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Sample records for dose inhaler mdi

  1. Measurement of particle size characteristics of metered dose inhaler (MDI) aerosols.

    Science.gov (United States)

    Dolovich, M

    1991-01-01

    Measurement of the aerodynamic size of an aerosol allows a prediction of its deposition efficiency and behaviour in the lung. The dynamics of volatile or pressurized (MDI) aerosols presents problems not encountered in the characterization of solid or liquid particles alone. For example, the data obtained in real-time sampling as opposed to measuring an aged aerosol provide a truer representation of circumstances during actual clinical use, yet this may be difficult to achieve due to propellent evaporation. A number of particle sizing systems have been developed based upon light scattering techniques and aerodynamic principles. Each method has its limitations; in general, they successfully measure the aerodynamic size distributions of MDI aerosols. Cascade impactors, the "gold standard" of the industry have the advantage that they allow analysis of drug mass as well as other tracers within the aerosol, but the process as a whole is labour intensive, with limited resolution. Highly automated laser-based systems developed over the past 10 years measure the surface characteristics of the aerosol rather than the direct measurement of mass. Because of different values obtained from various sizing systems, it is suggested that all MDI drugs be sized using cascade impactors but that parallel data be obtained using an alternative sizing system.

  2. Inhaled corticosteroid metered-dose inhalers: how do variations in technique for solutions versus suspensions affect drug distribution?

    Science.gov (United States)

    Robinson, Christie A; Tsourounis, Candy

    2013-03-01

    To assess the literature that evaluates how variations in metered-dose inhaler (MDI) technique affect lung distribution for inhaled corticosteroids (ICSs) formulated as MDI suspensions and solutions. PubMed (up to November 2012) and Cochrane Library (up to November 2012) were searched using the terms metered-dose inhalers, HFA 134a, Asthma/*drug therapy, and inhaled corticosteroids. In addition, reference citations from publications identified were reviewed. All articles in English from the data sources that assessed MDI technique comparing total lung distribution (TLD) of MDI solutions or suspensions formulated with ICSs were included in the review. Five relevant studies were identified. Five controlled studies compared how variations in MDI technique affect TLD for ICS MDI solutions with suspensions. MDI solutions resulted in greater TLD compared with larger particle MDI suspensions. Delayed or early inspiration upon device actuation of MDI solutions resulted in less TLD than coordinated actuation, but with a 3- to 4-times greater TLD than MDI suspensions inhaled using a standard technique. A sixth study evaluated inspiratory flow rates (IFR) for small, medium, and large particles. Rapid and slow IFRs resulted in similar TLD for small particles, while far fewer particles reached the airways with medium and large particles at rapid, rather than slow, IFRs. Based on the literature evaluated, standard MDI technique should be used for ICS suspensions. ICS MDI solutions can provide a higher average TLD than larger-particle ICS suspensions using standard technique, discoordinated inspiration and medication actuation timing, or rapid and slow IFRs. ICS MDI solutions allow for a more forgiving technique, which makes them uniquely suitable options for patients with asthma who have difficultly with MDI technique.

  3. Dose model for inhalation

    International Nuclear Information System (INIS)

    Raicevic, J.; Ninkovic, M.; Merkle, M.

    1997-01-01

    This paper deals with calculation of doses in the environment. There are in general five exposure pathways which are customarily considered within such calculations: cloud shine, ground shine, inhalation after resuspension and ingestion. Since in fact each of these exposure pathways is represented by an independent mechanism, it is usual to consider these environmental dose models separately for each exposure pathway. As one example, the inhalation of the material from the radioactive passing cloud, as well as the inhalation of the radioactive material resuspended in the air are considered, giving the same formulas which are used in the new european accident consequence assessment code system COSYMA. (author)

  4. The abbreviated impactor measurement (AIM) concept: part II--Influence of evaporation of a volatile component-evaluation with a "droplet-producing" pressurized metered dose inhaler (pMDI)-based formulation containing ethanol as cosolvent.

    Science.gov (United States)

    Mitchell, J P; Nagel, M W; Avvakoumova, V; MacKay, H; Ali, R

    2009-01-01

    The abbreviated impactor measurement (AIM) concept is a potential solution to the labor-intensive full-resolution cascade impactor (CI) methodology for inhaler aerosol aerodynamic particle size measurement. In this validation study, the effect of increasing the internal dead volume on determined mass fractions relating to aerodynamic particle size was explored with two abbreviated impactors both based on the Andersen nonviable cascade impactor (ACI) operating principle (Copley fast screening Andersen impactor [C-FSA] and Trudell fast screening Andersen impactor [T-FSA]). A pressurized metered dose inhaler-delivered aerosol producing liquid ethanol droplets after propellant evaporation was chosen to characterize these systems. Measures of extrafine, fine, and coarse particle mass fractions from the abbreviated systems were compared with corresponding data obtained by a full-resolution ACI. The use of liquid ethanol-sensitive filter paper provided insight by rendering locations visible where partly evaporated droplets were still present when the "droplet-producing" aerosol was sampled. Extrafine particle fractions based on impactor-sized mass were near equivalent in the range 48.6% to 54%, comparing either abbreviated system with the benchmark ACI-measured data. The fine particle fraction of the impactor-sized mass determined by the T-FSA (94.4 +/- 1.7%) was greater than using the C-FSA (90.5 +/- 1.4%) and almost identical with the ACI-measured value (95.3 +/- 0.4%). The improved agreement between T-FSA and ACI is likely the result of increasing the dead space between the entry to the induction port and the uppermost impaction stage, compared with that for the C-FSA. This dead space is needed to provide comparable conditions for ethanol evaporation in the uppermost parts of these impactors.

  5. Comparative in vitro evaluation of four corticosteroid metered dose inhalers : Consistency of delivered dose and particle size distribution

    NARCIS (Netherlands)

    de Vries, Tjalling W; Rottier, Bart L; Gjaltema, Doetie; Hagedoorn, Paul; Frijlink, Henderik W; de Boer, Anne H

    2009-01-01

    Introduction: Recent developments concerning pressurized metered dose inhalers (pMDIs) with inhaled corticosteroids (ICS) are the introduction of ciclesonide and the replacement of propellants. As the results of in vivo studies depend on pMDI performance, it is necessary to evaluate pMDIs in vitro

  6. Effect of drug load and plate coating on the particle size distribution of a commercial albuterol metered dose inhaler (MDI) determined using the Andersen and Marple-Miller cascade impactors.

    Science.gov (United States)

    Nasr, M M; Ross, D L; Miller, N C

    1997-10-01

    The purpose of this study is to investigate the effect of drug load, the coating of impactor stages, and the design of cascade impactors on albuterol MDIs particle size distribution measurements. The results of the investigation will be used to explain the "loading effect" recently reported. Particle size distribution parameters of a commercial albuterol MDI were measured using both Andersen (AI) and Marple-Miller (MMI) Cascade Impactors, where plates were either left uncoated or coated with silicone or glycerin. A previously validated HPLC-EC method was used for the assay of albuterol collected by the impactor and in single spray content determinations. Coating impactor collection plates had an impact on measured MMAD and GSD values for single puff measurements but very little or no effect for the multi puff measurements. Due to particle bounce, the percent of albuterol fine particles deposited in the filter and impactor finer stages (coated single puff or multi-puff (coated and uncoated) measurements. Evaluation of drug load and plate coating are necessary to determine whether observed particle size distributions are representative of the generated aerosol or are the result of particle bounce and reentrainment. In order to minimize particle bounce, especially for single puff determinations, it may be useful to apply a thin layer of a sticky coating agent to the surfaces of impactor plates.

  7. EVALUATION OF THE METERED-DOSE INHALER TECHNIQUE AMONG HEALTHCARE PROVIDERS

    Directory of Open Access Journals (Sweden)

    E. Nadi F. Zeraati

    2005-07-01

    Full Text Available Poor inhaler technique is a common problem both in asthmatic patients and healthcare providers, which contributes to poor asthma control. This study was performed to evaluate the adequacy of metered-dose inhaler (MDI technique in a sample of physicians and nurses practicing in hospitals of Hamadan University of Medical Sciences. A total of 173 healthcare providers voluntary participated in this study. After the participants answered a questionnaire aimed at identifying their involvement in MDI prescribing and counseling, a trained observer assessed their MDI technique using a checklist of nine steps. Of the 173 participants, 35 (20.2% were physicians and 138 (79.8% were nurses. Only 12 participants (6.93% performed all steps correctly. Physicians performed essential steps significantly better than nurses (85.7% vs. 63.8%, P < 0.05. The majority of healthcare providers responsible for instructing patients on the correct MDI technique were unable to perform this technique correctly, indicating the need for regular formal training programs on inhaler techniques.

  8. The interaction between the oropharyngeal geometry and aerosols via pressurised metered dose inhalers.

    Science.gov (United States)

    Ehtezazi, T; Saleem, I; Shrubb, I; Allanson, D R; Jenkinson, I D; O'Callaghan, C

    2010-01-01

    This study investigated the effect of oropharyngeal geometry on inhaled aerosol characteristics via pressurised metered dose inhalers (pMDIs), both with or without spacers. Seven adult oropharyngeal models with different centreline lengths, total volumes, and degrees of constriction were employed as induction ports for a laser diffraction particle size analyser and cascade impactor. Particle size change over time, mass median aerodynamic diameter (MMAD), average median volume diameter (D(V)50), inhaled doses, and oropharyngeal depositions (percentage of the nominal dose) for aerosols via suspension and ultrafine pMDIs with or without spacers at 30 l/min airflow were determined. Variations in oropharyngeal geometry caused significant variations in inhaled particle size distributions, doses, oropharyngeal drug depositions, and particle size change over time when pMDIs were used without spacers. However, inhaled aerosol characteristics had marginal variations for the ultrafine pMDI plus large volume spacer (MMAD range: 0.69-0.78 microm, D(V)50 range: 1.27-1.36 microm, inhaled dose range: 46.46-52.92%). It was found that the amounts of inhaled aerosol particles with aerodynamic size of less than 0.83 microm via pMDIs plus large volume spacer were slightly affected by the oropharyngeal geometry. Inhaling ultrafine aerosols via spacers may reduce the effect of oropharyngeal geometry on inhaled aerosol properties.

  9. Oronasal and Tracheostomy Delivery of Soft Mist and Pressurized Metered-Dose Inhalers With Valved Holding Chamber.

    Science.gov (United States)

    Berlinski, Ariel; Cooper, Brandy

    2016-07-01

    Some pediatric tracheostomized patients who receive inhaled drugs undergo decannulation, and it is unknown whether the dose has to be adjusted. Pressurized metered-dose inhalers (pMDIs) and soft mist inhalers (SMIs) used with valved holding chambers (VHCs) made of non-electrostatic material are available. We hypothesized that using an SMI and changing the delivery route from tracheostomy to oronasal would increase lung dose. Four units of a metallic VHC were studied with albuterol hydrofluoroalkane (pMDI) and albuterol/ipratropium bromide with an SMI using an anatomically correct in vitro model of a 5-y-old spontaneously breathing tracheostomized child. The drug was captured in a filter and was termed lung dose. We tested breathing patterns with tidal volumes of 50, 155, and 300 mL. A mask and a special adapter were used as interfaces for oronasal and tracheostomy delivery, respectively. Spectrophotometry (276 nm) was used to determine albuterol concentration. The use of SMI resulted in a higher lung dose than the pMDI for all tested conditions except delivery through tracheostomy with tidal volume of 155 mL (P = .69). Switching from oronasal to tracheostomy delivery increased the lung dose for all tested conditions except for the pMDI with the 300-mL tidal volume (P = .83). The use of SMI resulted in higher deposition in the tracheostomy tube than the pMDI. In general, an SMI delivers a higher lung dose than a pMDI when using a metallic spacer during oronasal and tracheostomy route with the latter providing a higher lung dose. Copyright © 2016 by Daedalus Enterprises.

  10. A Rationale for Going Back to the Future: Use of Disposable Spacers for Pressurised Metered Dose Inhalers

    Directory of Open Access Journals (Sweden)

    Mark Sanders

    2015-01-01

    Full Text Available The introduction of pressurised metered dose inhalers (MDIs in the mid-1950s completely transformed respiratory treatment. Despite decades of availability and healthcare support and development of teaching aids and devices to promote better use, poor pMDI user technique remains a persistent issue. The main pMDI user aid is the spacer/valved holding chamber (VHC device. Spacer/chamber features (size, shape, configuration, construction material, and hygiene considerations can vie with clinical effectiveness (to deliver the same dose as a correctly used pMDI, user convenience, cost, and accessibility. Unsurprisingly, improvised, low-cost alternatives (plastic drink bottles, paper cups, and paper towel rolls have been pressed into seemingly effective service. A UK law change permitting schools to hold emergency inhalers and spacers has prompted a development project to design a low-cost, user-friendly, disposable, and recyclable spacer. This paper spacer requires neither preuse priming nor washing, and has demonstrated reproducible lung delivery of salbutamol sulphate pMDI, comparable to an industry-standard VHC, an alternative paperboard VHC, and pMDI alone. This new device appears to perform better than these other VHC devices at the low flow rates thought achievable by paediatric patients. The data suggest that this disposable spacer may have a place in the single-use emergency setting.

  11. Aerodynamic particle size of metered-dose inhalers determined by the quartz crystal microbalance and the Andersen cascade impactor.

    Science.gov (United States)

    Tzou, T Z

    1999-09-10

    Given the rapid sizing capability and high sensitivity, the quartz crystal microbalance (QCM) cascade impactor has been evaluated for the size determination of metered-dose inhaler (MDI) aerosols. The effects of surfactants present in MDI formulations, crystal coating, particle bounce and crystal overloading on the QCM cascade impactor are investigated. To reduce particle bounce, it is necessary to coat the crystals and use new coated surfaces for each measurement. Mass median aerodynamic diameters (MMADs) obtained from the QCM cascade impactor are compared to those from the commonly used Andersen cascade impactor. For MDI formulations containing little or no surfactants, MMADs obtained from the QCM and Andersen cascade impactors are comparable. For MDI formulations containing a significant amount of surfactant (or any non-volatile excipients), the QCM cascade impactor measures the combined size distribution of the drug and non-volatile excipients. A technique is devised in this study to deduce the drug-only size distribution from the QCM impactor for surfactant-containing MDI formulations and show comparable results to the Andersen cascade impactor except for high drug load Intal. The QCM impactor has proved to be a useful tool for rapid size measurement of MDI formulations.

  12. A valved holding chamber does not decrease the bronchodilator activity of budesonide-formoterol combination metered dose inhaler.

    Science.gov (United States)

    Mansfield, Lyndon E; Maynes, Ruby

    2013-02-01

    Spacers and valved holding chambers (VHCs) were developed to facilitate using pressurized metered dose inhaler (pMDI) by patients who could not coordinate the actions required for successful pMDI use. There is little in vivo evidence about how VHC may affect the bronchodilation from combination drugs in pMDI. This study was to determine the effect, if any, of VHC on the bronchodilating actions of the pMDI budesonide/formoterol combination. Sixteen adult asthmatic subjects with 15% or greater reversibility of forced expiratory volume in one second (FEV-1), 15 minutes after inhaling 180-360 μg of albuterol, participated. The study had a randomized crossover design with each subject using budesonide-formoterol pMDI as described in the product information one timeand on a second occasion using the pMDI with a VHC. Spirometry and impedance osscilometry were measured at baseline and repeatedly over a 12-hour period. This study was approved by IntegReview Institutional Review Board, Austin, TX, USA. The clinical trial number for this study was NCT 009-15538 (http://www.westernskymed.com). The area under the curve of FEV-1, the FEV-1, and the fraction FEV-1/FVC was similar over the 12-hour time frame with both methods. Resistance was not different at any time point. In both procedures, the onset of bronchodilation occurred rapidly within 3 to 5 minutes. In well-trained asthmatic subjects, both tested methods caused equivalent bronchodilation. This suggests a VHC itself has no deleterious effect on the bronchodilator activity in the combined drug. These results may not apply to patients who have coordination problems with the pMDI and further study is indicated.

  13. Evaluation of the Metered-Dose Inhaler Technique among Health Care Providers Practicing in Hamadan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    E. Nadi

    2004-07-01

    Full Text Available Poor inhaler technique is a common problem both in asthma patients and health care providers , which contributes to poor asthma control. The aim of this study was to evaluate the correctness of metered-dose inhaler (MDI technique in a sample of physicians , pharmacists and nurses practicing in Hamadan University hospitals. A total of 176 healthcare providers (35 internists and general physicians , 138 nurses and 3 pharmacists were participated voluntary in this study. After the participants answered a questionnaire aimed at identifying their involvement in MDI prescribing and counseling , a trained observer assessed their MDI technique using a checklist of ten steps.Of the 176 participants , 35(20% were physician , and 3 subjects (2% were pharmacists , and 138 (78% were nurses. However only 6 participants (3.4% performed all steps correctly. Physicians performed significantly better than non-physicians (8.6% vs. 2.13%.The majority of healthcare providers responsible for instructing patients on the correct MDI technique were unable to perform this technique correctly ‘indicating the need for regular formal training programmes on inhaler techniques.

  14. Characterization of the spray velocities from a pressurized metered-dose inhaler.

    Science.gov (United States)

    Crosland, Brian Michael; Johnson, Matthew Ronald; Matida, Edgar Akio

    2009-06-01

    Pressurized metered dose inhalers (pMDIs) are widely used to deliver aerosolized medications to the lungs, most often to relieve the symptoms of asthma. Over the past decade, pMDIs have been modified in several ways to eliminate the use of chlorofluorocarbons in their manufacture while increasing efficacy. Numerical simulations are being used more frequently to predict the flow and deposition of particles at various locations, both inside the respiratory tract as well as in pMDIs and add-on devices. These simulations require detailed information about the spray generated by a pMDI to ensure the validity of their results. This paper presents detailed, spatially resolved velocity measurements of the spray emitted from salbutamol sulfate pMDIs obtained using optically triggered particle image velocimetry (PIV). Instantaneous planar velocity measurements were taken and ensemble-averaged at nine different times during the spray event ranging from 1.3 to 100 msec after a pneumatically controlled actuation. The mean spray velocities were shown to be bimodal in time, with two velocity peaks and velocity magnitudes found to be much lower than published data from instantaneous single point measurements. Planar velocity data at each time step were analyzed to produce prescriptive velocity profiles suitable for use in numerical simulations. Spray geometry data are also reported. Statistical comparisons from several thousand individual spray events indicate that there is no significant difference in measured velocity among (1) two brands of pMDI canisters, (2) two pMDIs of the same brand but having different lot numbers, and (3) a full pMDI versus an almost empty pMDI. The addition of a secondary air flow of 30 SLPM (to represent simultaneous inhalation and spray actuation) deflected the spray downward but did not have a significant effect on flow velocity. Further experiments with an added cylindrical spacer revealed that within the spacer, the spray direction and cone angle

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

    Science.gov (United States)

    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.

  16. Awareness of the ozone layer and acceptance of a new CFC-free metered dose inhaler among asthmatic patients.

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    Liam, C K; Lim, K H

    1998-08-01

    University of Malaya Medical Centre, Kuala Lumpur, Malaysia. To assess the awareness of the ozone layer and the acceptance of the new non-chlorofluorocarbon (CFC) propellant hydrofluoroalkane 134a salbutamol pressurised metered dose inhaler (MDI) Airomir among asthmatic patients. A total of 113 consecutive asthmatic patients aged 12 years and above from the out- and in-patient services of the hospital were interviewed using a questionnaire. Sixty-five per cent of the patients were aware of the existence of the ozone layer, 23% that CFCs play a role in ozone depletion, and only 10% that current MDIs contained CFCs. All the patients felt that pressurised MDIs should be made CFC-free after they had considered the role of CFCs in the destruction of the ozone layer. Eighty-one per cent of 94 patients who preferred the Airomir inhaler over a multi-dose dry powder inhaler for administering bronchodilator medications were willing to switch to the new inhaler once it became available on the market. Awareness of the damaging effect of CFCs on the ozone layer among asthmatic patients would encourage them to change to an ozone-friendly, CFC-free pressurised MDI.

  17. Recent patents in pressurised metered dose inhalers.

    Science.gov (United States)

    Ehtezazi, Touraj

    2012-04-01

    In this paper recent patents in pressurised metered dose inhalers have been reviewed. The patents are related to novel valves, dose-counters, formulations, add-on devices, reduction of propellant leakage and inkjet technology. Recently patented dose-counters provide mechanisms that are less susceptible to inaccuracy, and are battery-less electronic dose-counters with the help of miniature electromechanical generators. Regarding the formulation aspect, recent patents provide methods for combinational pMDIs and more stable products. Advantages of recently patented valves are being spring-free and less subject to loss of prime. Recent developments in micromachining have allowed patents that incorporate inkjet technology to develop inhalers that are similar to pMDIs, but produce uniform aerosol droplets. Coating canisters with suitable polymers has reduced need for excipients. Recently patented add-on devices reduce aerosol deposition in the spacer by creating turbulence on the walls of the chamber. Blockage of nozzles in actuators is prevented by providing tapered nozzle channels. In conclusion, these patents show better understanding of pMDIs and provide methods to achieve products with much improved reliability, aerosol performance and stability.

  18. 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.

  19. 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.

  20. Measurement of Inhaled Corticosteroid Adherence in Inner-City, Minority Children with Persistent Asthma by Parental Report and Integrated Dose Counter

    Science.gov (United States)

    Reznik, Marina; Ozuah, Philip O.

    2012-01-01

    Parents often overreport adherence to asthma treatment regimens making accurate assessment of medication adherence in clinical practice difficult. This study was conducted to compare two adherence assessment methods clinicians may choose from when assessing patient inhaled corticosteroid (ICS) adherence: parental report and dose counter measurements of metered-dose inhaler (MDI) actuation. Participants included children (N = 50) with persistent asthma and their parents (N = 50). At enrollment, children received a new, marked ICS at the dose prescribed by their physician. Thirty days following enrollment, we measured ICS adherence by parental report and objectively, with a dose counter. Parental report overestimated ICS adherence when compared to dose counter. We found a statistically significant overall difference between parental report and objectively measured adherence. A dose counter that most ICS inhalers are equipped with may be a more reliable alternative measure of ICS adherence in a clinical practice setting. PMID:22505947

  1. 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.

  2. Internal Flow and Near-Orifice Spray Visualisations of a Model Pharmaceutical Pressurised Metered Dose Inhaler

    International Nuclear Information System (INIS)

    Versteeg, H K; Hargrave, G K; Kirby, M

    2006-01-01

    The pressurised Metered Dose Inhaler (pMDI) has become the most prescribed drug delivery system for treating the respiratory diseases. However, the spray generation mechanism of these devices has not been extensively researched and there is very little information regarding the two-phase fluid dynamics associated with pre-atomisation inside the valve stem. The aim of the work presented in this paper is to provide high-quality, time-resolved imaging of the internal flow structures of pMDIs in an attempt to link the characteristics of the internal flow to external spray atomization processes. Visualisations of the aerosols in the near-orifice region findings from previous studies of commercial pMDIs and showed the following characteristics: (i) start-up transient (ii) fully developed spray with slow spray density variations and (iii) rapid spray density pulsations with large droplet production. The results clearly highlighted the potential of optical diagnostics in the development of improved accounts of the state of the flow inside a pMDI valve and its relationship with drop formation

  3. [Study of personal best value of peak expiratory flow in patients with asthma--comparison of the highest value of daily PEF under good control and the highest value of daily PEF obtained after using repeated inhaled beta2-agonist during high-dose inhaled steroid treatment].

    Science.gov (United States)

    Watanabe, Naoto; Makino, Sohei; Kihara, Norio; Fukuda, Takeshi

    2008-12-01

    In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF. In the present study, we considered whether the daily highest PEF could be used as the best PEF or not. Subjects were 30 asthmatics who were well controlled but whose baseline PEF values were less than 80 percent of predicted values. We compared the daily highest PEF and the highest of PEF obtained after repeated inhaled beta2-agonist (salbutamol MDI every 20 minutes three times). All subjects then received 1600 microg/day of beclomethasone dipropionate (BDP) for 4 to 8 weeks. We studied the effect of high-dose inhaled steroid treatment on each PEF value and compared the daily highest PEF and the highest PEF obtained after using repeated salbutamol MDI during high dose inhaled steroid therapy on the examination day again. The baseline PEF, daily highest PEF and the highest PEF obtained after salbutamol MDI were significantly less than the each values obtained after high-dose BDP. The best PEF value of them was the value obtained after repeated salbutamol MDI during high dose BDP. We suggest that the daily highest PEF under good control is not a substitute for best PEF because it changes according to the degree of improvement of airway inflammation. We recommend that a course of high dose inhaled steroid is effective in finding the best value of PEF for each individual with moderate asthma.

  4. A review of co-milling techniques for the production of high dose dry powder inhaler formulation.

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    Lau, Michael; Young, Paul M; Traini, Daniela

    2017-08-01

    Drug delivery by inhalation offers several advantages compared to other dosage forms, including rapid clinical onset, high bioavailability, and minimal systemic side effects. Drug delivery to the lung can be achieved as liquid suspensions or solutions in nebulizers and pressurized metered-dose inhalers (pMDI), or as dry powders in dry powder inhalers (DPIs). Compared to other delivery systems, DPIs are, in many cases, considered the most convenient as they are breath actuated and do not require the use of propellants. Currently, the delivery of low drug doses for the treatment of lung conditions such as asthma and chronic obstructive pulmonary disease are well established, with numerous commercial products available on the market. The delivery of low doses can be achieved from either standard carrier- or aggregate-based formulations, which are unsuitable in the delivery of high doses due to particle segregation associated with carrier active site saturation and the cohesiveness of micronized aggregates which have poor flow and de-agglomeration properties. High-dose delivery is required for the treatment of lung infection (i.e. antibiotics) and in the emerging application of drug delivery for the management of systemic conditions (i.e. diabetes). Therefore, there is a demand for new methods for production of high-dose dry powder formulations. This paper presents a review of co-mill processing, for the production of high-efficiency inhalation therapies, including the jet mill, mechanofusion, or ball mill methodologies. We investigate the different techniques, additives, and drugs studied, and impact on performance in DPI systems.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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.

  8. A correlation equation for the mass median aerodynamic diameter of the aerosol emitted by solution metered dose inhalers.

    Science.gov (United States)

    Ivey, James W; Lewis, David; Church, Tanya; Finlay, Warren H; Vehring, Reinhard

    2014-04-25

    A correlation equation for the mass median aerodynamic diameter (MMAD) of the aerosol emitted by solution metered dose inhalers (MDIs) is presented. A content equivalent diameter is defined and used to describe aerosols generated by evaporating metered dose inhaler sprays. A large set of cascade impaction data is analyzed, and the MMAD and geometric standard deviation is calculated for each datum. Using dimensional analysis, the mass median content equivalent diameter is correlated with formulation variables. Based on this correlation in combination with mass balance considerations and the definition of the aerodynamic diameter, an equation for prediction of the MMAD of an inhaler given the pressure of the propellant in the metering chamber of the MDI valve and the surface tension of the propellant is derived. The accuracy of the correlation equation is verified by comparison with literature results. The equation is applicable to both HFA (hydrofluoroalkane) propellants 134a and 227ea, with varying levels of co-solvent ethanol. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Evaluation of proficiency in using different inhaler devices among intern doctors

    Directory of Open Access Journals (Sweden)

    Ravish M Kshatriya

    2016-01-01

    Full Text Available Context: Doctors may have deficiencies in the ability to use different inhalers, which in turn, can result in improper technique by the patients and poorly controlled asthma and chronic obstructive pulmonary disease (COPD. Aims: To evaluate intern doctors' proficiency in using various inhaler devices. Materials and Methods: Seventy interns were evaluated for their proficiency in using pressurized metered dose inhaler (pMDI, pMDI with spacer, rotahaler, turbuhaler, and nebulizer. A structured assessment sheet was scored for identification and preparation of device, administration, coordination, and skill of explanation on a scale of 0–5. Common errors such as failure to shake pMDI before use, inability to identify the empty device, inadequate breath holding, and failure to advise gargles after use were recorded. Results: pMDI and pMDI with spacer were identified correctly by 89% and 79% of interns. Over 90% could identify rotahaler and nebulizer whereas only 9% could identify turbuhaler. 79% and 60% could prepare pMDI and pMDI with spacer appropriately. Nebulizer preparation was performed correctly by 79% and almost all interns could not prepare turbuhaler. Only one intern administered turbuhaler correctly. About half of the participants knew the correct co-ordination for pMDI and pMDI with spacer. Two interns showed proper co-ordination in using turbuhaler. None could provide correct explanation for turbuhaler usage; whereas 76% and 70% did it for nebulizer and rotahaler, respectively. Only 43% of interns remembered to shake pMDI before use. Conclusions: Proficiency in using different inhaler devices amongst interns is poor. It is essential to provide adequate training for inhaler devices usage to medical graduates for proper management of asthma and COPD patients by those future primary care physicians and specialists.

