Efficacy and safety of ipratropium bromide/salbutamol sulphate administered in a hydrofluoroalkane metered-dose inhaler for the treatment of COPD

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Bhattacharya A

2016-06-01

Full Text Available Amal Bhattacharya,1 Salil Bhargava,2 Virendra Singh,3 Deepak Talwar,4 Jagdeep Whig,5 Juliet Rebello,6 Shrinivas Purandare,6 Jaideep Gogtay6 1Department of Medicine, MP Shah Medical College, Jamnager, Gujarat, 2Tuberculosis and Chest Diseases, MGM Medical College, Indore, Madhya Pradesh, 3Pulmonary Division, SMS Hospital, Jaipur, Rajasthan, 4Respiratory Diseases, Metro Hospital and Heart Institute, Noida, Uttar Pradesh, 5Department of Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab, 6Clinical Research Department, Cipla Ltd, Mumbai, Maharashtra, India Background: The use of chlorofluorocarbons (CFCs has contributed to the depletion of the stratospheric ozone layer resulting in serious health concerns. Ipratropium bromide/salbutamol sulphate CFC-pressurized metered-dose inhalers (IB/SAL-CFC pMDI have been in widespread use for many years without any apparent ill consequences. This combination has now been reformulated using the hydrofluoroalkane (HFA propellant. This study sought to establish the clinical noninferiority of a new HFA-containing IB/SAL pMDI to the conventional IB/SAL-CFC pMDI in subjects with mild/moderate COPD.Methods: This was a randomized, double-blind, parallel-group, multicenter study in two consecutive periods: a 14-day run-in period followed by a 85-day treatment period. Eligible mild-to-moderate stable COPD subjects aged 40-75 years were enrolled into the study and entered the run-in period during which subjects withdrew all the bronchodilators, except for salbutamol as rescue medication. Subjects were randomized to 85 days treatment with either IB/SAL-HFA or IB/SAL-CFC, 20 µg qid.Results: Of the 290 randomized patients, 249 completed the study. The primary efficacy variable was the change in forced expiratory volume in one second from predose to 60 minutes after dosing on day 85. At the end of the treatment period, the adjusted mean change in forced expiratory volume in one second at 60 minutes was 123�

Factors affecting the efficiency of aerosolized salbutamol delivery via a metered dose inhaler and equine spacer device.

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Pirie, R S; McGorum, B C; Owen, C; Carr, O; Oakley, H; McLachlan, G

2017-06-01

Despite frequent use of metered dose inhalers (MDIs) and spacers in equine practice, limited information exists on the efficiency of aerosol delivery using such devices. We determined the particle size distribution within an MDI-generated salbutamol aerosol delivered via an equine spacer using 'best practice' delivery technique and assessed the effect of variations in MDI use technique (shaking prior to each actuation, rapid repetitive actuations, and MDI angulation) on aerosol delivery efficiency. Under optimal conditions, only 53(±18) μg salbutamol per 100 μg actuation was delivered beyond the spacer. Although this aerosol had a high [89.6% (±2.4)] fine particle (aerodynamic diameter [2.52 (±0.29) μm], and particle size variability [geometric SD - 1.66 (±0.16) μm], within all particle size fractions, there was a high coefficient of variance (31-79%) of the percentage salbutamol delivered between experimental runs, thus impeding any effort to predict drug delivery to the patient during equine inhalation therapy. Despite observable trends and with the exception of minor statistically significant changes in the least abundant particle sizes, none of the deviations from a 'best practice' delivery technique significantly altered the relative salbutamol delivery beyond the spacer, a finding which has potential relevance with regard to maintaining user compliance. © 2016 John Wiley & Sons Ltd.

Impact of droplet evaporation rate on resulting in vitro performance parameters of pressurized metered dose inhalers.

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Sheth, Poonam; Grimes, Matthew R; Stein, Stephen W; Myrdal, Paul B

2017-08-07

Pressurized metered dose inhalers (pMDIs) are widely used for the treatment of pulmonary diseases. The overall efficiency of pMDI drug delivery may be defined by in vitro parameters such as the amount of drug that deposits on the model throat and the proportion of the emitted dose that has particles that are sufficiently small to deposit in the lung (i.e., fine particle fraction, FPF). The study presented examines product performance of ten solution pMDI formulations containing a variety of cosolvents with diverse chemical characteristics by cascade impaction with three inlets (USP induction port, Alberta Idealized Throat, and a large volume chamber). Through the data generated in support of this study, it was demonstrated that throat deposition, cascade impactor deposition, FPF, and mass median aerodynamic diameter of solution pMDIs depend on the concentration and vapor pressure of the cosolvent, and the selection of model throat. Theoretical droplet lifetimes were calculated for each formulation using a discrete two-stage evaporation process model and it was determined that the droplet lifetime is highly correlated to throat deposition and FPF indicating that evaporation kinetics significantly influences pMDI drug delivery. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of InspirEase on the deposition of metered-dose aerosols in the human respiratory tract

International Nuclear Information System (INIS)

Newman, S.P.; Woodman, G.; Clarke, S.W.; Sackner, M.A.

1986-01-01

A radiotracer technique has been used to assess the effects of a 700-ml collapsible holding chamber (InspirEase, Key Pharmaceuticals Inc.) on the deposition of metered-dose aerosols in ten patients with obstructive airways disease (mean forced expiratory volume in one second [FEV1], 64.5 percent of predicted). Patterns of deposition obtained by patients' usual techniques with the metered-dose inhaler (MDI) were compared with those by correct MDI technique (actuation coordinated with slow deep inhalation and followed by ten seconds of breath-holding) and with those by InspirEase. Deposition of aerosol was assessed by placing Teflon particles labelled with 99mTc inside placebo canisters, and inhaling maneuvers were monitored by respiratory inductive plethysmography (Respitrace). Nine of the ten patients had imperfect technique with the MDI, the most prevalent errors being rapid inhalation and failure to hold their breath adequately. With patients' usual MDI techniques, 6.5 +/- 1.2 percent (mean +/- SE) of the dose reached the lungs. This was increased to 11.2 +/- 1.3 percent (p less than 0.02) with correct technique and increased further to 14.8 +/- 1.4 percent (p less than 0.05) with InspirEase. Oropharyngeal deposition exceeded 80 percent of the dose for the MDI alone but was only 9.5 +/- 0.9 percent with InspirEase (p less than 0.01); 59.2 +/- 2.1 percent of the dose was retained within InspirEase itself. It is concluded that InspirEase gives whole lung deposition of metered-dose aerosols greater than that from a correctly used MDI, while oropharyngeal deposition is reduced approximately nine times

Evaluating inhaler use technique in COPD patients

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Pothirat C

2015-07-01

Full Text Available Chaicharn Pothirat, Warawut Chaiwong, Nittaya Phetsuk, Sangnual Pisalthanapuna, Nonglak Chetsadaphan, Woranoot Choomuang Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: Poor inhalation techniques are associated with decreased medication delivery and poor disease control in chronic obstructive pulmonary disease (COPD. The purpose of this study was to evaluate techniques for using inhaler devices in COPD patients.Methods: A prospective cross-sectional study was conducted to assess patient compliance with correct techniques for using inhaler devices across four regimens, ie, the pressurized metered-dose inhaler (pMDI, the pMDI with a spacer, the Accuhaler®, and the Handihaler®. The percentage of compliance with essential steps of correct device usage for each regimen was recorded without prior notification when COPD patients presented for a routine visit, and 1 month after receiving face-to-face training. We compared the percentage of compliance between the devices and risk factors related to incorrect techniques using logistic regression analysis. Percentage of patient compliance with correct techniques was compared between the two visits using the chi-square test. Statistical significance was set at P<0.05.Results: A total of 103 COPD patients (mean age 71.2±9.2 years, males 64.1%, low education level 82.5%, and percent predicted forced expiratory volume in 1 second 51.9±22.5 were evaluated. Seventy-seven patients (74.8% performed at least one step incorrectly. Patients using the Handihaler had the lowest compliance failure (42.5%, and the odds ratio for failure with the other devices compared with the Handihaler were 4.6 (95% confidence interval [CI] 1.8–11.8 for the pMDI, 3.1 (95% CI 1.2–8.2 for the pMDI with a spacer, and 2.4 (95% CI 1.1–5.2 for the Accuhaler. Low education level was the single most important factor related

Inhaled medication for asthma management: evaluation of how asthma patients, medical students, and doctors use the different devices

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Muniz Janaína Barbosa

2003-01-01

Full Text Available Asthma results from a combination of three essential features: airflow obstruction, hyperresponsiveness of airways to endogenous or exogenous stimuli and inflammation. Inadequacy of the techniques to use different inhalation devices is one of the causes of therapeutic failure. The main purpose of this study was to evaluate how 20 medical students, 36 resident physicians of Internal Medicine/Pediatrics, and 40 asthma patients used three devices for inhalation therapy containing placebo. All patients were followed at the Pulmonary Outpatient Service of Botucatu Medical School and had been using inhaled medication for at least six months. The following devices were evaluated: metered dose inhalers (MDI, dry powder inhalers (DPI, and MDI attached to a spacer device. A single observer applied a protocol containing the main steps necessary to obtain a good inhaler technique to follow and grade the use of different devices. Health care professionals tested all three devices and patients tested only the device being used on their management. MDI was the device best known by doctors and patients. MDI use was associated with errors related to the coordination between inspiration and device activation. Failure to exhale completely before inhalation of the powder was the most frequent error observed with DPI use. In summary, patients did not receive precise instruction on how to use inhaled medication and health care professionals were not well prepared to adequately teach their patients.

In vitro tests for aerosol deposition. III: effect of inhaler insertion angle on aerosol deposition.

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Delvadia, Renish R; Longest, P Worth; Hindle, Michael; Byron, Peter R

2013-06-01

Inhaler orientation with respect to a patient's mouth may be an important variable determining the efficiency of aerosol lung delivery. The effect of insertion angle on regional deposition was evaluated for a series of inhalers using concurrent in vitro and computational fluid dynamics (CFD) analysis. Geometrically realistic physical mouth-throat (MT) and upper tracheobronchial (TB) models were constructed to connect different inhalers at a series of insertion angles relative to the horizontal plane of the model. These models were used to assess albuterol sulfate deposition from the Novolizer(®) dry powder inhaler (DPI), Proventil(®) HFA pressurized metered dose inhaler (MDI), and Respimat(®) Soft Mist™ Inhaler (SMI) following the actuation of a single dose. Drug deposition from Novolizer DPI was studied for Salbulin(®) and an experimental "drug only" formulation. Albuterol sulfate was recovered and quantified from the device and the MT and TB regions. Significant differences in MT and total lung dose (TLD) of albuterol sulfate deposition were not observed for Salbulin Novolizer DPI and Respimat SMI inserted at different angles. In contrast, drug-only Novolizer DPI and Proventil HFA MDI showed a significant difference in MT and TLD deposition using different insertion angles. For drug-only Novolizer DPI and Proventil HFA MDI, the lowest and the highest MT depositions were observed at +10° and -20°, respectively; for Respimat SMI and Salbulin Novolizer DPI, these angles were -10° and +10°, and +20° and -20°, respectively. CFD simulations were in agreement with the experimental results and illustrated shifts in local particle deposition associated with changes in insertion angle. The effect of inhaler orientation at the inhaler-mouth interface on MT aerosol deposition appeared to be dependent on velocity, aerosol size, and formulation. These findings not only demonstrate the need for patient education on correct inhaler orientation, but provide important

The effect of actuator nozzle designs on the electrostatic charge generated in pressurised metered dose inhaler aerosols.

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Chen, Yang; Young, Paul M; Fletcher, David F; Chan, Hak Kim; Long, Edward; Lewis, David; Church, Tanya; Traini, Daniela

2015-04-01

To investigate the influence of different actuator nozzle designs on aerosol electrostatic charges and aerosol performances for pressurised metered dose inhalers (pMDIs). Four actuator nozzle designs (flat, curved flat, cone and curved cone) were manufactured using insulating thermoplastics (PET and PTFE) and conducting metal (aluminium) materials. Aerosol electrostatic profiles of solution pMDI formulations containing propellant HFA 134a with different ethanol concentration and/or model drug beclomethasone dipropionate (BDP) were studied using a modified electrical low-pressure impactor (ELPI) for all actuator designs and materials. The mass of the deposited drug was analysed using high performance liquid chromatography (HPLC). Both curved nozzle designs for insulating PET and PTFE actuators significantly influenced aerosol electrostatics and aerosol performance compared with conducting aluminium actuator, where reversed charge polarity and higher throat deposition were observed with pMDI formulation containing BDP. Results are likely due to the changes in plume geometry caused by the curved edge nozzle designs and the bipolar charging nature of insulating materials. This study demonstrated that actuator nozzle designs could significantly influence the electrostatic charges profiles and aerosol drug deposition pattern of pMDI aerosols, especially when using insulating thermoplastic materials where bipolar charging is more dominant.

Comparative study of budesonide as a nebulized suspension vs pressurized metered-dose inhaler in adult asthmatics

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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...... treatment periods with budesonide 0.8 mg b.i.d. administered by a pressurized metered-dose inhaler (pMDI) with spacer (Nebuhaler) and budesonide 1 mg and 4 mg b.i.d. administered by a Pari Inhalier Boy jet nebulizer. The nebulizer was activated only during inspiration. The total mass output was similar from...... the two devices but their fraction of small particles differed by a factor of 2 in favour of pMDI. Effect was evaluated from daily home measurements of peak expiratory flow (PEF), need of beta 2-agonist and symptom scores. Plasma cortisol and budesonide levels were measured in a subgroup of 10 patients...

Evaluation of metered dose inhaler spray velocities using phase Doppler anemometry (PDA).

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Liu, Xiaofei; Doub, William H; Guo, Changning

2012-02-28

Droplet velocity is an important parameter which can significantly influence inhalation drug delivery performance. Together with the droplet size, this parameter determines the efficiency of the deposition of MDI products at different sites within the lungs. In this study, phase Doppler anemometry (PDA) was used to investigate the instantaneous droplet velocity emitted from MDIs as well as the corresponding droplet size distribution. The nine commercial MDI products surveyed showed significantly different droplet velocities, indicating that droplet velocity could be used as a discriminating parameter for in vitro testing of MDI products. The droplet velocity for all tested MDI products decreased when the testing distance was increased from 3 cm to 6 cm from the front of mouthpiece, with CFC formulations showing a larger decrease than HFA formulations. The mean droplet diameters of the nine MDIs were also significantly different from one-another. Droplet size measurements made using PDA (a number-based technique) could not be directly compared to results obtained using laser light scattering measurements (a volume-based technique). This work demonstrates that PDA can provide unique information useful for characterizing MDI aerosol plumes and evaluating MDI drug delivery efficiency. PDA could also aid the evaluation of in vitro equivalence in support of formulation or manufacturing changes and in evaluation of abbreviated new drug applications (ANDAs) for MDIs. Published by Elsevier B.V.

Identification of inhaler technique errors with a routine procedure in Portuguese community pharmacy

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Castel-Branco MM

2017-12-01

Full Text Available Background: A correct selection of drugs prescribed, but also the choice of the appropriate inhaler device, is crucial for the control of respiratory diseases. Objective: To evaluate the inhaler technique and identify potential errors of patients when treated with inhalers by testing a routinary procedure to be implemented in any community pharmacy. Methods: Adults with asthma/COPD and under inhalation therapy were invited to demonstrate how they use their inhalers. After direct observation it was registered whether all the sequential steps included in the summary of product characteristics (SmPC were performed. Results: The study involved 67 patients from 4 community pharmacies (Portugal central region: 34 (50.7% males, 65.4 (SD=18.28 years old, 42 (62.7% with COPD, and 23 (34.3% using more than one inhaler. The 67 patients used 95 inhalers, comprising: 57 (60.0% multiple dose DPI (dry powder inhalers, 18 (18.9% single dose DPI, 16 (16.8% pMDI (pressurized metered dose inhalers, 2 (2.1% pMDI+spacer and 2 (2.1% SMI (soft mist inhalers. No errors were made only by 9 (13.4% patients. In the 75 DPIs techniques, the most frequent errors were ‘no previous forced expiration’ (46=61.3% and ‘no 10s apnea after inhalation’ (51=68.0%; in the 16 pMDIs techniques common errors were ‘lack of hand-lung coordination’ (7=43.8 %, ‘no previous forced exhalation’ (8=50.0% and ‘no apnea after inhalation’ (10=62.5%. After inhaling from 56 devices containing corticosteroids, 34 (60.7% of the patients did not wash their mouth. Conclusion: The study demonstrated the possibility of performing this procedure routinely in Portuguese community pharmacies and also its utility, since 58 (87% of patients had at least one error during the inhalers use.

Deposition and transport of linezolid mediated by a synthetic surfactant Synsurf® within a pressurized metered dose inhaler: a Calu-3 model

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van Rensburg, Lyné; van Zyl, Johann M; Smith, Johan

2018-01-01

Background Previous studies in our laboratory demonstrated that a synthetic peptide containing lung surfactant enhances the permeability of chemical compounds through bronchial epithelium. The purpose of this study was to test two formulations of Synsurf® combined with linezolid as respirable compounds using a pressurized metered dose inhaler (pMDI). Methods Aerosolization efficiency of the surfactant-drug microparticles onto Calu-3 monolayers as an air interface culture was analyzed using a Next Generation Impactor™. Results The delivered particles and drug dose showed a high dependency from the preparation that was aerosolized. Scanning electron microscopy imaging allowed for visualization of the deposited particles, establishing them as liposomal-type structures (diameter 500 nm to 2 μm) with filamentous features. Conclusion The different surfactant drug combinations allow for an evaluation of the significance of the experimental model system, as well as assessment of the formulations providing a possible noninvasive, site-specific, delivery model via pMDI.

A cross-sectional observational study to assess inhaler technique in Saudi hospitalized patients with asthma and chronic obstructive pulmonary disease

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Ammari, Maha Al; Sultana, Khizra; Yunus, Faisal; Ghobain, Mohammed Al; Halwan, Shatha M. Al

2016-01-01

Objectives: To assess the proportion of critical errors committed while demonstrating the inhaler technique in hospitalized patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional observational study was conducted in 47 asthmatic and COPD patients using inhaler devices. The study took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia between September and December 2013. Two pharmacists independently assessed inhaler technique with a validated checklist. Results: Seventy percent of patients made at least one critical error while demonstrating their inhaler technique, and the mean number of critical errors per patient was 1.6. Most patients used metered dose inhaler (MDI), and 73% of MDI users and 92% of dry powder inhaler users committed at least one critical error. Conclusion: Inhaler technique in hospitalized Saudi patients was inadequate. Health care professionals should understand the importance of reassessing and educating patients on a regular basis for inhaler technique, recommend the use of a spacer when needed, and regularly assess and update their own inhaler technique skills. PMID:27146622

Changes in body water distribution during treatment with inhaled steroid in pre-school children

DEFF Research Database (Denmark)

Heitmann, B L; Anhøj, Jacob; Bisgaard, A M

2004-01-01

.i.d. delivered via Babyhaler, budesonide pressurized metered dose inhaler (pMDI) 200 microg b.i.d. delivered via Nebuchamber and placebo. Spacers were primed before use. In total, 40 children aged 1-3 years, with mild intermittent asthma were included. Twenty-five of the children completed all three treatments...... overall this effect was not statistically significant (0.1 growth during inhaled steroid treatment seems to partly reflect generalized changes...

Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

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Graham Ian D

2009-10-01

Full Text Available Abstract Background Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers in pediatric emergency departments (PEDs for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs. Methods Using a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs, and respiratory therapists (RTs, and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU categories of elements known to influence the uptake of innovations. Results One hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway. Conclusion Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.

Which inhaled corticosteroid and long-acting β-agonist combination is better in patients with moderate-to-severe asthma, a dry powder inhaler or a pressurized metered-dose inhaler?

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Muraki, Masato; Gose, Kyuya; Hanada, Soichiro; Sawaguchi, Hirochiyo; Tohda, Yuji

2017-11-01

Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which should be recommended for asthma patients with given sets of characteristics. In the current study, the beneficial effects and side effects associated with DPIs and pMDIs were compared, and the question of which device should be recommended for asthma patients was investigated. A prospective, randomized, crossover, comparative study in adult outpatients with asthma was conducted using salmeterol/fluticasone propionate combination (SFC) 50 μg/250 μg, one inhalation of Adoair ® 250 Diskus ® twice daily or two inhalations of Adoair ® 125 Aerosol twice daily, for 8 weeks. Questionnaires, exhaled nitric oxide (FeNO) tests and pulmonary function tests were administered after the use of each device for 8 weeks, and the results derived from each device were compared. Sixty-eight subjects were included in the final analysis. There were no significant differences between quality-of-life scores, FeNO, spirometry test results and forced oscillation results. With regard to patient preferences, 57.4% preferred the Adoair ® Aerosol and 35.3% preferred the Adoair ® Diskus ® , as determined via the comparative evaluation questionnaire. Although DPI prescription accounts for the predominant market share of combined ICS/LABA in Japan, patients preferred a pMDI device to a DPI device. Compared to DPIs, pMDIs may be the preferential choice for patients with asthma.

An In Vitro Aerosolization Efficiency Comparison of Generic and Branded Salbutamol Metered Dose Inhalers

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Sara Rahimkhani, Saeed Ghanbarzadeh, Ali Nokhodchi, Hamed Hamishehkar

2017-03-01

Full Text Available Background: Due to the high rate of pulmonary diseases, respiratory drug delivery systems have been attracted excessive attention for the past decades. Because of limitations and growing drug bill, physicians are encouraged to prescribe generically whenever possible. The purpose of this study was to evaluate whether there was any significant difference in aerosolization performance between a reference brand Salbutamol (A Metered Dose Inhalers (MDIs and two generic products (B and C. Methods: The aerosolization performance of MDIs was evaluated by calculating aerosolization indexes including fine particle fraction (FPF, fine particle dose (FPD, geometric standard deviation (GSD and mass median aerodynamic diameters (MMAD by using the next generation impactor. Results: Although aerosolization indexes of MDI A were superior than the Iranian brands, but the differences were not statistically significant. Conclusion: These results verified that generic MDIs deliver similar quantities of Salbutamol to the reference brand and aerosolization performance parameters of generic Salbutamol MDIs did not differ significantly from the reference brand.

Evaluation of Inhaled Versus Deposited Dose Using the Exponential Dose-Response Model for Inhalational Anthrax in Nonhuman Primate, Rabbit, and Guinea Pig.

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Gutting, Bradford W; Rukhin, Andrey; Mackie, Ryan S; Marchette, David; Thran, Brandolyn

2015-05-01

The application of the exponential model is extended by the inclusion of new nonhuman primate (NHP), rabbit, and guinea pig dose-lethality data for inhalation anthrax. Because deposition is a critical step in the initiation of inhalation anthrax, inhaled doses may not provide the most accurate cross-species comparison. For this reason, species-specific deposition factors were derived to translate inhaled dose to deposited dose. Four NHP, three rabbit, and two guinea pig data sets were utilized. Results from species-specific pooling analysis suggested all four NHP data sets could be pooled into a single NHP data set, which was also true for the rabbit and guinea pig data sets. The three species-specific pooled data sets could not be combined into a single generic mammalian data set. For inhaled dose, NHPs were the most sensitive (relative lowest LD50) species and rabbits the least. Improved inhaled LD50 s proposed for use in risk assessment are 50,600, 102,600, and 70,800 inhaled spores for NHP, rabbit, and guinea pig, respectively. Lung deposition factors were estimated for each species using published deposition data from Bacillus spore exposures, particle deposition studies, and computer modeling. Deposition was estimated at 22%, 9%, and 30% of the inhaled dose for NHP, rabbit, and guinea pig, respectively. When the inhaled dose was adjusted to reflect deposited dose, the rabbit animal model appears the most sensitive with the guinea pig the least sensitive species. © 2014 Society for Risk Analysis.

The use of a quartz crystal microbalance as an analytical tool to monitor particle/surface and particle/particle interactions under dry ambient and pressurized conditions: a study using common inhaler components.

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Turner, N W; Bloxham, M; Piletsky, S A; Whitcombe, M J; Chianella, I

2016-12-19

Metered dose inhalers (MDI) and multidose powder inhalers (MPDI) are commonly used for the treatment of chronic obstructive pulmonary diseases and asthma. Currently, analytical tools to monitor particle/particle and particle/surface interaction within MDI and MPDI at the macro-scale do not exist. A simple tool capable of measuring such interactions would ultimately enable quality control of MDI and MDPI, producing remarkable benefits for the pharmaceutical industry and the users of inhalers. In this paper, we have investigated whether a quartz crystal microbalance (QCM) could become such a tool. A QCM was used to measure particle/particle and particle/surface interactions on the macroscale, by additions of small amounts of MDPI components, in the powder form into a gas stream. The subsequent interactions with materials on the surface of the QCM sensor were analyzed. Following this, the sensor was used to measure fluticasone propionate, a typical MDI active ingredient, in a pressurized gas system to assess its interactions with different surfaces under conditions mimicking the manufacturing process. In both types of experiments the QCM was capable of discriminating interactions of different components and surfaces. The results have demonstrated that the QCM is a suitable platform for monitoring macro-scale interactions and could possibly become a tool for quality control of inhalers.

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

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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

Primary aspergillosis of vocal cord: Long-term inhalational steroid use can be the miscreant

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Arpita Saha

2015-12-01

Full Text Available Primary laryngeal aspergillosis is extremely rare, especially in an immunocompetent host. It is commonly found as a part of systemic infection in immunocompromised patients. A case of vocal cord aspergillosis with no systemic extension in an immunocompetent patient on long-term steroid metered dose inhaler (MDI is presented here, because of its rarity. The present case is a 28-year-old asthmatic female who was on inhalational steroid for 8 years, presented with sudden onset of severe dysphonia for 5 days. Fiberoptic laryngoscopy demonstrated whitish plaque involving right vocal cord, clinically suggestive of fungal laryngitis. Microlaryngeal laser surgery was performed with stripping of the plaque. Histopathology demonstrated ulcerated hyperplastic squamous epithelium with masses of fungal hyphae, which was confirmed to be Aspergillus species on fungal culture. This rare but serious adverse effect of long-term steroid MDI use must be kept in mind while treating an asthmatic patient. We also present a brief review of literature of laryngeal aspergillosis.

Evaluation of workers' exposure to methylene diphenyl diisocyanate (MDI) in an automobile manufacturing company, Iran.

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Kakooei, Hossein; Shahtaheri, Seyed Jamaleddin; Karbasi, Hossein-Ali

2006-01-01

Evaluation of personal inhalation exposure to methylene diphenyl diisocyanate (MDI) among 39 employees, working in the window fixation and window glue processes in an automobile manufacturing company was performed. This study was conducted for both case and control groups. After sampling and sample preparation processes, MDI was determined with a UV-VIS spectrophotometer at 590 nm; the lung function was assessed with a digital spirometer, too. The average concentration of MDI in the window fixation, and window glue workplaces were 34.53 and 27.37 micro g/m3, respectively, which was lower than the threshold limit value (TLV) recommended by the American Conference of Governmental Industrial Hygienists (ACGIH) (51 micro g/m3). Respiratory symptoms in the exposed group were significantly different compared to the unexposed group (p < .05). Lung capacities in the case group were lower than in the control group (p < .05). Therefore, MDI can be easily measured making it possible to evaluate the adverse effects caused by occupational exposure.

RSAC, Gamma Doses, Inhalation and Ingestion Doses, Fission Products Inventory after Fission Products Release

International Nuclear Information System (INIS)

Richardson, L.C.

1967-01-01

1 - Description of problem or function: RSAC generates a fission product inventory from a given set of reactor operating conditions and then computes the external gamma dose, the deposition gamma dose, and the inhalation-ingestion dose to critical body organs as a result of exposure to these fission products. Program output includes reactor operating history, fission product inventory, dosages, and ingestion parameters. 2 - Method of solution: The fission product inventory generated by the reactor operating conditions and the inventory remaining at various times after release are computed using the equations of W. Rubinson in Journal of Chemical Physics, Vol. 17, pages 542-547, June 1949. The external gamma dose and the deposition gamma dose are calculated by determining disintegration rates as a function of space and time, then integrating using Hermite's numerical techniques for the spatial dependence. The inhalation-ingestion dose is determined by the type and quantity of activity inhaled and the biological rate of decay following inhalation. These quantities are integrated with respect to time to obtain the dosage. The ingestion dose is related to the inhalation dose by an input constant

Dose-Dependent Protective Effect of Inhalational Anesthetics Against Postoperative Respiratory Complications

DEFF Research Database (Denmark)

Grabitz, Stephanie D; Farhan, Hassan N; Ruscic, Katarina J

2017-01-01

OBJECTIVES: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications. DESIGN: Prospective analysis of data on file in surgical cases between January 2007...... with endotracheal intubation. INTERVENTIONS: Median effective dose equivalent of inhalational anesthetics during surgery (derived from mean end-tidal inhalational anesthetic concentrations). MEASUREMENTS AND MAIN RESULTS: Postoperative respiratory complications occurred in 6,979 of 124,497 cases (5.61%). High...... inhalational anesthetic dose of 1.20 (1.13-1.30) (median [interquartile range])-fold median effective dose equivalent versus 0.57 (0.45-0.64)-fold median effective dose equivalent was associated with lower odds of postoperative respiratory complications (odds ratio, 0.59; 95% CI, 0.53-0.65; p

Effect of budesonide/formoterol pressurized metered-dose inhaler on exacerbations versus formoterol in chronic obstructive pulmonary disease: The 6-month, randomized RISE (Revealing the Impact of Symbicort in reducing Exacerbations in COPD) study.

Science.gov (United States)

Ferguson, Gary T; Tashkin, Donald P; Skärby, Tor; Jorup, Carin; Sandin, Kristina; Greenwood, Michael; Pemberton, Kristine; Trudo, Frank

2017-11-01

Prevention of exacerbations is a primary goal for chronic obstructive pulmonary disease (COPD) therapy. This randomized, double-blind, double-dummy, parallel-group, multicenter study evaluated the effect of budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus formoterol dry powder inhaler (DPI) on reducing COPD exacerbations. 1219 patients aged ≥40 years with moderate-to-very-severe COPD (per lung function) and a history of ≥1 COPD exacerbation received budesonide/formoterol pMDI 320/9 μg twice daily (BID) during a 4-week run-in. Patients were then randomized 1:1 to receive budesonide/formoterol pMDI 320/9 μg BID (n = 606) or formoterol DPI 9 μg BID (n = 613) for 26 weeks. Exacerbations were identified using predefined criteria for symptom worsening and treatment with systemic corticosteroids and/or antibiotics and/or hospitalization. The primary endpoint was annual rate of exacerbations. Budesonide/formoterol pMDI resulted in a 24% reduction in annual rate of exacerbations (0.85 vs 1.12; rate ratio: 0.76 [95% CI: 0.62, 0.92]; P = 0.006), and a significant risk reduction for time to first exacerbation (hazard ratio: 0.78 [95% CI: 0.64, 0.96]; P = 0.016) versus formoterol DPI. The most commonly reported adverse events (AEs; ≥3%) in budesonide/formoterol and formoterol groups were COPD (4.5% vs 8.6%) and nasopharyngitis (5.0% vs 5.2%). Pneumonia AEs were reported in 0.5% and 1.0% of budesonide/formoterol-treated and formoterol-treated patients, respectively. Budesonide/formoterol pMDI is an effective treatment option for reducing exacerbation rates in COPD patients with moderate-to-very-severe airflow limitation and history of exacerbations. No increase in pneumonia was observed with budesonide/formoterol; safety data were consistent with its established profile. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Inhalation dose assessment for Maralinga and Emu

International Nuclear Information System (INIS)

Johnston, P.N.; Lokan, K.H.; Williams, G.A.

1990-01-01

Dose assessments for the inhalation of artificial radionuclides are presented for all types of contaminated areas at Maralinga and Emu. These enable Committed Effective Dose Equivalent (CEDE), to be estimated by scaling at any area of interest where activity concentrations are known. In the case of Aborigines, these dose are estimated assuming respirable dust loadings of 1 mg/m 3 for adults and 1.5 mg/m 3 for children and infants. Details of the calculations are presented in the appendix. The model of the respiratory system used in this assessment is that described in Interantional Commission on Radiological Protection (ICRP) Publication 30 (ICRP, 1979a). With the exception of Kuli, which is contaminated with uranium, at all other sites it is only the inhalation of plutonium and americium that contributes significantly to the dose, and of these 239 Pu is the largest contributor. Therefore, considering the long half lives of the radionuclides concerned, it appears that the inhalation problems highlighted by this dose assessment will not diminish significantly within any reasonable period of time and hence management strategies must be developed to deal with such problems. 32 refs., 5 tabs., 1 fig

Isocyanate and total inhalable particulate air measurements in the European wood panel industry.

Science.gov (United States)

Vangronsveld, E; Berckmans, S; Verbinnen, K; Van Leeuw, C; Bormans, C

2010-11-01

It is well known that the use of MDI (methylene diphenyldiisocyanate) as an alternative for formaldehyde-based resins is seen as a responsible option to reduce formaldehyde emissions for CWP (Composite Wood Products) in buildings. However, there are concerns raised regarding the exposure risk of workers. The purpose of this article is to provide the reader with factual information to demonstrate that the use of MDI compared to other agents used in CWP production processes does not pose increased inhalation exposure risks for workers. Personal and area air measurements were carried out at nine Composite Wood Panel plants throughout Europe to assess potential inhalation exposures to MDI and wood dust as Total Inhalable Particulates (TIP). In total, 446 pairs of samples were collected for MDI and TIP of which 283 pairs were personal samples and the remaining 163 pairs were area samples collected at key locations along the production line. This data together with published formaldehyde exposure data has been used to evaluate the exposure safety margin opposite what are considered relevant occupational exposure limits. The methods used for sampling and analysing MDI and TIP are based on internationally accepted methods, i.e. MDHS 25/3 (or ISO 16702) for MDI, and MDHS 14/3 for TIP. The job functions with an increased exposure profile for TIP were the cleaners, drying operators and quality control staff, and for MDI, the cleaners and quality control staff. The areas with an increased exposure profile for TIP are the conveyor area from OSB blender to former area and the OSB press infeed, and for MDI the OSB weigh belt and OSB former bin area. The exposure safety margin opposite the selected exposure limits can be ranked as MDI>TIP>formaldehyde (high margin of safety to low margin of safety), indicating that the use of MDI also reduces the exposure risks to workers during production of CWP compared to formaldehyde. By reducing the airborne TIP concentrations, a respiratory

Experiment of aerosol-release time for a novel automatic metered dose inhaler

Directory of Open Access Journals (Sweden)

Mingrong Zhang

2016-05-01

Full Text Available The objective of this study was to evaluate the aerosol-release time in the development of a new automatic adapter for metered dose inhaler. With this device, regular manually operated metered dose inhalers become automatic. During the study, an inhalation simulator was designed and tested with the newly developed mechatronic system. By adjusting the volume and the pressure of the vacuum tank, most human inhalation waveforms were able to simulate. As an example, regular quick-deep and slow-deep waveforms were matched within reasonable accuracy. Finally, with the help of dynamic image processing, the aerosol-release time (Tr was carefully measured and fully discussed, including the switch-on time (Ts, the mechatronics-hysteresis (Tm and the intentional-delay (Ti. Under slow-deep inhalation condition which is suitable for metered dose inhaler medicine delivery, the switch-on flow-rate could reach as low as 10 L/min, and the corresponding switch-on time was approximately 0.20 s. While the mechatronics-hysteresis depended on the brand of metered dose inhaler, assuming there was no intentional-delay, the aerosol-release time could be as low as 0.40 and 0.60 s, respectively, for two commercially available metered dose inhalers studied in this article. Therefore, this newly developed mechatronic adapter system could ensure aerosol-release time (Tr within satisfactory range for metered dose inhalers.

Accidental Cutaneous Burns Secondary to Salbutamol Metered Dose Inhaler

Directory of Open Access Journals (Sweden)

Ashutosh Kale

2010-01-01

Full Text Available We report a case of accidental cutaneous burns caused by salbutamol metered dose inhaler. A 9-year-old boy underwent dental extraction at a children's hospital and was incidentally noted to have burn injuries on dorsum of both hands. On questioning, the boy revealed that a few days ago his 14-year-old brother, who is an asthmatic, playfully sprayed his salbutamol metered dose inhaler on the back of both his hands with the inhaler's mouth piece being in direct contact with the patient's skin. On examination, there was a rectangular area of erythema with superficial peeling on the dorsum of both hands, the dimensions of which exactly matched those of the inhaler's mouthpiece. It is possible that the injury could have been a chemical burn from the pharmaceutical/preservative/propellant aerosol or due to the physical effect of severe cooling of the skin or mechanical abrasive effect of the aerosol blasts or a combination of some or all the above mechanisms. This case highlights the importance of informing children and parents of the potentially hazardous consequences of misusing a metered dose inhaler.

Particle exposure and inhaled dose during commuting in Singapore

Science.gov (United States)

Tan, Sok Huang; Roth, Matthias; Velasco, Erik

2017-12-01

Exposure concentration and inhaled dose of particles during door-to-door trips walking and using motorized transport modes (subway, bus, taxi) are evaluated along a selected route in a commercial district of Singapore. Concentrations of particles smaller than 2.5 μm in size (PM2.5), black carbon, particle-bound polycyclic aromatic hydrocarbons, number of particles, active surface area and carbon monoxide have been measured in-situ using portable instruments. Simultaneous measurements were conducted at a nearby park to capture the background concentrations. The heart rate of the participants was monitored during the measurements as a proxy of the inhalation rate used to calculate the inhaled dose of particles. All measured metrics were highest and well above background levels during walking. No significant difference was observed in the exposure concentration of PM2.5 for the three motorized transport modes, unlike for the metrics associated with ultrafine particles (UFP). The concentration of these freshly emitted particles was significantly lower on subway trips. The absence of combustion sources, use of air conditioning and screen doors at station platforms are effective measures to protect passengers' health. For other transport modes, sections of trips close to accelerating and idling vehicles, such as bus stops, traffic junctions and taxi stands, represent hotspots of particles. Reducing the waiting time at such locations will lower pollutants exposure and inhaled dose during a commute. After taking into account the effect of inhalation and travel duration when calculating dose, the health benefit of commuting by subway for this particular district of Singapore became even more evident. For example, pedestrians breathe in 2.6 and 3.2 times more PM2.5 and UFP, respectively than subway commuters. Public buses were the second best alternative. Walking emerged as the worst commuting mode in terms of particle exposure and inhaled dose.

Reverse water-in-fluorocarbon emulsions for use in pressurized metered-dose inhalers containing hydrofluoroalkane propellants.

Science.gov (United States)

Butz, N; Porté, C; Courrier, H; Krafft, M P; Vandamme, Th F

2002-05-15

Pulmonary administration of drugs has demonstrated numerous advantages in the treatment of pulmonary diseases due to direct targeting to the respiratory tract. It enables avoiding the first pass effect, reduces the amount of drugs administered, targets drugs to specific sites and reduces their side effects. Reverse water-in-fluorocarbon (FC) emulsions are potential drug delivery systems for pulmonary administration using pressurized metered-dose inhalers (pMDI). The external phase of these emulsions consists of perfluorooctyl bromide (PFOB, perflubron), whereas their internal phase contains the drugs solubilized or dispersed in water. These emulsions are stabilized by a perfluoroalkylated dimorpholinophosphate (F8H11DMP), i.e. a fluorinated surfactant. This study demonstrates the possibility of delivering a reverse fluorocarbon emulsion via the pulmonary route using a CFC-free pMDI. Two hydrofluoroalkanes (HFAs) (Solkane(R) 134a and Solkane(R) 227) were used as propellants, and various solution (or emulsion)/propellant ratios (1/3, 1/2, 2/3, 1/1, 3/2, 3/1 v/v) were investigated. The insolubility of water (with or without the fluorinated surfactant F8H11DMP) in both HFA 227 and HFA 134a was demonstrated. PFOB and the reverse emulsion were totally soluble or dispersible in all proportions in both propellants. This study demonstrated also that the reverse FC emulsion can be successfully used to deliver caffeine in a homogeneous and reproducible way. The mean diameter of the emulsion water droplets in the pressured canister was investigated immediately after packaging and after 1 week of storage at room temperature. Best results were obtained with emulsion/propellant ratios comprised between 2/3 and 3/2, and with HFA 227 as propellant.

Estimation of chloroform inhalation dose by other routes based on the relationship of area under the blood concentration-time curve (AUC)-inhalation dose to chloroform distribution in the blood of rats.

Science.gov (United States)

Take, Makoto; Takeuchi, Tetsuya; Haresaku, Mitsuru; Matsumoto, Michiharu; Nagano, Kasuke; Yamamoto, Seigo; Takamura-Enya, Takeji; Fukushima, Shoji

2014-01-01

The present study investigated the time-course changes of concentration of chloroform (CHCl3) in the blood during and after exposure of male rats to CHCl3 by inhalation. Increasing the dose of CHCl3 in the inhalation exposed groups caused a commensurate increase in the concentration of CHCl3 in the blood and the area under the blood concentration-time curve (AUC). There was good correlation (r = 0.988) between the inhalation dose and the AUC/kg body weight. Based on the AUC/kg body weight-inhalation dose curve and the AUC/kg body weight after oral administration, inhalation equivalent doses of orally administered CHCl3 were calculated. Calculation of inhalation equivalent doses allows the body burden due to CHCl3 by inhalation exposure and oral exposure to be directly compared. This type of comparison facilitates risk assessment in humans exposed to CHCl3 by different routes. Our results indicate that when calculating inhalation equivalent doses of CHCl3, it is critical to include the AUC from the exposure period in addition to the AUC after the end of the exposure period. Thus, studies which measure the concentration of volatile organic compounds in the blood during the inhalation exposure period are crucial. The data reported here makes an important contribution to the physiologically based pharmacokinetic (PBPK) database of CHCl3 in rodents.

Immune sensitization to methylene diphenyl diisocyanate (MDI resulting from skin exposure: albumin as a carrier protein connecting skin exposure to subsequent respiratory responses

Directory of Open Access Journals (Sweden)

Redlich Carrie A

2011-03-01

Full Text Available Abstract Background Methylene diphenyl diisocyanate (MDI, a reactive chemical used for commercial polyurethane production, is a well-recognized cause of occupational asthma. The major focus of disease prevention efforts to date has been respiratory tract exposure; however, skin exposure may also be an important route for inducing immune sensitization, which may promote subsequent airway inflammatory responses. We developed a murine model to investigate pathogenic mechanisms by which MDI skin exposure might promote subsequent immune responses, including respiratory tract inflammation. Methods Mice exposed via the skin to varying doses (0.1-10% w/v of MDI diluted in acetone/olive oil were subsequently evaluated for MDI immune sensitization. Serum levels of MDI-specific IgG and IgE were measured by enzyme-linked immunosorbant assay (ELISA, while respiratory tract inflammation, induced by intranasal delivery of MDI-mouse albumin conjugates, was evaluated based on bronchoalveolar lavage (BAL. Autologous serum IgG from "skin only" exposed mice was used to detect and guide the purification/identification of skin proteins antigenically modified by MDI exposure in vivo. Results Skin exposure to MDI resulted in specific antibody production and promoted subsequent respiratory tract inflammation in animals challenged intranasally with MDI-mouse albumin conjugates. The degree of (secondary respiratory tract inflammation and eosinophilia depended upon the (primary skin exposure dose, and was maximal in mice exposed to 1% MDI, but paradoxically limited in mice receiving 10-fold higher doses (e.g. 10% MDI. The major antigenically-modified protein at the local MDI skin exposure site was identified as albumin, and demonstrated biophysical changes consistent with MDI conjugation. Conclusions MDI skin exposure can induce MDI-specific immune sensitivity and promote subsequent respiratory tract inflammatory responses and thus, may play an important role in MDI asthma

An OOP Approach to Simplify MDI Application Development An OOP Approach to Simplify MDI Application Development

Directory of Open Access Journals (Sweden)

Donato Hernández Fusilier

2012-02-01

Full Text Available The Multiple Document Interface (MDI is a Microsoft Windows specification that allows managing multiple documents using a single graphic interface application. An MDI application allows opening several documents simultaneously. Only one document is active at a particular time. MDI applications can be deployed using Win32 or Microsoft Foundation Classes (MFC. Programs developed using Win32 are faster than those using MFC. However, Win32applications are difficult to implement and prone to errors. It should be mentioned that, learning how to properly use MFC to deploy MDI applications is not simple, and performance is typically worse than that of Win32 applications. A method to simplify the development of MDI applications using Object-Oriented Programming (OOP is proposed. Subsequently, it is shown that this method generates compact code that is easier to read and maintain than other methods (i.e., MFC. Finally, it is demonstrated that the proposed method allowsthe rapid development of MDI applications without sacrificing application performance.La Interfase para Múltiples Documentos (MDI es una especificación del sistema operativo Microsoft Windows que permite manipular varios documentos usando un sólo programa. Un programa del tipo MDI permite abrir varios documentos simultáneamente. En un instante dado, sólo un documento es activo. Los programas del tipo MDI pueden desarrollarseu sando Win32 o las clases fundamentales de Microsoft (MFC. Los programas desarrollados usando Win32 son más rápidos que los programas que usan MFC. Sin embargo, éstos son difíciles de implementar promoviendo la existencia de errores. Cabe mencionar que el desarrollo de programas del tipo MDI usando MFC no es sencillo, y que su desempeño estípicamente peor que el de un programa del tipo Win32. Se propone un método que drásticamente simplifica el desarrollo de programas del tipo MDI por medio de la Programación Orientada a Objetos (POO. Se demuestra que el m

Cumulative high doses of inhaled formoterol have less systemic effects in asthmatic children 6-11 years-old than cumulative high doses of inhaled terbutaline.

Science.gov (United States)

Kaae, Rikke; Agertoft, Lone; Pedersen, Sören; Nordvall, S Lennart; Pedroletti, Christophe; Bengtsson, Thomas; Johannes-Hellberg, Ingegerd; Rosenborg, Johan

2004-10-01

To evaluate high dose tolerability and relative systemic dose potency between inhaled clinically equipotent dose increments of formoterol and terbutaline in children. Twenty boys and girls (6-11 years-old) with asthma and normal ECGs were studied. Ten doses of formoterol (Oxis) 4.5 microg (F4.5) or terbutaline (Bricanyl) 500 microg (T500) were inhaled cumulatively via a dry powder inhaler (Turbuhaler) over 1 h (three patients) or 2.5 h (17 patients) and compared to a day of no treatment, in a randomised, double-blind (active treatments only), crossover trial. Blood pressure (BP), ECG, plasma potassium, glucose, lactate, and adverse events were monitored up to 10 h to assess tolerability and relative systemic dose potency. Formoterol and terbutaline had significant beta2-adrenergic effects on most outcomes. Apart from the effect on systolic BP, QRS duration and PR interval, the systemic effects were significantly more pronounced with terbutaline than with formoterol. Thus, mean minimum plasma potassium, was suppressed from 3.56 (95% confidence interval, CI: 3.48-3.65) mmol l(-1) on the day of no treatment to 2.98 (CI: 2.90-3.08) after 10 x F4.5 and 2.70 (CI: 2.61-2.78) mmol l(-1) after 10 x T500, and maximum Q-Tc (heart rate corrected Q-T interval [Bazett's formula]) was prolonged from 429 (CI: 422-435) ms on the day of no treatment, to 455 (CI: 448-462) ms after 10 x F4.5 and 470 (CI: 463-476) ms after 10 x T500. Estimates of relative dose potency indicated that F4.5 microg had the same systemic activity as the clinically less effective dose of 250 microg terbutaline. The duration of systemic effects differed marginally between treatments. Spontaneously reported adverse events (most frequently tremor) were fewer with formoterol (78% of the children) than with terbutaline (95%). A serious adverse event occurred after inhalation of 45 microg formoterol over the 1 h dosing time, that prompted the extension of dosing time to 2.5 h. Multiple inhalations over 2.5 h of

Experiment of aerosol-release time for a novel automatic metered dose inhaler

OpenAIRE

Mingrong Zhang; Songhao Wang; Yu-Ching Yang

2016-01-01

The objective of this study was to evaluate the aerosol-release time in the development of a new automatic adapter for metered dose inhaler. With this device, regular manually operated metered dose inhalers become automatic. During the study, an inhalation simulator was designed and tested with the newly developed mechatronic system. By adjusting the volume and the pressure of the vacuum tank, most human inhalation waveforms were able to simulate. As an example, regular quick-deep and slow-de...

Systemic delivery of atropine sulfate by the MicroDose Dry-Powder Inhaler.

Science.gov (United States)

Corcoran, T E; Venkataramanan, R; Hoffman, R M; George, M P; Petrov, A; Richards, T; Zhang, S; Choi, J; Gao, Y Y; Oakum, C D; Cook, R O; Donahoe, M

2013-02-01

Inhaled atropine is being developed as a systemic and pulmonary treatment for the extended recovery period after chemical weapons exposure. We performed a pharmacokinetics study comparing inhaled atropine delivery using the MicroDose Therapeutx Dry Powder Inhaler (DPIA) with intramuscular (IM) atropine delivery via auto-injector (AUTO). The MicroDose DPIA utilizes a novel piezoelectric system to aerosolize drug and excipient from a foil dosing blister. Subjects inhaled a 1.95-mg atropine sulfate dose from the dry powder inhaler on one study day [5 doses × 0.4 mg per dose (nominal) delivered over 12 min] and received a 2-mg IM injection via the AtroPen® auto-injector on another. Pharmacokinetics, pharmacodynamic response, and safety were studied for 12 hr. A total of 17 subjects were enrolled. All subjects completed IM dosing. One subject did not perform inhaled delivery due to a skin reaction from the IM dose. Pharmacokinetic results were as follows: area under the curve concentration, DPIA=20.1±5.8, AUTO=23.7±4.9 ng hr/mL (means±SD); maximum concentration reached, DPIA=7.7±3.5, AUTO=11.0±3.8 ng/mL; time to reach maximum concentration, DPIA=0.25±0.47, AUTO=0.19±0.23 hr. Pharmacodynamic results were as follows: maximum increase in heart rate, DPIA=18±12, AUTO=23±13 beats/min; average change in 1-sec forced expiratory volume at 30 min, DPIA=0.16±0.22 L, AUTO=0.11±0.29 L. The relative bioavailability for DPIA was 87% (based on output dose). Two subjects demonstrated allergic responses: one to the first dose (AUTO), which was mild and transient, and one to the second dose (DPIA), which was moderate in severity, required treatment with oral and intravenous (IV) diphenhydramine and IV steroids, and lasted more than 7 days. Dry powder inhalation is a highly bioavailable route for attaining rapid and consistent systemic concentrations of atropine.

Design optimization of a novel pMDI actuator for systemic drug delivery.

Science.gov (United States)

Kakade, Prashant P; Versteeg, Henk K; Hargrave, Graham K; Genova, Perry; Williams Iii, Robert C; Deaton, Daniel

2007-01-01

Pressurized metered dose inhalers (pMDIs) are the most widely prescribed and economical respiratory drug delivery systems. Conventional pMDI actuators-those based on "two-orifice-and-sump" designs-produce an aerosol with a reasonable respirable fraction, but with high aerosol velocity. The latter is responsible for high oropharyngeal deposition, and consequently low drug delivery efficiency. Kos' pMDI technology is based on a proprietary vortex nozzle actuator (VNA), an innovative actuator configuration that seeks to reduce aerosol plume velocity, thereby promoting deep lung deposition. Using VNA development as a case study, this paper presents a systematic design optimization process to improve the actuator performance through use of advanced optical characterization tools. The optimization effort mainly relied on laser-based optical diagnostics to provide an improved understanding of the fundamentals of aerosol formation and interplay of various geometrical factors. The performance of the optimized VNA design thus evolved was characterized using phase Doppler anemometry and cascade impaction. The aerosol velocities for both standard and optimized VNA designs were found to be comparable, with both notably less than conventional actuators. The optimized VNA design also significantly reduces drug deposition in the actuator as well as USP throat adapter, which in turn, leads to a significantly higher fine particle fraction than the standard design (78 +/- 3% vs. 63 +/- 2% on an ex valve basis). This improved drug delivery efficiency makes VNA technology a practical proposition as a systemic drug delivery platform. Thus, this paper demonstrates how advanced optical diagnostic and characterization tools can be used in the development of high efficiency aerosol drug delivery devices.

Spiromax, a New Dry Powder Inhaler: Dose Consistency under Simulated Real-World Conditions.

Science.gov (United States)

Canonica, Giorgio Walter; Arp, Jan; Keegstra, Johan René; Chrystyn, Henry

2015-10-01

Spiromax(®) is a novel dry powder inhaler for patients with asthma or chronic obstructive pulmonary disease (COPD). The studies presented here provide further data on attributes (in vitro dosing consistency with budesonide-formoterol (DuoResp) Spiromax; flow rates through empty versions of the Spiromax and Turbuhaler inhaler) of importance to patients with asthma or COPD. Dose-delivery studies were performed using low-, middle-, and high-strength DuoResp Spiromax. Dose consistency was assessed over inhaler life. Total emitted doses (TEDs) were measured at various flow rates, after exposure to high and low temperature or humidity, at different inhaler orientations, and after dropping the inhaler. The criterion for evaluating dose uniformity was whether mean TEDs were within the product specification limits. In separate studies, flow rates were measured after training, using the patient information leaflets, and again after enhanced training as part of a randomized, open-label, cross-over study. Mean values for both budesonide and formoterol were within 85%-115% of the label claim for each strength of DuoResp Spiromax for initial dose uniformity and for the other investigated conditions (temperature, humidity, orientation, dropping, knocking), with the exception of approximately an 80% increase in first dose after dropping the inhaler (subsequent doses not affected). In the flow rate patient study, two patients' inhalations with Spiromax and six with Turbuhaler were 60 L/min. DuoResp Spiromax consistently meets dose uniformity criteria, under controlled laboratory conditions and with variations intended to mimic real-world use. Following enhanced training, all patients in the flow study were able to achieve the minimal inspiratory flow rate of >30 L/min, which is required for effective treatment.

