiology and treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life (QOL are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men with CP/CPPS. The purpose of our study was to assess the impact of standardized full body and auricular acupuncture in men refractory to conventional therapies and collect pilot data to warrant further randomized trials. Methods Ten men diagnosed with category IIIA or IIIB CP/CPPS >6 months, refractory to at least 1 conventional therapy (antibiotics, anti-inflammatory agents, 5-α reductase inhibitors, α-1 blockers and scoring >4 on the pain subset of the NIH-CPSI were prospectively analyzed in an Institutional Review Board (IRB approved, single-center clinical trial (Columbia University Medical Center IRB#AAAA-7460. Standardized full body and auricular acupuncture treatment was given twice weekly for 6 weeks. The primary endpoints were total score of the NIH-CPSI and assessment of serious adverse events. The secondary endpoints were individual scores of the NIH-CPSI and QOL questionnaire scores of the short-form 36 (SF-36. Results The median age of the subjects was 36 years (range 29–63. Decreases in total NIH-CPSI scores (mean ± SD after 3 and 6 weeks from baseline (25.1 ± 6.6 were 17.6 ± 5.7 (P Conclusion The preliminary findings, although limited, suggest the potential therapeutic role of acupuncture in the treatment of CP/CPPS. Data from this and previous studies warrant randomized trials of acupuncture for CP/CPPS and particular attention towards acupuncture point selection, treatment intervention, and durability of acupuncture.

  8. Early maladaptive schema factors, chronic pain and depressiveness: a study with 271 chronic pain patients and 331 control participants.

    Science.gov (United States)

    Saariaho, Tom; Saariaho, Anita; Karila, Irma; Joukamaa, Matti

    2012-01-01

    Chronic pain and depression are coexisting entities with high simultaneous prevalence. Both are linked with early adversities. Early maladaptive schemas (EMS) can be seen as a reflection of these adversities. EMSs extensively indicate underlying psychic patterns and provide a good opportunity to detect covert processes and psychic shapes (latent factors), which create the basis of how people rate their schemas. The purpose of this study was to explore these latent, higher order schema factors (SF) and to find out how they are associated with pain intensity or depression in chronic pain patients and a control sample. The study subjects consisted of 271 first-visit pain patients and 331 control participants. Sociodemographic and pain data were gathered by questionnaire; 18 EMSs were measured with the Young Schema Questionnaire (short form) and depressiveness was measured with the Beck Depression Inventory, Version II. Exploratory factor and regression analyses were used. The chronic pain patient group showed two SFs. The first SF showed a shameful, defective, socially isolated, failure, emotionally inhibited, deprived, submissive and resigned pattern. The second SF showed a demanding, approval seeking, self-sacrificing and punitive pattern. SF1 predicted more than half of the depressiveness in the pain patient sample. A three-factor structure was found in the control sample, and SFs 1 and 3 together predicted almost one-third of depressiveness. The pain patient and the control groups had a different, higher order factor structure. We assume that SF1 in the pain patients reflected a rather serious, undefined early psychic trauma and was also associated with their depressiveness. PMID:21210495

  9. Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies

    OpenAIRE

    Roddy, E.; Mallen, C.; Belcher, J.

    2015-01-01

    Introduction To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis. Methods Systematic review and meta-analysis of epidemiological studies. Data sources; MEDLINE, EMBASE and CINAHL databases, hand-searched reference lists, citation history and contact with authors. Eligibility criteria: cohort, case–control or cross-sectional studies which examined the...

  10. THE EFFECTS OF PRACTICING SWIMMING IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. CASE STUDY

    OpenAIRE

    Petrescu S.; Ciolan G. A.; Păunescu M.

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is comprised primarily of two related diseases - chronic bronchitis and emphysema. Clinical research on the effects of swimming on the quality of the life of patients with various lung diseases showed that the use of water therapy programs have significant effects on the induction of pulmonary edema as well as on mild to moderate asthma. The case study presented in this study, aged 52, male, from urban area, smoker (30PA), with a weight of 96 kg an...

  11. Antibody Response Rates To Hepatitis B Vaccination in Children With Chronic Renal Failure: An Observational Study

    OpenAIRE

    Ece, İbrahim; Kibar, Ayse Esin; Oflaz, Burhan; Cakar, Nilgun; Balli, Sevket; Akkok, Nermin; Kara, Nazli

    2013-01-01

    Introduction: Hepatitis B virus (HBV) infection is one of the most important factors increasing the mortality and the mobility in patients with chronic renal failure (CRF). There are a limited number of studies of pediatric patients with CRF regarding the response to double doses and protection rates. In this study, our aim was to compare the antibody levels and the respond rates to recombinant hepatitis B vaccine in children with chronic renal failure (CRF). Materials and Methods: In this pr...