  10. Non-CFC metered dose inhalers: the patent landscape.

    Science.gov (United States)

    Bowman, P A; Greenleaf, D

    1999-09-10

    There have been many patent applications to the European Patent Office over the past decade involving the transition of pressurised metered dose inhalers from the CFCs to non-CFC propellants. In addition to those where formulations are changed, there are those relating to specific drugs or drug classes, processes of manufacture and modifications to the container/closure system. Many of these have been opposed, usually on the grounds of obviousness. However, due to the length of time for the opposition process and the fact that there are few non-CFC pressurised inhalers on the market yet, the complete picture of which patents are valid has yet to unfold.

  11. 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

    (Andersen Sampler). The effect of repeated use and cleaning of the spacers on the passive fallout of aerosol within the spacers was determined by evacuating the dose on a filter 2, 5, 10 and 30 s after actuating the spray. The drugs were quantified by liquid chromatography. The NebuChamber delivered...... the highest doses, both maximal dose and dose to ventilator. The recovered doses (means+/-SD) were 55+/-6% and 51+/-2%, respectively, of the delivered dose from the pMDI. The corresponding results for the Babyhaler were 41+/-7% and 24+/-4% and for the Aerochamber 27+/-3% and 17+/-3%. The passive fallout...... of aerosol, determined as half-life (t1/2) was around approximately 30 s for the NebuChamber, 9-15 s for the Babyhaler and approximately 10 s for the AeroChamber. The present study confirms that there are significant differences in dose output from different combinations of pressurized metered dose inhalers...

  12. 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

  13. The biologically effective dose in inhalation nanotoxicology.

    Science.gov (United States)

    Donaldson, Ken; Schinwald, Anja; Murphy, Fiona; Cho, Wan-Seob; Duffin, Rodger; Tran, Lang; Poland, Craig

    2013-03-19

    In all branches of toxicology, the biologically effective dose (BED) is the fraction of the total dose of a toxin that actually drives any toxic effect. Knowledge of the BED has a number of applications including in building structure-activity relationships, the selection of metrics, the design of safe particles, and the determination of when a nanoparticle (NP) can be considered to be "new" for regulatory purposes. In particle toxicology, we define the BED as "the entity within any dose of particles in tissue that drives a critical pathophysiogically relevant form of toxicity (e.g., oxidative stress, inflammation, genotoxicity, or proliferation) or a process that leads to it." In conventional chemical toxicology, researchers generally use the mass as the metric to describe dose (such as mass per unit tissue or cells in culture) because of its convenience. Concentration, calculated from mass, may also figure in any description of dose. In the case of a nanoparticle dose, researchers use either the mass or the surface area. The mass of nanoparticles is not the only driver of their activity: the surfaces of insoluble particles interact with biological systems, and soluble nanoparticles can release factors that interact with these systems. Nanoparticle shape can modify activity. In this Account, we describe the current knowledge of the BED as it pertains to different NP types. Soluble toxins released by NPs represent one potential indicator of BED for wholly or partially soluble NPs composed of copper or zinc. Rapid dissolution of these NPs into their toxic ions in the acidic environment of the macrophage phagolysosome causes those ions to accumulate, which leads to lysosome destabilization and inflammation. In contrast, soluble NPs that release low toxicity ions, such as magnesium oxide NPs, are not inflammogenic. For insoluble NPs, ζ potential can serve as a BED measurement because the exposure of the particle surface to the acidic milieu of the phagolysosome and

  14. 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.

  15. 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.

  16. 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 ...

  17. Technique training does not improve the ability of most patients to use pressurised metered-dose inhalers (pMDIs).

    Science.gov (United States)

    Hardwell, Alison; Barber, Victoria; Hargadon, Tina; McKnight, Eddie; Holmes, John; Levy, Mark L

    2011-03-01

    According to guidelines, inhaler technique should be tested in all patients, particularly those with poorly controlled asthma. We aimed to assess uncontrolled asthma patients' ability to use a pressurised metered-dose inhaler (pMDI) using the Aerosol Inhalation Monitor (AIM, © Vitalograph). Practices invited patients for a detailed clinical review by trained asthma nurses according to practice-agreed protocols. Reviews took place from 1st April to 30th June 2008, and included checking of inhaler technique. Reasons for invitations included, time since last review, asthma control, prescriptions, adherence to medical advice. A proxy measure of control--the total number of short-acting β2-agonist (SABA) bronchodilator inhaler canisters prescribed in the previous 12 months--was used. Data on 77 pre-determined clinical parameters (including prescribing and healthcare utilisation data) were collected. Patient-completed postal symptom questionnaires (the RCP 3 questions) were obtained in some patients. All patients using pMDIs had at least two assessments using the AIM, and where appropriate inhaler technique education was provided. 2123 (24% of those invited) symptomatic asthma patients were reviewed; 1291 (61%) were using pMDIs (mean age 52 years; SD 21), of whom over 80% were in BTS/SIGN Steps 2 and 3. 1092 (85.6%) of those patients using pMDIs failed the first AIM assessment. There was a significant increase in the number of patients able to use their pMDIs correctly following instruction after the second (129 to 260 of 1197 patients, p<0.01) and third (61 to 181 of 528 patients, p< 0.01) tests. However, 78.4% and 65.7% of those tested twice and three times, respectively, failed the AIM assessment despite instruction. Logistic regression analysis failed to show any effect of age and BTS step on these outcomes. A majority of symptomatic asthma patients in this study were unable to use pMDIs correctly. It is essential to check all patients' ability to use their

  18. Multimodal particle size distributions emitted from HFA-134a solution pressurized metered-dose inhalers.

    Science.gov (United States)

    Smyth, Hugh D C; Hickey, Anthony J

    2003-01-01

    The purpose of this research was to investigate the measurement and in vitro delivery implications of multimodal distributions, occurring near or in the respirable range, emitted from pressurized metered-dose inhalers (pMDIs). Particle size distributions of solution pMDIs containing hydrofluoroalkane-134a (HFA-134a) and ethanol were evaluated using 2 complementary particle-sizing methods: laser diffraction (LD) and cascade impaction (CI). Solution pMDIs were formulated from mixtures of HFA-134a (50%-97.5% wt/wt) and ethanol. A range of propellant concentrations was selected for a range of vapor pressures. The fluorescent probe, Rhodamine B, was included for chemical analysis. The complementary nature of LD and CI allowed identification of 2 dominant particle size modes at 1 and 10 micro m or greater. Increasing propellant concentrations resulted in increases in the proportion of the size distributions at the 1- micro m mode and also reduced the particle size of the larger droplet population. Despite significant spatial differences and time scales of measurement between the particle-sizing techniques, the fine particle fractions obtained from LD and CI were practically identical. This was consistent with LD experiments, which showed that particle sizes did not decrease with increasing measurement distance, and may be explained by the absence of significant evaporation/disintegration of larger droplets. The fine particle fractions (FPFs) emitted from HFA-134a/ethanol solution pMDI can be predicted on the basis of formulation parameters and is independent of measurement technique. These results highlight the importance of presenting particle size distribution data from complementary particle size techniques.

  19. Saharan dust levels in Greece and received inhalation doses

    Science.gov (United States)

    Mitsakou, C.; Kallos, G.; Papantoniou, N.; Spyrou, C.; Solomos, S.; Astitha, M.; Housiadas, C.

    2008-12-01

    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 received during exposure in heavily polluted urban or smoking areas.

  20. Urine concentrations of repetitive doses of inhaled salbutamol

    DEFF Research Database (Denmark)

    Elers, J; Pedersen, Lars; Henninge, J

    2011-01-01

    of beta2-agonists. We enrolled 10 asthmatics and 10 controls in an open-label study in which subjects inhaled repetitive doses of 400 microgram salbutamol every second hour (total 1600 microgram), which is the permitted daily dose by the World Anti-Doping Agency (WADA). Blood samples were collected...... and the median ranged from 268 to 611 ng×mL (-1). No samples exceeded the WADA threshold value of 1000 ng×mL (-1) when corrected for the urine specific gravity. When not corrected one sample exceeded the cut-off value with urine concentration of 1082 ng×mL (-1). In conclusion we found no differences in blood...... and urine concentrations between asthmatic and healthy subjects. We found high variability in urine concentrations between subjects in both groups. The variability between subjects was still present after the samples were corrected for urine specific gravity....

  1. 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

  2. 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.

  3. 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

  4. 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)

  5. Inhalants

    Science.gov (United States)

    ... mood changes How can people get treatment for addiction to inhalants? Some people seeking treatment for use of inhalants have found behavioral therapy to be helpful: Cognitive-behavioral therapy helps patients recognize, avoid, and cope ...

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Evaluation of the TSI aerosol impactor 3306/3321 system using a redesigned impactor stage with solution and suspension metered-dose inhalers.

    Science.gov (United States)

    Harris, Julie A; Stein, Stephen W; Myrdal, Paul B

    2006-03-10

    The purpose of this research was to evaluate a redesigned impactor stage for the TSI Model 3306 Impactor Inlet with nozzles adjusted to obtain a target cut-point of 4.7 microm. It has been determined that the previous cut-point used in the Model 3306 was nominally closer to 4.14 microm, thus potentially impacting the characterization of aerosol mass. The reassessment of the Model 3306 was performed on 4 solution and 2 suspension metered-dose inhaler (MDI) formulations. The redesigned impactor stage resulted in a 5% to 6% increase in aerosol mass when compared with the previous impactor stage for the products Ventolin-HFA, Proventil-HFA, and 2 cyclosporin solution formulations with high ethanol concentrations (15% wt/wt). For the formulations with low ethanol concentrations (3% wt/wt), minimal differences were observed between the 2 cut-points. In addition, this study reevaluated the requirement of a vertical inlet extension length when using the TSI 3306/3321 system with the redesigned cut-point. It was shown that the use of a 20-cm extension provides mass and aerosol size distributions that are comparable to the Andersen 8-stage Cascade Impactor, for both solution and suspension MDIs. This work indicates that the TSI 3306/3321 system is suitable for preformulation studies of both suspension and solution MDI systems.

  8. Efficacy of salbutamol by nebulizer versus metered dose inhaler with home-made non-valved spacer in acute exacerbation of childhood asthma.

    Science.gov (United States)

    Yasmin, S; Mollah, A H; Basak, R; Islam, K T; Chowdhury, Y S

    2012-01-01

    This study was done to evaluate and to compare the efficacy of jet nebulizer and metered dose inhaler (MDI) with home-made non-valved spacer (HM NVS) to deliver aerosolized salbutamol in acute exacerbation of asthma in children. HM NVS was made by 500ml plastic mineral water bottle. It was perforated at the bottom for the insertion of MDI and proximal end was cut for placing the mouth. This prospective randomized study was conducted in the department of Pediatrics, Dhaka Medical College Hospital, during April 2007 to March 2008 with 50 known cases (2-12 years) of bronchial asthma with acute exacerbation. After randomized enrollment, each patient received three doses of salbutamol either through a jet nebulizer or through a HM NVS. Oxygen saturation (SaO2), wheeze, heart rate, respiratory rate were recorded throughout the treatment period. Data were analyzed with SPSS for Windows 10.0 at p value 0.05). After therapy improvement was noted among the nebulizer group (SaO2 87.7±2.5 vs. 94.3±2.8 percent; RR 59.2±7.3 vs. 39.3±4.9 per minute; HR 155.4±11.8 vs. 151.60±17.3 per minute; wheeze 88% vs. 8%) as well as in the MDI with HM NVS group (SaO2 89.0±1.8 vs. 94.8±1.8 percent; RR 63.2±4.8 vs. 38.7±6.4 per minute; HR 149.0±10.8 vs. 144.5±13.5 per minute; wheeze 84% vs. 16%) [p0.05]. The overall response to these modalities of treatment was satisfactory in nebulizer (19/25) and HM NVS (17/25). Salbutamol delivered through both nebulizer as well as MDI with HM NVS is equally effective in the treatment of acute asthma in children.

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Nikander, K; Munch, E

    1998-01-01

    . A consistent trend showed the nebulizer treatment to be at least as efficient as the pMDI plus spacer treatment. In actual fact, the apparent order of effect was: 4 mg nebulized suspension treatment > or = 1 mg nebulized suspension treatment > or = 0.8 mg pMDI with spacer treatment. Plasma budesonide...... and plasma cortisol also exhibited dose-related levels independent of device. The adverse effects reported appeared to be related to the dose rather than delivery device. Accordingly, the effect was related to total mass output, rather than to the small particle fraction of the budesonide aerosol...

  10. 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

  11. 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

  12. 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

  13. Inhalants

    Science.gov (United States)

    ... one session can cause a person to lose consciousness and possibly even die . With repeated inhaling, many ... using right now, especially if you have immediate access to it. Choose your poison--stimulants like cocaine ...

  14. 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

    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 beta2-adrenergic effects on most outcomes. Apart from the effect on systolic BP, QRS duration......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...

  15. Inhalation threshold of toxicological concern (TTC) - structural alerts discriminate high from low repeated-dose inhalation toxicity

    OpenAIRE

    Schüürmann, Gerrit; Ebert, Ralf-Uwe; Tluczkiewicz, Inga; Escher, S.E.; Kühne, R.

    2016-01-01

    The threshold of toxicological concern (TTC) of a compound represents an exposure value below which the associated human health risk is considered negligible. As such, this approach offers assessing the risk of potential toxicants when little or no toxicological information is available. For the inhalation repeated-dose TIC, the goal was to derive structural alerts that discriminate between high- and low-toxic compounds. A further aim was to identify physicochemical parameters related to the ...

  16. 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.

  17. Similar Results in Children with Asthma for Steady State Pharmacokinetic Parameters of Ciclesonide Inhaled with or without Spacer

    Directory of Open Access Journals (Sweden)

    H. Boss

    2010-01-01

    Full Text Available Background Ciclesonide is an inhaled corticosteroid administered by a metered dose inhaler (MDI to treat bronchial asthma. After inhalation, the inactive ciclesonide is converted by esterases in the airways to active metabolite desisobutyryl-ciclesonide (des-CIC. Aim To compare the pharmacokinetic (PK parameters of des-CIC in children after administration of therapeutic dose of ciclesonide with and without spacer (AeroChamber Plus™. Methods Open-label, 3 period, cross over, repeated dose, PK study in 37 children with mild to moderate stable asthma (age: 6–11 y; body weight: 20–53 kg. During each 7-day treatment period, ciclesonide was inhaled once in the morning: A 160 μg MDI with spacer, B 80 μg MDI with spacer, and C 160 μg MDI without spacer. Serum PK parameters of ciclesonide and des-CIC were determined on Day 7 of each period. The primary PK parameters were the AUC τ and C max for des-CIC. Results Inhaling ciclesonide with spacer led to a dose proportional systemic exposure (AUC τ of des-CIC (0.316 μg*h/L for 80 μg and 0.663 μg*h/L for 160 μg. The dose-normalized systemic exposure for des-CIC (based on AUC τ was 27% higher after inhalation of ciclesonide 80 μg or 160 μg with spacer than without spacer; the corresponding C max values for des-CIC were, respectively, 63% and 55% higher with spacer. No clinically relevant abnormalities or adverse drug reactions were observed. Conclusions Inhalation of therapeutic ciclesonide dose with spacer led to a slight increase in the systemic exposure of des-CIC, which does not warrant dose adjustment.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. 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

  20. Protective effect of a low single dose inhaled steroid against exercise induced bronchoconstriction

    NARCIS (Netherlands)

    Visser, R.; Wind, M.; de Graaf, B.; de Jongh, Franciscus H.C.; van der Palen, Jacobus Adrianus Maria; Thio, B.J.

    2015-01-01

    Objective Daily use of inhaled corticosteroids (ICS) reduces exercise induced bronchoconstriction (EIB) in asthmatic children. A high single dose of ICS also provided acute protection against EIB. Objective of this study is to investigate whether a low single dose of ICS offers protection against

  1. Achieving Consistent Multiple Daily Low-Dose Bacillus anthracis Spore Inhalation Exposures in the Rabbit Model

    Science.gov (United States)

    2012-06-13

    generating , sizing, quan- tifying, and sampling aerosols of inert materials also hold true for bioaerosols , i.e., for aerosolizing materials of...characterization, traditional bioaerosol generation and collection techniques can be employed to achieve consistent and reproducible low-dose expo- sures... generate and aerosolize consistent daily low aerosol concentrations and resultant low inhalation doses to rabbits. The pilot feasibility characterization

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

    Science.gov (United States)

    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

  3. 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.

  4. Radiation dose to the respiratory airway linings from inhalation of [/sup 15/O]-carbon dioxide

    International Nuclear Information System (INIS)

    Bigler, R.E.; Sgouros, G.; Zanzonico, P.B.; Cosma, M.; Leonard, R.W.; Dahl, J.R.

    1985-01-01

    Estimates of the radiation dose to the upper airways including the trachea, oropharnyx, and nasal linings from inhalation of oxygen-15 labeled CO/sub 2/ studies are provided. Three air administration procedures were examined; inhalation by nose, by mouth and by mouth through a mouthpiece. Attention is given to the inhaled radioactive gas absorbed and retained in the mucus and saliva layers lining the respiratory passages. The authors estimates from direct measurements in saliva and mucus of the highest total radiation dose is to the oropharnyx (5.2 rads, mouth; 2.8 rads, nose). The dose to the trachea was estimated to be 3.5 rads from mucus measurements from dogs. The comparative dose to lungs is 1.2 rads (Bigler and Sgouros, JNM 24:431, 1983). These doses are for steady-state measurements involving the breathing of 1 mCi/1-air for 1 hr. Single breath estimates can be obtained by dividing by the number of breaths per hr (720). Although this procedure leads to a 10% reduction in the radiation dose to the lung, the radiation dose to the lining of the vein infused is high, ranging from 70 to 430 rads for equal activity administered. The authors recommend considering the lung as the tissue at highest risk for both inhalation and IV administration procedures

  5. Lung deposition of inhaled drugs increases with age

    DEFF Research Database (Denmark)

    Onhøj, J; Thorsson, L; Bisgaard, H

    2000-01-01

    versus time (AUC). Terminal half-life (T(1/2)) was evaluated. Dose to patient, AUC, and T(1/2) were similar in the three age groups (p > 0.35). Nebuchamber delivers the same dose of budesonide to young children and adults. Yet the plasma concentration of budesonide was similar in young children...... and adults. Therefore, lung dose is increased with age. This suggests that from a safety perspective, the prescribed dose of budesonide inhaled from a pMDI with Nebuchamber spacer need not be adjusted for age or use of facemask. Children and adults can use the same nominal dose of budesonide via Nebuchamber...

  6. Estimation of inhalation radiation doses associated with a strontium-90 dirty bomb event

    International Nuclear Information System (INIS)

    Reshetin, V.P.

    2006-01-01

    The initial stage of dispersion of 90 Sr radiological dispersion device (dirty bomb) in a terrorist event was investigated on the basis of a numerical solution of the full system of Navier-Stokes equations. Maximum inhalation doses at the level of ≥1, ≥5, ≥10, ≥50 mSv are used as evaluative criteria to assess probable consequences. The intentional release of a relatively small amount of 90 Sr using a conventional explosive has the potential to cause internal exposure to beta-radiation with relatively high maximum inhalation doses achieving hundreds of mSv, but the spatial extent of the area within which high exposures might occur is very small with most of the population receiving maximum inhalation doses between 1-10 mSv. The extent of radiation contamination (area and activity) is dependent on 90 Sr particle size, the height of release, and local weather conditions

  7. Inhalation threshold of toxicological concern (TTC) - Structural alerts discriminate high from low repeated-dose inhalation toxicity.

    Science.gov (United States)

    Schüürmann, Gerrit; Ebert, Ralf-Uwe; Tluczkiewicz, Inga; Escher, Sylvia E; Kühne, Ralph

    2016-03-01

    The threshold of toxicological concern (TTC) of a compound represents an exposure value below which the associated human health risk is considered negligible. As such, this approach offers assessing the risk of potential toxicants when little or no toxicological information is available. For the inhalation repeated-dose TTC, the goal was to derive structural alerts that discriminate between high- and low-toxic compounds. A further aim was to identify physicochemical parameters related to the inhalation-specific bioavailability of the compounds, and to explore their use as predictors of high vs low toxicity. 296 compounds with subacute, subchronic and chronic inhalation toxicity NOEC (no-observed effect concentration) values were subdivided into three almost equal-sized high-, medium- and low-toxic (HTox, MTox, LTox) potency classes. Whereas the derived 14 HTox and 7 LTox structural alerts yield an only moderate discrimination between these three groups, the high-toxic vs low-toxic mis-classification is very low: LTox-predicted compounds are not HTox to 97.5%, and HTox-predicted compounds not LTox to 88.6%. The probability of a compound being HTox vs LTox is triggered further by physicochemical properties encoding the tendency to evaporate from blood. The new structural alerts may aid in the predictive inhalation toxicity assessment of compounds as well as in designing low-toxicity chemicals, and provide a rationale for the chemistry underlying the toxicological outcome that can also be used for scoping targeted experimental studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Air activity variations as estimation of inhalation dose for the gases fission products

    International Nuclear Information System (INIS)

    Mousavi Shirazi, A; Jahanfarnia, G.; Rahgoshay, M.; Aghanajafi, C.; Sardari, D.

    2008-01-01

    This article presents that dissolved impurities are responsible for water activity and the release of fission gases Radon and Thoron into the reactor hall atmosphere. In normal operation of the reactor at 400 kilowatts, wide fluctuations in airborne activity (gross beta) between 15,000-200,000 dpm/m 3 have been noticed. The aerosol concentration, reactor hall temperature, relative humidity and ventilation rate are the factors influencing the levels of airborne activity in the reactor hall atmosphere. These parameters are discussed in relation to the observed air activities. The diffusion coefficient of the decay products and the unattached fraction of the decay products are necessary parameters for the estimation of lung dose. These have been measured. Internal exposure results from the deposition of radioactive material within the body through inhalation, ingestion and absorption. A recent study has indicated that inhalation is the main route of entry, and nearly 75% of the cases of internal contamination are attributable to inhalation. It has been demonstrated that the inert fission gases like Radon and Thoron do not contribute significantly to the dose due to inhalation to the working personnel in reactors, but their decay products which are particulate β emitters, contribute significant inhalation dose

  9. 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)

  10. Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach.

    Science.gov (United States)

    Taylor, Terence E; Zigel, Yaniv; Egan, Clarice; Hughes, Fintan; Costello, Richard W; Reilly, Richard B

    2018-02-01

    Many patients make critical user technique errors when using pressurised metered dose inhalers (pMDIs) which reduce the clinical efficacy of respiratory medication. Such critical errors include poor actuation coordination (poor timing of medication release during inhalation) and inhaling too fast (peak inspiratory flow rate over 90 L/min). Here, we present a novel audio-based method that objectively assesses patient pMDI user technique. The Inhaler Compliance Assessment device was employed to record inhaler audio signals from 62 respiratory patients as they used a pMDI with an In-Check Flo-Tone device attached to the inhaler mouthpiece. Using a quadratic discriminant analysis approach, the audio-based method generated a total frame-by-frame accuracy of 88.2% in classifying sound events (actuation, inhalation and exhalation). The audio-based method estimated the peak inspiratory flow rate and volume of inhalations with an accuracy of 88.2% and 83.94% respectively. It was detected that 89% of patients made at least one critical user technique error even after tuition from an expert clinical reviewer. This method provides a more clinically accurate assessment of patient inhaler user technique than standard checklist methods.

  11. Prescribed doses of inhaled steroids in Dutch children : too little or too much, for too short a time

    NARCIS (Netherlands)

    Schirm, E.; de Vries, T.W.; Tobi, H.; van den Berg, P.B.; de Jong-van den Berg, L.T.W.

    2006-01-01

    Aims To investigate the dosage and duration of inhaled steroids prescribed to children and to compare the prescribed doses with recommended doses for the treatment of asthma in children. Methods For 2514 Dutch children aged 0-12 years who had used inhaled steroids in 2002, pharmacy dispensing data

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Roy E Barnewall

    2012-06-01

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

  14. 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

    OBJECTIVE: To study the systemic activity of inhaled steroids in young children. METHODS: Forty children with mild asthma aged 1 to 3 years were studied in a 3-way crossover, randomized, placebo-controlled, double-blind trial. Treatment with inhaled fluticasone propionate, 200 microg twice daily...... 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...... 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...

  15. Characterisation of high dose aerosols from dry powder inhalers

    NARCIS (Netherlands)

    Grasmeijer, Floris; Hagedoorn, Paul; Frijlink, Henderik W; de Boer, Anne H

    2012-01-01

    Developments in high dose dry powder aerosol delivery will increasingly challenge the applicability of currently used aerosol characterisation techniques. With cascade impaction analysis bounce effects can negatively influence stage collection efficiency, especially with increasing impactor loads.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Dioxin inhalation doses from wood combustion in indoor cookfires

    Science.gov (United States)

    Northcross, Amanda L.; Katharine Hammond, S.; Canuz, Eduardo; Smith, Kirk R.

    2012-03-01

    Approximately 3 billion people worldwide rely on solid biomass fuels for household cooking and space heating, and approximately 50-60% use wood, often indoors in poorly ventilated situations. Daily exposures to high concentrations of smoke from cookstoves inside kitchens create large smoke exposures for women cooks and their small children. The smoke from burning the wood fuel contains hundred of toxic compounds, including dioxins and furans some of the most toxic compounds known to science. Health effects from exposure to dioxins include reproductive and developmental problems, damage the immune system, interference with hormones and also cause cancer. This study measured concentrations of dioxins and furans in a typical Guatemalan village home during open cookfires. Measured concentrations averaged 0.32 ± 0.07 ng m-3 over 31 fires. A Monte Carlo simulation was conducted using parameter estimates based on 8 years of research experience in the study area. The estimated total daily intake of 17 particle phase dioxin and furans for women, a 5-year-old child and a 6-month-old infant were 1.2 (S.D. = 0.4), 1.7 (S.D. = 0.7) and 2.0 (S.D. = 0.5) respectively. The 46% of babies have and estimated total daily intake (TDI) which exceed the WHO TDI guideline for dioxins and furans, 3% of women and 26% of 5-year-old children based solely inhalation of particle phase dioxins in woodsmoke from an open cooking fire. These values maybe underestimates, as they did not include gas phase concentrations or ingestion of dioxins and furans through food, which is the largest route of exposure in the developed world.

  18. Practical, regulatory and clinical considerations for development of inhalation drug products

    Directory of Open Access Journals (Sweden)

    Shuguang Hou

    2015-12-01

    Full Text Available The formulation and device collectively constitute an inhalation drug product. Development of inhaled drugs must consider the compatibility between formulation and device in order to achieve the intended pharmaceutical performance and usability of the product to improve patient compliance with treatment instruction. From the points of formulation, device and patient use, this article summarizes the inhalation drugs, including pressurized metered dose inhaler (pMDI, dry powder inhaler (DPI, and nebulizer that are currently available in the US and UK markets. It also discusses the practical considerations for the development of inhalers and provides an update on the corresponding regulations of the FDA (U.S. Food and Drug Administration and the EMA (European Medicines Agency.

  19. 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......PURPOSE: The purpose of the present study was to investigate the effect of high-dose inhaled terbutaline on muscle strength, maximal sprinting, and time-trial performance in trained men. METHODS: Nine non-asthmatic males with a [Formula: see text] of 58.9 ± 3.1 ml min(-1) kg(-1) (mean ± SEM......, 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...