Cumulative high doses of inhaled formoterol have less systemic effects in asthmatic children 6–11 years-old than cumulative high doses of inhaled terbutaline

Science.gov (United States)

Kaae, Rikke; Agertoft, Lone; Pedersen, Sören; Nordvall, S Lennart; Pedroletti, Christophe; Bengtsson, Thomas; Johannes-Hellberg, Ingegerd; Rosenborg, Johan

2004-01-01

Objectives To evaluate high dose tolerability and relative systemic dose potency between inhaled clinically equipotent dose increments of formoterol and terbutaline in children. Methods Twenty boys and girls (6–11 years-old) with asthma and normal ECGs were studied. Ten doses of formoterol (Oxis®) 4.5 µg (F4.5) or terbutaline (Bricanyl®) 500 µg (T500) were inhaled cumulatively via a dry powder inhaler (Turbuhaler®) over 1 h (three patients) or 2.5 h (17 patients) and compared to a day of no treatment, in a randomised, double-blind (active treatments only), crossover trial. Blood pressure (BP), ECG, plasma potassium, glucose, lactate, and adverse events were monitored up to 10 h to assess tolerability and relative systemic dose potency. Results Formoterol and terbutaline had significant β2-adrenergic effects on most outcomes. Apart from the effect on systolic BP, QRS duration and PR interval, the systemic effects were significantly more pronounced with terbutaline than with formoterol. Thus, mean minimum plasma potassium, was suppressed from 3.56 (95% confidence interval, CI: 3.48–3.65) mmol l−1 on the day of no treatment to 2.98 (CI: 2.90–3.08) after 10 × F4.5 and 2.70 (CI: 2.61–2.78) mmol l−1 after 10 × T500, and maximum Q-Tc (heart rate corrected Q-T interval [Bazett's formula]) was prolonged from 429 (CI: 422–435) ms on the day of no treatment, to 455 (CI: 448–462) ms after 10 × F4.5 and 470 (CI: 463–476) ms after 10 × T500. Estimates of relative dose potency indicated that F4.5 µg had the same systemic activity as the clinically less effective dose of 250 µg terbutaline. The duration of systemic effects differed marginally between treatments. Spontaneously reported adverse events (most frequently tremor) were fewer with formoterol (78% of the children) than with terbutaline (95%). A serious adverse event occurred after inhalation of 45 µg formoterol over the 1 h dosing time, that prompted the extension of dosing time to 2.5 h

Impact of multiple-dose versus single-dose inhaler devices on COPD patients’ persistence with long-acting β2-agonists: a dispensing database analysis

Science.gov (United States)

van Boven, Job FM; van Raaij, Joost J; van der Galiën, Ruben; Postma, Maarten J; van der Molen, Thys; Dekhuijzen, PN Richard; Vegter, Stefan

2014-01-01

Background: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients’ persistence with long-acting β2-agonists (LABAs). Aims: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs. Methods: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. Results were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities. Results: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76–1.26, P=0.99). Over 80% re-started or switched medication. Conclusions: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients’ persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year. PMID:25274453

Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations.

Science.gov (United States)

McKeever, Tricia; Mortimer, Kevin; Wilson, Andrew; Walker, Samantha; Brightling, Christopher; Skeggs, Andrew; Pavord, Ian; Price, David; Duley, Lelia; Thomas, Mike; Bradshaw, Lucy; Higgins, Bernard; Haydock, Rebecca; Mitchell, Eleanor; Devereux, Graham; Harrison, Timothy

2018-03-08

Asthma exacerbations are frightening for patients and are occasionally fatal. We tested the concept that a plan for patients to manage their asthma (self-management plan), which included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate, would reduce the incidence of severe asthma exacerbations among adults and adolescents with asthma. We conducted a pragmatic, unblinded, randomized trial involving adults and adolescents with asthma who were receiving inhaled glucocorticoids, with or without add-on therapy, and who had had at least one exacerbation in the previous 12 months. We compared a self-management plan that included an increase in the dose of inhaled glucocorticoids by a factor of 4 (quadrupling group) with the same plan without such an increase (non-quadrupling group), over a period of 12 months. The primary outcome was the time to a first severe asthma exacerbation, defined as treatment with systemic glucocorticoids or an unscheduled health care consultation for asthma. A total of 1922 participants underwent randomization, of whom 1871 were included in the primary analysis. The number of participants who had a severe asthma exacerbation in the year after randomization was 420 (45%) in the quadrupling group as compared with 484 (52%) in the non-quadrupling group, with an adjusted hazard ratio for the time to a first severe exacerbation of 0.81 (95% confidence interval, 0.71 to 0.92; P=0.002). The rate of adverse effects, which were related primarily to local effects of inhaled glucocorticoids, was higher in the quadrupling group than in the non-quadrupling group. In this trial involving adults and adolescents with asthma, a personalized self-management plan that included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate resulted in fewer severe asthma exacerbations than a plan in which the dose was not increased. (Funded by the Health Technology

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

Starting with a higher dose of inhaled corticosteroids in primary care asthma treatment

NARCIS (Netherlands)

van der Molen, T; Meyboom-de Jong, B; Mulder, HH; Postma, DS

New British guidelines on the treatment of asthma (9) advocate starting with a higher dose of inhaled corticosteroids in newly detected asthma patients. We investigated whether initiating inhaled steroid treatment with a higher dose is clinically more effective than a lower dose in steroid naive

Cumulative high doses of inhaled formoterol have less systemic effects in asthmatic children 6-11 years-old than cumulative high doses of inhaled terbutaline

DEFF Research Database (Denmark)

Kaae, Rikke; Agertoft, Lone; Pedersen, Sören

2004-01-01

OBJECTIVES: To evaluate high dose tolerability and relative systemic dose potency between inhaled clinically equipotent dose increments of formoterol and terbutaline in children. METHODS: Twenty boys and girls (6-11 years-old) with asthma and normal ECGs were studied. Ten doses of formoterol (Oxi...

Organ dose from inhaled radionuclides taking lull period into account

International Nuclear Information System (INIS)

Datta, S.

1982-01-01

The dosimetry of inhaled radionuclides is generally carried out in accordance with the lung model recommended by the ICRP Task Group on Lung Dynamics. The relevant expressions are integrated over a given period, assuming continuous inhalation in an atmosphere of constant aerosol concentration. Though for the same amount of intake the dose commitment is found to be independent of variations in the rate of intake, the dose determined over specific intervals of time, is influenced by it or by lull intervals therein. Formulae are developed to arrive at doses to different organs when the subject's intake is constant and continuous for 8 hours, followed by a lull period of 16 hours each day. Results are given for a number of radionuclides and are compared with values characteristic of continuous inhalation. It is observed that when exposure is assumed to be continuous the dose for the same intake of activity is underestimated as compared to the dose when lull period is taken into account. For working periods of 6 days and 30 days the underestimate ranges from 5%-20% and 0.6% to 4.5% respectively. (author)

Radiation dose estimates and hazard evaluations for inhaled airborne radionuclides: Final report

International Nuclear Information System (INIS)

Mewhinney, J.A.

1987-09-01

The project objective was to conduct confirmatory research on physical chemical characteristics of aerosols produced during manufacture of mixed plutonium and uranium oxide nuclear fuel, to determine the radiation dose distribution in tissues of animals after inhalation exposure to representative aerosols of these materials, and to provide estimates of the relationship of radiation dose and biological response in animals after such inhalation exposure. The first chapter summarizes the physical chemical characterization of samples of aerosols collected from gloveboxes at industrial facilities during normal operations. This chapter provides insights into key aerosol characteristics which are of potential importance in determining the biological fate of specific radionuclides contained in the particulates that would be inhaled by humans following accidental release. The second chapter describes the spatial and temporal distribution of radiation dose in tissues of three species of animals exposed to representative aerosols collected from the industrial facilities. These inhalation studies provide a basis for comparison of the influence of physical chemical form of the inhaled particulates and the variability among species of animal in the radiation dose to tissue. The third chapter details to relationship between radiation dose and biological response in rats exposed to two aerosol forms each at three levels of initial pulmonary burden. This study, conducted over the lifespan of the rats and assuming results to be applicable to humans, indicates that the hazard to health due to inhalation of these industrial aerosols is not different than previously determined for laboratory produced aerosol of PuO 2 . Each chapter is processed separately for the data base

Systemic activity of inhaled steroids in 1- to 3-year-old children with asthma

DEFF Research Database (Denmark)

Anhøj, Jacob; Bisgaard, Anne Marie; Bisgaard, Hans

2002-01-01

delivered via pressurized metered-dose inhaler (pMDI) and Babyhaler (FP400), was compared with budesonide, 200 microg twice daily delivered via pMDI and NebuChamber (BUD400), and to placebo. The Babyhaler was primed before use. Knemometry was used to detect systemic steroid activity. It was performed...... with a hand-held knemometer after 1 and 4 weeks of treatment. The increase in lower-leg length within this 3-week period was used as the outcome measure. The intention-to-treat population was analyzed by analysis of variance. RESULTS: The increases in the lower-leg length during placebo, BUD400, and FP400...... treatments were 85, 45, and 34 microm/d, respectively (adjusted mean). The growth in lower-leg length was significantly reduced from both steroid treatments. The difference between BUD400 and placebo was -40 microm/d (n = 25; 95% confidence interval [CI]: -8 to -72). The difference between FP400 and placebo...

COPD patient satisfaction with ipratropium bromide/albuterol delivered via Respimat: a randomized, controlled study

Directory of Open Access Journals (Sweden)

Ferguson GT

2013-03-01

Full Text Available Gary T Ferguson,1 Mo Ghafouri,2 Luyan Dai,2 Leonard J Dunn31Pulmonary Research Institute of Southeast Michigan, Livonia, MI, USA; 2Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA; 3Clinical Research of West Florida, Inc, Clearwater, FL, USABackground: Ipratropium bromide/albuterol Respimat inhaler (CVT-R was developed as an environmentally friendly alternative to ipratropium bromide/albuterol metered-dose inhaler (CVT-MDI, which uses a chlorofluorocarbon propellant.Objective: The objective of this study was to evaluate patient satisfaction, device usage, and long-term safety of CVT-R compared to CVT-MDI, and to the simultaneous administration of ipratropium bromide hydrofluoroalkane (HFA; I and albuterol HFA (A metered-dose inhalers as dual monotherapies (I + A.Design: This is a 48-week, open-label, randomized, active-controlled, parallel-group study (n = 470 comparing CVT-R to CVT-MDI and to I + A.Participants: Patients were at least 40 years of age, diagnosed with chronic obstructive pulmonary disease (COPD, and current or exsmokers.Interventions: Patients were randomized to receive: (1 CVT-R, one inhalation four times daily (QID; or (2 CVT-MDI, two inhalations QID; or (3 I + A two inhalations of each inhaler QID.Main measures: Patient Satisfaction and Preference Questionnaire (PASAPQ performance score (primary endpoint and adverse events.Key results: PASAPQ performance score was significantly higher (CVT-R versus CVT-MDI, 9.6; and CVT-R versus I + A, 6.2; both P < 0.001 when using CVT-R compared to CVT-MDI or I + A at all visits starting from week 3, while CVT-MDI and I + A treatment groups were similar. Time to first COPD exacerbation was slightly longer in the CVT-R group compared to the other treatment groups, although it did not reach statistical significance (CVT-R versus CVT-MDI, P = 0.57; CVT-R versus I + A, P = 0.22. Rates of withdrawal and patient refusal to continue treatment were lower in CVT-R compared with CVT-MDI

Effect of Pressurized Metered Dose Inhaler Spray Characteristics and Particle Size Distribution on Drug Delivery Efficiency.

Science.gov (United States)

Yousefi, Morteza; Inthavong, Kiao; Tu, Jiyuan

2017-10-01

A key issue in pulmonary drug delivery is improvement of the delivery device for effective and targeted treatment. Pressurized metered dose inhalers (pMDIs) are the most popular aerosol therapy device for treating lung diseases. This article studies the effect of spray characteristics: injection velocity, spray cone angle, particle size distribution (PSD), and its mass median aerodynamic diameter (MMAD) on drug delivery. An idealized oral airway geometry, extending from mouth to the main bronchus, was connected to a pMDI device. Inhalation flow rates of 15, 30, and 60 L/min were used and drug particle tracking was a one-way coupled Lagrangian model. The results showed that most particles deposited in the pharynx, where the airway has a reduced cross-sectional area. Particle deposition generally decreased with initial spray velocity and with increased spray cone angle for 30 and 60 L/min flow rates. However, for 15 L/min flow rate, the deposition increased slightly with an increase in the spray velocity and cone angle. The effect of spray cone angle was more significant than the initial spray velocity on particle deposition. When the MMAD of a PSD was reduced, the deposition efficiency also reduces, suggesting greater rates of particle entry into the lung. The deposition rate showed negligible change when the MMAD was more than 8 μm. Spray injection angle and velocity change the drug delivery efficacy; however, the efficiency shows more sensitivity to the injection angle. The 30 L/min airflow rate delivers spray particles to the lung more efficiently than 15 and 60 L/min airflow rate, and reducing MMAD can help increase drug delivery to the lung.

Clinical outcome associated with the use of different inhalation method with and without humidification in asthmatic mechanically ventilated patients.

Science.gov (United States)

Moustafa, Islam O F; ElHansy, Muhammad H E; Al Hallag, Moataz; Fink, James B; Dailey, Patricia; Rabea, Hoda; Abdelrahim, Mohamed E A

2017-08-01

Inhaled-medication delivered during mechanical-ventilation is affected by type of aerosol-generator and humidity-condition. Despite many in-vitro studies related to aerosol-delivery to mechanically-ventilated patients, little has been reported on clinical effects of these variables. The aim of this study was to determine effect of humidification and type of aerosol-generator on clinical status of mechanically ventilated asthmatics. 72 (36 females) asthmatic subjects receiving invasive mechanical ventilation were enrolled and assigned randomly to 6 treatment groups of 12 (6 females) subjects each received, as possible, all inhaled medication using their assigned aerosol generator and humidity condition during delivery. Aerosol-generators were placed immediately after humidifier within inspiratory limb of mechanical ventilation circuit. First group used vibrating-mesh-nebulizer (Aerogen Solo; VMN) with humidification; Second used VMN without humidification; Third used metered-dose-inhaler with AeroChamber Vent (MDI-AV) with humidification; Forth used MDI-AV without humidification; Fifth used Oxycare jet-nebulizer (JN) with humidification; Sixth used JN without humidification. Measured parameters included clinical-parameters reflected patient response (CP) and endpoint parameters e.g. length-of-stay in the intensive-care-unit (ICU-days) and mechanical-ventilation days (MV-days). There was no significant difference between studied subjects in the 6 groups in baseline of CP. VMN resulted in trend to shorter ICU-days (∼1.42days) compared to MDI-AV (p = 0.39) and relatively but not significantly shorter ICU-days (∼0.75days) compared JN. Aerosol-delivery with or without humidification did not have any significant effect on any of parameters studied with very light insignificant tendency of delivery at humid condition to decrease MV-days and ICU-days. No significant effect was found of changing humidity during aerosol-delivery to ventilated-patient. VMN to deliver

MDI: Mathematica database interface for the MFEDB

International Nuclear Information System (INIS)

Wiley, J.C.; Miner, W.H. Jr.; Ross, D.W.

1992-04-01

We describe a new interface for the Magnetic Fusion Energy Database, MFEDB, which uses Mathematica reg-sign as a front end. MDI is a Mathematica package that defines a basic set of MFEDB access functions. The package will also accept standard SQL queries. Each function returns Mathematica-style lists, which can then be manipulated with any of the Mathematica functions. MDI also provides some utility functions for plotting and analyzing the data. The MDI package essentially makes the MFEDB an extension of Mathematica. The user may use any of the many Mathematica front-ends including telnet, X-Windows, or a notebook. The mdi.m package may be obtained by anonymous FTP from the MFEDB site or by use of netmfe, and E-mail database interface. MDI is a example of distributed computing. Behind the user interface, MDI calls an RPC client program that communicates with an RPC server on the MFEDB computer. It relies on the network communication capabilities of Mathematica to connect the user to a workstation running the Mathematica kernel. The Mathematica kernel is then connected to the MFEDB host workstation by a client/server pair of RPC processes. If the Mathematica kernel is to be run on the users' machine, the RPC client program must also be obtained and installed. The MDI RPC server is also available for users who would like to provide their own client software. The server returns ASCII tables from standards queries and may be accessed and processed by any program on the internet that has access to RPC services

Effect of different single-session educational modalities on improving medical students' ability to demonstrate proper pressurized metered dose inhaler technique.

Science.gov (United States)

Dominelli, Giulio S; Dominelli, Paolo B; Rathgeber, Steven L; Webster, Sheila B

2012-05-01

Pressurized metered dose inhalers (pMDIs) remain important therapeutic options for obstructive lung diseases. The ability to instruct and evaluate inhaler technique is a crucial skill that all medical professionals should possess; unfortunately, many professionals lack proficiency with pMDIs. We aimed to determine if brief education interventions of differing modalities can positively affect medical students' skills over the long term. The baseline ability of medical students and first year residents to use pMDIs was scored via a 10-point scoring system. Students were randomized to receive no education, one-on-one instruction, or video instruction. Students were then retested immediately after the education and at the 3-month mark for retention of acquired skills. Video, one-on-one and the placebo groups modalities statistically improved the average medical student's score in the immediate retesting (7.5 and 7.4 vs. 4.7, p grades at the immediate recall significantly improved for both modalities. During retention testing, only video education had a statistically significant improvement in pass rate over the control group, as defined by an average score of 7 or better (8 vs. 1, p improve medical students' ability to use pMDIs in short-term testing. However, only video education retained significant improvement compared with control after 3 months. This suggests that compared with traditional one-on-one teaching, video education is an effective means of teaching medical students how to improve their pMDI technique.

14C-Methylenebisphenylisocyanate (14C-MDI). Study of absorption after single dermal and intradermal administration in rats

International Nuclear Information System (INIS)

Leibold, E.; Hoffmann, H.D.; Hildebrand, B.

1999-01-01

The absorption, distribution and excretion of radioactivity was studied in groups of four male Wistar rats following a single dermal and intradermal administration of 14 C- Methylenebisphenylisocyanate ( 14 C-MDI) at nominal dose levels of 4.0 and 0.4 mg/cm 2 for dermal administration and 0.4 mg/animal for intradermal administration. These dose levels nominally corresponded to 40 and 4.0 mg/animal for dermal administration. Considering the animal weights, dose levels corresponded to about 140 and 14 mg/kg body weight (dermal administration) and 1.4 mg/kg body weight (intradermal administration). In the experiments with dermal administration, animals were exposed for 8 hours and sacrificed 8, 24 or 120 h after beginning of exposure. In the experiment with intradermal administration, animals were sacrificed 120 h after treatment. After dermal administration of 14 C-MDI, mean recoveries of radioactivity from all dose groups were in the range from 97.86 to 108.07% of the total radioactivity administered. Generally, the largest proportion of radioactivity was found at the application site and dressing. The total amount of radioactivity absorbed (including excreta, cage wash, tissues/organs and carcass) increased with increasing sacrifice time. Dermal absorption was very low and quantitatively similar at both dose levels; maximally ca. 0.9 % of the applied radioactivity was absorbed. After intradermal administration of 14 C-MDI, the mean recovery of radioactivity was 100.90 % of the radioactivity administered. The largest proportion of radioactivity was found at the application site. The total amount of radioactivity absorbed (including excreta, cage wash, tissues/organs and carcass) amounted to about 26 % of the radioactivity applied. Irrespective of the mode of administration of 1 4C -MDI, concentrations of radioactivity in tissues and organs generally were below 1 μg Eq/g at 120 h after administration. In summary, the results of this study comparing systemic

Inhalation dose due to indoor radon and thoron concentrations in the surrounding villages of Hyderabad, Andhra Pradesh, India

International Nuclear Information System (INIS)

Sreenath Reddy, M.; Sreenivasa Reddy, B.; Yadagiri Reddy, P.; Gopal Reddy, Ch.; Rama Reddy, K.

2006-01-01

Inhalation of radon, thoron and their decay products is the major contribution to the total radioactive dose received by the human population from the natural radiation. The indoor inhalation doses due to radon, thoron and their progenies in the surrounding villages of Hyderabad, India are evaluated. The average inhalation dose due to radon and its progeny is found to be 0.26 ± 0.21 mSv y -1 and due to thoron and its progeny is 0.35 ± 0.38 mSv y -1 . The inhalation dose is also analyzed based on the types of floor, roof and walls of the dwellings and it is found that the dwellings with mud type construction materials have higher inhalation dose. Generally, the contribution of thoron and its progeny to the total dose is neglected but in the present study area the fractional dose of thoron and its progeny is found to be comparable to that of radon and its progeny. (author)

Increasing Doses of Inhaled Corticosteroids Compared to Adding Long-Acting Inhaled beta(2)-Agonists in Achieving Asthma Control

NARCIS (Netherlands)

O'Byrne, Paul M.; Naya, Ian P.; Kallen, Anders; Postma, Dirkje S.; Barnes, Peter J.

2008-01-01

Background: Combination therapy with inhaled corticosteroids (ICSs) and long-acting beta(2)-agonists (LABAs), or treatment with high doses of ICSs alone improves asthma control when therapy with low-dose ICSs is not sufficient. However, it is not known which of these treatment options is more

Committed effective dose from thoron daughters inhalation

International Nuclear Information System (INIS)

Campos, M.P.; Pecequilo, B.R.S.

2000-01-01

Mankind's interest in natural radiation exposure levels has increased over the past fifty years and it is now recognized that the most significant contributors to human irradiation by natural sources are the short-lived decay products of radon ( 222 Rn) and thoron ( 220 Rn). Despite the thoron short half-life of 55 s, effective dose from inhalation of thoron an its progeny ( 212 Pb and 212 Bi) must be considered, owing to the high thorium background in countries like Brazil, China and India, for example. The indoor committed effective dose was assessed by air sampling at the thorium purification plant and the nuclear materials storage site of the Instituto de Pesquisas Energeticas e Nucleares; Sao Paulo, Brazil. A total of 21 glass fiber filter samples was analyzed by high resolution gamma ray spectrometry in order to obtain the 212 Pb and 212 Bi activities. The equilibrium equivalent concentration (EEC) varied from 0.3 Bq/m 3 to 6.8 Bq/m 3 for the storage site air samples and from 9.9 Bq/m 3 to 249.8 Bq/m 3 for the thorium purification plant air samples. As retention studies indicate a biological half-life of a few hours inhaled thoron progeny in the human lungs, the main fraction of the potential alpha energy (PAEC) deposited is absorbed in the lungs, meaning negligible to the effective dose the contribution of the dose in other times. The committed effective dose due thoron progeny was performed by compartimental analysis following the ICRP 66 lung compartimental model and ICRP 67 lead compartimental model. The values obtained varied from 0.03 mSv/a to 0.67 mSv/a for the storage site air samples and from 0.12 mSv/a to 6.00 mSv/a for the thorium purification plant air samples. (author)

Studies on possibility for alleviation of lifestyle diseases by low-dose irradiation or radon inhalation

International Nuclear Information System (INIS)

Kataoka, T.; Sakoda, A.; Yoshimoto, M.; Nakagawa, S.; Toyota, T.; Nishiyama, Y.; Yamato, K.; Ishimori, Y.; Kawabe, A.; Hanamoto, K.; Taguchi, T.; Yamaoka, K.

2011-01-01

Our previous studies showed the possibility that activation of the anti-oxidative function alleviates various oxidative damages, which are related to lifestyle diseases. Results showed that, low-dose X-ray irradiation activated superoxide dismutase and inhibits oedema following ischaemia-reperfusion. To alleviate ischaemia-reperfusion injury with transplantation, the changes of the anti-oxidative function in liver graft using low-dose X-ray irradiation immediately after exenteration were examined. Results showed that liver grafts activate the anti-oxidative function as a result of irradiation. In addition, radon inhalation enhances the anti-oxidative function in some organs, and alleviates alcohol-induced oxidative damage of mouse liver. Moreover, in order to determine the most effective condition of radon inhalation, mice inhaled radon before or after carbon tetrachloride (CCl 4 ) administration. Results showed that radon inhalation alleviates CCl 4 -induced hepatopathy, especially prior inhalation. It is highly possible that adequate activation of anti-oxidative functions induced by low-dose irradiation can contribute to preventing or reducing oxidative damages, which are related to lifestyle diseases. (authors)

Radiation dose to the lungs due to inhalation of alpha emitters

International Nuclear Information System (INIS)

Haque, A.K.M.M.; Al-Affan, I.A.M.

1987-01-01

The radiation dose to the lungs due to inhalation of radon daughters has been computed with improved data on lung models, aerosol parameters, deposition and clearance mechanisms. The dose corresponds to mean radon concentration of 23 Bq/m 3 indoors (recent NRPB Survey) for different living conditions. The dose rate to basal cells in gen. 5 is 12 mGy/WLM. (author)

{sup 14}C-Methylenebisphenylisocyanate ({sup 14}C-MDI). Study of absorption after single dermal and intradermal administration in rats

Energy Technology Data Exchange (ETDEWEB)

Leibold, E.; Hoffmann, H.D.; Hildebrand, B

1999-07-01

The absorption, distribution and excretion of radioactivity was studied in groups of four male Wistar rats following a single dermal and intradermal administration of {sup 14}C- Methylenebisphenylisocyanate ({sup 14}C-MDI) at nominal dose levels of 4.0 and 0.4 mg/cm{sup 2} for dermal administration and 0.4 mg/animal for intradermal administration. These dose levels nominally corresponded to 40 and 4.0 mg/animal for dermal administration. Considering the animal weights, dose levels corresponded to about 140 and 14 mg/kg body weight (dermal administration) and 1.4 mg/kg body weight (intradermal administration). In the experiments with dermal administration, animals were exposed for 8 hours and sacrificed 8, 24 or 120 h after beginning of exposure. In the experiment with intradermal administration, animals were sacrificed 120 h after treatment. After dermal administration of {sup 14}C-MDI, mean recoveries of radioactivity from all dose groups were in the range from 97.86 to 108.07% of the total radioactivity administered. Generally, the largest proportion of radioactivity was found at the application site and dressing. The total amount of radioactivity absorbed (including excreta, cage wash, tissues/organs and carcass) increased with increasing sacrifice time. Dermal absorption was very low and quantitatively similar at both dose levels; maximally ca. 0.9 % of the applied radioactivity was absorbed. After intradermal administration of {sup 14}C-MDI, the mean recovery of radioactivity was 100.90 % of the radioactivity administered. The largest proportion of radioactivity was found at the application site. The total amount of radioactivity absorbed (including excreta, cage wash, tissues/organs and carcass) amounted to about 26 % of the radioactivity applied. Irrespective of the mode of administration of 1{sup 4C}-MDI, concentrations of radioactivity in tissues and organs generally were below 1 {mu}g Eq/g at 120 h after administration. In summary, the results of this

RSAC-6, Gamma doses, inhalation and ingestion doses, fission products inventory after fission products release

International Nuclear Information System (INIS)

Wenzel, Douglas R.; Schrader, Brad J.

2007-01-01

1 - Description of program or function: RSAC-6 is the latest version of the program RSAC (Radiological Safety Analysis Computer Program). It calculates the consequences of a release of radionuclides to the atmosphere. Using a personal computer, a user can generate a fission product inventory; decay and in-grow the inventory during transport through processes, facilities, and the environment; model the downwind dispersion of the activity; and calculate doses to downwind individuals. Internal dose from the inhalation and ingestion pathways is calculated. External dose from ground surface and plume gamma pathways is calculated. New and exciting updates to the program include the ability to evaluate a release to an enclosed room, resuspension of deposited activity and evaluation of a release up to 1 meter from the release point. Enhanced tools are included for dry deposition, building wake, occupancy factors, respirable fraction, AMAD adjustment, updated and enhanced radionuclide inventory and inclusion of the dose-conversion factors from FOR 11 and 12. 2 - Methods: RSAC6 calculates meteorological dispersion in the atmosphere using Gaussian plume diffusion for Pasquill-Gifford, Hilmeier-Gifford and Markee models. A unique capability is the ability to model Class F fumigation conditions, the meteorological condition that causes the highest ground level concentrations from an elevated release. Doses may be calculated for various pathways including inhalation, ingestion, ground surface, air immersion, water immersion pathways. Dose calculations may be made for either acute or chronic releases. Internal doses (inhalation and ingestion) are calculated using the ICRP-30 model with dose conversion factors from FOR 11. External factors are calculated using FOR 12. 3 - Unusual Features: RSAC6 calculates complete progeny in-growth and decay during all accident phases. The calculation of fission product inventories in particularly useful in the analysis of accidents where the

Determination of albumin adducts of 4,4'-methylenediphenyl diisocyanate after specific inhalative challenge tests in workers.

Science.gov (United States)

Sabbioni, Gabriele; Dongari, Nagaraju; Kumar, Anoop; Baur, Xaver

2016-10-17

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important isocyanate used in the industry. Lung sensitization with bronchial asthma is the main disorder in exposed workers. Albumin adducts of MDI might be involved in specific immunological reactions. MDI adducts with lysine (MDI-Lys) of albumin have been found in MDI-workers and construction workers. MDI-Lys is an isocyanate-specific adduct of MDI with albumin. In the present study, we report MDI-adducts in workers undergoing diagnostic MDI challenge tests. The workers were exposed for 2h to 5ppb of MDI. The adduct levels increase significantly after the exposure to MDI in the challenge chamber. About 0.6% of the dose was bound to albumin. So far, only urinary metabolites of MDI were measured to monitor isocyanate workers. However, such urinary metabolites are not isocyanate specific. Therefore, we propose to measure albumin adducts for monitoring MDI exposed subjects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Radiation load of the electro-thermal production of phosphorus. Part 1. The inhalation dose for operators

International Nuclear Information System (INIS)

Erkens, W.H.H.

2003-01-01

The phosphate ore which is processed by Thermphos International in Vlissingen, Netherlands, to produce element phosphorus contains circa 1 Bq per gram uranium 238. As a result of this production process radionuclides are emitted and slags that contain natural radioisotopes are formed. The slags can be used as a building material for roads and water works. During the production of phosphorus the waste material calcinate is formed as well. Operators, working in the production process of phosphorus and laborers, working in road construction and hydraulic engineering inhale radioisotopes. In two articles attention will be paid to the inhalation doses, how the doses are measured, measures that were taken to reduce and control the doses, and the ALARA-principles. This article is focused on the inhalation doses for operators in the phosphorus production industry [nl

Quantity and Quality of Inhaled Dose Predicts Immunopathology in Tuberculosis

Directory of Open Access Journals (Sweden)

Kevin Patrick Fennelly

2015-06-01

Full Text Available Experimental animal models of tuberculosis (TB have convincingly demonstrated that inhaled dose predicts immunopathology and survival. In contrast, the importance of inhaled dose has generally not been appreciated in TB epidemiology, clinical science, or the practice of TB control. Infectiousness of TB patients has traditionally been assessed using microscopy for acid-fast bacilli in the sputum, which should be considered only a risk factor. We have recently demonstrated that cough aerosol cultures from index cases with pulmonary TB are the best predictors of new infection among household contacts. We suggest that cough aerosols of M. tuberculosis are the best surrogates of inhaled dose, and we hypothesize that the quantity of cough aerosols is associated with TB infection versus disease. Although several factors affect the quality of infectious aerosols, we propose that the particle size distribution of cough aerosols is an important predictor of primary upper airway disease and cervical lymphadenitis and of immune responses in exposed hosts. We hypothesize that large droplet aerosols (> 5 microns containing M. tuberculosis deposit in the upper airway and can induce immune responses without establishing infection. We suggest that this may partially explain the large proportion of humans who never develop TB disease in spite of having immunological evidence of M. tuberculosis infection (e.g. positive TST or IGRA. If these hypotheses are proven true, they would alter the current paradigm of latent TB infection and reactivation, further demonstrating the need for better biomarkers or methods of assessing TB infection and the risk of developing disease.

Dose-effect studies with inhaled plutonium in beagles

International Nuclear Information System (INIS)

Anon.

1982-01-01

Data are presented for all dogs employed in current life-span dose effect studies with inhaled 239 PuO 2 , and 239 Pu nitrate. Information is presented on the estimated initial alveolar deposition, based on external thorax counts and on estimated lung weights at time of exposure. Information is also provided on the current interpretation of the most prominent clinical-pathological features associated with the death of animals

Radon-thoron levels and inhalation dose distribution patterns in India dwellings

International Nuclear Information System (INIS)

Ramachandran, T.V.; Eappen, K.P.; Nair, R.N.; Mayya, Y.S.; Sadasivan, S.

2003-09-01

A countrywide survey on radon and thoron levels has been carried out in Indian dwellings under a Coordinated Research Project sponsored by the Board of Research in Nuclear Sciences (BRNS), Department of Atomic Energy (DAE). Eight universities and a few research institutions from different parts of the country participated in this project. Under this project, radon and thoron levels were measured using Solid State Nuclear Track Detector (SSNTD) -spark counter based passive technique. A plastic twin chamber radon -thoron dosimeter was developed and standardized for the survey. This radon-thoron discriminating dosimeter uses three SSNTDs; two of which are exposed in cup modes and the third one is exposed in bare mode. Calibration factors (CF) are obtained for cup and bare mode SSNTDs through controlled experiments in a calibration facility. Calibration factors obtained from experiments showed very good agreement with the calibration factors derived from theoretical models. Four nodal centres were set up each at Kalpakkam, Jodhpur, Jaduguda and Mumbai for calibration and standardization of the dosimeter system. Inter calibration of the dosimeters were also carried out for comparison purpose. Nearly 4500 measurements in about 1400 dwellings were made during the survey period. An analysis of the data shows that the indoor radon gas concentrations at different locations vary between 4.6 and 147.0 Bq.m -3 with a geometric mean of 23.0 Bq.m -3 (GSD 2.61). Indoor thoron gas concentrations, in general, are found to be less than the radon concentrations and vary from 3.6 to 42.8 Bq.m -3 with a geometric mean of 12.2 Bq.m -3 (GSD 3.22). The mean annual inhalation dose rate due to radon, thoron and their progeny in the dwellings is estimated to be 0.97 mSv.y -1 (GSD 2.49). It is observed that the major contribution to the indoor inhalation dose is due to radon and its progeny. However, the contribution due to thoron and its progeny is not trivial as it is about 20 % of the total

Contribution of inhalation by food animals to man's ingestion dose

International Nuclear Information System (INIS)

Zach, R.

1985-01-01

Animals' inhalation (AI) pathway was evaluated for 57 radionuclides using infant dose predictions from the food-chain model LIMCAL. With ingestion transfer coefficients fMi to define transfer from the respiratory tract to milk, the AI pathway appeared to be insignificant compared to animals' plant ingestion, as implicitly assumed in most environmental assessment models for nuclear installations. Using ICRP Publication 30 respiratory clearance models for man to adjust ingestion transfer coefficients, animals' inhalation appeared to be important, particularly for some actinide radionuclides. The AI pathway also appeared to be significant relative to man's inhalation, especially for infants. The importance of the AI pathway varied greatly between radionuclides, and results strongly suggest that it cannot be ignored in environmental assessments. Until better data become available to implement this pathway fully, adjusted ingestion transfer coefficient values can be used for transfer from animals' respiratory tract to milk and other food products

Aerosol delivery from spacers in wheezy infants: a daily life study

NARCIS (Netherlands)

H.M. Janssens (Hettie); E.M. Heijnen; V.M. de Jong; W.C.J. Hop (Wim); W.P. Holland (Wim); J.C. de Jongste (Johan); H.A.W.M. Tiddens (Harm)

2000-01-01

textabstractThe aims of this study were to assess and compare dose delivery and dose variability of pressurized metered dose inhalers (pMDI)/spacers in wheezy infants in daily life and to investigate factors influencing aerosol delivery. In an open randomized

Radiation load of the electro-thermal production of phosphorus. Part 2. The inhalation dose in road construction

International Nuclear Information System (INIS)

Erkens, W.H.H.; Hermans, P.M.J.A.; Timmermans, C.W.M.

2003-01-01

The phosphate ore which is processed by Thermphos International in Vlissingen, Netherlands, to produce element phosphorus contains circa 1 Bq per gram uranium 238. As a result of this production process radionuclides are emitted and slags that contain natural radioisotopes are formed. The slags can be used as a building material for roads and water works. During the production of phosphorus the waste material calcinate is formed as well. Operators, working in the production process of phosphorus and laborers, working in road construction and hydraulic engineering inhale radioisotopes. In two articles attention will be paid to the inhalation doses, how the doses are measured, measures that were taken to reduce and control the doses, and the ALARA-principles. This article is focused on the inhalation doses for road construction workers [nl

Uncertainty of the thyroid dose conversion factor for inhalation intakes of 131I and its parametric uncertainty

International Nuclear Information System (INIS)

Harvey, R. P.; Hamby, D. M.; Palmer, T. S.

2006-01-01

Inhalation exposures of 131 I may occur in the physical form of a gas as well as a particulate. The physical characteristics pertaining to these different types of releases influence the intake and subsequent dose to an exposed individual. The thyroid dose received is influenced by the route through which 131 I enters the body and its subsequent clearance, absorption and movement throughout the body. The radioactive iodine taken up in the gas-exchange tissues is cleared to other tissues or absorbed into the bloodstream of the individual and transferred to other organs. Iodine in the circulatory system is then taken up by the thyroid gland with resulting dose to that tissue. The magnitude of and uncertainty in the thyroid dose is important to the assessment of individuals exposed to airborne releases of radioiodine. Age- and gender-specific modelling parameters have resulted in significant differences between gas uptake, particulate deposition and inhalation dose conversion factors for each age and gender group. Inhalation dose conversion factors and their inherent uncertainty are markedly affected by the type of iodine intake. These differences are expected due to the modelling of particulate deposition versus uptake of gas in the respiratory tract. Inhalation dose estimates via iodine gases are very similar and separate classifications may not be necessarily based on this assessment. (authors)

Influence of radiation-dose pattern from inhaled beta--gamma-emitting radionuclides on canine peripheral lymphocytes

International Nuclear Information System (INIS)

Jones, R.K.; Boecker, B.B.; Pickrell, J.A.; Hobbs, C.H.; McClellan, R.O.

1976-01-01

As part of studies assess the biological hazards associated with inhaled radionuclides, periodic hematologic evaluations were performed on beagle dogs given a single nose-only exposure to aerosols of beta--gamma-emitting isotopes. The physical form and specific radionuclides selected produced radiation-dose patterns representative of those which might be encountered in the event of human accidental exposures. Dogs received graded lung burdens of either 90 Y, 91 Y, 144 Ce, or 90 Sr, each in fused clay. Differences in the effective half-lives of these radionuclides resulted in a spectrum of cumulative radiation doses to lung delivered at a variety of dose rates. Since the form in which the radionuclides were inhaled was relatively insoluble, the lung and intrathoracic tissues represented the primary recipient of the dose. Regardless of the effective half-life of radionuclide retention, a dose-related depression of peripheral lymphocytes was observed at various times after inhalation exposure. The time at which maximum depression and subsequent recovery occurred, however, was most directly related to the effective half-life of the radionuclide. Of special interest was the persistence of lymphopenia through 2 1 / 2 years after exposure to 144 Ce and 90 Sr in fused clay where, other than tracheobronchial lymph nodes, the lymphoid tissue received very little radiation dose. The possible mechanisms responsible for lymphocyte depression from these various radiation-dose patterns are discussed

Lung dose and lung cancer risk by inhalation of radon daughters

International Nuclear Information System (INIS)

Jacobi, W.

1983-01-01

The inhalation of short-lived radon daughters constitutes the most important occupational radiation exposure in mines, particularly in uranium mines. Among some groups of miners exposed in the past to relatively high radon levels, an excess lung cancer incidence has been observed. In addition to this occupational hazard, the observed radon levels in domestic houses indicate that the inhalation of short-lived radon daughters seems to be the most important component of the radiation exposure of the population from natural sources. For the quantification and judgment of the radiological impact by inhalation of radon daughters in mines as well as in houses, it is necessary to estimate the relationships between the inhaled activity or potential alpha (α) energy of these radionuclides, the dose to target tissues in the lung, and the possible associated lung cancer (LC) risk. It is the purpose of this paper to give a condensed review of our present knowledge in this field and to indicate the main gaps and uncertainties where future research seems necessary

A review of the uncertainties in internal radiation dose assessment for inhaled thorium

International Nuclear Information System (INIS)

Hewson, G.S.

1989-01-01

Present assessments of internal radiation dose to designated radiation workers in the mineral sands industry, calculated using ICRP 26/30 methodology and data, indicate that some workers approach and exceed statutory radiation dose limits. Such exposures are indicative of the need for a critical assessment of work and operational procedures and also of metabolic and dosimetric models used to estimate internal dose. This paper reviews past occupational exposure experience with inhaled thorium compounds, examines uncertainties in the underlying radiation protection models, and indicates the effect of alternative assumptions on the calculation of committed effective dose equivalent. The extremely low recommended inhalation limits for thorium in air do not appear to be well supported by studies on the health status of former thorium refinery workers who were exposed to thorium well in excess of presently accepted limits. The effect of cautious model assumptions is shown to result in internal dose assessments that could be up to an order of magnitude too high. It is concluded that the effect of such uncertainty constrains the usefulness of internal dose estimates as a reliable indicator of actual health risk. 26 refs., 5 figs., 3 tabs

Development of the Muscle Dysmorphia Inventory (MDI).

Science.gov (United States)

Rhea, D J; Lantz, C D; Cornelius, A E

2004-12-01

The development of the 6-factor, 27-item Muscle Dysmorphia Inventory (MDI) was based on Lantz et al. proposed model of characteristics associated with Muscle Dysmorphia. quantitative procedures including item-to-total correlations, exploratory and confirmatory factor analyses, and structure equation modeling confirmed the construct validity of the scale. Convergent validity was also tested. bodybuilding and powerlifting competition venues, weight training facilities, and university athletic venues. the 1(st) study consisted of 77 experienced male free weight lifters. The 2(nd) study consisted of 156 male non-competitive bodybuilders and weight lifters and 168 elite level powerlifters and bodybuilders. The 3(rd) study consisted of 151 male and female bodybuilders and weight lifters. each participant completed demographic information, the MDI, Drive for Thinness subscale of the Eating Disorder Inventory, and the Training Dependency subscale of the Bodybuilding Dependence Scale. Reliability estimates (Cronbach's a) ranged from 0.72 to 0.94. Factor loadings in all 3 studies supported the 6-factor structure (size/symmetry, supplement use, exercise dependence, pharmacological use, dietary behavior, and physique protection). Much of the scale validation was focused on construct validity, however, correlations with the MDI's subscales and the Training Dependency subscale of the Bodybuilding Dependence Scale and the Drive for Thinness subscale of the Eating Disorder Inventory provided evidence of convergent validity also. From these preliminary results, the MDI appears to contribute to the identification of a newly formed disorder by offering a multi-dimensional measure of factors related to Muscle Dysmorphia.

Uncertainties on lung doses from inhaled plutonium.

Science.gov (United States)

Puncher, Matthew; Birchall, Alan; Bull, Richard K

2011-10-01

In a recent epidemiological study, Bayesian uncertainties on lung doses have been calculated to determine lung cancer risk from occupational exposures to plutonium. These calculations used a revised version of the Human Respiratory Tract Model (HRTM) published by the ICRP. In addition to the Bayesian analyses, which give probability distributions of doses, point estimates of doses (single estimates without uncertainty) were also provided for that study using the existing HRTM as it is described in ICRP Publication 66; these are to be used in a preliminary analysis of risk. To infer the differences between the point estimates and Bayesian uncertainty analyses, this paper applies the methodology to former workers of the United Kingdom Atomic Energy Authority (UKAEA), who constituted a subset of the study cohort. The resulting probability distributions of lung doses are compared with the point estimates obtained for each worker. It is shown that mean posterior lung doses are around two- to fourfold higher than point estimates and that uncertainties on doses vary over a wide range, greater than two orders of magnitude for some lung tissues. In addition, we demonstrate that uncertainties on the parameter values, rather than the model structure, are largely responsible for these effects. Of these it appears to be the parameters describing absorption from the lungs to blood that have the greatest impact on estimates of lung doses from urine bioassay. Therefore, accurate determination of the chemical form of inhaled plutonium and the absorption parameter values for these materials is important for obtaining reliable estimates of lung doses and hence risk from occupational exposures to plutonium.

Computational fluid dynamics (CFD) assisted performance evaluation of the Twincer™ disposable high-dose dry powder inhaler.

Science.gov (United States)

de Boer, Anne H; Hagedoorn, Paul; Woolhouse, Robert; Wynn, Ed

2012-09-01

To use computational fluid dynamics (CFD) for evaluating and understanding the performance of the high-dose disposable Twincer™ dry powder inhaler, as well as to learn the effect of design modifications on dose entrainment, powder dispersion and retention behaviour. Comparison of predicted flow and particle behaviour from CFD computations with experimental data obtained with cascade impactor and laser diffraction analysis. Inhaler resistance, flow split, particle trajectories and particle residence times can well be predicted with CFD for a multiple classifier based inhaler like the Twincer™. CFD computations showed that the flow split of the Twincer™ is independent of the pressure drop across the inhaler and that the total flow rate can be decreased without affecting the dispersion efficacy or retention behaviour. They also showed that classifier symmetry can be improved by reducing the resistance of one of the classifier bypass channels, which for the current concept does not contribute to the swirl in the classifier chamber. CFD is a highly valuable tool for development and optimisation of dry powder inhalers. CFD can assist adapting the inhaler design to specific physico-chemical properties of the drug formulation with respect to dispersion and retention behaviour. © 2012 The Authors. JPP © 2012 Royal Pharmaceutical Society.

ANALYSIS OF RESPIRATORY DEPOSITION OF INHALED AMBIENT AEROSOLS FOR DIFFERENT DOSE METRICS

Science.gov (United States)

ANALYSIS OF RESPIRATORY DEPOSITION OF INHALED AMBIENT AEROSOLS FOR DIFFERENT DOSE METRICS.Chong S. Kim, SC. Hu**, PA Jaques*, US EPA, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC 27711; **IIT Research Institute, Chicago, IL; *South...

Age-specific inhalation radiation dose commitment factors for selected radionuclides

International Nuclear Information System (INIS)

Strenge, D.L.; Peloquin, R.A.; Baker, D.A.

1982-08-01

Inhalation dose commitment factors are presented for selected radionuclides for exposure of individuals in four age groups: infant, child, teen and adult. Radionuclides considered are 35 S, 36 Cl, 45 Ca, 67 Ga, 75 Se, 85 Sr, 109 Cd, 113 Sn, 125 I, 133 Ba, 170 Tm, 169 Yb, 182 Ta, 192 Ir, 198 Au, 201 Tl, 204 Tl, and 236 Pu. The calculational method is based on the human metabolic model of ICRP as defined in Publication 2 (ICRP 1959) and as used in previous age-specific dose factor calculations by Hoenes and Soldat (1977). Dose commitment factors are presented for the following organs of reference: total body, bone, liver, kidney, thyroid, lung and lower large intestine

Radioactivity of 210Pb in Japanese cigarettes and radiation dose from smoking inhalation

International Nuclear Information System (INIS)

Sakoda, A.; Fukao, K.; Kawabe, A.; Kataoka, T.; Hanamoto, K.; Yamaoka, K.

2012-01-01

It is well known that cigarette tobaccos contain naturally occurring radioactive nuclides such as 210 Pb and 210 Po. In many countries, the radioactivity of tobaccos has been measured to estimate the effective dose from smoking inhalation. The present study covered 24 cigarette brands including the top 20 of sales in Japan between April 2008 and March 2009. The activity concentrations of 210 Pb were measured by gamma-ray spectrometry, and then those of its progeny ( 210 Po) were evaluated assuming the radioactive equilibrium between the two nuclides. Their concentrations were in the range of 2-14 mBq cigarette -1 with an arithmetic mean of 8±3 mBq cigarette -1 . The annual committed effective doses were also calculated, based on the scenario that a smoker consumes 20 cigarettes a day. The average doses from 210 Pb and 210 Po inhalations were 22±9 and 68±27 uμSv y -1 , respectively. (authors)

In vitro dose comparison of Respimat® inhaler with dry powder inhalers for COPD maintenance therapy

Directory of Open Access Journals (Sweden)

Ciciliani A

2017-05-01

Full Text Available Anna-Maria Ciciliani,1,2 Peter Langguth,1 Herbert Wachtel2 1Institute of Pharmacy and Biochemistry, Faculty 09 (Chemistry, Pharmaceutics and Geosciences, Johannes Gutenberg University, Mainz, 2Analytical Development Department, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany Background: Combining in vitro mouth–throat deposition measurements, cascade impactor data and computational fluid dynamics (CFD simulations, four different inhalers were compared which are indicated for chronic obstructive pulmonary disease (COPD treatment.Methods: The Respimat inhaler, the Breezhaler, the Genuair, and the Ellipta were coupled to the idealized Alberta throat model. The modeled dose to the lung (mDTL was collected downstream of the Alberta throat model using either a filter or a next generation impactor (NGI. Idealized breathing patterns from COPD patient groups – moderate and very severe COPD – were applied. Theoretical lung deposition patterns were assessed by an individual path model.Results and conclusion: For the Respimat the mDTL was found to be 59% (SD 5% for the moderate COPD breathing pattern and 67% (SD 5% for very severe COPD breathing pattern. The percentages refer to nominal dose (ND in vitro. This is in the range of 44%–63% in vivo in COPD patients who display large individual variability. Breezhaler showed a mDTL of 43% (SD 2% for moderate disease simulation and 51% (SD 2% for very severe simulation. The corresponding results for Genuair are mDTL of 32% (SD 2% for moderate and 42% (SD 1% for very severe disease. Ellipta vilanterol particles showed a mDTL of 49% (SD 3% for moderate and 55% (SD 2% for very severe disease simulation, and Ellipta fluticasone particles showed a mDTL of 33% (SD 3% and 41% (SD 2%, respectively for the two breathing patterns. Based on the throat output and average flows of the different inhalers, CFD simulations were performed. Laminar and turbulent steady flow calculations indicated that

Monte Carlo calculation of received dose from ingestion and inhalation of natural uranium

International Nuclear Information System (INIS)

Trobok, M.; Zupunski, Lj.; Spasic-Jokic, V.; Gordanic, V.; Sovilj, P.

2009-01-01

For the purpose of this study eighty samples are taken from the area Bela Crkva and Vrsac. The activity of radionuclide in the soil is determined by gamma- ray spectrometry. Monte Carlo method is used to calculate effective dose received by population resulting from the inhalation and ingestion of natural uranium. The estimated doses were compared with the legally prescribed levels. (author) [sr

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

Dose-effect studies with inhaled plutonium nitrate in dogs

International Nuclear Information System (INIS)

Dagle, G.E.; Cannon, W.C.; Case, A.C.; Madison, R.M.; McShane, J.F.; Stevens, D.L.; Rowe, S.E.; Ragan, H.A.; Schirmer, R.E.

1980-01-01

Beagle dogs given a single inhalation exposure to 239 Pu(NO 3 ) 4 , and observed for life-span dose-effect relationship, died from radiation pneumonitis (four of five at the highest dosage level, in 14 to 25 mo postexposure; 1 of 20 at the medium-high dosage level, at 34 mo postexposure). There were also indications in these dogs of radiation osteosis, characterized by peritrabecular fibrosis. One dog, at 39 mo postexposure, has radiographic evidence of an osteosarcoma. Leukopenia, lymphopenia, neutropenia and decreased numbers of circulating monocytes and eosinophils occurred at the two highest dosage levels, as previously reported (Annual Report, 1978). Twelve dogs given a single inhalation exposure to 238 Pu(NO 3 ) 4 showed a more rapid translocation of 238 Pu(NO 3 ) 4 to bone and liver than was observed for 239 Pu(NO 3 ) 4 , but at 1 yr postexposure the percentage of the final body burden in bone and liver were similar for the two isotopes

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... KB] Using a metered dose inhaler (inhaler in mouth) Your browser does not support iframes Using a metered dose inhaler (inhaler in mouth) [PDF – 370 KB] Your browser does not support ...

The mitochondrial outer membrane protein MDI promotes local protein synthesis and mtDNA replication.

Science.gov (United States)

Zhang, Yi; Chen, Yong; Gucek, Marjan; Xu, Hong

2016-05-17

Early embryonic development features rapid nuclear DNA replication cycles, but lacks mtDNA replication. To meet the high-energy demands of embryogenesis, mature oocytes are furnished with vast amounts of mitochondria and mtDNA However, the cellular machinery driving massive mtDNA replication in ovaries remains unknown. Here, we describe a Drosophila AKAP protein, MDI that recruits a translation stimulator, La-related protein (Larp), to the mitochondrial outer membrane in ovaries. The MDI-Larp complex promotes the synthesis of a subset of nuclear-encoded mitochondrial proteins by cytosolic ribosomes on the mitochondrial surface. MDI-Larp's targets include mtDNA replication factors, mitochondrial ribosomal proteins, and electron-transport chain subunits. Lack of MDI abolishes mtDNA replication in ovaries, which leads to mtDNA deficiency in mature eggs. Targeting Larp to the mitochondrial outer membrane independently of MDI restores local protein synthesis and rescues the phenotypes of mdi mutant flies. Our work suggests that a selective translational boost by the MDI-Larp complex on the outer mitochondrial membrane might be essential for mtDNA replication and mitochondrial biogenesis during oogenesis. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Measurement of specific parameters for dose calculation after inhalation of aerols containing transuranium elements

International Nuclear Information System (INIS)

Ramounet-le Gall, B.; Fritsch, P.; Abram, M.C.; Rateau, G.; Grillon, G.; Guillet, K.; Baude, S.; Berard, P.; Ansoborlo, E.; Delforge, J.

2002-01-01

A review on specific parameter measurements to calculate doses per unit of incorporation according to recommendations of the International Commission of Radiological Protection has been performed for inhaled actinide oxides. Alpha activity distribution of the particles can be obtained by autoradiography analysis using aerosol sampling filters at the work places. This allows us to characterize granulometric parameters of 'pure' actinide oxides, but complementary analysis by scanning electron microscopy is needed for complex aerosols. Dissolution parameters with their standard deviation are obtained after rat inhalation exposure, taking into account both mechanical lung clearance and actinide transfer to the blood estimated from bone retention. In vitro experiments suggest that the slow dissolution rate might decrease as a function of time following exposure. Dose calculation software packages have been developed to take into account granulometry and dissolution parameters as well as specific physiological parameters of exposed individuals. In the case of poorly soluble actinide oxides, granulometry and physiology appear as the main parameters controlling dose value, whereas dissolution only alters dose distribution. Validation of these software packages are in progress. (author)

TPP-dendrimer nanocarriers for siRNA delivery to the pulmonary epithelium and their dry powder and metered-dose inhaler formulations.