  12. Anxiety in Children and Adolescents with Chronic Kidney Disease - Multicenter National Study Results

    OpenAIRE

    Katarzyna Kiliś-Pstrusińska; Anna Medyńska; Piotr Adamczak; Irena Bałasz- Chmielewska; Ryszard Grenda; Agnieszka Kluska-Jóźwiak; Beata Leszczyńska; Ilona Olszak-Szot; Monika Miklaszewska; Maria Szczepańska; Marcin Tkaczyk; Anna Wasilewska; Katarzyna Zachwieja; Maria Zajączkowska; Helena Ziółkowska

    2013-01-01

    Background/Aims: Chronic medical illness is a significant risk factor for the development of psychiatric disorders. The aims of the study were: to investigate the level of anxiety in children with chronic kidney disease (CKD) and to identify factors associated with the presence of that emotional problem. Methods: CKD children on hemodialysis (HD, n=22), peritoneal dialysis (PD, n=20,) and on conservative treatment (CT, n=95) were enrolled in the study. We used State-Trait Anxiety Inventory (S...

  13. A cognitive-behavioural program for adolescents with chronic pain - A pilot study

    OpenAIRE

    Merlijn, Vivian; Hunfeld, Joke; Wouden, Hans; Hazebroek-Kampschreur, Alice; van Suijlekom-Smit, Lisette; Koes, Bart; Passchier, Jan

    2005-01-01

    textabstractThe purpose of this pilot study is to evaluate the feasibility of a cognitive-behavioural training program for adolescents with chronic pain irrespective of pain localisation. A secondary aim was to give an impression of the effect of the program on pain and quality of life. Eight adolescents (14-18 years) with chronic non-organic pain recruited from the general population (and their parents) participated in this pilot study. The intervention included five group meetings alternate...

  14. [ECG indices in dogs after inhalation of 239Pu].

    Science.gov (United States)

    Karpova, V N

    1985-11-01

    Dogs of both sexes aged 2 to 4 were subjected to inhalation inoculation with polymer 239Pu or submicron 239PuO2 aerosols in amounts close to acute, subacute and chronically effective ones. ECG was recorded in standard, amplified and single leads (V3). All calculations were done by lead II. Signs of the right heart overburdening were noted in the presence of the P-pulmonale complex, deep S1 wave or cardiac electrical axis of SI-SII-SIII type. Signs of the right heart overburdening were revealed after inhalation of polimer 239Pu (70%). The absence of similar changes in damage caused by 239Pu could be attributed to its fast resorption from the lungs resulting in more moderate lesion of the respiratory organs.

  15. Neuropsychological effects of chronic low-dose exposure to polychlorinated biphenyls (PCBs: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Klett Martin

    2005-10-01

    Full Text Available Abstract Background Exposure to indoor air of private or public buildings contaminated with polychlorinated biphenyls (PCBs has raised health concerns in long-term users. This exploratory neuropsychological group study investigated the potential adverse effects of chronic low-dose exposure to specific air-borne low chlorinated PCBs on well-being and behavioral measures in adult humans. Methods Thirty employees exposed to indoor air contaminated with PCBs from elastic sealants in a school building were compared to 30 non-exposed controls matched for education and age, controlling for gender (age range 37–61 years. PCB exposure was verified by external exposure data and biological monitoring (PCB 28, 101, 138, 153, 180. Subjective complaints, learning and memory, executive function, and visual-spatial function was assessed by standardized neuropsychological testing. Since exposure status depended on the use of contaminated rooms, an objectively exposed subgroup (N = 16; PCB 28 = 0.20 μg/l; weighted exposure duration 17.9 ± 7 years was identified and compared with 16 paired controls. Results Blood analyses indicated a moderate exposure effect size (d relative to expected background exposure for total PCB (4.45 ± 2.44 μg/l; d = 0.4. A significant exposure effect was found for the low chlorinated PCBs 28 (0.28 ± 0.25 μg/l; d = 1.5 and 101 (0.07 ± 0.09 μg/l; d = 0.7. Although no neuropsychological effects exceeded the adjusted significance level, estimation statistics showed elevated effect sizes for several variables. The objectively exposed subgroup showed a trend towards increased subjective attentional and emotional complaints (tiredness and slowing of practical activities, emotional state as well as attenuated attentional performance (response shifting and alertness in a cued reaction task. Conclusion Chronic inhalation of low chlorinated PCBs that involved elevated blood levels was associated with a subtle attenuation of emotional well

  16. The Influence of Chronic Ego Depletion on Goal Adherence: An Experience Sampling Study.

    Directory of Open Access Journals (Sweden)

    Ligang Wang

    Full Text Available Although ego depletion effects have been widely observed in experiments in which participants perform consecutive self-control tasks, the process of ego depletion remains poorly understood. Using the strength model of self-control, we hypothesized that chronic ego depletion adversely affects goal adherence and that mental effort and motivation are involved in the process of ego depletion. In this study, 203 students reported their daily performance, mental effort, and motivation with respect to goal directed behavior across a 3-week time period. People with high levels of chronic ego depletion were less successful in goal adherence than those with less chronic ego depletion. Although daily effort devoted to goal adherence increased with chronic ego depletion, motivation to adhere to goals was not affected. Participants with high levels of chronic ego depletion showed a stronger positive association between mental effort and performance, but chronic ego depletion did not play a regulatory role in the effect of motivation on performance. Chronic ego depletion increased the likelihood of behavior regulation failure, suggesting that it is difficult for people in an ego-depletion state to adhere to goals. We integrate our results with the findings of previous studies and discuss possible theoretical implications.