  20. 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)

  1. 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

  2. Evaluating inhaler use technique in COPD patients

    Directory of Open Access Journals (Sweden)

    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

  3. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-04-01

    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.

  5. 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)

  6. Characterisation of high dose aerosols from dry powder inhalers.

    Science.gov (United States)

    Grasmeijer, Floris; Hagedoorn, Paul; Frijlink, Henderik W; de Boer, Anne H

    2012-11-01

    Developments in high dose dry powder aerosol delivery will increasingly challenge the applicability of currently used aerosol characterisation techniques. With cascade impaction analysis bounce effects can negatively influence stage collection efficiency, especially with increasing impactor loads. In this study the suitability of the multi stage liquid impinger (MSLI) and the Next Generation Impactor (NGI) for the characterisation of dry powder aerosols containing up to 50mg of drug is evaluated. The occurrence of bounce effects is quantitatively assessed by comparison with data obtained from laser diffraction analysis. The liquid based impaction surfaces of the MSLI largely prevent bounce effects, but the low number of cut-off values associated with this impactor hinders accurate data interpretation. With the NGI, a standard high viscosity plate coating insufficiently reduces bounce effects, causing the fraction <1 μm to be higher than what can maximally be expected based on the primary particle size distribution (PSD) obtained from RODOS dispersion. With this type of impactor, the use of solvent soaked filters as impaction surface is necessary to eliminate bounce effects. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. 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.

  8. 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

  9. 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....

  10. Inhaled beta-stimulants - a study of high-dose v. conventional-dose ...

    African Journals Online (AJOL)

    A randomised double-blind controlled trial was conducted in order to compare pulmonary function and protective effects of salbutamol 200 μg v. 1 000 μg by inhalation. Twenty-three known asthmatics took part in the study for a period of 12 weeks. Pulmonary function tests were performed at home (peak expiratory flow-rate ...

  11. Inhaled beta-stimulants - a study of high-dose v. conventional-dose ...

    African Journals Online (AJOL)

    1991-06-01

    Jun 1, 1991 ... sation and intermittent positive pressure breathing.6 However, no studies have been done to assess the efficacy of ... and if they were pregnant. All patients used conventional inhaled bronchodilators. Oral .... single breath helium-carbon monoxide dilution technique. The mean of 3 test values was used and ...

  12. 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

  13. 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

  14. Assessing the reliability of dose coefficients for inhaled and ingested radionuclides

    International Nuclear Information System (INIS)

    Puncher, Matthew; Harrison, John D

    2012-01-01

    Consideration of uncertainties on doses can provide numerical estimates of the reliability of the protection quantities (dose coefficients) used in radiation protection to assess exposures to radionuclides that enter the body by ingestion or inhalation (‘internal emitters’). Uncertainty analysis methods have been widely applied to quantify uncertainties on doses, including effective dose. However, it is not always clear how the distributions of effective dose per unit intake that result from such analyses should be interpreted with respect to the intended use of effective dose in radiation protection and the use of dose coefficients as reference values. The ICRP system of radiological protection is reviewed briefly and it is argued that the reliability of an effective dose coefficient as a protection device can best be determined by comparing the nominal detriment adjusted cancer risk associated with the dose coefficient, with a best estimate of risk for the exposure pathway and exposed population group, considering uncertainties in biokinetic, dosimetric and risk parameters. Because it is the uncertainty on the population mean of this quantity that is required, the effect of parameter variability should be distinguished from the effect of parameter uncertainty when performing uncertainty analyses. A methodology for performing the uncertainty analysis is discussed and studies that quantify uncertainty on doses and risk from intakes of radionuclides are reviewed. (paper)

  15. 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.

  16. 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)

  17. 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

  18. {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.)

  19. 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

  20. 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

  1. 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

  2. Redistribution of 210Po in cigarettes during smoking and estimation of inhaled dose to smokers

    International Nuclear Information System (INIS)

    Zhang Lianping

    1991-01-01

    The contents of 210 Po in nine brands of filter-tipped cigarettes and their redistribution during smoking are reported. The average content of 210 Po in a cigarette is 11.6 mBq. About 10% of 210 Po in a cigarette transfers into the main-stream of smoke during standard smoking process. A one-pack-a-day smoker inhales 8,8 Bq of 210 Po per year and the accumulated dose equivalent is 4.5 mSv for 30 consecutive years. The risk of death from lung cancer due to 210 Po in cigarette is 9 x 10 -6 for the smoker

  3. Modelling and mitigating dose to firefighters from inhalation of radionuclides in wildland fire smoke.

    Energy Technology Data Exchange (ETDEWEB)

    Viner, Brian J. [Savannah River National Laboratory, Savannah River Site, Aiken, SC

    2015-06-12

    Firefighters responding to wildland fires where surface litter and vegetation contain radiological contamination will receive a radiological dose by inhaling resuspended radioactive material in the smoke. This may increase their lifetime risk of contracting certain types of cancer. Using published data, we modelled hypothetical radionuclide emissions, dispersion and dose for 70th and 97th percentile environmental conditions and for average and high fuel loads at the Savannah River Site. We predicted downwind concentration and potential dose to firefighters for radionuclides of interest (137Cs, 238Pu, 90Sr and 210Po). Predicted concentrations exceeded dose guidelines in the base case scenario emissions of 1.0 x 107Bq ha-1 for 238Pu at 70th percentile environmental conditions and average fuel load levels for both 4- and 14-h shifts. Under 97th percentile environmental conditions and high fuel loads, dose guidelines were exceeded for several reported cases for 90Sr, 238Pu and 210Po. The potential for exceeding dose guidelines was mitigated by including plume rise (>2ms-1) or moving a small distance from the fire owing to large concentration gradients near the edge of the fire. This approach can quickly estimate potential dose from airborne radionuclides in wildland fire and assist decision-making to reduce firefighter exposure.

  4. Validation of scores of use of inhalation devices: valoration of errors *

    Science.gov (United States)

    Zambelli-Simões, Letícia; Martins, Maria Cleusa; Possari, Juliana Carneiro da Cunha; Carvalho, Greice Borges; Coelho, Ana Carla Carvalho; Cipriano, Sonia Lucena; de Carvalho-Pinto, Regina Maria; Cukier, Alberto; Stelmach, Rafael

    2015-01-01

    Abstract Objective: To validate two scores quantifying the ability of patients to use metered dose inhalers (MDIs) or dry powder inhalers (DPIs); to identify the most common errors made during their use; and to identify the patients in need of an educational program for the use of these devices. Methods: This study was conducted in three phases: validation of the reliability of the inhaler technique scores; validation of the contents of the two scores using a convenience sample; and testing for criterion validation and discriminant validation of these instruments in patients who met the inclusion criteria. Results: The convenience sample comprised 16 patients. Interobserver disagreement was found in 19% and 25% of the DPI and MDI scores, respectively. After expert analysis on the subject, the scores were modified and were applied in 72 patients. The most relevant difficulty encountered during the use of both types of devices was the maintenance of total lung capacity after a deep inhalation. The degree of correlation of the scores by observer was 0.97 (p < 0.0001). There was good interobserver agreement in the classification of patients as able/not able to use a DPI (50%/50% and 52%/58%; p < 0.01) and an MDI (49%/51% and 54%/46%; p < 0.05). Conclusions: The validated scores allow the identification and correction of inhaler technique errors during consultations and, as a result, improvement in the management of inhalation devices. PMID:26398751

  5. 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

  6. 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

  7. 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

  8. 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

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

    International Nuclear Information System (INIS)

    Mayya, Y. S.; Mishra, R.; Prajith, R.; Gole, A. C.; Sapra, B. K.; Chougaonkar, M. P.; Nair, R. R. K.; Ramola, R. C.; Karunakara, N.; Koya, P. K. M.

    2012-01-01

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

  10. Dose calculations for the respiratory tract from inhaled natural radioactive nuclides as a function of age

    International Nuclear Information System (INIS)

    Hofmann, W.; Steinhaeusler, F.; Pohl, E.

    1979-01-01

    The deposition and retention models and the anatomical and physiological data as proposed by the ICRP Task Groups on Lung Dynamics and Reference Man are valid only for adult dosimetry. However, the change of the growing organism causes an age-dependent variation of the radiation burden to the respiratory tract. Therefore, age-dependent functions of anatomical and physiological parameters were defined. For this purpose data were either interpolated from literature or calculated from theoretical modeling. With these functions and defined aerosol composition, age-dependent deposition probabilities in the single regions of the respiratory tract were determined. For the demonstration of lung dosimetry as a function of age the naturally occurring radon daughters were used as an example. By applying typical mean nuclide concentrations found in the atmosphere of an urban environment and defined age-dependent daily life patterns, the annual inhaled amount of radioactivity was computed. With the above data, dose calculations for the single ICRP lung model compartments were performed. This revealed that the inhaled dose in both the tracheobronchial and pulmonary regions showed a strong dependence on age; a pronounced maximum value was reached at the age of about 6 yr for radon and thoron decay products. (author)

  11. Inhaled Radon Progeny Dose Conversion Factors (DCF) for Real Population of a City

    International Nuclear Information System (INIS)

    Vucic, D.; Nikezic, D.

    2008-01-01

    Dose conversion factor (DCF) of inhaled radon short lived progeny in human lung is defined as weighted effective dose in lung per unit exposure to radon progeny. It is given in units mSv/WLM. Calculation of DCF was conducted through the several successive steps by means of home written FORTRAN90 code. By using standard aerosol and subject related parameters, our code gave a value for DCF=16 mSv/WLM, that is close to 15 mSv/WLM that was recommended by ICRP66 (Marsh and Birchall). Then, we have varied subject related parameters based on statistical data about real population of Nis, city in the southeastern part of Serbia. Inhalation parameters and lung ventilation parameters have been varied according to sex, age and the kind of physical activity. Other parameters related to the atmosphere, weighting factors and the epithelia thickness have been kept on their best estimates. In this way a distribution of DCF for one real population has been acquired. It has been found that DCF is log normally distributed. (author)

  12. 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)

  13. Evaluation of inhalation TTC values with the database RepDose.

    Science.gov (United States)

    Escher, S E; Tluczkiewicz, I; Batke, M; Bitsch, A; Melber, C; Kroese, E D; Buist, H E; Mangelsdorf, I

    2010-11-01

    The thresholds of toxicological concern (TTCs) define limit values for substances of unknown toxicity below which dietary intake is considered to be of no concern to human health. The TTC concept has already been used for risk assessment of e.g. food contaminants or flavoring substances and is in discussion to be applied to other classes of compounds such as cosmetic ingredients, household products, non-relevant metabolites in drinking water, and impurities in pharmaceuticals. The present publication aimed to evaluate whether the current TTC concept can also be applied to define limit values for inhalation exposure, using a data set of 203 industrial chemicals from the database RepDose. It has been shown, that the NOEC values in classes 1, 2, and 3 are distributed over six orders of magnitude resulting in a considerable overlap between the distribution curves for the three classes. Inhalation thresholds for Cramer classes 1 (compounds likely to be of low-toxicity), 2 (compounds likely to be of moderate toxicity), and 3 (compounds suspect for high toxicity) were analyzed close to the approach described by Munro for oral TTCs. The 5th percentiles NOEC of Cramer classes 1-3 result in thresholds of 1.5×10(-3) ppm for Cramer class 1 and 2.2×10(-5) ppm for Cramer class 3. A threshold could not be derived for class 2 because of the small number of compounds available. If calculated as body doses, the inhalation thresholds for classes 1 and 3 (71 and 4 μg/person/d, respectively) are considerably lower than the oral thresholds derived by Munro (1800 and 90 μg/person/d). It has been shown that one reason for this difference is the high sensitivity of the respiratory tract to local effects. In a next step, the values obtained were further refined. If organophosphates or compounds with structural alerts for genotoxicity are excluded, the TTC in Cramer class 1 increases, whereas the TTC in Cramer class 3 remains the same. Based on these analyses two inhalation TTCs for non

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. Size Distribution of Inorganic Species and Their Inhaled Dose in a Detergent Industrial Workplace

    International Nuclear Information System (INIS)

    Karanasiou, A.; Eleftheriadis, K.; Vratolis, S.; Zarbas, P.; Mihalopoulos, N.; Mitsakou, C.; Housiadas, C.; Lazaridis, M.; Ondracek, J.; Dzumbova, L.

    2008-01-01

    Aerosol particles in the workplace of a detergent industry were sampled during July 2005 by a Berner low-pressure impactor. The samples were analyzed by atomic absorption spectrometry and ion chromatography in order to determine the size distribution of metallic elements and water-soluble inorganic ions. The size distributions of some characteristic metallic elements (Cu, Fe, Al) were unimodal with their maximum found in coarse particles. Among the water-soluble aerosol components SO 4 + , NO 3 - , Cl - , NH 4 + and Ca ++ were the major contributors to total particle mass. The lung deposition resulting from the partially hygroscopic aerosol is estimated. The calculated lung deposition reveals the impact of separate chemical aerosol compounds on the levels of the inhaled dose. The differences observed between the total and regional deposition of the different compounds appear mainly due to their different size distributions

  19. 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

  20. 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)

  1. 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

  2. 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 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÷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 131 I 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.

  3. 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...

  4. 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

  5. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study.

    Science.gov (United States)

    Osman, Abuzar; Ahmed Hassan, Imad S; Ibrahim, Mohamed Izham M

    2012-04-01

    Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists''ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden. To evaluate community pharmacists' practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan. THREE HUNDRED COMMUNITY PHARMACIES LOCATED AROUND THE THREE MAJOR HOSPITALS IN THE CAPITAL CITY (KHARTOUM) AND FOUR OTHER PROVINCES WERE APPROACHED, AND FOUR ASTHMA DEVICES WERE ASSESSED: Metered-dose inhaler (MDI) (n=105), MDI with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a pharmacist) acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know. More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct) all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an "optimal technique". The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus) either did not know proper technique or were totally unfamiliar with the devices. The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge of proper use of commonly dispensed asthma inhaler

  6. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study

    Directory of Open Access Journals (Sweden)

    Osman A

    2012-06-01

    Full Text Available Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists’ ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden.Objective: To evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan.Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI (n=105, MDI with Spacer (n=83, Turbuhaler (n=61, and Diskus (n=51. Investigator (a pharmacist acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know.Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an “optimal technique”. The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus either did not know proper technique or were totally unfamiliar with the devices.Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. A computer program to calculate the committed dose equivalent after the inhalation of radioactivity

    International Nuclear Information System (INIS)

    Van der Woude, S.

    1989-03-01

    A growing number of people are, as part of their occupation, at risk of being exposed to radiation originating from sources inside their bodies. The quantification of this exposure is an important part of health physics. The International Commission on Radiological Protection (ICRP) developed a first-order kinetics compartmental model to determine the transport of radioactive material through the human body. The model and the parameters involved in its use, are discussed. A versatile computer program was developed to do the following after the in vivo measurement of either the organ- or whole-body activity: calculate the original amount of radioactive material which was inhaled (intake) by employing the ICRP compartmental model of the human body; compare this intake to calculated reference levels and state any action to be taken for the case under consideration; calculate the committed dose equivalent resulting from this intake. In the execution of the above-mentioned calculations, the computer program makes provision for different aerosol particle sizes and the effect of previous intakes. Model parameters can easily be changed to take the effects of, for instance, medical intervention into account. The computer program and the organization of the data in the input files are such that the computer program can be applied to any first-order kinetics compartmental model. The computer program can also conveniently be used for research on problems related to the application of the ICRP model. 18 refs., 25 figs., 5 tabs

  12. 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.

  13. The effective bolus dose of remifentanil to facilitate laryngeal mask airway insertion during inhalation induction of sevoflurane in children.

    Science.gov (United States)

    Kim, Hyuckgoo; Jung, Sung Mee; Park, Sang-Jin

    2015-10-01

    The additional administration of remifentanil during inhalation induction with sevoflurane could provide better conditions for laryngeal mask airway (LMA) insertion than sevoflurane alone. This study was designed to evaluate the 50 % effective bolus dose (ED50) and 95 % effective bolus dose (ED95) of remifentanil required for LMA insertion in children during inhalation induction with sevoflurane. Pediatric patients aged 3-12 years requiring general anesthesia were recruited. A predetermined dose of remifentanil was injected over 30 s after the induction of general anesthesia with sevoflurane. LMA insertion was attempted 60 s after remifentanil injection. The dose of remifentanil was determined using the Dixon's up-and-down method, starting from 0.5 μg/kg (step size of 0.05 μg/kg). The study was conducted until seven cross-over points and 29 children were collected. The ED50 of remifentanil for successful LMA insertion during sevoflurane inhalation induction in children was 0.168 ± 0.035 μg/kg using Dixon's method. In addition, the ED50 and ED95 of remifentanil from the probit analysis were 0.176 μg/kg (95 % confidence limits, 0.102-0.216 μg/kg) and 0.268 μg/kg (95 % confidence limits, 0.223-0.659 μg/kg), respectively. The ED50 and ED95 of remifentanil for successful LMA insertion in children were estimated to be 0.176 (0.168) and 0.268 μg/kg during inhalation induction with 2.1 % sevoflurane.

  14. 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

    2015-01-01

    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 (PTFE) 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 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 (MMAD) of 1.53 µm and fine particle fractions (FPFs) less than 5 µm 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. PMID:25986955

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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/sub 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/sup 0/C heat treated UO/sub 2/ + PuO/sub 2/, 1750/sup 0/C heat-treated (U,Pu)O/sub 2/ or 850/sup 0/C heat-treated pure PuO/sub 2/. The fourth paper described dose-response studies in which rats were exposed to (U,Pu)O/sub 2/ or pure PuO/sub 2/. This paper updates earlier reports and summarizes the status of animals through approximately 650 days after inhalation.

  17. 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)

  18. 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

  19. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature.

    Science.gov (United States)

    Brocklebank, D; Ram, F; Wright, J; Barry, P; Cates, C; Davies, L; Douglas, G; Muers, M; Smith, D; White, J

    2001-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are common diseases of the airways and lungs that have a major impact on the health of the population. The mainstay of treatment is by inhalation of medication to the site of the disease process. This can be achieved by a number of different device types, which have wide variations in costs to the health service. A number of different inhalation devices are available. The pressurised metered-dose inhaler (pMDI) is the most commonly used and cheapest device, which may also be used in conjunction with a spacer device. Newer chlorofluorocarbons (CFC)-free inhaler devices using hydrofluoroalkanes (HFAs) have also been developed. The drug is dissolved or suspended in the propellant under pressure. When activated, a valve system releases a metered volume of drug and propellant. Other devices include breath-actuated pMDIs (BA-pMDI), such as Autohaler and Easi-Breathe. They incorporate a mechanism activated during inhalation that triggers the metered-dose inhaler. Dry powder inhalers (DPI), such as Turbohaler, Diskhaler, Accuhaler and Rotahaler, are activated by inspiration by the patient. The powdered drug is dispersed into particles by the inspiration. With nebulisers oxygen, compressed air, or ultrasonic power is used to break up solutions or suspensions of medication into droplets for inhalation. The aerosol is administered by mask or by a mouthpiece. There has been no previous systematic review of the evidence of clinical effectiveness and cost-effectiveness of these different inhaler devices. To review systematically the clinical effectiveness and cost-effectiveness of inhaler devices in asthma and COPD. The different aspects of inhaler devices were separated into the most clinically relevant comparisons. Methods involved systematic searching of electronic databases and bibliographies for randomised controlled trials (RCTs) and systematic reviews. Pharmaceutical companies and experts in the field were contacted

  20. Study of the Emitted Dose After Two Separate Inhalations at Different Inhalation Flow Rates and Volumes and an Assessment of Aerodynamic Characteristics of Indacaterol Onbrez Breezhaler®150 and 300 μg.

    Science.gov (United States)

    Abadelah, Mohamad; Chrystyn, Henry; Bagherisadeghi, Golshan; Abdalla, Gaballa; Larhrib, Hassan

    2018-01-01

    Onbrez Breezhaler® is a low-resistance capsule-based device that was developed to deliver indacaterol maleate. The study was designed to investigate the effects of both maximum flow rate (MIF) and inhalation volume (Vin) on the dose emission of indacaterol 150 and 300 μg dose strengths after one and two inhalations using dose unit sampling apparatus (DUSA) as well as to study the aerodynamic characteristics of indacaterol Breezhaler® using the Andersen cascade impactor (ACI) at a different set of MIF and Vin. Indacaterol 150 and 300 μg contain equal amounts of lactose per carrier. However, 150 μg has the smallest carrier size. The particle size distribution (PSD) of indacaterol DPI formulations 150 and 300 μg showed that the density of fine particles increased with the increase of the primary pressure. For both strengths (150 μg and 300 μg), ED1 increased and ED2 decreased when the inhalation flow rate and inhaled volume increased. The reduction in ED1 and subsequent increase in ED2 was such that when the Vin is greater than 1 L, then 60 L/min could be regarded as the minimum MIF. The Breezhaler was effective in producing respirable particles with an MMAD ≤5 μm irrespective of the inhalation flow rate, but the mass fraction of particles with an aerodynamic diameter <3 μm is more pronounced between 60 and 90 L/min. The dose emission of indacaterol was comparable for both dose strengths 150 and 300 μg. These in vitro results suggest that a minimum MIF of 60 L/min is required during routine use of Onbrez Breezhaler®, and confirm the good practice to make two separate inhalations from the same dose.

  1. Study of antioxidative effects and anti-inflammatory effects in mice due to low-dose X-irradiation or radon inhalation

    Science.gov (United States)

    Kataoka, Takahiro

    2013-01-01

    Low-dose irradiation induces various stimulating effects, especially activation of the biological defense system including antioxidative and immune functions. Oxidative stress induced by reactive oxygen species (ROS) can cause cell damage and death and can induce many types of diseases. This paper reviews new insights into inhibition of ROS-related diseases with low-dose irradiation or radon inhalation. X-irradiation (0.5 Gy) before or after carbon tetrachloride (CCl4) treatment inhibits hepatopathy in mice. X-irradiation (0.5 Gy) before ischemia-reperfusion injury or cold-induced brain injury also inhibits edema. These findings suggest that low-dose X-irradiation has antioxidative effects due to blocking the damage induced by free radicals or ROS. Moreover, radon inhalation increases superoxide dismutase activity in many organs and inhibits CCl4-induced hepatic and renal damage and streptozotocin-induced type I diabetes. These findings suggest that radon inhalation also has antioxidative effects. This antioxidative effect against CCl4-induced hepatopathy is comparable to treatment with ascorbic acid (vitamin C) at a dose of 500 mg/kg weight, or α-tocopherol (vitamin E) treatment at a dose of 300 mg/kg weight, and is due to activation of antioxidative functions. In addition, radon inhalation inhibits carrageenan-induced inflammatory paw edema, suggesting that radon inhalation has anti-inflammatory effects. Furthermore, radon inhalation inhibits formalin-induced inflammatory pain and chronic constriction injury-induced neuropathic pain, suggesting that radon inhalation relieves pain. Thus, low-dose irradiation very likely activates the defense systems in the body, and therefore, contributes to preventing or reducing ROS-related injuries, which are thought to involve peroxidation. PMID:23420683

  2. Determining factors of aerosol deposition for four pMDI-spacer combinations in an infant upper airway model.

    Science.gov (United States)

    Janssens, Hettie M; Krijgsman, Arno; Verbraak, Ton F M; Hop, Wim C J; de Jongste, Johan C; Tiddens, Harm A W M

    2004-01-01

    The aim of this study was to measure and compare the influence of tidal volume (Vt) respiratory rate (RR) and pMDI/spacer combination on aerosol deposition of 4 pMDI/spacer combinations, which are used for infants. An anatomically correct upper airway model of a 9-month-old infant was connected to a breathing simulator. Sinusoidal breathing patterns were simulated with; duty cycle T(i)/T(tot) = 0.42, Vt: 25, 50, 75, 100, 150, 200 ml (RR: 30 breaths/min); and RR: 20, 30, 42, 60, 78 breaths/min (Vt: 100 mL). pMDI/Spacers tested were: budesonide 200 microg/Nebuchamber, fluticasone 125 microg/Babyhaler and both budesonide and fluticasone with Aerochamber. Plastic spacers were detergent coated to reduce electrostatic charge. Spacer-output and lung dose were measured by a filter positioned between spacer and facemask or between model and breathing simulator. Particle size distribution of lung dose was assessed with an impactor during simulated breathing. Spacer-output was significantly positively correlated with Vt for all pMDI/spacers (all R > 0.77, p particles particles in the upper airways. Deposition of particles <2.1 microm is relatively flow independent. When electrostatic charge of spacers is reduced, lung dose is pMDI dependent and spacer independent.

  3. Dose-responses over time to inhaled fluticasone propionate treatment of exercise- and methacholine-induced bronchoconstriction in children with asthma

    NARCIS (Netherlands)

    Hofstra, WB; Neijens, HJ; Duiverman, EJ; Kouwenberg, JM; Mulder, PGH; Kuethe, MC; Sterk, PJ

    When treating bronchial hyperresponsiveness to so-called direct and indirect stimuli, distinct pathophysiological mechanisms might require differences in dose and duration of inhaled corticosteroid therapy. To test this hypothesis in children with asthma, we investigated the time- and dose-dependent

  4. Chronic inhalation of carbon monoxide: effects on the respiratory and cardiovascular system at doses corresponding to tobacco smoking.

    Science.gov (United States)

    Sørhaug, Sveinung; Steinshamn, Sigurd; Nilsen, Odd G; Waldum, Helge L

    2006-12-07

    Carbon monoxide (CO) is a dangerous poison in high concentrations, but the long-term effects of low doses of CO, as in the gaseous component of tobacco smoke, are not well known. The aims of our study were to evaluate the long-term effects of inhaled CO on the respiratory and cardiovascular system at doses corresponding to tobacco smoking and its effect on tumourigenesis and pulmonary neuroendocrine (NE) cells. Female Wistar rats were exposed to either CO (200 ppm) for 20 h/day (n=51) or air (n=26) for 72 weeks. Carboxyhaemoglobin was 14.7+/-0.3% in CO exposed animals and 0.3+/-0.1% in controls. In the lungs, no signs of pathology similar to that associated with cigarette smoking were observed, and no differences in number of pulmonary NE cells were observed between the groups. Chronic CO inhalation induced a 20% weight increase of the right ventricle (p=0.001) and a 14% weight increase of the left ventricle and interventricular septum (prespiratory pathology associated with tobacco smoking. The effects on the cardiovascular system seem to involve myocardial hypertrophy, but not atherogenesis.

  5. Inhaled carbon dioxide causes dose-dependent paradoxical bradypnea in animals anesthetized with pentobarbital, but not with isoflurane or ketamine.

    Science.gov (United States)

    Ginosar, Yehuda; Nachmanson, Nathalie Corchia; Shapiro, Joel; Weissman, Charles; Abramovitch, Rinat

    2015-10-01

    In spontaneously breathing mice anesthetized with pentobarbital, we observed unexpected paradoxical bradypnea following 5% inhaled CO2. Observational study 7-8 week CB6F1/OlaHsd mice (n = 99), anesthetized with 30 mg/kg intraperitoneal pentobarbital. Interventional study: Adult male Wistar rats (n = 18), anesthetized either with 30 mg/kg intraperitoneal pentobarbital, 100 mg/kg intraperitoneal ketamine or 1.5% isoflurane. Rats had femoral artery cannulas inserted for hemodynamic monitoring and serial arterial blood gas measurements. Observational study: There was a marked reduction in respiratory rate following 4 min of normoxic hypercapnia; average reduction of 9 breaths/min (p pentobarbital (p = 0.046). Increasing inspired CO2 caused dose-dependent acidosis following pentobarbital and isoflurane (p = 0.013 and p = 0.017, respectively); but not following ketamine-xylazine (p = 0.58). Inhaled CO2 caused paradoxical dose-dependent bradypnea in animals anesthetized with pentobarbital, an observation not hitherto reported as a part of anesthesia-related respiratory depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. 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.

  7. Inhalation and ingestion intakes with associated dose estimates for level II and level III personnel using Capstone study data.