Science.gov (United States)

Bielski, Elizabeth; Zhong, Qian; Mirza, Hamad; Brown, Matthew; Molla, Ashura; Carvajal, Teresa; da Rocha, Sandro R P

2017-07-15

The regulation of genes utilizing the RNA interference (RNAi) mechanism via the delivery of synthetic siRNA has great potential in the treatment of a variety of lung diseases. However, the delivery of siRNA to the lungs is challenging due to the poor bioavailability of siRNA when delivered intraveneously, and difficulty in formulating and maintaining the activity of free siRNA when delivered directly to the lungs using inhalation devices. The use of non-viral vectors such as cationic dendrimers can help enhance the stability of siRNA and its delivery to the cell cytosol. Therefore, in this work, we investigate the ability of a triphenylphosphonium (TPP) modified generation 4 poly(amidoamine) (PAMAM) dendrimer (G4NH 2 -TPP) to enhance the in vitro transfection efficiency of siRNA in a model of the pulmonary epithelium and their aerosol formulations in pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs). Complexes of siRNA and G4NH 2 -TPP were prepared with varying TPP densities and increasing N/P ratios. The complexation efficiency was modulated by the presence of the TPP on the dendrimer surface, allowing for a looser complexation compared to unmodified dendrimer as determined by gel electrophoresis and polyanion competition assay. An increase in TPP density and N/P ratio led to an increase in the in vitro gene knockdown of stably green fluorescent protein (eGFP) expressing lung alveolar epithelial (A549) cells. G4NH 2 -12TPP dendriplexes (G4NH 2 PAMAM dendrimers containing 12 TPP molecules on the surface complexed with siRNA) at N/P ratio 30 showed the highest in vitro gene knockdown efficiency. To assess the potential of TPP-dendriplexes for pulmonary use, we also developed micron particle technologies for both pMDIs and DPIs and determined their aerosol characteristics utilizing an Andersen Cascade Impactor (ACI). Mannitol microparticles encapsulating 12TPP-dendriplexes were shown to be effective in producing aerosols suitable for deep lung

Using smartphone as a motion detector to collect time-microenvironment data for estimating the inhalation dose

International Nuclear Information System (INIS)

Hoi, Tran Xuan; Phuong, Huynh Truc; Van Hung, Nguyen

2016-01-01

During the production of iodine-131 from neutron irradiated tellurium dioxide by the dry distillation, a considerable amount of "1"3"1I vapor is dispersed to the indoor air. People who routinely work at the production area may result in a significant risk of exposure to chronic intake by inhaled "1"3"1I. This study aims to estimate the inhalation dose for individuals manipulating the "1"3"1I at a radioisotope production. By using an application installed on smartphones, we collected the time-microenvironment data spent by a radiation group during work days in 2015. Simultaneously, we used a portable air sampler combined with radioiodine cartridges for grabbing the indoor air samples and then the daily averaged "1"3"1I concentration was calculated. Finally, the time-microenvironment data jointed with the concentration to estimate the inhalation dose for the workers. The result showed that most of the workers had the annual internal dose in 1÷6 mSv. We concluded that using smartphone as a motion detector is a possible and reliable way instead of the questionnaires, diary or GPS-based method. It is, however, only suitable for monitoring on fixed indoor environments and limited the targeted people. - Highlights: • We constructed the time-microenvironment patterns with 1-min resolution by using a smartphone application. • Exposure to "1"3"1I at the dry distillation areas may lead to an acute inhalation dose significantly. • Using smartphone as a motion detector in indoor exposure monitoring is a reliable method.

Influence of variations in dose and dose rates on biological effects of inhaled beta-emitting radionuclides

International Nuclear Information System (INIS)

McClellan, R.O.; Benjamin, S.A.; Boecker, B.B.; Hahn, F.F.; Hobbs, C.H.; Jones, R.K.; Lundgren, D.L.

1976-01-01

The biological effects of inhaled β-emitting radionuclides, 90 Y, 91 Y, 144 Ce and 90 Sr, are being investigated in beagle dogs that received single acute exposures at 12 to 14 months of age. The aerosols studied have included 91 YC1 3 , 144 CeC1 3 , 90 SrC1 2 , and 90 Y, 91 Y, 144 Ce or 90 Sr in aluminosilicate particles. Thus, 91 YCl 3 , 144 CeCl 3 and the aluminosilicate containing radionuclide particles all resulted in significant exposures to lung; 91 YC1 3 , 144 CeC1 3 an 90 SrC1 2 resulted in significant exposures to bone; 91 YC1 3 and 144 CeC1 3 resulted in significant exposures to liver. The higher initial doserate exposures have been more effective than low dose-rate exposures on a per-rad basis in producing early effects. To date ( 144 CeO 2 , it was observed that, on a μCi initial lung burden per kilogram body weight basis, mice did not develop pulmonary tumours whereas beagle dogs did. To fid out the reason for this observation mice have been repeatedly exposed by inhalation to 144 CeO 2 to maintain lung burdens of 144 Ce that resulted in radiation dose rates similar to that observed in beagle dogs. Several of the repeatedly exposed mice developed malignant pulmonary tumours. Thus, with similar dose rates and cumulative doses to the lung, mice and dogs responded in a similar manner to chronic β radiation

ANALYSIS OF RESPIRATORY DESPOSITION DOSE OF INHALED AMBIENT AEROSOLS FOR DIFFERENT SIZE FRACTIONS

Science.gov (United States)

ANALYSIS OF RESPIRATORY DEPOSITION DOSE OF INHALED AMBIENT AEROSOLS FOR DIFFERENT SIZE FRACTIONS. Chong S. Kim, SC. Hu**, PA Jaques*, US EPA, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC 27711; **IIT Research Institute, Chicago, IL; *S...

Saharan dust levels in Greece and received inhalation doses

Directory of Open Access Journals (Sweden)

C. Mitsakou

2008-12-01

Full Text Available The desert of Sahara is one of the major sources of mineral dust on Earth, producing around 2×10⁸ tons/yr. Under certain weather conditions, dust particles from Saharan desert get transported over the Mediterranean Sea and most of Europe. The limiting values set by the directive EC/30/1999 of European Union can easily be exceeded by the transport of desert dust particles in the south European Region and especially in urban areas, where there is also significant contribution from anthropogenic sources. In this study, the effects of dust transport on air quality in several Greek urban areas are quantified. PM₁₀ concentration values from stationary monitoring stations are compared to dust concentrations for the 4-year period 2003–2006. The dust concentration values in the Greek areas were estimated by the SKIRON modelling system coupled with embedded algorithms describing the dust cycle. The mean annual dust contribution to daily-averaged PM₁₀ concentration values was found to be around or even greater than 10% in the urban areas throughout the years examined. Natural dust transport may contribute by more than 20% to the annual number of exceedances – PM₁₀ values greater than EU limits – depending on the specific monitoring location. In a second stage of the study, the inhaled lung dose received by the residents in various Greek locations is calculated. The particle deposition efficiency of mineral dust at the different parts of the human respiratory tract is determined by applying a lung dosimetry numerical model, which incorporates inhalation dynamics and aerosol physical processes. The inhalation dose from mineral dust particles was greater in the upper respiratory system (extrathoracic region and less significant in the lungs, especially in the sensitive alveolar region. However, in cases of dust episodes, the amounts of mineral dust deposited along the human lung are comparable to those

From dust to dose: Effects of forest disturbance on increased inhalation exposure.

Science.gov (United States)

Whicker, Jeffrey J; Pinder, John E; Breshears, David D; Eberhart, Craig F

2006-09-15

Ecosystem disturbances that remove vegetation and disturb surface soils are major causes of excessive soil erosion and can result in accelerated transport of soils contaminated with hazardous materials. Accelerated wind erosion in disturbed lands that are contaminated is of particular concern because of potential increased inhalation exposure, yet measurements regarding these relationships are lacking. The importance of this was highlighted when, in May of 2000, the Cerro Grande fire burned over roughly 30% of Los Alamos National Laboratory (LANL), mostly in ponderosa pine (Pinus ponderosa) forest, and through areas with soils containing contaminants, particularly excess depleted and natural uranium. Additionally, post-fire thinning was performed in burned and unburned forests on about 25% of LANL land. The first goal of this study was to assess the potential for increased inhalation dose from uranium contaminated soils via wind-driven resuspension of soil following the Cerro Grande Fire and subsequent forest thinning. This was done through analysis of post-disturbance measurements of uranium air concentrations and their relationships with wind velocity and seasonal vegetation cover. We found a 14% average increase in uranium air concentrations at LANL perimeter locations after the fire, and the greatest air concentrations occurred during the months of April-June when wind velocities are highest, no snow cover, and low vegetation cover. The second goal was to develop a methodology to assess the relative contribution of each disturbance type towards increasing public and worker exposure to these resuspended soils. Measurements of wind-driven dust flux in severely burned, moderately burned, thinned, and unburned/unthinned forest areas were used to assess horizontal dust flux (HDF) in these areas. Using empirically derived relationships between measurements of HDF and respirible dust, coupled with onsite uranium soil concentrations, we estimate relative increases in

Characterization of a New High-Dose Dry Powder Inhaler (DPI) Based on a Fluidized Bed Design.

Science.gov (United States)

Farkas, Dale R; Hindle, Michael; Longest, P Worth

2015-11-01

The objective of this study was to develop a new high-efficiency dry powder inhaler (DPI) that can effectively aerosolize large masses (25-100 mg) of spray dried powder formulations. The DPI was designed to implement a concept similar to a fluidized bed for aerosolization using small mixing balls made of polytetrafluoroethylene along with a larger, hollow dosing sphere filled with the powder. The performance of the fluidized bed DPI was compared, based on emitted dose (ED) and aerosolization efficiency, to other recently developed capsule-based DPIs that were designed to accommodate smaller powder masses (~2-20 mg). The inhalers were tested with spray dried excipient enhanced growth (EEG) formulations that contained an antibiotic (ciprofloxacin) and hygroscopic excipient (mannitol). The new fluidized bed design produced an ED of 71% along with a mass median aerodynamic diameter of 1.53 μm and fine particle fractions <5 and 1 μm of 93 and 36%, respectively, when used to deliver a 100 mg loaded mass of EEG powder with the advantage of not requiring multiple capsules. Surprisingly, performance of the device was further improved by removing the mixing balls from the inhaler and only retaining the dose containment sphere.

In vitro performance of three combinations of spacers and pressurized metered dose inhalers for treatment in children

DEFF Research Database (Denmark)

Berg, E; Madsen, J; Bisgaard, H

1998-01-01

The performance of pressurized metered dose inhalers (pMDIs) and spacers in correct dose recommendations is important, but limited information on dose delivery and fine-particle dose from different combinations of spacers and pMDIs is available. In this study, three combinations of spacers and p...... and spacers, with the NebuChamber giving the highest dose, both as delivered dose and in droplets account for these differences....

Formulation and Development of Metered Dose Inhalations of Salbutamol in Solution Form

Science.gov (United States)

Khale, Anubha; Bajaj, Amrita

2011-01-01

In the present study attempts were made to prepare metered dose inhalation of salbutamol in solution form and compared it with the marketed metered dose inhalation in suspension form. Solution form of the drug was found better than marketed suspension formulation with respect to homogeneity and content uniformity. Propellant blend P-11 and P-12 in the proportion 30:70 was selected as it gave optimum vapour pressure. Surfactant oleic acid in concentration 10 mg per can was selected as it gave best results with clarity, spray pattern, vapour pressure, content per spray and rate of evaporation. Ethyl alcohol 2 ml per can was used as a cosolvent to give a clear solution, optimum vapour pressure, maximum content per spray and fair rate of evaporation. The selected formulation was subjected to the physico-chemical evaluation tests as per the standard pharmacopoeial procedures and the characteristics of the formulations were further compared with a conventional marketed formulation. In vitro study reveled the net respirable fraction was better than marketed preparation. PMID:22923867

Influences of the Ratio of Polyol and MDI on the Acoustic Parameters of Polyurethane

Science.gov (United States)

Wang, Yonghua; Liu, Zheming; Wu, Haiquan; Zhang, Chengchun; Yu, Huadong; Ren, Luquan; Ichchou, Mohamed

2018-05-01

In this paper, the influence of different ratio of polyol and MDI on the absorption coefficient and acoustic parameters of polyurethane was studied. Ratio of 100:40 and 100:45 show the best sound absorption performance, and the change trend of transmission loss and sound absorption coefficient are opposite. The flow resistance increased with the increasing of the ratio of polyol and MDI, the greater the flow resistance, the worse the high frequency sound absorption property of the polyurethane. When the ratio of polyol and MDI keep 100:45, the minimum porosity of sample, the polyurethane porosity increase with the ratio of polyol and MDI increase.

Humidity affects the morphology of particles emitted from beclomethasone dipropionate pressurized metered dose inhalers.

Science.gov (United States)

Ivey, James W; Bhambri, Pallavi; Church, Tanya K; Lewis, David A; McDermott, Mark T; Elbayomy, Shereen; Finlay, Warren H; Vehring, Reinhard

2017-03-30

The effects of propellant type, cosolvent content, and air humidity on the morphology and solid phase of the particles produced from solution pressurized metered dose inhalers containing the corticosteroid beclomethasone dipropionate were investigated. The active ingredient was dissolved in the HFA propellants 134a and 227ea with varying levels of the cosolvent ethanol and filled into pressurized metered dose inhalers. Inhalers were actuated into an evaporation chamber under controlled temperature and humidity conditions and sampled using a single nozzle, single stage inertial impactor. Particle morphology was assessed qualitatively using field emission scanning electron microscopy and focused ion beam-helium ion microscopy. Drug solid phase was assessed using Raman microscopy. The relative humidity of the air during inhaler actuation was found to have a strong effect on the particle morphology, with solid spheroidal particles produced in dry air and highly porous particles produced at higher humidity levels. Air humidification was found to have no effect on the solid phase of the drug particles, which was predominantly amorphous for all tested formulations. A critical level of air relative humidity was required to generate porous particles for each tested formulation. This critical relative humidity was found to depend on the amount of ethanol used in the inhaler, but not on the type of propellant utilized. The results indicate that under the right circumstances water vapor saturation followed by nucleated water condensation or ice deposition occurs during particle formation from evaporating propellant-cosolvent-BDP droplets. This finding reveals the importance of condensed water or ice as a templating agent for porosity when particle formation occurs at saturated conditions, with possible implications on the pharmacokinetics of solution pMDIs and potential applications in particle engineering for drug delivery. Copyright © 2017 Elsevier B.V. All rights reserved.

From dust to dose: Effects of forest disturbance on increased inhalation exposure

International Nuclear Information System (INIS)

Whicker, Jeffrey J.; Pinder, John E.; Breshears, David D.; Eberhart, Craig F.

2006-01-01

Ecosystem disturbances that remove vegetation and disturb surface soils are major causes of excessive soil erosion and can result in accelerated transport of soils contaminated with hazardous materials. Accelerated wind erosion in disturbed lands that are contaminated is of particular concern because of potential increased inhalation exposure, yet measurements regarding these relationships are lacking. The importance of this was highlighted when, in May of 2000, the Cerro Grande fire burned over roughly 30% of Los Alamos National Laboratory (LANL), mostly in ponderosa pine (Pinus ponderosa) forest, and through areas with soils containing contaminants, particularly excess depleted and natural uranium. Additionally, post-fire thinning was performed in burned and unburned forests on about 25% of LANL land. The first goal of this study was to assess the potential for increased inhalation dose from uranium contaminated soils via wind-driven resuspension of soil following the Cerro Grande Fire and subsequent forest thinning. This was done through analysis of post-disturbance measurements of uranium air concentrations and their relationships with wind velocity and seasonal vegetation cover. We found a 14% average increase in uranium air concentrations at LANL perimeter locations after the fire, and the greatest air concentrations occurred during the months of April-June when wind velocities are highest, no snow cover, and low vegetation cover. The second goal was to develop a methodology to assess the relative contribution of each disturbance type towards increasing public and worker exposure to these resuspended soils. Measurements of wind-driven dust flux in severely burned, moderately burned, thinned, and unburned/unthinned forest areas were used to assess horizontal dust flux (HDF) in these areas. Using empirically derived relationships between measurements of HDF and respirible dust, coupled with onsite uranium soil concentrations, we estimate relative increases in

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... metered dose inhaler with a spacer [ PDF – 377 KB] Your browser does not support iframes Cómo usar ... inhalador de dosis fija con espaciador [PDF – 343 KB] Using a metered dose inhaler (inhaler in mouth) ...

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

International Nuclear Information System (INIS)

Hirayama, Akio; Kishimoto, Yoichiro; Shinohara, Kunihiko.

1978-01-01

The computer program ACRO has been developed to calculate organ doses from acute or chronic inhalation and ingestion of radionuclides. The ICRP Task Group Lung Model (TGLM) was used for inhalation model, and a simple one-compartment model for ingestion. This program is written in FORTRAN IV, and can be executed with storage requirements of about 260 K bytes. (auth.)

Granulometric determinations and inhalation dose assessment for atmospheric aerosol contaminated by 137Cs

International Nuclear Information System (INIS)

Castellani, C.M.; Luciani, A.; Oliviero, L.; Donato, R.

1996-07-01

During the redevelopment of Brescia freight-yard a measurement campaign of atmospheric aerosol was carried out: in fact a 137 Cs ground contamination, caused by the permanence of wagons carrying iron materials contaminated by this radionuclide, had been found out. During the redevelopment phases of excavation and can filling the workers were exposed to the danger of radioactive aerosol inhalation. The aim of the measurement campaign was to test the aerosol sampling and granulometric analysis methodologies with their sensitivity related to the inhalation dose assessments. The results of both aerosuspended mass and activity, evaluated by means of a portable cascade impactor, are presented. The granulometries have been interpolated with a log normal distribution using an iterative routine minimizing the square deviation between the calculated and experimental data. The results related to the dose assessments are also presented. These evaluations have been carried out using both the granulometric information obtained and the more recent models (ICRP 66) both the total concentration data and the dose coefficients referring to the standard conditions of ICRP 68 and of the Italian law (D.Lgs. 230/95). Furthermore the significance and the reliability of the dose assessments referring to the different methodologies are discussed, also in relation to the possibility of using this sampling methodologies for other radionuclides and different exposure conditions

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

International Nuclear Information System (INIS)

Strenge, D.L.; Peloquin, R.A.

1981-04-01

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

ANALYSIS OF RESPIRATORY DEPOSITION OF INHALED PARTICLES FOR DIFFERENT DOSE METRICS: COMPARISON OF NUMBER, SURFACE AREA AND MASS DOSE OF TYPICAL AMBIENT BI-MODAL AEROSOLS

Science.gov (United States)

ANALYSIS OF RESPIRATORY DEPOSITION OF INHALED PARTICLES FOR DIFFERENT DOSE METRICS: COMPARISON OF NUMBER, SURFACE AREA AND MASS DOSE OF TYPICAL AMBIENT BI-MODAL AEROSOLS.Chong S. Kim, SC. Hu*, PA Jaques*, US EPA, National Health and Environmental Effects Research Laboratory, ...

Using smartphone as a motion detector to collect time-microenvironment data for estimating the inhalation dose.

Science.gov (United States)

Hoi, Tran Xuan; Phuong, Huynh Truc; Van Hung, Nguyen

2016-09-01

During the production of iodine-131 from neutron irradiated tellurium dioxide by the dry distillation, a considerable amount of (131)I vapor is dispersed to the indoor air. People who routinely work at the production area may result in a significant risk of exposure to chronic intake by inhaled (131)I. This study aims to estimate the inhalation dose for individuals manipulating the (131)I at a radioisotope production. By using an application installed on smartphones, we collected the time-microenvironment data spent by a radiation group during work days in 2015. Simultaneously, we used a portable air sampler combined with radioiodine cartridges for grabbing the indoor air samples and then the daily averaged (131)I concentration was calculated. Finally, the time-microenvironment data jointed with the concentration to estimate the inhalation dose for the workers. The result showed that most of the workers had the annual internal dose in 1÷6mSv. We concluded that using smartphone as a motion detector is a possible and reliable way instead of the questionnaires, diary or GPS-based method. It is, however, only suitable for monitoring on fixed indoor environments and limited the targeted people. Copyright © 2016 Elsevier Ltd. All rights reserved.

Computational fluid dynamics (CFD) assisted performance evaluation of the Twincer (TM) disposable high-dose dry powder inhaler

NARCIS (Netherlands)

de Boer, Anne H.; Hagedoorn, Paul; Woolhouse, Robert; Wynn, Ed

Objectives To use computational fluid dynamics (CFD) for evaluating and understanding the performance of the high-dose disposable Twincer (TM) dry powder inhaler, as well as to learn the effect of design modifications on dose entrainment, powder dispersion and retention behaviour. Methods Comparison

Albuterol Delivery via Facial and Tracheostomy Route in a Model of a Spontaneously Breathing Child.

Science.gov (United States)

Cooper, Brandy; Berlinski, Ariel

2015-12-01

Some pediatric patients receiving therapeutic aerosols undergo tracheostomy, and others who are tracheostomized continue requiring inhaled therapies upon decannulation. It is unknown whether a dose adjustment is required. Different devices are available for facial and tracheostomy delivery, and in some instances, the assisted technique is used. We hypothesized that the change from face mask to tracheostomy would result in a decrease in the lung dose. A breathing simulator connected in series to a filter holder and an anatomically correct head model of a child was used. The drug captured in the filter was termed the lung dose. Breathing patterns with tidal volumes of 50, 155, and 300 mL were tested. Albuterol hydrofluoroalkane (pressurized metered-dose inhaler [pMDI]) with an AeroChamber Mini (face and 4.5-mm tracheostomy), AeroTrach (4.5-mm tracheostomy), and AeroChamber (face) and albuterol (2.5 mg/3 mL) with a continuous output nebulizer (face and 4.5-mm tracheostomy) were tested. Masks were used for facial delivery. Four units of each device were tested. Particle size of the pMDI was measured by cascade impaction. Albuterol concentration was determined via spectrophotometry (276 nm). Switching from facial to tracheostomy delivery increased lung dose with nebulizer (all breathing patterns). When a pMDI was used, lung dose was unchanged or increased for the 50- and 155-mL and decreased for the 300-mL breathing pattern. The use of the assisted technique increased lung dose only during nebulization with the 300-mL breathing pattern. The particle size of the pMDI decreased by 19-23% when traveling through the tracheostomy tube, which retained tracheostomy was variable and depended on the delivery device and the breathing pattern. There is no advantage of using the assisted technique to enhance aerosol delivery. Copyright © 2015 by Daedalus Enterprises.

The variation of organ doses with the particle size and chemical form of an inhaled radioactive aerosol

International Nuclear Information System (INIS)

Hunt, B.W.; Adams, N.; Reissland, J.A.

1979-04-01

In this report, radiation doses to organs are calculated as a function of the particle size of the inhaled radioactive material. Aerosols with an Activity Median Aerodynamic Diameter (AMAD) from 0.1 μm to 20 μm are considered and doses accumulated by various organs in periods ranging from 1 day to 70 years are given for 65 radionuclides. A computer program is used which calculates the transformations taking place in each organ per curie of inhaled nuclide from the basic radioactivity and metabolic data. The program also calculates the resulting doses both for the organ in which the transformations occur and from penetrating radiation emitted as a result of transformations in other organs. The effects of particle size and chemical form of the nuclides on the doses received by organs are discussed. Tables of doses accumulated by 10 specific organs and other organs together with effective whole body doses are given for particle sizes 0.1 μm, 1 μm and 10 μm (AMAD). (author)

Growth of extrapulmonary tumours after inhalation of small doses of plutonium oxide by rats

International Nuclear Information System (INIS)

Nolibe, D.; Masse, R.; L'Hullier, I.; Metivier, H.; Lafuma, J.

1983-01-01

After inhalation of plutonium oxide ( 239 PuO 2 ) involving initial lung burdens ranging from 74 to 103 Bq, male rats of the Wistar strain are kept in conditions allowing maximum survival; tumour incidences for the target organ (lung) and for the rest of the organs are calculated separately after the death of the animals. In the outbred Wistar rat the incidence of lung tumours is 18.5% for an initial lung burden of 74 Bq. The mean survival time of animals having such tumours is 973 days after inhalation. For an initial burden of 103 Bq syngenetic Wistar AG rats show a lower frequency of lung tumours (6.1%), but also a much reduced mean survival time, namely 757 days. Compared with the frequencies observed in the corresponding control groups, the frequency of non-pulmonary tumours is twice as high (12%) in consanguineous rats and six times as high (25.9%) in conventional rats. A supralinear dose-effect relationship at very low doses seems improbable in view of the dose delivered ( -3 Gy in the most exposed organs, such as the liver) and, in particular, because there is no correlation between the dose delivered to the organs and the location of the tumours. The exposed animals show, on the one hand, no specificity of organs for the surplus extrapulmonary tumours observed, and on the other, an inhibition by about 45% in the natural cytotoxic activity (natural killers) measured one year after inhalation. These observations suggest the hypothesis that an anti-tumour control mechanism is affected, perhaps as a result of the irradiation experienced during the circulation of blood cells in the lung capillaries. The failure of this system would in that case allow the expression of neoplastic characters as ageing progresses. A non-specific BCG immunotherapy does not restore this anti-tumour control system. (author)

Inhalation Therapy in Horses.

Science.gov (United States)

Cha, Mandy L; Costa, Lais R R

2017-04-01

This article discusses the benefits and limitations of inhalation therapy in horses. Inhalation drug therapy delivers the drug directly to the airways, thereby achieving maximal drug concentrations at the target site. Inhalation therapy has the additional advantage of decreasing systemic side effects. Inhalation therapy in horses is delivered by the use of nebulizers or pressured metered dose inhalers. It also requires the use of a muzzle or nasal mask in horses. Drugs most commonly delivered through inhalation drug therapy in horses include bronchodilators, antiinflammatories, and antimicrobials. Copyright © 2016 Elsevier Inc. All rights reserved.

Can patients with asthma feel inhaler therapy working right away? Two clinical trials testing the effect of timing of assessment on patient perception.

Science.gov (United States)

Leidy, Nancy Kline; Gutierrez, Benjamin; Lampl, Kathy; Uryniak, Tom; O'Brien, Christopher D

2009-12-01

Feeling a maintenance therapy work right away may provide positive reinforcement and may offer one way to improve adherence in patients with asthma. Precise measurement is required to accurately compare the presence of this effect across clinical trial treatment groups. Two randomized, controlled studies tested whether timing of assessment (daily vs weekly, study 1; and predose vs postdose, study 2) influenced patients' reports of whether they can feel a medication working right away (perception), and their satisfaction with this perception (satisfaction). These 2-week US-based multicenter double-blind, parallel-group studies included patients > or = 18 years of age with mild to moderate persistent asthma. In each, patients were randomized to one of two drugs with different onset profiles: budesonide/formoterol pressurized metered-dose inhaler (pMDI) 80/4.5 microg x 2 inhalations (160/9 microg) twice daily or budesonide pMDI 80 microg x 2 inhalations (160 microg) twice daily. Patients were further randomized to complete previously validated perception and satisfaction questions in a cross-over fashion, either daily and weekly (N = 123) or predose and postdose (N = 134). Patient surveys also assessed perceptions of the onset of effect of medication and their value of these perceptions. No significant differences were observed in patients' reports of perception, either daily versus weekly or predose versus postdose. A statistically significant difference in satisfaction was found in study 1 only, favoring weekly recall (p away (136 of 157 patients) identified positive airway sensations. Most patients reported that feeling their medication work right away is reassuring and would help them manage their asthma. Assessment timing has no effect on patient response to the perception of feeling a medication working right away. Differences found in satisfaction levels reported with weekly versus daily recall were consistent across treatment groups, indicating that no bias

Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

Directory of Open Access Journals (Sweden)

Darbà J

2016-02-01

Full Text Available Josep Darbà,1 Gabriela Ramírez,2 Antoni Sicras,3 Laura García-Bujalance,4 Saku Torvinen,5 Rainel Sánchez-de la Rosa6 1Department of Economics, Universitat de Barcelona, 2BCN Health Economics & Outcomes Research S.L., 3Department of Planning, Badalona Serveis Assistencials S.A., Barcelona, 4Market Access Department, Teva Pharmaceutical, Madrid, Spain; 5Market Access Department, Teva Pharmaceuticals Europe BV, Amsterdam, the Netherlands; 6Medical Department, Teva Pharmaceutical, Madrid, Spain Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213 whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler®, Turbuhaler®, and NEXThaler® or pressurized metered-dose inhalers (pMDI. Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results: The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second, comorbidities and general practitioner (GP consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29–39, 40–50, and 51–61 age groups or suffering from more than two

Doses from potential inhalation by people living near plutonium contaminated areas

International Nuclear Information System (INIS)

Iranzo Gonzales, E.; Salvador Ruiz, S.

1983-09-01

An aviation accident above the town of Palomares, Spain resulted in four thermonuclear bombs carried by one of the planes falling. The nuclear fuel in two of them ignited and formed an aerosol which contaminated a 226-hectare area of underbrush, farmland and an urban center. The magnitude of risk to people living in the area who may have inhaled the plutonium aerosol or dusts during the fifteen-year period since the time the accident is addressed in this report. In addition the internal radiation doses that people may have received during this period and during a fifty-year period commencing with the accident is estimated. In brief summary, the lungs received the greatest dose equivalent (1966 to 1980). Over the fifty year period (to 2015) the bones are projected to receive the greatest dose. For the remaining organs - liver-intestines-kidneys, - the relationships or between the doses that will be accumulated up to the year 2015 and the corresponding annual dose equivalent limits are less than those for the bones and lungs

Design and Development of a Salbutamol Intake Detector for Low Respiratory Treatment

Science.gov (United States)

Vui Hin, Tsen; Ilyani Ramli, Nur

2017-08-01

This paper proposed a new salbutamol intake detector design using asthma spacer and gas sensor. The device enable real time monitoring of propellant level inhaled by the infant which will decrease the recovery time of the asthma attack. Microcontroller Arduino UNO is program to control the input and output of the system. MQ6 gas sensor detecting the propellant Hydrofluoroalkane from the metered dose inhaler (MDI) canister and demonstrated the level of propellant inhaled on the LCD in real time. MQ6 gas sensor suitable used to detect concentration of propellant inside the asthma spacer due to it is low sensitive to natural gas where include the carbon dioxide exhaled by the infant. Besides this, MQ6 gas sensor also highly sensitive to propane and the preview aerosol inventor mentioned propane as propellant which used for MDI to push the salbutamol out from MDI canister. Therefore, MQ6 gas sensor is suitable to detect propellant inside asthma spacer. The output voltage of MQ6 in initial state where no propellant inside asthma spacer is between 0.55V and 0.65V. Furthermore, when the MDI canister is been pressed, the concentration of propellant is increased and the output voltage of MQ6 gas sensor also increased in ranged between 1.1V and 1.2V.

Reversibility of pulmonary function after inhaling salbutamol in different doses and body postures in asthmatic children.

Science.gov (United States)

Visser, R; Kelderman, S; de Jongh, F H C; van der Palen, J; Thio, B J

2015-10-01

Pulmonary medication is often delivered in the form of medical aerosols designed for inhalation. Recently, breath actuated inhalers (BAI's) gained popularity as they can be used without spacers. A major drawback of BAI's is the impaction in the upper airway. Stretching the upper airway by a forward leaning body posture with the neck extended ("sniffing position") during inhalation may reduce upper airway impaction and improve pulmonary deposition. Aim of this study was to investigate the reversibility of lung function with different doses salbutamol inhaled with a BAI in the forward leaning posture compared to the standard posture in asthmatic children. 22 clinically stable asthmatic children, 5-14 years old, performed four reversibility measurements. Children inhaled 200 μg or 400 μg salbutamol with a BAI in the standard or in the forward leaning posture with the neck extended in a randomized single-blinded cross-over design. Reversibility of lung function after inhaling salbutamol in the forward leaning posture was not significantly different compared to inhalation in the standard posture. Mean FEV1 reversibility was significantly greater after inhaling 400 μg salbutamol compared to 200 μg salbutamol in the standard posture (9.4% ± 9.5% versus 4.5% ± 7.5%, difference 4.9% (95CI 0.9; 9.0%); p = 0.021). In clinically stable asthmatic children, inhalation of salbutamol with a BAI in a forward leaning posture does not increase reversibility of lung function. Inhalation of 400 μg compared to 200 μg salbutamol with a BAI does improve reversibility. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reliability of the MDi Psoriasis® Application to Aid Therapeutic Decision-Making in Psoriasis.

Science.gov (United States)

Moreno-Ramírez, D; Herrerías-Esteban, J M; Ojeda-Vila, T; Carrascosa, J M; Carretero, G; de la Cueva, P; Ferrándiz, C; Galán, M; Rivera, R; Rodríguez-Fernández, L; Ruiz-Villaverde, R; Ferrándiz, L

2017-09-01

Therapeutic decisions in psoriasis are influenced by disease factors (e.g., severity or location), comorbidity, and demographic and clinical features. We aimed to assess the reliability of a mobile telephone application (MDi-Psoriasis) designed to help the dermatologist make decisions on how to treat patients with moderate to severe psoriasis. We analyzed interobserver agreement between the advice given by an expert panel and the recommendations of the MDi-Psoriasis application in 10 complex cases of moderate to severe psoriasis. The experts were asked their opinion on which treatments were most appropriate, possible, or inappropriate. Data from the same 10 cases were entered into the MDi-Psoriasis application. Agreement was analyzed in 3 ways: paired interobserver concordance (Cohen's κ), multiple interobserver concordance (Fleiss's κ), and percent agreement between recommendations. The mean percent agreement between the total of 1210 observations was 51.3% (95% CI, 48.5-54.1%). Cohen's κ statistic was 0.29 and Fleiss's κ was 0.28. Mean agreement between pairs of human observers only, excluding the MDi-Psoriasis recommendations, was 50.5% (95% CI, 47.6-53.5%). Paired agreement between the recommendations of the MDi-Psoriasis tool and the majority opinion of the expert panel (Cohen's κ) was 0.44 (68.2% agreement). The MDi-Psoriasis tool can generate recommendations that are comparable to those of experts in psoriasis. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

New Delivery Systems and Propellants

Directory of Open Access Journals (Sweden)

Myrna Dolovich

1999-01-01

Full Text Available The removal of chlorofluorocarbon (CFC propellants from industrial and household products has been agreed to by over 165 countires of which more than 135 are developing countries. The timetable for this process is outlined in the Montreal Protocol on Substances that Deplete the Ozone Layer document and in several subsequent amendments. Pressured metered dose inhalers (pMDIs for medical use have been granted temporary exemptions until replacement formulations, providing the same medication via the same route, and with the same efficacy and safety profiles, are approved for human use. Hydrofluoroalkanes (HFAs are the alternative propellants for CFCs-12 and -114. Their potential for damage to the ozone layer is nonexistent, and while they are greenhouse gases, their global warming potential is a fraction (one-tenth of that of CFCs. Replacement formulations for almost all inhalant respiratory medications have been or are being produced and tested; in Canada, it is anticipated that the transition to these HFA or CFC-free pMDIs will be complete by the year 2005. Initially, an HFA pMDI was to be equivalent to the CFC pMDI being replaced, in terms of aerosol properties and effective clinical dose. However, this will not necessarily be the situation, particularly for some corticosteroid products. Currently, only one CFC-free formulation is available in Canada – Airomir, a HFA salbutamol pMDI. This paper discusses the in vitro aerosol characteristics, in vivo deposition and clinical data for several HFA pMDIs for which there are data available in the literature. Alternative delivery systems to the pMDI, namely, dry powder inhalers and nebulizers, are briefly reviewed.

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.

Age-dependent doses to members of the public from intake of radionuclides: Pt. 5. Compilation of ingestion and inhalation dose coefficients

International Nuclear Information System (INIS)

1996-01-01

The present report is a compilation of age-dependent committed effective dose coefficients for ingestion and inhalation of radionuclides of the 31 elements covered in previous CRP Publications. The biokinetic models for adults given in ICRP Publication 30 are applied to calculate these dose coefficients, except that age-specific excretion rates are used and increased gastrointestinal absorption in infants is assurred. Changes in body mass, and tissue geometry in children are also taken into account. (UK)

Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations.

Science.gov (United States)

Jackson, Daniel J; Bacharier, Leonard B; Mauger, David T; Boehmer, Susan; Beigelman, Avraham; Chmiel, James F; Fitzpatrick, Anne M; Gaffin, Jonathan M; Morgan, Wayne J; Peters, Stephen P; Phipatanakul, Wanda; Sheehan, William J; Cabana, Michael D; Holguin, Fernando; Martinez, Fernando D; Pongracic, Jacqueline A; Baxi, Sachin N; Benson, Mindy; Blake, Kathryn; Covar, Ronina; Gentile, Deborah A; Israel, Elliot; Krishnan, Jerry A; Kumar, Harsha V; Lang, Jason E; Lazarus, Stephen C; Lima, John J; Long, Dayna; Ly, Ngoc; Marbin, Jyothi; Moy, James N; Myers, Ross E; Olin, J Tod; Raissy, Hengameh H; Robison, Rachel G; Ross, Kristie; Sorkness, Christine A; Lemanske, Robert F

2018-03-08

Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year. Children were treated for 48 weeks with maintenance low-dose inhaled glucocorticoids (fluticasone propionate at a dose of 44 μg per inhalation, two inhalations twice daily) and were randomly assigned to either continue the same dose (low-dose group) or use a quintupled dose (high-dose group; fluticasone at a dose of 220 μg per inhalation, two inhalations twice daily) for 7 days at the early signs of loss of asthma control ("yellow zone"). Treatment was provided in a double-blind fashion. The primary outcome was the rate of severe asthma exacerbations treated with systemic glucocorticoids. The rate of severe asthma exacerbations treated with systemic glucocorticoids did not differ significantly between groups (0.48 exacerbations per year in the high-dose group and 0.37 exacerbations per year in the low-dose group; relative rate, 1.3; 95% confidence interval, 0.8 to 2.1; P=0.30). The time to the first exacerbation, the rate of treatment failure, symptom scores, and albuterol use during yellow-zone episodes did not differ significantly between groups. The total glucocorticoid exposure was 16% higher in the high-dose group than in the low-dose group. The difference in linear growth between the high-dose group and the low-dose group was -0.23 cm per year (P=0.06). In children with mild-to-moderate persistent asthma treated with daily inhaled glucocorticoids, quintupling the dose at the early signs of loss of asthma control did not reduce the rate of severe asthma

A non-electrostatic spacer for aerosol delivery

DEFF Research Database (Denmark)

Bisgaard, H; Anhøj, J; Klug, B

1995-01-01

A pear shaped non-electrostatic spacer, composed of steel with a volume of 250 ml and equipped with a facemask containing integrated inlet and outlet valves for inspiration and expiration, was compared with three plastic spacers. The plastic spacers were primed with repeated puffs from a budesonide...... pressurised metered dose inhaler (p-MDI) to minimise the electrostatic charge on the plastic. The procedure prolonged the half life (t1/2) of the aerosol in the Nebuhaler from nine to 32 seconds. A normal cleaning procedure reduced the aerosol t1/2 back to baseline. The t1/2 of the aerosol in the metal spacer...... was 27 seconds and independent of the use of p-MDI. In vitro the maximum dose of budesonide from a p-MDI, expressed as a percentage of the nominal dose, was 56% from the non-electrostatic spacer, 61% from the Nebuhaler, 45% from the Babyhaler, and 30% from the AeroChamber. In 124 children, age 6 months...

Inhaled plutonium nitrate in dogs

International Nuclear Information System (INIS)

Dagle, G.E.

1987-01-01

The major objective of this project is to determine dose-effect relationships of inhaled plutonium nitrate in dogs to aid in predicting health effects of accidental exposure in man. For lifespan dose-effect studies, beagle dogs were given a single inhalation exposure to 239 Pu(NO 3 ) 4 , in 1976 and 1977. The earliest biological effect was on the hematopoietic system; lymphopenia and neutropenia occurred at the two highest dose levels. They have also observed radiation pneumonitis, lung cancer, and bone cancer at the three highest dose levels. 1 figure, 3 tables

Inhaled plutonium nitrate in dogs

International Nuclear Information System (INIS)

Dagle, G.E.

1986-01-01

The major objective of this project is to determine dose-effect relationships of inhaled plutonium nitrate in dogs to aid in predicting health effects of accidental exposure in man. For lifespan dose-effect studies, beagle dogs were given a single inhalation exposure to 239 Pu(NO 3 ) 4 , in 1976 and 1977. The earliest biological effect was on the hematopoietic system; lymphopenia and neutropenia occurred at the two highest dose levels. The authors have also observed radiation pneumonitis, lung cancer, and bone cancer at the three highest dose levels. 1 figure, 4 tables

Inhaled plutonium nitrate in dogs

International Nuclear Information System (INIS)

Dagle, G.E.

1982-01-01

The major objective of this project is to determine dose-effect relationships of inhaled plutonium nitrate in dogs to aid in the prediction of health effects of accidental exposure in man. For lifespan dose-effect studies, beagle dogs were given a single inhalation exposure to 239 Pu(NO 3 ) 4 , in 1976 and 1977. The earliest biological effect was on the hematopoietic system; as described in previous Annual Reports, lymphopenia and neutropenia occurred at the two highest dose levels. Radiation pneumonitis, lung cancer, and bone cancer have been observed at the highest dose levels

Estimation of inhalation doses from airborne releases using gross monitors

International Nuclear Information System (INIS)

Goldstein, N.P.

1978-01-01

Monitoring programs at most nuclear facilities involve continuous gross measurements supplemented by periodic isotopic analyses of release samples. The isotopic measurements are required to accurately assess the potential dose from the various effluent streams, but in between these measurements, one depends on the gross monitors to provide approximate indications of the dose. The effluent streams release a variety of nuclides, each with its own dose factor. This means that the relationship between the counting rate in a gross monitor and the potential dose of the effluent being monitored will depend on the isotopic composition of this release. If this composition changes, then the dose indicated by the gross monitor (calibrated for the original group of isotopes) may be significantly in error. The problem of indicating inhalation doses from gross monitoring of airborne releases is considered. In order for this type of monitor to accurately indicate dose, regardless of the isotopic makeup of a release, the analysis shows that its response to each isotope should be proportional to the dose factor of that isotope. These ideas are applied to the monitoring of air particulates using gross beta and gross gamma monitors. The study shows that the former more closely satisfies this condition and as a result, satisfactorily indicates the actual dose from reactor effluents, as determined from detailed isotopic data published in the literature. On the other hand, the gross gamma monitor, with its poorer fit to the condition, provided less than satisfactory accuracy in its dose estimates. In addition, a variety of other mathematical response functions were considered but their dose estimation capabilities were not much better than the straight beta response. The study shows that reasonably accurate dose estimates can be made using properly selected gross monitors, but that significant errors can result with improper ones. (author)

Radiation-dose estimates and hazard evaluations for inhaled airborne radionuclides. Annual progress report, July 1981-June 1982

International Nuclear Information System (INIS)

Mewhinney, J.A.

1983-06-01

The objective was to conduct confirmatory research on aerosol characteristics and the resulting radiation dose distribution in animals following inhalation and to provide prediction of health consequences in humans due to airborne radioactivity which might be released in normal operations or under accident conditions during production of nuclear fuel composed of mixed oxides of U and Pu. Four research reports summarize the results of specific areas of research. The first paper details development of a method for determination of specific surface area of small samples of mixed oxide or pure PuO 2 particles. The second paper details the extension of the biomathematical model previously used to describe retention, distribution and excretion of Pu from these mixed oxide aerosols to include a description of Am and U components of these aerosols. The third paper summarizes the biological responses observed in radiation dose pattern studies in which dogs, monkeys and rate received inhalation exposures to either 750 0 C heat treated UO 2 + PuO 2 , 1750 0 C heat-treated (U,Pu)O 2 or 850 0 C heat-treated pure PuO 2 . The fourth paper described dose-response studies in which rats were exposed to (U,Pu)O 2 or pure PuO 2 . This paper updates earlier reports and summarizes the status of animals through approximately 650 days after inhalation

Pharmacokinetics and Bioavailability of Inhaled Esketamine in Healthy Volunteers.

Science.gov (United States)

Jonkman, Kelly; Duma, Andreas; Olofsen, Erik; Henthorn, Thomas; van Velzen, Monique; Mooren, René; Siebers, Liesbeth; van den Beukel, Jojanneke; Aarts, Leon; Niesters, Marieke; Dahan, Albert

2017-10-01

Esketamine is traditionally administered via intravenous or intramuscular routes. In this study we developed a pharmacokinetic model of inhalation of nebulized esketamine with special emphasis on pulmonary absorption and bioavailability. Three increasing doses of inhaled esketamine (dose escalation from 25 to 100 mg) were applied followed by a single intravenous dose (20 mg) in 19 healthy volunteers using a nebulizer system and arterial concentrations of esketamine and esnorketamine were obtained. A multicompartmental pharmacokinetic model was developed using population nonlinear mixed-effects analyses. The pharmacokinetic model consisted of three esketamine, two esnorketamine disposition and three metabolism compartments. The inhalation data were best described by adding two absorption pathways, an immediate and a slower pathway, with rate constant 0.05 ± 0.01 min (median ± SE of the estimate). The amount of esketamine inhaled was reduced due to dose-independent and dose-dependent reduced bioavailability. The former was 70% ± 5%, and the latter was described by a sigmoid EMAX model characterized by the plasma concentration at which absorption was impaired by 50% (406 ± 46 ng/ml). Over the concentration range tested, up to 50% of inhaled esketamine is lost due to the reduced dose-independent and dose-dependent bioavailability. We successfully modeled the inhalation of nebulized esketamine in healthy volunteers. Nebulized esketamine is inhaled with a substantial reduction in bioavailability. Although the reduction in dose-independent bioavailability is best explained by retention of drug and particle exhalation, the reduction in dose-dependent bioavailability is probably due to sedation-related loss of drug into the air.

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

Directory of Open Access Journals (Sweden)

Eric J Griez

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

Radiation dose estimates and hazard evaluations for inhaled airborne radionuclides. Annual progress report, July 1980-June 1981

International Nuclear Information System (INIS)

Mewhinney, J.A.

1982-04-01

The objective of this project is to conduct confirmatory research on aerosol characteristics and the resulting radiation dose distribution in animals following inhalation and to provide prediction of health consequences in humans due to airborne radioactivity which might be released in normal operations or under accident conditions during production of nuclear fuel composed of mixed oxides of U and Pu. Four research reports summarize the results of specific areas of research being conducted. The first presents final results for several types of physical chemical characterization accomplished on samples of aerosols collected at an industrial facility during normal fabrication of mixed oxide fuel. Many of these characterizations were also done on aerosol samples collected during animal inhalation exposure procedures for biological studies using these aerosol materials. The second paper reports on the methods development process used for establishing a capability for measurement of the specific surface area of aerosols, an important determinant in the rate of dissolution of particulates deposited in lung. The third paper provides updated information on the retention, distribution and excretion of Pu after inhalation by Beagles of aerosols of either 750 0 C treated UO 2 + PuO 2 , 1750 0 C treated (U,Pu)O 2 or 850 0 C treated pure PuO 2 . This paper also reports the results of the formulation of a biomathematical model useful in describing the results of these three inhalation studies. The fourth paper describes the early results from two studies in which Fischer-344 rats received inhalation exposure to aerosols of (U,Pu)O 2 or pure PuO 2 to determine the relationship of radiation dose to biological response

Dose and effect of inhaled ozone in resting versus exercising human subjects: comparison with resting rats

Science.gov (United States)

Dose and effect of inhaled ozone in resting versus exercising human subjects: comparison with resting rats Authors: Gary E. Hatch, John McKee, James Brown, Bill McDonnell, Elston Seal, Joleen Soukup, Ralph Slade, Kay Crissman and Robert Devlin, National Health and Environmental...

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Controlling Tools for Control Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers ... inhaler with a spacer Your browser does not support iframes Using a metered dose inhaler with a ...

Inhaled plutonium oxide in dogs

International Nuclear Information System (INIS)

Park, J.F.

1985-01-01

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

Electrostatic Properties of Particles for Inhalation

OpenAIRE

Rowland, Martin

2015-01-01

Dry powder inhalers (DPIs) and pressurised metered dose inhalers (pMDIs) aredevices used to deliver therapeutic agents to the lungs. Typically, inhaled activepharmaceutical ingredients (APIs) are electrically resistive materials and are prone toaccumulating electrostatic charge. The build-up of charge on inhaled therapeutics hastraditionally been viewed as a nuisance as it may result in problems such as weighingerrors, agglomeration, adhesion to surfaces and poor flow. Energetic processing st...

The History of Therapeutic Aerosols: A Chronological Review.

Science.gov (United States)

Stein, Stephen W; Thiel, Charles G

2017-02-01

In 1956, Riker Laboratories, Inc., (now 3 M Drug Delivery Systems) introduced the first pressurized metered dose inhaler (MDI). In many respects, the introduction of the MDI marked the beginning of the modern pharmaceutical aerosol industry. The MDI was the first truly portable and convenient inhaler that effectively delivered drug to the lung and quickly gained widespread acceptance. Since 1956, the pharmaceutical aerosol industry has experienced dramatic growth. The signing of the Montreal Protocol in 1987 led to a surge in innovation that resulted in the diversification of inhaler technologies with significantly enhanced delivery efficiency, including modern MDIs, dry powder inhalers, and nebulizer systems. The innovative inhalers and drugs discovered by the pharmaceutical aerosol industry, particularly since 1956, have improved the quality of life of literally hundreds of millions of people. Yet, the delivery of therapeutic aerosols has a surprisingly rich history dating back more than 3500 years to ancient Egypt. The delivery of atropine and related compounds has been a crucial inhalation therapy throughout this period and the delivery of associated structural analogs remains an important therapy today. Over the centuries, discoveries from many cultures have advanced the delivery of therapeutic aerosols. For thousands of years, therapeutic aerosols were prepared by the patient or a physician with direct oversight of the patient using custom-made delivery systems. However, starting with the Industrial Revolution, advancements in manufacturing resulted in the bulk production of therapeutic aerosol delivery systems produced by people completely disconnected from contact with the patient. This trend continued and accelerated in the 20th century with the mass commercialization of modern pharmaceutical inhaler products. In this article, we will provide a summary of therapeutic aerosol delivery from ancient times to the present along with a look to the future. We

Radiation doses of inhaled ash from the lignite power plants

International Nuclear Information System (INIS)

Boshevski, Tome; Pop-Jordanov, Jordan; Chaushevski, Anton

1997-01-01

The coal-fired thermal power plants in Macedonia use lignite obtained by surface mining. The lignite contains traces of thorium-232, uranium-238 and uranium-235, which are long-lived natural radioactive isotopes. After lignite combustion, the concentration of these isotopes in the ash is increased. Due to the long life of fossil materials, the decay products are basically grouped in three radioactive chains that are in a semi-steady state, resulting in equal activity of all isotopes from the chain. Among the members of each chain there are α and β emitters followed by γ quanta emitters. The energies of the α and β particles are important for determining the effective dose. The γ quanta provide information about the chain activity and isotope types. Gamma-spectroscopy studies of the ash samples from the power plants in the City of Bitola in Macedonia have confirmed the presence of several radioactive decay products from the uranium and thorium radioactive chains. Using measurements of the radioactivity of the ash in the Bitola region, the total dose from ash inhalation for the population in the Bitola region was calculated and presented in this paper. Also, analysis of the procedure for determining the maximum allowable dose from radioactive contamination of the environment, is described in this paper. (Original)

Microphase separation behavior on the surfaces of PEG-MDI-PDMS multiblock copolymer coatings

International Nuclear Information System (INIS)

Fang Hongxia; Zhou Shuxue; Wu Limin

2006-01-01

A series of poly(ethylene glycol)(PEG)-4,4'-diphenylmethanediisocyanate(MDI)-poly(dimethylsiloxane) (PDMS) multiblock copolymers were synthesized by employing two-step growth polymerization technique. Atomic force microscopy (AFM) observed nanoscopically well-organized phase-separated surfaces consisting of hydrophilic domain from PEG and MDI segments and hydrophobic domain from PDMS segments even with 50 wt.% PDMS in the copolymer, and the multiblock copolymer coatings presented a surface free energy of as low as 6-8 mN m -1

{sup 131}I age-dependent inhalation dose in Southern Poland from Fukushima accident

Energy Technology Data Exchange (ETDEWEB)

Brudecki, K.; Szufa, K.; Mietelski, J.W. [Polish Academy of Sciences, Institute of Nuclear Physics, Krakow (Poland)

2017-03-15

A general method for calculating doses absorbed from isotopes released in nuclear accidents is presented. As an example, this method was used to calculate doses for inhabitants of Southern Poland due to inhalation of {sup 131}I released due to the Fukushima nuclear plant accident. {sup 131}I activity measurements in the air of that region provided the basis for the study. The proposed model is based on a complex biokinetic model for iodine merging the Leggett model developed in 2010 with the human respiratory tract and gastrointestinal tract models recommended by the International Commission on Radiological Protection (ICRP). This model is described here, and it is demonstrated that resulting dose estimates are consistent with those obtained using the ICRP methodology. Using the developed model, total doses were calculated for six age groups of both genders, for gaseous and aerosol fractions alike. The committed effective dose, H{sub 50}, for an adult man reached 16 nSv, which is lower than 0.001% of the background dose. The dose for the thyroid of an adult reached 0.33 μSv, which corresponds to circa 0.0007% of the dose to the population of Southern Poland after the Chernobyl nuclear plant accident. (orig.)

Age dependent systemic exposure to inhaled salbutamol

DEFF Research Database (Denmark)

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

2007-01-01

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

Dose-effect studies with inhaled plutonium oxide in beagles

International Nuclear Information System (INIS)

Park, J.F.; Buschbom, R.L.; Case, A.C.

1976-01-01

Beagle dogs given single exposure to 239 PuO 2 or 238 PuO 2 aerosols are being observed for life-span dose-effect relationships. The 239 Pu 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 238 Pu have died during the first two postexposure years. After inhalation of 239 PuO 2 or 238 PuO 2 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

Biological clearance and committed dose equivalent in pulmonary region from inhaled radioaerosols for lung scanning

Energy Technology Data Exchange (ETDEWEB)

Soni, P.S.; Sharma, S.M.; Raghunath, B.; Somasundaram, S.

1987-01-01

Biological clearance half-lives (Tsub(b)) of different /sup 99/Tcsup(m)-labelled compounds from each lung have been determined, after administering the radioaerosol to normal subjects using the BARC dry aerosol generation and inhalation system. Based on these experimental clearance half-lives, the committed dose equivalent to the lungs has been computed using both the ICRP lung model and MIRD-11 values.

Biological clearance and committed dose equivalent in pulmonary region from inhaled radioaerosols for lung scanning

International Nuclear Information System (INIS)

Soni, P.S.; Sharma, S.M.; Raghunath, B.; Somasundaram, S.

1987-01-01

Biological clearance half-lives (Tsub(b)) of different 99 Tcsup(m)-labelled compounds from each lung have been determined, after administering the radioaerosol to normal subjects using the BARC dry aerosol generation and inhalation system. Based on these experimental clearance half-lives, the committed dose equivalent to the lungs has been computed using both the ICRP lung model and MIRD-11 values. (author)

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

Directory of Open Access Journals (Sweden)

Dora M. Lombardi

2006-12-01

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

Variability in dose-equivalent assessments for inhaled U3O8 concentrations

International Nuclear Information System (INIS)

Hewson, G.; Blyth, D.I.