  17. RESPIRATORY STUDIES IN CHRONIC MOUNTAIN SICKNESS:THE PERUVIAN EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Fabiola León-Velarde

    2005-01-01

    @@ Chronic Mountain Sickness (CMS) is a multifactorial disease caused by a limited capacity to achieve complete adaptation to life under chronic hypoxic conditions. It is accompanied by excessive erythrocitosis (levels of erythrocytes above the normal value set for each altitude), and in advances cases also by pulmonary hypertension. The hypoxemia, caused by central or peripheral respiratory disorders and/or associated to diverse risk factors, produces the excessive erythrocytosis. The most common symptoms are headaches, dizziness, breathlessness, sleep disturbances, tinnitus, physical and mental fatigue, anorexia, and bone and muscle pain. The most common signs are an intermittent or permanent cyanosis, hyperemia and venous dilatation in hands or feet (Monge-M et al., 1928; Winslow and Monge-C, 1987). Aging, respiratory diseases, sleep, menopause, and overweight has proved to be additional risk factors in the development of CMS (Kryger et al., 1978; León-Velarde et al., 1993; Sime et al., 1975; León-Velarde et al., 1997; León-Velarde et al., 2001; Monge-C et al., 1992; Normand et al., 1992)

  18. The Effect of Glucocorticoids on Bone Mass in Patients with Asthma and Chronic obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Evrim Karadağ Saygı

    2005-06-01

    Full Text Available Inhaled corticosteroids and bronchodilators have become a key element in the maintenance treatment of bronchial asthma and chronic obstructive pulmanory disease (COPD. It is well known that long-term systemic steroid use causes osteoporosis, whereas inhaled corticosteroids and bronchodilators have been discussed to be cause of such side-affect. The aim of this study was to detect the effect of long term inhaled/oral steroids and bronchodilators on bone mineral density (BMD with asthma and COPD. Fifty-three patients with bronchial asthma (n=44 and COPD (n=9 were enrolled in this study. BMD were measured and risk factors for osteoporosis were detected. BMD measurements of lumbar area of the spine (L2-4, neck of femur and femoral ward’s triangle zone were performed by the dual energy x-ray absorptiometer (LUNAR. 53 patients evaluated in three groups according to treatment type; 26 patients were using inhaled corticosteroids and bronchodilators (group 1, 18 patients were using only bronchodilators (group 2 and 9 patients were using (group 3 oral corticosteroids and bronchodilators. There were significant differences between group 3 and other two groups in terms of BMD, T and Z scores of the lumbar and femoral neck (p0.05. As a result, we suggest that systemic corticosteroids negatively affect bone mineral density more than inhaled corticosteroids in patients with COPD.

  19. The impact of large tidal volume ventilation on the absorption of inhaled insulin in rabbits

    DEFF Research Database (Denmark)

    Petersen, Astrid Heide; Laursen, Torben; Ahrén, Bo;

    2007-01-01

    Previous studies have shown that ventilation patterns affect absorption of inhaled compounds. Thus, the aim of this study was to investigate the effect of large tidal volume ventilation (LTVV) on the absorption of inhaled insulin in rabbits. Mechanically ventilated rabbits were given human insuli...

  20. Patient considerations in the treatment of COPD: focus on the new combination inhaler umeclidinium/vilanterol

    Directory of Open Access Journals (Sweden)

    Albertson TE

    2015-02-01

    Full Text Available Timothy E Albertson,1–3 Richart Harper,1,2 Susan Murin,1,2 Christian Sandrock1 1Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA; 2Department of Medicine, Veterans Administration Northern California Health Care System, Mather, CA, USA; 3Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA Abstract: Medication adherence among patients with chronic diseases, such as COPD, may be suboptimal, and many factors contribute to this poor adherence. One major factor is the frequency of medication dosing. Once-daily dosing has been shown to be an important variable in medication adherence in chronic diseases, such as COPD. New inhalers that only require once-daily dosing are becoming more widely available. Combination once-daily inhalers that combine any two of the following three agents are now available: 1 a long-acting muscarinic antagonist; 2 a long acting beta2 agonist; and 3 an inhaled corticosteroid. A new once-daily inhaler with both a long-acting muscarinic antagonist, umeclidinium bromide, and a long acting beta2 agonist, vilanterol trifenatate, is now available worldwide for COPD treatment. It provides COPD patients convenience, efficacy, and a very favorable adverse-effects profile. Additional once-daily combination inhalers are available or will soon be available for COPD patients worldwide. The use of once-daily combination inhalers will likely become the standard maintenance management approach in the treatment of COPD because they improve medication adherence. Keywords: medication adherence, long-acting beta2 agonist, long-acting muscarinic antagonist, inhaled corticosteroid, chronic obstructive pulmonary disease