    Science.gov (United States)

    Szrom, Frances; Falo, Gerald A; Lodde, Gordon M; Parkhurst, Mary Ann; Daxon, Eric G

    2009-03-01

    Depleted uranium (DU) intake rates and subsequent dose rates were estimated for personnel entering armored combat vehicles perforated with DU penetrators (level II and level III personnel) using data generated during the Capstone DU Aerosol Study. Inhalation intake rates and associated dose rates were estimated from cascade impactors worn by sample recovery personnel and from cascade impactors that served as area monitors. Ingestion intake rates and associated dose rates were estimated from cotton gloves worn by sample recovery personnel and from wipe-tests samples from the interior of vehicles perforated with large-caliber DU munitions. The mean DU inhalation intake rate for level II personnel ranged from 0.447 mg h(-1) based on breathing zone monitor data (in and around a perforated vehicle) to 14.5 mg h(-1) based on area monitor data (in a perforated vehicle). The mean DU ingestion intake rate for level II ranged from 4.8 mg h(-1) to 38.9 mg h(-1) based on the wipe-tests data including surface-to-glove transfer factors derived from the Capstone data. Based on glove contamination data, the mean DU ingestion intake rates for level II and level III personnel were 10.6 mg h(-1) and 1.78 mg h(-1), respectively. Effective dose rates and peak kidney uranium concentration rates were calculated based on the intake rates. The peak kidney uranium concentration rate cannot be multiplied by the total exposure duration when multiple intakes occur because uranium will clear from the kidney between the exposures.

  8. Carcinogenesis From Inhaled (PuO2)-Pu-239 in Beagles: Evidence for Radiation Homeostasis at Low Doses?

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Darrell R.; Weller, Richard E.

    2010-09-01

    From the early 1970s to the late 1980s, Pacific Northwest National Laboratory conducted life-span studies in beagle dogs on the biological effects of inhaled plutonium (239PuO2, 238PuO2, and 239Pu[NO3]4) to help predict risks associated with accidental intakes in workers. Years later, the purpose of the present follow-up study is to reassess the dose-response relationship for lung cancer induction in the 239PuO2 dogs compared to controls, with particular focus on the dose-response at low lung doses. A 239PuO2 aerosol (2.3 μm AMAD, 1.9 μm GSD) was administered to six groups of 20 young (18-month old) beagle dogs (10 males and 10 females) by inhalation at six different activity levels, as previously described in Laboratory reports. Control dogs were sham-exposed. In dose level 1, initial pulmonary lung depositions were 130 ± 48 Bq (3.5 ± 1.3 nCi), corresponding to 1 Bq g-1 lung tissue (0.029 ± 0.001 nCi g-1. Groups 2 through 6 received initial lung depositions (mean values) of 760, 2724, 10345, 37900, and 200000 Bq (22, 79, 300, 1100, and 5800 nCi) 239PuO2, respectively. For each dog, the absorbed dose to lungs was calculated from the initial lung burden and the final lung burden at time of death and lung mass, assuming a single, long-term retention function. Insoluble plutonium oxide exhibited long retention times in the lungs. Increased dose-dependent mortality due to lung cancer (bronchiolar-alveolar carcinoma, adenocarcinoma, epidermoid carcinoma) and radiation pneumonitis (highest exposures group) was observed in dogs exposed to 239PuO2. Calculated lung doses ranged from a few cGy in early-sacrificed dogs to 7764 cGy in dogs that experienced early deaths from radiation pneumonitis. Data were regrouped by lifetime lung dose and plotted as a function of lung tumor incidence. Lung tumor incidence in controls and zero-dose exposed dogs was 18% (5/28). However, no lung tumors were observed in 16 dogs with the lowest lung doses (8 to 22 cGy, mean 14.4 ± 7.6 c

  9. Carcinogenesis from inhaled (239)PuO(2) in beagles: Evidence for radiation homeostasis at low doses?

    Science.gov (United States)

    Fisher, Darrell R; Weller, Richard E

    2010-09-01

    From the early 1970's to the late 1980's, Pacific Northwest National Laboratory conducted life-span studies in beagle dogs on the biological effects of inhaled plutonium ((238)PuO(2), (239)PuO(2), and Pu[NO(3)](4)) to help predict risks associated with accidental intakes in workers. Years later, the purpose of the present follow-up study was to reassess the dose-response relationship for lung cancer in the PuO(2) dogs compared to controls-with particular focus on the dose-response at relatively low lung doses. A PuO(2) aerosol (2.3 mum activity-median aerodynamic diameter, 1.9 mum geometric standard deviation) was administered to six groups of 20 young (18-mo-old) beagle dogs (10 males and 10 females) by inhalation at six different activity levels, as previously described in Laboratory reports. Control dogs were sham-exposed. In dose level 1, initial pulmonary lung depositions were 130 + or - 48 Bq (3.5 + or - 1.3 nCi), corresponding to 1 Bq g lung tissue (0.029 + or - 0.001 nCi g(-1)). Groups 2 through 6 received initial lung depositions (mean values) of 760, 2,724, 10,345, 37,900, and 200,000 Bq (22, 79, 300, 1,100, and 5,800 nCi) PuO(2), respectively. For each dog, the absorbed dose to lungs was calculated from the initial lung burden and the final lung burden at time of death and lung mass, assuming a single, long-term retention function. Insoluble plutonium oxide exhibited long retention times in the lungs. Increased dose-dependent mortality due to lung cancer (bronchiolar-alveolar carcinoma, adenocarcinoma, and epidermoid carcinoma) and radiation pneumonitis (in the highest exposure group) were observed in dogs exposed to PuO(2). Calculated lung doses ranged from a few cGy (lowest exposure level) to 7,764 cGy in dogs that experienced early deaths from radiation pneumonitis. Data were regrouped by lifetime lung dose and plotted as a function of lung tumor incidence. The lung tumor incidence in controls and zero-dose exposed dogs was 18% (5/28). However, no

  10. Twenty-eight-day repeated-dose inhalation exposure of rats to diethylene glycol monoethyl ether.

    Science.gov (United States)

    Hardy, C J; Coombs, D W; Lewis, D J; Klimisch, H J

    1997-08-01

    This study was carried out to provide information on the effects of inhalation of diethylene glycol monoethyl ether, a substance used in industry which may be accidentally inhaled by man. Sprague-Dawley CD rats were exposed by inhalation to a test atmosphere containing diethylene glycol monoethyl ether in a nose-only exposure system for 6 hr a day, 5 days a week for 28 days. Mean exposure levels were 0. 09, 0.27, and 1.1 mg/liter. At the two lowest exposure levels the test substance was present entirely as vapor, but at the highest exposure level the test atmosphere was approximately equally divided by mass into respirable droplets (aerosol) and vapor. A comprehensive battery of toxicological evaluations including food consumption, body weight, clinical signs, hematology, and biochemistry revealed no evidence of a systemic effect of exposure. Histopathological examination showed changes indicative of mild nonspecific irritation in the upper respiratory tract of rats exposed at the two highest exposure levels. These changes consisted of foci of necrosis in the ventral cartilage of the larynx of rats exposed at 0.27 or 1.1 mg/liter and an increase in eosinophilic inclusions in the olfactory epithelium of the nasal mucosa of rats exposed at 1.1 mg/liter. The no observed adverse effect level for systemic effects was 1.1 mg/liter and the no observed adverse effect level for signs indicative of mild nonspecific irritation of the upper respiratory tract was 0.09 mg/liter.

  11. Terbutaline: level the playing field for inhaled β2-agonists by introducing a dosing and urine threshold

    DEFF Research Database (Denmark)

    Jacobson, Glenn A; Hostrup, Morten

    2017-01-01

    Terbutaline, a short-acting β2-agonist similar to salbutamol, is widely used in Europe in the treatment of asthma and exercise-induced bronchoconstriction. Unlike salbutamol, terbutaline requires therapeutic use exemption (TUE) for therapeutic inhaled use in competitive sport. There is now...... compelling evidence that supratherapeutic use of terbutaline is performance enhancing, via oral dosing and inhalation. It is likely that the ergogenic effects of terbutaline are class specific for all β2-agonists. The World Anti-Doping Agency (WADA) has introduced dosing and urine threshold and decision...

  12. Radon-222 in groundwater and effective dose due to ingestion and inhalation in the city of Ibadan, Nigeria.

    Science.gov (United States)

    Ademola, Janet Ayobami; Oyeleke, Oyebode Akanni

    2017-03-20

    Radon concentration in groundwater collected from the eleven Local Government Areas (LGAs) of Ibadan, Nigeria, was analyzed. Annual effective doses due to ingestion and inhalation of radon from the consumption of the water were determined. The arithmetic means (AMs) of radon concentration for the 11 LGAs varied from 2.18 to 76.75 Bq l -1 with a standard deviation of 1.57 and 70.64 Bq l -1 , respectively. The geometric means (GMs) varied from 1.67 to 49.47 Bq l -1 with geometric standard deviation of 2.22 and 3.04, respectively. About 58% of the 84 water samples examined had a higher concentration of radon than the 11.1 Bq l -1 recommended by United States Environmental Protection Agency (USEPA); the AMs of six LGAs and GMs of three LGAs were higher than the recommended value. However the AMs and GMs of all the LGAs with about 93% of the water sampled were lower than the 100 Bq l -1 recommended by the World Health Organization and EURATOM drinking water directive. The concentration of radon varied with the geological formation of the area. The AMs of the annual effective dose due to ingestion of radon in water ranged from 0.036 to 1.261 mSv y -1 , 0.071 to 2.521 mSv y -1 and 0.042 to 1.471 mSv y -1 for adult, child and infant, respectively and the GMs in the range of 0.026 to 0.813, 0.055 to 1.625 and 0.032 to 0.948 mSv y -1 , respectively. The AMs of 10 LGAs and GMs of 7 LGAs were higher than the recommended reference dose level of 0.1 mSv y -1 from the consumption of water for the duration of one year for all the three categories of people. The AMs and GMs of the annual effective dose due to inhalation of radon in drinking water ranged from 0.533 to 18.82 μSv y -1 and 0.411 to 12.13 μSv y -1 , respectively, contributing less to the overall dose.

  13. 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"

  14. Lack of long-term effects of high-dose inhaled beclomethasone for respiratory syncytial virus bronchiolitis: a randomized placebo-controlled trial

    NARCIS (Netherlands)

    Zomer-Kooijker, K.; Ent, C.K. van der; Ermers, M.J.; Rovers, M.M.; Bont, L.J.; et al.,

    2014-01-01

    BACKGROUND: Previously, we showed that high-dose early initiated inhaled corticosteroids during respiratory syncytial virus bronchiolitis partially and transiently prevents subsequent recurrent wheeze. Here, we study treatment effect on lung function at age 6. METHODS: This is a 6-year follow-up

  15. 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.

  16. Discriminating Ability of Abbreviated Impactor Measurement Approach (AIM) to Detect Changes in Mass Median Aerodynamic Diameter (MMAD) of an Albuterol/Salbutamol pMDI Aerosol.

    Science.gov (United States)

    David Christopher, J; Patel, Rajni B; Mitchell, Jolyon P; Tougas, Terrence P; Goodey, Adrian P; Quiroz, Jorge; Andersson, Patrik U; Lyapustina, Svetlana

    2017-11-01

    This article reports on results from a two-lab, multiple impactor experiment evaluating the abbreviated impactor measurement (AIM) concept, conducted by the Cascade Impaction Working Group of the International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS). The goal of this experiment was to expand understanding of the performance of an AIM-type apparatus based on the Andersen eight-stage non-viable cascade impactor (ACI) for the assessment of inhalation aerosols and sprays, compared with the full-resolution version of that impactor described in the pharmacopeial compendia. The experiment was conducted at two centers with a representative commercially available pressurized metered dose inhaler (pMDI) containing albuterol (salbutamol) as active pharmaceutical ingredient (API). Metrics of interest were total mass (TM) emitted from the inhaler, impactor-sized mass (ISM), as well as the ratio of large particle mass (LPM) to small particle mass (SPM). ISM and the LPM/SPM ratio together comprise the efficient data analysis (EDA) metrics. The results of the comparison demonstrated that in this study, the AIM approach had adequate discrimination to detect changes in the mass median aerodynamic diameter (MMAD) of the ACI-sampled aerodynamic particle size distribution (APSD), and therefore could be employed for routine product quality control (QC). As with any test method considered for inclusion in a regulatory filing, the transition from an ACI (used in development) to an appropriate AIM/EDA methodology (used in QC) should be evaluated and supported by data on a product-by-product basis.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Radiation dose to workers due to the inhalation of dust during granite fabrication

    International Nuclear Information System (INIS)

    Zwack, L M; Stewart, J H; McCarthy, J F; Allen, J G; McCarthy, W B

    2014-01-01

    There has been very little research conducted to determine internal radiation doses resulting from worker exposure to ionising radiation in granite fabrication shops. To address this issue, we estimated the effective radiation dose of granite workers in US fabrication shops who were exposed to the maximum respirable dust and silica concentrations allowed under current US regulations, and also to concentrations reported in the literature. Radiation doses were calculated using standard methods developed by the International Commission on Radiological Protection. The calculated internal doses were very low, and below both US occupational standards (50 mSv yr −1 ) and limits applicable to the general public (1 mSv yr −1 ). Workers exposed to respirable granite dust concentrations at the US Occupational Safety and Health Administration (OSHA) respirable dust permissible exposure limit (PEL) of 5 mg m −3 over a full year had an estimated radiation dose of 0.062 mSv yr −1 . Workers exposed to respirable granite dust concentrations at the OSHA silica PEL and at the American Conference of Governmental Industrial Hygienists Threshold Limit Value for a full year had expected radiation doses of 0.007 mSv yr −1 and 0.002 mSv yr −1 , respectively. Using data from studies of respirable granite dust and silica concentrations measured in granite fabrication shops, we calculated median expected radiation doses that ranged from <0.001 to 0.101 mSv yr −1 . (paper)

  19. Estimates of inhalation doses resulting from the possible use of phospho-gypsum plaster-board in Australian homes.

    Science.gov (United States)

    O'Brien, R S; Peggie, J R; Leith, I S

    1995-04-01

    Current materials used as internal lining in Australian buildings are based on natural gypsum of low radium content. A study was carried out to estimate the contribution to the annual effective dose due to airborne contamination from chemical by-product gypsum plaster-board of higher radium content if it were used as an internal lining. The 226Ra content and 222Rn exhalation rate were measured for several samples of the plaster-board, and the behavior of 222Rn and its progeny (218Po, 214Pb, 214Bi, and 214Po) in a typical building was modeled numerically, using the results of the exhalation rate measurements as input. For building ventilation rates greater than approximately 0.5 air changes per hour, the contribution to the total annual effective dose from inhalation of 222Rn and its progeny exhaled from the phospho-gypsum plaster-board is estimated to be below 1 mSv. This contribution is reduced if the surface of the plaster-board is coated with paint or cardboard, or if the very fine particles are removed from the phospho-gypsum during manufacture of the plaster-board. The effective doses arising from dust generation during the installation of the plaster-board are also estimated to be below 1 mSv. The recommended action level of 200 Bq m-3 for radon in air in Australia corresponds to an annual effective dose of approximately 6 mSv. The study indicates that the suggested acceptable level of 185 Bq kg-1 for the 226Ra concentration in the plaster-board may be too restrictive under Australian conditions.

  20. Automated Sunspot Detection and Classification Using SOHO/MDI Imagery

    Science.gov (United States)

    2015-03-01

    AUTOMATED SUNSPOT DETECTION AND CLASSIFICATION USING SOHO/MDI IMAGERY THESIS Samantha R. Howard, 1st Lieutenant, USAF AFIT-ENP-MS-15-M-078 DEPARTMENT...Government and is not subject to copyright protection in the United States. AFIT-ENP-MS-15-M-078 AUTOMATED SUNSPOT DETECTION AND CLASSIFICATION USING SOHO...MS-15-M-078 AUTOMATED SUNSPOT DETECTION AND CLASSIFICATION USING SOHO/MDI IMAGERY Samantha R. Howard, B.S. 1st Lieutenant, USAF Committee Membership

  1. Personal exposure to grass pollen: relating inhaled dose to background concentration

    DEFF Research Database (Denmark)

    Peel, Robert George; Hertel, Ole; Smith, Matt

    2013-01-01

    lasted for approximately 25 to 30 minutes and was performed at 2-hour intervals from noon to midevening under moderate exercise by 2 individuals. Results: A median ratio of dose rate to background concentration of 0.018 was recorded, with higher ratio values frequently occurring at 12 to 2 PM, the time...

  2. Age and sex dependent inhalation doses to members of the public from indoor thoron progeny

    International Nuclear Information System (INIS)

    Bi, L; Tschiersch, J; Li, W B; Li, J L

    2010-01-01

    The increased indoor thoron level in Europe, North America and Asia has shown that the exposure to thoron and its decay products cannot be ignored in some environments. The contribution of thoron and its progeny can be a significant component of the total exposure from radon and thoron. In the present paper, radiation dose assessment of members of the public of different age and sex exposed to 220 Rn progeny under different daily life activities is performed through a dosimetric approach. Dose conversion coefficients under typical indoor conditions were estimated to be in the range of 107 nSv (Bq h m -3 ) -1 for infant to 81.7 nSv (Bq h m -3 ) -1 for adult. The results of this work emphasized that small children receive a radiation dose of 25% more than adults under the same conditions, and people performing exercise receive a radiation dose 100% more than when sleeping. The results of this work are appropriate to the risk assessment of thoron exposure to members of the public who live in areas with high radon and thoron concentrations.

  3. A method for comparison of animal and human alveolar dose and toxic effect of inhaled ozone

    International Nuclear Information System (INIS)

    Hatch, G.E.; Koren, H.; Aissa, M.

    1989-01-01

    Present models for predicting the pulmonary toxicity of O 3 in humans from the toxic effects observed in animals rely on dosimetric measurements of O 3 mass balance and species comparisons of mechanisms that protect tissue against O 3 . The goal of the study described was to identify a method to directly compare O 3 dose and effect in animals and humans using bronchoalveolar lavage fluid markers. The feasibility of estimating O 3 dose to alveoli of animals and humans was demonstrated through assay of reaction products of 18 O-labeled O 3 in lung surfactant and macrophage pellets of rabbits. The feasibility of using lung lavage fluid protein measurements to quantify the O 3 toxic response in humans was demonstrated by the finding of significantly increased lung lavage protein in 10 subjects exposed to 0.4 ppm O 3 for 2 h with intermittent periods of heavy exercise. The validity of using the lavage protein marker to quantify the response in animals has already been established. The positive results obtained in both the 18 O 3 and the lavage protein studies reported here suggest that it should be possible to obtain a direct comparison of both alveolar dose and toxic effect of O 3 to alveoli of animals or humans

  4. 210Po in cigarette and the radiation dose inhaled by smoker

    International Nuclear Information System (INIS)

    Wang Xin; Chen Xingan; Pan Yingdong

    2000-01-01

    The contents of Polonium-210 in 16 brands of cigarettes from China and 4 brands of cigarettes from abroad were reported. The method that the authors used for separating Polonium-210 was electrochemical deposition method. The 210 Po contents were analyzed in whole cigarettes from freshly opened packs. The 210 Po contents of the China-made cigarettes ranged from 13.7 to 43.4 mBq/cig, from 18.0 to 67.3 mBq/g respectively, the mean values were 26.5 mBq/cig and 33.7 mBq/g respectively. The content of 210 Po in cigarettes from China is higher than that from abroad. The polonium contents of the ash, butt and main stream smoke were reported. The cigarettes were smoked with the eight-channel smoking machine for determining the concentration of the radionuclides in main stream smoke. ('Main Stream' means smoke taken into the mouth). About 15% of 210 Po contained in a cigarette was transferred into the main stream smoke, 40% of the whole 210 Po content remained in the ash and butt for filter cigarette, 60% for non-filter. The daily intake of the 210 Po from cigarette was 80 mBq, the annual dose equivalent to the lung tissue of human body was 0.46 mSv. In view of present knowledge, it is improbable that this dose is significant for the higher incidence of lung tissue of human body was 0.46 mSv. In view of present knowledge, it is improbable that this dose is significant for the higher incidence of lung cancer in smokers

  5. Radon measurements and effective dose from radon inhalation estimation in the Neapolitan catacombs

    International Nuclear Information System (INIS)

    Quarto, M.; Pugliese, M.; Roca, V.; Loffredo, F.; Zambella, C.

    2014-01-01

    In this study, the indoor radon activity concentrations have been measured in the Neapolitan catacombs using LR115 detectors. The detectors were exposed for two quarters, one in the warm season and the other in the cold. This has allowed one to evaluate the seasonal variations of concentrations, while the diurnal variations were evaluated performing continuous measurements by a Radim 5 monitor. The authors found that radon concentrations were lower in winter than in summer. Based on their values, taking into consideration the working hours in the catacombs and the equilibrium factor of 0.4, the effective dose to workers was estimated. (authors)

  6. Radon measurements and effective dose from radon inhalation estimation in the Neapolitan catacombs.

    Science.gov (United States)

    Quarto, M; Pugliese, M; Loffredo, F; Zambella, C; Roca, V

    2014-03-01

    In this study, the indoor radon activity concentrations have been measured in the Neapolitan catacombs using LR115 detectors. The detectors were exposed for two quarters, one in the warm season and the other in the cold. This has allowed one to evaluate the seasonal variations of concentrations, while the diurnal variations were evaluated performing continuous measurements by a Radim 5 monitor. The authors found that radon concentrations were lower in winter than in summer. Based on their values, taking into consideration the working hours in the catacombs and the equilibrium factor of 0.4, the effective dose to workers was estimated.

  7. Comparison of the TSI Model 3306 Impactor Inlet with the Andersen Cascade Impactor: solution metered dose inhalers.

    Science.gov (United States)

    Myrdal, Paul B; Stein, Stephen W; Mogalian, Erik; Hoye, William; Gupta, Abhishek

    2004-09-01

    The product performance of a series of solution Metered Dose Inhalers (MDIs) were evaluated using the TSI Model 3306 Impactor Inlet and the Andersen Cascade Impactor (ACI). The goal of the study was to test whether the fine particle and coarse particle depositions obtained using the Model 3306 were comparable to those results obtained by ACI testing. The analysis using the Model 3306 was performed as supplied by the manufacturer as well as with 20 cm and 40 cm vertical extensions that were inserted between the Model 3306 and the USP Inlet. Nine different solution formulations were evaluated. The drug concentrations ranged from 0.08 to 0.8% w/w and the ethanol cosolvent concentration varied between 5 and 20% w/w. In general, it was found that good correlations between the two instruments were obtained. However, for formulations containing 10-20% w/w ethanol it is shown that an extension fitted to the Model 3306 yielded an improved correlation to those obtained from the ACI.

  8. 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

  9. 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

  10. 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

  11. Application of USP inlet extensions to the TSI impactor system 3306/3320 using HFA 227 based solution metered dose inhalers.

    Science.gov (United States)

    Mogalian, Erik; Myrdal, Paul Brian

    2005-12-01

    The objective of this study was to further evaluate the need for a vertical inlet extension when testing solution metered dose inhalers using the TSI Model 3306 Impactor Inlet in conjunction with the TSI Model 3320 Aerodynamic Particle Sizer (APS). The configurations tested using the TSI system were compared to baseline measurements that were performed using the Andersen Mark II 8-stage cascade impactor (ACI). Seven pressurized solution metered dose inhalers were tested using varied concentrations of beclomethasone dipropionate (BDP), ethanol, and HFA 227 propellant. The inhalers were tested with the cascade impactor, and with the TSI system. The TSI system had three different configurations as the manufacturer provided (0 cm) or with inlet extensions of 20 and 40 cm. The extensions were located between the USP inlet and the Model 3306 Impactor Inlet. There were no practical differences between each system for the stem, actuator, or USP inlet. The fine particle mass (aerodynamic mass TSI system in order to give mass results that correlate to the ACI, especially for formulations having significant concentrations of low volatility excipients. Additionally, the results generated from this study were used to evaluate the product performance of HFA 227 based solution formulations that contain varying concentrations of ethanol as a cosolvent.

  12. High-dose inhaled corticosteroids and add-on therapy use in adults with asthma in the UK in 2003: an observational study.

    Science.gov (United States)

    Thomas, Mike; Leather, David; Price, David

    2006-06-01

    To quantify use of high dose inhaled corticosteroids (ICS) and add-on therapy in adults, and children aged 12 and over, in the community. Cross-sectional observational survey of UK general practice prescribing records from July 2002 to June 2003 utilising the Doctors Independent Network clinical database. 30,895 patients aged 12 and over were treated for asthma with inhaled corticosteroids, with a quantifiable daily dose recommendation in 22,027 cases. Twenty-seven percent (95% Confidence Intervals 26-28%) were prescribed 'high-dose' ICS (>800 mcg/day beclomethasone or equivalent). Of these, 32% (31-33%) were not currently prescribed add-on therapy (long acting B2 agonists, leukotriene antagonists, theophylines), and most of these (84%, 82-86%) had never received a prior trial of add-on therapy. High dose ICS therapy was commonly prescribed to people with asthma, frequently without co-prescribed add-on therapy. Many adults with more severe asthma may be receiving treatment that does not accord with current evidence of best practice.

  13. A new approach to characterise pharmaceutical aerosols: measurement of aerosol from a single dose aqueous inhaler with an optical particle counter.

    Science.gov (United States)

    Kuhli, Maren; Weiss, Maximilian; Steckel, Hartwig

    2010-01-31

    An in-line sampling system with dilution units for aqueous droplet aerosols from single dose inhalers (Berodual Respimat, Boehringer Ingelheim Pharma GmbH & Co. KG, Germany) for an optical particle counter is described. The device has been designed to interface with a white light aerosol spectrometer (welas digital 2100, Palas GmbH, Germany) that allows the time-resolved measurement of highly concentrated aerosols. Performance of the sampling system with regard to the measured particle size distribution (PSD) is compared to Next Generation Impactor (NGI) and to laser diffraction measurements (Sympatec Inhaler and open bench). Optimal settings of the sampling system lead to PSDs that correspond well to those measured by the evaporation minimising NGI approach (15 L/min, cooled) and laser diffraction. The better accuracy of the new dilution unit in presence of an additional aerosol sampling filter in comparison to a previously described aerosol sampling system is shown for different settings of the sampling system. This allows a more precise quantification of the delivered drug amount which is also well correlated to the aerosol volume measured by the welas system. In addition, using time-resolved welas measurements provides insight into droplet size, evaporation and size changes of aerosol clouds delivered by liquid inhalers. Copyright 2009 Elsevier B.V. All rights reserved.

  14. 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

  15. 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

    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....... SETTING: Thirty-three outpatient centers in nine countries. PATIENTS: Two hundred thirty-seven children aged 12 to 47 months with documented history of recurrent wheeze or asthma symptoms. INTERVENTIONS: Two dosages of FP, 100 microg/d and 200 microg/d, and placebo administered in two divided doses via...

  16. Iatrogenic Cushing's syndrome in an HIV-infected patient treated with inhaled corticosteroids (fluticasone propionate) and low dose ritonavir enhanced PI containing regimen.

    Science.gov (United States)

    Clevenbergh, P; Corcostegui, M; Gérard, D; Hieronimus, S; Mondain, V; Chichmanian, R M; Sadoul, J L; Dellamonica, P

    2002-04-01

    In HIV-infected patients, ritonavir, a potent cytochrome P450 inhibitor, is increasingly used to improve the pharmacokinetic profile of the associated protease inhibitor. HIV physicians are often faced with potential drug-drug interaction while treating associated diseases. We report the case of an HIV-infected patient with clinical features of Cushing's syndrome due to the interaction of low dose ritonavir with inhaled fluticasone propionate (FP). Safety of life-long CYP450 inhibition has still to be demonstrated. Copyright 2002 The British Infection Society.

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

    International Nuclear Information System (INIS)

    Gundavarapu, Sravanthi; Zhuang, Jianguo; Barrett, Edward G.; Xu, Fadi; Russell, Robert G.; Sopori, Mohan L.

    2014-01-01

    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 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 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 50 sarin inhalation, and epinephrine may limit the ventilatory, inflammatory, and lethal effects of sarin. - Highlights: • Inhalation exposure of rats to LD 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. • Epinephrine improves

  18. 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.

  19. The development of a novel high-dose pressurized aerosol dry-powder device (PADD) for the delivery of pumactant for inhalation therapy.