1985-01-01

A potentially significant radiological hazard exists in the packaging area of uranium mills through the inhalation of airborne uranium octoxide (U 3 O 8 ). The Radiation Protection (Mining and Milling Code (1980) requires the measurement and assessment of quarterly, annual and cumulative dose equivalents for employees working in these areas. Arising through differences which exist between the abovementioned Code and ICRP 30, and assumptions of particle size and dust concentration distributions, confusion exists within Australia regarding the methods which can be used to make the required assessments. Exposure data were collected during routine monitoring at an operating mill facility and were interpreted using different methods and a range of assumptions. Results indicated the dust at this facility is characterised by an AMAD greater than 10 μ, and dust concentrations were distributed lognormally. Assumptions of a normal distribution may result in an overestimate of the dose equivalent. The importance of particle size in dose assessments using ICRP 30 techniques was highlighted. Information was masked when employee data was grouped to provide work category dose assessments. The use of ICRP 30 methods were recommended to provide uniformity throughout Australia

Inhalation Toxicology Research Institute annual report, October 1, 1983-September 30, 1984

International Nuclear Information System (INIS)

Guilmette, R.A.; Medinsky, M.A.

1984-12-01

The report describes research in the following areas: (1) aerosol generation and characterization; (2) deposition and fate of inhaled materials; (3) dose-response relationships for inhaled radionuclides; (4) dose-response relationships for inhaled chemical toxicants; and (5) biological factors that influence dose-response relationships. Project descriptions have been individually entered into the date base

Dose-effect studies with inhaled plutonium oxide in beagles

International Nuclear Information System (INIS)

Park, J.F.; Buschbom, R.L.; Case, A.C.

1977-01-01

Beagle dogs given a single exposure to 239 PuO 2 or 238 PuO 2 aerosols are being observed for life-span dose-effect relationships. The 239 Pu 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. Five additional dogs with body burdens of 0.7 to 1.8 μCi died due to pulmonary neoplasia 3 to 5 yr after exposure. None of the dogs exposed to 238 Pu have died during the first 3 postexposure yr. Lymphocytopenia was the earliest observed effect after inhalation of 239 PuO 2 or 238 PuO 2 , occurring 0.5 to 2 yr after deposition of greater than or equal to 80 nCi plutonium in the lungs

Enantioselective disposition of (R)-salmeterol and (S)-salmeterol in urine following inhaled dosing and application to doping control

DEFF Research Database (Denmark)

Jacobson, Glenn A; Hostrup, Morten; Narkowicz, Christian K

2017-01-01

Salmeterol (USAN, INN, BAN) is a long-acting beta2-adrenoceptor agonist (LABA) widely used in the treatment of airways disease. Although salmeterol is permitted via inhalation by athletes and supratherapeutic dosing may enhance performance, no urine threshold has been established by the World Anti...

Sustainable Intensified Process Retrofit for the Production of MDI

DEFF Research Database (Denmark)

Babi, Deenesh Kavi; Woodley, John; Gani, Rafiqul

Process intensification (PI) is a means by which processes can be made more efficient and sustainable at different levels, the unit operations, functional and phenomena levels. Therefore PI can be used for making process improvements at the functional level for the production of an important poly...... polyurethane, methylene diphenyldi-isocyanate (MDI)....

Inhalation Toxicology Research Institute. Annual report, October 1, 1981-September 30, 1982

International Nuclear Information System (INIS)

Snipes, M.B.; Marshall, T.C.; Martinez, B.S.

1982-12-01

Studies are presented of the effect on man of airborne particulates and gaseous emissions associated with the production of energy. Included in the report from the Inhalation Toxicology Research Institute are papers on: (1) the physical and chemical characterization of energy technology aerosols; (2) laboratory studies of aerosol generation and characterization; (3) in vitro predictors of toxicity; (4) disposition and fate of inhaled materials; (5) dose-response relationships for inhaled radionuclides; (6) dose-response relationships for inhaled chemical toxicants; (7) biological factors which influence dose-response relationships; and (8) risk assessment

Performance of Dry Powder Inhalers with Single Dosed Capsules in Preschool Children and Adults Using Improved Upper Airway Models

Directory of Open Access Journals (Sweden)

Sandra Lindert

2014-02-01

Full Text Available The pulmonary administration of pharmaceutical aerosols to patients is affected by age-dependent variations in the anatomy of the upper airways and the inhalation pattern. Considering this aspect, different upper airway models, representing the geometries of adults and preschool children, and a conventional induction port according to the European Pharmacopeia were used for in vitro testing of dry powder inhalers with single dosed capsules (Cyclohaler®, Handihaler® and Spinhaler®. Deposition measurements were performed using steady flow rates of 30 and 60 L/min for the Handihaler®/Spinhaler® and 30, 60 and 75 L/min for the Cyclohaler®. The inhalation volume was set at 1 L. For the Cyclohaler®, the in vitro testing was supplemented by a pediatric inhalation profile. Slight differences of pulmonary deposition between the idealized adult (11%–15% and pediatric (9%–11% upper airway model were observed for the Cyclohaler®. The applied pediatric inhalation profile resulted in a reduction of pulmonary deposition by 5% compared to steady conditions and indicated the influence of the inhalation pattern on the amount of pulmonary deposited particles. The comparison of two pediatric upper airway models showed no differences. The performance of the Handihaler® was similar to the Cyclohaler®. The Spinhaler® showed an insufficient performance and limited reproducibility in our investigations.

Dose-effect studies with inhaled plutonium oxide in beagles

International Nuclear Information System (INIS)

Park, J.F.; Case, A.C.; Catt, D.L.

1978-01-01

Beagle dogs given a single exposure to 239 PuO 2 and 238 PuO 2 aerosols are being observed for life-span dose-effect relationships. The 239 Pu 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 238 Pu 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 239 PuO 2 or 238 PuO 2 , occurring 0.5 to 2 yr after deposition of equal to or greater than 80 nCi plutonium in the lungs

Dose-effect studies with inhaled plutonium oxide in beagles

International Nuclear Information System (INIS)

Park, J.F.; Case, A.C.; Catt, D.L.

1980-01-01

Beagle dogs given a single exposure to 239 PuO 2 and 238 PuO 2 aerosols are being observed for life-span dose-effect relationships. The 239 Pu 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 238 Pu 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 239 PuO 2 or 238 PuO 2 , occurring 0.5 to 2 yr after deposition of >80 nCi plutonium in the lungs

Dose-effect studies with inhaled plutonium oxide in beagles

International Nuclear Information System (INIS)

Park, J.F.; Busch, R.H.; Case, A.C.

1979-01-01

Beagle dogs given a single exposure to 239 PuO 2 and 238 PuO 2 aerosols are being observed for life-span dose-effect relationships. The 239 Pu 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 238 Pu 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 239 PuO 2 or 238 PuO 2 , occurring 0.5 to 2 yr after deposition of greater than or equal to 80 nCi plutonium in the lungs

Argon inhalation attenuates retinal apoptosis after ischemia/reperfusion injury in a time- and dose-dependent manner in rats.

Directory of Open Access Journals (Sweden)

Felix Ulbrich

Full Text Available Retinal ischemia and reperfusion injuries (IRI permanently affect neuronal tissue and function by apoptosis and inflammation due to the limited regenerative potential of neurons. Recently, evidence emerged that the noble gas Argon exerts protective properties, while lacking any detrimental or adverse effects. We hypothesized that Argon inhalation after IRI would exert antiapoptotic effects in the retina, thereby protecting retinal ganglion cells (RGC of the rat's eye.IRI was performed on the left eyes of rats (n = 8 with or without inhaled Argon postconditioning (25, 50 and 75 Vol% for 1 hour immediately or delayed after ischemia (i.e. 1.5 and 3 hours. Retinal tissue was harvested after 24 hours to analyze mRNA and protein expression of Bcl-2, Bax and Caspase-3, NF-κB. Densities of fluorogold-prelabeled RGCs were analyzed 7 days after injury in whole-mounts. Histological tissue samples were prepared for immunohistochemistry and blood was analyzed regarding systemic effects of Argon or IRI. Statistics were performed using One-Way ANOVA.IRI induced RGC loss was reduced by Argon 75 Vol% inhalation and was dose-dependently attenuated by lower concentrations, or by delayed Argon inhalation (1504±300 vs. 2761±257; p<0.001. Moreover, Argon inhibited Bax and Bcl-2 mRNA expression significantly (Bax: 1.64±0.30 vs. 0.78±0.29 and Bcl-2: 2.07±0.29 vs. 0.99±0.22; both p<0.01, as well as caspase-3 cleavage (1.91±0.46 vs. 1.05±0.36; p<0.001. Expression of NF-κB was attenuated significantly. Immunohistochemistry revealed an affection of Müller cells and astrocytes. In addition, IRI induced leukocytosis was reduced significantly after Argon inhalation at 75 Vol%.Immediate and delayed Argon postconditioning protects IRI induced apoptotic loss of RGC in a time- and dose-dependent manner, possibly mediated by the inhibition of NF-κB. Further studies need to evaluate Argon's possible role as a therapeutic option.

Effectiveness of the different methods of inhalation drugs delivery in children with bronchial asthma

Directory of Open Access Journals (Sweden)

S.M. Nedelska

2017-02-01

Full Text Available Aim of the work — to evaluate the effectiveness of inhalation technique when using different types of inhalers (dry powder inhalers — Turbuhaler, Diskus, metered-dose inhalers, breath-actuated inhalers — Easyhaler. Materials and methods. 45 patients aged 6–17 years underwent the evaluation of inhalation technique accuracy with the use of In-Check-Dial — apparatus, which imitates the airway resistance that should be overcome during inspiration through different inhaler types, and measure inspiration velocity. Incidence of mistakes was studied in different age groups. Results. 80 % of children aged 6–7 years made mistakes while using Turbuhaler, 73.3 % — metered-dose inhaler, 60 % — Easyhaler. There were no mistakes in patients making inhalation by means of Diskhaler. 100 % of children aged 12–14 years incorrectly used metered-dose inhaler. Easyhaler was incorrectly used in 66.6 % of cases, Diskhaler — in 26.6 %. Among elder group, incidence of mistakes when making inhalations through Turbuhaler was lower — 40 % in 12–14-year-old group and 25 % — in 15–17-year-old (р < 0.05. Children of 15–17 years old are able to use Turbuhaler and Diskus (mistakes in 33.3 and 46.6 %, respectively. At the same time, none of the patients have done the correct inhalation by means of metered-dose inhaler, 93.3 % of the patients have mistakes when using Easyhaler. Conclusions. The incidence of mistakes depends on the age and inhaler type and reaches 26–100 %. Minimal quantity of mistakes is seen for Diskus (in all age groups, maxi­mal — for metered-dose inhaler. For the purpose of optimal inhaler choice in a child with bronchial asthma, it is advisable to measure the inspiratory flow with the help of In-Check-Dial before therapy administration.

An equivalence study comparing nitrous oxide and oxygen with low-dose sevoflurane and oxygen as inhalation sedation agents in dentistry for adults.

Science.gov (United States)

Allen, M; Thompson, S

2014-11-01

The aim of this study was to examine whether sevoflurane in oxygen was equivalent to near equipotent concentrations of nitrous oxide in oxygen when used as an inhalation sedation agent in terms of patient and user acceptability. Forty anxious dental patients referred to the sedation suite at Cardiff University School of Dentistry received either nitrous oxide to a maximum concentration of 40% or sevoflurane to a maximum concentration of 0.3% for a routine maxillary plastic restoration with articaine infiltration local analgesia. The inhalation sedation agent to be administered was chosen by a random number allocator. Measurements of blood pressure, oxygen saturation, heart rate, respiratory rate and bispectral index were recorded every 5 minutes. At the end of the treatment episode the patient, the operator and an observer who was unaware of the agent used, recorded their impressions about the episode by completing questionnaires. In the doses used in this study, sevoflurane was found to be as effective as an inhalation sedation agent as the standard dose of nitrous oxide used in normal inhalation sedation in the treatment of adult anxious dental patients. Sevoflurane in low concentrations is equivalent in effect to near equipotent concentrations of nitrous oxide. This would suggest that further research, perhaps with slightly higher concentrations of sevoflurane, is needed. If sevoflurane was shown to be acceptable at slightly higher concentrations, there is scope to explore the development of equipment specifically designed to deliver sevoflurane as an inhalation sedation agent in future.

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

International Nuclear Information System (INIS)

Lee, Jeong Ho; Lee, Chang Woo; Choi, Yong Ho; Chun, Ki Jung; Kim, Kook Chan; Kim, Sang Bok; Kim, Jin Kyu

1991-07-01

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

Lifestyle and age as determinates of intake and dose from inhaled radionuclides

International Nuclear Information System (INIS)

Fields, D.E.; Yalcintas, M.G.

1989-01-01

The whole-body dose from inhaled radionuclides is a complex function of factors describing exposure and physiology. Exposure-related factors may be estimated by considering likely emission rates combined with measured time-varying meteorological (transport) parameters and estimated exercise patterns. Physiological factors, strongly influencing radionuclide intake and consequent radiation dose, have been catalogued as functions of age and activity level. Both exercise patterns and physiological factors are related to age of the exposed individual. Combining these factors permits estimates to be made of the span of exposures that may be expected in a typical population. The ratio of highest to lowest radionuclide intake is predicted to be of the order of 40, suggesting that specification of an 'average' value may be misleading if this value approaches regulatory limits. Individuals exposed to maximal risk may be identified, and are likely to be active children. Activity pattern (lifestyle) is a primary determinant of risk. (author)

Inhaled plutonium nitrate in dogs

International Nuclear Information System (INIS)

Dagle, G.E.; Cannon, W.C.; Ragan, H.A.; Watson, C.R.; Stevens, D.L.; Cross, F.T.; Dionne, P.J.; Harrington, T.P.

1978-01-01

Beagle dogs given a single inhalation exposure to 239 Pu(NO 3 ) 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 238 Pu(NO 3 ) 4 than after 239 Pu(NO 3 ) 4 inhalation

Human Dose-Response Data for Francisella tularensis and a Dose- and Time-Dependent Mathematical Model of Early-Phase Fever Associated with Tularemia After Inhalation Exposure.

Science.gov (United States)

McClellan, Gene; Coleman, Margaret; Crary, David; Thurman, Alec; Thran, Brandolyn

2018-04-25

Military health risk assessors, medical planners, operational planners, and defense system developers require knowledge of human responses to doses of biothreat agents to support force health protection and chemical, biological, radiological, nuclear (CBRN) defense missions. This article reviews extensive data from 118 human volunteers administered aerosols of the bacterial agent Francisella tularensis, strain Schu S4, which causes tularemia. The data set includes incidence of early-phase febrile illness following administration of well-characterized inhaled doses of F. tularensis. Supplemental data on human body temperature profiles over time available from de-identified case reports is also presented. A unified, logically consistent model of early-phase febrile illness is described as a lognormal dose-response function for febrile illness linked with a stochastic time profile of fever. Three parameters are estimated from the human data to describe the time profile: incubation period or onset time for fever; rise time of fever; and near-maximum body temperature. Inhaled dose-dependence and variability are characterized for each of the three parameters. These parameters enable a stochastic model for the response of an exposed population through incorporation of individual-by-individual variability by drawing random samples from the statistical distributions of these three parameters for each individual. This model provides risk assessors and medical decisionmakers reliable representations of the predicted health impacts of early-phase febrile illness for as long as one week after aerosol exposures of human populations to F. tularensis. © 2018 Society for Risk Analysis.

Real-world healthcare utilization in asthma patients using albuterol sulfate inhalation aerosol (ProAir® HFA with and without integrated dose counters

Directory of Open Access Journals (Sweden)

Kerwin EM

2017-05-01

Full Text Available Edward M Kerwin,1 Thomas J Ferro,2 Rinat Ariely,3 Debra E Irwin,4 Ruchir Parikh3 1Clinical Trials Division, Clinical Research Institute of Southern Oregon, PC, Medford, OR, 2Global Medical Affairs, 3Global Health Economics and Outcome Research, Teva Pharmaceuticals, Frazer, PA, 4Outcomes Research, Truven Health Analytics, Durham, NC, USA Background: Accurate tracking of the administered dose of asthma rescue inhalers is critical for optimal disease management and is related to reductions in rates of unscheduled health care utilization in asthma patients. There are few published data on the real-world impact of rescue inhalers with integrated dose counters (IDCs on health care resource utilization (HRU for asthma patients. This study evaluates HRU among users of ProAir® hydrofluoroalkane (HFA (albuterol sulfate inhalation aerosol, with IDC versus without IDC, in asthma patients.Methods: This was a retrospective administrative claims study of asthma patients receiving a new prescription for albuterol inhalation aerosol without IDC during 2 years (January 2011–December 2012 or with IDC during the first full year after IDC implementation in the USA (July 2013–July 2014. Six months of continuous enrollment with medical and prescription drug benefits were required before and after the first prescription during the study period. Data on respiratory-related hospitalizations and emergency department (ED visits were collected during the follow-up period.Results: A total of 135,305 (32% patients used albuterol inhalation aerosol with IDC, and 287,243 (68% patients received albuterol inhalation aerosol without IDC. After adjusting for baseline confounding factors, the odds ratio (OR for experiencing a respiratory-related hospitalization (OR=0.92; 95% confidence interval [CI] 0.88–0.96 or ED visit (OR=0.92; 95% CI 0.90–0.94 was significantly lower among patients using albuterol inhalation aerosol with IDC versus without IDC.Conclusion: In a real

Pharmacokinetics and pharmacodynamics of high doses of pharmaceutically prepared heroin, by intravenous or by inhalation route in opioid-dependent patients

NARCIS (Netherlands)

Rook, Elisabeth J.; van Ree, Jan M.; van den Brink, Wim; Hillebrand, Michel J. X.; Huitema, Alwin D. R.; Hendriks, Vincent M.; Beijnen, Jos H.

2006-01-01

A pharmacokinetic-pharmacodynamic study was performed in opioid-dependent patients in the Netherlands, who were currently treated with high doses of pharmaceutically prepared heroin on medical prescription. Besides intravenous heroin, heroin was prescribed for inhalation by "chasing the dragon"

Dose conversion factors for inhalation applicable to the mining and milling of radioactive ores

International Nuclear Information System (INIS)

Hartley, B.M.

1992-01-01

The ICRP recommended revised dose limits for exposure to ionising radiation in November 1990. As well as reducing the annual occupational dose equivalent limit to an average of 20 mSv over 5 years, modified organ weighting factors were recommended, reflecting improved understanding of cancer risk factors for tissues and organs. The adjustment of weighting factors means that derived air concentrations conversion factors and annual limits on intake for exposure to airborne radionuclides are not simply modified by the ratio of the old to the new limits. A recalculation of these factors for radionuclides of interest in the mining and milling of radioactive ores is presented. A computer program for this purpose, based on the ICRP 30 inhalation model, is described. Rapid calculations of dose conversion factors are possible for the naturally occurring radionuclides in the 235 U, 238 U and 232 Th decay chains for which data are given in the supplements to ICRP 30. 7 refs., 12 tabs., 5 figs

A user's guide to the inhalation and external radiation collective dose module NECTAR-POPDOS

International Nuclear Information System (INIS)

Merlin, J.H.

1982-02-01

NECTAR-POPDOS is a module of the computer program NECTAR, which has been written in modular form to evaluate radioactive releases from nuclear fuel, their dispersion in the environment and the consequent individual and collective doses to man. The NECTAR-POPDOS module may be used to evaluate external and inhalation collective doses to any specified area of Great Britain, either to the total population or to any one of six age groups, using population data from the 1971 UK census. If a dose-risk function is defined, the module may be used to assess population health effects or for optimisation studies. The module is based on the stand-alone program POPDOS2, and is written in Fortran IV. The input data to the module is described and the module's limitations and sources of inaccuracy are discussed. Appendices to the report contain the necessary Job Control Language for running NECTAR, a list of NECTAR-POPDOS subroutines, and the input and output of two sample NECTAR-POPDOS cases. (author)

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

DEFF Research Database (Denmark)

Heijerman, Harry; Westerman, Elsbeth; Conway, Steven

2009-01-01

, mucolytics/mucous mobilizers, anti-inflammatory drugs, bronchodilators and combinations of solutions. Additionally, we review the current knowledge on devices for inhalation therapy with regard to optimal particle sizes and characteristics of wet nebulisers, dry powder and metered dose inhalers. Finally, we...... review the current status of inhaled medication in CF, including the mechanisms of action of the various drugs, their modes of administration and indications, their effects on lung function, exacerbation rates, survival and quality of life, as well as side effects. Specifically we address antibiotics...

Efficacy and safety of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma

NARCIS (Netherlands)

Scicchitano, R; Aalbers, R; Ukena, D; Manjra, A; Fouquert, L; Centanni, S; Boulet, LP; Naya, IP; Hultquist, C

Objectives:This study evaluated the efficacy and safety of a novel asthma management strategy - budesonide/formoterol for both maintenance and symptom relief (Symbicort Single Inhaler Therapy*) - compared with a higher maintenance dose of budesonide in patients with moderate to severe asthma.

A comparison of the major depression inventory (MDI) and the beck depression inventory (BDI) in severely depressed patients

DEFF Research Database (Denmark)

Konstantinidis, Anastasios; Martiny, Klaus; Bech, Per

2011-01-01

We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression.......We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression....

Inhaled plutonium oxide in dogs

International Nuclear Information System (INIS)

Anon.

1981-01-01

This project is concerned with long-term experiments to determine the life-span dose-effect relationships of inhaled 239 PuO 2 and 238 PuO 2 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

Inhalation Toxicology Research Institute annual report, October 1, 1982-September 30, 1983

International Nuclear Information System (INIS)

1983-12-01

The mission of the Inhalation Toxicology Research Institute (ITRI) is to investigate the nature and magnitude of human health effects that might result from inhalation of airborne materials encountered in the work place, special attention is directed toward airborne particulate and gaseous emissions released by various energy technologies or from national defense activities. Included are five papers on the physical and chemical characterization of energy technology aerosols, 10 papers on laboratory studies of aerosol generation and characterization, 11 papers on in vitro predictors of toxicity, 12 papers on disposition and fate of inhaled materials, 24 papers on dose-response relationships for inhaled radionuclides, 3 papers on dose-response relationships for inhaled chemical toxicants, 8 papers on biological factors that influence dose-response relationships, and 4 papers are concerned with risk assessment

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

International Nuclear Information System (INIS)

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

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

Lead-210, bismuth-210, polonium-210. Natural activity, internal dosimetry, and dose factors for ingestion and inhalation

International Nuclear Information System (INIS)

Jacobi, W.

1979-02-01

Starting with a comprehensive review of the normal, natural activity of 210 Pb and 210 Po in the environment and in the tissues of the human body, a model of the activity and dose distributions of this nuclides in the human body is developed. Dose factors for ingestion with food and for inhalation are derived from this model, related to the intake rate unit. This 'natural exposure model' can be used for an estimation of the population exposure due to normal natural radiation as well as to man-made sourcess of these nuclides, e.g. coal-fired power plants. (orig.) [de

The effect of inhaled fluticasone propionate in the treatment of young asthmatic children

DEFF Research Database (Denmark)

Bisgaard, H; Gillies, J; Groenewald, M

1999-01-01

The response in asthmatic young children to inhaled steroids within the usual pediatric dose range is unknown. We therefore evaluated the dose-related response in young children with moderate asthma to inhaled fluticasone propionate (FP) (delivered via the Babyhaler spacer device) within the pedi......The response in asthmatic young children to inhaled steroids within the usual pediatric dose range is unknown. We therefore evaluated the dose-related response in young children with moderate asthma to inhaled fluticasone propionate (FP) (delivered via the Babyhaler spacer device) within...... the pediatric dose range. A total of 237 children (mean age 28 mo, range 12 to 47) with moderate asthmatic symptoms were studied in this multicenter, randomized, double-blind, parallel group, placebo-controlled study of 12 wk treatment following a 4-wk run-in period. The median use of rescue medication was 1...

Inhalational and dermal exposures during spray application of biocides.

Science.gov (United States)

Berger-Preiss, Edith; Boehncke, Andrea; Könnecker, Gustav; Mangelsdorf, Inge; Holthenrich, Dagmar; Koch, Wolfgang

2005-01-01

Data on inhalational and potential dermal exposures during spray application of liquid biocidal products were generated. On the one hand, model experiments with different spraying devices using fluorescent tracers were carried out to investigate the influence of parameters relevant to the exposure (e.g. spraying equipment, nozzle size, direction of application). On the other hand, measurements were performed at selected workplaces (during disinfection operations in food and feed areas; pest control operations for private, public and veterinary hygiene; wood protection and antifouling applications) after application of biocidal products such as Empire 20, Responsar SC, Omexan-forte, Actellic, Perma-forte; Fendona SC, Pyrethrum mist; CBM 8, Aldekol Des 03, TAD CID, Basileum, Basilit. The measurements taken in the model rooms demonstrated dependence of the inhalation exposure on the type of spraying device used, in the following order: "spraying with low pressure" < "airless spraying" < "fogging" indicating that the particle diameter of the released spray droplets is the most important parameter. In addition inhalation exposure was lowest when the spraying direction was downward. Also for the potential dermal exposure, the spraying direction was of particular importance: overhead spraying caused the highest contamination of body surfaces. The data of inhalational and potential dermal exposures gained through workplace measurements showed considerable variation. During spraying procedures with low-pressure equipments, dose rates of active substances inhaled by the operators ranged from 7 to 230 microg active substance (a.s.)/h. An increase in inhaled dose rates (6-33 mg a.s./h) was observed after use of high application volumes/time unit during wood protection applications indoors. Spraying in the veterinary sector using medium-pressure sprayers led to inhaled dose rates between 2 and 24mga.s./h. The highest inhaled dose rates were measured during fogging (114 mg a

Real-time measurement of inhaled and exhaled cigarette smoke: Implications for dose

Energy Technology Data Exchange (ETDEWEB)

McGrath, Conor; Warren, Nigel; Biggs, Philip; McAughey, John, E-mail: conor_mcgrath@bat.co [British American Tobacco, Group R and D Centre, Southampton, SO15 8TL (United Kingdom)

2009-02-01

Inhalation of tobacco smoke aerosol is a two-step process involving puffing followed by inhalation. Measured smoke deposition efficiencies in the lung (20-70%) are greater than expected for smoke particles of 150 -- 250 nm count median diameter (CMD). Various mechanisms have been put forward to explain this enhanced deposition pattern, including coagulation, hygroscopic growth, condensation and evaporation, changes in composition, or changes in inhalation behaviour. This paper represents one of a series of studies seeking to better quantify smoke chemistry, inhalation behaviour and cumulative particle growth. The studies have been conducted to better understand smoke dosimetry and links to disease as part of a wider programme defining risk and potential harm reduction. In this study, the average CMD of inhaled smoke was 160 nm while the average CMD of exhaled smoke was 239 nm with an average growth factor of 1.5.

Real-time measurement of inhaled and exhaled cigarette smoke: Implications for dose

International Nuclear Information System (INIS)

McGrath, Conor; Warren, Nigel; Biggs, Philip; McAughey, John

2009-01-01

Inhalation of tobacco smoke aerosol is a two-step process involving puffing followed by inhalation. Measured smoke deposition efficiencies in the lung (20-70%) are greater than expected for smoke particles of 150 -- 250 nm count median diameter (CMD). Various mechanisms have been put forward to explain this enhanced deposition pattern, including coagulation, hygroscopic growth, condensation and evaporation, changes in composition, or changes in inhalation behaviour. This paper represents one of a series of studies seeking to better quantify smoke chemistry, inhalation behaviour and cumulative particle growth. The studies have been conducted to better understand smoke dosimetry and links to disease as part of a wider programme defining risk and potential harm reduction. In this study, the average CMD of inhaled smoke was 160 nm while the average CMD of exhaled smoke was 239 nm with an average growth factor of 1.5.

Knowledge of spacer device, peak flow meter and inhaler technique ...

African Journals Online (AJOL)

Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient's knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and ...

Effect of processing temperature on the bitumen/MDI-PEG reactivity

Energy Technology Data Exchange (ETDEWEB)

Martin-Alfonso, M.J.; Partal, P.; Navarro, F.J.; Garcia-Morales, M. [Departamento de Ingenieria Quimica, Facultad de Ciencias Experimentales, Campus de ' El Carmen' , Universidad de Huelva, 21071, Huelva (Spain); Bordado, J.C.M. [Chemical and Biological Engineering Department, IBB, Instituto Superior Tecnico, Av. Rovisco Pais 1049-001 Lisbon (Portugal); Diogo, A.C. [Materials Engineering Department, Instituto Superior Tecnico, Av. Rovisco Pais 1049-001 Lisbon (Portugal)

2009-04-15

Reactive polymers are lately gaining acceptance to give added value to a residue of the crude oil refining process such as bitumen. The resulting material should display enhanced mechanical properties to be considered for advanced applications in construction. In the present paper, we report the effect of processing temperature on the reaction between bitumen compounds and an isocyanate-based reactive polymer, synthesized by reaction of polymeric MDI (4,4'-diphenylmethane diisocyanate) with a low molecular weight polyethylene-glycol (PEG). Rheokinetics experiments, viscosity measurements at 60 C, atomic force microscopy (AFM) characterization, thin layer chromatography (TLC-FID) analysis and thermogravimetric studies (TGA) were performed on the reactive polymer and on samples of MDI-PEG modified bitumen containing 2 wt.% of the polymer. Results showed the existence of an optimum processing temperature arisen as a consequence of opposite effects: microstructural availability for the formation of a polymer-bitumen network, reaction ability and polymer thermal degradation. Consequently, this study aims to serve as a guideline for the refining and asphalt industries facing the stage of selecting the optimum processing parameters. (author)

Respirable versus inhalable dust sampling

International Nuclear Information System (INIS)

Hondros, J.

1987-01-01

The ICRP uses a total inhalable dust figure as the basis of calculations on employee lung dose. This paper was written to look at one aspect of the Olympic Dam dust situation, namely, the inhalable versus respirable fraction of the dust cloud. The results of this study will determine whether it is possible to use respirable dust figures, as obtained during routine monitoring to help in the calculations of employee exposure to internal radioactive contaminants

Effect of inhaled formoterol and budesonide on exacerbations of asthma

NARCIS (Netherlands)

Pauwels, RA; Lofdahl, CG; Postma, DS; Tattersfield, AE; OByrne, P; Barnes, PJ; Ullman, A

1997-01-01

Background The role of long-acting, inhaled beta(2)-agonists in treating asthma is uncertain. In a double-blind study, we evaluated the effects of adding inhaled formoterol to both lower and higher doses of the inhaled glucocorticoid budesonide. Methods After a four-week run-in period of treatment

Real-life characteristics of asthma inhaler device use in South Korea

NARCIS (Netherlands)

Wan Yau Ming, S.; Rhee, C.K.; Park, H.Y.; Yoo, K.H.; Kim, D.K.; Van Boven, J.F.; Price, D.; Park, H.S.

2016-01-01

Background and Aims: Historically, dry powder inhalers (DPIs) were considered to provide better airway distribution, easier identification of empty devices, and easier handling when compared to pressurized metered dose inhalers (pMDIs). Prior research into the major handling errors with inhaler

Fevipiprant, an oral prostaglandin DP2 receptor (CRTh2) antagonist, in allergic asthma uncontrolled on low-dose inhaled corticosteroids.

Science.gov (United States)

Bateman, Eric D; Guerreros, Alfredo G; Brockhaus, Florian; Holzhauer, Björn; Pethe, Abhijit; Kay, Richard A; Townley, Robert G

2017-08-01

Dose-related efficacy and safety of fevipiprant (QAW039), an oral DP 2 (CRTh2) receptor antagonist, was assessed in patients with allergic asthma uncontrolled by low-dose inhaled corticosteroids (ICS).Adult patients were randomised to 12 weeks' treatment with once-daily (1, 3, 10, 30, 50, 75, 150, 300 or 450 mg q.d ) or twice-daily (2, 25, 75 or 150 mg b.i.d ) fevipiprant (n=782), montelukast 10 mg q.d (n=139) or placebo (n=137). All patients received inhaled budesonide 200 μg b.i.d Fevipiprant produced a statistically significant improvement in the primary end-point of change in pre-dose forced expiratory volume in 1 s at week 12 (p=0.0035) with a maximum model-averaged difference to placebo of 0.112 L. The most favourable pairwise comparisons to placebo were for the fevipiprant 150 mg q.d and 75 mg b.i.d groups, with no clinically meaningful differences between q.d and b.i.d Montelukast also demonstrated a significant improvement in this end-point. No impact on other efficacy end-points was observed. Adverse events were generally mild/moderate in severity, and were evenly distributed across doses and treatments.Fevipiprant appears to be efficacious and well-tolerated in this patient population, with an optimum total daily dose of 150 mg. Further investigations into the clinical role of fevipiprant in suitably designed phase III clinical trials are warranted. Copyright ©ERS 2017.

Development of Respimat® Soft Mist™ Inhaler and its clinical utility in respiratory disorders

Directory of Open Access Journals (Sweden)

Dalby RN

2011-09-01

Full Text Available Richard N Dalby1, Joachim Eicher2, Bernd Zierenberg21Department of Pharmaceutical Sciences, University of Maryland, Baltimore, MD, USA; 2Boehringer Ingelheim, Ingelheim, GermanyAbstract: The Respimat® Soft Mist™ Inhaler (SMI (Boehringer Ingelheim International GmbH, Ingelheim, Germany was developed in response to the need for a pocket-sized device that can generate a single-breath, inhalable aerosol from a drug solution using a patient-independent, reproducible, and environmentally friendly energy supply. This paper describes the design and evolution of this innovative device from a laboratory concept model and the challenges that were overcome during its development and scaleup to mass production. A key technical breakthrough was the uniblock, a component combining filters and nozzles and made of silicon and glass, through which drug solution is forced using mechanical power. This allows two converging jets of solution to collide at a controlled angle, generating a fine aerosol of inhalable droplets. The mechanical energy comes from a spring which is tensioned by twisting the base of the device before use. Additional features of the Respimat® SMI include a dose indicator and a lockout mechanism to avoid the problems of tailing-off of dose size seen with pressurized metered dose inhalers. The Respimat® SMI aerosol cloud has a unique range of technical properties. The high fine particle fraction allied with the low velocity and long generation time of the aerosol translate into a higher fraction of the emitted dose being deposited in the lungs compared with aerosols from pressurized metered dose inhalers and dry powder inhalers. These advantages are realized in clinical trials in adults and children with obstructive lung diseases, which have shown that the efficacy and safety of a pressurized metered dose inhaler formulation of a combination bronchodilator can be matched by a Respimat® SMI formulation containing only one half or one quarter

AGE-DEPENDENT INHALATION DOSE DUE TO EXPOSURE OF SHORT LIVED PROGENY OF RADON AND THORON FOR DIFFERENT AGE GROUPS IN JAMMU & KASHMIR, HIMALAYAS.

Science.gov (United States)

Sharma, Sumit; Kumar, Ajay; Mehra, Rohit

2018-05-16

Dosimetric approach is used in this study for the assessment of doses due to inhalation of short lived radon/thoron progeny to the inhabitants of Udhampur district of Jammu & Kashmir. This paper also presents the activity concentrations and unattached fraction of radon and thoron progeny. The observed annual concentration of attached and unattached 222Rn and 220Rn progeny has been found to vary from 8 to 32 and 0.09 to 14 Bq/m3, 0.75 to 3.16 and 0.01 to 1.13 Bq/m3, respectively. The inhalation doses from radon progeny to different body organs of different age groups have been calculated by using the age dependent biokinetic model. The attachment rate of 222Rn and indoor aerosol concentration of 222Rn and 220Rn have been estimated and their relation between them has also been studied. The dose conversion factor for mouth and nasal breathing to different exposure conditions has been obtained from Porstendorfer model.

Nonparametric statistical techniques used in dose estimation for beagles exposed to inhaled plutonium nitrate

International Nuclear Information System (INIS)

Stevens, D.L.; Dagle, G.E.

1986-01-01

Retention and translocation of inhaled radionuclides are often estimated from the sacrifice of multiple animals at different time points. The data for each time point can be averaged and a smooth curve fitted to the mean values, or a smooth curve may be fitted to the entire data set. However, an analysis based on means may not be the most appropriate if there is substantial variation in the initial amount of the radionuclide inhaled or if the data are subject to outliers. A method has been developed that takes account of these problems. The body burden is viewed as a compartmental system, with the compartments identified with body organs. A median polish is applied to the multiple logistic transform of the compartmental fractions (compartment burden/total burden) at each time point. A smooth function is fitted to the results of the median polish. This technique was applied to data from beagles exposed to an aerosol of 239 Pu(NO 3 ) 4 . Models of retention and translocation for lungs, skeleton, liver, kidneys, and tracheobronchial lymph nodes were developed and used to estimate dose. 4 refs., 3 figs., 4 tabs

Lung dosimetry for inhaled radon progeny

International Nuclear Information System (INIS)

Hofmann, W.

1986-01-01

Lung cancer risk assessment for inhaled radon progeny requires a detailed knowledge of the dose distribution pattern throughout the human respiratory tract. Current lung dosimetry models take into acocunt aerosol deposition in a formalized airway structrue, modification of the initial deposition pattern by clearance mechanisms, and the energy deposited by alpha particles in sensitive cells of the bronchial epithelium. The resulting dose distribution pattern depends on the characteristics of the inhaled aerosol and the breathing pattern. Special emphasis has been laid on the age dependency of the anatomical structure of the human lung and the resulting doses, as well as on the rediological significance of enhanced aerosol deposition at bronchial bifuraction. The biological variability inherent in all morphometric, physiological and histological parameters involved in lung dosimetry suggests the application of stochastic modelling techniques. Examples for the use of Monte Carlo methods presented here are the random walk of inhaled particles through a random airway geometry, and the influence of the intra-subject variability of radiation doses on radiation protection standards. At the cellular level the concept of absorbed dose loses its significance and has to be replaced by microdosimetric concepts, such as internal microdosimtry or track structure theory. An image-analysis model allows us to construct specific energy distributions in sensitive lung cells. Application of a track structure model of alpha particle interaction with bronchial epithelial cells permits the calculation of probabilities for inactivation, transformation, and tumor induction. The latter has been used to analyse lung cancer risk at low doses in Chinese high background areas

Puffing and inhalation behaviour in cigarette smoking: Implications for particle diameter and dose

Energy Technology Data Exchange (ETDEWEB)

Dickens, Colin; McGrath, Conor; Warren, Nigel; Biggs, Philip; McAughey, John, E-mail: colin_dickens@bat.co [British American Tobacco, Group R and D Centre, Southampton, SO15 8TL (United Kingdom)

2009-02-01

Inhalation of tobacco smoke aerosol is a two-step process involving puffing followed by inhalation. Measured smoke deposition efficiencies in the lung (20-70%) are greater than expected for smoke particles of diameter 150 - 250 nm CMD. Various mechanisms have been put forward to explain this enhanced deposition pattern, including coagulation, hygroscopic growth, condensation and evaporation, changes in composition, or changes in inhalation behaviour. This paper represents one of a series of studies seeking to better quantify smoke chemistry, inhalation behaviour and cumulative particle growth. The studies have been conducted to better understand smoke dosimetry and links to disease as part of a wider programme defining risk and potential harm reduction. In this study, it was noted that particle deposition increased with increasing inhalation depth, and that smoke inhalation volumes were generally greater than normal tidal breathing volumes. A weak association was observed between particle diameter and puff flow, but no strong association between particle diameter and retention efficiency.

Puffing and inhalation behaviour in cigarette smoking: Implications for particle diameter and dose

International Nuclear Information System (INIS)

Dickens, Colin; McGrath, Conor; Warren, Nigel; Biggs, Philip; McAughey, John

2009-01-01

Inhalation of tobacco smoke aerosol is a two-step process involving puffing followed by inhalation. Measured smoke deposition efficiencies in the lung (20-70%) are greater than expected for smoke particles of diameter 150 - 250 nm CMD. Various mechanisms have been put forward to explain this enhanced deposition pattern, including coagulation, hygroscopic growth, condensation and evaporation, changes in composition, or changes in inhalation behaviour. This paper represents one of a series of studies seeking to better quantify smoke chemistry, inhalation behaviour and cumulative particle growth. The studies have been conducted to better understand smoke dosimetry and links to disease as part of a wider programme defining risk and potential harm reduction. In this study, it was noted that particle deposition increased with increasing inhalation depth, and that smoke inhalation volumes were generally greater than normal tidal breathing volumes. A weak association was observed between particle diameter and puff flow, but no strong association between particle diameter and retention efficiency.

Opportunities for inhaler device selection in elderly patients with asthma or COPD

Directory of Open Access Journals (Sweden)

Barrons R

2015-12-01

Full Text Available Robert Barrons,1 James Wheeler,2 J Andrew Woods1 1Wingate University School of Pharmacy, Wingate, NC, USA; 2University of Tennessee Health Science Center, Nashville, TN, USA Abstract: An anticipated surge in the elderly population will be accompanied by a rise in aging patients with asthma or COPD. Clinician selection of inhalers needs to address the unique challenges to elderly patients. These challenges to the use of inhalers include diminished physical and cognitive abilities, as well as cost reimbursement issues associated with polypharmacy and the Medicare gap. Clinicians should consider patient preferences for an inhaler device that provides ease of administration, and addresses conveniences such as portability, visual, and auditory indicators of dosing completion. The addition of spacer devices resolves hand-breath coordination difficulty with pressurized metered dose inhalers, but reduces overall inhaler convenience. Soft mist inhalers (Respimat® improve ease of administration, but use may be limited by cost and formulary availability. Multiple dose dry powder inhalers provide convenience and simplified use by requiring only one to two steps prior to administration, but concerns of peak inspiratory flow requirements remain among patients with advanced age and severity of COPD. If unaddressed, these challenges to inhaler selection contribute to inappropriate use of inhalers in 41% to 69% of patients, accompanied by at least 51% non-adherence to treatment. Clinicians must first avail themselves of reputable educational resources regarding new inhaler developments and administration, for competent patient instruction. Patient education should include a checklist of inhaler technique, with physical demonstration of each device by the patient and provider. Device demonstration significantly improves inhaler technique and identifies the need for nebulization therapy. Clinician and patient knowledge of available inhalers and their

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.

Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

Science.gov (United States)

Devereux, Graham; Cotton, Seonaidh; Barnes, Peter; Briggs, Andrew; Burns, Graham; Chaudhuri, Rekha; Chrystyn, Henry; Davies, Lisa; De Soyza, Anthony; Fielding, Shona; Gompertz, Simon; Haughney, John; Lee, Amanda J; McCormack, Kirsty; McPherson, Gladys; Morice, Alyn; Norrie, John; Sullivan, Anita; Wilson, Andrew; Price, David

2015-06-10

Chronic obstructive pulmonary disease (COPD) is associated with high morbidity, mortality, and health-care costs. An incomplete response to the anti-inflammatory effects of inhaled corticosteroids is present in COPD. Preclinical work indicates that 'low dose' theophylline improves steroid responsiveness. The Theophylline With Inhaled Corticosteroids (TWICS) trial investigates whether the addition of 'low dose' theophylline to inhaled corticosteroids has clinical and cost-effective benefits in COPD. TWICS is a randomised double-blind placebo-controlled trial conducted in primary and secondary care sites in the UK. The inclusion criteria are the following: an established predominant respiratory diagnosis of COPD (post-bronchodilator forced expiratory volume in first second/forced vital capacity [FEV1/FVC] of less than 0.7), age of at least 40 years, smoking history of at least 10 pack-years, current inhaled corticosteroid use, and history of at least two exacerbations requiring treatment with antibiotics or oral corticosteroids in the previous year. A computerised randomisation system will stratify 1424 participants by region and recruitment setting (primary and secondary) and then randomly assign with equal probability to intervention or control arms. Participants will receive either 'low dose' theophylline (Uniphyllin MR 200 mg tablets) or placebo for 52 weeks. Dosing is based on pharmacokinetic modelling to achieve a steady-state serum theophylline of 1-5 mg/l. A dose of theophylline MR 200 mg once daily (or placebo once daily) will be taken by participants who do not smoke or participants who smoke but have an ideal body weight (IBW) of not more than 60 kg. A dose of theophylline MR 200 mg twice daily (or placebo twice daily) will be taken by participants who smoke and have an IBW of more than 60 kg. Participants will be reviewed at recruitment and after 6 and 12 months. The primary outcome is the total number of participant-reported COPD exacerbations requiring

Toxicity of inhaled alpha-emitting radionuclides - Status report

International Nuclear Information System (INIS)

Muggenburg, B.A.; Mewhinney, J.A.; Guilmette, R.A.; Gillett, N.A.; Diel, J.H.; Lundgren, D.L.; Hahn, F.F.; Boecker, B.B.; McClellan, R.O.

1988-01-01

The toxicity of inhaled alpha-emitting radionuclides is being investigated in a series of interrelated dose-response studies. Dogs, rodents, and nonhuman primates have been exposed to monodisperse or polydisperse aerosols of the oxides of 239 Pu, 238 Pu, 241 Am, or 244 Cm to measure the relative importance of average organ dose, local dose around particles, specific activity, chemical form, particle size, and number of particles inhaled to the development of biological effects. The influence of animal species, age at exposure, and pre-existing lung disease, as well as the effects of repeated exposure, are also being studied, because they may influence the toxicity of these radionuclides. (author)

Evaluating the length of stay and value of time in a pediatric emergency department with two models by comparing two different albuterol delivery systems.

Science.gov (United States)

Staggs, Lauren; Peek, Meagan; Southard, Gary; Gracely, Ed; Baxendale, Sidney; Cross, Keith P; Kim, In K

2012-01-01

Asthma is one of the most common childhood illnesses and accounts for a substantial amount of pediatric emergency department visits. Historically, acute exacerbations are treated with a beta agonist via nebulizer therapy (NEB). However, with the advent of the spacer, the medication can be delivered via a metered dose inhaler (MDI+S) with the same efficacy for mild-to-moderate asthma exacerbations. To date, no study has been done to evaluate emergency department (ED) length of stay (LOS) and opportunity cost between nebulized vs MDI+S. The objective of this study was to compare ED LOS and associated opportunity cost among children who present with a mild asthma exacerbation according to the delivery mode of albuterol: MDI+S vs NEB. A structured, retrospective cross-sectional study was conducted. Medical records were reviewed from children aged 1-18 years treated at an urban pediatric ED from July 2007 to June 2008 with a discharge diagnosis International Classification of Disease-9 of asthma. Length of stay was defined: time from initial triage until the time of the guardian signature on the discharge instructions. An operational definition was used to define a mild asthma exacerbation; those patients requiring only one standard weight based albuterol treatment. Emergency department throughput time points, demographic data, treatment course, and delivery method of albuterol were recorded. Three hundred and four patients were analyzed: 94 in the MDI+S group and 209 in the NEB group. Mean age in years for the MDI+S group was 9.57 vs 5.07 for the NEB group (pgroup vs 61.7% in the NEB group (pdifference between groups in: race, insurance status, gender, or chest radiographs. The mean ED LOS for patients in the MDI+S group was 170 minutes compared to 205 minutes in the NEB group. On average, there was a 25.1 minute time savings per patient in ED treatment time (ptime were chest radiograph, steroids, and treatment mode. Opportunity cost analysis estimated a potential cost

Lung cancer and inhaled uranium ore dust in rats

International Nuclear Information System (INIS)

Mitchel, R.E.J.; Jackson, J.S.

1997-01-01

Using a nose only inhalation system, 187 nine week old male Sprague-Dawley rats were exposed to two different concentrations of natural uranium ore dust aerosol (44% U) without significant radon content. Inhalation exposures averaged about 4.2 h/day, 5 days/week for 65 weeks at which point lung uranium burdens in the two groups averaged 0.9 and 1.9 mg/g dry weight. Animals (63) exposed to the air stream without dust served as controls. After inhalation exposure ceased, the rats were allowed to live for their natural lifetime, a maximum of about 900 days after the start of dust inhalation. Lung uranium burdens were measured at the time of death of each animal. Lung burdens were found to decline exponentially after dust inhalation ceased, and the rate of decline was independent of the initial lung burden. All lungs were examined at necropsy and histologically for lung tumors. Lung tumors of lung origin were observed in both exposed groups and in the control group. The frequency of primary malignant lung tumors was 0.016, 0.175 and 0.328 and primary non-malignant lung tumors 0.016, 0.135 and 0.131 in the control low and high aerosol exposed groups respectively. Absorbed dose to the lung was calculated for each animal in the study. The average maximum doses for all the animals exposed to the low or high concentration of dust aerosol were 0.87 Gy and 1.64 Gy respectively. The average risk of malignant lung tumors from inhaled natural uranium ore dust was therefore about 0.20 tumors/animal/Gy. For animals with lung tumors, the average doses were 0.98 and 1.90 in the exposed groups. In both exposed groups, the frequency of primary malignant or non-malignant lung tumors was significantly greater than in the control group (p < 0.02) and the frequency of primary malignant lung tumors in the two exposed group were significantly different from each other (p = 0.05). The frequency of primary lung tumors (malignant and non-malignant) was calculated as a function of dose

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

International Nuclear Information System (INIS)

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. (authors)

Estimation of risk for lung cancer induced by inhaled alpha-emitting radionuclides at very low doses

International Nuclear Information System (INIS)

Mahaffey, J.A.; Sanders, C.L.

1979-01-01

Results of statistical analyses of data from experiments in which rats were exposed to transuranics by inhalation imply that tumor incidence extrapolated to lower doses is not dependent on the chemical form of the transuranic. Using many questionable assumptions and several alternative models, most of the analyses predicted that irradiation at the current occupational exposure limit of 15 rem/year would increase the tumor incidence in rats to about three times the spontaneous incidence--the spontaneous incidence being defined by a single observed tumor

A method for determining an indicator of effective dose calculation due to inhalation of Radon and its progeny from in vivo measurements

International Nuclear Information System (INIS)

Estrada, Julio Jose da Silva

1994-01-01

Direct measurement of the absolved dose to lung tissue from inhalation of radon and its progeny is not possible and must be calculated using dosimetric models, taking into consideration the several parameters upon which the dose calculation depends. To asses the dose due to inhalation of radon and its progeny, it is necessary to estimate the cumulative exposure. Historically, this has been done using WLM values estimated with measurements of radon concentration in air. The radon concentration in air varies significantly, however, in space with time, and the exposed individual is also constantly moving around. This makes it almost impossible to obtain a precise estimate of an individual's inhalation exposure. This work describes a pilot study to calculate lung dose from the deposition of radon progeny, via estimates of cumulative exposure derived from in vivo measurements of 210 Pb, in subjects exposed to above-average radon and its progeny concentrations in their home environments. The measurements were performed in a whole body counter. With this technique, the exposed individuals become, in affect, their own samplers and dosimeters and the estimate of cumulative exposure is not affected by the variation of the atmospheric concentration of radon and its progeny in time and space. Forty individuals identified as living in homes with radon levels ranging from about 740 Bq/m 3 to 150.000 Bq/m 3 were measured. Also, additional 34 measurements were made on personnel from NYUMC/NIEM who live in a residential area surrounding the laboratory in which the levels of radon have been shown to be at below average values. To realize these measurements a methodology was developed to determine the subject's background, using a head phantom made with a cubic plastic container containing known amounts of potassium and calcium dissolved in four liters of water. The effective doses calculated from the in vivo measurements are compared to effective doses estimated, for the same

Lung tumors and radon inhalation in over 2000 rats: Approximate linearity across a wide range of doses and potentiation by tobacco smoke

International Nuclear Information System (INIS)

Gray, R.G.; Lafuma, J.; Parish, S.E.; Peto, R.; CEA Centre d'Etudes Nucleaires de Fontenay-aux-Roses

1986-01-01

More than 2000 rats were exposed to cumulative doses of up to 28,000 WLMs of radon gas. More than 300 pulmonary tumors were induced by this exposure, most being nonfatal lesions detected only at autopsy of animals that had died of unrelated causes. Above 6000 WLMs rats suffered increasingly from life shortening due to radiation-induced nonneoplastic causes and so had less time in which to develop tumors. When adjusted for these competing causes of death, the hazard function for the excess risk of developing pulmonary tumors was approximately linearly related to dose throughout the range of doses studied. This suggests that some previously reported high-dose ''reductions'' in radiogenic tumor-induction rates may chiefly have involved the killing of rats rather than the killing of precursor cells. Rats exposed to radon and then to six months of inhalation of tobacco smoke had a four times greater age-specific prevalence of pulmonary tumors than rats exposed to an identical radon dose either alone or preceded by tobacco smoke inhalation. This suggests that tobacco smoke may accelerate the carcinogenic process by acting as a promoter of radiation-induced somatic damage. These data suggest that, for assessing human risk from exposure to radon, the linear model should be assumed, but that the WLM is not on its own an adequate index of carcinogenic insult. 7 refs., 2 figs., 4 tabs

Granulometric determinations and inhalation dose assessment for atmospheric aerosol contaminated by {sup 137}Cs; Determinazioni granulometriche e valutazioni di dose da inalazione per aerosol atmosferico contaminato da {sup 137}CS

Energy Technology Data Exchange (ETDEWEB)

Castellani, C.M.; Luciani, A. [ENEA, Centro Ricerche `E. Clementel`, Bologna (Italy). Dip. Ambiente; Oliviero, L.; Donato, R. [ENEA, Centro Ricerche Saluggia, Vercelli (Italy). Dip. Ambiente

1996-07-01

During the redevelopment of Brescia freight-yard a measurement campaign of atmospheric aerosol was carried out: in fact a {sup 137}Cs ground contamination, caused by the permanence of wagons carrying iron materials contaminated by this radionuclide, had been found out. During the redevelopment phases of excavation and can filling the workers were exposed to the danger of radioactive aerosol inhalation. The aim of the measurement campaign was to test the aerosol sampling and granulometric analysis methodologies with their sensitivity related to the inhalation dose assessments. The results of both aerosuspended mass and activity, evaluated by means of a portable cascade impactor, are presented. The granulometries have been interpolated with a log normal distribution using an iterative routine minimizing the square deviation between the calculated and experimental data. The results related to the dose assessments are also presented. These evaluations have been carried out using both the granulometric information obtained and the more recent models (ICRP 66) both the total concentration data and the dose coefficients referring to the standard conditions of ICRP 68 and of the Italian law (D.Lgs. 230/95). Furthermore the significance and the reliability of the dose assessments referring to the different methodologies are discussed, also in relation to the possibility of using this sampling methodologies for other radionuclides and different exposure conditions.

Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity

DEFF Research Database (Denmark)

Bech, Per; Timmerby, N; Martiny, K

2015-01-01

BACKGROUND: The Major Depression Inventory (MDI) was developed to cover the universe of depressive symptoms in DSM-IV major depression as well as in ICD-10 mild, moderate, and severe depression. The objective of this study was to evaluate the standardization of the MDI as a depression severity......-IV major depression. The conventional VAS scores for no, mild, moderate, and severe depression were used for the standardization of the MDI. RESULTS: The inter-correlation for the MDI with the clinician ratings (VAS, MES, HAM-D17 and HAM-D6) increased over the rating weeks in terms of Pearson coefficients....... After nine weeks of therapy the coefficient ranged from 0.74 to 0.83. Using the clinician-rated VAS depression severity scale, the conventional MDI cut-off scores for no or doubtful depression, and for mild, moderate and severe depression were confirmed. CONCLUSIONS: Using the VAS as index of external...