    Science.gov (United States)

    Young, Paul M; Thompson, Jim; Woodcock, Derek; Aydin, Mo; Price, Robert

    2004-01-01

    The performance of a novel dry powder inhaler designed to deliver exceptionally high doses was investigated using pumactant as a model powder. Pumactant (a synthetic lung surfactant consisting of a phospholipid mixture), with a 90th percentile particle size of 2.92 microm is highly cohesive, has a high moisture affinity (6.2% w/w at 45% RH), and is predominantly amorphous. The device (pressurized aerosol dry-powder delivery [PADD]) utilizes pressurized gas to aerosolize a powder bed from a reservoir and delivers it through a conventional mouthpiece. The influence of loaded dose on dry powder delivery and can pressure on aerosolization efficiency was investigated. Analysis of the delivered dose studies suggested a linear relationship between loaded dose and delivered dose (R(2) = 0.96, for loaded doses of 0-250 mg), with a delivery efficiency of 70%. Analysis of the aerosolization efficiency using a Marple Miller type impactor suggested fine particle fractions (particles with an aerodynamic diameter of <5 microm) of approximately 30% using canister pressures of 8-14 bars. These results indicate that the PADD device may be a useful tool in delivering high-dose medicaments, as a carrier-free formulation, to the deep lung.

  20. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Profile Tables and Graphs Asthma Call-back Survey Technical Information Prevalence Tables BRFSS Prevalence Data NHIS Prevalence ... inhaler with a spacer Your browser does not support iframes Using a metered dose inhaler with a ...

  1. Asthma Inhalers: Which One's Right for You?

    Science.gov (United States)

    ... containing medication that fits into a boot-shaped plastic mouthpiece. With most metered dose inhalers, medication is ... org/diseases-conditions/asthma/in-depth/asthma-inhalers/ART-20046382 . Mayo Clinic Footer Legal Conditions and Terms ...

  2. 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.

  3. 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.

  4. The determination of the inhalable fraction of 40K activity in marijuana (Cannabis sativa L. buds by instrumental neutron activation analysis and the effective dose to the body

    Directory of Open Access Journals (Sweden)

    Johann M.R. Antoine

    2017-07-01

    Full Text Available Total potassium in marijuana (Cannabis sativa L. buds was determined using instrumental neutron activation analysis. The mass fraction of 40K and its activity were derived using the natural isotopic ratios of potassium. The total potassium in the marijuana buds ranged from 0.84% to 3.15% with a mean mass fraction of 1.93%. The activity concentrations of 40K in the samples of marijuana ranged from 253 to 946 Bq kg−1 with a mean activity concentration of 581 Bq kg−1. The effective dose to the body from smoking marijuana is lower than that for comparable tobacco smoking. Simulated smoking experiments show that over 90% of 40K is retained in the cigarette ash. Accepted methods of determining effective dose to the body from 40K inhalation are likely overestimations for both marijuana and tobacco cigarette smoke.

  5. 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.

  6. Rats with Chronic, Stable Pulmonary Hypertension Tolerate Low Dose Sevoflurane Inhalation as Well as Normal Rats Do.

    Science.gov (United States)

    Yin, Xiaoqing; Wang, Lu; Qin, Gang; Luo, Hui; Liu, Xiao; Zhang, Fan; Ye, Zhi; Zhang, Junjie; Wang, E

    2016-01-01

    The effects of low concentration of sevoflurane on right ventricular (RV) function and intracellular calcium in the setting of pulmonary arterial hypertension (PAH) have not been investigated clearly. We aim to study these effects and associated signaling pathways in rats with PAH. Hemodynamics were assessed with or without sevoflurane inhalation in established PAH rats. We analysis the classic RV function parameters and RV-PA coupling efficiency using steady-state PV loop recordings. The protein levels of SERCA2, PLB and p-PLB expression was analyzed by western blot to assess their relevance in PAH. Rats with PAH presented with RV hypertrophy and increased pulmonary arterial pressure. The values of Ea, R/L ratio, ESP, SW, PRSW, +dP/dtmax and the slope of the dP/dtmax-EDV relationship increased significantly in PAH rats (Ppulmonary blood pressure, HR, RV contractility, and increased the R/L ratio in both groups. Sevoflurane reduced the expression of SERCA2 and increased the expression of PLB in both groups. Interestingly, sevoflurane only reduced the p-PLB/PLB ratio in PAH rats, not in normal rats. Rats with chronic, stable pulmonary hypertension tolerate low concentrations of sevoflurane inhalation as well as normal rats do. It may be related to the modulation of the SERCA2-PLB signaling pathway.

  7. Rats with Chronic, Stable Pulmonary Hypertension Tolerate Low Dose Sevoflurane Inhalation as Well as Normal Rats Do.

    Directory of Open Access Journals (Sweden)

    Xiaoqing Yin

    Full Text Available The effects of low concentration of sevoflurane on right ventricular (RV function and intracellular calcium in the setting of pulmonary arterial hypertension (PAH have not been investigated clearly. We aim to study these effects and associated signaling pathways in rats with PAH.Hemodynamics were assessed with or without sevoflurane inhalation in established PAH rats. We analysis the classic RV function parameters and RV-PA coupling efficiency using steady-state PV loop recordings. The protein levels of SERCA2, PLB and p-PLB expression was analyzed by western blot to assess their relevance in PAH.Rats with PAH presented with RV hypertrophy and increased pulmonary arterial pressure. The values of Ea, R/L ratio, ESP, SW, PRSW, +dP/dtmax and the slope of the dP/dtmax-EDV relationship increased significantly in PAH rats (P<0.05. Sevoflurane induced a concentration-dependent decrease of systemic and pulmonary blood pressure, HR, RV contractility, and increased the R/L ratio in both groups. Sevoflurane reduced the expression of SERCA2 and increased the expression of PLB in both groups. Interestingly, sevoflurane only reduced the p-PLB/PLB ratio in PAH rats, not in normal rats.Rats with chronic, stable pulmonary hypertension tolerate low concentrations of sevoflurane inhalation as well as normal rats do. It may be related to the modulation of the SERCA2-PLB signaling pathway.

  8. CO inhalation at dose corresponding to tobacco smoke worsens cardiac remodeling after experimental myocardial infarction in rats.

    Science.gov (United States)

    Mirza, Alain; Eder, Véronique; Rochefort, Gaël Y; Hyvelin, Jean-Marc; Machet, Marie Christine; Fauchier, Laurent; Bonnet, Pierre

    2005-06-01

    We hypothesized that inhalation of carbon monoxide (CO) (500 ppm), similar to that in tobacco smoke, disturbs the cardiovascular adaptation after myocardial infarction by increasing remodeling. Four groups of rats were assessed. Two groups had myocardial infarction induced by the ligation of the left coronary artery: the first group was exposed to air (infarcted air group, n = 12), and the second was exposed to CO (infarcted CO group, n = 11). They were compared to two sham-operated groups, a control air group (n = 10), and a control CO group (n = 7) exposed (3 weeks) to CO. Aerobic endurance capacity was assessed in both the infarct CO and infarct air group (endurance capacity = 0.043 +/- 0.006 m.min(-1).g(-1) vs. 0.042 +/- 0.005 m.min(-1).g(-1), not significant). In the infarcted CO group compared to the infarcted air group, the dilatation of the left ventricle observed 3 weeks after infarction was increased, (left ventricular diastolic (LVD) diameter (D) = 9 +/- 0.4 vs. 7 +/- 0.4 mm, p infarcted CO group, the infarct size increased. Echocardiography and histology showed hypertrophy of the contralateral wall similar to that observed in the noninfarcted control CO group. In conclusion, chronic CO inhalation worsens heart failure in rats with myocardial infarction by an increase in the infarct size and hypertrophy remodeling.

  9. SOI/MDI studies of active region seismology and evolution

    Science.gov (United States)

    Tarbell, Ted D.; Title, Alan; Hoeksema, J. Todd; Scherrer, Phil; Zweibel, Ellen

    1995-01-01

    The solar oscillations investigation (SOI) will study solar active regions using both helioseismic and conventional observation techniques. The Michelson Doppler imager (MDI) can perform Doppler continuum and line depth imagery and can produce longitudinal magnetograms, showing either the full disk or a high resolution field of view. A dynamics program of continuous full disk Doppler observations for two months per year, campaign programs of eight hours of continuous observation per day, and a synoptic magnetic program of about 15 full disk magnetograms per day, are planned. The scientific plans, measurements and observation programs, are described.

  10. Investigation on the development of measurement techniques, the behavior in the environment and the estimation of internal radiation dose by inhalation for some typical atmospheric radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Hikaru [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1996-06-01

    Radionuclides in surface atmosphere on the earth are {sup 222}Rn, {sup 220}Rn and their short lived progeny, {sup 7}Be, {sup 85}Kr, {sup 3}H, {sup 14}C, {sup 137}Cs, {sup 90}Sr and so on. In this paper, among them, {sup 222}Rn, their short lived progeny ({sup 218}Po, {sup 214}Pb, {sup 214}Bi, {sup 214}Po), {sup 7}Be, {sup 3}H, and {sup 90}Sr are focused on as follows based on the experimental and observed results, 1. Development of their measurement techniques, 2. Analysis of their variation of atmospheric concentration with time and places, 3. Analysis of their interaction characteristics with surface environment including plants, 4. Estimation of internal radiation doses by inhalation of them. (author). 228 refs.

  11. [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.

  12. Cascade impactor practice for a high dose dry powder inhaler at 90 L/min: NGI versus modified 6-stage and 8-stage ACI.

    Science.gov (United States)

    Kamiya, Akihiko; Sakagami, Masahiro; Byron, Peter R

    2009-03-01

    The compendial methods of particle size distribution (PSD) profile determination for dry powder inhalers (DPIs) were compared between the Next Generation Pharmaceutical Impactor (NGI) and the Andersen Cascade Impactor (ACI). Relenza Rotadisk (zanamivir) and Diskhaler was used as a model DPI and sampled into each impactor via its preseparator (PS), at 90 L/min under various protocols. In the NGI, silicone coating was shown to be indispensable to prevent or minimize particle bounce and reentrainment, and to reduce wall losses to the levels acceptable to the compendia (5%). In contrast, the ACI exceeded this 5% limit, regardless of coating, implying different wall loss mechanisms from the NGI. Particle bounce occurred in both impactors, inaccurately undersizing the PSD profiles for Relenza, unless the collection surfaces were coated or an increased number of doses were employed. Hence, the PSD profile for Relenza following single dose collection in the stage-coated NGI was the most accurate. In contrast, the use of the ACI and its PS for Relenza at 90 L/min suffered from several problems, even though the poorly designed PS still resulted in consistent impactor dose and PSD profiles, compared to those obtained from the NGI and its PS. (c) 2008 Wiley-Liss, Inc. and the American Pharmacists Association

  13. INREM II: a computer implementation of recent models for estimating the dose equivalent to organs of man from an inhaled or ingested radionuclide

    International Nuclear Information System (INIS)

    Killough, G.G.; Dunning, D.E. Jr.; Pleasant, J.C.

    1978-01-01

    This report describes a computer code, INREM II, which calculates the internal radiation dose equivalent to organs of man which results from the intake of a radionuclide by inhalation or ingestion. Deposition and removal of radioactivity from the respiratory tract is represented by the ICRP Task Group Lung Model. A four-segment catenary model of the GI tract is used to estimate movement of radioactive material that is ingested or swallowed after being cleared from the respiratory tract. Retention of radioactivity in other organs is specified by linear combinations of decaying exponential functions. The formation and decay of radioactive daughters is treated explicitly, with each radionuclide species in the chain having its own uptake and retention parameters, as supplied by the user. The dose equivalent to a target organ is computed as the sum of contributions from each source organ in which radioactivity is assumed to be situated. This calculation utilizes a matrix of S-factors (rem/μCi-day) supplied by the user for the particular choice of source and target organs. Output permits the evaluation of crossfire components of dose when penetrating radiations are present. INREM II is coded in FORTRAN IV and has been compiled and executed on an IBM-360 computer

  14. Radiation dose due to radon and thoron progeny inhalation in high-level natural radiation areas of Kerala, India.

    Science.gov (United States)

    Omori, Yasutaka; Tokonami, Shinji; Sahoo, Sarata Kumar; Ishikawa, Tetsuo; Sorimachi, Atsuyuki; Hosoda, Masahiro; Kudo, Hiromi; Pornnumpa, Chanis; Nair, Raghu Ram K; Jayalekshmi, Padmavaty Amma; Sebastian, Paul; Akiba, Suminori

    2017-03-20

    In order to evaluate internal exposure to radon and thoron, concentrations for radon, thoron, and thoron progeny were measured for 259 dwellings located in high background radiation areas (HBRAs, outdoor external dose: 3-5 mGy y -1 ) and low background radiation areas (control areas, outdoor external dose: 1 mGy y -1 ) in Karunagappally Taluk, Kerala, India. The measurements were conducted using passive-type radon-thoron detectors and thoron progeny detectors over two six-month measurement periods from June 2010 to June 2011. The results showed no major differences in radon and thoron progeny concentrations between the HBRAs and the control areas. The geometric mean of the annual effective dose due to radon and thoron was calculated as 0.10 and 0.44 mSv, respectively. The doses were small, but not negligible compared with the external dose in the two areas.

  15. 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

  16. Inhalation Injuries

    Science.gov (United States)

    Inhalation injuries are acute injuries to your respiratory system and lungs. They can happen if you breathe in toxic substances, such as smoke (from fires), chemicals, particle pollution, and gases. Inhalation injuries can also be caused by extreme heat; these are a type of thermal injuries. ...

  17. Mapping local cerebral blood flow by means of computerized tomography with a short inhalation of low-dose stable xenon

    International Nuclear Information System (INIS)

    Nakagawara, Jyoji; Karasawa, Jun; Tasawa, Toshiaki; Touho, Hajime; Nakauchi, Mikio; Kagawa, Masa-aki; Asai, Masa-aki; Kuriyama, Yoshihiro; Kikuchi, Haruhiko.

    1986-01-01

    A non-invasive technique has been developed for mapping the local blood-brain partition coefficient (λi), the local build-up rate constant (κi), and the local cerebral blood flow (l-CBF) by means of xenon-enhanced computerized tomography (CT) using a YMS CT 9000 scanner. After denitrogenation for 10 minutes, a 30 % xenon/oxygen mixture is inhaled for 4 - 8 minutes through a rubber face-mask and a delivery system of stable xenon. The time course of local cerebral CT enhancement is utilized in order to calculate, the λi, κi, and l-CBF values. The CT enhancement data during the washin-washout phase are fitted to the mathematical functions, based on Kety's formula, using least-squares curve-fitting analysis. Several case studies of patients with cerebral vascular accidents are presented to demonstrate the characterization of the λi and l-CBF patterns in various tissues; the results are of sufficient quality for the management of patients. The theoretical assumptions underlying stable xenon CT CBF measurements are discussed. (author)

  18. 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.

  19. Biological characterization of radiation exposure and dose estimates for inhaled uranium milling effluents. Annual progress report April 1, 1982-March 31, 1983

    International Nuclear Information System (INIS)

    Eidson, A.F.

    1984-05-01

    The problems addressed are the protection of uranium mill workers from occupational exposure to uranium through routine bioassay programs and the assessment of accidental worker exposures. Comparisons of chemical properties and the biological behavior of refined uranium ore (yellowcake) are made to identify important properties that influence uranium distribution patterns among organs. These studies will facilitate calculations of organ doses for specific exposures and associated health risk estimates and will identify important bioassay procedures to improve evaluations of human exposures. A quantitative analytical method for yellowcake was developed based on the infrared absorption of ammonium diuranate and U 3 O 8 mixtures in KBr. The method was applied to yellowcake samples obtained from six operating mills. The composition of yellowcake from the six mills ranged from nearly pure ammonium diuranate to nearly pure U 3 O 8 . The composition of yellowcake samples taken from lots from the same mill was only somewhat less variable. Because uranium mill workers might be exposed to yellowcake either by contamination of a wound or by inhalation, a study of retention and translocation of uranium after subcutaneous implantation in rats was done. The results showed that 49% of the implanted yellowcake cleared from the body with a half-time (T sub 1/2) in the body of 0.3 days, and the remainder was cleared with a T sub 1/2 of 11 to 30 days. Exposures of Beagle dogs by nose-only inhalation to aerosols of commercial yellowcake were completed. Biochemical indicators of kidney dysfunction that appeared in blood and urine 4 to 8 days after exposure to the more soluble yellowcake showed significant changes in dogs, but levels returned to normal by 16 days after exposure. No biochemical evidence of kidney dysfunction was observed in dogs exposed to the less soluble yellowcake form. 18 figures, 9 tables

  20. Biological characterization of radiation exposure and dose estimates for inhaled uranium milling effluents. Annual progress report April 1, 1982-March 31, 1983

    Energy Technology Data Exchange (ETDEWEB)

    Eidson, A.F.

    1984-05-01

    The problems addressed are the protection of uranium mill workers from occupational exposure to uranium through routine bioassay programs and the assessment of accidental worker exposures. Comparisons of chemical properties and the biological behavior of refined uranium ore (yellowcake) are made to identify important properties that influence uranium distribution patterns among organs. These studies will facilitate calculations of organ doses for specific exposures and associated health risk estimates and will identify important bioassay procedures to improve evaluations of human exposures. A quantitative analytical method for yellowcake was developed based on the infrared absorption of ammonium diuranate and U/sub 3/O/sub 8/ mixtures in KBr. The method was applied to yellowcake samples obtained from six operating mills. The composition of yellowcake from the six mills ranged from nearly pure ammonium diuranate to nearly pure U/sub 3/O/sub 8/. The composition of yellowcake samples taken from lots from the same mill was only somewhat less variable. Because uranium mill workers might be exposed to yellowcake either by contamination of a wound or by inhalation, a study of retention and translocation of uranium after subcutaneous implantation in rats was done. The results showed that 49% of the implanted yellowcake cleared from the body with a half-time (T sub 1/2) in the body of 0.3 days, and the remainder was cleared with a T sub 1/2 of 11 to 30 days. Exposures of Beagle dogs by nose-only inhalation to aerosols of commercial yellowcake were completed. Biochemical indicators of kidney dysfunction that appeared in blood and urine 4 to 8 days after exposure to the more soluble yellowcake showed significant changes in dogs, but levels returned to normal by 16 days after exposure. No biochemical evidence of kidney dysfunction was observed in dogs exposed to the less soluble yellowcake form. 18 figures, 9 tables.

  1. Assessment of occupational radiation doses due to inhalation of iodine-131 by workers in some Egyptian hospitals

    International Nuclear Information System (INIS)

    Rizk, R.A.M.; Mahrous, A.; Eid, I.; HELAL, N.L.

    2006-01-01

    The present study deals with the assessment of internal radiation doses due to intake of 131 I for workers of nuclear medicine units in some hospitals in Egypt. Intake of isotopes may occur via different pathways, therefore, monitoring of workers and workplaces are integral part of the occupational radiation protection and radiation control programs. For estimating 131 I intake and consequently the internal radiation doses for some occupational radiation workers in radiotherapy sections of hospitals, 24 h urine samples were weekly collected for six weeks. The 131 I activity in three samples was measured using hyper pure germanium (HPGe) detector. The obtained results were compared with the dose limits recommended by the International Commission on Radiological Protection (ICRP, 1991)

  2. Dose calculations for infants and youths due to the inhalation of radon and its decay products in the normal environment

    International Nuclear Information System (INIS)

    Hofmann, W.; Steinhaeusler, F.

    1977-01-01

    Radon and its progenies in the atmosphere of normal working- and living-rooms contribute to parts of the respiratory tract the highest radiation load from all the natural radioactive environment. The base of todays calculations are the lung model of the ICRP-task groups and the physiological data of the ICRP-Reference Man. Both deal extensively with the problems associated with the adult but much less consideration is given to the physiological properties of the growing organism and the resulting radiation load. Functions for age dependent parameters, comprising geometrical dimensions of lung parts as well as respiratory standards were defined. With the use of a hybrid-computer the modifying influence of several parameters of the ICRP-lung model was investigated for the compartmental deposition of decay products as well as clearance effects. Furthermore typical daily routines for various ages, ranging from newborn to adult, comprising different activities, such resting, light and heavy work and times spent indoors and outdoors were considered; this shows great influence on the minute volume. Considering all these factors dose assessments were performed, which reveiled that the doses in the respiratory tract reach a maximum value for the age between 5 and 10 years. These values exceed the corresponding dose values for adults by factors of 2 and more. Dose calculations are presented for children of various ages and compared with those of male and female adults with different life patterns

  3. Space-weather MDI Active Region Patches (SMARPs)

    Science.gov (United States)

    Bobra, Monica

    2017-08-01

    We are developing a new data product from the Michelson Doppler Imager (MDI) onboard the Solar and Heliospheric Observatory (SoHO) called Space-weather MDI Active Region Patches (SMARPs). The SMARP data series provide maps of the photospheric line-of-sight magnetic field in patches that encompass automatically tracked magnetic concentrations, or active regions, for their entire lifetime. These concentrations are automatically detected in the photospheric line-of-sight magnetic field data using a method described in Turmon et al. (2010) and, thus, are necessarily different from NOAA's definition of an active region. As such, these regions are assigned their own identification number, or SMARP number, which is also linked to a NOAA active region number should it exist. In addition, keywords in the SMARP data series include parameters that concisely characterize the magnetic field distribution. These parameters may be useful for active region event forecasting and for identifying regions of interest. These parameters are calculated per patch and are available on a 96 minute cadence.The SMARP data product is designed to provide seamless coverage with its counterpart, the Space-weather HMI Active Region Patches (SHARPs), described in Bobra et al. (2014). Together, the SMARP and SHARP data series provide continuous coverage of tracked active regions for two solar cycles from 1996 to the present day. The SMARP data series, which runs from April 1996 to October 2010, contains 9496 unique active regions tracked throughout their lifetime. The SHARP data series, which runs from May 2010 to the present day, contains (as of May 30, 2017) 3883 unique active regions tracked throughout their lifetime. In addition, the two series contain 118 unique active regions during the overlap period between May and October 2010. SMARP data will be available at jsoc.stanford.edu and the photospheric line-of-sight magnetic field maps will be available in either of two different coordinate

  4. Investigation into the Manufacture and Properties of Inhalable High-Dose Dry Powders Produced by Comilling API and Lactose with Magnesium Stearate.

    Science.gov (United States)

    Lau, Michael; Young, Paul M; Traini, Daniela

    2017-08-01

    The aim of the study was to understand the impact of different concentrations of the additive material, magnesium stearate (MGST), and the active pharmaceutical ingredient (API), respectively, on the physicochemical properties and aerosol performance of comilled formulations for high-dose delivery. Initially, blends of API/lactose with different concentrations of MGST (1-7.5% w/w) were prepared and comilled by the jet-mill apparatus. The optimal concentration of MGST in comilled formulations was investigated, specifically for agglomerate structure and strength, particle size, uniformity of content, surface coverage, and aerosol performance. Secondly, comilled formulations with different API (1-40% w/w) concentrations were prepared and similarly analyzed. Comilled 5% MGST (w/w) formulation resulted in a significant improvement in in vitro aerosol performance due to the reduction in agglomerate size and strength compared to the formulation comilled without MGST. Higher concentrations of MGST (7.5% w/w) led to reduction in aerosol performance likely due to excessive surface coverage of the micronized particles by MGST, which led to failure in uniformity of content and an increase in agglomerate strength and size. Generally, comilled formulations with higher concentrations of API increased the agglomerate strength and size, which subsequently caused a reduction in aerosol performance. High-dose delivery was achieved at API concentration of >20% (w/w). The study provided a platform for the investigation of aerosol performance and physicochemical properties of other API and additive materials in comilled formulations for the emerging field of high-dose delivery by dry powder inhalation.

  5. Inhalant Abuse

    Science.gov (United States)

    ... Paper) paint thinner cleaning fluids nail polish remover rubber cement gasoline. Teenagers are the most common abusers ... severe cases, it can cause sudden death. Inhalants block oxygen flow to your brain and other organs. ...

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    The study aimed to investigate dose consistency and particle distribution from the dry powder inhalers Diskus and Turbuhaler. Full profiles of inhalation pressure versus time were recorded in 18 4 yr old and 18 8 yr old asthmatic children through Diskus and Turbuhaler inhalers. These data were us...

  7. 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 Focusing 3A. Focus ... your metered dose inhaler. Print the step-by-step instructions and keep them with your ... dose inhaler one to two inches from mouth Your browser does not support ...

  8. The effect of ethanol on the formation and physico-chemical properties of particles generated from budesonide solution-based pressurized metered-dose inhalers.

    Science.gov (United States)

    Zhu, Bing; Traini, Daniela; Chan, Hak-Kim; Young, Paul M

    2013-11-01

    The aerosol performance of budesonide solution-based pressurized metered-dose inhalers (HFA 134a), with various amounts of ethanol (5-30%, w/w) as co-solvents, was evaluated using impaction and laser diffraction techniques. With the increase of ethanol concentration in a formulation, the mass median aerodynamic diameter was increased and the fine particle fraction showed a significant decline. Although data obtained from laser diffraction oversized that of the impaction measurements, good correlations were established between the two sets of data. Particles emitted from all the five formulations in this study were amorphous, with two different types of morphology - the majority had a smooth surface with a solid core and the others were internally porous with coral-like surface morphology. The addition of ethanol in the formulation decreased the percentage of such irregular-shape particles from 52% to 2.5% approximately, when the ethanol concentration was increased from 5% to 30%, respectively. A hypothesis regarding the possible particle formation mechanisms was also established. Due to the difference of droplet composition from the designed formulation during the atomization process, the two types of particle may have gone through distinct drying processes: both droplets will have a very short period of co-evaporation, droplets with less ethanol may be dried during such period; while the droplets containing more ethanol will undergo an extra condensation stage before the final particle formation.

  9. The Skeletal Effects of Inhaled Glucocorticoids.

    Science.gov (United States)

    Sutter, Stephanie A; Stein, Emily M

    2016-06-01

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

  10. Assessment of inhalation and ingestion doses from exposure to radon gas using passive and active detecting techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ismail, A. H.; Jafaar, M. S. [Universiti Sains Malaysia, 11800 USM, Penang (Malaysia)

    2011-07-01

    The aim of this study was to assess an environmental hazard of radon exhalation rate from the samples of soil and drinking water in selected locations in Iraqi Kurdistan, passive (CR-39NTDs) and active (RAD7) detecting techniques has been employed. Long and short term measurements of emitted radon concentrations were estimated for 124 houses. High and lower radon concentration in soil samples was in the cities of Hajyawa and Er. Tyrawa, respectively. Moreover, for drinking water, high and low radon concentration was in the cities of Similan and Kelak, respectively. A comparison between our results with that mentioned in international reports had been done. Average annual dose equivalent to the bronchial epithelium, stomach and whole body in the cities of Kelak and Similan are estimated, and it was varied from 0.04{+-}0.01 mSv to 0.547{+-}0.018 mSv, (2.832{+-}0.22)x10{sup -5} to (11.972{+-}2.09)x10{sup -5} mSv, and (0.056 {+-}0.01) x10{sup -5} to (0.239{+-}0.01)x10{sup -5} mSv, respectively. This indicated that the effects of dissolved radon on the bronchial epithelium are much than on the stomach and whole body. (authors)

  11. A comparative study of indoor radon levels and inhalation dose in some areas of Punjab and Haryana, India

    International Nuclear Information System (INIS)

    Bajwa, B.S.; Singh, Harmanjit; Singh, Joga; Singh, Surinder

    2009-01-01

    Indoor radon concentrations have been measured for two consecutive half-year periods in a wide range of dwellings of some regions of Punjab and Haryana states. The objective was to find correlation between the variations of indoor radon levels with the sub-soil, local geology, type of building materials, etc. of the two regions. So keeping this in view the indoor radon measurements have been carried out in the dwellings of different villages around the Tusham ring complex, Bhiwani District, Haryana, known to be composed of acidic volcanics and the associated granites along with some villages of Amritsar District, Punjab. The indoor radon concentration in the dwellings around Tusham (Haryana) have been found to be varying from 120.5±95 to 915.2±233 Bq m -3 , whereas it ranges from 60.0±37 to 235.6±96 Bq m -3 for the dwellings of Punjab. The 222 Rn concentration observed at most of locations particularly around Tusham ring complex region is higher than that of all the villages studied in Punjab region. Local geology including embedded granitic rocks, sub-soil, etc. as well as building materials having higher radioactive content are the major contributors for the higher indoor radon levels observed in the dwelling around Tusham, where few dwellings have higher radon concentrations than the ICRP, 1993 recommendations. The annual effective dose equivalent has also been estimated for each location of the both regions, which has been found to be varying from 1.0 to 17.2 mSv/y. (author)

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

    Directory of Open Access Journals (Sweden)

    Yunes Panahi

    2013-12-01

    , Saburi A, Shohrati M, Ghanei M. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis. Asia Pac J Med Toxicol 2013;2:126-130.

  13. A new penetration test method: protection efficiency of glove and clothing materials against diphenylmethane diisocyanate (MDI).

    Science.gov (United States)

    Henriks-Eckerman, Maj-Len; Mäkelä, Erja

    2015-03-01

    Reported cases of allergic contact dermatitis caused by methylenediphenyl diisocyanate (MDI) have increased and thereby increased the need for adequate skin protection. Current standardized permeation and penetration test methods give information about efficacy of protective materials against individual components of the polyurethane systems. They do not give information of what kind of clothing materials workers should wear against splashes when handling mixed MDI-polyurethane formulations, which contain MDI, its oligomers, and polyols. The aim of this study was to develop and validate a sensitive penetration test method that can be used to select clothing that is protective enough against uncured splashes of MDI-polyurethane, still easy to use, and also, to find affordable glove materials that provide adequate protection during a short contact. The penetration of MDI through eight representative glove or clothing materials was studied with the developed test procedure. One MDI hardener and two polymeric MDI (PMDI)-polyol formulations representing different curing times were used as test substances. The materials tested included work clothing (woven) fabric, arm shields (nonwoven fabric), old T-shirt, winter gloves, and gloves of nitrile rubber, leather, vinyl (PVC), and natural rubber. A drop (50 µl) of test substance was added to the outer surface of the glove/clothing material, which had Tape Fixomull attached to the inner surface as a collection medium. After penetration times of 5 or 20min, the collecting material was removed and immediately immersed into acetonitrile containing 1-(2-methoxyphenyl)-piperazine for derivatization. The formed urea derivatives of 2,4'-MDI and 4,4'-MDI were analysed using liquid chromatography with mass spectrometric and UV detection. The precision of the test method was good for the material with high penetration (work clothing fabric) of MDI, as the relative standard deviation (RSD) was 14 and 20%. For the arm shield with a low

  14. Financial effect of converting ipratropium-albuterol therapy from inhalers to nebulizer treatments at an academic health system.

    Science.gov (United States)

    Loborec, Steven M; Johnson, Shawn E; Keating, Ellen A

    2016-02-01

    The results of a study to assess the financial impact of an automatic formulary substitution of ipratropium-albuterol nebulization solution for ipratropium-albuterol metered-dose inhalers (MDIs) at an academic health system are reported. The study was conducted at a 1242-bed urban academic health system. Data were collected regarding all respiratory medication administrations during a three-month period before the MDI-to-nebulizer substitution (October-December 2012) and the same period of 2013 (after the substitution was implemented). Purchasing data were compared between the two time periods to measure the impact of the formulary substitution on pharmacy department costs, and documented administrations were assessed to evaluate associated changes in respiratory therapist (RT) workload. With 100% prescriber compliance with the formulary substitution, the number of MDI administrations of ipratropium-albuterol declined from 13,667 in October-December 2012 to zero in the same period of 2013. The substitution required expenditures for equipment (vibrating mesh nebulizer technology and patient-specific kits) and RT personnel (one additional RT was hired), but those added costs were substantially outweighed by cost savings resulting from a substantial reduction in overall respiratory drug spending. An automatic substitution of ipratropium-albuterol nebulization solution for MDIs resulted in a three-month savings of $99,359 in drug cost and an extrapolated full-year savings of $397,436. When additional costs associated with the substitution were taken into account, there was an overall savings of $146,806 during the implementation year and a projected savings of $257,936 for each following year. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  15. Systematic Review of Errors in Inhaler Use

    DEFF Research Database (Denmark)

    Sanchis, Joaquin; Gich, Ignasi; Pedersen, Søren

    2016-01-01

    in these outcomes over these 40 years and when partitioned into years 1 to 20 and years 21 to 40. Analyses were conducted in accordance with recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Strengthening the Reporting of Observational Studies in Epidemiology. Results Data...... A systematic search for articles reporting direct observation of inhaler technique by trained personnel covered the period from 1975 to 2014. Outcomes were the nature and frequencies of the three most common errors; the percentage of patients demonstrating correct, acceptable, or poor technique; and variations...... were extracted from 144 articles reporting on a total number of 54,354 subjects performing 59,584 observed tests of technique. The most frequent MDI errors were in coordination (45%; 95% CI, 41%-49%), speed and/or depth of inspiration (44%; 40%-47%), and no postinhalation breath-hold (46%; 42...

  16. Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

    International Nuclear Information System (INIS)

    McIntosh, Alyson; Shoushtari, Asal N.; Benedict, Stanley H.; Read, Paul W.; Wijesooriya, Krishni

    2011-01-01

    Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0–3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 ± 3 mm inferior, 1 ± 2 mm right, and 1 ± 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

  17. Nicotine Oral Inhalation

    Science.gov (United States)

    Nicotine oral inhalation is used to help people stop smoking. Nicotine oral inhalation should be used together with a ... support groups, counseling, or specific behavioral change techniques. Nicotine inhalation is in a class of medications called ...

  18. Substance use - inhalants

    Science.gov (United States)

    ... types of abused inhalants are: Aerosols, such as air freshener, deodorant, fabric protector, hair spray, vegetable oil spray, ... aerosol into the nose or mouth Glading. Inhaling air-freshener aerosols Huffing. Inhaling from a rag soaked with ...

  19. Safety, Tolerability and Pharmacokinetics of Single Doses of Oxytocin Administered via an Inhaled Route in Healthy Females: Randomized, Single-blind, Phase 1 Study

    Directory of Open Access Journals (Sweden)

    Disala Fernando

    2017-08-01

    Interpretation: These data suggest that similar oxytocin systemic exposure can be achieved with IM and IH administration routes, and no safety concerns were identified with either route. The inhalation route may offer the opportunity to increase access to oxytocin for women giving birth in resource-poor settings.

  20. Design and in vitro performance testing of multiple air classifier technology in a new disposable inhaler concept (Twincer (R)) for high powder doses

    NARCIS (Netherlands)

    de Boer, Anne H; Hagedoorn, Paul; Westerman, Elsbeth M; Le Brun, Paul P H; Heijerman, Harry G M; Frijlink, Henderik W

    2006-01-01

    Dry powder inhalation of antibiotics in cystic fibrosis (CF) therapy may be a valuable alternative for wet nebulisation, because it saves time and it improves lung deposition. In this study, it is shown that the use of multiple air classifier technology enables effective dispersion of large amounts

  1. Know How to Use Your Asthma Inhaler

    Medline Plus

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

  2. 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

  3. Towards an inhalative in vivo application of immunomodulating gelatin nanoparticles in horse-related preformulation studies.

    Science.gov (United States)

    Fuchs, Sebastian; Klier, John; May, Anna; Winter, Gerhard; Coester, Conrad; Gehlen, Heidrun

    2012-01-01

    Delivering active ingredients using biocompatible and biodegradable carriers such as gelatin nanoparticles (GNPs) to the lung constitutes a promising non-invasive route of administration. However, the pulmonary delivery of nanoparticle-based immunotherapy is still a field that requires more clarification. In this study, GNPs loaded with cytosine-phosphate-guanine oligodeoxynucleotides (CpG-ODN)-loaded and plain GNPs were aerosolised either by a conventional pressured metered dose inhaler (pMDI) or by active or passive vibrating-mesh (VM) nebulisers. GNP sizes after nebulisation by active and passive VM nebulisers were 248.2 ± 7.34 and 222.3 ± 1.42 nm, respectively. GNP concentrations after aerosolisation were found consistent and second-stage particle deposition in an impinger was up to 65.68 ± 11.2% of the nebulised dose. VM nebulisers produced high fine particle fractions, while pMDIs did not. Nebulised CpG-ODN-loaded GNPs remained capable to stimulate IL-10 release (225.2 ± 56.3 pg/ml) in vitro from equine alveolar lymphocytes. Thus, a novel system for pulmonary GNP-mediated immunotherapy in vivo was established.

  4. 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....

  5. Effect of pMDI isocyanate additive on mechanical and thermal ...

    Indian Academy of Sciences (India)

    Abstract. The effect of polymeric methylene diphenyl diisocyanate (pMDI) on mechanical and thermal properties of Kenaf fibre (KF) reinforced thermoplastic polyurethane (TPU) composites was studied. Various percentages viz. 2%, 4% and 6%, were studied. The composites were characterized by using tensile testing, ...

  6. 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

  7. Effects of Known Determinants on Methylene Bisphenyl Isocyanate (MDI) Concentration During Spray-On Truck Bed-Lining Processes.

    Science.gov (United States)

    Schaal, Nicholas C; Brazile, William J; Finnie, Katie L; Tiger, James P

    2017-08-01

    Occupational exposure to methylene bisphenyl isocyanate (MDI) presents serious worker health concerns as it may lead to short- and long-term health effects such as asthma, airway irritation, hypersensitivity pneumonitis, and irritation of skin and mucous membranes. While studies of worker isocyanate exposures during vehicle painting activities are widespread, few studies have investigated the spray-on truck bed-liner (STBL) industry. The purpose of this study was to determine the effectiveness of several ventilation system variables and process characteristics in controlling MDI concentrations in the STBL industry. A total of 47 personal air samples were collected for MDI during 18 site visits at nine STBL companies in Colorado and Wyoming. Ventilation system and process characteristics that were assessed included: ventilation system face velocity, airflow, air changes per minute (AC/M), capture velocity, percent of MDI in bed-liner product, application temperature, application pressure, paint booth temperature, paint booth relative humidity, paint booth volume, and quantity of bed-liner product applied. Pearson correlation revealed percentage of MDI in bed-liner product (r = 0.557, n = 14, P < 0.05) and process temperature (r = 0.677, n = 14, P < 0.05) had high positive correlation with MDI concentration. Ventilation system face velocity (r = -0.578, n = 14, P < 0.05) and AC/M (r = -0.657, n = 14, P < 0.05) had high negative correlation with MDI concentration while airflow (r = -0.475, n = 14, P < 0.05) and capture velocity (r = -0.415, n = 14, P = 0.07) had moderate negative correlation with MDI concentration. Multiple linear regression revealed process temperature and capture velocity made a statistically significant and unique contribution in estimating MDI concentration (F (2, 11) = 10.99, P < 0.05) with an adjusted R2 of 0.61, explaining 61% of the variability in MDI concentration. This investigation contributed to an understudied STBL industry by targeting

  8. 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...... a dose on a microg kg(-1) basis caused reduced systemic exposure in young children (Y) compared with older children (O) (C(max-microg kg(-1)-adjusted) Y : O ratio (95%CI) = 0.55 (0.47, 0.65)) whereas a fixed nominal dose irrespective of age caused increased exposure in young children (C(max) Y : O ratio...... (95%CI) = 1.7 (1.3, 2.2)). CONCLUSIONS: For similar systemic exposure, dosing should be adjusted to age or size but not on a fixed microg kg(-1) basis, which may lead to unnecessary suboptimal dosing....

  9. Propose of a model for dose and hazard calculation due the Rn-222, Rn-220 and its short half-life daugthers inhalation

    International Nuclear Information System (INIS)

    Mauricio, C.L.P.

    1982-01-01

    The compartimental dosimetric model is used to simulate, by computer, the interactions of the inhalated radon atom radiations and its short half-life daugthers with cells. The metabolic trajectory of these radionuclides is described by differential equations of continuous medium dynamics, where the elements transform by radioactive decay. This work permits to determine the individual retenction function, beeing useful in radioprotection routines or emergence situations. The results of internal dosimetry are consistent with the new I.C.R.P. - 32 international recommendations. (L.C.) [pt

  10. 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

  11. 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

  12. An inhaled dose of budesonide induces genes involved in transcription and signaling in the human airways: enhancement of anti- and proinflammatory effector genes.

    Science.gov (United States)

    Leigh, Richard; Mostafa, Mahmoud M; King, Elizabeth M; Rider, Christopher F; Shah, Suharsh; Dumonceaux, Curtis; Traves, Suzanne L; McWhae, Andrew; Kolisnik, Tyler; Kooi, Cora; Slater, Donna M; Kelly, Margaret M; Bieda, Mark; Miller-Larsson, Anna; Newton, Robert

    2016-08-01

    Although inhaled glucocorticoids, or corticosteroids (ICS), are generally effective in asthma, understanding their anti-inflammatory actions in vivo remains incomplete. To characterize glucocorticoid-induced modulation of gene expression in the human airways, we performed a randomized placebo-controlled crossover study in healthy male volunteers. Six hours after placebo or budesonide inhalation, whole blood, bronchial brushings, and endobronchial biopsies were collected. Microarray analysis of biopsy RNA, using stringent (≥2-fold, 5% false discovery rate) or less stringent (≥1.25-fold, P  ≤   0.05) criteria, identified 46 and 588 budesonide-induced genes, respectively. Approximately two third of these genes are transcriptional regulators (KLF9, PER1, TSC22D3, ZBTB16), receptors (CD163, CNR1, CXCR4, LIFR, TLR2), or signaling genes (DUSP1, NFKBIA, RGS1, RGS2, ZFP36). Listed genes were qPCR verified. Expression of anti-inflammatory and other potentially beneficial genes is therefore confirmed and consistent with gene ontology (GO) terms for negative regulation of transcription and gene expression. However, GO terms for transcription, signaling, metabolism, proliferation, inflammatory responses, and cell movement were also associated with the budesonide-induced genes. The most enriched functional cluster indicates positive regulation of proliferation, locomotion, movement, and migration. Moreover, comparison with the budesonide-induced expression profile in primary human airway epithelial cells shows considerable cell type specificity. In conclusion, increased expression of multiple genes, including the transcriptional repressor, ZBTB16, that reduce inflammatory signaling and gene expression, occurs in the airways and blood and may contribute to the therapeutic efficacy of ICS. This provides a previously lacking insight into the in vivo effects of ICS and should promote strategies to improve glucocorticoid efficacy in inflammatory diseases.

  13. 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 ...

  14. 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 ...

  15. 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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    improvement in lung function throughout 12 weeks. Both MF/F doses were superior to MF in improving asthma control and reducing nocturnal awakenings due to asthma requiring short-acting beta(2)-agonist use. All treatments were well tolerated. Asthma patients who were poorly controlled on high-dose ICS...... 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...... recorded. Seven hundred twenty-eight patients were randomized. Significant improvement from baseline to week 12 occurred for mean change in FEV(1) AUC(0-12h) with MF/F 400/10 microg (4.19 L x hour) versus MF 400 microg (2.04 L x hour; p

  17. 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

  18. A dose and time response Markov model for the in-host dynamics of infection with intracellular bacteria following inhalation: with application to Francisella tularensis.

    Science.gov (United States)

    Wood, R M; Egan, J R; Hall, I M

    2014-06-06

    In a novel approach, the standard birth-death process is extended to incorporate a fundamental mechanism undergone by intracellular bacteria, phagocytosis. The model accounts for stochastic interaction between bacteria and cells of the immune system and heterogeneity in susceptibility to infection of individual hosts within a population. Model output is the dose-response relation and the dose-dependent distribution of time until response, where response is the onset of symptoms. The model is thereafter parametrized with respect to the highly virulent Schu S4 strain of Francisella tularensis, in the first such study to consider a biologically plausible mathematical model for early human infection with this bacterium. Results indicate a median infectious dose of about 23 organisms, which is higher than previously thought, and an average incubation period of between 3 and 7 days depending on dose. The distribution of incubation periods is right-skewed up to about 100 organisms and symmetric for larger doses. Moreover, there are some interesting parallels to the hypotheses of some of the classical dose-response models, such as independent action (single-hit model) and individual effective dose (probit model). The findings of this study support experimental evidence and postulations from other investigations that response is, in fact, influenced by both in-host and between-host variability.

  19. Comparison in the calculation of committed effective dose using the ICRP 30 and ICRP 60 models for a repeated incorporation by inhalation of I-125

    International Nuclear Information System (INIS)

    Carreno P, A.L.; Cortes C, A.; Alonso V, G.; Serrano P, F.

    2005-01-01

    Presently work, a comparison in the calculation of committed effective dose using the models of the ICRP 30 and those of the ICRP 60 for the analysis of internal dose due to repeated incorporation of I-125 is shown. The estimations of incorporated activity are obtained starting from the proportionate data for an exercise of inter comparison, with which it should be determined the internal dose later on. For to estimate the initial activity incorporated by repeated dose was assumed that this it was given through of multiple individual incorporations which happened in the middle points of the monitoring periods. The results using the models of the ICRP 30 and of the ICRP 60 are compared and the causes of the differences are analyzed. (Author)

  20. The influence of exercise and dehydration on the urine concentrations of salbutamol after inhaled administration of 1600 µg salbutamol as a single dose in relation to doping analysis

    DEFF Research Database (Denmark)

    Haase, Christoffer Bjerre; Backer, Vibeke; Kalsen, Anders

    2016-01-01

    The present study investigated the influence of exercise and dehydration on the urine concentrations of salbutamol after inhalation of that maximal permitted (1600 µg) on the 2015 World Anti-Doping Agency (WADA) prohibited list. Thirteen healthy males participated in the study. Urine concentrations...... of salbutamol were measured during three conditions: exercise (EX), exercise+dehydration (EXD), and rest (R). Exercise consisted of 75 min cycling at 60% of VO2max and a 20-km time-trial. Fluid intake was 2300, 270, and 1100 mL during EX, EXD, and R, respectively. Urine samples of salbutamol were collected 0.......0±0.7 ng/mL) than EX(3.8±0.8 ng/mL) and EXD(3.6±0.8 ng/mL). AUC was lower for R (14.1±2.8 ng/mL·∙h) than EX (16.9±2.9 ng/mL·∙h)(Pdehydration affect urine concentrations of salbutamol and increase the risk of Adverse Analytical Findings...

  1. Inhaler devices for patients with COPD.

    Science.gov (United States)

    Fink, James B; Colice, Gene L; Hodder, Rick

    2013-08-01

    Chronic obstructive pulmonary disease (COPD) continues to be associated with increased morbidity and mortality risk in spite of updated guidelines and a better understanding of this condition. Progressive airflow limitation and resultant hyperinflation-the respiratory hallmarks of this complex and often under-diagnosed disease-can be treated with pharmacotherapies emitted via nebulizers, pressurized metered-dose inhalers, dry powder inhalers, or a Soft Mist inhaler. Pharmaceutical company proprietary issues, technological innovations, and societal pressure have expanded the list of available inhalers, with a limited range of medications available for any one device. Each device has different operating and maintenance instructions, and successful use of a given drug/device combination requires that patients understand, maintain, and use each of their devices properly in order to ensure consistent and optimal pulmonary drug delivery. Clinicians are faced with a range of physical and psychosocial issues unique to each patient with COPD that must be overcome in order to match a suitable inhaler to the individual. Improved drug delivery afforded by next-generation inhalers, coupled with an awareness of device-specific and patient-specific variables affecting inhaler use, may improve clinical outcomes in the treatment of COPD.

  2. Inhalation therapy in mechanical ventilation

    Science.gov (United States)

    Maccari, Juçara Gasparetto; Teixeira, Cassiano; Gazzana, Marcelo Basso; Savi, Augusto; Dexheimer-Neto, Felippe Leopoldo; Knorst, Marli Maria

    2015-01-01

    Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients. PMID:26578139

  3. Biotransformation of 2,3,3,3-tetrafluoropropene (HFO-1234yf) in male, pregnant and non-pregnant female rabbits after single high dose inhalation exposure.

    Science.gov (United States)

    Schmidt, Tobias; Bertermann, Rüdiger; Rusch, George M; Hoffman, Gary M; Dekant, Wolfgang

    2012-08-15

    2,3,3,3-Tetrafluoropropene (HFO-1234yf) is a novel refrigerant intended for use in mobile air conditioning. It showed a low potential for toxicity in rodents studies with most NOAELs well above 10,000 ppm in guideline compliant toxicity studies. However, a developmental toxicity study in rabbits showed mortality at exposure levels of 5,500 ppm and above. No lethality was observed at exposure levels of 2,500 and 4,000 ppm. Nevertheless, increased subacute inflammatory heart lesions were observed in rabbits at all exposure levels. Since the lethality in pregnant animals may be due to altered biotransformation of HFO-1234yf and to evaluate the potential risk to pregnant women facing a car crash, this study compared the acute toxicity and biotransformation of HFO-1234yf in male, female and pregnant female rabbits. Animals were exposed to 50,000 ppm and 100,000 ppm for 1h. For metabolite identification by (19)F NMR and LC/MS-MS, urine was collected for 48 h after inhalation exposure. In all samples, the predominant metabolites were S-(3,3,3-trifluoro-2-hydroxypropanyl)-mercaptolactic acid and N-acetyl-S-(3,3,3-trifluoro-2-hydroxypropanyl)-L-cysteine. Since no major differences in urinary metabolite pattern were observed between the groups, only N-acetyl-S-(3,3,3-trifluoro-2-hydroxypropanyl)-L-cysteine excretion was quantified. No significant differences in recovery between non-pregnant (43.10 ± 22.35 μmol) and pregnant female (50.47 ± 19.72 μmol) rabbits were observed, male rabbits exposed to 100,000 ppm for one hour excreted 86.40 ± 38.87 μmol. Lethality and clinical signs of toxicity were not observed in any group. The results suggest that the lethality of HFO-1234yf in pregnant rabbits unlikely is due to changes in biotransformation patterns or capacity in pregnant rabbits. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Biotransformation of 2,3,3,3-tetrafluoropropene (HFO-1234yf) in male, pregnant and non-pregnant female rabbits after single high dose inhalation exposure

    International Nuclear Information System (INIS)

    Schmidt, Tobias; Bertermann, Rüdiger; Rusch, George M.; Hoffman, Gary M.; Dekant, Wolfgang

    2012-01-01

    2,3,3,3-Tetrafluoropropene (HFO-1234yf) is a novel refrigerant intended for use in mobile air conditioning. It showed a low potential for toxicity in rodents studies with most NOAELs well above 10,000 ppm in guideline compliant toxicity studies. However, a developmental toxicity study in rabbits showed mortality at exposure levels of 5,500 ppm and above. No lethality was observed at exposure levels of 2,500 and 4,000 ppm. Nevertheless, increased subacute inflammatory heart lesions were observed in rabbits at all exposure levels. Since the lethality in pregnant animals may be due to altered biotransformation of HFO-1234yf and to evaluate the potential risk to pregnant women facing a car crash, this study compared the acute toxicity and biotransformation of HFO-1234yf in male, female and pregnant female rabbits. Animals were exposed to 50,000 ppm and 100,000 ppm for 1 h. For metabolite identification by 19 F NMR and LC/MS-MS, urine was collected for 48 h after inhalation exposure. In all samples, the predominant metabolites were S-(3,3,3-trifluoro-2-hydroxypropanyl)-mercaptolactic acid and N-acetyl-S-(3,3,3-trifluoro-2-hydroxypropanyl)-L-cysteine. Since no major differences in urinary metabolite pattern were observed between the groups, only N-acetyl-S-(3,3,3-trifluoro-2-hydroxypropanyl)-L-cysteine excretion was quantified. No significant differences in recovery between non-pregnant (43.10 ± 22.35 μmol) and pregnant female (50.47 ± 19.72 μmol) rabbits were observed, male rabbits exposed to 100,000 ppm for one hour excreted 86.40 ± 38.87 μmol. Lethality and clinical signs of toxicity were not observed in any group. The results suggest that the lethality of HFO-1234yf in pregnant rabbits unlikely is due to changes in biotransformation patterns or capacity in pregnant rabbits. -- Highlights: ► No lethality and clinical signs were observed. ► No differences in metabolic pattern between pregnant and non-pregnant rabbits. ► Rapid and similar metabolite

  5. Propossal of a model for the calculation of doses and of the risk due to inhalation and ingestion of radionuclides from nuclear facilities

    International Nuclear Information System (INIS)

    Bertelli Neto, L.

    1980-10-01

    An improvement of existing models for the various body components and simulates the human body metabolic behaviour as a whole, are presented. It takes into account the uptake of material, via nose or mouth, up to its excretion by urine or faeces. It has an aditional choice for calculation, which permits the evaluation of the quantity of material that has settled inside the organism, using the data obtained from the quantitative analysis of the excreta. The simulation of the metabolic process leads to the possibility of dose and detriment estimation as well as the corresponding mortality and genetic risks. Metabolic tests were made for physiological comparison and for the determination of the whole body dose equivalent. Tests were made, using different intake and excretion activities, to verify the validity of the proposed model. (E.G.) [pt

  6. 1-Bromopropane, an alternative to ozone layer depleting solvents, is dose-dependently neurotoxic to rats in long-term inhalation exposure.

    Science.gov (United States)

    Ichihara, G; Kitoh, J; Yu, X; Asaeda, N; Iwai, H; Kumazawa, T; Shibata, E; Yamada, T; Wang, H; Xie, Z; Takeuchi, Y

    2000-05-01

    1-Bromopropane has been newly introduced as an alternative to ozone layer-depleting solvents. We aimed to clarify the dose-dependent effects of 1-bromopropane on the nervous system. Forty-four Wistar male rats were randomly divided into 4 groups of 11 each. The groups were exposed to 200, 400, or 800 ppm of 1-bromopropane or only fresh air 8 h per day for 12 weeks. Grip strength of forelimbs and hind limbs, maximum motor nerve conduction velocity (MCV), and distal latency (DL) of the tail nerve were measured in 9 rats of each group every 4 weeks. The other 2 rats of each group were perfused at the end of the experiment for morphological examinations. The rats of the 800-ppm group showed poor kicking and were not able to stand still on the slope. After a 12-week exposure, forelimb grip strength decreased significantly at 800 ppm and hind limb grip strength decreased significantly at both 400 and 800 ppm or after a 12-week exposure. MCV and DL of the tail nerve deteriorated significantly at 800 ppm. Ovoid or bubble-like debris of myelin sheaths was prominent in the unraveled muscular branch of the posterior tibial nerve in the 800-ppm group. Swelling of preterminal axons in the gracile nucleus increased in a dose-dependent manner. Plasma creatine phosphokinase (CPK) decreased dose-dependently with significant changes at 400 and 800 ppm. 1-Bromopropane induced weakness in the muscle strength of rat limbs and deterioration of MCV and DL in a dose-dependent manner, with morphological changes in peripheral nerve and preterminal axon in the gracile nucleus. 1-Bromopropane may be seriously neurotoxic to humans and should thus be used carefully in the workplace.

  7. OKORLEY .mdi

    African Journals Online (AJOL)

    USER

    area under coconut cultivation in Ghana is estimated as 43000 ha (Dery et al., 1995). The coconut, like oil palm is an economic crop in Ghana. The crop serves several economic purposes ranging from the provision of fuel, food, indigenous building materials to industrial raw materials including fibre and oil. Coconut was a.

  8. Automated recognition and characterization of solar active regions based on the SOHO/MDI images

    Science.gov (United States)

    Pap, J. M.; Turmon, M.; Mukhtar, S.; Bogart, R.; Ulrich, R.; Froehlich, C.; Wehrli, C.

    1997-01-01

    The first results of a new method to identify and characterize the various surface structures on the sun, which may contribute to the changes in solar total and spectral irradiance, are shown. The full disk magnetograms (1024 x 1024 pixels) of the Michelson Doppler Imager (MDI) experiment onboard SOHO are analyzed. Use of a Bayesian inference scheme allows objective, uniform, automated processing of a long sequence of images. The main goal is to identify the solar magnetic features causing irradiance changes. The results presented are based on a pilot time interval of August 1996.

  9. 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.

  10. 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

  11. 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

  12. 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)

  13. 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

  14. 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

  15. Know How to Use Your Asthma Inhaler

    Medline Plus

    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 ...