Exposures from external radiation and from inhalation of resuspended material

International Nuclear Information System (INIS)

Jacob, P.; Roth, P.; Golikov, V.; Balonov, M.; Erkin, V.; Likhtariov, I.; Garger, E.; Kashparov, V.

1996-01-01

In the modelling of external exposures due to cesium released during the reactor accident of Chernobyl, gamma dose rates in air over open undisturbed sites are considered to be different according to the unsoluble fraction in the deposit. This is taken into account by forming different classes according to the distance from the Chernobyl NPP. The effect of the different migration behavior in these distance classes on the gamma dose rate in air is found to increase with time. Predictions of gamma dose rates in air are based on measurements of the nuclear weapons tests fallout. Various population groups in the CIS countries are defined according to their place of residence (rural or urban), their occupation or age (indoor resp. outdoor workers, pensioners, school-children, or preschool-children), and their kind of residence (wooden, brick, or multi-storey house). Model results for various population groups are compared with the results of TLD-measurements of individual external exposures. For the calculation of inhalation doses, the new ICRP model for the respiratory tract was used. The dose assessments were conducted for measured size resolved activity distributions of resuspended material, obtained at different locations and for several kinds of agricultural operations. Inhalation doses vary considerably with respect to different kinds of work. Tractor drivers receive much higher doses than other agricultural workers, especially when the cabin window of the tractor is open. Effective doses due to the inhalation of resuspended plutonium are assessed to be a few μSv per initial deposit of one kBq/m 2 . Inhalation doses from 137 Cs are usually smaller by an order of magnitude than the doses from Pu, provided a high solubility is assumed for resuspended Cs

Computationally efficient analysis of particle transport and deposition in a human whole-lung-airway model. Part II: Dry powder inhaler application.

Science.gov (United States)

Kolanjiyil, Arun V; Kleinstreuer, Clement; Sadikot, Ruxana T

2017-05-01

Pulmonary drug delivery is becoming a favored route for administering drugs to treat both lung and systemic diseases. Examples of lung diseases include asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD) as well as respiratory distress syndrome (ARDS) and pulmonary fibrosis. Special respiratory drugs are administered to the lungs, using an appropriate inhaler device. Next to the pressurized metered-dose inhaler (pMDI), the dry powder inhaler (DPI) is a frequently used device because of the good drug stability and a minimal need for patient coordination. Specific DPI-designs and operations greatly affect drug-aerosol formation and hence local lung deposition. Simulating the fluid-particle dynamics after use of a DPI allows for the assessment of drug-aerosol deposition and can also assist in improving the device configuration and operation. In Part I of this study a first-generation whole lung-airway model (WLAM) was introduced and discussed to analyze particle transport and deposition in a human respiratory tract model. In the present Part II the drug-aerosols are assumed to be injected into the lung airways from a DPI mouth-piece, forming the mouth-inlet. The total as well as regional particle depositions in the WLAM, as inhaled from a DPI, were successfully compared with experimental data sets reported in the open literature. The validated modeling methodology was then employed to study the delivery of curcumin aerosols into lung airways using a commercial DPI. Curcumin has been implicated to possess high therapeutic potential as an antioxidant, anti-inflammatory and anti-cancer agent. However, efficacy of curcumin treatment is limited because of the low bioavailability of curcumin when ingested. Hence, alternative drug administration techniques, e.g., using inhalable curcumin-aerosols, are under investigation. Based on the present results, it can be concluded that use of a DPI leads to low lung deposition efficiencies because large amounts of

Indoor radon levels and inhalation doses in dwellings near the some sites of Himachal Pradesh, India

International Nuclear Information System (INIS)

Bajwa, B.S.; Singh, S.; Virk, H.S.

2005-01-01

In view of the fact that radon and its daughters are a major source of natural radiation exposure, the measurement of radon concentration levels in dwellings has assumed ever-increasing importance. Keeping this in view, the indoor radon level measurements were carried out in the dwellings of different villages known to be located in the vicinity of uranium-mineralized pockets of Hamirpur district, Himachal Pradesh. Track-etch technique, a passive method using the Solid State Nuclear Track Detectors (SSNTDs), LR-115 type II, was utilized for these measurements. An attempt has been made to assess the levels of the indoor radon in the dwellings and inhalation dose rates of the population living in these villages. The radon concentrations were found to be varying with seasonal changes, building materials and mode of construction of houses. The radon concentrations were found to be higher in houses made from local sandstone and with mud floor in comparison to the houses having cemented brick floors. The annual indoor radon concentration and thus annual effective dose in most of the dwellings of these villages is certainly quite higher and even in some of the dwellings it even exceeds the upper limit of the proposed action level of ICRP, 1993. The inhalation dose rates in dwellings of these villages located in the vicinity of uranium mineralized pockets of Hamirpur district, Himachal Pradesh have been found to be quite higher than dose rate in the dwellings in the Amritsar city, Punjab, which is located in a completely uranium free zone. The radon survey in the dwellings of these villages has also been carried out using the Alpha-Guard technique, which is based on the pulse ionization chamber. The indoor radon concentration levels measured using the active technique of Alpha Guard have been found to be quite different from those measured in these dwellings by the passive technique of SSNTDs; indicating the importance of the SSNTDs in the long-term integrated measurement

Combined effects of inhalation of Radon daughter products and tobacco smoke

International Nuclear Information System (INIS)

Chameaud, J.; Perraud, R.; Chretien, J.; Masse, R.; Lafuma, J.

1980-01-01

Over the last 10 years, more than 500 lung cancers have been induced in rats by inhalations of radon daughter products at various concentrations and cumulated doses. These cancers were compared with human cancers. Another study examines the cocarcinogenic effect of tobacco smoke. In the first experiment, 100 rats were exposed to a 4000-WLM (working level month) cumulated dose of radon daughter products. Fifty animals were then administered tobacco smoke by inhalation in a fume box during 5 months (i.e., for a total of 352 hr). In the group inhaling radon only, 17 cancers appeared; in the radon-tobacco group, 32 cancers were observed, many of them larger and more invasive than those seen in animals exposed to radon only. Under the same conditions tobacco smoke was inhaled by rats previously exposed to lower doses of radon daughter products (two groups of 30 rats each, at 500 and 100 WLM, respectively). Again, the number of cancers observed was greater than the number of cancers expected if the rats had inhaled radon only. The carcinogenic and potentiating action of tobacco smoke was clearly demonstrated

Toxicity of inhaled alpha-emitting radionuclides - Status report

Energy Technology Data Exchange (ETDEWEB)

Muggenburg, B A; Mewhinney, J A; Guilmette, R A; Gillett, N A; Diel, J H; Lundgren, D L; Hahn, F F; Boecker, B B; McClellan, R O

1988-12-01

The toxicity of inhaled alpha-emitting radionuclides is being investigated in a series of interrelated dose-response studies. Dogs, rodents, and nonhuman primates have been exposed to monodisperse or polydisperse aerosols of the oxides of {sup 239}Pu, {sup 238}Pu, {sup 241}Am, or {sup 244}Cm to measure the relative importance of average organ dose, local dose around particles, specific activity, chemical form, particle size, and number of particles inhaled to the development of biological effects. The influence of animal species, age at exposure, and pre-existing lung disease, as well as the effects of repeated exposure, are also being studied, because they may influence the toxicity of these radionuclides. (author)

Analytical determination of specific 4,4'-methylene diphenyl diisocyanate hemoglobin adducts in human blood.

Science.gov (United States)

Gries, Wolfgang; Leng, Gabriele

2013-09-01

4,4'-Methylene diphenyl diisocyanate (MDI) is one of the most important isocyanates in the industrial production of polyurethane and other MDI-based synthetics. Because of its high reactivity, it is known as a sensitizing agent, caused by protein adducts. Analysis of MDI is routinely done by determination of the nonspecific 4,4'-methylenedianiline as a marker for MDI exposure in urine and blood. Since several publications have reported specific adducts of MDI and albumin or hemoglobin, more information about their existence in humans is necessary. Specific adducts of MDI and hemoglobin were only reported in rats after high-dose MDI inhalation. The aim of this investigation was to detect the hemoglobin adduct 5-isopropyl-3-[4-(4-aminobenzyl)phenyl]hydantoin (ABP-Val-Hyd) in human blood for the first time. We found values up to 5.2 ng ABP-Val-Hyd/g globin (16 pmol/g) in blood samples of workers exposed to MDI. Because there was no information available about possible amounts of this specific MDI marker, the analytical method focused on optimal sensitivity and selectivity. Using gas chromatography-high-resolution mass spectrometry with negative chemical ionization, we achieved a detection limit of 0.02 ng ABP-Val-Hyd/g globin (0.062 pmol/g). The robustness of the method was confirmed by relative standard deviations between 3.0 and 9.8 %. Combined with a linear detection range up to 10 ng ABP-Val-Hyd/g globin (31 pmol/g), the enhanced precision parameter demonstrates that the method described is optimized for screening studies of the human population.

An evaluation of children's metered-dose inhaler technique for asthma medications.

Science.gov (United States)

Burkhart, Patricia V; Rayens, Mary Kay; Bowman, Roxanne K

2005-03-01

Regardless of the medication delivery system, health care providers need to teach accurate medication administration techniques to their patients, educate them about the particular nuances of the prescribed delivery system (eg, proper storage), and reinforce these issues at each health encounter. A single instruction session is not sufficient to maintain appropriate inhaler techniques for patients who require continued use. Providing written steps for the administration technique is helpful so that the patient can refer to them later when using the medication. The National Heart, Lung, and Blood Institute's "Practical Guide for the Diagnosis and Management of Asthma" recommends that practitioners follow these steps for effective inhaler technique training when first prescribing an inhaler: 1. Teach patients the steps and give written instruction handouts. 2. Demonstrate how to use the inhaler step-by-step. 3. Ask patients to demonstrate how to use the inhaler. Let the patient refer to the handout on the first training. Then use the handout asa checklist to assess the patient's future technique. 4. Provide feedback to patients about what they did right and what they need to improve. Have patients demonstrate their technique again, if necessary. The last two steps should be performed (ie, demonstration and providing feedback on what patients did right and what they need to improve) at every subsequent visit. If the patient makes multiple errors, it is advisable to focus on improving one or two key steps at a time. With improvements in drug delivery come challenges, necessitating that practitioners stay current with new medication administration techniques. Teaching and reinforcing accurate technique at each health care encounter are critical to help ensure medication efficacy for patients with asthma. Since one fifth of children in the study performed incorrect medication technique even after education, checklists of steps for the correct use of inhalation devices

The predictive value of mental health for long-term sickness absence: the Major Depression Inventory (MDI) and the Mental Health Inventory (MHI-5) compared.

Science.gov (United States)

Thorsen, Sannie Vester; Rugulies, Reiner; Hjarsbech, Pernille U; Bjorner, Jakob Bue

2013-09-17

Questionnaires are valuable for population surveys of mental health. Different survey instruments may however give different results. The present study compares two mental health instruments, the Major Depression Inventory (MDI) and the Mental Health Inventory (MHI-5), in regard to their prediction of long-term sickness absence. Questionnaire data was collected from N = 4153 Danish employees. The questionnaire included the MDI and the MHI-5. The information of long-term sickness absence was obtained from a register. We used Cox regression to calculate covariance adjusted hazard ratios for long-term sickness absence for both measures. Both the MDI and the MHI-5 had a highly significant prediction of long-term sickness absence. A one standard deviation change in score was associated with an increased risk of long-term sickness absence of 27% for the MDI and 37% for the MHI-5. When both measures were included in the same analysis, the MHI-5 performed best. In general population surveys, the MHI-5 is a better predictor of long-term sickness absence than the MDI.

Safety of an alkalinizing buffer designed for inhaled medications in humans.

Science.gov (United States)

Davis, Michael D; Walsh, Brian K; Dwyer, Scott T; Combs, Casey; Vehse, Nico; Paget-Brown, Alix; Pajewski, Thomas; Hunt, John F

2013-07-01

Airway acidification plays a role in disorders of the pulmonary tract. We hypothesized that the inhalation of alkalinized glycine buffer would measurably alkalinize the airways without compromising lung function or causing adverse events. We evaluated the safety of an inhaled alkaline glycine buffer in both healthy subjects and in subjects with stable obstructive airway disease. This work includes 2 open-label safety studies. The healthy controls were part of a phase 1 safety study of multiple inhalations of low-dose alkaline glycine buffer; nebulized saline was used as a comparator in 8 of the healthy controls. Subsequently, a phase 2 study in subjects with stable obstructive airway disease was completed using a single nebulized higher-dose strategy of the alkaline inhalation. We studied 20 non-smoking adults (10 healthy controls and 10 subjects with obstructive airway disease), both at baseline and after inhalation of alkaline buffer. We used spirometry and vital signs as markers of clinical safety. We used changes in fraction of exhaled nitric oxide (NO) and exhaled breath condensate (EBC) pH as surrogate markers of airway pH modification. Alkaline glycine inhalation was tolerated by all subjects in both studies, with no adverse effects on spirometric parameters or vital signs. Airway alkalinization was confirmed by a median increase in EBC pH of 0.235 pH units (IQR 0.56-0.03, P = .03) in subjects after inhalation of the higher-dose alkaline buffer (2.5 mL of 100 mmol/L glycine). Alkalinization of airway lining fluid is accomplished with inhalation of alkaline glycine buffer and causes no adverse effects on pulmonary function or vital signs.

Inhaled plutonium oxide in dogs

International Nuclear Information System (INIS)

Park, J.F.

1982-01-01

This project is concerned with long-term experiments to determine the lifespan dose-effect relationships of inhaled 239 PuO 2 and 238 PuO 2 in beagles. Beagle dogs given a single exposure to 239 PuO 2 or 238 PuO 2 aerosols are being observed for lifespan dose-effect relationships. The 239 Pu 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 238 Pu 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 239 PuO 2 or 238 PuO 2

Inhalation dose assessment inside various storage godowns of a phosphatic fertiliser plant

International Nuclear Information System (INIS)

Shukla, V.K.; Eapen, C.D.; Mishra, U.C.

1995-01-01

The paper presents the assessment of inhalation dose from 222 Rn daughters received by the persons working inside various godowns, meant for storing rock phosphate and different types of phosphatic fertilisers produced by a plant at Bombay. The dose assessment was made by measuring the respirable airborne concentrations of 222 Rn daughters inside the godowns. Rock phosphate is the base material for the production of phosphatic fertilisers and it contains significant quantities of 226 Ra. 226 Ra activity in rock phosphate from different places is ranging between 5 (Udaipur, India) to 1480 Bq/kg (Florida, USA) and its range in NP: 20-20-0 and NPK: 15-15-15 type fertilisers is 254 to 272 Bq/kg and 127 to 208 Bq/kg respectively. 226 Ra is the source of emanation of 222 Rn inside the godowns. It was observed that though the specific activity of 218 Po, 214 Pb and 214 Bi in the total airborne particulate matter was higher inside the rock phosphate godown but the specific activity of the aforementioned radionuclides in the respirable fractions inside the phosphatic fertilisers' godown were more. The reasons for these observations are discussed in the paper. (author). 7 refs., 2 tabs

Evaluation of Inhaler Techniques Among Asthma Patients Seen in ...

African Journals Online (AJOL)

Background: An Adequate and an effective dose of inhalation drugs can be administered only if the correct inhaler‑specific technique is followed by asthma patients. There is paucity of data on this subject among Nigerians and Africans. Aims: This observational study was to assess the inhaler techniques among asthma ...

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study.

Science.gov (United States)

Engelkes, Marjolein; van Blijderveen, Jan C; Overbeek, Jetty A; Kuiper, Josephine; Herings, Ron C M; Sturkenboom, Miriam C J M; de Jongste, Johan C; Verhamme, Katia M C; Janssens, Hettie M

2017-11-29

The expiration of patents of brand inhalation medications and the ongoing pressure on healthcare budgets resulted in a growing market for generics. To study the use of brand and generic inhalation medication and the frequency of switching between brand and generic and between devices. In addition, we investigated whether switching affected adherence. From dispensing data from the Dutch PHARMO Database Network a cohort aged ≥ 5 years, using ≥ 1 year of inhalation medication between 2003 and 2012 was selected. Switching was defined as changing from brand to generic or vice versa. In addition, we studied change in aerosol delivery device type (e.g., DPI, pMDI, and nebulizers). Adherence was calculated using the medication possession ratio (MPR). The total cohort comprised 70,053 patients with 1,604,488 dispensations. Per calendar year, 5% switched between brand and generic inhalation medication and 5% switched between devices. Median MPRs over the first 12 months ranged between 33 and 55%. Median MPR over the total period was lower after switch from brand to generic and vice versa for formoterol (44.5 vs. 42.1 and 63.5 vs. 53.8) and beclomethasone (93.8 vs. 59.8 and 81.3 vs. 55.9). Per year, switching between brand and generic inhalation medication was limited to 5% of the patients, switching between device types was observed in 5% as well. Adherence to both generic and brand inhalation medication was low. Effect of switching on adherence was contradictory; depending on time period, medication and type, and direction of switching. Further research on reasons for switching and potential impact on clinical outcomes is warranted.

Dispersing the Mists: An Experimental History of Medicine Study into the Quality of Volatile Inhalations.

Science.gov (United States)

Murnane, Barry; Gallagher, Cathal T; Snell, Noel; Sanders, Mark; Moshksar, Ramin; Murnane, Darragh

2017-06-01

Dr. Nelson's Improved Inhaler was first marketed with an advertisement in The Lancet in 1865. Revolutionary at the time for its ease of use and patient-friendliness, the inhaler is still in use for self-treatment by many all over the world. On the occasion of its 150th anniversary, this study reports an experimental historical medicine approach to identify evidence for the quality of vapor inhalers. Through accessing reviews of the device's use by the contemporary medical establishment, it was established that Dr. Nelson's Inhaler enjoyed a reputation of quality and efficacy among reputable physicians generating empirical evidence of clinical performance. There was a general absence of product performance tests during this period. Therefore, modern inhalation performance testing was applied to test the aerosol delivery performance for Friars' Balsam, and its key chemical constituent, benzoic acid (BA). A respirable dose of 59.9 ± 9.0 μg of BA was aerosolized in a 10 minutes period from a dose of 3.3 mL Friars' Balsam (equivalent to 35.1 ± 0.2 mg of BA) in 375 mL of steaming water using the glass twin stage impinger at a flow rate of 60 L·min -1 . The respirable dose from a standardized aqueous BA inhalation formulation increased from 115.9 ± 10.6 to 200.2 ± 19.9 μg by increasing the simulated inhalation period from 5 to 10 minutes. When tested with a simulated inhalation maneuver (500 mL tidal volume, 13 minutes -1 respiration rate, 1:2 inspiratory:expiratory ratio) a respirable dose of 112.8 ± 40.3 μg was produced. This work has highlighted the potential for aerosol drug delivery using steam inhalers that are popular with patients. Physicians should therefore be aware of the potential for lung dosing with irritants when patients self-medicate using the Nelson Inhaler with vaporizing formulations such as Friars' Balsam.

Teaching inhaler use in chronic obstructive pulmonary disease patients.

Science.gov (United States)

Lareau, Suzanne C; Hodder, Richard

2012-02-01

To review barriers to the successful use of inhalers in patients with chronic obstructive pulmonary disease (COPD), and the role of the nurse practitioner (NP) in facilitating optimum inhaler use. Review of the national and international scientific literature. Pharmacologic treatment of COPD patients comprises mainly inhaled medications. Incorrect use of inhalers is very common in these individuals. Some of the consequences of poor inhaler technique include reduced therapeutic dosing, medication adherence, and disease stability, which can lead to increased morbidity, decreased quality of life, and a high burden on the healthcare system. Knowledgeable evaluation and frequent reassessment of inhaler use coupled with education of patients, caregivers, and healthcare professionals can significantly improve the benefits COPD patients derive from inhaled therapy. Patient education is vital for correct use of inhalers and to ensure the effectiveness of inhaled medications. The NP has a critical role in assessing potential barriers to successful learning by the patient and improving inhaler technique and medication management. The NP can also facilitate success with inhaled medications by providing up-to-date inhaler education for other healthcare team members, who may then act as patient educators. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

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.

Contribution of time-activity pattern and microenvironment to black carbon (BC) inhalation exposure and potential internal dose among elementary school children

Science.gov (United States)

Jeong, Hyeran; Park, Donguk

2017-09-01

The aims of this study were to quantify the contributions of activities or microenvironments (MEs) to daily total exposure to and potential dose of black carbon (BC). Daily BC exposures (24-h) were monitored using a micro-aethalometer micoAeth AE51 with forty school-aged children living in an urban area in Korea from August 2015 to January 2016. The children's time-activity patterns and the MEs they visited were investigated by means of a time-activity diary (TAD) and follow-up interviews with the children and their parents. Potential inhaled dose was estimated by multiplying the airborne BC concentrations (μg/m3) we monitored for the time the children spent in a particular ME by the inhalation rate (IR, m3/h) for the time-activity performed. The contribution of activities and MEs to overall daily exposure to and potential dose of BC was quantified. Overall mean daily potential dose was equal to 24.1 ± 10.6 μg/day (range: 6.6-46.3 μg/day). The largest contribution to BC exposure and potential dose (51.9% and 41.7% respectively) occurred in the home thanks to the large amount of time spent there. Transportation was where children received the most intense exposure to (14.8%) and potential dose (20.2%) of BC, while it accounted for 7.6% of daily time. School on weekdays during the semester was responsible for 20.3% of exposure and 22.5% of potential dose. Contribution to BC exposure and potential dose was altered by several time-activity parameters, such as type of day (weekdays vs. weekends; school days vs. holidays), season, and gender. Traveling by motor vehicle and subway showed more elevated exposure or potential dose intensity on weekdays or school days, probably influenced by the increased surrounding traffic volumes on these days compared to on weekends or holidays. This study may be used to prioritize targets for minimizing children's exposure to BC and to indicate outcomes of BC control strategies.

Radon in the Underground Workplaces; Assessment of the Annual Effective Dose due to Inhaled Radon for the Seoul Subway Station Staffs

Energy Technology Data Exchange (ETDEWEB)

Song, Myeong Han; Chang, Byung Uck; Kim, Yong Jae [University of Science and Technology, Daejeon (Korea, Republic of); Lee, Hwa Yong [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Heo, Dong Hey [Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of)

2010-12-15

The effective dose of the Seoul subway staffs due to inhaled radon ({sup 222}Rn) in their workplace was investigated depended on radon concentration exposed at each workplace, and working hours and working types of the staffs. Annual average radon concentrations ranged from 16.5 to 93.0 Bq·m{sup -3}. The staffs commonly spend 2,304 hours in the underground spaces a year. With the radon concentrations and the working hours of the staffs, estimated annual effective doses ranged from 0.23 to 0.73 mSv·y{sup -1}.

Radon in the Underground Workplaces; Assessment of the Annual Effective Dose due to Inhaled Radon for the Seoul Subway Station Staffs

International Nuclear Information System (INIS)

Song, Myeong Han; Chang, Byung Uck; Kim, Yong Jae; Lee, Hwa Yong; Heo, Dong Hey

2010-01-01

The effective dose of the Seoul subway staffs due to inhaled radon ( 222 Rn) in their workplace was investigated depended on radon concentration exposed at each workplace, and working hours and working types of the staffs. Annual average radon concentrations ranged from 16.5 to 93.0 Bq·m -3 . The staffs commonly spend 2,304 hours in the underground spaces a year. With the radon concentrations and the working hours of the staffs, estimated annual effective doses ranged from 0.23 to 0.73 mSv·y -1

Experimental study of the combined effects of inhalation of radon daughter products and tobacco smoke

International Nuclear Information System (INIS)

Chameaud, J.; Perraud, R.; Chretien, J.; Masse, R.; Lafuma, J.

1979-01-01

For 10 years, over 500 lung cancers have been induced in rats by inhalations of radon daughter products at various concentrations and cumulated doses. Considering several points and the dose-effect relationship especially, such cancers can be compared with human cancers. This type of experiments, fully mastered, has made it possible to undertake under good conditions the study of the co-carcinogenic effect of various inhaled pollutants such as tobacco smoke. In a first experiment, 100 rats were exposed to a 4000WLM cumulated dose of radon daughter products, knowing that this level induces some 30% of lung cancers. 50 animals were then administered tobacco smoke by inhalation in a fume box during 5 months (350 h.) In the group inhaling radon only, 17 cancers appeared; in the radon -tobacco group 32 cancers bigger and more invasive were observed. Under the same conditions, tobacco smoke was inhaled by rats previously exposed to lower doses of radon daughter products (2 groups of 30 rats, 500 and 100 WLM respectively). Again, the number of cancers observed was higher that the number of cancers expected if the rats had inhaled radon only. This co-carcinogenic and potentiating action of tobacco was clearly demonstrated. Further experiments are considered in order to determine the processes involved

Inhaled Surfactant Therapy in Newborns in Artificial Lung Ventilation

Directory of Open Access Journals (Sweden)

S. A. Perepelitsa

2014-01-01

Full Text Available Objective: to evaluate the efficiency of inhaled surfactant therapy in neonatal infants with respiratory failure.Subjects and methods. The trial enrolled 13 premature neonatal infants; their mean gestational age was 31.8±2.8 weeks and the birth weight was 1825±600.9 g. They had a oneminute Apgar score of 4.3±1.4. All the neonates needed mechanical ventilation (MV atbirth because the leading clinical sign was respiratory failure caused by acute intranatal hypoxia, neonatal amniotic fluid aspiration, respiratory distress syndrome (RDS, and cerebral ischemia. Curosurf was injected in a dose of 174.7±21 mg/kg in the infants with neonatal RDS at 35 minutes of life. All the babies included in the study were noted to have severe disease and prolonged MV. After stabilization of their status, the neonates received combination therapy involving surfactantBL inhalation to reduce the duration of MV. The dose of the agent was 75 mg. Results. After surfactantBL inhalation, effective spontaneous respiration occurred in 69.2% of the newborn infants; successful extubation was carried out. The median duration ofMV after surfactant BL inhalation was 22 hours (4—68 hours. There were no reintubated cases after inhalation therapy. Following surfactantBL inhalation, 4 (30.8% patients remained to be on MV as a control regimen; 3 of them had highfre quency MV. SurfactantBL inhalation made it possible to change the respiratory support regimen and to reduce MV parame ters in these babies. 

Inhaled Steroids: First Line Treatment of Adult Asthma

Directory of Open Access Journals (Sweden)

André Cartier

1995-01-01

Full Text Available Corticosteroids are the most potent inhaled anti-inflammatory drugs for asthma treatment. This paper reviews the clinical evidence supporting the early use of inhaled steroids in asthma as a first line treatment. Inhaled steroids can probably alter the course of asthma, especially in mild asthmatics. Once they have been shown to improve control of asthma and even if the need for beta2-agonists is virtually nil, their use should be continued at low doses (ie, equivalent to 400 to 500 μg of budesonide or beclomethasone for at least one year before attempting to reduce the dosage.

Late effects of inhaled 253Es(NO3)3 in rats

International Nuclear Information System (INIS)

Ballou, J.E.; Dagle, G.E.; Gies, R.A.; Smith, L.G.

1979-01-01

Einsteinium-253 nitrate was administered as an aerosol to male Wistar rats and the long-term biological effects were followed for the animals' life span. Lung was the major target organ for absorbed radiation dose and tumor induction, in agreement with results for other inhaled transuranic nitrates. The earlier finding of a high incidence of bone tumors following intratracheal instillation of 253 EsCl 3 was not confirmed in the present study with inhaled 253 Es(NO 3 ) 3 . The reason for the difference in bone tumor production is believed to be related to the different acute toxicities of intratracheally instilled and inhaled 253 Es. Intratracheally instilled 253 EsCl 3 was less acutely toxic (only a single lobe or one-half the lung was irradiated); thus, a larger more tumorigenic dose could be translocated to bone without shortening the life span to the extent that bone tumors could not be expressed. The radiation dose from inhaled 253 Es(NO 3 ) 3 was uniformly spread throughout both lungs and early death due to a generalized radiation pneumonitis precluded the development of long-term effects in bone. (author)

Inhalation toxicology of 241Am(NO3)3

International Nuclear Information System (INIS)

Ballou, J.E.; Gies, R.A.; Beasley, A.H.

1980-01-01

Inhaled 241 Am(NO 3 ) 3 was rapidly cleared from the lung (90% in 30 days) and translocated principally to skeleton. Although the estimated radiation dose to lung was twofold greater than the bone dose, the principal treatment-related lesion appeared to be osteosarcoma of the skeleton

Adhesion of nitrile rubber (NBR) to polyethylene terephthalate (PET) fabric. Part 1: PET surface modification by methylenediphenyl di-isocyanate (MDI)

International Nuclear Information System (INIS)

Razavizadeh, Mahmoud; Jamshidi, Masoud

2016-01-01

Graphical abstract: - Highlights: • Glutaric anhydride peroxide (GAP) was grafted on PET surface by UV irradiation method. Then MDI was attached to GAP on PET surface. • The fabric was vulcanized by nitrile rubber. • Peet test was performed after each stage of surface modification. • Curing temperature was increased and the tests were repeated. • Effect of MDI coating on PET without carboxylation was evaluated. Effect of vulcanizing temperature on this product was also studied. - Abstract: Fiber to rubber adhesion is an important subject in rubber composite industry. It is well known that surface physical, mechanical and chemical treatments are effective methods to improve interfacial bonding. Ultra violet (UV) light irradiation is an efficient method which is used to increase interfacial interactions. In this research UV assisted chemical modification of PET fabric was used to increase its bonding to nitrile rubber (NBR). NBR is perfect selection to produce fuel and oil resistant rubber parts but it has weak bonding to fabrics. For this purpose at first, the PET fabric was carboxylated under UV irradiation and then methylenediphenyl diisocyanate (MDI) was reacted and grafted to carboxylated PET. T-peel test was used to evaluate PET fabric to NBR bonding strength. Attenuated total reflectance-Fourier transform infrared spectroscopy (FTIR-AT) was used to assess surface modifications of the PET fabrics. The chemical composition of the PET surfaces before and after carboxylation and MDI grafting was investigated by X-ray photoelectron spectroscopy (XPS). It was found that at vulcanizing temperature of 150 °C, carboxylation in contrary to MDI grafting, improved considerably PET to NBR adhesion. Finally effect of curing temperature on PET to NBR bonding strength was determined. It was found that increasing vulcanizing temperature to 170 °C caused considerable improvement (about 134%) in bonding strength.

Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients.

Science.gov (United States)

Moustafa, Islam O F; Ali, Mohammed R A-A; Al Hallag, Moataz; Rabea, Hoda; Fink, James B; Dailey, Patricia; Abdelrahim, Mohamed E A

During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups. Groups 1 and 2 received 5000 μg salbutamol using vibrating mesh (VM) and jet nebulizers (JN), respectively, while group 3 received 1600 μg (16 puffs) of salbutamol via metered dose inhaler with AeroChamber Vent (MDI-AV). All devices were placed in the inspiratory limb of ventilator downstream from the humidifier. Each subject received aerosol with and without humidity at >24 h intervals with >12 h washout periods between salbutamol doses. Patients voided urine 15 min before each study dose and urine samples were collected at 0.5 h post dosing and pooled for the next 24 h. The MDI-AV and VM resulted in a higher percentage of urinary salbutamol levels compared to the JN (p < 0.05). Urine levels were similar between humidity and dry conditions. Our findings suggest that in-vitro reports overestimate the impact of dry vs. heated humidified conditions on the delivery of aerosol during invasive mechanical ventilation. Copyright © 2017 Elsevier Inc. All rights reserved.

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

(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...

Lung dosimetry for inhaled radon progeny in smokers

International Nuclear Information System (INIS)

Baias, P. F.; Hofmann, W.; Winkler-Heil, R.; Cosma, C.; Duliu, O. G.

2010-01-01

Cigarette smoking may change the morphological and physiological parameters of the lung. Thus the primary objective of the present study was to investigate to what extent these smoke-induced changes can modify deposition, clearance and resulting doses of inhaled radon progeny relative to healthy non-smokers (NSs). Doses to sensitive bronchial target cells were computed for four categories of smokers: (1) Light, short-term (LST) smokers, (2) light, long-term (LLT) smokers, (3) heavy, short-term (HST) smokers and (4) heavy, long-term (HLT) smokers. Because of only small changes of morphological and physiological parameters, doses for the LST smokers hardly differed from those for NSs. For LLT and HST smokers, even a protective effect could be observed, caused by a thicker mucus layer and increased mucus velocities. Only in the case of HLT smokers were doses higher by about a factor of 2 than those for NSs, caused primarily by impaired mucociliary clearance, higher breathing frequency, reduced lung volume and airway obstructions. These higher doses suggest that the contribution of inhaled radon progeny to the risk of lung cancer in smokers may be higher than currently assumed on the basis of NS doses. (authors)

Design and application of a new modular adapter for laser diffraction characterization of inhalation aerosols

NARCIS (Netherlands)

de Boer, Anne; Gjaltema, D; Hagedoorn, P; Schaller, M; Witt, W; Frijlink, H W

2002-01-01

An inhaler adapter has been designed for the characterization of the aerosol clouds from medical aerosol generators such as nebulizers, dry powder inhalers (dpis) and metered dose inhalers (mdis) with laser diffraction technology. The adapter has a pre-separator, for separation of large particles

Inhalation drug delivery devices: technology update

Directory of Open Access Journals (Sweden)

Ibrahim M

2015-02-01

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

Dose patterns for 106RuO4 inhaled by Fischer-344 rats and Beagle dogs

International Nuclear Information System (INIS)

Runkle, G.E.; Snipes, M.B.

1978-01-01

Ruthenium-106 is an abundant fission product radionuclide in the nuclear fuel cycle which has potential for release as ruthenium tetroxide. Ruthenium tetroxide is a vapor, diffuses rapidly through air and porous materials, is chemically reactive and is rapidly reduced by any organic material to the dioxide form. Current ICRP recommendations consider the lung and gastrointestinal tract as critical organs for inhaled particles of radioactive ruthenium. This study was designed to provide additional data needed to adequately assess the risk for humans potentially exposed to 106 Ru encountered in this vapor form. Fischer-344 rats and Beagle dogs were given a nose-only exposure to 106 RuO 4 vapor to determine its distribution and retention patterns. The largest percentage of the initial body burden was found in the nasopharyngeal region of the respiratory tract. Less than 1% of the initial body burden was deposited in the pulmonary region. Most of the 106 Ru was cleared via the feces. A biomathematical simulation model was developed to fit the tissue and excreta data from the rat. This model was used to assess the short-term and long-term risks after inhalation of 106 RuO 4 . The observed deposition, retention and dose patterns for ruthenium tetroxide indicate the nasopharyngeal region should be considered as a critical region when considering the consequences of human exposure to this vapor

Toxicity studies of inhaled beta-emitting radionuclides - Status report

Energy Technology Data Exchange (ETDEWEB)

Hahn, F F; Boeker, B B; Gillett, N A; Griffith, W C; Lundgren, D L; McClellan, R O; Muggenburg, B A; Snipes, M B

1988-12-01

The effects of beta-emitting radionuclides inhaled in either a relatively soluble form ({sup 90}SrCl{sub 2}, {sup 144}CeCl{sub 3}, {sup 91}yl{sub 3}, or {sup 137}CsCl) or in a relatively insoluble form ({sup 90}Y, {sup 91}Y, {sup 144}Ce or {sup 90}Sr in fused aluminosilicate particles [FAP]) have been studied in laboratory animals. The results showed that the total beta dose and the dose-rate pattern can modify both the neoplastic and non-neoplastic effects of inhaled beta-emitting radionuclides. In addition, the solubility and chemical characteristics of the radionuclides influence which organs are affected. Effects are seen primarily in organs where the radionuclide is ultimately accumulated, e.g., lung, bone, liver, or tracheobronchial lymph nodes. In addition, effects may be seen in organs where there is little accumulation, but where the radiation dose may still be high, e.g., nasal epithelium and heart. Studies of inhaled {sup 144}Ce-FAP in four different species showed that, compared to mice and dogs, lung tumor risk factors are very low for Syrian hamsters and high for rats. Studies of mice, Syrian hamsters, rats, and dogs repeatedly exposed to aerosols of {sup 144}Ce-FAP showed that lung tumor incidence correlates better with cumulative dose to the lung than with dose rate. Most of the studies in this program are nearing completion and full analyses are in progress. (author)

[Deliberate interruptions and changes of dose of inhaled corticosteroids by asthma patients: "a community pharmacy study"].

Science.gov (United States)

Laforest, L; Van Ganse, É; Devouassoux, G; Chatté, G; Tamberou, C; Belhassen, M; Chamba, G

2015-01-01

Adherence to inhaled corticosteroids (ICS) remains a major issue for asthma management, even among patients receiving a regular prescription from their doctor. The frequency of deliberate interruption of ICS, and of spontaneous changes of dose, were studied in a population of asthma patients recruited in community pharmacies. Asthma patients (aged 18-50) recruited in community pharmacies reported in self-administered questionnaires their spontaneous interruptions and changes of doses of ICS during the past 3 months. The characteristics of patients who interrupted their therapy or who modified the dose were compared with other patients. The studied population included 252 patients (mean age 35 year-old, females: 59%), of whom 62% had inadequately controlled asthma. Among these patients, 25% had interrupted ICS therapy during the past 3 months, while 21% spontaneously changed the dose. The most reported reason for interrupting ICS was the cessation of symptoms (50%). In multivariate analysis, interrupting ICS was mainly associated with inadequate asthma control (OR=3.1, 95% CI 1.5-6.4), while the strongest association with changing ICS doses was the patients' perception of asthma as a concern in their lives (OR=3.2, 95% CI 1.2-8.4). These results underline a poor understanding of the purpose of ICS therapy by patients. They also highlight the need of therapeutic education to improve the management of the disease. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Modulation of Immune Response in Asthmatic Patients by Using Inhaled Tuberculin

International Nuclear Information System (INIS)

Abou Gamrah, E.M.; Borai, I.H.; Zahran, W.E.; Labib, I.B.; Lotfy, O.A.

2008-01-01

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

Individual monitoring program for internal contamination by inhaled uranium

International Nuclear Information System (INIS)

Vazquez, C.; Chapel, M.L.; Saenz Gancedo, R.

1988-01-01

The metabolic behaviour of inhaled uranium is studied. Using a particular analytical method applied to the models and dose assessment methods recommended by ICRP, the organ committed equivalent dose and effective equivalent dose are calculated. The exact ALI and DAC are derived from there. In the paper, the influence that various parameters have on those results are considered for the specific case of a particular nuclear element fabrication factory. Different AMAD and solubility type of inhaled material are specially analyzed. The results show the paramount importance of some of these parameters on the secondary and derived dose limits. Relationships between the real intake, as a fraction of ALI, and the lung retention or urine excretion are shown for different cases and intake forms hypothesis. Minimum detectable intakes with the available experimental techniques are then established. The results shown in the papel are a useful tool to help on the decision on the type and frequency of the individual monitoring techniques to be established in different circumstances. (Author)

Deposition, translocation and effects of transuranic particles inhaled by experimental animals

International Nuclear Information System (INIS)

Craig, D.K.; Ballou, J.E.; Dagle, G.E.; Mahlum, D.D.; Park, J.F.; Sanders, C.L.; Sikov, M.R.; Stuart, B.O.

1977-01-01

Inhalation exposure constitutes the most likely route of entrance for transuranics into the body. Cancer is the most likely consequence of exposure, but several thousand workers have been exposed during the last 30 yrs without, so far, evidence of exposure-related effects. Several soluble and insoluble transuranic compounds have been studied in rodents and dogs, either alone or combined with exposure to other materials (e.g., PuO/sub 2/--UO/sub 2/ fuel and Na). These studies have provided a wide variety of spatial and temporal dose distribution patterns in the lung. The distribution and total initial deposition in the respiratory tract is a function of the physical characteristics of the inhaled aerosols (size distribution, shape, hygroscopicity) and of the morphology and physiology of the animal. Translocation rates, organ and tissue distribution and excretion in urine and feces, are a function of the physicochemical characteristics of the deposited material (solubility, specific activity, chemical compound, etc.). Differences in rate of translocation of the solubilized material, primarily to the liver and bone, determines the radiation dose to the various tissues involved. Insoluble particles of plutonium dioxide are transferred to the thoracic lymph nodes, which may be functionally destroyed as a consequence. Radiation pneumonitis and pulmonary fibrosis are the main causes of death in animals with cumulative radiation doses to the lung of a few thousand rads. The most significant long-term effect of inhaled transuranic compounds in animals is the development of lung and bone tumors. The main type of lung tumor in both dog and rat is the bronchioloalveolar carcinoma (adenocarcinoma). However, tumor type is a function of radiation dose and dose-distribution at high doses. Bone ranks next to lung as the tissue developing the most tumors following inhalation of transuranics

Deposition, translocation, and effects of transuranic particles inhaled by experimental animals

International Nuclear Information System (INIS)

Craig, D.K.; Ballou, J.E.; Dagle, G.E.; Mahlum, D.D.; Park, J.F.; Sanders, C.L.; Sikov, M.R.; Stuart, B.O.

1977-01-01

Inhalation exposure constitutes the most likely route of entrance for transuranics into the body. Cancer is the most likely consequence of exposure, but several thousand workers have been exposed during the last 30 yrs without, so far, evidence of exposure-related effects. Several soluble and insoluble transuranic compounds have been studied in rodents and dogs, either alone or combined with exposure to other materials (e.g., PuO 2 --UO 2 fuel and Na). These studies have provided a wide variety of spatial and temporal dose distribution patterns in the lung. The distribution and total initial deposition in the respiratory tract is a function of the physical characteristics of the inhaled aerosols (size distribution, shape, hygroscopicity) and of the morphology and physiology of the animal. Translocation rates, organ and tissue distribution and excretion in urine and feces, are a function of the physicochemical characteristics of the deposited material (solubility, specific activity, chemical compound, etc.). Differences in rate of translocation of the solubilized material, primarily to the liver and bone, determines the radiation dose to the various tissues involved. Insoluble particles of plutonium dioxide are transferred to the thoracic lymph nodes, which may be functionally destroyed as a consequence. Radiation pneumonitis and pulmonary fibrosis are the main causes of death in animals with cumulative radiation doses to the lung of a few thousand rads. The most significant long-term effect of inhaled transuranic compounds in animals is the development of lung and bone tumors. The main type of lung tumor in both dog and rat is the bronchioloalveolar carcinoma (adenocarcinoma). However, tumor type is a function of radiation dose and dose-distribution at high doses. Bone ranks next to lung as the tissue developing the most tumors following inhalation of transuranics

Economics of "essential use exemptions" for metered-dose inhalers under the Montreal Protocol.

Science.gov (United States)

DeCanio, Stephen J; Norman, Catherine S

2007-10-01

The Montreal Protocol on Substances that Deplete the Ozone Layer has led to rapid reductions in the use of ozone-depleting substances worldwide. However, the Protocol provides for "essential use exemptions" (EUEs) if there are no "technically and economically feasible" alternatives. An application that might qualify as an "essential use" is CFC-powered medical metered-dose inhalers (MDIs) for the treatment of asthma and chronic obstructive pulmonary disease (COPD), and the US and other nations have applied for exemptions in this case. One concern is that exemptions are necessary to ensure access to medications for low-income uninsureds. We examine the consequences of granting or withholding such exemptions, and conclude that government policies and private-sector programs are available that make it economically feasible to phase out chlorofluorocarbons (CFCs) in this application, thereby furthering the global public health objectives of the Montreal Protocol without compromising the treatment of patients who currently receive medication by means of MDIs.

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Evaluation Roadblocks 1A. Focus On: Walking Through the Steps and Standards 2. Getting Started 3. Describing and ... to use your metered dose inhaler. Print the step-by-step instructions and keep them with your ...

Dose reconstruction in deforming lung anatomy: Dose grid size effects and clinical implications

International Nuclear Information System (INIS)

Rosu, Mihaela; Chetty, Indrin J.; Balter, James M.; Kessler, Marc L.; McShan, Daniel L.; Ten Haken, Randall K.

2005-01-01

In this study we investigated the accumulation of dose to a deforming anatomy (such as lung) based on voxel tracking and by using time weighting factors derived from a breathing probability distribution function (p.d.f.). A mutual information registration scheme (using thin-plate spline warping) provided a transformation that allows the tracking of points between exhale and inhale treatment planning datasets (and/or intermediate state scans). The dose distributions were computed at the same resolution on each dataset using the Dose Planning Method (DPM) Monte Carlo code. Two accumulation/interpolation approaches were assessed. The first maps exhale dose grid points onto the inhale scan, estimates the doses at the 'tracked' locations by trilinear interpolation and scores the accumulated doses (via the p.d.f.) on the original exhale data set. In the second approach, the 'volume' associated with each exhale dose grid point (exhale dose voxel) is first subdivided into octants, the center of each octant is mapped to locations on the inhale dose grid and doses are estimated by trilinear interpolation. The octant doses are then averaged to form the inhale voxel dose and scored at the original exhale dose grid point location. Differences between the interpolation schemes are voxel size and tissue density dependent, but in general appear primarily only in regions with steep dose gradients (e.g., penumbra). Their magnitude (small regions of few percent differences) is less than the alterations in dose due to positional and shape changes from breathing in the first place. Thus, for sufficiently small dose grid point spacing, and relative to organ motion and deformation, differences due solely to the interpolation are unlikely to result in clinically significant differences to volume-based evaluation metrics such as mean lung dose (MLD) and tumor equivalent uniform dose (gEUD). The overall effects of deformation vary among patients. They depend on the tumor location, field

A self-rating scale for patient-perceived side effects of inhaled corticosteroids

Directory of Open Access Journals (Sweden)

Dijkstra Antoon

2006-10-01

Full Text Available Abstract Background Patient-reported side effect questionnaires offer a simple method for the systematic measurement of drug-related side effects. In order to measure patients' inhaled corticosteroids (ICS related side effect perceptions the 14-day retrospective Inhaled Corticosteroid Questionnaire (ICQ was developed. In this research we aim to assess the construct validity and reliability of the ICQ and test its responsiveness to dose changes in adult asthma patients. Methods In a cross-sectional study, current inhaler users with asthma completed the ICQ (27 with non ICS inhaler; 61 BDP equivalent daily ICS low dose ≤400 μg; 62 mid dose 401–800 μg; and 105 with high dose >800 μg. We generated 3 construct validity hypotheses: 1 a hierarchical dose-response pattern for scoring of the individual items on the ICQ, and statistically significant differences in the scores of each of the 15 ICQ domains by ICS dose group 2 an association between ICS dose and ICQ scoring after adjusting for appropriate confounders in multiple regression; 3 greater convergence between local side effect domains than between systemic and local domains of the scale. Test-retest reliability was assessed on a randomly selected subgroup of patients (n = 73 who also completed the ICQ a second time after 7 days. In a separate longitudinal study, 61 patients with asthma completed the ICQ at baseline and after changing their daily ICS dose, at 2- and 6- months, in order to test the ICQ's responsiveness. Results All three construct validity hypotheses were well supported: 1 a statistically significant difference existed in scores for 14 domains, the high ICS dose group scoring highest; 2 ICS dose independently predicted ICQ scoring after adjusting for confounders; 3 greater convergence existed between local ICQ domains than between local and systemic domains. The ICQ had good reproducibility: test-retest intraclass correlation coefficients were ≥0.69 for all but the 'Facial

Comparison of the bronchodilatation produced by inhalation of ipratropium bromide and salbutamol sequentially and in fixed dose combination in stable bronchial asthma patients

Directory of Open Access Journals (Sweden)

Mohan A

2006-01-01

Full Text Available Objectives : The combination of a 43-2 agonist and an anticholinergic agent is of-ten used to manage bronchial asthma. However, it is unclear whether these drugs should be given separately in sequence or in a fixed dose combination for maximum effect. Methods : 27 patients with stable bronchial asthma were given the above two drugs in two separate sessions one week apart. In one session they were given the above two drugs as a fixed dose combination and in the other session, they were given se-quentially with salbutamol following ipratropium after 30 minutes. Spirometry was performed at baseline and 15, 30 and 60 minutes after inhaling the second drug. Results : Both groups showed significant improvement in forced vital capacity (FVC, forced expiratory time in one second (FEV 1 , peak expiratory flow rate (PEFR and forced expiratory flow (FEF 25-75 from baseline upto one hour. FVC increased initially and then stabilized; however, the increase was more sustained in the group getting combination treatment. This group also showed a higher rise in FEV 1 (p=0.02. Both FEV 1 and FEF 25-75 decreased after 30 minutes in the group that received sequential therapy. PEFR increased continuously till 60 minutes in both groups and there was no significant difference between them (p=0.98. Interpretation and Conclusion: Both methods of drug dosing produce equivalent bronchodilation. Fixed dose combinations produced a more sustained rise in FVC and higher increase in FEV 1 . Hence fixed dose combinations are more effective short-term bronchodilators and give an added advantage of reducing the number of inhalers required, thus improv-ing compliance.

Interpretation of positive results of a methacholine inhalation challenge and 1 week of inhaled bronchodilator use in diagnosing and treating cough-variant asthma.

Science.gov (United States)

Irwin, R S; French, C T; Smyrnios, N A; Curley, F J

1997-09-22

In diagnosing cough due to asthma, methacholine chloride inhalation challenge (MIC) interpreted in a traditional fashion has been shown to have positive predictive values from 60% to 82%. To determine whether any features of positive results of an MIC or the results of a 1-week trial of inhaled beta-agonist therapy were helpful in predicting when the cough was due to asthma. The study design was a prospective, randomized, double-blind, placebo-controlled, crossover format performed in adult, nonsmoking subjects, who were referred for diagnosis and treatment of chronic cough. The subjects had no other respiratory complaints or medical conditions for which they were taking medications, the results of baseline spirometry and chest roentgenograms were normal, and the results of MIC were positive. After obtaining baseline data, including MICs on 2 separate days, objective cough counting, and self-assessment of cough severity using a visual analog scale, subjects were randomized to receive 2 inhalations (1.3 mg) of metaproterenol sulfate or placebo by metered dose inhaler attached to a spacer device every 4 hours while awake. At 1 week, data identical to baseline were collected, and subjects received the other metered dose inhaler for 7 days. At 1 week, data identical to baseline were collected. After completion of the protocol, subjects were followed up in the clinic to observe the final response of the cough to specific therapy. Based on the disappearance of the cough with specific therapy, the cough was due to asthma in 9 of 15 subjects and nonasthma in 6 of 15 subjects. Baseline data were similar between groups. With respect to MICs, there were no significant differences between groups in the cumulative dose of methacholine that provoked a 20% decrease in forced expiratory volume in 1 second from the postsaline baseline value (PD20 values), slopes of dose-response curves, and maximal-response plateaus. Cough severity significantly improved after 1 week of

Changes of indoor aerosol characteristics and their associated variation on the dose conversion factor due to radon progeny inhalation

International Nuclear Information System (INIS)

Tokonami, Shinji; Ishikawa, Tetsuo; Yonehara, Hidenori; Yamada, Yuji; Matsuzawa, Takao; Iimoto, Takeshi

2003-01-01

Since the dose conversion factor (hereafter called DCF) due to radon progeny inhalation is strongly dominated by aerosol characteristics in the environment, it is important to understand the air quality for accurate dose assessment. Thus temporal variations on aerosol concentration, its particle size and its related airborne radioactivities were continuously measured in an actual indoor environment with a relatively high radon concentration. The following human activities were added during the observation period: air-conditioning, removal of aerosol with an air cleaner and ventilation. DCFs based on these activities were evaluated with the latest International Commission of Radiological Protection (ICRP) respiratory tract model and were compared among them. Consequently, the present study has shown that operation of air cleaner enhanced the DCF critically because the unattached fraction increased significantly due to removal of aerosols. (author)

Estudo comparativo do manuseamento dos vários dispositivos de inalação utilizados em Portugal** Trabalho concotTente ao Premia Thome Villar/Boehringer Ingelhcim, 1999 (Secção A

Directory of Open Access Journals (Sweden)

António Morais

2001-01-01

Full Text Available RESUMO: A terapêutica inalatória tern urn papel fundamental no tratamento das doençs respiratórias. Esta importância deve-se à administração directa do fármaco na area em tratamento, o que leva à necessidade de menores doses de farmaco, com menores efeitos secundários, um mais rápido início de acção e uma maior eficácia terapêutica do mesmo. Quando prescrevemos urn inalador, temos que ter em conta as varias caracteristicas quer do farmaco, quer do inalador, nomeadamente a facilidade com que este ultimo pode ser manuseado.O objectivo deste estudo foi o de pesquisar o grau de dificuldade exigido na realização da manobra inalat6ria dos vários inaladores existentes em Portugal, alem das preferencias em relação aos mesmos por parte da população estudada. Uma população de 80 individuos, com media de idades de 45 anos (24-78, sendo 49 (61,2% homens e 31 (38,8% mulhercs, sem anterior contacto com inaladores, apos a aprcsentação de 6 inaladores frequentementc utilizados em Portugal (MDI e os DPI's Rotahaler, Turbohaler, Diskus, Diskhaler e Aerolizer, escolhiam qual delcs eque achavam ser esteticamentc o mais c o menos atractivo. Seguidamente cram instruldos sobre a maneira correcta de inalar com os aparelhos de inalação incluidos no estudo. Apos a instrução de cada inalador, tinham 3 tentativas para inalar de forma correcta com o mcsmo. Após as manobras inalat6rias com os 6 inaladorcs, os individuos CSCOlhiam qual deles e que tinha sido o mais fáicil co mais difícil de manusear, e em caso de terem de efectuar terapêutica inalatória qual deles é que escolheriam é qual deles é que rejeitariam.O Disk us - 22 (27,5 % e o Aerolizer - 21 (26,2 % foram considerados os mais atractivos enquanto o Turbuhaler foi considcrado o menos atraente-18 (22,5 %. 0 Turbuhaler- 25 (31,2%, foi considerado como o mais facil de ser manuseado versus o MDI - 36

Objective measurement of inhaler inhalation flow profile using acoustic methods

Energy Technology Data Exchange (ETDEWEB)

Lacalle, H.; Taylor, T.E.; Marco, S.; Reilly, R.B.

2016-07-01

Patients with asthma and chronic obstructive pulmonary diseases (COPD) are mostly treated with inhalers that deliver medication directly to their airways. Drug delivery from dry powder inhalers (DPIs) is very much reliant on the inhalation manoeuvre, specifically the peak inspiratory flow rate (PIFR), inspiratory capacity (IC) and inhalation rise time (IRT) of the inhalation. It has been widely reported that patients may not follow correct inhalation technique while using their inhaler. In this study, a novel acoustic method is proposed to accurately estimate inhalation flow profile using only one inhalation recording for calibration. An Ellipta DPI was placed inside an airtight container with a spirometer connected in order to measure inhalation flow parameters. An acoustic recording device (Inhaler Compliance Assessment (INCA)) was also attached to the DPI. Inhalation audio and flow signals were recorded simultaneously. The data were collected from 20 healthy subjects while performing inhaler inhalations at a range of inspiratory flow rates. A power law regression model was computed to obtain the relationship between the acoustic envelope of the inhalation and flow profile of each recording. Each model was tested on the remaining audio signals to estimate flow profile. The average estimation error was found to be 10.5±0.3% for estimating flow profile from audio signals. Inhalation flow profile parameters (PIFR, IC and IRT) could then be measured from the estimated flow profile with high accuracy giving information on user inhalation technique. This method may assist in improving patient inhaler adherence and overall disease control. (Author)

Inhaled Loxapine for Agitation in Intoxicated Patients: A Case Series.

Science.gov (United States)

Roncero, Carlos; Ros-Cucurull, Elena; Palma-Álvarez, Raúl Felipe; Abad, Alfonso Carlos; Fadeuilhe, Christian; Casas, Miquel; Grau-López, Lara

Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms of agitation in adults with psychiatric disorders (eg, schizophrenia) within 10 minutes of administration. Recently, some reports have documented the usefulness of loxapine in dual diagnoses patients with agitation. However, the efficacy of loxapine in intoxicated patients has not been deeply addressed. This report describes a case series of 12 patients (with addiction or dual disorder) who received inhaled loxapine for symptoms of psychomotor agitation during intoxication with different substances (eg, alcohol, cannabis, or cocaine) at 1 center in Spain. Data from 12 patients were reviewed, 5 patients were attended at the emergency room, 4 at the addiction and dual diagnosis unit, and 3 were treated during hospitalization for detoxification. All patients were under effects of substances. They had substance use disorder (including cannabis, cocaine, alcohol, hypnotics, and hallucinogens), and almost all (90%) presented 1 or more psychiatric disorders. One dose of inhaled loxapine was effective in 9 patients (75%), and in 3 patients, a second dose was required. Only mild dizziness was reported in 1 patient after the second dose. The acute agitation was effectively and quickly managed with inhaled loxapine in all intoxicated patients and enabled the appropriate clinical evaluation of the agitated state and the patient's management.

Inhaled Micro/Nanoparticulate Anticancer Drug Formulations: An Emerging Targeted Drug Delivery Strategy for Lung Cancers.

Science.gov (United States)

Islam, Nazrul; Richard, Derek

2018-05-24

Local delivery of drug to the target organ via inhalation offers enormous benefits in the management of many diseases. Lung cancer is the most common of all cancers and it is the leading cause of death worldwide. Currently available treatment systems (intravenous or oral drug delivery) are not efficient in accumulating the delivered drug into the target tumor cells and are usually associated with various systemic and dose-related adverse effects. The pulmonary drug delivery technology would enable preferential accumulation of drug within the cancer cell and thus be superior to intravenous and oral delivery in reducing cancer cell proliferation and minimising the systemic adverse effects. Site-specific drug delivery via inhalation for the treatment of lung cancer is both feasible and efficient. The inhaled drug delivery system is non-invasive, produces high bioavailability at low dose and avoids first pass metabolism of the delivered drug. Various anticancer drugs including chemotherapeutics, proteins and genes have been investigated for inhalation in lung cancers with significant outcomes. Pulmonary delivery of drugs from dry powder inhaler (DPI) formulation is stable and has high patient compliance. Herein, we report the potential of pulmonary drug delivery from dry powder inhaler (DPI) formulations inhibiting lung cancer cell proliferation at very low dose with reduced unwanted adverse effects. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Toxicity of inhaled 90SrCl2 in Beagle dogs. XIII

International Nuclear Information System (INIS)

Muggenburg, B.A.; Hahn, F.F.; Boecker, B.B.; Jones, R.K.; McClellan, R.O.; Pickrell, J.A.

1979-01-01

The metabolism, dosimetry and biological effects of inhaled 90 SrCl 2 in the Beagle dog are being studied to provide a basis for assessing the consequences of inhaling 90 Sr such as might be released in certain nuclear accidents. Seventy-two dogs were exposed to aerosols containing 90 Sr resulting in initial body burdens ranging from 2.5 to 250 μCi 90 Sr/kg body weight. To date, 60 90 Sr-exposed dogs have died or have been euthanized, six during the first 31 days after inhalation of 90 Sr with bone marrow aplasia and 54 between 585 and 5109 days after inhalation of 90 Sr. The latter group includes 32 dogs with bone-related neoplasms, two with upper respiratory tract carcinomas and five dogs with various diseases of the lower respiratory tract and heart. The other 15 dogs and diseases in organs that received little or no radiation dose, such as the gastrointestinal tract, urinary tract and the central nervous system. The skeletons of the dogs dying with bone-related neoplasms received initial radiation dose rates of 3.2 to 55 rads/day and cumulative doses to death of 2800 to 22 000 rads. Fourteen control dogs have died or been euthanized, two during the last year with mammary carcinoma and intestinal lymphosarcoma. Serial observations are continuing on the six surviving 90 Sr dogs and six controls

The relative effectiveness of inhaled alpha- and beta-emitting radionuclides in producing lung cancer

International Nuclear Information System (INIS)

Boecker, B.B.; Hahn, F.F.; Muggenburg, B.A.; Guilmetter, R.A.; Griffith, W.C.; McClellan, R.O.

1988-01-01

Proper assessment of a long-term human health risks associated with inhaled radionuclides requires knowledge of dose to critical cells and tissues and relationships between dose and effect for different biological end points. Results from epidemiological studies of exposed human populations provided important information for such assessments. However, because the types of exposures are limited, these results need to be supplemented with more detailed information on dosimetry and biological effects available through studies in laboratory animals and in vitro systems. To provide health risk information for inhaled fission product and actinide aerosols, life-span studies are being conducted using beagle dogs and other species at the Lovelace Inhalation Toxicology Research Institute (ITRI). Results of two life-span studies in dogs involving inhalation of the beta emitter 91 Y in fused aluminosilicate particles or the alpha emitter 239 PuO 2 are reported here

Airborne concentrations of methylene diphenyl diisocyanate (MDI) in North American wood mills during the manufacturing of oriented strand board (OSB).

Science.gov (United States)

Karoly, William J; Flatley, John J; Stevenson, Ralph D; Bowers, John D

2004-12-01

Air monitoring data were collected from industrial hygiene surveys over an 8-year period in oriented strand board (OSB) mills. Personal samples were taken to evaluate potential employee exposures to MDI. Area samples were taken to determine the effectiveness of control measures used in the mills to prevent fugitive emissions of wood dust, MDI, and MDI-coated wood dust from the OSB manufacturing process. Personal sampling results (578 samples covering 11 different job categories) ranged from 0.0002-0.524 mg/m3, with a GM = 0.001 and GSD = 3.71. Area sampling results (1657 samples covering 14 stationary locations in the mills) ranged from 0.0002-2.5 mg/m3, with a GM = 0.004 and GSD = 5.52. The statistical range of the data suggests high variability. While exposures to MDI above the established limits (0.051 mg/m3, 8-hour time-weighted average, 0.2 mg/m3, ceiling) can and do occur when engineering controls are not maintained and/or proper work practices and personal protective equipment are not followed/used for certain high exposure potential tasks, the data indicate that over 97% of the personal and 92% of the area sampling results are less than 0.051 mg/m3. Wipe testing was performed to determine the presence of removable, unreacted diisocyanates (NCO functional groups)from various surfaces. Positive results were found in about 13% of the wipe tests on surfaces confined to the blender, forming line, and hopper deck process areas.

Cost-effectiveness of fluticasone propionate administered via metered-dose inhaler plus babyhaler spacer in the treatment of asthma in preschool-aged children

DEFF Research Database (Denmark)

Bisgaard, H; Price, M J; Maden, Christian Nicolai

2001-01-01

a metered-dose inhaler and a Babyhaler (Glaxo Wellcome; Middlesex, UK) spacer device. MEASUREMENTS: Effectiveness in terms of asthma exacerbations, control of cough and wheeze symptoms, symptom-free days, overall direct costs of asthma management in Danish kroner at 1999 prices, and mean and incremental......STUDY OBJECTIVES: To evaluate the cost-effectiveness of inhaled fluticasone propionate (FP) in children aged 12 to 47 months with asthma symptoms. DESIGN: A retrospective economic analysis conducted from the perspective of the Danish health-care system, based on clinical data from a 12-week study...... cost-effectiveness ratios. RESULTS: FP, 200 microg/d, was significantly more effective than placebo treatment in terms of the proportion of exacerbation-free patients (73.7% vs 59.8%; p = 0.025) and patients experiencing a > or = 25% improvement in cough symptoms (57.9% vs 39.0%; p = 0.018). The costs...

Report of the panel on inhaled actinides

International Nuclear Information System (INIS)

Anon.

1978-01-01

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

Efeito do salbutamol liberado através de inalador de pó seco sobre o broncoespasmo induzido por metacolina Effects of salbutamol delivered by dry-powder inhaler on methacholine-induced bronchoconstriction

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Adalberto Sperb Rubin

2004-06-01

(MDIs are the drugs usually used for the reversal of methacholine-induced bronchoconstriction. The b2 agonists that are delivered by dry-powder inhaler (DPI can be an efficacious option. OBJECTIVE: To evaluate the effectiveness and speed of action of salbutamol delivered by DPI (Pulvinal; Butovent®, in comparison to salbutamol delivered by MDI, in reversing methacholine-induced bronchoconstriction. METHOD: Sixty successive methacholine-induced bronchoconstriction patients who presented a decrease of at least 20% in forced expiratory volume (FEV1 were evaluated prospectively. Of these 60 patients, we randomized 30 (first group to receive 200 mcg of salbutamol by MDI and 30 (second group to receive 200 mcg of salbutamol by DPI (Pulvinal. Both drugs were administered with the objective of reversing bronchoconstriction during the final phase of a bronchoprovocation test. The FEV1 values obtained at 1 and 5 minutes after bronchodilator administration were evaluated. RESULTS: The groups were comparable in gender distribution, age, weight, dose level provoking a 20% drop in FEV1 (first group: 1.3 mg; second group: 1.19 mg; p = 0.79 and post-methacholine FEV1 (first group: 2.03 l; second group: 1.99 l; p = 0.87, with no statistically significant differences between the two groups. In the first group (MDI, the mean increase in FEV1 was 16.2% (at 1 minute and 22.2% (at 5 minutes, and in the second group (DPI it was 17% (at 1 minute and 23.6% (at 5 minutes. There was no statistically significant difference between the groups (p = 0.8. CONCLUSION: The beta2-agonists delivered by DPI (Pulvinal present the same bronchodilator efficacy and speed of action as do those delivered by the more traditional MDI method.

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

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Arun Jenish J

2012-03-01

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

The importance of determining the air exchange rate in flats and buildings for calculations of the averted indoor inhalation doses arising from contaminated outdoor air

International Nuclear Information System (INIS)

Jilek, Karel; Thomas, J.; Bulanek, B.; Lenk, J.; Marikova, S.

2015-01-01

The indoor-outdoor air exchange rate is an important parameter when refining estimates of the averted inhaled doses to population in houses and buildings after an emergency event resulting in contamination of outdoor air with a radioactive material. The air exchange rates measured in 70 occupied houses and in 20 unoccupied houses using N 2 O as the tracer gas are presented, and the results of modelling the averted doses in the residential buildings for both gaseous and aerosol outdoor contaminants are demonstrated. (orig.)

Calculating radiation exposure and dose

International Nuclear Information System (INIS)

Hondros, J.

1987-01-01

This paper discusses the methods and procedures used to calculate the radiation exposures and radiation doses to designated employees of the Olympic Dam Project. Each of the three major exposure pathways are examined. These are: gamma irradiation, radon daughter inhalation and radioactive dust inhalation. A further section presents ICRP methodology for combining individual pathway exposures to give a total dose figure. Computer programs used for calculations and data storage are also presented briefly

Anticoagulant effects of inhaled unfractionated heparin in the dog as determined by partial thromboplastin time and factor Xa activity.

Science.gov (United States)

Manion, Jill S; Thomason, John M; Langston, Vernon C; Claude, Andrew K; Brooks, Marjory B; Mackin, Andrew J; Lunsford, Kari V

2016-01-01

To evaluate the anticoagulant effects of inhaled heparin in dogs. This study was conducted in 3 phases. In phase 1, bronchoalveolar lavage fluid (BALf) was collected to generate an in vitro calibration curve to relate heparin concentration to the activated partial thromboplastin time (aPTT). In phase 2, heparin was administered via nebulization to determine the threshold dose needed to prolong systemic aPTT. In phase 3, the local anticoagulant activity of inhaled heparin was determined by measurement of BALf anti-Xa activity and aPTT. University teaching hospital. Six healthy intact female Walker Hounds were used in this study. Two dogs were used for each phase. Inhaled unfractionated sodium heparin was administered in doses ranging from 50,000 to 200,000 IU. In vitro addition of heparin to BALf caused a prolongation in aPTT. Inhaled heparin at doses as high as 200,000 IU failed to prolong systemic aPTT, and a threshold dose could not be determined. No significant local anticoagulant effects were detected. Even at doses higher than those known to be effective in people, inhaled heparin appears to have no detectable local or systemic anticoagulant effects in dogs with the current delivery method. © Veterinary Emergency and Critical Care Society 2015.

MDI Biological Laboratory Arsenic Summit: Approaches to Limiting Human Exposure to Arsenic

OpenAIRE

Stanton, Bruce A.

2015-01-01

This report is the outcome of the meeting: “Environmental and Human Health Consequences of Arsenic”, held at the MDI Biological Laboratory in Salisbury Cove, Maine, August 13–15, 2014. Human exposure to arsenic represents a significant health problem worldwide that requires immediate attention according to the World Health Organization (WHO). One billion people are exposed to arsenic in food and more than 200 million people ingest arsenic via drinking water at concentrations greater than inte...

Toxicity of 91Y inhaled in a relatively insoluble form by Beagle dogs. IX

International Nuclear Information System (INIS)

Hobbs, C.H.; Hahn, F.F.; McClellan, R.O.; Mauderly, J.L.; Muggenburg, B.A.; Pickrell, J.A.

1978-01-01

Studies of the radiation hazards due to inhalation of 91 Y in fused aluminosilicate particles have been undertaken in Beagle dogs to assess the biological consequences of inhaling a relatively insoluble, energetic beta emitter with an intermediate effective half-life in the lung. A radiation-dose pattern study in which 30 dogs were serially sacrificed from 0 to 320 days after inhalation exposure to 91 Y in fused aluminosilicate particles has been completed. A longevity study is in progress in which 96 dogs were exposed to achieve initial lung burdens ranging from 11 to 300 μCi 91 Y in fused aluminosilicate particles/kg body weight and 12 dogs were exposed to stable yttrium in fused aluminosilicate particles. To date, 56 dogs have died in the longevity study between 113 and 2841 days after exposure. Forty of these dogs, with cumulative radiation doses to lung between 8,300 and 60,000 rads, died with clinicopathologic findings of radiation pneumonitis and/or pulmonary fibrosis at 113 to 1011 days after exposure. Fifteen dogs that died between 1115 and 2841 days after exposure with cumulative doses to lung ranging from 16,000 to 25,000 rads had pulmonary carcinomas. One dog that died at 1847 days after exposure with a cumulative dose to lung of 9,700 rads had a hemangiosarcoma of the spleen. Forty exposed dogs with doses to lung of 2,400 to 18,000 rads and 12 control dogs remain alive from 2563 to 3116 days after inhalation exposure and will continue to be studied throughout the remainder of their life span to determine the relationship between radiation dose, dose rate and biologic effects

Evaluation of factors that allow the clinician to taper inhaled corticosteroids in childhood asthma

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Kentaro Matsuda

1999-01-01

Full Text Available Inhaled corticosteroids are potent and effective treatment agents for controlling symptoms of childhood asthma. However, there are no predictive factors that help to determine which patients with asthma are likely to be tapered off inhaled corticosteroids successfully. We examined whether any factor or combination of factors could help the clinician safely discontinue inhaled steroid therapy. Thirty-six asthmatic children whose symptoms were stable on low-dose beclomethasone dipropionate (BDP were divided by parental choice into two groups: maintenance BDP (n = 11 and no BDP (n = 25. Methacholine inhalation tests were performed at the beginning of the study and after 1 month. Twelve children (48% who had BDP discontinued developed exacerbations after 2–3 months, whereas there were no problems in the maintenance group. The no BDP group was retrospectively divided into two subgroups: exacerbation (+ and (−. The threshold to methacholine in the exacerbation (+ subgroup decreased significantly in advance of clinical symptoms. The two subgroups were analyzed statistically by two-group discriminant function analysis. The change in threshold to methacholine, the dose and potency of drugs, duration of asthma and gender (female correlated with exacerbation. These results suggest that discontinuation of inhaled steroids should be done carefully, even in stable asthmatic children. The methacholine inhalation test, gender, drugs and history may be used as references for discontinuing inhaled steroids.

Plutonium dose-effect relationship

International Nuclear Information System (INIS)

Matsuoka, Osamu

1976-01-01

Dose in internal exposure to Pu was investigated, and dose-effect relationship was discussed. Dose-effect relationship in internal exposure was investigated by means of two methods, which were relationship between dose and its effect (relationship between μ Ci/Kg and its effect), and exposure dose and its effects (rad-effect), and merits and demerits of two methods were mentioned. Problems in a indication method such as mean dose were discussed with respect to the dose in skeleton, the liver and the lung. Pu-induced osteosarcoma in mice rats, and beagles was described, and differences in its induction between animals were discussed. Pulmonary neoplasma induced by 239 PuO 2 inhalation in beagles was reported, and description was made as to differences in induction of lung cancer between animals when Pu was inhaled and was taken into the lung. A theoretical and experimental study of a extrapolation of the results of the animal experiment using Pu to human cases is necessary. (Serizawa, K.)

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

International Nuclear Information System (INIS)

Kelly, W.T.; Baile, E.M.; Brancatisano, A.; Pare, P.D.; Engel, L.A.

1992-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-01-01

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

Factors associated with appropriate inhaler use in patients with COPD – lessons from the REAL survey

Directory of Open Access Journals (Sweden)

Price D

2018-02-01

Full Text Available David Price,1,2 Dorothy L Keininger,3 Boomi Viswanad,4 Matthias Gasser,5 Susann Walda,5 Florian S Gutzwiller3 1Division of Applied Health Sciences, Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Observational and Pragmatic Research Institute, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4Novartis Healthcare Pvt. Ltd., Hyderabad, India; 5GfK Switzerland AG, Basel, Switzerland Background: Nonadherence to medication and incorrect use of inhalers represent significant barriers to optimal disease management of patients with chronic obstructive pulmonary disease (COPD. Thus, health care professionals (HCPs play a critical role in educating their patients on appropriate inhaler use and in ensuring medication adherence. However, many patients do not receive appropriate inhaler training or have not had their inhaler technique checked.Methods: The Real-life Experience and Accuracy of inhaLer use (REAL survey was a computer-assisted, telephonic survey consisting of 23 questions gathering real-world information on correct inhaler use, inhalation technique, device attributes, adherence, dosing accuracy, training, correct device use, ease of use, and factors that influence patient adherence in commercially available inhalers delivering COPD maintenance therapy. All results are based on patient-reported data.Results: The survey was conducted between January 4, 2016 and February 2, 2016. A total of 764 patients using various inhalers (Breezhaler® =186; Ellipta® =191; Genuair® =194; Respimat® =201 with mild to very severe COPD, with a mean ± SD age 56±9.8 years, completed the survey. Patient self-reported adherence was significantly lower in younger patients compared to older patients (p=0.020. Eighty-three percent of patients indicated that a demonstration (in-person was “very helpful” versus 58% for video. Patient preferences for training methods were as follows: demonstration of inhaler use (83%, video (58%, instructions for

Estimate of 50-year dose commitment to various organs and tissues of the body from inhalation of 222Rn free of its daughters

International Nuclear Information System (INIS)

Bernard, S.R.; Ford, M.R.; Snyder, W.S.

1976-01-01

Some topics discussed are as follows: retention of 222 Rn in fat, bone, heart, muscle, skin, testes, and urinary bladder; retention equations for Rn; decay scheme for Rn and 226 Ra; metabolic models for Po, Pb, and Bi; dose estimates to target organs for 222 Rn and its daughters that are not inhaled but produced from decay of 222 Rn; and estimation of MPC for bone marrow, gonads, and total body

Aerosol particle size does not predict pharmacokinetic determined lung dose in children

DEFF Research Database (Denmark)

Bønnelykke, Klaus; Chawes, Bo L K; Vindfeld, Signe

2013-01-01

In vitro measures of aerosol particles size, such as the fine particle mass, play a pivotal role for approval of inhaled anti-asthmatic drugs. However, the validity as a measure of dose to the lungs in children lacks evidence. In this study we investigated for the first time the association between...... an in vivo estimate of lung dose of inhaled drug in children and the corresponding particle size segments assessed ex vivo. Lung dose of fluticasone propionate after inhalation from a dry powder inhaler (Diskus®) was studied in 23 children aged 4-7 and 12-15 years with mild asthma. Six-hour pharmacokinetics...... was assessed after single inhalation. The corresponding emitted mass of drug in segments of aerosol particle size was assessed ex vivo by replicating the inhalation flows recorded by transducers built into the Diskus® inhaler and re-playing them in a breathing simulator. There was no correlation between any...

Patient considerations in the treatment of COPD: focus on the new combination inhaler umeclidinium/vilanterol

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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

Development of a High Efficiency Dry Powder Inhaler: Effects of Capsule Chamber Design and Inhaler Surface Modifications

Science.gov (United States)

Behara, Srinivas R.B.; Farkas, Dale R.; Hindle, Michael; Longest, P. Worth

2013-01-01

Purpose The objective of this study was to explore the performance of a high efficiency dry powder inhaler (DPI) intended for excipient enhanced growth (EEG) aerosol delivery based on changes to the capsule orientation and surface modifications of the capsule and device. Methods DPIs were constructed by combining newly designed capsule chambers (CC) with a previously developed three-dimensional (3D) rod array for particle deagglomeration and a previously optimized EEG formulation. The new CCs oriented the capsule perpendicular to the incoming airflow and were analyzed for different air inlets at a constant pressure drop across the device. Modifications to the inhaler and capsule surfaces included use of metal dispersion rods and surface coatings. Aerosolization performance of the new DPIs was evaluated and compared with commercial devices. Results The proposed capsule orientation and motion pattern increased capsule vibrational frequency and reduced the aerosol MMAD compared with commercial/modified DPIs. The use of metal rods in the 3D array further improved inhaler performance. Coating the inhaler and capsule with PTFE significantly increased emitted dose (ED) from the optimized DPI. Conclusions High efficiency performance is achieved for EEG delivery with the optimized DPI device and formulation combination producing an aerosol with MMAD 90%, and ED > 80%. PMID:23949304

Development of a high efficiency dry powder inhaler: effects of capsule chamber design and inhaler surface modifications.

Science.gov (United States)

Behara, Srinivas R B; Farkas, Dale R; Hindle, Michael; Longest, P Worth

2014-02-01

The objective of this study was to explore the performance of a high efficiency dry powder inhaler (DPI) intended for excipient enhanced growth (EEG) aerosol delivery based on changes to the capsule orientation and surface modifications of the capsule and device. DPIs were constructed by combining newly designed capsule chambers (CC) with a previously developed three-dimensional (3D) rod array for particle deagglomeration and a previously optimized EEG formulation. The new CCs oriented the capsule perpendicular to the incoming airflow and were analyzed for different air inlets at a constant pressure drop across the device. Modifications to the inhaler and capsule surfaces included use of metal dispersion rods and surface coatings. Aerosolization performance of the new DPIs was evaluated and compared with commercial devices. The proposed capsule orientation and motion pattern increased capsule vibrational frequency and reduced the aerosol MMAD compared with commercial/modified DPIs. The use of metal rods in the 3D array further improved inhaler performance. Coating the inhaler and capsule with PTFE significantly increased emitted dose (ED) from the optimized DPI. High efficiency performance is achieved for EEG delivery with the optimized DPI device and formulation combination producing an aerosol with MMAD  90%, and ED > 80%.

Efficacy and safety of inhaled carbon monoxide during pulmonary inflammation in mice.

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Michael R Wilson

2010-07-01

Full Text Available Pulmonary inflammation is a major contributor to morbidity in a variety of respiratory disorders, but treatment options are limited. Here we investigate the efficacy, safety and mechanism of action of low dose inhaled carbon monoxide (CO using a mouse model of lipopolysaccharide (LPS-induced pulmonary inflammation.Mice were exposed to 0-500 ppm inhaled CO for periods of up to 24 hours prior to and following intratracheal instillation of 10 ng LPS. Animals were sacrificed and assessed for intraalveolar neutrophil influx and cytokine levels, flow cytometric determination of neutrophil number and activation in blood, lung and lavage fluid samples, or neutrophil mobilisation from bone marrow.When administered for 24 hours both before and after LPS, inhaled CO of 100 ppm or more reduced intraalveolar neutrophil infiltration by 40-50%, although doses above 100 ppm were associated with either high carboxyhemoglobin, weight loss or reduced physical activity. This anti-inflammatory effect of CO did not require pre-exposure before induction of injury. 100 ppm CO exposure attenuated neutrophil sequestration within the pulmonary vasculature as well as LPS-induced neutrophilia at 6 hours after LPS, likely due to abrogation of neutrophil mobilisation from bone marrow. In contrast to such apparently beneficial effects, 100 ppm inhaled CO induced an increase in pulmonary barrier permeability as determined by lavage fluid protein content and translocation of labelled albumin from blood to the alveolar space.Overall, these data confirm some protective role for inhaled CO during pulmonary inflammation, although this required a dose that produced carboxyhemoglobin values close to potentially toxic levels for humans, and increased lung permeability.

Toxicity of inhaled Ca-DTPA in the beagle dog

International Nuclear Information System (INIS)

Smith, V.H.; Ragan, H.A.; Lund, J.E.; Hackett, P.L.

1975-01-01

There are several advantages to the administration of Ca- DTPA by inhalation rather than intravenous drip for the decorporation of certain radionuclides. Among these are the possibility of treating very promptly following an accidental incorporation to achieve maximum treatment effectiveness and convenince for medical management, even to the extent that treatment can be self-administered. The present investigational New Drug permit allows treatment of humans only by the intravenous route and animal studies are required to justify the new route. Earlier work in rats and hamsters showed five successive daily inhalations of Ca-DTPA aerosols (dose 1 to 4 times human i.v. dose) produced a transitory emphysema in 17/40 rats serially sacrificed up to 3 weeks following the last exposure and in 10/20 hamsters up to 1 week after exposure. No emphysema was seen in rats sacrificed after 3 weeks and in hamsters after 1 week following the exposures. Results of tests in dogs administered DTPA by inhalation showed hyperplasia of the gastric submucosal lymphoid follicles observed 1 week following the last exposure may be treatment-related, but other observed changes were considered unrelated. (U.S.)

The effect of exercise on the absorption of inhaled human insulin in healthy volunteers

DEFF Research Database (Denmark)

Petersen, Astrid Heide; Kohler, Gerd; Korsatko, Stefan

2008-01-01

overall absorption. Aims To investigate the effect of moderate exercise on the absorption of inhaled insulin. Methods A single-centre, randomized, open-label, three-period cross-over trial was carried out in 12 nonsmoking healthy subjects. A dose of 3.5 mg inhaled human insulin was administered via...

Inhalational Gentamicin Treatment Is Effective Against Pneumonic Plague in a Mouse Model

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David Gur

2018-04-01

Full Text Available Pneumonic plague is an infectious disease characterized by rapid and fulminant development of acute pneumonia and septicemia that results in death within days of exposure. The causative agent of pneumonic plague, Yersinia pestis (Y. pestis, is a Tier-1 bio-threat agent. Parenteral antibiotic treatment is effective when given within a narrow therapeutic window after symptom onset. However, the non-specific “flu-like” symptoms often lead to delayed diagnosis and therapy. In this study, we evaluated inhalational gentamicin therapy in an infected mouse model as a means to improve antibiotic treatment efficacy. Inhalation is an attractive route for treating lung infections. The advantages include directly dosing the main infection site, the relative accessibility for administration and the lack of extensive enzymatic drug degradation machinery. In this study, we show that inhalational gentamicin treatment administered 24 h post-infection, prior to the appearance of symptoms, protected against lethal intranasal challenge with the fully virulent Y. pestis Kimberley53 strain (Kim53. Similarly, a high survival rate was demonstrated in mice treated by inhalation with another aminoglycoside, tobramycin, for which an FDA-approved inhaled formulation is clinically available for cystic fibrosis patients. Inhalational treatment with gentamicin 48 h post-infection (to symptomatic mice was also successful against a Y. pestis challenge dose of 10 i.n.LD50. Whole-body imaging using IVIS technology demonstrated that adding inhalational gentamicin to parenteral therapy accelerated the clearance of Y. pestis from the lungs of infected animals. This may reduce disease severity and the risk of secondary infections. In conclusion, our data suggest that inhalational therapy with aerosolized gentamicin may be an effective prophylactic treatment against pneumonic plague. We also demonstrate the benefit of combining this treatment with a conventional parenteral

Clinical and immunologic findings of methylene diphenyl diisocyanate-induced occupational asthma in a car upholstery factory.

Science.gov (United States)

Hur, G-Y; Koh, D-H; Choi, G-S; Park, H-J; Choi, S-J; Ye, Y-M; Kim, K-S; Park, H-S

2008-04-01

Although methylene diphenyl diisocyanate (MDI) is widely used in many industries, there have been few immunological studies of MDI-induced occupational asthma. We investigated the effects of MDI exposure on the clinical and immunologic condition of workers in a single car upholstery factory. Fifty-eight MDI-exposed workers were studied. Work-related lower-respiratory symptoms (WRRS) were identified using a questionnaire. Serum-specific IgE and IgG antibodies to MDI-human serum albumin conjugate were detected by ELISA. Atopy was evaluated using a skin prick test. MDI-induced occupational asthma was confirmed in the symptomatic workers with a positive result on an MDI-specific inhalation test. Thirteen (22.4%) of the subjects complained of WRRS. MDI-induced occupational asthma was confirmed in five (8.6%) of the workers, and occupational eosinophilic bronchitis was confirmed in two (3.5%). The prevalence of specific IgG antibodies (20.7%) was higher than that of specific IgE antibodies (8.6%). The prevalence of MDI-induced occupational asthma/eosinophilic bronchitis was strongly associated with the presence of both WRRS and serum-specific IgG antibodies to an MDI-human serum albumin conjugate (Pworkers. The prevalence of MDI-induced occupational asthma was 8.6%, and MDI-induced eosinophilic bronchitis was confirmed in two workers. The presence of work-related lower-respiratory symptoms and serum-specific IgG antibodies to an MDI-human serum albumin conjugate may be used to predict MDI-induced occupational asthma/eosinophilic bronchitis in MDI-exposed workers.

Know How to Use Your Asthma Inhaler

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Full Text Available ... Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking your medicine exactly as your doctor ... and by avoiding things that can cause an attack. Watch a video to follow ... keep them with your Asthma Action Plan. Using a metered dose inhaler with ...

Optimizing the Entrainment Geometry of a Dry Powder Inhaler: Methodology and Preliminary Results.

Science.gov (United States)

Kopsch, Thomas; Murnane, Darragh; Symons, Digby

2016-11-01

For passive dry powder inhalers (DPIs) entrainment and emission of the aerosolized drug dose depends strongly on device geometry and the patient's inhalation manoeuvre. We propose a computational method for optimizing the entrainment part of a DPI. The approach assumes that the pulmonary delivery location of aerosol can be determined by the timing of dose emission into the tidal airstream. An optimization algorithm was used to iteratively perform computational fluid dynamic (CFD) simulations of the drug emission of a DPI. The algorithm seeks to improve performance by changing the device geometry. Objectives were to achieve drug emission that was: A) independent of inhalation manoeuvre; B) similar to a target profile. The simulations used complete inhalation flow-rate profiles generated dependent on the device resistance. The CFD solver was OpenFOAM with drug/air flow simulated by the Eulerian-Eulerian method. To demonstrate the method, a 2D geometry was optimized for inhalation independence (comparing two breath profiles) and an early-bolus delivery. Entrainment was both shear-driven and gas-assisted. Optimization for a delay in the bolus delivery was not possible with the chosen geometry. Computational optimization of a DPI geometry for most similar drug delivery has been accomplished for an example entrainment geometry.

Inhaled Steroids

Science.gov (United States)

... considerations when your dosage changes. What about side effects and inhaled steroids? The most common side effects with inhaled steroids ... inhaled steroid has much less potential for side effects than steroid pills or syrups. There have been concerns regarding ...

Lung Deposition And Biological Effects Of Inhaled Radon Progenies

International Nuclear Information System (INIS)

Balashazy, I.; Farkas, A.; Szoke, I.; Moustafa, M.; Kudela, G.

2010-01-01

Inhaled radon progenies provide more than the half of natural radiation exposure. There is increasing evidence that the cellular distribution of radiation burden is an important factor regarding the biological response to ionisation radiation, thus, one of our tasks was the characterisation of the distribution of cellular exposure. Histological studies of former uranium miners presented strong correlation between primer deposition hot spots and neoplastic lesions. Most of these lesions were located along the carinal regions of the large bronchial airways. In the present work, computational fluid dynamics (CFD) approaches have been applied to simulate the deposition distribution of inhaled radon progenies along central human airways. The geometry and the cellular structure of epithelial lung tissue were numerically reconstructed based on anatomical and histological data. Single and multiple ha-hit and cellular dose distributions have been computed applying Monte Carlo modelling techniques at different breathing conditions. Figure 1. Deposition enhancement factor (EF) of inhaled radon progenies on a central airway bifurcation in airway generations 4-5 during light physical activity breathing condition. Size of scanning surface element is a 45μm side triangle. Left panel: EF max=1400,Dp=200 nm (attached). Right panel: EF max1290, Dp= 1 nm (unattached). Values of local per average deposition densities, that is, enhancement factors (Figure 1), hit probabilities and doses may be up to two-three orders of magnitude higher in the deposition hot spots than the average values. Dose calculations revealed that some cell clusters may receive high doses even at low exposure conditions. Applying the model to different radiation exposure conditions useful relations can be received regarding the linear-non threshold hypothesis

Inhalant Abuse

Science.gov (United States)

... is when you pour the product into a bag, hold it over your mouth and nose, and inhale. How is inhalant abuse diagnosed? If you think your child is abusing inhalants, talk to them. Be honest and open. Tell them ...

The effect of body posture during medication inhalation on exercise induced bronchoconstriction in asthmatic children

NARCIS (Netherlands)

Visser, R.; Wind, M.; de Graaf, B.J.; de Jong, F.H.; van der Palen, Jacobus Adrianus Maria; Thio, B.J.

2015-01-01

RATIONALE: Inhaling medication in a standard body posture leads to impaction of particles in the sharp angle of the upper airway. Stretching the upper airway by extending the neck in a forward leaning body posture may improve pulmonary deposition. A single dose of inhaled corticosteroids (ICS)

Systemic activity of inhaled topical steroid in toddlers studied by knemometry

DEFF Research Database (Denmark)

Bisgaard, H

1993-01-01

of four weeks with placebo or budesonide in daily doses of 200 micrograms and 800 micrograms administered as a pressurized aerosol inhaled via a spacer with a face mask. Twenty-nine percent (median) of the nominal dose was delivered at the mouth of the children. Three children were withdrawn because...

Inhaler technique maintenance: gaining an understanding from the patient's perspective.

Science.gov (United States)

Ovchinikova, Ludmila; Smith, Lorraine; Bosnic-Anticevich, Sinthia

2011-08-01

The aim of this study was to determine the patient-, education-, and device-related factors that predict inhaler technique maintenance. Thirty-one community pharmacists were trained to deliver inhaler technique education to people with asthma. Pharmacists evaluated (based on published checklists), and where appropriate, delivered inhaler technique education to patients (participants) in the community pharmacy at baseline (Visit 1) and 1 month later (Visit 2). Data were collected on participant demographics, asthma history, current asthma control, history of inhaler technique education, and a range of psychosocial aspects of disease management (including adherence to medication, motivation for correct technique, beliefs regarding the importance of maintaining correct technique, and necessity and concern beliefs regarding preventer therapy). Stepwise backward logistic regression was used to identify the predictors of inhaler technique maintenance at 1 month. In total 145 and 127 participants completed Visits 1 and 2, respectively. At baseline, 17% of patients (n = 24) demonstrated correct technique (score 11/11) which increased to 100% (n = 139) after remedial education by pharmacists. At follow-up, 61% (n = 77) of patients demonstrated correct technique. The predictors of inhaler technique maintenance based on the logistic regression model (X(2) (3, N = 125) = 16.22, p = .001) were use of a dry powder inhaler over a pressurized metered-dose inhaler (OR 2.6), having better asthma control at baseline (OR 2.3), and being more motivated to practice correct inhaler technique (OR 1.2). Contrary to what is typically recommended in previous research, correct inhaler technique maintenance may involve more than repetition of instructions. This study found that past technique education factors had no bearing on technique maintenance, whereas patient psychosocial factors (motivation) did.

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

International Nuclear Information System (INIS)

Boecker, B.B.; Hahn, F.F.; Mauderly, J.L.; McClellan, R.O.

1980-01-01

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 144 Ce 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.)

ASSESSING THE HEALTH EFFECTS AND RISKS ASSOCIATED WITH CHILDREN’S INHALATION EXPOSURES – ASTHMA AND ALLERGY

Science.gov (United States)

Adults and children may have different reactions to inhalation exposures, which may be the result of differences in inhaled or target tissue doses following similar exposures, and/or due to growth and development of the lung which continues postnatally in distinct stages. Because...

Animal study on biological responses by radon inhalation making use of waste rock which contains feeble activity of uranium (Joint research)

International Nuclear Information System (INIS)

Ishimori, Yuu; Sakoda, Akihiro; Tanaka, Hiroshi; Mitsunobu, Fumihiro; Yamaoka, Kiyonori; Kataoka, Takahiro; Yamato, Keiko; Nishiyama, Yuichi

2013-06-01

Okayama University and the Japan Atomic Energy Agency (JAEA) have carried out the collaborative study of physiological effects of inhaled radon for the low-dose range. Main assignments were as follows. Based on the clinical knowledge, Misasa Medical Center (Okayama University Hospital) clarified the issues that should be addressed. Graduate School of Health Sciences (Okayama University) supervised the research and studied the biological responses. The JAEA made the development and control of a facility for radon inhalation experiments and the investigation of biokinetics and absorbed doses of radon. From 2007 to 2011, the following results were obtained. (1) Literature on effects of radon for the low-dose range was surveyed to determine the present tasks. (2) The first Japanese large-scale facility was developed for radon inhalation experiments with small animals. (3) Relationships between radon concentration and inhalation time were widely examined to understand the change in antioxidative functions due to radon, which are the most basic parameters. (4) Inhibitory effects of radon on oxidative damages were observed using model mice with reactive oxygen- or free radical-related diseases like alcohol-induced oxidative damages and type I diabetes. (5) In order to discuss biological responses quantitatively following radon inhalation, the biokinetics of inhaled radon was examined and the model for calculation of absorbed doses for organs and tissues was obtained. (author)

Commentary on inhaled {sup 239}PuO{sub 2} in dogs - a prophylaxis against lung cancer?

Energy Technology Data Exchange (ETDEWEB)

Cuttler, J.M., E-mail: jerrycuttler@rogers.com [Cuttler and Associates, Vaughan, ON (Canada); Feinendegen, L. [Brookhaven National Laboratories, Upton, NY (United States)

2015-07-01

Several studies on the effect of inhaled plutonium-dioxide particulates and the incidence of lung tumors in dogs reveal beneficial effects when the cumulative alpha-radiation dose is low. There is a threshold at an exposure level of about 100 cGy for excess tumor incidence and reduced lifespan. The observations conform to the expectations of the radiation hormesis dose-response model and contradict the predictions of the Linear No-Threshold (LNT) hypothesis. These studies suggest investigating the possibility of employing low-dose alpha-radiation, such as from {sup 239}PuO{sub 2} inhalation, as a prophylaxis against lung cancer. (author)

Commentary on inhaled {sup 239}PuO{sub 2} in dogs - a prophylaxis against lung cancer?

Energy Technology Data Exchange (ETDEWEB)

Cuttler, J.M. [Cuttler and Assoc., Vaughan, Ontario (Canada); Feinendegen, L. [Brookhaven National Laboratories, Upton, New York (United States)

2015-06-15

Several studies on the effect of inhaled plutonium-dioxide particulates and the incidence of lung tumors in dogs reveal beneficial effects when the cumulative alpha-radiation dose is low. There is a threshold at an exposure level of about 100 cGy for excess tumor incidence and reduced lifespan. The observations conform to the expectations of the radiation hormesis dose-response model and contradict the predictions of the Linear No-Threshold (LNT) hypothesis. These studies suggest investigating the possibility of employing low-dose alpha-radiation, such as from {sup 239}PuO {sub 2} inhalation, as a prophylaxis against lung cancer. (author)

Biological effects like cancer formation due to inhalational exposure to plutonium. What are evident in animal experiments?

International Nuclear Information System (INIS)

Oghiso, Yoichi

2013-01-01

Literatures on the title subject are reviewed and problems to be solved are given. There are 2 reports of dog experiments of inhaled Pu by Pacific Northwest Laboratory (PNL), which have given results incompatible/compatible with risk assessments hitherto: one with the micro-particle of Pu-nitrate, 239 Pu(NO 3 ) 4 , in which the dog lung is compared with human's by histology and autoradiography, presenting findings that differ from the previous ICRP assumption of the homogeneous distribution in the lung; and the other with 239 PuO 2 , indicating that non-tumorous diseases are agreeable with the determinative effect defined by ICRP. Other literatures have shown that effects of Pu inhalation differ dependently on the solubility of its chemical form and on its isotope ( 239 Pu and 238 Pu). Size of the inhaled Pu particle affects its deposition and thereby its influence on the air tract and other tissues. Rats are also used in Pu inhalation experiments. The significant increase of malignant lung tumor incidence is shown with 239 PuO 2 inhalation at >1 Gy lung absorbed dose by PNL and Inhalation Toxicology Research Institute (ITRI) and by National Institute of Radiological Sciences (NIRS), at >0.7 Gy and not at 239 PuO 2 inhalation in dogs involves the long-term decrease of peripheral lymphocytes, acute radiation pneumonia and chronic fibroid lung at 10-20 Gy, which can be a cause of death. There are many studies of the lung tumor formation at various carcinogenic steps in rats. Problems to be solved for the inhaled Pu compound are the elucidation of accuracy and validity concerning the metabolic parameters, alpha-ray dose assessment, dose rate effects of particle size; the biological factors modifying the metabolism and effect; and the relationship of cancer formation with non-tumorous diseases. (T.T)

Evaluation of a new irradiation left breast method in the inhalation phase

International Nuclear Information System (INIS)

Silva, Laura E. da; Gullo, Rafael G.; Ferreira, Diogo A.V.; Silva, Leonardo P. da

2016-01-01

Radiation therapy is the primary therapeutic approach to breast cancer and involves significant exposure of heart and lungs, especially in cases of left breast. The implementation of a methodology to reduce the dose in these sites is important to ensure better quality of life to the patient. This work aims reduced heart and lung dose when performing the radiotherapy planning considering only the inhalation phase. Three patients with breast left present were scanning with CT during free breathing and respiratory monitoring and the planning has done on both images series. The results showed a reduction in mean heart dose of 53% on average. As for lung volumes, was obtained a mean reduction of 44.6% and 51% of the left lung which received 10 Gy and 20 Gy, respectively. This study showed that the use of the respiratory gating radiotherapy in the left breast in inhalation phase can reduce heart and lung doses. (author)

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

International Nuclear Information System (INIS)

Lundgren, D.L.; Damon, E.G.; Diel, J.H.; Hahn, F.F.

1981-01-01

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 239 PuO 2 in rats. (author)

In vivo effects of synthetic cannabinoids JWH-018 and JWH-073 and phytocannabinoid Δ9-THC in mice: inhalation versus intraperitoneal injection.

Science.gov (United States)

Marshell, R; Kearney-Ramos, T; Brents, L K; Hyatt, W S; Tai, S; Prather, P L; Fantegrossi, W E

2014-09-01

Human users of synthetic cannabinoids (SCBs) JWH-018 and JWH-073 typically smoke these drugs, but preclinical studies usually rely on injection for drug delivery. We used the cannabinoid tetrad and drug discrimination to compare in vivo effects of inhaled drugs with injected doses of these two SCBs, as well as with the phytocannabinoid Δ(9)-tetrahydrocannabinol (Δ(9)-THC). Mice inhaled various doses of Δ(9)-THC, JWH-018 or JWH-073, or were injected intraperitoneally (IP) with these same compounds. Rectal temperature, tail flick latency in response to radiant heat, horizontal bar catalepsy, and suppression of locomotor activity were assessed in each animal. In separate studies, mice were trained to discriminate Δ(9)-THC (IP) from saline, and tests were performed with inhaled or injected doses of the SCBs. Both SCBs elicited Δ(9)-THC-like effects across both routes of administration, and effects following inhalation were attenuated by pretreatment with the CB1 antagonist/inverse agonist rimonabant. No cataleptic effects were observed following inhalation, but all compounds induced catalepsy following injection. Injected JWH-018 and JWH-073 fully substituted for Δ(9)-THC, but substitution was partial (JWH-073) or required relatively higher doses (JWH-018) when drugs were inhaled. These studies demonstrate that the SCBs JWH-018 and JWH-073 elicit dose-dependent, CB1 receptor-mediated Δ(9)-THC-like effects in mice when delivered via inhalation or via injection. Across these routes of administration, differences in cataleptic effects and, perhaps, discriminative stimulus effects, may implicate the involvement of active metabolites of these compounds. Copyright © 2014 Elsevier Inc. All rights reserved.

Radiation doses connected with tunnel excavation at Kvanefjeld

International Nuclear Information System (INIS)

Soerensen, A.

1980-12-01

The results of measurements of calculations of radiation doses in connection with the tunnel work in Kvanefjeld is presented. Doses from external gamma radiaton were measured by means of TL-dosemeters. Doses from inhalation of radon and thoron daughters where calculated on the basis of measured concentrations at the working places and record keeping of the working time of each employee. The same procedure was used for estimating doses from inhaled ore dust. The conversion from dust exposure to effective dose equivalent is based on the DAC-values from ICRP 30. The highest recorded dose to an individual employed during both of the two working periods (within 13 months) was approximately 1100 mrem. (A.S.)

A method for determining an indicator of effective dose calculation due to inhalation of Radon and its progeny from in vivo measurements; Um metodo para determinar um indicador para calcular dose efetiva devida a inalacao de Radonio e seus descendentes utilizando medicoes in vivo

Energy Technology Data Exchange (ETDEWEB)

Estrada, Julio Jose da Silva

1994-07-01

Direct measurement of the absolved dose to lung tissue from inhalation of radon and its progeny is not possible and must be calculated using dosimetric models, taking into consideration the several parameters upon which the dose calculation depends. To asses the dose due to inhalation of radon and its progeny, it is necessary to estimate the cumulative exposure. Historically, this has been done using WLM values estimated with measurements of radon concentration in air. The radon concentration in air varies significantly, however, in space with time, and the exposed individual is also constantly moving around. This makes it almost impossible to obtain a precise estimate of an individual's inhalation exposure. This work describes a pilot study to calculate lung dose from the deposition of radon progeny, via estimates of cumulative exposure derived from in vivo measurements of {sup 210} Pb, in subjects exposed to above-average radon and its progeny concentrations in their home environments. The measurements were performed in a whole body counter. With this technique, the exposed individuals become, in affect, their own samplers and dosimeters and the estimate of cumulative exposure is not affected by the variation of the atmospheric concentration of radon and its progeny in time and space. Forty individuals identified as living in homes with radon levels ranging from about 740 Bq/m{sup 3} to 150.000 Bq/m{sup 3} were measured. Also, additional 34 measurements were made on personnel from NYUMC/NIEM who live in a residential area surrounding the laboratory in which the levels of radon have been shown to be at below average values. To realize these measurements a methodology was developed to determine the subject's background, using a head phantom made with a cubic plastic container containing known amounts of potassium and calcium dissolved in four liters of water. The effective doses calculated from the in vivo measurements are compared to effective doses estimated, for

A method for determining an indicator of effective dose calculation due to inhalation of Radon and its progeny from in vivo measurements; Um metodo para determinar um indicador para calcular dose efetiva devida a inalacao de Radonio e seus descendentes utilizando medicoes in vivo

Energy Technology Data Exchange (ETDEWEB)

Estrada, Julio Jose da Silva

1994-07-01

Direct measurement of the absolved dose to lung tissue from inhalation of radon and its progeny is not possible and must be calculated using dosimetric models, taking into consideration the several parameters upon which the dose calculation depends. To asses the dose due to inhalation of radon and its progeny, it is necessary to estimate the cumulative exposure. Historically, this has been done using WLM values estimated with measurements of radon concentration in air. The radon concentration in air varies significantly, however, in space with time, and the exposed individual is also constantly moving around. This makes it almost impossible to obtain a precise estimate of an individual's inhalation exposure. This work describes a pilot study to calculate lung dose from the deposition of radon progeny, via estimates of cumulative exposure derived from in vivo measurements of {sup 210} Pb, in subjects exposed to above-average radon and its progeny concentrations in their home environments. The measurements were performed in a whole body counter. With this technique, the exposed individuals become, in affect, their own samplers and dosimeters and the estimate of cumulative exposure is not affected by the variation of the atmospheric concentration of radon and its progeny in time and space. Forty individuals identified as living in homes with radon levels ranging from about 740 Bq/m{sup 3} to 150.000 Bq/m{sup 3} were measured. Also, additional 34 measurements were made on personnel from NYUMC/NIEM who live in a residential area surrounding the laboratory in which the levels of radon have been shown to be at below average values. To realize these measurements a methodology was developed to determine the subject's background, using a head phantom made with a cubic plastic container containing known amounts of potassium and calcium dissolved in four liters of water. The effective doses calculated from the in vivo measurements are compared to effective doses

Experience of the irradiation method under mixed gas (95% O2 plus 5% CO2) inhalation

International Nuclear Information System (INIS)

Ikeda, Michio; Tazaki, Eio

1978-01-01

The irradiation method under mixed gas of 95% O 2 plus CO 2 inhalation at one atomosphere was discussed to improve therapeutic results, in malignant tumors which are not greatly sensitive to irradiation. Randomized study was done in each attending institute, with common protocols. As a result, no positive effect was recognized in irradiation method under mixed gas inhalation with daily dose of 200 rad and 5 fractions per week, which is widely used clinically. But when irradiation dose was increased up to 500 to 600 rad per fraction, effect of the mixed gas was remarkable. But against this, observing for years, results in irradiation under mixed gas inhalation were not always related to the improvement of the long term survival. (author)

Adhesion of nitrile rubber (NBR) to polyethylene terephthalate (PET) fabric. Part 1: PET surface modification by methylenediphenyl di-isocyanate (MDI)

Science.gov (United States)

Razavizadeh, Mahmoud; Jamshidi, Masoud

2016-01-01

Fiber to rubber adhesion is an important subject in rubber composite industry. It is well known that surface physical, mechanical and chemical treatments are effective methods to improve interfacial bonding. Ultra violet (UV) light irradiation is an efficient method which is used to increase interfacial interactions. In this research UV assisted chemical modification of PET fabric was used to increase its bonding to nitrile rubber (NBR). NBR is perfect selection to produce fuel and oil resistant rubber parts but it has weak bonding to fabrics. For this purpose at first, the PET fabric was carboxylated under UV irradiation and then methylenediphenyl diisocyanate (MDI) was reacted and grafted to carboxylated PET. T-peel test was used to evaluate PET fabric to NBR bonding strength. Attenuated total reflectance-Fourier transform infrared spectroscopy (FTIR-AT) was used to assess surface modifications of the PET fabrics. The chemical composition of the PET surfaces before and after carboxylation and MDI grafting was investigated by X-ray photoelectron spectroscopy (XPS). It was found that at vulcanizing temperature of 150 °C, carboxylation in contrary to MDI grafting, improved considerably PET to NBR adhesion. Finally effect of curing temperature on PET to NBR bonding strength was determined. It was found that increasing vulcanizing temperature to 170 °C caused considerable improvement (about 134%) in bonding strength.

Inhalation toxicity of methanol/gasoline in rats: effects of 13-week exposure.

Science.gov (United States)

Poon, R; Park, G; Viau, C; Chu, I; Potvin, M; Vincent, R; Valli, V

1998-01-01

The subchronic inhalation toxicity of a methanol/gasoline blend (85% methanol, 15% gasoline, v/v) was studied in rats. Sprague Dawley rats (10 animals per group) of both sexes were exposed to vapours of methanol/gasoline at 50/3, 500/30 and 5000/300ppm for 6 hours per day, 5 days per week, for 13 weeks. Control animals inhaled filtered room air only. Control recovery and high dose recovery groups were also included which inhaled room air for an extra 4 weeks following the treatment period. No clinical signs of toxicity were observed in the treatment group and their growth curves were not significantly different from the control. Except for decreased forelimb grip strength in high dose females, no treatment-related neurobehavioural effects (4-6 hours post inhalation) were observed using screening tests which included cage-side observations, righting reflex, open field activities, and forelimb and hindlimb grip strength. At necropsy, the organ to body weight ratios for the liver, spleen, testes, thymus and lungs were not significantly different from the control group. There were no treatment-related effects in the hematological endpoints and no elevation in serum formate levels. Minimal serum biochemical changes were observed with the only treatment-related change being the decreased creatinine in the females. A dose-related increase in urinary ascorbic acid was detected in males after 2, 4 and 8 weeks of exposure, but not after the 12th week, and in females only at week-2. Increased urinary albumin was observed in treated males starting at the lowest dose and at all exposure periods, but not in females. A treatment-related increase in urinary beta 2-microglobulin was detected in males at week-2 only. Except for mild to moderate mucous cell metaplasia in nasal septum B, which occurred more often and with a slightly higher degree of severity in the low dose groups of both sexes, and presence of a minimal degree of interstitial lymphocyte infiltration in the prostate

Comparison of modeled estimates of inhalation exposure to aerosols during use of consumer spray products.

Science.gov (United States)

Park, Jihoon; Yoon, Chungsik; Lee, Kiyoung

2018-05-30

In the field of exposure science, various exposure assessment models have been developed to complement experimental measurements; however, few studies have been published on their validity. This study compares the estimated inhaled aerosol doses of several inhalation exposure models to experimental measurements of aerosols released from consumer spray products, and then compares deposited doses within different parts of the human respiratory tract according to deposition models. Exposure models, including the European Center for Ecotoxicology of Chemicals Targeted Risk Assessment (ECETOC TRA), the Consumer Exposure Model (CEM), SprayExpo, ConsExpo Web and ConsExpo Nano, were used to estimate the inhaled dose under various exposure scenarios, and modeled and experimental estimates were compared. The deposited dose in different respiratory regions was estimated using the International Commission on Radiological Protection model and multiple-path particle dosimetry models under the assumption of polydispersed particles. The modeled estimates of the inhaled doses were accurate in the short term, i.e., within 10 min of the initial spraying, with a differences from experimental estimates ranging from 0 to 73% among the models. However, the estimates for long-term exposure, i.e., exposure times of several hours, deviated significantly from the experimental estimates in the absence of ventilation. The differences between the experimental and modeled estimates of particle number and surface area were constant over time under ventilated conditions. ConsExpo Nano, as a nano-scale model, showed stable estimates of short-term exposure, with a difference from the experimental estimates of less than 60% for all metrics. The deposited particle estimates were similar among the deposition models, particularly in the nanoparticle range for the head airway and alveolar regions. In conclusion, the results showed that the inhalation exposure models tested in this study are suitable

Radiation exposure and risk estimates for inhaled airborne radioactive pollutants including hot particles. Annual report 1 July 1976--30 June 1977

International Nuclear Information System (INIS)

Mewhinney, J.A.