  16. Terbutaline accumulates in blood and urine following daily therapeutic inhalation

    DEFF Research Database (Denmark)

    Krogh, Nanna; Rzeppa, Sebastian; Dyreborg, Anders

    2017-01-01

    PURPOSE: This study investigated pharmacokinetics of terbutaline after single and seven consecutive days of inhalation in exercising trained men. METHODS: Twelve healthy young trained men underwent two pharmacokinetic trials comparing single dose (2 mg) and seven consecutive days (2 mg×d) of inha......PURPOSE: This study investigated pharmacokinetics of terbutaline after single and seven consecutive days of inhalation in exercising trained men. METHODS: Twelve healthy young trained men underwent two pharmacokinetic trials comparing single dose (2 mg) and seven consecutive days (2 mg......×d) of inhaled terbutaline. After inhalation of terbutaline at each trial, subjects performed 90 min of bike ergometer exercise at 65% of maximal oxygen consumption after which they stayed inactive. Blood and urine samples were collected before and after inhalation of terbutaline. Samples were analyzed by high...

  17. Reasons for Inhalant Use.

    Science.gov (United States)

    Joe, George W.; Simpson, D. Dwayne

    1991-01-01

    Among 110 Mexican-American adolescents in a Texas drug abuse program, initial use of toxicant inhalants was related to availability and sensation-seeking, followed by psychological problems, parental and home problems, and peer influence. Quitting inhalant use was related to social pressures, attitude change, and perceived health risks. (Author/SV)

  18. Pediatric inhalation injury

    OpenAIRE

    Sen, Soman

    2017-01-01

    Smoke inhalation injury can cause severe physiologic perturbations. In pediatric patients, these perturbations cause profound changes in cardiac and pulmonary physiology. In this review, we examine the pathology, early management options, ventilator strategy, and long-term outcomes in pediatric patients who have suffered a smoke inhalation injury.

  19. 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...

  20. Inhalation devices: from basic science to practical use, innovative vs generic products.

    Science.gov (United States)

    Pirozynski, Michal; Sosnowski, Tomasz R

    2016-11-01

    Inhalation therapy is a convenient method of treating respiratory diseases. The key factors required for inhalation are the preparation of drug carriers (aerosol particles) allowing reproducible dosing during administration. These technical challenges are accomplished with a variety of inhalation devices (inhalers) and medicinal formulations, which are optimized to be easily converted into inhalable aerosols. Areas covered: This review is focused on the most important, but often overlooked, effects, which are required for the reliable and reproducible inhalable drug administration. The effects of patient-related issues that influence inhalation therapy, such as proper selection of inhalers for specific cases is discussed. We also discuss factors that are the most essential if generic inhalation product should be considered equivalent to the drugs with the clinically confirmed efficacy. Expert opinion: Proper device selection is crucial in clinical results of inhalation therapy. The patients' ability to coordinate inhalation with actuation, generation of optimal flow through the device, use of optimal inspiratory volume, all produces crucial effects on disease control. Also the severity of the disease process effects proper use of inhalers. Interchanging of inhalers can produce potentially conflicting problem regarding efficacy and safety of inhalation therapy.

  1. Inhaled corticosteroids for cystic fibrosis.

    Science.gov (United States)

    Balfour-Lynn, Ian M; Welch, Karen

    2016-08-23

    participants were randomised and less than half of the included trials gave details on how allocation was concealed. Trials were generally judged to have a low risk of bias from blinding, except for two which were open label or did not use a placebo. There were some concerns that a number of trials had not been published in peer-reviewed journals, but the risk of bias from this was unclear. Inclusion criteria varied between trials, as did type and duration of treatment and timing of outcome assessments. Objective measures of airway function were reported in most trials but were often incomplete. Significant benefit has not been conclusively demonstrated. Four trials systematically documented adverse effects and growth was significantly affected in one study using high doses. Evidence from these trials is insufficient to establish whether inhaled corticosteroids are beneficial in cystic fibrosis, but withdrawal in those already taking them has been shown to be safe. There is some evidence they may cause harm in terms of growth. It has not been established whether long-term use is beneficial in reducing lung inflammation, which should improve survival, but it is unlikely this will be proven conclusively in a randomised controlled trial.

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    The study aimed to investigate dose consistency and particle distribution from the dry powder inhalers Diskus and Turbuhaler. Full profiles of inhalation pressure versus time were recorded in 18 4 yr old and 18 8 yr old asthmatic children through Diskus and Turbuhaler inhalers. These data were used...... represents the changes in flow rate over time through the device than the constant flow rate usually applied with an impactor alone. The aerosol cloud was released before the peak inspiratory effort had been achieved and accordingly the early part and not the peak of the inspiratory performance...... the varying age groups and inspiratory flow performances when compared to the Turbuhaler in terms of the proportion of the dose emitted at each particle size. This improvement is at the expense of a low fine particle mass and a high proportion of coarse particles from the Diskus as compared...

  8. Albuterol Oral Inhalation

    Science.gov (United States)

    ... Corgard), and propranolol (Inderal); digoxin (Lanoxin); diuretics ('water pills'); epinephrine (Epipen, Primatene Mist); other inhaled medications used to relax the air passages such as metaproterenol and levalbuterol (Xopenex); and ...

  9. Ipratropium Oral Inhalation

    Science.gov (United States)

    Ipratropium oral inhalation is used to prevent wheezing, shortness of breath, coughing, and chest tightness in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of ...

  10. Insulin Human Inhalation

    Science.gov (United States)

    Insulin inhalation is used in combination with a long-acting insulin to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar ...

  11. Cromolyn Oral Inhalation

    Science.gov (United States)

    ... your doctor.Cromolyn oral 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. Your doctor will prescribe ...

  12. Automated bolus advisor control and usability study (ABACUS): does use of an insulin bolus advisor improve glycaemic control in patients failing multiple daily insulin injection (MDI) therapy? [NCT01460446].

    Science.gov (United States)

    Cavan, David A; Ziegler, Ralph; Cranston, Iain; Barnard, Katharine; Ryder, Jacqueline; Vogel, Claudia; Parkin, Christopher G; Koehler, Walter; Vesper, Iris; Petersen, Bettina; Wagner, Robin S

    2012-10-13

    People with T1DM and insulin-treated T2DM often do not follow and/or adjust their insulin regimens as needed. Key contributors to treatment non-adherence are fear of hypoglycaemia, difficulty and lack of self-efficacy associated with insulin dose determination. Because manual calculation of insulin boluses is both complex and time consuming, people may rely on empirical estimates, which can result in persistent hypoglycaemia and/or hyperglycaemia. Use of automated bolus advisors (BA) has been shown to help insulin pump users to more accurately meet prandial insulin dosage requirements, improve postprandial glycaemic excursions, and achieve optimal glycaemic control with an increased time within optimal range. Use of a BA containing an early algorithm based on sliding scales for insulin dosing has also been shown to improve HbA1c levels in people treated with multiple daily insulin injections (MDI). We designed a study to determine if use of an automated BA can improve clinical and psychosocial outcomes in people treated with MDI. The Automated Bolus Advisor Control and Usability Study (ABACUS) is a 6-month, prospective, randomised, multi-centre, multi-national trial to determine if automated BA use improves glycaemic control as measured by a change in HbA1c in people using MDI with elevated HbA1c levels (#62;7.5%). A total of 226 T1DM and T2DM participants will be recruited. Anticipated attrition of 20% will yield a sample size of 90 participants, which will provide #62;80% power to detect a mean difference of 0.5%, with SD of 0.9%, using a one-sided 5% t-test, with 5% significance level. Other measures of glycaemic control, self-care behaviours and psychosocial issues will also be assessed. It is critical that healthcare providers utilise available technologies that both facilitate effective glucose management and address concerns about safety and lifestyle. Automated BAs may help people using MDI to manage their diabetes more effectively and minimise the risk of

  13. Automated bolus advisor control and usability study (ABACUS: does use of an insulin bolus advisor improve glycaemic control in patients failing multiple daily insulin injection (MDI therapy? [NCT01460446

    Directory of Open Access Journals (Sweden)

    Cavan David A

    2012-10-01

    Full Text Available Abstract Background People with T1DM and insulin-treated T2DM often do not follow and/or adjust their insulin regimens as needed. Key contributors to treatment non-adherence are fear of hypoglycaemia, difficulty and lack of self-efficacy associated with insulin dose determination. Because manual calculation of insulin boluses is both complex and time consuming, people may rely on empirical estimates, which can result in persistent hypoglycaemia and/or hyperglycaemia. Use of automated bolus advisors (BA has been shown to help insulin pump users to more accurately meet prandial insulin dosage requirements, improve postprandial glycaemic excursions, and achieve optimal glycaemic control with an increased time within optimal range. Use of a BA containing an early algorithm based on sliding scales for insulin dosing has also been shown to improve HbA1c levels in people treated with multiple daily insulin injections (MDI. We designed a study to determine if use of an automated BA can improve clinical and psychosocial outcomes in people treated with MDI. Methods/design The Automated Bolus Advisor Control and Usability Study (ABACUS is a 6-month, prospective, randomised, multi-centre, multi-national trial to determine if automated BA use improves glycaemic control as measured by a change in HbA1c in people using MDI with elevated HbA1c levels (#62;7.5%. A total of 226 T1DM and T2DM participants will be recruited. Anticipated attrition of 20% will yield a sample size of 90 participants, which will provide #62;80% power to detect a mean difference of 0.5%, with SD of 0.9%, using a one-sided 5% t-test, with 5% significance level. Other measures of glycaemic control, self-care behaviours and psychosocial issues will also be assessed. Discussion It is critical that healthcare providers utilise available technologies that both facilitate effective glucose management and address concerns about safety and lifestyle. Automated BAs may help people using MDI to

  14. Radioactive gas inhalator

    International Nuclear Information System (INIS)

    LeMon, D.E.

    1975-01-01

    An ''inhalator'', or more particularly an apparatus for permitting a patient to inhale a radioactive gas in order to provide a diagnostic test of the patient's lung area, is described. The disclosed apparatus provides a simple, trouble-free mechanism for achieving this result; and, furthermore, provides an improved testing method. Moreover, the disclosed apparatus has the capability of gradually introducing the test condition in a manner that makes it easy for the patient to become acclimated to it. (U.S.)

  15. 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

  16. 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...

  17. Effectiveness of Inhalant Abuse Legislation.

    Science.gov (United States)

    Batis, Jeffery C

    2017-01-28

    Since peaking in the 1990s, inhalant abuse has steadily decreased over the past two decades. Concurrently, nearly every state has passed legislation aimed at minimizing inhalant abuse. While males have historically been more likely to abuse inhalants than females, there is no longer a sex effect in self-reported rates of inhalant abuse. The objective of the present study is to evaluate the effect of anti-inhalant abuse legislation on self-reported rates of inhalant abuse, in high school age males and females. Beginning in 1993, the CDC's biannual Youth Risk Behavior Surveillance Survey asked respondents if they have ever used inhalants to get high. Data from these surveys were collected, along with the date of passage of anti-inhalant abuse legislation in 46 of 50 states. ANOVAs were conducted to assess the effect of legislation on self-reported inhalant abuse rates. There were no significant main effects or interactions that demonstrated that inhalant abuse rates decreased in males or females following passage of legislation aimed at decreasing inhalant abuse. Conclusion/Importance: To date, 46 of 50 states have passed laws aimed at minimizing inhalant abuse, and while inhalant abuse rates have been decreasing for the past two decades, there is no evidence that this decline is related to enactment of these laws. Further research is needed to determine the cause of the decrease in inhalant abuse. The laws may benefit from amendments to include options for treatment.

  18. 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)

  19. Evaluation of the effects of zafirlukast 40 mg b.i.d. in addition to preexisting therapy of high-dose inhaled steroids on symptomatic patients with reversible respiratory obstruction: preliminary data.

    Science.gov (United States)

    Centanni, S; Santus, P; Casanova, F; Di Marco, F; Brazzola, G; Canonica, G W

    2000-01-01

    Clinical evidence of the efficacy of zafirlukast is available for mild-to-moderate asthma, but further evidence is needed on its use in the more severe forms, uncontrolled by traditional therapy. The aim of this study was to evaluate the efficacy of zafirlukast 40 mg b.i.d. as an add-on to high dose inhaled corticosteroids (HDICs). A secondary aim was to assess the drug's safety and the patients' evaluation of oral therapy and compliance. Twenty-two asthmatic patients (13 females, aged 12-70 years) taking short-acting beta 2-agonists as needed and HDICs as maintenance therapy, entered a 2-week screening phase. At the end, 18 patients with baseline forced expiratory volume (FEV)1 = 50-80% of predicted, a reversibility of > or = 15% and a > or = 10 weekly total of daytime symptom score, were given zafirlukast 40 mg b.i.d. and were reevaluated every 4 weeks for 12 weeks. Adverse events, withdrawals and changes in hematology were recorded. A diary and a questionnaire were used for subjective patient assessment. Sixteen patients (nine females, mean age 40) completed the study. Mean FEV1, (absolute value and percentage vs. predicted) was significantly higher (p < 0.05) vs. baseline after zafirlukast, with a mean improvement of 0.2 l/sec (2.4 vs. 2.2) or 6% (76% vs. 70%) of predicted. Similarly, a significant (p < 0.001) increase in peak expiratory flow was observed (6 vs. 5.5 l/sec). There was no statistically significant variation in forced expiratory flow 25-75. Analysis of the diaries showed a statistically significant reduction (p < 0.05) of morning symptoms (0.73 vs. 4.6) and of daytime symptoms score (2.3 vs. 5.3). There was no evidence of improvement in night time symptoms and use of beta 2-agonists. Three patients experienced adverse events and four suffered a single exacerbation not requiring hospital admission. Subjective evaluation was positive: 75% reported an improvement, 25% found no change and 40% particularly appreciated the oral therapy. In conclusion

  20. Inhaled americium dioxide

    International Nuclear Information System (INIS)

    Park, J.F.

    1982-01-01

    This project includes experiments to determine the effects of Zn-DTPA therapy on the retention, translocation and biological effects of inhaled 241 AmO 2 . Beagle dogs that received inhalation exposure to 241 AmO 2 developed leukopenia, clincial chemistry changes associated with hepatocellular damage, and were euthanized due to respiratory insufficiency caused by radiation pneumonitis 120 to 131 days after pulmonary deposition of 22 to 65 μCi 241 Am. Another group of dogs that received inhalation exposure to 241 AmO 2 and were treated daily with Zn-DTPA had initial pulmonary deposition of 19 to 26 μCi 241 Am. These dogs did not develop respiratory insufficiency, and hematologic and clinical chemistry changes were less severe than in the non-DTPA-treated dogs

  1. 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

  2. Safe and Efficacious Use of Automated Bolus Advisors in Individuals Treated With Multiple Daily Insulin Injection (MDI) Therapy

    Science.gov (United States)

    Parkin, Christopher G.; Barnard, Katharine; Hinnen, Deborah A.

    2015-01-01

    Numerous studies have shown that use of integrated automated bolus advisors (BAs) provides significant benefits to individuals using insulin pump devices, including improved glycemic control and greater treatment satisfaction. Within the past few years, BA devices have been developed specifically for individuals treated with multiple daily insulin injection (MDI) therapy; however, many clinicians who treat these individuals may be unfamiliar with insulin pump therapy and, thus, BA use. Findings from the Automated Bolus Advisor Control and Usability Study (ABACUS) revealed that BA use can be efficacious and clinically meaningful in MDI therapy, and that most patients are willing and able to use this technology appropriately when adequate clinical support is provided. The purpose of this article is to review key learnings from ABACUS and provide practical advice for initiating BA use and monitoring therapy. PMID:25795641

  3. Latitudinal Transport of Angular Momentum by Cellular Flows Observed with MDI

    Science.gov (United States)

    Hathaway, David H.; Gilman, Peter A.; Beck, John G.; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    We have analyzed Doppler velocity images from the MDI instrument on SOHO to determine the latitudinal transport of angular momentum by the cellular photospheric flows. Doppler velocity images from 60-days in May to July of 1996 were processed to remove the p-mode oscillations, the convective blue shift, the axisymmetric flows, and any instrumental artifacts. The remaining cellular flows were examined for evidence of latitudinal angular momentum transport. Small cells show no evidence of any such transport. Cells the size of supergranules (30,000 km in diameter) show strong evidence for a poleward transport of angular momentum. This would be expected if supergranules are influenced by the Coriolis force, and if the cells are elongated in an east-west direction. We find good evidence for just such an east-west elongation of the supergranules. This elongation may be the result of differential rotation shearing the cellular structures. Data simulations of this effect support the conclusion that elongated supergranules transport angular momentum from the equator toward the poles, Cells somewhat larger than supergranules do not show evidence for this poleward transport. Further analysis of the data is planned to determine if the direction of angular momentum transport reverses for even larger cellular structures. The Sun's rapidly rotating equator must be maintained by such transport somewhere within the convection zone.

  4. Adenosine dry powder inhalation for bronchial challenge testing, part 1 : Inhaler and formulation development and in vitro performance testing

    NARCIS (Netherlands)

    Lexmond, Anne J.; Hagedoorn, Paul; Van Der Wiel, Erica; Hacken, ten Nicolaas; Frijlink, Henderik W.; De Boer, Anne H.

    2014-01-01

    Dry powder administration of adenosine by use of an effective inhaler may be an interesting alternative to nebulisation of adenosine 5 '-monophosphate in bronchial challenge testing, because of a shorter administration time and more consistent delivered fine particle dose over the entire dose range.

  5. 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

  6. 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

    of exercise on the absorption of inhaled insulin. * In this study in healthy volunteers we found that exercise early after dosing increased absorption (15-20%) of inhaled insulin over the first 2 h after start of exercise, with an approximately 30% increase in maximal insulin concentration, and unchanged...... 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......What is already known about this subject * Exercise is known to affect absorption of other inhaled substances, but so far there are no reports on the effect of exercise on the absorption of inhaled insulin in humans. What this paper adds * This report is the first to investigate the effect...

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

    Science.gov (United States)

    Stanton, Bruce A; Caldwell, Kathleen; Congdon, Clare Bates; Disney, Jane; Donahue, Maria; Ferguson, Elizabeth; Flemings, Elsie; Golden, Meredith; Guerinot, Mary Lou; Highman, Jay; James, Karen; Kim, Carol; Lantz, R Clark; Marvinney, Robert G; Mayer, Greg; Miller, David; Navas-Acien, Ana; Nordstrom, D Kirk; Postema, Sonia; Rardin, Laurie; Rosen, Barry; SenGupta, Arup; Shaw, Joseph; Stanton, Elizabeth; Susca, Paul

    2015-09-01

    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 international standards. Although the US Environmental Protection Agency (EPA) has set a limit of 10 μg/L in public water supplies and the WHO has recommended an upper limit of 10 μg/L, recent studies indicate that these limits are not protective enough. In addition, there are currently few standards for arsenic in food. Those who participated in the Summit support citizens, scientists, policymakers, industry, and educators at the local, state, national, and international levels to (1) establish science-based evidence for setting standards at the local, state, national, and global levels for arsenic in water and food; (2) work with government agencies to set regulations for arsenic in water and food, to establish and strengthen non-regulatory programs, and to strengthen collaboration among government agencies, NGOs, academia, the private sector, industry, and others; (3) develop novel and cost-effective technologies for identification and reduction of exposure to arsenic in water; (4) develop novel and cost-effective approaches to reduce arsenic exposure in juice, rice, and other relevant foods; and (5) develop an Arsenic Education Plan to guide the development of science curricula as well as community outreach and education programs that serve to inform students and consumers about arsenic exposure and engage them in well water testing and development of remediation strategies.

  8. Chlorine Gas Inhalation

    Science.gov (United States)

    White, Carl W.; Martin, James G.

    2010-01-01

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

  9. 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.

  10. Radioactive aerosol inhalation apparatus

    International Nuclear Information System (INIS)

    Bordoni, M.E.; Lieberman, E.

    1987-01-01

    An aerosol inhalation apparatus for supplying an aerosol mist containing radioactive tagged particles to a subject is described comprising a reusable radiation-shielding container having lid means. The contents of the container are readily accessible. A radioactive aerosol inhalation device includes first and second conduit means in the container and passing therethrough, means for communicating with an air passageway of a subject connected to the first and second conduit means externally of the container. Valve means control exhalation from the second conduit means. A nebulizer is within the container connected to the first conduit means. Means are positioned at least in part within the container and in fluid communication with the nebulizer for allowing introduction of radioactive solution from outside the container into the nebulizer

  11. Inhalation of uranium ores

    International Nuclear Information System (INIS)

    Stuart, B.O.; Jackson, P.O.

    1975-01-01

    In previous studies the biological dispositions of individual long-lived alpha members of the uranium chain ( 238 U, 234 U and 230 Th) were determined during and following repeated inhalation exposures of rats to pitchblende (26 percent U 3 O 8 ) ore. Although finely dispersed ore in secular equilibrium was inhaled, 230 Th/ 234 U radioactivity ratios in the lungs rose from 1.0 to 2.5 during 8 weeks of exposures and increased to 9.2 by four months after cessation of exposures. Marked non-equilibrium levels were also found in the tracheobronchial lymph nodes, kidneys, liver, and femur. Daily exposures of beagle dogs to high levels of this ore for 8 days resulted in lung 230 Th/ 234 U ratios of >2.0. Daily exposures of dogs to lower levels (0.1 mg/1) for 6 months, with sacrifice 15 months later, resulted in lung and thoracic lymph node 230 Th/ 234 U ratios ranging from 3.6 to 9 and nearly 7, respectively. The lungs of hamsters exposed to carnotite (4 percent U 3 O 8 ) ore in current lifespan studies show 230 Th/ 234 U ratios as high as 2.0 during daily inhalation of this ore in secular equilibrium. Beagle dogs sacrificed after several years of daily inhalations of the same carnotite ore plus radon daughters also showed marked non-equilibrium ratios of 230 Th/ 234 U, ranging from 5.6 to 7.4 in lungs and 6.2 to 9.1 in thoracic lymph nodes. This pattern of higher retention of 230 Th than 234 U in lungs, thoracic lymph nodes, and other tissues is thus consistent for two types of uranium ore among several species and suggests a reevaluation of maximum permissible air concentrations of ore, currently based only on uranium content

  12. Nonthermal Inhalation Injury.

    Science.gov (United States)

    1992-01-01

    accessory muscles may be an important sign of respiratory distress and possible obstruction. An unstable pattern of breathing or apnea are ominous signs and... concepts in all areas of practice (Emergency Nurses Association, 1991). Direct care allows the emergency CNS to attain competency with new equipment...emergency physicians on protocols regarding smoke inhalation patients will aid in preventing premature discharge. In advance, the CNS develops algorithms

  13. Heroin self-administration by means of 'chasing the dragon': pharmacodynamics and bioavailability of inhaled heroin

    NARCIS (Netherlands)

    Hendriks, V. M.; van den Brink, W.; Blanken, P.; Bosman, I. J.; van Ree, J. M.

    2001-01-01

    In this controlled clinical study, the bioavailability and pharmacodynamics of inhaled heroin are evaluated and compared between 'chasing the dragon' and inhalation from a heating device, and at three dose levels, 25, 50 and 100 mg heroin, in two separate study phases. In study phase 1, no

  14. 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)

  15. Studies on in vitro biostability and blood compatibility of polyurethane potting compound based on aromatic polymeric MDI for extracorporeal devices.

    Science.gov (United States)

    Hridya, V K; Jayabalan, M

    2009-12-01

    Polyurethane potting compound based on aromatic isocyanurate of polymeric MDI, poly propylene glycol (PPG400) and trimethylol propane (TMP) has significant favourable properties, good pot life and setting characteristics. The cured potting compound of this formulation has appreciable thermal stability and mechanical properties. In vitro biostability of cured potting compound has been found to be excellent without any significant degradation in simulated physiological media and chemical environment. Studies on blood-material interaction and cytotoxicity reveal in vitro blood compatibility and compatibility with cells of this potting compound.

  16. 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

  17. 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.

  18. 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.

  19. Adrenal function in asthmatic children treated with inhaled budesonide

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Damkjaer Nielsen, M

    1991-01-01

    The effect of the inhaled topical steroid budesonide on adrenal function was evaluated in 33 children (aged 7-15 years) with moderate bronchial asthma. The trial was designed as a prospective single-blind study of the effect of budesonide in daily doses of 200 microgram through 400 microgram to 8...

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

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yong Chan; Chung, Hyang Mi [The University of Suwon, Hwasung (Korea, Republic of); Choi, Jae Won; Chun, Byoung Chul [Inje University, Gimhae (Korea, Republic of)

    2012-02-15

    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.

  1. 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

  2. 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

  3. 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. 

  4. Respiratory management of inhalation injury.

    Science.gov (United States)

    Mlcak, Ronald P; Suman, Oscar E; Herndon, David N

    2007-02-01

    Advances in the care of patients with major burns have led to a reduction in mortality and a change in the cause of their death. Burn shock, which accounted for almost 20 percent of burn deaths in the 1930s and 1940s, is now treated with early, vigorous fluid resuscitation and is only rarely a cause of death. Burn wound sepsis, which emerged as the primary cause of mortality once burn shock decreased in importance, has been brought under control with the use of topical antibiotics and aggressive surgical debridement. Inhalation injury has now become the most frequent cause of death in burn patients. Although mortality from smoke inhalation alone is low (0-11 percent), smoke inhalation in combination with cutaneous burns is fatal in 30 to 90 percent of patients. It has been recently reported that the presence of inhalation injury increases burn mortality by 20 percent and that inhalation injury predisposes to pneumonia. Pneumonia has been shown to independently increase burn mortality by 40 percent, and the combination of inhalation injury and pneumonia leads to a 60 percent increase in deaths. Children and the elderly are especially prone to pneumonia due to a limited physiologic reserve. It is imperative that a well organized, protocol driven approach to respiratory care of inhalation injury be utilized so that improvements can be made and the morbidity and mortality associated with inhalation injury be reduced.

  5. Insulin inhalation: NN 1998.

    Science.gov (United States)

    2004-01-01

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

  6. 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

  7. Exubera. Inhale therapeutic systems.

    Science.gov (United States)

    Bindra, Sanjit; Cefalu, William T

    2002-05-01

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

  8. 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.

  9. Avaliação do conhecimento sobre o uso de inaladores dosimetrados entre profissionais de saúde de um hospital pediátrico Evaluation of the knowledge of health professionals at a pediatric hospital regarding the use of metered-dose inhalers

    Directory of Open Access Journals (Sweden)

    Fábio Pereira Muchão

    2008-01-01

    Full Text Available OBJETIVO: Avaliar os conhecimentos sobre o uso e manejo de inaladores pressurizados dosimetrados entre profissionais de um hospital pediátrico terciário. MÉTODOS: Foram realizadas avaliações sobre o conhecimento do uso de inaladores pressurizados dosimetrados através de questionários teóricos e práticos, com médicos, fisioterapeutas, enfermeiras e auxiliares de enfermagem, atribuindo-se uma nota de 0 a 10 para cada avaliação. Calcularam-se as medianas das notas obtidas pelos profissionais de cada categoria, as questões com maiores e menores índices de erros, e foi feita a comparação descritiva do desempenho das diversas categorias profissionais. A análise estatística foi feita através do método de Kruskal-Wallis de comparação de medianas. Também foi realizada a análise através de regressão logística múltipla seqüencial. RESULTADOS: Foram avaliados 30 médicos residentes ou estagiários de pediatria, 23 médicos assistentes, 29 fisioterapeutas, 33 enfermeiras e 31 auxiliares de enfermagem. Os médicos residentes, fisioterapeutas e médicos assistentes obtiveram desempenho significativamente superior aos dos enfermeiros e auxiliares de enfermagem. Apenas os médicos residentes obtiveram mediana superior a 6. CONCLUSÕES: O conhecimento a respeito do uso de inaladores dosimetrados entre os profissionais de saúde da instituição é insatisfatório, principalmente entre enfermeiros e auxiliares de enfermagem, diretamente envolvidos na aplicação prática dos inaladores dosimetrados.OBJECTIVE: To evaluate health professionals working at a tertiary pediatric hospital in terms of their knowledge regarding the practical use of metered-dose inhalers. METHODS: Practical and written tests on the use of metered-dose inhalers were applied to physicians, physical therapists, nurses and nursing assistants. A score from 0 to 10 was assigned to each evaluation, and median scores were calculated for each professional category

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. Delineating pMDI model reactions with loblolly pine via solution-state NMR spectroscopy. Part 1, Catalyzed reactions with wood models and wood polymers

    Science.gov (United States)

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

    2011-01-01

    To better understand adhesive interactions with wood, reactions between model compounds of wood and a model compound of polymeric methylene diphenyl diisocyanate (pMDI) were characterized by solution-state NMR spectroscopy. For comparison, finely ground loblolly pine sapwood, milled-wood lignin and holocellulose from the same wood were isolated and derivatized with...