1978-03-01

Contents: Mixed-oxide fuel fabrication; Generation of aerosols of mixed uranium-plutonium oxides from dry powders for animal inhalation exposures; Analytical radiochemical determination of U, Pu and Am in biological samples; Physical chemical characterization of mixed uranium-plutonium oxide nuclear fuel as samples during animal inhalation exposure; Pilot studies of deposition and retention of industrial mixed-oxide aerosols in the laboratory rat; Extended radiation dose pattern studies of aerosols of mixed uranium-plutonium oxides treated at 750C inhaled by Fishcer-344 rats, beagle dogs and cynomolgus monkeys; Extended radiation dose pattern studies of aerosols of plutonium dioxide, treated at 850C and inhaled by Fischer-344 rats, beagle dogs and cynomolgus monkeys

Deposition, distribution and retention of inhaled /sup 239/PuO/sub 2/ in the lungs of rats with pulmonary emphysema

Energy Technology Data Exchange (ETDEWEB)

Lundgren, D L; Damon, E G; Diel, J H; Hahn, F F [Lovelace Foundation for Medical Education and Research, Albuquerque, NM (USA). Inhalation Toxicology Research Inst.

1981-02-01

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 /sup 239/PuO/sub 2/ in rats.

Modeling the effect of continuous infusion DTPA therapy on the retention and dosimetry of inhaled actinides

International Nuclear Information System (INIS)

Guilmette, R.A.; Muggenburg, B.A.

1988-01-01

A biokinetic model of the treatment of dogs that inhaled 241 AmO 2 aerosols with continuously infused DTPA has been adapted from a model previously published by Mewhinney and Griffith. This model simulated both the tissue retention and excretion of 241 Am, and was used to estimate the cumulative radiation doses to tissues at risk from 241 Am alpha radiation. The results showed that at 64 days after exposure, the liver dose of the DTPA-treated animals was 3% that of the corresponding controls, the skeletal dose was 2%, the kidney dose was 4%, and the lung dose was 67% of controls. This paper describes a biokinetic and dosimetric model that was adapted from a previously published model. It was developed to provide a means of estimating radiation doses for cases where continuously infused DTPA therapy is used to reduce radiation dose. The model was formulated for the case of 241 Am0 2 inhalation, a physicochemical form of Am that is moderately soluble in vivo, and one to which people have been exposed. Because adequate human data, particularly tissue data, are not available from cases of accidental human exposure to 241 Am, two published data sets from experiments in which Beagle dogs inhaled 241 Am0 2 aerosols have been used to obtain parameter estimates for the model. The model simulations were then used to provide dose estimates with and without infused-DTPA therapy. (author)

Internal dose estimates

International Nuclear Information System (INIS)

Wrenn, M.E.

1977-01-01

Internal doses, the procedures for making them and their significance has been reviewed. Effects of uranium, radium, lead-210, polonium-210, thorium in man are analysed based on data from tables and plots. Dosimetry of some ingested nuclides and inhalation dose due to radon-222, radon-220 and their daugther products are discussed [pt

Inhalation Exposure Input Parameters for the Biosphere Model

Energy Technology Data Exchange (ETDEWEB)

K. Rautenstrauch

2004-09-10

This analysis is one of 10 reports that support the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN) biosphere model. The ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the conceptual model as well as the mathematical model and its input parameters. This report documents development of input parameters for the biosphere model that are related to atmospheric mass loading and supports the use of the model to develop biosphere dose conversion factors (BDCFs). The biosphere model is one of a series of process models supporting the total system performance assessment (TSPA) for a Yucca Mountain repository. Inhalation Exposure Input Parameters for the Biosphere Model is one of five reports that develop input parameters for the biosphere model. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling, and the plan for development of the biosphere abstraction products for TSPA, as identified in the Technical Work Plan for Biosphere Modeling and Expert Support (BSC 2004 [DIRS 169573]). This analysis report defines and justifies values of mass loading for the biosphere model. Mass loading is the total mass concentration of resuspended particles (e.g., dust, ash) in a volume of air. Mass loading values are used in the air submodel of ERMYN to calculate concentrations of radionuclides in air inhaled by a receptor and concentrations in air surrounding crops. Concentrations in air to which the receptor is exposed are then used in the inhalation submodel to calculate the dose contribution to the receptor from inhalation of contaminated airborne particles. Concentrations in air surrounding plants are used in the plant submodel to calculate the concentrations of radionuclides in foodstuffs contributed from uptake by foliar interception.

Inhalation Exposure Input Parameters for the Biosphere Model

International Nuclear Information System (INIS)

K. Rautenstrauch

2004-01-01

This analysis is one of 10 reports that support the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN) biosphere model. The ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the conceptual model as well as the mathematical model and its input parameters. This report documents development of input parameters for the biosphere model that are related to atmospheric mass loading and supports the use of the model to develop biosphere dose conversion factors (BDCFs). The biosphere model is one of a series of process models supporting the total system performance assessment (TSPA) for a Yucca Mountain repository. Inhalation Exposure Input Parameters for the Biosphere Model is one of five reports that develop input parameters for the biosphere model. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling, and the plan for development of the biosphere abstraction products for TSPA, as identified in the Technical Work Plan for Biosphere Modeling and Expert Support (BSC 2004 [DIRS 169573]). This analysis report defines and justifies values of mass loading for the biosphere model. Mass loading is the total mass concentration of resuspended particles (e.g., dust, ash) in a volume of air. Mass loading values are used in the air submodel of ERMYN to calculate concentrations of radionuclides in air inhaled by a receptor and concentrations in air surrounding crops. Concentrations in air to which the receptor is exposed are then used in the inhalation submodel to calculate the dose contribution to the receptor from inhalation of contaminated airborne particles. Concentrations in air surrounding plants are used in the plant submodel to calculate the concentrations of radionuclides in foodstuffs contributed from uptake by foliar interception

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

Energy Technology Data Exchange (ETDEWEB)

Gundavarapu, Sravanthi; Zhuang, Jianguo; Barrett, Edward G.; Xu, Fadi; Russell, Robert G.; Sopori, Mohan L., E-mail: msopori@lrri.org

2014-01-15

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

The MDI-Mediated Lateral Crosslinking of Polyurethane Copolymer and the Impact on Tensile Properties and Shape Memory Effect

International Nuclear Information System (INIS)

Chung, Yong Chan; Chung, Hyang Mi; Choi, Jae Won; Chun, Byoung Chul

2012-01-01

The maximum stress and strain at break remained high and stable after MDI-mediated crosslinking. Similarly, shape recovery and shape retention tests also showed excellent and reproducible results. The MDI-mediated crosslinking was responsible for the interesting tensile and shape memory results. Therefore, it was demonstrated in this investigation that the allophanate type crosslinking, unlike previous misleading information, was possible under the mild reaction conditions. Polyurethane (PU) has long been investigated due to its excellent mechanical properties, shape memory effect, and biocompatibility, and was grafted with pendant functional groups to tailor the polymer characteristics without affecting their basic structure. Actually, polyethyleneglycol has been grafted to polyurethane to improve biocompatibility in biomedical applications, and low temperature flexibility could be improved by the pendant naphthol group grafted to PU. In the field of shape memory polyurethane, mechanical and shape memory properties could be improved by terminal crosslinking with glycerol, pentaerythritol, and dextrin. Alternatively, a flexible crosslinking method was devised to demonstrate both high mechanical strength and shape recovery

Estimation of inhalation flow profile using audio-based methods to assess inhaler medication adherence

Science.gov (United States)

Lacalle Muls, Helena; Costello, Richard W.; Reilly, Richard B.

2018-01-01

Asthma and chronic obstructive pulmonary disease (COPD) patients are required to inhale forcefully and deeply to receive medication when using a dry powder inhaler (DPI). There is a clinical need to objectively monitor the inhalation flow profile of DPIs in order to remotely monitor patient inhalation technique. Audio-based methods have been previously employed to accurately estimate flow parameters such as the peak inspiratory flow rate of inhalations, however, these methods required multiple calibration inhalation audio recordings. In this study, an audio-based method is presented that accurately estimates inhalation flow profile using only one calibration inhalation audio recording. Twenty healthy participants were asked to perform 15 inhalations through a placebo Ellipta™ DPI at a range of inspiratory flow rates. Inhalation flow signals were recorded using a pneumotachograph spirometer while inhalation audio signals were recorded simultaneously using the Inhaler Compliance Assessment device attached to the inhaler. The acoustic (amplitude) envelope was estimated from each inhalation audio signal. Using only one recording, linear and power law regression models were employed to determine which model best described the relationship between the inhalation acoustic envelope and flow signal. Each model was then employed to estimate the flow signals of the remaining 14 inhalation audio recordings. This process repeated until each of the 15 recordings were employed to calibrate single models while testing on the remaining 14 recordings. It was observed that power law models generated the highest average flow estimation accuracy across all participants (90.89±0.9% for power law models and 76.63±2.38% for linear models). The method also generated sufficient accuracy in estimating inhalation parameters such as peak inspiratory flow rate and inspiratory capacity within the presence of noise. Estimating inhaler inhalation flow profiles using audio based methods may be

Lifetime tumor risk coefficients for beagle dogs that inhaled cerium-144 chloride

International Nuclear Information System (INIS)

Boecker, B.B.; Hahn, F.F.; Griffith, W.C.

1995-01-01

Reported here is one of the life-span radionuclide toxicology studies being conducted at ITRI in Beagle dogs. These studies are examining the life-span health risks of inhaled Β-, γ- and α-emitting radionuclides to expand available knowledge on these risks especially for the many cases for which human data are not available. The outcomes of these studies are providing important information on dosimetry and dose-response relationships for these inhaled radionuclides and the relative importance of a broad range of dose- and effect-modifying factors. A number of these studies are currently coming to completion. Much of the ITRI effort is being directed to final reviews of the dosimetric, clinical, and pathologic results and writing summary manuscripts. Radiation doses and effects in tissues adjacent to bone, specifically those of epithelial or marrow origin, should be considered when determining risks from internally deposited, bone-seeking radionuclides such as 144 Ce

Biokinetics and internal dosimetry of inhaled metal tritide particles

Science.gov (United States)

Wang, Yansheng

1998-12-01

Metal tritides (MT), stable chemical compounds of tritium, are widely used in nuclear engineering facilities. MT particles can be released as aerosols. Inhaling MT particles is a potential occupational radiation hazard. Little information is available on their dissolution behavior, biokinetics, and dosimetry. The objectives of present dissertation are to estimate dissolution rates, to develop biokinetic models, to improve internal dosimetric considerations, and to classify MT materials. This study consisted of three phases: In vitro dissolution in a simulated lung fluid, In vivo rat experiments on retention and clearance, and biokinetic modeling and dosimetric evaluation. There was a supporting study on self- absorption of tritium beta in MT particles. MT materials used in this study were titanium (Ti) and zirconium (Zr) tritides. Results shows considerable self-absorption of beta particles and their energy, even for respirable MT particles smaller than 5 μm. The self-absorption factors should be required for counting MT particle samples and for estimating absorbed dose to tissues. In vitro and in vivo dissolution data indicate that Ti and Zr tritides are poorly soluble materials. Ti tritide belongs to the W class or M type while Zr tritide can be classified as Y class or S type. Due to long retention time of the MT particles, tritium betas directly from the particles contribute over 90% of the absorbed dose to lung. The lung dose contributes most of the effective dose to the whole body. Dissolved tritium including tritiated water (HTO) and organically bound tritium (OBT) has less effect on the lung dose and effective dose. Results on the annual limit on intake (ALI) indicate that the current radiation protection guideline based on HTO is not adequate for inhalation exposure to MT particles and needs to be modified. The biokinetic models developed in this study have predictive powers to estimate the consequences of a human inhalation exposure to MT aerosols. The

Bio-mathematical models for radon daughters inhalation. The ModeLung software

International Nuclear Information System (INIS)

Tomulescu, Vlad C.; Rusu, Mircea

2002-01-01

Radon and its decay daughters are the most important sources for natural irradiation of population. ModeLung software is based on the human respiratory tract compartment model and is computing radiation doses on several internal organs and tissues for subjects inhaling radon daughters attached to aerosols. Radiation doses are presented for several subjects performing different types of activity under specific environmental conditions. (authors)

Indoor inhalation dose estimates due to radon and thoron in some areas of South-Western Punjab (India))

International Nuclear Information System (INIS)

Kumar, S.; Singh, S.; Bajwa, B. S.; Singh, B.; Sabharwal, A. D.; Eappen, K. P.

2008-01-01

LR-115 (type II)-based radon-thoron discriminating twin-chamber dosemeters have been used for estimating radon 222 Rn) and thoron 220 Rn) concentrations in dwellings of south-western Punjab (India)). The present study region has shown pronounced cases of cancer incidents in the public [Thakur, Rao, Rajwanshi, Parwana and Kumar (Epidemiological study of high cancer among rural agricultural community of Punjab in Northern India. Int J Environ Res Public Health 2008; 5(5):399-407) and Kumar et al. (Risk assessment for natural uranium in subsurface water of Punjab state (India)). Hum Ecol Risk Assess 2011;17:381-93)]. Radon being a carcinogen has been monitored in some dwellings selected randomly in the study area. Results show that the values of radon 222 Rn) varied from 21 to 79 Bq m -3 , with a geometric mean of 45 Bq m -3 [geometric standard deviation (GSD 1.39)], and those of thoron 220 Rn) from minimum detection level to 58 Bq m -3 with a geometric mean of 19 Bq m -3 (GSD 1.88). Bare card data are used for computing the progeny concentration by deriving the equilibrium factor (F) using a root finding method [Mayya, Eappen and Nambi (Methodology for mixed field inhalation dosimetry in monazite areas using a twin-cup dosemeter with three track detectors. Radiat Prot Dosim 1998; 77(3): 177-84)]. Inhalation doses have been calculated and compared using UNSCEAR equilibrium factors and by using the calculated F-values. The results show satisfactory comparison between the values. (authors)

Derived ERLs for inhalation of alpha-emitting aerorols

International Nuclear Information System (INIS)

Macdonald, H.F.

1977-01-01

Derived alpha action levels are expressed as dpm/m 3 and give the airborne concentration of an assumed mixture of α-emitters which if inhaled for a period of 4 hours would result in a dose commitment to members of the critical group in the exposed population equal to the emergency reference levels (ERLs) of dose recommended by the Medical Research Council (1975). The period of 4 hours is chosen as a realistic time during which an assessment of the severity of a release may be made and appropriate countermeasures instituted. The derived α ERLs are set with reference to the potential range of isotopic releases for a specific reactor system and in the case of gas-cooled magnox reactors, a value of 10 3 dpm/m 3 (170 Bqm -3 ) has been used. This level was based upon the lung and GI tract models originally recommended by ICRP 2 (1959:1964) and revised ERLs for the inhalation of α-emitters consequent upon the improved metabolic models subsequently proposed by the ICRP (1966:1972) are evaluated. It is shown that the derived α ERLs for irradiated magnox and AGR fuels are largely independent of the physico-chemical forms of the released material, while variations with cooling time of fuel are also discussed. In addition, the special limits imposed by the chemical toxicity of uranium when inhaled in a soluble, low enriched form are briefly outlined

Induction of cancers in the rat after inhalation of alpha-emitting radionuclides

International Nuclear Information System (INIS)

Morin, M.; Nenot, J.C.; Masse, R.; Nolibe, D.; Metivier, H.; Lafuma, J.

1976-01-01

Experiments have been conducted for several years on the toxic action of inhaled alpha-emitters on laboratory rats. The inhaled radionuclides were 239 Pu, 238 Pu and 241 Am in oxide and nitrate form. The initial alveolar activities varied to give total activities ranging from 1 to 200 thousand million alpha-particles per gram of lung. Variations, depending on the physico-chemical form of the nuclides, in the space and time distributions of the dose are observed. The influence of the two parameters on life span reduction, latency time and frequency of cancer occurrence, initial location of tumours and their histological types were studied. A theoretical model relating the cancerogenous effect to the dose is compared with experimental data. (author)

Effects of inhaled Linalool in anxiety, social interaction and aggressive behavior in mice.

Science.gov (United States)

Linck, V M; da Silva, A L; Figueiró, M; Caramão, E B; Moreno, P R H; Elisabetsky, E

2010-07-01

Aromatherapy uses essential oils (EOs) for several medical purposes, including relaxation. The association between the use of aromas and a decrease in anxiety could be a valuable instrument in managing anxiety in an ever increasing anxiogenic daily life style. Linalool is a monoterpene commonly found as the major volatile component of EOs in several aromatic plant species. Adding to previously reported sedative effects of inhaled linalool, the aim of this study was to investigate the effects of inhaled linalool on anxiety, aggressiveness and social interaction in mice. Additionally, we investigated the effects of inhaled linalool on the acquisition phase of a step-down memory task in mice. Inhaled linalool showed anxiolytic properties in the light/dark test, increased social interaction and decreased aggressive behavior; impaired memory was only seen the higher dose of linalool. These results strengthen the suggestion that inhaling linalool rich essential oils can be useful as a mean to attain relaxation and counteract anxiety. (c) 2009 Elsevier GmbH. All rights reserved.

Animal study on biological responses by radon inhalation making use of waste rock which contains feeble activity of uranium (2) (Joint research)

International Nuclear Information System (INIS)

Ishimori, Yuu; Sakoda, Akihiro; Tanaka, Hiroshi; Mitsunobu, Fumihiro; Yamaoka, Kiyonori; Kataoka, Takahiro; Etani, Reo

2016-03-01

Okayama University and the Japan Atomic Energy Agency (JAEA) have carried out the collaborative study of physiological effects of inhaled radon for the low-dose range. Main assignments were as follows. Based on the clinical knowledge, Misasa Medical Center (Okayama University Hospital) clarified the issues that should be addressed. Graduate School of Health Sciences (Okayama University) supervised the research and studied the biological responses. The JAEA made the development and control of a facility for radon inhalation experiments and the investigation of biokinetics and exposure doses of radon. From 2009 to 2013, the following results were obtained. (1) Literature on drinking effects of radon hot spring water was surveyed to determine the present tasks. (2) Under the present experimental conditions, drinking of hot spring water into which radon was intentionally introduced using the equipment in the facility did not have significant effects on mice. (3) Inhibitory effects of antioxidant pre-supplements (Vitamins C and E) and radon pre-inhalation on hepatic or renal oxidative damage were examined to make the comparison. (4) In order to discuss biological responses quantitatively following radon inhalation, the biokinetics of inhaled radon were studied. (5) Some exposure routes due to inhalation of radon or its progeny were modeled to calculate organ doses in mice. (author)

Influence of Natural Lung Surfactant Inhalations on Clinical Symptoms and Pulmonary Function Parameters in Patients with Bronchial Asthma. Communication 1

Directory of Open Access Journals (Sweden)

O.V. Stepanova

2016-12-01

Full Text Available Background: Damage to lung surfactant (LS enabling the lung local immunity may contribute to the development of bronchial inflammation in patients with bronchial asthma. Methods and Results: A 40-day course of 16 LS (Surfactant-BL inhalations at the dose of 25mg was added to inhaled corticosteroids (ICS and short/long-acting bronchodilators or combined inhalers in 14 patients with bronchial asthma. After 7 inhalations, patients demonstrated a significant decrease in shortness of breath and bronchospasm attacks, double reduction of ICS dose (p=0.01, and improvement of pulmonary function. Forced vital capacity (FVC increases during treatment in a linear fashion (y=62.9+5.60•x; p<0.05, reaching the normal level (80% after 9 inhalations (Day 15. Forced expiratory volume (FEV1 increases in a linear fashion (y=50.7+4.15•x; p<0.05 without reaching the normal level (80% after 16 inhalations (Day 41. The FEV1/FVC ratio does not change significantly in the time period between Day 1 to Day 15. By Day 41 the value decreases significantly to 67.4±4.66% (p<0.05. The peak expiratory flow (PEF parameter increases in a linear fashion (y=53.9+5.00•x; p<0.01 from 57.7±6.33% to 76.2±9.33% of the predicted value. Conclusion: LS inhalations improve the condition of patients with BA, allow ICS dose reduction by 2 times, and improve pulmonary function parameters.

Toxicity of inhaled 144CeCl3 in beagle dogs

International Nuclear Information System (INIS)

Muggenburg, B.A.; Hahn, F.F.; Boecker, B.B.; McClellan, R.O.; Pickrell, J.A.

1980-01-01

The metabolism, dosimetry and effects of inhaled 144 CeCl 3 in beagle dogs are being studied to assess the biological consequences of inhaling 144 Ce. Studies have shown that the 144 Ce deposited in the lung as 144 CeCl 3 is translocated at a moderately rapid rate to liver and skeleton and that significant radiation doses are accumulated by all three organs. Fifty-five dogs that inhaled 144 CeCl 3 and 17 control dogs are being observed for their life span. The 144 Ce-exposed dogs had long-term retained burdens that ranged from 2.6 to 360 μCi 144 Ce/kg body weight. Fifty-three of the dogs exposed to 144 CeCl 3 have died and twelve control dogs have died. Serial observations are continuing on the two surviving exposed dogs and five control dogs

Investigating pulmonary and systemic pharmacokinetics of inhaled olodaterol in healthy volunteers using a population pharmacokinetic approach.

Science.gov (United States)

Borghardt, Jens Markus; Weber, Benjamin; Staab, Alexander; Kunz, Christina; Formella, Stephan; Kloft, Charlotte

2016-03-01

Olodaterol, a novel β2-adrenergic receptor agonist, is a long-acting, once-daily inhaled bronchodilator approved for the treatment of chronic obstructive pulmonary disease. The aim of the present study was to describe the plasma and urine pharmacokinetics of olodaterol after intravenous administration and oral inhalation in healthy volunteers by population pharmacokinetic modelling and thereby to infer its pulmonary fate. Plasma and urine data after intravenous administration (0.5-25 μg) and oral inhalation (2.5-70 μg via the Respimat® inhaler) were available from a total of 148 healthy volunteers (single and multiple dosing). A stepwise model building approach was applied, using population pharmacokinetic modelling. Systemic disposition parameters were fixed to estimates obtained from intravenous data when modelling data after inhalation. A pharmacokinetic model, including three depot compartments with associated parallel first-order absorption processes (pulmonary model) on top of a four-compartment body model (systemic disposition model), was found to describe the data the best. The dose reaching the lung (pulmonary bioavailable fraction) was estimated to be 49.4% [95% confidence interval (CI) 46.1, 52.7%] of the dose released from the device. A large proportion of the pulmonary bioavailable fraction [70.1% (95% CI 66.8, 73.3%)] was absorbed with a half-life of 21.8 h (95% CI 19.7, 24.4 h). The plasma and urine pharmacokinetics of olodaterol after intravenous administration and oral inhalation in healthy volunteers were adequately described. The key finding was that a high proportion of the pulmonary bioavailable fraction had an extended pulmonary residence time. This finding was not expected based on the physicochemical properties of olodaterol. © 2015 The British Pharmacological Society.

Inhalation Exposure Input Parameters for the Biosphere Model

Energy Technology Data Exchange (ETDEWEB)

M. Wasiolek

2006-06-05

This analysis is one of the technical reports that support the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN), referred to in this report as the biosphere model. ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the conceptual model as well as the mathematical model and its input parameters. This report documents development of input parameters for the biosphere model that are related to atmospheric mass loading and supports the use of the model to develop biosphere dose conversion factors (BDCFs). The biosphere model is one of a series of process models supporting the total system performance assessment (TSPA) for a Yucca Mountain repository. ''Inhalation Exposure Input Parameters for the Biosphere Model'' is one of five reports that develop input parameters for the biosphere model. A graphical representation of the documentation hierarchy for the biosphere model is presented in Figure 1-1 (based on BSC 2006 [DIRS 176938]). This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling and how this analysis report contributes to biosphere modeling. This analysis report defines and justifies values of atmospheric mass loading for the biosphere model. Mass loading is the total mass concentration of resuspended particles (e.g., dust, ash) in a volume of air. Mass loading values are used in the air submodel of the biosphere model to calculate concentrations of radionuclides in air inhaled by a receptor and concentrations in air surrounding crops. Concentrations in air to which the receptor is exposed are then used in the inhalation submodel to calculate the dose contribution to the receptor from inhalation of contaminated airborne particles. Concentrations in air surrounding plants are used in the plant submodel to calculate the concentrations of radionuclides in foodstuffs contributed from uptake by foliar interception. This

Inhalation Exposure Input Parameters for the Biosphere Model

International Nuclear Information System (INIS)

M. Wasiolek

2006-01-01

This analysis is one of the technical reports that support the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN), referred to in this report as the biosphere model. ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the conceptual model as well as the mathematical model and its input parameters. This report documents development of input parameters for the biosphere model that are related to atmospheric mass loading and supports the use of the model to develop biosphere dose conversion factors (BDCFs). The biosphere model is one of a series of process models supporting the total system performance assessment (TSPA) for a Yucca Mountain repository. ''Inhalation Exposure Input Parameters for the Biosphere Model'' is one of five reports that develop input parameters for the biosphere model. A graphical representation of the documentation hierarchy for the biosphere model is presented in Figure 1-1 (based on BSC 2006 [DIRS 176938]). This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling and how this analysis report contributes to biosphere modeling. This analysis report defines and justifies values of atmospheric mass loading for the biosphere model. Mass loading is the total mass concentration of resuspended particles (e.g., dust, ash) in a volume of air. Mass loading values are used in the air submodel of the biosphere model to calculate concentrations of radionuclides in air inhaled by a receptor and concentrations in air surrounding crops. Concentrations in air to which the receptor is exposed are then used in the inhalation submodel to calculate the dose contribution to the receptor from inhalation of contaminated airborne particles. Concentrations in air surrounding plants are used in the plant submodel to calculate the concentrations of radionuclides in foodstuffs contributed from uptake by foliar interception. This report is concerned primarily with the

Radiation Dose to Post-Chernobyl Cleanup Workers

Science.gov (United States)

Radiation dose calculation for post-Chernobyl Cleanup Workers in Ukraine - both external radiation exposure due to fallout and internal doses due to inhalation (I131 intake) or ingestion of contaminated foodstuffs.

Lifetime tumor risk coefficients for beagle dogs that inhaled cerium-144 chloride

Energy Technology Data Exchange (ETDEWEB)

Boecker, B.B.; Hahn, F.F.; Griffith, W.C. [and others

1995-12-01

Reported here is one of the life-span radionuclide toxicology studies being conducted at ITRI in Beagle dogs. These studies are examining the life-span health risks of inhaled {Beta}-, {gamma}- and {alpha}-emitting radionuclides to expand available knowledge on these risks especially for the many cases for which human data are not available. The outcomes of these studies are providing important information on dosimetry and dose-response relationships for these inhaled radionuclides and the relative importance of a broad range of dose- and effect-modifying factors. A number of these studies are currently coming to completion. Much of the ITRI effort is being directed to final reviews of the dosimetric, clinical, and pathologic results and writing summary manuscripts. Radiation doses and effects in tissues adjacent to bone, specifically those of epithelial or marrow origin, should be considered when determining risks from internally deposited, bone-seeking radionuclides such as {sup 144}Ce.

Fluticasone furoate and vilanterol inhalation powder for the treatment of chronic obstructive pulmonary disease.

Science.gov (United States)

Matera, Maria Gabriella; Capuano, Annalisa; Cazzola, Mario

2015-02-01

Fluticasone furoate/vilanterol (FF/VI) is a novel inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) fixed dose combination that, by simplifying the dosing schedule, allows, for the first time in a member of the ICS/LABA class, a shift from twice-daily to once-daily treatment. FF/VI is delivered via a novel, single-step activation, multi-dose dry powder inhaler for oral inhalation, Ellipta. Regrettably, there are no head-to-head trials that have shown superiority in the safety or efficacy of FF versus other ICSs, but evidence shows that VI has a quicker onset of effect versus salmeterol. However, the clinical utility of this effect in a maintenance medication is still questionable. Furthermore, benefits of FF/VI over twice-daily ICS/LABA comparator have not been shown yet and, in addition, its adverse event profile is generally consistent with the known class effects of an ICS/LABA fixed dose combination. In particular, there is an increase in the risk of pneumonia among patients treated with FF/VI relative to VI, mainly among those who benefit most from FF/VI. Nevertheless, the interesting pharmacological profiles of both FF and VI, the possibility that FF/VI can be administered once-daily, and the attractive characteristics of Ellipta are important features that could help FF/VI to be a successful combination in the treatment of chronic obstructive pulmonary disease.

The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes

Directory of Open Access Journals (Sweden)

Bosnic-Anticevich S

2016-12-01

incidence rate ratio (IRR comparing the rate of exacerbations between study cohorts. A secondary outcome compared average daily use of short-acting beta agonist (SABA. Results: The final study sample contained 8,225 patients in each cohort (mean age 67 [SD, 10], 57% males, 37% current smokers. Patients in the similar-devices cohort had a lower rate of exacerbations compared with those in the mixed-devices cohort (adjusted IRR 0.82, 95% confidence interval [CI] 0.80–0.84 and were less likely to be in a higher-dose SABA group (adjusted proportional odds ratio 0.54, 95% CI 0.51–0.57. Conclusion: COPD patients who were prescribed one or more additional inhaler devices requiring similar inhalation techniques to their previous device(s showed better outcomes than those who were prescribed devices requiring different techniques. Keywords: chronic obstructive pulmonary disease, inhalation technique, exacerbations, inhaler devices, observational, matched cohort

Characteristic pathological changes of main organs of rates after inhalation of depleted uranium aerosol

International Nuclear Information System (INIS)

Cao Zhenshan; Zhu Maoxiang; Yang Zhihua; Pan Xiujie; Li Yuanmin

2005-01-01

Objective: To explore the pathological and morphometric alteration of main organs of rat after inhalation of depleted uranium (DU) aerosole in order to provide information for medical protection against DU weapons. Methods: Routine pathological technique and morphometric measurements were used to observe histopathological and morphological changes in lung, kidney, spleen, liver, brain of rats 1-14 months after inhalation of DU aerosol. Results: After inhalation of DU aerosol, lymphocytic infiltration in the pulmonary parenchyma, serious bronchitis, pulmonary hemorrhage and abscess formation were seen in some of the rats; distinct dilatation of tubules in renal cortex and papillae, casts in some tubules of the cortex, medulla and papillae, and interstitial hemorrhage were found in some other rats; diminution of the area of splenic white pulp, reduction of megakaryocytic mitosis were also observed, the incidence and severity of above changes in the lung and kidney, but not in the liver and brain, showed dependance on the length of time after inhalation or the dose of DU inhaled. Conclusion There are evident injurious effects on rat lung, kidney and spleen by inhalation of DU aerosol. (authors)

Investigating the reactivity of pMDI with wood cell walls using high-resolution solution-state NMR spectroscopy

Science.gov (United States)

Daniel J. Yelle; John Ralph; Charles R. Frihart

2009-01-01

The objectives of this study are the following: (1) Use solution-state NMR to assign contours in HSQC spectra of the reaction products between pMDI model compounds and: (a) lignin model compounds, (b) milled-wood lignin, (c) ball-milled wood, (d) microtomed loblolly pine; (2) Determine where and to what degree urethane formation occurs with loblolly pine cell wall...

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 asthma uncontrolled on high-dose inhaled corticosteroids (ICS). In a 12-week, randomized, multicenter, double-blind, parallel-group study, patients (>or=12 years of age) were randomized to MF/F 200/10 microg, MF/F 400/10 microg, or MF 400 microg, b.i.d. after a 2- to 3-week open-label run in with MF 400...... microg b.i.d. The primary end point was mean change in area under the curve from 0 to 12 hours in forced expiratory volume in 1 second (FEV(1) AUC(0-12h)) from baseline to week 12 for MF/F 400/10 microg versus MF 400 microg. Effects of MF/F on asthma control and symptoms were evaluated and adverse events...

Proposed retention model for human inhalation exposure to 241AmO2

International Nuclear Information System (INIS)

Mewhinney, J.A.; Griffith, W.C.; Muggenburg, B.A.

1980-01-01

A dosimetry model based on a four-year study in Beagle dogs was developed to predict patterns of absorbed radiation doses for people exposed by inhalation to 241 AmO 2 . Following a single inhalation exposure to one of three sizes of monodisperse or a polydisperse aerosol of 241 AmO 2 , pairs of dogs were sacrificed at 8, 32, 64 and 256 days, and 2 and 4 years. For about 80% of the initial lung burden, the retention halftimes were 11, 18, 26 and 27 days for the 0.75, 1.5 and 3.0 μm aerodynamic diameter and the 1.8 μm activity median aerodynamic diameter aerosols, respectively. For the remaining 20% of the initial lung burden, the retention halftimes were between 200 to 300 days with no apparent particle size influence. Additional 241 Am metabolic studies reported in the literature using inhalation exposure or injection of the citrate complex were synthesized in the model as were eleven reported cases of human inhalation exposure. This model is compared to the ICRP II and TGLD lung models, both developed by analogy to Pu metabolism. The proposed model differs from these latter models in two important areas: (a) lung retention of 241 AmO 2 could not be adapted to the classifications used in these models, and (b) the fractional translocation from lung to other organs is 2 to 8 times larger. These factors considerably alter the predicted radiation dose distribution among organs and lead to the conclusion that derived radiation protection standards for 241 AmO 2 inhalation exposure should be modified. (author)

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

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Weissmann Norbert

2005-07-01

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

Practice makes perfect: self-reported adherence a positive marker of inhaler technique maintenance.

Science.gov (United States)

Azzi, Elizabeth; Srour, Pamela; Armour, Carol; Rand, Cynthia; Bosnic-Anticevich, Sinthia

2017-04-24

Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included. Data consisted of patient demographics, clinical data, medication-related factors and patient-reported outcomes. Mixed effects logistic regression was used to identify predictors of inhaler technique maintenance at 1 month. The variables found to be independently associated with inhaler technique maintenance using logistic regression (Χ 2 (3,n = 238) = 33.24, p < 0.000) were inhaler technique at Visit 1 (OR 7.1), device type (metered dose inhaler and dry powder inhalers) (OR 2.2) and self-reported adherent behavior in the prior 7 days (OR 1.3). This research is the first to unequivocally establish a predictive relationship between inhaler technique maintenance and actual patient adherence, reinforcing the notion that inhaler technique maintenance is more than just a physical skill. Inhaler technique maintenance has an underlying behavioral component, which future studies need to investigate. BEHAVIORAL ELEMENT TO CORRECT LONG-TERM INHALER TECHNIQUES: Patients who consciously make an effort to perfect asthma inhaler technique will maintain their skills long-term. Elizabeth Azzi at the University of Sydney, Australia, and co-workers further add evidence that there is a strong behavioral component to patients retaining correct inhaler technique over time. Poor inhaler technique can limit asthma control, affecting quality of life and increasing the chances of severe exacerbations. Azzi's team followed 238 patients to

Toxicity of inhaled 90Y in fused clay particles in beagle dogs. VI

International Nuclear Information System (INIS)

Hobbs, C.H.; Chiffelle, T.L.; Hahn, F.F.; Jones, R.K.; Mauderly, J.L.; McClellan, R.O.; Pickrell, J.A.

1974-01-01

Studies on the metabolism, dosimetry, and effects of inhaled 90 Y in fused clay in the Beagle dog are being continued to assess the consequences of inhalation of an energetic beta emitter that has a short effective half-life in the lung. A radiation dose pattern study in which 12 dogs were sacrificed in pairs at 0, 2, 4, 6, 8, and 12 days post-inhalation exposure has been completed. A longevity study in which 89 dogs have been exposed to 90 Y fused clay with initial lung burdens ranging from 80 to 5200 μCi/kg body weight and 12 control dogs were exposed to stable yttrium in fused clay is in progress. The 90 Y was retained in lung with a half-life similar to its physical half-life (64 hours) and with only small quantities translocated to tracheobronchial lymph nodes, skeleton, and liver. The infinite radiation doses to lung, tracheobronchial lymph nodes, skeleton, and liver for an initial lung burden of 100 μCi 90 Y/kg of body weight were estimated to be 1600, 170, 0.54, and 0.38 rads, respectively. Thirty-eight of 39 dogs with doses to lung from 9300 to 70,000 rads have died at 7.5 to 903 days post-exposure. The one surviving dog in this dose range has radiographic evidence of pulmonary fibrosis at 1316 days post-exposure. All the dogs that died had radiation pneumonitis. The dog that died at 903 days post-exposure with a dose to lung of 11,000 rads also had 2 small pulmonary adenomas. Fifty exposed dogs with doses to lung of 1300 to 7900 rads are surviving with no significant abnormalities at 1278 to 1834 days post-exposure and will be studied for the remainder of their lifespan. (U.S.)

Chronic cigarette smoke exposure increases the pulmonary retention and radiation dose of 239Pu inhaled as 239PuO2 by F344 rats

International Nuclear Information System (INIS)

Finch, G.L.; Lundgren, D.L.; Barr, E.B.; Chen, B.T.; Griffith, W.C.; Hobbs, C.H.; Hoover, M.D.; Nikula, K.J.; Mauderly, J.L.

1998-01-01

As a portion of a study to examine how chronic cigarette smoke exposure might alter the risk of lung tumors from inhaled 239 PuO 2 in rats, the effects of smoke exposure on alpha-particle lung dosimetry over the life-span of exposed rats were determined. Male and female rats were exposed to inhaled 239 PuO 2 alone or in combination with cigarette smoke. Animals exposed to filtered air along served as controls for the smoke exposure. Whole-body exposure to mainstream smoke diluted to concentrations of either 100 or 250 mg total particulate matter m -3 began at 6 wk of age and continued for 6 h d -1 , 5 d wk -1 , for 30 mo. A single, pernasal, acute exposure to 239 PuO 2 was given to all rats at 12 wk of age. Exposure to cigarette smoke caused decreased body weight gains in a concentration dependent manner. Lung-to-body weight ratios were increased in smoke-exposed rats. Rats exposed to cigarette smoke before the 239 PuO 2 exposure deposited less 239 Pu in the lung than did controls. Except for male rats exposed to LCS, exposure to smoke retarded the clearance of 239 Pu from the lung compared to control rats through study termination at 870 d after 239 PuO 2 exposure. Radiation doses to lungs were calculated by sex and by exposure group for rats on study for at least 360 d using modeled body weight changes, lung-to-body weight ratios, and standard dosimetric calculations. For both sexes, estimated lifetime radiation doses from the time of 239 PuO 2 exposure to death were 3.8 Gy, 4.4 Gy, or 6.7 Gy for the control, LCS, or HCS exposure groups, respectively. Assuming an approximately linear dose-response relationship between radiation dose and lung neoplasm incidence, approximate increases of 20% or 80% in tumor incidence over controls would be expected in rats exposed to 239 PuO 2 and LCS or 239 PuO 2 and HCS, respectively

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

Inhalative cadmium effects in pregnant and fetal rats

Energy Technology Data Exchange (ETDEWEB)

Prigge, E.

1978-01-01

Pregnant and non-pregnant rats were continuously exposed for 21 days to an aerosol containing 0.2, 0.4, and 0.6 mg cadmium/m/sup 3/ air. Pregnant and non-pregnant rats exposed to clean air served as controls. The aerosol was generated by an ultrasonic nebulizer and was carried into inhalation chambers. The median aerodynamic diameters were on the order of 0.6 ..mu..m. After inhalation of cadmium aerosols, serum iron levels were not lowered significantly in adult rats. A polycythaemic response of non-pregnant rats was observed due to a direct stimulatory effect of cadmium on erythropoiesis. Polycythaemia was less marked in pregnancy, presumably due to iron loss to placenta and fetus. Disturbances of pulmonary gas exchange or decreased plasma volumes were excluded as causative mechanisms of polycythaemia. In pregnant rats there was a marked dose dependent decrease of the activity of the alkaline phosphatase after cadmium inhalation, while there was no effect in exposed non-pregnant rats. This decreased enzyme activity, together with slowed growth rates and hemolytic effect indicate a higher sensitivity to cadmium in pregnancy. Proteinuria was not found in neither pregnant nor non-pregnant rats. Therefore, it is concluded that in this respect cadmium intoxication by inhalation does not resemble human toxemia of pregnancy, as discussed in the literature.

Subchronic inhalation toxicity of gold nanoparticles

Directory of Open Access Journals (Sweden)

Chung Yong

2011-05-01

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

Inhaled budesonide for adults with mild-to-moderate asthma: a randomized placebo-controlled, double-blind clinical trial

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Ana Luisa Godoy Fernandes

2001-09-01

Full Text Available CONTEXT: Budesonide is an inhaled corticosteroid with high topical potency and low systemic activity recommended in the treatment of chronic asthma. OBJECTIVE: This study was conducted to determine the efficacy and safety of inhaled budesonide via a breath-activated, multi-dose, dry-powder inhaler. TYPE OF STUDY: Multicenter randomized parallel-group, placebo-controlled, double-blind, clinical trial. SETTING: Multicenter study in the university units. PARTICIPANTS: Adult patients with mild-to-moderate asthma that was not controlled using bronchodilator therapy alone. PROCEDURES: Comparison of budesonide 400 µg administered twice daily via a breath-activated, multi-dose, dry-powder inhaler with placebo, in 43 adult patients (aged 15 to 78 years with mild-to-moderate asthma (FEV1 71% of predicted normal that was not controlled using bronchodilator therapy alone. MAIN MEASUREMENTS: Efficacy was assessed by pulmonary function tests and asthma symptom control (as perceived by the patients and the use of rescue medication. RESULTS: Budesonide 400 µg (bid was significantly more effective than placebo in improving morning peak expiratory flow (mean difference: 67.9 l/min; P < 0.005 and FEV1 (mean difference: 0.60 l; P < 0.005 over the 8-week treatment period. Onset of action, assessed by morning peak expiratory flow, occurred within the first two weeks of treatment. CONCLUSIONS: Budesonide via a breath-activated, multi-dose, dry-powder inhaler results in a rapid onset of asthma control, which is maintained over time and is well tolerated in adults with mild-to-moderate asthma.

Limiting values of radionuclide intake and air concentration and dose conversion factors for inhalation, submersion, and ingestion: Federal guidance report No. 11

International Nuclear Information System (INIS)

Eckerman, K.F.; Wolbarst, A.B.; Richardson, A.C.B.

1988-09-01

Radiation protection programs for workers are based, in the United States, on a hierarchy of limitations stemming from Federal guidance approved by the President. This guidance, which consists of principles, policies, and numerical primary guides, is used by Federal agencies as the basis for developing and implementing their own regulatory standards. The primary guides are usually expressed in terms of limiting doses to workers. The protection of workers against taking radioactive materials into the body, however, is accomplished largely through the use of regulations based on derived guides expressed in terms of quantities or concentrations of radionuclides. The values of these derived guides are chosen so as to assure that workers in work environments that conform to them are unlikely to receive radiation doses that exceed the primary guides. The purpose of the present report is to set forth derived guides that are consistent with current Federal radiation protection guidance. They are intended to serve as the basis for regulations setting upper bounds on the inhalation and ingestion of, and submersion in, radioactive materials in the workplace. The report also includes tables of exposure-to-dose conversion factors, for general use in assessing average individual committed doses in any population that is adequately characterized by Reference Man. 38 refs

Limiting values of radionuclide intake and air concentration and dose conversion factors for inhalation, submersion, and ingestion: Federal guidance report No. 11

Energy Technology Data Exchange (ETDEWEB)

Eckerman, K.F.; Wolbarst, A.B.; Richardson, A.C.B.

1988-09-01

Radiation protection programs for workers are based, in the United States, on a hierarchy of limitations stemming from Federal guidance approved by the President. This guidance, which consists of principles, policies, and numerical primary guides, is used by Federal agencies as the basis for developing and implementing their own regulatory standards. The primary guides are usually expressed in terms of limiting doses to workers. The protection of workers against taking radioactive materials into the body, however, is accomplished largely through the use of regulations based on derived guides expressed in terms of quantities or concentrations of radionuclides. The values of these derived guides are chosen so as to assure that workers in work environments that conform to them are unlikely to receive radiation doses that exceed the primary guides. The purpose of the present report is to set forth derived guides that are consistent with current Federal radiation protection guidance. They are intended to serve as the basis for regulations setting upper bounds on the inhalation and ingestion of, and submersion in, radioactive materials in the workplace. The report also includes tables of exposure-to-dose conversion factors, for general use in assessing average individual committed doses in any population that is adequately characterized by Reference Man. 38 refs.

Dosimetry of 239Pu in dogs that inhaled monodisperse aerosols of 239PuO2

International Nuclear Information System (INIS)

Guilmette, R.A.; Muggenburg, B.A.; Hahn, F.F.; Mewhinney, J.A.; Seiler, F.A.; Boecker, B.B.; McClellan, R.O.

1987-01-01

Existing data from human exposure cases and experimental animal studies on the fate and dosimetry of inhaled insoluble Pu particles are inadequate to provide a comprehensive description and evaluation of the tissues at risk from the alpha radiations of Pu. To improve our knowledge of the dosimetry of inhaled insoluble 239 PuO 2 , this paper describes the uptake and retention of 239 Pu in the tissues of dogs that received single inhalation exposures to monodisperse aerosols of 239 PuO 2 . These data include times through 3 years after exposure. Using analytical functions fitted to each tissue data set, 1100-day radiation doses were calculated for lung, liver, skeleton, kidney, spleen, and tracheobronchial, mediastinal, sternal, hepatic, mandibular, and retropharyngeal lymph nodes. The dosimetry results suggest that the lung and lymph nodes associated with lymphatic drainage of the respiratory tract are the principal sites of alpha irradiation. However, the doses for the different respiratory tract lymph nodes vary by a factor of 2000, suggesting that assuming equivalent doses to respiratory tract lymph nodes is not appropriate. Other tissues receive radiation doses also but at levels one to three orders of magnitude less than the lung. Particle size dependence on uptake and retention was noted for the skeleton, mediastinal lymph nodes, hepatic lymph nodes, retropharyngeal lymph nodes, and mandibular lymph nodes

Solution of human respiratory tract model for chronic inhalation intake

International Nuclear Information System (INIS)

Nadar, Minal Y.; Singh, I.S.; Rao, D.D.; Pradeepkumar, K.S.

2014-01-01

For the radiation workers of fuel reprocessing and fuel fabrication plants, inhalation is one of the major routes of intake of internal contamination. In case of routine monitoring which would result in lung activity above detection limit, it is assumed that intake has occurred at the midpoint of monitoring interval so that underestimation introduced by the unknown time of intake is less than a factor of three. In the plants, chronic intakes of 239 Pu are possible if low levels of 239 Pu activities remain undetected. In ICRP-78, the retention values are given as a function of time for continuous chronic inhalation of 239 Pu at 1.71 Bq/day that would result in Committed Effective Dose (CED) of 20 mSv. Retention values (R) are not given for inhalation intake at any other rate. Therefore, Human Respiratory Tract Model (HRTM) is solved for continuous chronic inhalation at 1 Bq/day rate for type M compounds of 239 Pu to estimate R as a function of time. These values will be useful in estimating intake from lung activity measurements in case of chronic intakes

Range-finding risk assessment of inhalation exposure to nanodiamonds in a laboratory environment.

Science.gov (United States)

Koivisto, Antti J; Palomäki, Jaana E; Viitanen, Anna-Kaisa; Siivola, Kirsi M; Koponen, Ismo K; Yu, Mingzhou; Kanerva, Tomi S; Norppa, Hannu; Alenius, Harri T; Hussein, Tareq; Savolainen, Kai M; Hämeri, Kaarle J

2014-05-16

This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from in vitro studies. Here, the methods were utilized to assess workers' risk range of inhalation exposure to nanodiamonds (NDs) during handling and sieving of ND powder. NDs were agglomerated to over 500 nm particles, and mean exposure levels of different work tasks varied from 0.24 to 4.96 µg·m(-3) (0.08 to 0.74 cm(-3)). In vitro-experiments suggested that ND exposure may cause a risk for activation of inflammatory cascade. However, risk range characterization based on in vitro dose-response was not performed because accurate assessment of delivered (settled) dose on the cells was not possible. Comparison of ND exposure with common pollutants revealed that ND exposure was below 5 μg·m(-3), which is one of the proposed exposure limits for diesel particulate matter, and the workers' calculated dose of NDs during the measurement day was 74 ng which corresponded to 0.02% of the modeled daily (24 h) dose of submicrometer urban air particles.

Range-Finding Risk Assessment of Inhalation Exposure to Nanodiamonds in a Laboratory Environment

Directory of Open Access Journals (Sweden)

Antti J. Koivisto

2014-05-01

Full Text Available This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from in vitro studies. Here, the methods were utilized to assess workers’ risk range of inhalation exposure to nanodiamonds (NDs during handling and sieving of ND powder. NDs were agglomerated to over 500 nm particles, and mean exposure levels of different work tasks varied from 0.24 to 4.96 µg·m−3 (0.08 to 0.74 cm−3. In vitro-experiments suggested that ND exposure may cause a risk for activation of inflammatory cascade. However, risk range characterization based on in vitro dose-response was not performed because accurate assessment of delivered (settled dose on the cells was not possible. Comparison of ND exposure with common pollutants revealed that ND exposure was below 5 μg·m−3, which is one of the proposed exposure limits for diesel particulate matter, and the workers’ calculated dose of NDs during the measurement day was 74 ng which corresponded to 0.02% of the modeled daily (24 h dose of submicrometer urban air particles.

Hydrazine inhalation hepatotoxicity.

Science.gov (United States)

Kao, Yung Hsiang; Chong, C H; Ng, W T; Lim, D

2007-10-01

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.

Inhalation exposure to isocyanates of car body repair shop workers and industrial spray painters.

Science.gov (United States)

Pronk, Anjoeka; Tielemans, Erik; Skarping, Gunnar; Bobeldijk, Ivana; VAN Hemmen, Joop; Heederik, Dick; Preller, Liesbeth

2006-01-01

As part of a large-scale epidemiological study, occupational isocyanate exposure was assessed in spray-painting environments. The aim was to assess which compounds contribute to isocyanate exposure in car body repair shops and industrial painting companies, and to identify tasks with high risk of isocyanate exposure. Mainly personal task-based samples (n = 566) were collected from 24 car body repair shops and five industrial painting companies using impingers with DBA in toluene. Samples were analysed by LC-MS for isocyanate monomers, oligomers and products of thermal degradation. From the 23 analysed compounds, 20 were detected. Exploratory factor analysis resulted in a HDI, TDI and MDI factor with the thermal degradation products divided over the TDI and MDI factors. The HDI factor mainly consisted of HDI oligomers and was dominant in frequency and exposure levels in both industries. Spray painting of PU lacquers resulted in the highest exposures for the HDI factor (car body repair shops than in industrial painting companies. Exposure levels were low (car body repair shops (dose.

Pulmonary and cardiovascular responses of rats to inhalation of silver nanoparticles.

Science.gov (United States)

Roberts, Jenny R; McKinney, Walter; Kan, Hong; Krajnak, Kristine; Frazer, David G; Thomas, Treye A; Waugh, Stacey; Kenyon, Allison; MacCuspie, Robert I; Hackley, Vincent A; Castranova, Vincent

2013-01-01

Exposure to wet aerosols generated during use of spray products containing silver (Ag) has not been evaluated. The goal was to assess the potential for cardiopulmonary toxicity following an acute inhalation of wet silver colloid. Rats were exposed by inhalation to a low concentration (100 μg/m(3) ) using an undiluted commercial antimicrobial product (20 mg/L total silver; approximately 33 nm mean aerodynamic diameter [MAD]) or to a higher concentration (1000 μg/m(3)) using a suspension (200 mg/L total silver; approximately 39 nm MAD) synthesized to possess a similar size distribution of Ag nanoparticles for 5 h. Estimated lung burdens from deposition models were 0, 1.4, or 14 μg Ag/rat after exposure to control aerosol, low, and high doses, respectively. At 1 and 7 d postexposure, the following parameters were monitored: pulmonary inflammation, lung cell toxicity, alveolar air/blood barrier damage, alveolar macrophage activity, blood cell differentials, responsiveness of tail artery to vasoconstrictor or vasodilatory agents, and heart rate and blood pressure in response to isoproterenol or norepinephrine, respectively. Changes in pulmonary or cardiovascular parameters were absent or nonsignificant at 1 or 7 d postexposure with the exceptions of increased blood monocytes 1 d after high-dose Ag exposure and decreased dilation of tail artery after stimulation, as well as elevated heart rate in response to isoproterenol 1 d after low-dose Ag exposure, possibly due to bioavailable ionic Ag in the commercial product. In summary, short-term inhalation of nano-Ag did not produce apparent marked acute toxicity in this animal model.

Pentoxifylline does not alter the response to inhaled grain dust.

Science.gov (United States)

Jagielo, P J; Watt, J L; Quinn, T J; Knapp, H R; Schwartz, D A

1997-05-01

Pentoxifylline (PTX) has been shown to reduce sepsis-induced neutrophil sequestration in the lung and inhibit endotoxin-mediated release of tumor necrosis factor-alpha (TNF-alpha). Previously, we have shown that endotoxin appears to be the principal agent in grain dust causing airway inflammation and airflow obstruction following grain dust inhalation. To determine whether PTX affects the physiologic and inflammatory events following acute grain dust inhalation, 10 healthy, nonsmoking subjects with normal airway reactivity were treated with PTX or placebo (PL) followed by corn dust extract (CDE) inhalation (0.08 mL/kg), using a single-blinded, crossover design. Subjects received PTX (1,200 mg/d) or PL for 4 days prior to CDE inhalation and 400 mg PTX or PL on the exposure day. Both respiratory symptoms and declines in FEV1 and FVC occurred following CDE exposure in both groups, but there were no significant differences in the frequency of symptoms or percent declines from baseline in the FEV1 and FVC at any of the time points measured in the study. Elevations in peripheral blood leukocyte and neutrophil concentrations and BAL total cell, neutrophil, TNF-alpha, and interleukin-8 concentrations were measured 4 h following exposure to CDE in both the PTX- and PL-treated subjects, but no significant differences were found between treatment groups. These results suggest that pretreatment with PTX prior to inhalation of CDE, in the doses used in this study, does not alter the acute physiologic or inflammatory events following exposure to inhaled CDE.

[Theoretical and practical assessment of Lille general practice and pharmacy students' knowledge about use of inhaler devices for asthma control].

Science.gov (United States)

Veylon, P; Rochoy, M; Gautier, S; Wallaert, B; Berkhout, C

2018-04-01

Asthma is a potentially serious chronic respiratory disease impacting patients quality of life. Satisfactory control requires proper use of inhaled devices. This study assesses general medical residents and pharmacy students knowledge about proper use of inhaled asthma devices. We evaluated knowledge of 43 general practice students and 43 pharmacy students in Lille for three inhaler devices (metered-dose inhaler, Turbuhaler ® and Diskus ® ) during individual interviews. Students were assessed on 8 proper use criterias for each device. General practice and pharmacy students are unfamiliar with proper use of inhaler devices. However, pharmacy students get better average scores than general practice students for all devices included in this study: 6.3/8 respected criterias against 5/8 for metered-dose inhaler; 5.3/8 against 3.2/8 for Turbuhaler ® ; and 6/8 against 4.3/8 for Diskus ® . Pharmacy students more frequently perform a demonstration of proper use to patients when a device is first prescribed or when a prescription is renewed; general practice students more frequently ask patients themselves to perform a demonstration of proper use. Introducing trainings workshops for inhaler devices to pharmacy and general practice students appears appropriate in order to promote therapeutic patient education, to increase asthma control and better patients life quality. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Human dose pathways of radionuclides in forests

International Nuclear Information System (INIS)

Rantavaara, A.

2009-01-01

Forest soil, understorey vegetation and trees are all sources of radionuclides and human radiation doses after contaminating atmospheric deposition. People are exposed to radiation externally from sources outside the body and internally via ingestion and inhalation of radionuclides. Understorey vegetation contributes to ingestion doses through berries, herbs, wild honey, mushrooms and game meat; also trees provide feed to terrestrial birds and big game. During stay in forests people are subject to external radiation from forest floor and overstorey, and they may inhale airborne radioactive aerosol or gaseous radionuclides in ground level air. In the early phase of contamination also resuspended radionuclides may add to the internal dose of people via inhalation. People in Nordic countries are most exposed to radiation via ingestion of radionuclides in wild foods. The distribution of radionuclides in forests is changed by environmental processes, and thereby also the significance of various dose pathways to humans will change with time. External exposure is received in living environment from contaminated stemwood used as building timber and for manufacturing of furniture and other wood products. The aim of this paper is to outline the significance of various human dose pathways of radionuclides in forests considering the public and workers in forestry and production of bioenergy. Examples on effective doses are given based on two historical events, atmospheric nuclear weapon tests (mostly in 1950's and in 1960's) and the Chernobyl nuclear power plant accident in 1986. (au)

Inhalation of a dry powder ciprofloxacin formulation in healthy subjects: a phase I study.

Science.gov (United States)

Stass, Heino; Nagelschmitz, Johannes; Willmann, Stefan; Delesen, Heinz; Gupta, Abhishek; Baumann, Sybille

2013-06-01

Oral and intravenous formulations of ciprofloxacin have established efficacy and safety profiles in respiratory infections. A dry powder for inhalation (DPI) that uses Novartis' PulmoSphere™ technology has been developed to deliver high concentrations of ciprofloxacin to the lung with low systemic exposure using a portable and convenient passive dry powder inhaler (Novartis' T-326 inhaler). The primary objective was to investigate the safety and tolerability of ciprofloxacin DPI in healthy male subjects, with a secondary objective to investigate the pharmacokinetics of ciprofloxacin after ciprofloxacin DPI administration. This was a phase I, single-dose, single-site, randomized, single-blind, placebo-controlled, crossover study conducted in the hospital setting. Subjects were followed up for safety for approximately 2 weeks. Six healthy male subjects, aged 27-42 years with no history of pulmonary disease, repeated bronchitis or respiratory allergies were enrolled. In randomized order and separated by a 1-week washout period, subjects inhaled a single dose of ciprofloxacin DPI 32.5 mg or placebo from the T-326 inhaler. Primary safety parameters included vital signs, electrocardiogram, laboratory tests, adverse events and lung function (total specific resistance, thoracic gas volume and forced expiratory volume in 1 s). Plasma concentration-time data were used to calculate pharmacokinetic parameters. Ciprofloxacin DPI was well tolerated with no clinically relevant adverse effects on lung function. Estimates of lung deposition derived from physiology-based pharmacokinetic modelling suggest that approximately 40 % of the total dose of ciprofloxacin DPI reached the trachea/bronchi and alveolar space. Systemic ciprofloxacin was detected soon after inhalation [peak concentration in plasma (C(max)) 56.42 μg/L, median time to C max 0.625 h], but total systemic exposure was minimal (area under the plasma concentration-time curve 354.4 μg·h/L). Terminal elimination half

Toxicity of 144Ce inhaled in a relatively insoluble form by immature Beagle dogs. XVII

International Nuclear Information System (INIS)

Boeker, B.B.; Muggenburg, B.A.; Hahn, F.F.; Mauderly, J.L.; McClellan, R.O.

1988-01-01

Immature Beagle dogs (3-mo old) received a single, brief inhalation exposure to 144 Ce in fused aluminosilicate particles as part of a series of studies designed to study the effects of age on dose response relationships for inhaled radionuclides. Forty-nine dogs inhaled graded levels of 144 Ce that resulted in initial lung burdens ranging from 0.004-140 μCi/kg 0.15-5200 kBq/kg) body weight. Five control dogs inhaled nonradioactive fused aluminosilicate particles. Forty-one of the 144 Ce-exposed dogs have died: 11 with lung tumors 4 with tumors of the tracheobronchial lymph nodes, with a nasal cavity tumor, and 9 with non neoplastic diseases of the respiratory tract. Observations are continuing on the 8 144 Ce-exposed dogs that are surviving at this time. (author)

Toxicity of inhaled 238PuO2 II

International Nuclear Information System (INIS)

Muggenburg, B.A.; Mewhinney, J.A.; Merickel, B.S.; Boecker, B.B.; Hahn, F.F.; Guilmette, R.A.; Mauderly, J.L.; McClellan, R.O.

1980-01-01

Studies are in progress to determine dose-response relationships for inhaled 238 PuO 2 . Beagle dogs were given a single, brief, nose-only inhalation exposure to aerosols of monodisperse particles of 238 PuO 2 . Aerosols of two sizes were used, 1.5 μm aerodynamic diameter (AD) and 3.0 μm AD. Dogs were exposed to achieve initial lung burdens of 0.56, 0.28, 0.14, 0.07, 0.03 or 0.01 μCi 238 PuO 2 /kg body weight. Twelve dogs were exposed at each activity level to each aerosol particle size. The local dose around each 3.0 μm AD particle was 10 times higher than the local dose around 1.5 μm AD particles, but the dose averaged over the whole lung was the same at each activity level for both particle sizes. The lung retention of 238 Pu was divided into two phases of clearance. During the first 100 days after exposure, the average retention half-time for 238 Pu in the lung was 310 days. When the solubility changed due to particle breakup, the retention half-time decreased to 180 days during the period from 1OO to 1,500 days after exposure. The first biological effects observed were lymphopenia and neutropenia in peripheral blood. To date, 28 Beagle dogs have died at times from 536 to 1683 days after exposure. Initial lung burdens for the dead dogs ranged from 0.18 to 2.2 μCi 238 Pu/kg body weight. Nine died with radiation pneumonitis and pulmonary fibrosis, 10 died with lung tumors and 19 dogs died with bone tumors. There are 116 exposed and 22 control dogs surviving and under observation. Current patterns of dose versus response are discussed. (author)

Effect of inhaled formyl-methionyl-leucyl-phenylalanine on airway function.

Science.gov (United States)

Berend, N; Peters, M J; Armour, C L; Black, J L; Ward, H E

1988-01-01

Formyl-methionyl-leucyl-phenylalanine (FMLP), a synthetic, acylated tripeptide analogous to bacterial chemotactic factors, has been shown to cause bronchoconstriction in guinea pig, rabbit, and human airways in vitro. To determine whether FMLP causes bronchoconstriction in man in vivo, a preliminary study was undertaken in which five non-smokers (mean age 35 years, FEV1 94% (SEM 5%) predicted) and five smokers (mean age 34 years, FEV1 93% (6%) predicted) inhaled aerosols of FMLP. None of the subjects showed airway hyperresponsiveness to histamine (the provocative concentrations of histamine causing a fall of greater than or equal to 20% in FEV1 (PC20) were over 8 mg/ml). FMLP dissolved in 50% dimethylsulphoxide and 50% saline in concentrations of 0, 0.06, 0.12, 0.25, 0.5, 1.0, 2.0, and 4.0 mg/ml was administered to the subjects by means of a French-Rosenthal dosimeter, FEV1 being recorded after inhalation of each concentration. Dose dependent falls in FEV1 occurred in five non-smokers (geometric mean 1.76, 95% confidence limits 0.87-3.53 mg/ml) and three smokers (0.23, 0.07-0.78 mg/ml), with two smokers not responding by 20% to the highest concentration of FMLP. On a separate day the FMLP dose-response curves were repeated after nebulisation of 500 micrograms of ipratropium bromide. The PC20 FMLP in the responders more than doubled. In six additional normal subjects a histamine inhalation test was performed before and four and 24 hours after inhalation of FMLP. All subjects remained unresponsive to histamine. These results show that FMLP is a potent bronchoconstrictor in some non-asthmatic individuals in vivo and this may be important in bronchoconstriction related to infection in patients with chronic obstructive lung disease.

CONCEPTS, MODELS AND IMPLEMENTATION OF THE MARINE SPATIAL DATA INFRASTRUCTURE IN GERMANY (MDI-DE

Directory of Open Access Journals (Sweden)

C. Rüh

2012-07-01

Full Text Available In Germany currently the development of a marine data infrastructure takes place with the aim of merging information concerning the fields coastal engineering, hydrography and surveying, protection of the marine environment, maritime conservation, regional planning and coastal research. This undertaking is embedded in a series of regulations and developments on many administrative levels from which specifications and courses of action derive. To set up a conceptual framework for the marine data infrastructure (MDI-DE scientists at the Professorship for Geodesy and Geoinformatics at Rostock University are building a reference model, evaluating meta-information systems and developing models to support common workflows in marine applications. The reference model for the marine spatial data infrastructure of Germany (MDI-DE is the guideline for all developments inside this infrastructure. Because the undertaking is embedded in a series of regulations and developments this paper illustrates an approach on modelling a scenario for the Marine Strategy Framework Directive (MSFD using the Unified Modelling Language (UML. Evaluating how other countries built their marine spatial infrastructures is of main importance, to learn where obstacles are and errors are likely to occur. To be able to look at other initiatives from a neutral point of view it is necessary to construct a framework for evaluation of marine spatial data infrastructures. Spatial data infrastructure assessment approaches were used as bases and were expanded to meet the requirements of the marine domain. As an international case-study this paper will look at Canada's Marine Geospatial Data Infrastructure (MGDI, COINAtlantic and GeoPortal.

Concepts, Models and Implementation of the Marine Spatial Data Infrastructure in Germany Mdi-De

Science.gov (United States)

Rüh, C.; Bill, R.

2012-07-01

In Germany currently the development of a marine data infrastructure takes place with the aim of merging information concerning the fields coastal engineering, hydrography and surveying, protection of the marine environment, maritime conservation, regional planning and coastal research. This undertaking is embedded in a series of regulations and developments on many administrative levels from which specifications and courses of action derive. To set up a conceptual framework for the marine data infrastructure (MDI-DE) scientists at the Professorship for Geodesy and Geoinformatics at Rostock University are building a reference model, evaluating meta-information systems and developing models to support common workflows in marine applications. The reference model for the marine spatial data infrastructure of Germany (MDI-DE) is the guideline for all developments inside this infrastructure. Because the undertaking is embedded in a series of regulations and developments this paper illustrates an approach on modelling a scenario for the Marine Strategy Framework Directive (MSFD) using the Unified Modelling Language (UML). Evaluating how other countries built their marine spatial infrastructures is of main importance, to learn where obstacles are and errors are likely to occur. To be able to look at other initiatives from a neutral point of view it is necessary to construct a framework for evaluation of marine spatial data infrastructures. Spatial data infrastructure assessment approaches were used as bases and were expanded to meet the requirements of the marine domain. As an international case-study this paper will look at Canada's Marine Geospatial Data Infrastructure (MGDI), COINAtlantic and GeoPortal.

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.

Bronchial effects of leukotriene D4 inhalation in normal human lung

DEFF Research Database (Denmark)

Bisgaard, H; Groth, S

1987-01-01

airways in asthmatic patients out of attack. LTD4 caused a dose-dependent obstruction of the airways as measured by partial flow-volume curves and volume of trapped gas, yet only minor changes in forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate. LTD4 was 1900-7000 times more potent......The aim of the study was to investigate whether inhaled leukotriene (LT) D4 could mimic the characteristics of asthmatic patients after allergen-induced attack, i.e. a prolonged subclinical bronchial obstruction, an increased reactivity of the airways and a late reaction. The effects of LTD4 were...... than histamine. LTD4 inhalations were almost symptomless as opposed to the irritative and dyspnoeic symptoms seen after inhalation of histamine. The time duration for the induced change in partial flow-volume curves was the same for the two drugs. Approximately 30 min elapsed until the bronchial...

Comparison of the effect of broncodiatory albotrol from spacer and nebulazor foe freatment of Astma patients

Directory of Open Access Journals (Sweden)

sasan tavana

2007-04-01

Full Text Available Tavana S1, Nadi E1, Ansari M2, zeraati F3, Hashemi H1, Mani Kashani Kh4, Mavallat M5 1. Assistant professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences 2. Associate professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences 3. Associate professor, Department of Pharmacology, Faculty of medicine, Hamedan University of medical sciences 4. Instructor, Department of social medicine, Faculty of medicine, Hamedan University of medical sciences 5. General practitioner, Tuberculosis and lung research group, Faculty of medicine, Hamedan University of medical sciences Abstract Background: Asthma is an inflammatory and chronic disorder of trachobronchial tree that is associated with increased response to allergens. Treatment of acute attack of asthma is short acting b 2 agonist such as Albuterol that is used via a nebulizer or Metered-dose inhaler (MDI with and attached spacer. Object of this study was evaluation of therapeutic effects of Albuterol via a nebulizer or MDI with an attached holding chamber in patients that had been referred to Emergency departement of Mobasher Hospital in Hamadan. Materials and methods: The present study was a clinical trial (before and after in 60 patients that were suffered from acute attack asthma. Inclusion criterias were 16-65 years old age patients, FEV1, below 60% of predicted value, and cooperation for spirometry performance. Exclusion criterias were COPD, cardiovascular disorders, pneumonia, preumothorex, or their systemic or pulmonary disorders,severe respiratory failure with cyanosis or confusion, pregnancy and smoking. On arrival to the ED, all patients underwent spirometery and all of patients received oxygen and a single dose of 8 mg intravenous dexamethasone. Immediately thereafter patients were randomized to two groups.The study was designed as double blind trial. The first group patients received four puffs Albuterol attached to

Particle-size dependent effects in the Balb/c murine model of inhalational melioidosis

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Richard eThomas

2012-07-01

Full Text Available Deposition of Burkholderia pseudomallei within either the lungs or nasal passages of the Balb/c murine model resulted in different infection kinetics. The infection resulting from the inhalation of B. pseudomallei within a 12 um particle aerosol was prolonged compared to a 1 um particle aerosol with a mean time-to-death (MTD of 73.8 ± 11.3 h and 174.7 ± 14.9 h respectively. Inhalation of B. pseudomallei within 1 um or 12 um particle aerosols resulted in a median lethal dose (MLD of 4 and 12 cfu respectively. The 12 mm particle inhalational infection was characterised by involvement of the respiratory epithelium and inflammation of the neurological path leading from the olfactory epithelium to the olfactory bulb (100%, culminating in abscessation of the brain (33%. Initial involvement of the upper respiratory tract lymphoid tissues (nasal-associated lymphoid tissue and cervical lymph nodes was observed in both the 1 and 12 um particle inhalational infections (80-85%. Necrotising alveolitis and bronchiolitis were evident in both inhalational infections however lung pathology was greater after inhalation of the 1 mm particle aerosol with pronounced involvement of the mediastinal lymph node (50%. Terminal disease was characterised by bacteraemia in both inhalational infections with dissemination to the spleen, liver, kidneys and thymus. Treatment with co-trimoxazole was more effective than treatment with doxycycline irrespective of the size of the particles inhaled. Doxycycline was more effective against the 12 um particle inhalational infection as evidenced by increased time to death. However, both treatment regimes exhibited significant relapse when therapy was discontinued with massive enlargement and abscessation of the lungs, spleen and cervical lymph nodes observed.

Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

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Celik Ozlem

2012-08-01

Full Text Available Abstract Current guidelines recommend the use of inhaled corticosteroids (ICS for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing’s syndrome (CS. Fluticasone propionate (FP is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP.

Statistical tools and control of internal lubricant content of inhalation grade HPMC capsules during manufacture.

Science.gov (United States)

Ayala, Guillermo; Díez, Fernando; Gassó, María T; Jones, Brian E; Martín-Portugués, Rafael; Ramiro-Aparicio, Juan

2016-04-30

The internal lubricant content (ILC) of inhalation grade HPMC capsules is a key factor to ensure good powder release when the patient inhales a medicine from a dry powder inhaler (DPI). Powder release from capsules has been shown to be influenced by the ILC. The characteristics used to measure this are the emitted dose, fine particle fraction and mass median aerodynamic diameter. In addition the ILC level is critical for capsule shell manufacture because it is an essential part of the process that cannot work without it. An experiment has been applied to the manufacture of inhalation capsules with the required ILC. A full factorial model was used to identify the controlling factors and from this a linear model has been proposed to improve control of the process. Copyright © 2016 Elsevier B.V. All rights reserved.

Radiation doses from radioactivity in incandescent mantles

International Nuclear Information System (INIS)

1985-01-01

Thorium nitrate is used in the production of incandescent mantles for gas lanterns. In this report dose estimates are given for internal and external exposure that result from the use of the incandescent mantles for gas lanterns. The collective, effective dose equivalent for all users of gas mantles is estimated to be about 100 Sv per annum in the Netherlands. For the population involved (ca. 700,000 persons) this is roughly equivalent to 5% to 10% of the collective dose equivalent associated with exposure to radiation from natural sources. The major contribution to dose estimates comes from inhalation of radium during burning of the mantles. A pessimistic approach results in individual dose estimates for inhalation of up to 0.2 mSv. Consideration of dose consequences in case of a fire in a storage department learns that it is necessary for emergency personnel to wear respirators. It is concluded that the uncontrolled removal of used gas mantles to the environment (soil) does not result in a significant contribution to environmental radiation exposure. (Auth.)

Metabolism and dosimetry of 106Ru inhaled as 106RuO4 by beagle dogs

International Nuclear Information System (INIS)

Snipes, M.B.

1981-01-01

This report provides metabolism and dosimetry data for inhaled ruthenium developed from studies in Beagle dogs that were exposed by inhalation to 106 RuO 4 . Twenty-six dogs were exposed nose-only to 106 RuO 4 and sacrificed at times from 2 hr to 512 days after inhalation exposure. Ninety-nine percent of the initial body burden was retained with an effective half-time of 1.2 days, 0.7% with a half-time of 14 days and 0.3% with a half-time of 170 days. Initial deposition was primarily in the nasopharyngeal and tracheobronchial regions. Results for deposition and retention of 106 Ru inhaled as 106 RuO 4 in dogs were similar to what has been observed for humans. The data for dogs were used to develop a model to predict potential radiation exposure patterns for humans after inhalation exposure to 106 RuO 4 . The model indicates that for humans the nasopharyngeal region, lower large intestine, and tracheobronchial epithelium would receive approx. 36, 13 and 10 times, respectively, the dose to 500 days after inhalation exposure to 106 RuO 4 that the lung would receive. The nasopharyngeal region should be considered the critical region for inhalation exposures to 106 RuO 4 . (author)

Dermal and inhalation acute toxic class methods: test procedures and biometric evaluations for the Globally Harmonized Classification System.

Science.gov (United States)

Holzhütter, H G; Genschow, E; Diener, W; Schlede, E

2003-05-01

The acute toxic class (ATC) methods were developed for determining LD(50)/LC(50) estimates of chemical substances with significantly fewer animals than needed when applying conventional LD(50)/LC(50) tests. The ATC methods are sequential stepwise procedures with fixed starting doses/concentrations and a maximum of six animals used per dose/concentration. The numbers of dead/moribund animals determine whether further testing is necessary or whether the test is terminated. In recent years we have developed classification procedures for the oral, dermal and inhalation routes of administration by using biometric methods. The biometric approach assumes a probit model for the mortality probability of a single animal and assigns the chemical to that toxicity class for which the best concordance is achieved between the statistically expected and the observed numbers of dead/moribund animals at the various steps of the test procedure. In previous publications we have demonstrated the validity of the biometric ATC methods on the basis of data obtained for the oral ATC method in two-animal ring studies with 15 participants from six countries. Although the test procedures and biometric evaluations for the dermal and inhalation ATC methods have already been published, there was a need for an adaptation of the classification schemes to the starting doses/concentrations of the Globally Harmonized Classification System (GHS) recently adopted by the Organization for Economic Co-operation and Development (OECD). Here we present the biometric evaluation of the dermal and inhalation ATC methods for the starting doses/concentrations of the GHS and of some other international classification systems still in use. We have developed new test procedures and decision rules for the dermal and inhalation ATC methods, which require significantly fewer animals to provide predictions of toxicity classes, that are equally good or even better than those achieved by using the conventional LD(50)/LC

Novel devices for individualized controlled inhalation can optimize aerosol therapy in efficacy, patient care and power of clinical trials

Directory of Open Access Journals (Sweden)

Fischer A

2009-12-01

Full Text Available Abstract In the treatment of pulmonary diseases the inhalation of aerosols plays a key role - it is the preferred route of drug delivery in asthma, chronic obstructive pulmonary disease (COPD and cystic fibrosis. But, in contrast to oral and intravenous administration drug delivery to the lungs is controlled by additional parameters. Beside its pharmacology the active agent is furthermore determined by its aerosol characteristics as particle diameter, particle density, hygroscopicity and electrical charge. The patient related factors like age and stage of pulmonary disease will be additionally affected by the individual breathing pattern and morphometry of the lower airways. A number of these parameters with essential impact on the pulmonary drug deposition can be influenced by the performance of the inhalation system. Therefore, the optimization of nebulisation technology was a major part of aerosol science in the last decade. At this time the control of inspiration volume and air flow as well as the administration of a defined aerosol bolus was in the main focus. Up to date a more efficient and a more targeted pulmonary drug deposition - e.g., in the alveoli - will be provided by novel devices which also allow shorter treatment times and a better reproducibility of the administered lung doses. By such means of precise dosing and drug targeting the efficacy of inhalation therapy can be upgraded, e.g., the continuous inhalation of budesonide in asthma. From a patients' perspective an optimized inhalation manoeuvre means less side effects, e.g., in cystic fibrosis therapy the reduced oropharyngeal tobramycin exposure causes fewer bronchial irritations. Respecting to shorter treatment times also, this result in an improved quality of life and compliance. For clinical trials the scaling down of dose variability in combination with enhanced pulmonary deposition reduces the number of patients to be included and the requirement of pharmaceutical

The modelling of external exposure and inhalation pathways in COSYMA

International Nuclear Information System (INIS)

Brown, J.; Simmonds, JR.; Ehrhardt, J.; Hasemann, I.

1991-01-01

Following an accidental release of radionuclides to atmosphere the major direct exposure pathways of concern are: external irradiation from material in the cloud; internal exposure following inhalation of material in the cloud; external irradiation from material deposited on the ground; and external irradiation due to contamination of skin and clothes. In addition material resuspended from the ground can be inhaled and lead to internal exposure. In this paper the way that these exposure pathways are modelled in COSYMA is described. At present in COSYMA external exposure from deposited material is modelled using a dataset of doses per unit deposit of various radionuclides. This dataset, is based on activity deposited on undisturbed soil. The basic data are for doses outdoors and shielding factors are used to estimate doses for people indoors. Various groups of people spending different amounts of time indoors and out can be considered and shielding factors appropriate to three building types can be adopted. A more complex model has also been developed to predict radiation exposure following deposition to different surfaces in the environment. This model called EXPURT is briefly described in this paper. Using EXPURT, doses as a function of time after a single deposit have been calculated for people living in three types of area. These results are described in the paper and compared with those that are currently used in COSYMA. The paper will also discuss what future work is required in this area and the adequacy of existing models

Ciclesonide Oral Inhalation

Science.gov (United States)

... use ciclesonide inhalation.Ciclesonide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use ciclesonide ...

Flunisolide Oral Inhalation

Science.gov (United States)

... use flunisolide inhalation.Flunisolide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use flunisolide ...

Survey on the radiation exposure of the respiratory tract by inhalation of natural radionuclides

International Nuclear Information System (INIS)

Poretti, G.

1987-01-01

During the last twenty years, work carried out on radiation exposure of the respiratory tract due to the inhaled, naturally occurring nuclides radon, thoron and short-lived daughters has become increasingly important, because the doses received in the respiratory tract, due mainly to the effect of α rays, reach values among the general population which are comparable to or even higher than the average exposures per year of a population undergoing X-ray diagnostic examinations. A brief introduction to the physical characteristics of the natural radiation nuclides reaching the bronchi and lungs with the inhaled air (Rn-220 - thoron and short lived daughters), and the deposition and clearance of the nuclides (often linked to aerosols), is followed by a discussion of the anatomical/physiological characteristics of the ''lung models'', thanks to which it is possible to calculate the energy quantities (i.e. doses) deposited by the α rays in the epithelium of the lungs and bronchi. In addition the retention mechanisms of the radionuclides (as free ions or as aerosols) are briefly described, and finally the calculations to determine the quantity of radioactivity remaining on the walls of the respiratory tract are given. The construction of dosimetric models requires relatively precise knowledge of the thickness of the mucus layers and of the distribution of the nuclides in the mucus, the ciliary movement, the depth in the tissue of the radiation-sensitive cells etc. On the basis of local doses it is then possible to calculate approximately the regional doses for bronchi, lungs and other organs (via blood, accessible by the nuclides before excretion) for the short lived daughters of Rn-222 and Rn-220. Determination of the mean effective dose equivalent requires, amongst other things, knowledge of the concentration of the nuclides in the inhaled air and the mean respiratory frequency of the members of a population. (orig./HSI)

IRIS Toxicological Review of 1,4-Dioxane (with Inhalation ...

Science.gov (United States)

EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of 1,4-Dioxane (with inhalation update) that when finalized will appear on the Integrated Risk Information System (IRIS) database. 1,4-Dioxane is commonly used as a solvent, cleaning agent, chemical stabilizer, surface coating, adhesive agent, and an ingredient in chemical manufacture.

Aspergillus fumigatus viability drives allergic responses to inhaled conidia.

Science.gov (United States)

Nayak, Ajay P; Croston, Tara L; Lemons, Angela R; Goldsmith, W T; Marshall, Nikki B; Kashon, Michael L; Germolec, Dori R; Beezhold, Donald H; Green, Brett J

2018-04-13

Aspergillus fumigatus induced allergic airway disease has been shown to involve conidial germination in vivo but the immunological mechanisms remain uncharacterized. A subchronic murine exposure model was used to examine the immunological mediators that are regulated in response to either culturable or non-culturable A. fumigatus conidia. Female B6C3F1/N mice were repeatedly dosed via inhalation with 1 x 105 viable or heat inactivated conidia (HIC), twice a week for 13 weeks (26 exposures). Control mice inhaled HEPA-filtered air. The influence of A. fumigatus conidial germination on the pulmonary immunopathological outcomes was evaluated by flow cytometry analysis of cellular infiltration in the airways, assessment of lung mRNA expression, and quantitative proteomics and histopathology of whole lung tissue. Repeated inhalation of viable conidia, but not HIC, resulted in allergic inflammation marked by vascular remodeling, extensive eosinophilia, and accumulation of alternatively activated macrophages (AAMs) in the murine airways. More specifically, mice that inhaled viable conidia resulted in a mixed TH1 and TH2 (IL-13) cytokine response. Recruitment of eosinophils corresponded with increased Ccl11 transcripts. Furthermore, genes associated with M2 or alternatively activated macrophage polarization (e.g. Arg1, Chil3 and Retnla) were significantly upregulated in viable A. fumigatus exposed mice. In mice inhaling HIC, CD4+ T cells expressing IFN-γ (TH1) dominated the lymphocytic infiltration. Quantitative proteomics of the lung revealed metabolic reprogramming accompanied by mitochondrial dysfunction and endoplasmic reticulum stress stimulated by oxidative stress from repetitive microbial insult. Our studies demonstrate that A. fumigatus conidial viability in vivo is critical to the immunopathological presentation of chronic fungal allergic disease. Copyright © 2018. Published by Elsevier Inc.

Inhalation Exposure Input Parameters for the Biosphere Model

International Nuclear Information System (INIS)

M. A. Wasiolek

2003-01-01

This analysis is one of the nine reports that support the Environmental Radiation Model for Yucca Mountain Nevada (ERMYN) biosphere model. The ''Biosphere Model Report'' (BSC 2003a) describes in detail the conceptual model as well as the mathematical model and its input parameters. This report documents a set of input parameters for the biosphere model, and supports the use of the model to develop biosphere dose conversion factors (BDCFs). The biosphere model is one of a series of process models supporting the Total System Performance Assessment (TSPA) for a Yucca Mountain repository. This report, ''Inhalation Exposure Input Parameters for the Biosphere Model'', is one of the five reports that develop input parameters for the biosphere model. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling, and the plan for development of the biosphere abstraction products for TSPA, as identified in the ''Technical Work Plan: for Biosphere Modeling and Expert Support'' (BSC 2003b). It should be noted that some documents identified in Figure 1-1 may be under development at the time this report is issued and therefore not available at that time. This figure is included to provide an understanding of how this analysis report contributes to biosphere modeling in support of the license application, and is not intended to imply that access to the listed documents is required to understand the contents of this analysis report. This analysis report defines and justifies values of mass loading, which is the total mass concentration of resuspended particles (e.g., dust, ash) in a volume of air. Measurements of mass loading are used in the air submodel of ERMYN to calculate concentrations of radionuclides in air surrounding crops and concentrations in air inhaled by a receptor. Concentrations in air to which the

Late effects of inhaled 253Es(NO3)3 in the rat

International Nuclear Information System (INIS)

Ballou, J.E.; Smith, L.G.; Dagle, G.E.; Gies, R.A.

1979-01-01

The lungs of rats exposed to 253 Es(NO 3 ) 3 aerosols sustained the greatest cumulative radiation dose, approximately 6-fold higher than the skeletal dose. Malignant lung tumors (incidence 8.5, 27.6%) were observed after a mean cumulative lung dose of 26 and 400 rad, respectively. Higher lung doses were associated with severe life shortening that precluded the expression of delayed effects. Osteosarcomas of the skeleton (incidence 6.9%) were found after a mean cumulative skeletal dose of 68 rad. Earlier studies, which showed a high incidence of bone tumors and relatively fewer lung tumors after intratracheal instillation of 253 EsCl 3 , were not confirmed in this study with inhaled 253 Es(NO 3 ) 3

SU-F-T-444: Quality Improvement Review of Radiation Therapy Treatment Planning in the Presence of Dental Implants

Energy Technology Data Exchange (ETDEWEB)

Parenica, H; Ford, J [Texas A& M University, College Station, TX (United States); Mavroidis, P [University of North Carolina, Chapel Hill, NC, (United States); Li, Y; Stathakis, S [Cancer Therapy and Research Center, San Antonio, TX (United States); Papanikolaou, N [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States)

2016-06-15

Purpose: To quantify and compare the effect of metallic dental implants (MDI) on dose distributions calculated using Collapsed Cone Convolution Superposition (CCCS) algorithm or a Monte Carlo algorithm (with and without correcting for the density of the MDI). Methods: Seven previously treated patients to the head and neck region were included in this study. The MDI and the streaking artifacts on the CT images were carefully contoured. For each patient a plan was optimized and calculated using the Pinnacle3 treatment planning system (TPS). For each patient two dose calculations were performed, a) with the densities of the MDI and CT artifacts overridden (12 g/cc and 1 g/cc respectively) and b) without density overrides. The plans were then exported to the Monaco TPS and recalculated using Monte Carlo dose calculation algorithm. The changes in dose to PTVs and surrounding Regions of Interest (ROIs) were examined between all plans. Results: The Monte Carlo dose calculation indicated that PTVs received 6% lower dose than the CCCS algorithm predicted. In some cases, the Monte Carlo algorithm indicated that surrounding ROIs received higher dose (up to a factor of 2). Conclusion: Not properly accounting for dental implants can impact both the high dose regions (PTV) and the low dose regions (OAR). This study implies that if MDI and the artifacts are not appropriately contoured and given the correct density, there is potential significant impact on PTV coverage and OAR maximum doses.

SU-F-T-444: Quality Improvement Review of Radiation Therapy Treatment Planning in the Presence of Dental Implants

International Nuclear Information System (INIS)

Parenica, H; Ford, J; Mavroidis, P; Li, Y; Stathakis, S; Papanikolaou, N

2016-01-01

Purpose: To quantify and compare the effect of metallic dental implants (MDI) on dose distributions calculated using Collapsed Cone Convolution Superposition (CCCS) algorithm or a Monte Carlo algorithm (with and without correcting for the density of the MDI). Methods: Seven previously treated patients to the head and neck region were included in this study. The MDI and the streaking artifacts on the CT images were carefully contoured. For each patient a plan was optimized and calculated using the Pinnacle3 treatment planning system (TPS). For each patient two dose calculations were performed, a) with the densities of the MDI and CT artifacts overridden (12 g/cc and 1 g/cc respectively) and b) without density overrides. The plans were then exported to the Monaco TPS and recalculated using Monte Carlo dose calculation algorithm. The changes in dose to PTVs and surrounding Regions of Interest (ROIs) were examined between all plans. Results: The Monte Carlo dose calculation indicated that PTVs received 6% lower dose than the CCCS algorithm predicted. In some cases, the Monte Carlo algorithm indicated that surrounding ROIs received higher dose (up to a factor of 2). Conclusion: Not properly accounting for dental implants can impact both the high dose regions (PTV) and the low dose regions (OAR). This study implies that if MDI and the artifacts are not appropriately contoured and given the correct density, there is potential significant impact on PTV coverage and OAR maximum doses.

Hidrofluoralcano como propelente dos aerossóis pressurizados de dose medida: histórico, deposição pulmonar, farmacocinética, eficácia e segurança Hydrofluoroalkane as a propellant for pressurized metered-dose inhalers: history, pulmonary deposition, pharmacokinetics, efficacy and safety

Directory of Open Access Journals (Sweden)

Cássio C. Ibiapina

2004-12-01

Full Text Available OBJETIVO: Rever a literatura sobre o hidrofluoralcano como propelente dos inaladores de dose medida contendo medicamentos empregados na asma. FONTES DOS DADOS: O levantamento bibliográfico foi realizado em bancos de dados eletrônicos - MEDLINE, MDConsult, HighWire, Medscape e LILACS - e por pesquisa direta - referentes aos últimos 15 anos -, utilizando-se as seguintes palavras-chaves: hidrofluoralcano, asma e infância. SÍNTESE DOS DADOS: Foram selecionados 43 artigos originais abordando a questão da substituição do clorofluorcarbono pelo hidrofluoralcano. Este gás mostrou-se como uma alternativa de propelente segura, com deposição pulmonar de 50 a 60% e eficácia significativa quando comparado com placebo (p OBJECTIVE: To review the literature about hydrofluoroalkane as a propellent of pressurized metered-dose inhalers containing anti-asthma drugs. SOURCES OF DATA: Bibliographic search in electronic databases (MEDLINE, MDConsult, HighWire, Medscape and LILACS and direct search referring to the past 15 years, using the key words hydrofluoroalkane, asthma and childhood were carried out. SUMMARY OF THE FINDINGS: 43 original articles on the replacement of clorofluorcarbon by hydrofluoralkane were selected. Hydrofluoralkane showed to be a safe propellent, with pulmonary deposition ranging from 50 to 60%, and to have significant efficacy, when compared with placebo (p < 0.003 in controlled clinical trials. Most works using hydrofluoralkane included beclomethasone diproprionate. Approximate annual cost of a treatment with beclomethasone diproprionate/hydrofluoralkane was lower than with beclomethasone diproprionate/clorofluorcarbon. Some studies assessed salbutamol, fluticasone, flunisolide and the association fluticasone-salmeterol, with hydrofluoralkane as propellent in pressurized metered-dose inhalers. CONCLUSIONS: Efficacy and safety of hydrofluoralkane as propellent of bronchodilators and inhaled corticosteroids in adults was evidenced

Experimental study of the effect of wearing dust-proof mask on inhaled aerosol particle size

International Nuclear Information System (INIS)

Lu Shunguang; Mei Chongsheng; Wu Yuangqing; Ren Liuan.

1985-01-01

This paper describes a method for measuring particle size of inhaled aerosol with a phantom of human head wearing dust-proof mask and a cascade impactor. The results showed that AMAD of inhaled aerosol was degraded and the size distribution of particles changed when the dust-proof mask was wearing. The leak rate of mask increased as the size of dust particles decreased. The results are applicable to estimate internal exposure dose and to evaluate the dust-proof capacity of mask

Toxicity of {sup 144}Ce inhaled in a relatively insoluble form by immature Beagle dogs. XVII

Energy Technology Data Exchange (ETDEWEB)

Boeker, B B; Muggenburg, B A; Hahn, F F; Mauderly, J L; McClellan, R O

1988-12-01

Immature Beagle dogs (3-mo old) received a single, brief inhalation exposure to {sup 144}Ce in fused aluminosilicate particles as part of a series of studies designed to study the effects of age on dose response relationships for inhaled radionuclides. Forty-nine dogs inhaled graded levels of {sup 144}Ce that resulted in initial lung burdens ranging from 0.004-140 {mu}Ci/kg 0.15-5200 kBq/kg) body weight. Five control dogs inhaled nonradioactive fused aluminosilicate particles. Forty-one of the {sup 144}Ce-exposed dogs have died: 11 with lung tumors 4 with tumors of the tracheobronchial lymph nodes, with a nasal cavity tumor, and 9 with non neoplastic diseases of the respiratory tract. Observations are continuing on the 8 {sup 144}Ce-exposed dogs that are surviving at this time. (author)

Standardized dose factors for dose calculations - 1982 SRP reactor safety analysis report tritium, iodine, and noble gases

International Nuclear Information System (INIS)

Pillinger, W.L.; Marter, W.L.

1982-01-01

Standardized dose constants are recommended for calculation of offsite doses in the 1982 SRP Reactor Safety Analysis Report (SAR). Dose constants are proposed for inhalation of tritium and radioiodines and for submersion in a semi-infinite cloud of radioiodines and noble gases. The proposed constants, based on ICRP2 methodology for internal dose and methodology recommended by the US Nuclear Regulatory Commission for external dose, are compatible with dose calculational methods used at the Savannah River Plant and Savannah River Laboratory for normal releases of radioactivity. 8 references

Overcoming beta-agonist tolerance: high dose salbutamol and ipratropium bromide. Two randomised controlled trials

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Haney Sarah

2007-03-01

Full Text Available Abstract Background Asthmatics treated with long-acting beta-agonists have a reduced bronchodilator response to moderate doses of inhaled short acting beta-agonists during acute bronchoconstriction. It is not known if the response to higher doses of nebulised beta-agonists or other bronchodilators is impaired. We assessed the effect of long-acting beta-agonist treatment on the response to 5 mg nebulised salbutamol and to ipratropium bromide. Methods Two double-blind, placebo-controlled, crossover studies of inhaled formoterol 12 μg twice daily in patients with asthma. High-dose salbutamol: 36 hours after the last dose of 1 week of formoterol or placebo treatment, 11 subjects inhaled methacholine to produce a 20% fall in FEV1. Salbutamol 5 mg was then administered via nebuliser and the FEV1 was monitored for 20 minutes. Ipratropium: 36 hours after the last dose of 1 week of formoterol or placebo treatment, 11 subjects inhaled 4.5% saline to produce a 20% fall in FEV1. Salbutamol 200 μg or ipratropium bromide 40 μg was then inhaled and the FEV1 was monitored for 30 minutes. Four study arms compared the response to each bronchodilator after formoterol and placebo. Analyses compared the area under the bronchodilator response curves, adjusting for changes in pre-challenge FEV1, dose of provocational agent and FEV1 fall during the challenge procedure. Results The response to nebulised salbutamol was 15% lower after formoterol therapy compared to placebo (95% confidence 5 to 25%, p = 0.008. The response to ipratropium was unchanged. Conclusion Long-acting beta-agonist treatment induces tolerance to the bronchodilator effect of beta-agonists, which is not overcome by higher dose nebulised salbutamol. However, the bronchodilator response to ipratropium bromide is unaffected.

Effectiveness of Inhaled Loxapine in Dual-Diagnosis Patients: A Case Series.

Science.gov (United States)

Roncero, Carlos; Ros-Cucurull, Elena; Grau-López, Lara; Fadeuilhe, Christian; Casas, Miguel

2016-01-01

Episodes of psychotic agitation are frequent in patients with dual diagnosis, that is, in patients with concomitant psychiatric and substance use disorders. Rapid intervention is needed to treat the agitation at a mild stage to prevent the escalation to aggressive behavior. Inhaled loxapine has been demonstrated to rapidly improve symptoms of mild-to-moderate agitation in adults with psychiatric disorders (schizophrenia and bipolar disorder), but data on patients with dual diagnosis are scarce. This study is a retrospective review of data from a case series of patients with dual diagnosis, which were attended for symptoms of agitation while at the emergency room (n = 9), in the outpatient clinic (n = 4), or during hospitalization (n = 1) at 1 center in Spain. All patients received inhaled loxapine for treating the agitation episodes. Data from 14 patients with dual diagnosis were reviewed. All patients had 1 or more psychiatric disorders (schizophrenia, bipolar I disorder, drug-induced psychotic disorder, posttraumatic stress, borderline or antisocial personality disorder, depression, or anxiety) along with a variety of substance use disorders (alcohol, cocaine, cannabis, amphetamines, hypnotics and antianxiety drugs, caffeine, or street drugs). Overall, only 1 dose of inhaled loxapine (9.1 mg) was needed to calm each patient during an acute episode of agitation. Inhaled loxapine was rapid, effective, and well accepted in all dual-pathology patients presenting with acute agitation in the emergency setting. Inhaled loxapine facilitated both patient cooperation and an adequate management of his or her disease.

The toxicity of inhaled particles of 238PuO2 in dogs

International Nuclear Information System (INIS)

Muggenburg, B.A.; Guilmette, R.A.; Griffith, W.C. Jr.; Hahn, F.F.; Boecker, B.B.

1991-01-01

This study was conducted to determine the toxicity of inhaled 238 PuO 2 in the dog. Inhalation was selected because it is the mostly likely route of human exposure in the event of an accidental airborne release. Of 166 dog in the study, 72 inhaled 1.5μm and 72 inhaled 3.0 μm activity median aerodynamic diameter particles of 238 PuO 2 . Another 24 dogs inhaled the aerosol vector without plutonium. The aerosol exposures resulted in initial pulmonary burdens ranging from 37 to 0.11 and 55.5 to 0.37 kBq of 238 Pu/kg body mass, of 1.5 μm and 3.0 μ, particles, respectively. The particles dissolved slowly resulting in translocation of the Pu to liver, bone and other sites. The dogs were observed for biological effects over their life span. Necropsies were performed at death, and tissues were examined microscopically. The principal late-occurring effects were tumors of the lung, skeleton, and liver. Risk factors estimated for these cancers were 2800 lung cancers/10 4 Gy, 800 liver cancers/10 4 Gy, and 6200 bone cancers/10 4 Gy for dogs. The potential hazard from 238 Pu to humans may include tumors of the lung, bone and liver because of the likelihood of similarity of the dose patterns for the two species. 10 refs., 1 fig., 3 tabs

Twelve-month safety and efficacy of inhaled fluticasone propionate in children aged 1 to 3 years with recurrent wheezing

DEFF Research Database (Denmark)

Bisgaard, Hans; Allen, David; Milanowski, Janusz

2004-01-01

, exacerbations, and requirements for oral steroid treatment and more symptom-free days and days without use of rescue treatment. CONCLUSIONS: Twelve months of treatment with inhaled FP (100 microg twice daily) in preschool children aged 1 to 3 years with recurrent wheeze has no effect on growth and no other......OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children......, aged 1 to 3 years, with recurrent wheeze randomized in a 3:1 ratio to treatment for 52 weeks with FP (100 microg twice daily) via metered-dose inhaler and Babyhaler spacer device or SCG (5 mg 4 times daily) via metered-dose inhaler and Nebuhaler spacer device, respectively. RESULTS...

Human dose pathways of radionuclides in forests; Forests ecosystems

Energy Technology Data Exchange (ETDEWEB)

Rantavaara, A. (Radiation and Nuclear Safety Authority, Research and Environmental Surveillance, Helsinki (Finland))

2009-06-15

Forest soil, understorey vegetation and trees are all sources of radionuclides and human radiation doses after contaminating atmospheric deposition. People are exposed to radiation externally from sources outside the body and internally via ingestion and inhalation of radionuclides. Understorey vegetation contributes to ingestion doses through berries, herbs, wild honey, mushrooms and game meat; also trees provide feed to terrestrial birds and big game. During stay in forests people are subject to external radiation from forest floor and overstorey, and they may inhale airborne radioactive aerosol or gaseous radionuclides in ground level air. In the early phase of contamination also resuspended radionuclides may add to the internal dose of people via inhalation. People in Nordic countries are most exposed to radiation via ingestion of radionuclides in wild foods. The distribution of radionuclides in forests is changed by environmental processes, and thereby also the significance of various dose pathways to humans will change with time. External exposure is received in living environment from contaminated stemwood used as building timber and for manufacturing of furniture and other wood products. The aim of this paper is to outline the significance of various human dose pathways of radionuclides in forests considering the public and workers in forestry and production of bioenergy. Examples on effective doses are given based on two historical events, atmospheric nuclear weapon tests (mostly in 1950's and in 1960's) and the Chernobyl nuclear power plant accident in 1986. (au)

Effect of Transdermal Tulobuterol Added to Inhaled Corticosteroids in Asthma Patients

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Gen Tamura

2005-01-01

Methods: A randomized, double-blind, double-dummy, parallel-group, multicenter trial was conducted. Male and female patients with a diagnosis of asthma requiring inhaled short-acting β2-agonists despite treatment with inhaled corticosteroids took tulobuterol tape (1 mg or 2 mg and corresponding placebo tapes for 4 weeks. Results: Mean morning peak expiratory flows (PEF in the 1 and 2 mg/day groups were significantly increased from the baseline value by 23.8 and 35.9 L/min at week 4, respectively. The increase in mean morning PEF in the 2 mg/day group was significantly higher than that in the 1 mg/day group. The mean evening PEF was significantly increased in both treatment groups compared with baseline values. Although the increase in mean evening PEF in the 2 mg/day group was greater than that in the 1 mg/day group, the difference between groups was statistically significant only at week 1. The safety profiles of the two treatments were similar. Conclusions: In patients with persistent asthma who require inhaled short-acting β2-agonists while receiving inhaled corticosteroids, transdermal tulobuterol significantly improved PEF in a dose-dependent manner, i.e., greater effect with 2 mg than with 1 mg per day.

[The effect of the inhalation of a single atrovent dose on pulmonary ventilation function and respiratory mechanics in patients with chronic obstructive bronchitis].

Science.gov (United States)

Tetenev, F F; Cherniavskaia, G M

1989-01-01

A study was made of the action of inhalation of a single atrovent dose in 20 patients with chronic obstructive bronchitis. All the patients demonstrated a considerable abatement or disappearance of dyspnea, and a reduction of the number of dry rales. The vital capacity of the lungs, the volume of forced expiration, maximal pulmonary ventilation, MOCmax, MOC50, and MOC75 substantially increased. The respiratory work diminished on the average by 32.3% primarily due to the lessening of non-elastic lung resistance. The rise of pulmonary static extensibility and reduction of pulmonary elastic propulsion were recorded. In patients with and without clinical signs of bronchospasm, the action of atrovent was identical.

Committed equivalent organ doses and committed effective doses from intakes of radionuclides

CERN Document Server

Phipps, A W; Kendall, G M; Silk, T J; Stather, J W

1991-01-01

This report contains details of committed equivalent doses to individual organs for intakes by ingestion and inhalation of 1 mu m AMAD particles of 359 nuclides by infants aged 3 months, by children aged 1, 5, 10 and 15 years, and by adults. It complements NRPB-R245 which describes the changes which have taken place since the last NRPB compendium of dose per unit intake factors (dose coefficients) and gives summary tables. Information on the way committed doses increase with the integration period is given in NRPB-M289. The information given in these memoranda is also available as a microcomputer package - NRPB-SR245.

Once-daily use of inhaled corticosteroids: A new regimen in the treatment of persistent asthma

Directory of Open Access Journals (Sweden)

Jeffrey Leflein

2000-01-01

Strict patient adherence with prescribed anti-inflammatory medication is crucial for obtaining optimal therapeutic benefit for patients with asthma. Despite the proven effectiveness of inhaled corticosteroids, patient adherence to prescribed therapy is often low, resulting in increased patient morbidity. Complex dosing regimens contribute greatly to patient non-adherence. Thus, new once-daily regimens of inhaled corticosteroid treatment have been introduced as means to improve patient adherence and provide optimal therapeutic benefit. In the present review, the complex inflammatory and remodeling processes in asthma and their contributions to the clinical manifestations of the disease will be discussed. Currently available, once-daily inhaled corticosteroid treatment options and the advantages of these therapeutic options in the treatment of persistent asthma also will be discussed.

Inhalant allergies in children.

Science.gov (United States)

Mims, James W; Veling, Maria C

2011-06-01

Children with chronic or recurrent upper respiratory inflammatory disease (rhinitis) should be considered for inhalant allergies. Risk factors for inhalant allergies in children include a first-degree relative with allergies, food allergy in infancy, and atopic dermatitis. Although inhalant allergies are rare in infancy, inhalant allergies are common in older children and impair quality of life and productivity. Differentiating between viral and allergic rhinitis can be challenging in children, but the child's age, history, and risk factors can provide helpful information. Allergic rhinitis is a risk factor for asthma, and if one is present, medical consideration of the other is warranted. Copyright © 2011 Elsevier Inc. All rights reserved.

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Stochastic rat lung dosimetry for inhaled radon progeny: a surrogate for the human lung for lung cancer risk assessment

Energy Technology Data Exchange (ETDEWEB)

Winkler-Heil, R.; Hofmann, W. [University of Salzburg, Division of Physics and Biophysics, Department of Materials Research and Physics, Salzburg (Austria); Hussain, M. [University of Salzburg, Division of Physics and Biophysics, Department of Materials Research and Physics, Salzburg (Austria); Higher Education Commission of Pakistan, Islamabad (Pakistan)

2015-05-15

Laboratory rats are frequently used in inhalation studies as a surrogate for human exposures. The objective of the present study was therefore to develop a stochastic dosimetry model for inhaled radon progeny in the rat lung, to predict bronchial dose distributions and to compare them with corresponding dose distributions in the human lung. The most significant difference between human and rat lungs is the branching structure of the bronchial tree, which is relatively symmetric in the human lung, but monopodial in the rat lung. Radon progeny aerosol characteristics used in the present study encompass conditions typical for PNNL and COGEMA rat inhalation studies, as well as uranium miners and human indoor exposure conditions. It is shown here that depending on exposure conditions and modeling assumptions, average bronchial doses in the rat lung ranged from 5.4 to 7.3 mGy WLM{sup -1}. If plotted as a function of airway generation, bronchial dose distributions exhibit a significant maximum in large bronchial airways. If, however, plotted as a function of airway diameter, then bronchial doses are much more uniformly distributed throughout the bronchial tree. Comparisons between human and rat exposures indicate that rat bronchial doses are slightly higher than human bronchial doses by about a factor of 1.3, while lung doses, averaged over the bronchial (BB), bronchiolar (bb) and alveolar-interstitial (AI) regions, are higher by about a factor of about 1.6. This supports the current view that the rat lung is indeed an appropriate surrogate for the human lung in case of radon-induced lung cancers. Furthermore, airway diameter seems to be a more appropriate morphometric parameter than airway generations to relate bronchial doses to bronchial carcinomas. (orig.)

High-dose inhaled terbutaline increases muscle strength and enhances maximal sprint performance in trained men

DEFF Research Database (Denmark)

Hostrup, Morten; Kalsen, Anders; Bangsbo, Jens

2014-01-01

) participated in a double-blinded randomized crossover study. After administration of inhaled terbutaline (30 × 0.5 mg) or placebo, subjects' maximal voluntary isometric contraction (MVC) of m.quadriceps was measured. After MVC, subjects performed a 30-s Wingate test. Sixty minutes following the Wingate test......, subjects exercised for 10 min at 80 % of [Formula: see text] and completed a 100-kcal time trial. Aerobic contribution was determined during the Wingate test by indirect calorimetry. Furthermore, plasma terbutaline, lactate, glucose, and K(+) were measured. RESULTS: Inhalation of 15 mg terbutaline resulted...... = 0.019) and 3.3 ± 1.0 % (P = 0.009) higher for terbutaline than placebo. Net accumulation of plasma lactate was higher (P = 0.003) for terbutaline than placebo during the Wingate test, whereas [Formula: see text] above baseline was unchanged by terbutaline (P = 0.882). Time-trial performance...

Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique.

Science.gov (United States)

Basheti, Iman A; Armour, Carol L; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K

2008-07-01

To evaluate the feasibility, acceptability and effectiveness of a brief intervention about inhaler technique, delivered by community pharmacists to asthma patients. Thirty-one pharmacists received brief workshop education (Active: n=16, CONTROL: n=15). Active Group pharmacists were trained to assess and teach dry powder inhaler technique, using patient-centered educational tools including novel Inhaler Technique Labels. Interventions were delivered to patients at four visits over 6 months. At baseline, patients (Active: 53, CONTROL: 44) demonstrated poor inhaler technique (mean+/-S.D. score out of 9, 5.7+/-1.6). At 6 months, improvement in inhaler technique score was significantly greater in Active cf. CONTROL patients (2.8+/-1.6 cf. 0.9+/-1.4, p<0.001), and asthma severity was significantly improved (p=0.015). Qualitative responses from patients and pharmacists indicated a high level of satisfaction with the intervention and educational tools, both for their effectiveness and for their impact on the patient-pharmacist relationship. A simple feasible intervention in community pharmacies, incorporating daily reminders via Inhaler Technique Labels on inhalers, can lead to improvement in inhaler technique and asthma outcomes. Brief training modules and simple educational tools, such as Inhaler Technique Labels, can provide a low-cost and sustainable way of changing patient behavior in asthma, using community pharmacists as educators.