  12. Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde

    Science.gov (United States)

    Kosmider, Leon; Sobczak, Andrzej; Prokopowicz, Adam; Kurek, Jolanta; Zaciera, Marzena; Knysak, Jakub; Smith, Danielle; Goniewicz, Maciej L.

    2016-01-01

    Many non-cigarette tobacco products, including e-cigarettes, contain various flavorings, such as fruit flavours. Although many flavorings used in e-cigarettes are generally recognized as safe when used in food products, concerns have been raised about the potential inhalation toxicity of these chemicals. Benzaldehyde, which is a key ingredient in natural fruit flavors, has been shown to cause irritation of respiratory airways in animal and occupational exposure studies. Given the potential inhalation toxicity of this compound, we measured benzaldehyde in aerosol generated in a laboratory setting from flavored e-cigarettes purchased online and detected benzaldehyde in 108 out of 145 products. The highest levels of benzaldehyde were detected in cherry flavored products. The benzaldehyde doses inhaled with 30 puffs from flavored e-cigarettes were often higher than doses inhaled from a conventional cigarette. Levels in cherry flavored products were over 1000 times lower than doses inhaled in the workplace. While e-cigarettes seem to be a promising harm reduction tool for smokers, findings indicate that using these products could result in repeated inhalation of benzaldehyde, with long-term users risking regular exposure to the substance. Given the uncertainty surrounding adverse health effects stemming from long-term inhalation of flavoring ingredients such as benzaldehyde, clinicians need to be aware of this emerging risk and ask their patients about use of flavored e-cigarettes. PMID:26822067

  13. 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

  14. Mathematical modeling of inhalation exposure

    Science.gov (United States)

    Fiserova-Bergerova, V.

    1976-01-01

    The paper presents a mathematical model of inhalation exposure in which uptake, distribution and excretion are described by exponential functions, while rate constants are determined by tissue volumes, blood perfusion and by the solubility of vapors (partition coefficients). In the model, tissues are grouped into four pharmokinetic compartments. The model is used to study continuous and interrupted chronic exposures and is applied to the inhalation of Forane and methylene chloride.

  15. Potent Inhalational Anesthetics for Dentistry.

    Science.gov (United States)

    Satuito, Mary; Tom, James

    2016-01-01

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

  16. N6-Formyllysine as a Biomarker of Formaldehyde Exposure: Formation and Loss of N6-Formyllysine in Nasal Epithelium in Long-Term, Low-Dose Inhalation Studies in Rats.

    Science.gov (United States)

    Edrissi, Bahar; Taghizadeh, Koli; Moeller, Benjamin C; Yu, Rui; Kracko, Dean; Doyle-Eisele, Melanie; Swenberg, James A; Dedon, Peter C

    2017-08-21

    Exposure to both endogenous and exogenous formaldehyde has been established to be carcinogenic, likely by virtue of forming nucleic acid and proteins adducts such as N 6 -formyllysine. To better assess N 6 -formyllysine as a biomarker of formaldehyde exposure, we studied accumulation of N 6 -formyllysine adducts in tissues of rats exposed by inhalation to 2 ppm [ 13 C 2 H 2 ]-formaldehyde for 7, 14, 21, and 28 days (6 h/day) and investigated adduct loss over a 7-day postexposure period using liquid chromatography-coupled tandem mass spectrometry. Our results showed formation of exogenous adducts in nasal epithelium and to some extent in trachea but not in distant tissues of lung, bone marrow, or white blood cells, with a 2-fold increase over endogenous N 6 -formyllysine over a 3-week exposure period. Postexposure analyses indicated a biexponential decay of N 6 -formyllysine in proteins extracted from different cellular compartments, with half-lives of ∼25 and ∼182 h for the fast and slow phases, respectively, in cytoplasmic proteins. These results parallel the behavior of DNA adducts and DNA-protein cross-links, with protein adducts cleared faster than DNA-protein cross-links, and point to the potential utility of N 6 -formyllysine protein adducts as biomarkers of formaldehyde.

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Razavizadeh, Mahmoud; Jamshidi, Masoud, E-mail: mjamshidi@iust.ac.ir

    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.

  19. Inalador dosimetrado com espaçador artesanal versus nebulizador no tratamento da crise de sibilância na criança Metered-dose inhaler with home-made spacer versus nebulizers to treat moderate wheezing attacks in children

    Directory of Open Access Journals (Sweden)

    Liana Consuelo Santana Vilarinho

    2003-10-01

    oximetria. A comparação dos parâmetros clínicos e de saturação de oxigênio, entre os grupos, não mostrou diferença significativa após as doses de salbutamol, havendo equivalência clínica entre doses diferentes (três vezes menor no grupo IDE, em relação ao grupo NEB; os tempos de preparo e administração da medicação e o custo do tratamento foram significativamente menores no grupo IDE. O grau de satisfação das famílias foi semelhante nos dois grupos. CONCLUSÃO: O inalador dosimetrado com espaçador artesanal pode ser utilizado na admini stração de salbutamol a crianças em crise de sibilância, com algumas vantagens em relação ao nebulizador.OBJECTIVE: To compare the effectiveness of salbutamol administration by metered-dose inhaler with a home-made spacer versus jet nebulizer in children with moderate wheezing attacks. MATERIAL AND METHODS: A randomized, single-blinded trial was performed with a convenience sample of children presenting wheezing. The children were enrolled in an emergency room and randomly assigned to one of two treatment groups: home-made spacer group or nebulizer group. Clinical scores and oxygen saturation were recorded at baseline and 15 minutes after salbutamol administration. Treatment with salbutamol (100 µg/3 kg in the spacer group, and 250 µg/3 kg in the nebulizer group was repeated at 20-minute intervals, until the child was considered to have improved significantly, with no need of any further dose, or until three doses were delivered. Treatment cost, time spent to prepare and deliver the drug, and level of parental satisfaction with the treatment were recorded. RESULTS: Fifty-four children with age between 22 days and 11.7 years were enrolled - 27 in each group. Baseline and demographic characteristics were similar for both groups. The spacer was as effective as the nebulizer in terms of clinical score and oxygen saturation. The different doses (100 µg/3 kg with the spacer, and 250 µg/3 kg with the nebulizer were

  20. 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.

  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

  2. Adrenal suppression by inhaled corticosteroids in patients with asthma: A systematic review and quantitative analysis.

    Science.gov (United States)

    Kowalski, Marek L; Wojciechowski, Piotr; Dziewonska, Marta; Rys, Przemyslaw

    2016-01-01

    Inhaled corticosteroids used for treating persistent asthma can suppress adrenal cortisol secretion. This inhibition of endogenous cortisol secretion is an important marker of systemic steroid activity. Although meta-analyses have demonstrated a dose-dependent suppression of cortisol by inhaled corticosteroids, regardless of inhaler type, the impact of novel freon-free inhaled corticosteroid preparations has not been reviewed. The aim of this study was to synthesize all currently available studies on novel inhaled corticosteroid preparations, including ciclesonide, beclomethasone dipropionate, budesonide, and fluticasone propionate. In particular, we aimed to compare the effect of ciclesonide on cortisol suppression with other existing preparations. We carried out a systematic review of the medical data bases on cortisol suppression in patients due to inhaled corticosteroids. A multivariate regression model was used to determine dose-dependent relationships between each inhaled corticosteroid and cortisol suppression with respect to age, type of inhaler, and study design. From analysis of 64 studies identified in the review, the strongest dose-response urinary cortisol suppression was observed in patients treated with beclomethasone (8.4% per 100 μg; p = 0.029), followed by fluticasone (3.2% per 100 μg; p < 0.001), and budesonide (3.1% per 100 μg; p = 0.001). No significant urinary cortisol suppression was associated with ciclesonide treatment (1.8% per 100 μg; p = 0.267). Although ciclesonide did not affect cortisol levels, this appeared to be due to its unique pharmacokinetic properties rather than the use of a novel formulation. Our findings indicated that the introduction of novel freon-free delivery technologies for inhaled corticosteroids had not eliminated adverse adrenal suppression of cortisol secretion.

  3. Hematologic effects of inhaled plutonium in beagles

    International Nuclear Information System (INIS)

    Ragan, H.A.; Buschbom, R.L.; Park, J.F.; Dagle, G.E.; Weller, R.E.

    1986-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    OBJECTIVE: This population-based longitudinal study aimed to investigate trends in use of inhaled corticosteroids (ICS) and determinants of ICS use in young Danish adults with asthma. METHODS: 106 757 users, aged 18-44 years, of anti-asthmatic drugs were identified in the Danish Register of Medical...... prescriptions in 2006. CONCLUSION: Treatment with ICS among young Danish adult asthmatics has increased since 2001. This apparent improvement was associated with the introduction of fixed dose combination inhalers with ICS and inhaled long-acting beta-2-agonists. However, there is still room for improvement....... Product Statistics during 1997-2006. One year prevalences of ICS use were calculated in categories of gender, age, and annual consumption of inhaled beta-2-agonists (IBA) in defined daily doses (DDD) per year. Determinants of ICS use were estimated by logistic regression models. RESULTS: The one year...

  5. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Radiotoxicity of inhaled (239)PuO(2) in dogs.

    Science.gov (United States)

    Muggenburg, Bruce A; Guilmette, Raymond A; Hahn, Fletcher F; Diel, Joseph H; Mauderly, Joe L; Seilkop, Steven K; Boecker, Bruce B

    2008-12-01

    Beagle dogs inhaled graded exposure levels of insoluble plutonium dioxide ((239)PuO(2)) aerosols in one of three monodisperse particle sizes at the Lovelace Respiratory Research Institute (LRRI) to study the life-span health effects of different degrees of alpha-particle dose non-uniformity in the lung. The primary noncarcinogenic effects seen were lymphopenia, atrophy and fibrosis of the thoracic lymph nodes, and radiation pneumonitis and pulmonary fibrosis. Radiation pneumonitis/ pulmonary fibrosis occurred from 105 days to more than 11 years after exposure, with the lowest associated alpha-particle dose being 5.9 Gy. The primary carcinogenic effects also occurred almost exclusively in the lung because of the short range of the alpha-particle emissions. The earliest lung cancer was observed at 1086 days after the inhalation exposure. The most common type seen was papillary adenocarcinoma followed by bronchioloalveolar carcinoma. These lung cancer results indicate that a more uniform distribution of alpha-particle dose within the lung has an equal or possibly greater risk of neoplasia than less uniform distributions of alpha-particle dose. The results are consistent with a linear relationship between dose and response, but these data do not directly address the response expected at low dose levels. No primary tumors were found in the tracheobronchial and mediastinal lymph nodes despite the high alpha-particle radiation doses to these lymph nodes, and no cases of leukemia were observed.

  8. Aztreonam lysine for inhalation: new formulation of an old antibiotic.

    Science.gov (United States)

    Zeitler, Kristen; Salvas, Brian; Stevens, Vanessa; Brown, Jack

    2012-01-15

    The pharmacology, safety, efficacy, pharmacokinetics, pharmacodynamics, current place in therapy, and potential future therapeutic uses of inhaled aztreonam are reviewed. Inhaled aztreonam, a newly formulated lysine salt of the original monobactam antibiotic, is approved for the treatment of respiratory symptoms in patients with cystic fibrosis (CF) who are colonized with Pseudomonas aeruginosa. Its spectrum of activity is limited to susceptible gram-negative organisms, including P. aeruginosa. Lyophilized aztreonam lysine is diluted with 0.17% sodium chloride and administered using the Altera nebulizer system, which produces appropriate-sized particles for proper deposition in the lungs to achieve high sputum and low systemic concentrations. Mean sputum drug concentrations are highest 10 minutes after dose administration, and plasma concentrations peak one hour after inhalation. Aztreonam is excreted via active tubular secretion and glomerular filtration. Caution is advised in patients with renal or hepatic impairment, breastfeeding women, and patients age 65 years or older. Like the older i.v. formulation, inhaled aztreonam displays time-dependent killing. Phase III clinical trials have shown improvements in respiratory symptoms, decreased P. aeruginosa sputum density, prolonged time intervals between antibiotic treatments, and efficacy without the development of resistance in the face of repeated exposures. This formulation is available only from select specialty pharmacies and should only be used with the Altera nebulizer system. Inhaled aztreonam has shown efficacy and safety in patients seven years of age or older with CF who have P. aeruginosa airway infections. This product may complement existing therapies and offers the advantage of a new inhaled formulation to aid in treatment regimens.

  9. The Effects of Inhaled Budesonide on Lung Function in Smokers and Nonsmokers With Mild Persistent Asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Lamm, Carl Johan; Busse, William W

    2009-01-01

    difference being -83.1 mL (p 5 mL (p = 0.011) in smokers and + 46.5 mL (p = 0.001) in nonsmokers. The corresponding effect......BACKGROUND: Previous studies have suggested reduced benefit from inhaled corticosteroids (ICS) in smoking asthmatics. The objective of this post-hoc study was to study the effects of low dose inhaled budesonide on lung function in smokers and nonsmokers with mild persistent asthma. METHODS: Adult...

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

    Directory of Open Access Journals (Sweden)

    Nave R

    2013-03-01

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

  11. Inhaled mannitol for cystic fibrosis.

    Science.gov (United States)

    Nevitt, Sarah J; Thornton, Judith; Murray, Clare S; Dwyer, Tiffany

    2018-02-09

    Several agents are used to clear secretions from the airways of people with cystic fibrosis. Mannitol increases mucociliary clearance, but its exact mechanism of action is unknown. The dry powder formulation of mannitol may be more convenient and easier to use compared with established agents which require delivery via a nebuliser. Phase III trials of inhaled dry powder mannitol for the treatment of cystic fibrosis have been completed and it is now available in Australia and some countries in Europe. This is an update of a previous review. To assess whether inhaled dry powder mannitol is well tolerated, whether it improves the quality of life and respiratory function in people with cystic fibrosis and which adverse events are associated with the treatment. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic databases, handsearching relevant journals and abstracts from conferences.Date of last search: 28 September 2017. All randomised controlled studies comparing mannitol with placebo, active inhaled comparators (for example, hypertonic saline or dornase alfa) or with no treatment. Authors independently assessed studies for inclusion, carried out data extraction and assessed the risk of bias in included studies. The quality of the evidence was assessed using GRADE. Six studies (reported in 50 publications) were included with a total of 784 participants.Duration of treatment in the included studies ranged from 12 days to six months, with open-label treatment for an additional six months in two of the studies. Five studies compared mannitol with control (a very low dose of mannitol or non-respirable mannitol) and the final study compared mannitol to dornase alfa alone and to mannitol plus dornase alfa. Two large studies had a similar parallel design and provided data for 600 participants, which could be pooled where data for a particular outcome and time point were

  12. Inhalant Abuse: Is Your Child at Risk?

    Science.gov (United States)

    ... can be valuable as well. With help, your child can end inhalant use and learn how to make healthy choices for a lifetime. Perry H. Inhalant abuse in children and adolescents. https://www.uptodate.com/ ...

  13. Do misconceptions hinder effective inhalation therapy with dry powder inhalers?

    NARCIS (Netherlands)

    De Boer, A.H.; Hagedoorn, P.H.; Frijlink, H.W.F.

    Purpose: It is widely believed that high resistance dry powder inhalers (DPI's) can not be operated adequately by patients with reduced vital capacity and that a constant lung deposition requires a flow rate independent fine particle output (FPF). These beliefs may result in incorrect use and

  14. Application of Convolution Neural Network to the forecasts of flare classification and occurrence using SOHO MDI data

    Science.gov (United States)

    Park, Eunsu; Moon, Yong-Jae

    2017-08-01

    A Convolutional Neural Network(CNN) is one of the well-known deep-learning methods in image processing and computer vision area. In this study, we apply CNN to two kinds of flare forecasting models: flare classification and occurrence. For this, we consider several pre-trained models (e.g., AlexNet, GoogLeNet, and ResNet) and customize them by changing several options such as the number of layers, activation function, and optimizer. Our inputs are the same number of SOHO)/MDI images for each flare class (None, C, M and X) at 00:00 UT from Jan 1996 to Dec 2010 (total 1600 images). Outputs are the results of daily flare forecasting for flare class and occurrence. We build, train, and test the models on TensorFlow, which is well-known machine learning software library developed by Google. Our major results from this study are as follows. First, most of the models have accuracies more than 0.7. Second, ResNet developed by Microsoft has the best accuracies : 0.86 for flare classification and 0.84 for flare occurrence. Third, the accuracies of these models vary greatly with changing parameters. We discuss several possibilities to improve the models.

  15. 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

    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...... inhaled particle size segment and lung dose assessed by pharmacokinetics and adjusted for age and body size. Measures of particles size segments were not related to lung dose in children. Until further evidence is provided it may be warranted to emphasize pharmacokinetic or pharmacodynamic assessments...

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

    Directory of Open Access Journals (Sweden)

    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

  17. Advances in Audio-Based Systems to Monitor Patient Adherence and Inhaler Drug Delivery.

    Science.gov (United States)

    Taylor, Terence E; Zigel, Yaniv; De Looze, Céline; Sulaiman, Imran; Costello, Richard W; Reilly, Richard B

    2018-03-01

    Hundreds of millions of people worldwide have asthma and COPD. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler and the dry powder inhaler. Provided that they are used as prescribed, inhalers can improve patient clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions, and increased mortality rates, particularly in low- and middle-income countries. There are currently limited methods available to health-care professionals to objectively and remotely monitor patient inhaler adherence. This review describes recent sensor-based technologies that use audio-based approaches that show promising opportunities for monitoring inhaler adherence in clinical practice. This review discusses how one form of sensor-based technology, audio-based monitoring systems, can provide clinically pertinent information regarding patient inhaler use over the course of treatment. Audio-based monitoring can provide health-care professionals with quantitative measurements of the drug delivery of inhalers, signifying a clear clinical advantage over other methods of assessment. Furthermore, objective audio-based adherence measures can improve the predictability of patient outcomes to treatment compared with current standard methods of adherence assessment used in clinical practice. Objective feedback on patient inhaler adherence can be used to personalize treatment to the patient, which may enhance precision medicine in the treatment of chronic respiratory diseases. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  18. Physico-chemical characterisation of surface modified particles for inhalation.

    Science.gov (United States)

    Stank, Katharina; Steckel, Hartwig

    2013-05-01

    Surface modification of drugs for inhalation is a possibility to influence interparticulate forces. This can be necessary to achieve a sufficient aerosolisation during powder inhalation as the cohesiveness of the micronised drug can be reduced. In addition, the interaction with propellants in pressurised metered dose inhaler can be changed. This can be used to improve the physical stability of the suspension based formulations. A dry particle coating process was used for the alteration of particle surfaces. The blending of micronised salbutamol sulphate (SBS) with different concentrations of magnesium stearate (Mgst) or glycerol monostearate (GMS) was followed by co-milling with an air jet mill. The powder properties were characterised by SEM, EDX, laser diffraction, BET and inverse gas chromatography. Physical mixtures generated by Turbula blending were compared to co-milled samples. A slight particle size reduction was determined. The Mgst deposition on SBS particles was detected by EDX measurements. The dispersive surface energy of SBS is lowered and the energy distribution is more homogenous for the co-milled samples. This study proves the application of co-milling for surface modification in the inhalation area. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Cushing's syndrome due to interaction between inhaled corticosteroids and itraconazole.

    Science.gov (United States)

    Bolland, Mark J; Bagg, Warwick; Thomas, Mark G; Lucas, Jennifer A; Ticehurst, Rob; Black, Peter N

    2004-01-01

    To report a case of an interaction between inhaled corticosteroids and itraconazole causing iatrogenic Cushing's syndrome and provide a review of the relevant literature. A 70-year-old white woman on long-term treatment with high-dose inhaled corticosteroids for asthma was diagnosed as having Scedosporium apiospermum infection of the skin and subcutaneous tissues. As a result, she was treated with itraconazole for 2 months. She subsequently developed Cushing's syndrome due to a probable cytochrome P450-mediated interaction between itraconazole and budesonide. She also had secondary adrenal insufficiency requiring prolonged treatment with replacement hydrocortisone. Budesonide is a potent glucocorticoid that is metabolized in the liver by the CYP3A4 isoenzyme to inactive metabolites. Itraconazole is a potent cytochrome P450 inhibitor. It can inhibit the metabolism of oral or inhaled corticosteroids, producing cortisol excess leading to Cushing's syndrome and adrenal insufficiency. An assessment of causality indicated a possible adverse interaction between itraconazole and budesonide. The combination of itraconazole and inhaled corticosteroids is increasingly being used to treat conditions such as allergic bronchopulmonary aspergillosis. Clinicians need to be aware of the potential for an interaction between such a combination.

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

    Science.gov (United States)

    Taylor, Terence E; 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

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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%.

  6. Inhalation characteristics and their effects on in vitro drug delivery from dry powder inhalers .2. Effect of peak flow rate (PIFR) and inspiration time on the in vitro drug release from three different types of commercial dry powder inhalers

    NARCIS (Netherlands)

    deBoer, AH; Gjaltema, D; Hagedoorn, P

    1996-01-01

    Three commercial dry powder inhalers with completely different dosing and powder disintegration principles were evaluated in an in vitro deposition study. A four-stage cascade impactor was used for the range of flow rates between 20 and 60 1/min. Turbuhaler, Diskhaler and Spinhaler showed increasing

  7. Impact of inhalation therapy on oral health

    Directory of Open Access Journals (Sweden)

    Navneet Godara

    2011-01-01

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

  8. 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)

  9. [Effects of Instruction on Inhalation Techniques Using iPads - Web Application "Inhalation Lessons"].

    Science.gov (United States)

    Kogawa, Noriko; Ito, Reiko; Gon, Yasuhiro; Maruoka, Shuichiro; Hashimoto, Shu

    2015-12-01

    Instruction on inhalation techniques for chronic obstructive pulmonary disease(COPD)and asthma patients being treated with inhalants have sufficient therapeutic effects and are important to maintain adherence. However, problems continue to exist, including time constraints of medical staff that have a large number of patients and a lack of knowledge on inhalation instruction methods. A web application,"Inhalation Lessons,'for the iPad has been developed. It explains inhalation methods, and consists of videos and review tests. Instruction on inhalation techniques was performed using this application for patients that use Diskus, and the effects were examined. As a result, there are significant improvements in the inhalation techniques of patients after viewing the"Inhalation Lessons'application. Uniform instruction on inhalation techniques can be performed even in the field of homecare.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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)

  12. 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

  13. The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries

    NARCIS (Netherlands)

    Lewis, A.; Torvinen, S.; Dekhuijzen, P.N.R.; Chrystyn, H.; Watson, A.T.; Blackney, M.; Plich, A.

    2016-01-01

    BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are common chronic inflammatory respiratory diseases, which impose a substantial burden on healthcare systems and society. Fixed-dose combinations (FDCs) of inhaled corticosteroids (ICS) and long-acting beta2 agonists (LABA), often

  14. Passive inhalation of cannabis smoke

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-09-01

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

  15. Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs.

    Science.gov (United States)

    Celik, Ozlem; Niyazoglu, Mutlu; Soylu, Hikmet; Kadioglu, Pinar

    2012-08-29

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Cancer hazard from inhaled plutonium

    International Nuclear Information System (INIS)

    Gofman, J.W.

    1975-01-01

    The best estimate of the lung cancer potential in humans for inhaled insoluble compounds of plutonium (such as PuO 2 particles) has been grossly underestimated by such authoritative bodies as the International Commission on Radiological Protection and the British Medical Research Council. Calculations are presented of lung cancer induction by 239 Pu as insoluble particles and for deposited reactor-grade Pu. The reason for the gross underestimate of the carcinogenic effects of Pu by ICRP or the British Medical Research Council (BMRC) is their use of a totally unrealistic idealized model for the clearance of deposited Pu from the lungs and bronchi plus their non-recognition of the bronchi as the true site for most human lung cancers. The erroneous model used by such organizations also fails totally to take into account the effect of cigarette-smoking upon the physiological function of human lungs. Plutonium nuclides, such as 239 Pu, or other alpha particle-emitting nuclides, in an insoluble form represent an inhalation cancer hazard in a class some 100,000 times more potent than the potent chemical carcinogens, weight for weight. The already-existing lung cancer data for beagle dogs inhaling insoluble PuO 2 particles is clearly in order of magnitude agreement with calculations for humans

  18. 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

  19. 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.

  20. 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

  1. 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)

  2. Inhalation of Vehicle Emissions in Urban Environments

    OpenAIRE

    Marshall, Julian David

    2005-01-01

    This dissertation explores the relationship between motor vehicle emissions and the human inhalation intake of these emissions. Motor vehicles are ubiquitous to urban areas throughout the world. In most urban areas, vehicle emission are a significant contributor to air pollution problems. Inhalation of vehicle emissions has been shown to cause a number of adverse health effects. Better understanding of the relationship between emissions and inhalation will aid in designing effective strategie...

  3. 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)

  4. Modelling 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.

    1989-01-01

    A biokinetic model of the treatment of dogs that inhaled 241 AmO 2 aerosols with continuously infused DTPA has been adapted from a previously published model by Mewhinney and Griffith. This model was parameterised to simulate both the tissue retention and the excretion of 241 Am, and was used to estimate the cumulative radiation doses to tissues at risk from the α radiation of 241 Am. 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 skeleton dose was 2%, the kidney dose was 4% and the lung dose was 67% of controls. (author)

  5. KOUAKOU BROU.mdi

    African Journals Online (AJOL)

    AISA

    efforts entrepris tend à améliorer le niveau alimentaire des enfants en relevant le niveau protidique. Ainsi, devant l'urgence des besoins, des organisations internatio- nales et locales ont suscité et favorisé dans divers pays des études visant à mettre au point des aliments composés infantiles riches en protéines et destinés ...

  6. MANGARA A.mdi

    African Journals Online (AJOL)

    AISA

    Asteraceae, figurent également parmi les familles les plus représentées dans la flore de la région du Gharb, zone agrumicole au Maroc. (Bensellam et al., 1997 ; Lastic, 1989). La prédominance des microphanérophytes. (26,79 %) dans cette étude, est également observée dans les palmeraies de La Mé (Traoré et al., 2005) ...

  7. ALLOU K.mdi

    African Journals Online (AJOL)

    AISA

    counting of insects in activity (tentatives of flying, matings and feeding) was done every hour, while noting temperature and rainy days. This study reveals high insects activities with both ..... celles-ci n'ont eu qu'une faible influence car elles ont cessé à 20 h ne gênant pas la reprise d'activité jusqu'à 2 h ou à 3 h du matin. La.

  8. DJAHA ORSOT.mdi

    African Journals Online (AJOL)

    USER

    L'enherbement est un facteur qui limite la production agricole au Sud de la Côte d'Ivoire. Les Acacias australiens sont testés comme moyen de lutte contre ce fléau dans les zones littorale et de forêt dense humide sempervirente. La régénération des espèces herbacées a été plus faible sous les légumineuses.

  9. KOUAKOU ADJEmdi.MDI

    African Journals Online (AJOL)

    USER

    L'évolution des populations d'insectes ravageurs et des maladies, ainsi que leur incidence sur la récolte et l'efficacité des traitements chimiques ont été étudiées à la Station Expérimentale du Foro-Foro de l'Institut des Savanes (ex-IDESSA). Deux fongicides Manate 80 % et Peltar Flo et deux insecticides Décis 12 EC.

  10. TOURE A.mdi

    African Journals Online (AJOL)

    lara

    tic e s e t l'e ffic a c ité d'utilis a tio n de l'e n g rais az o té, d a n. s d e. s e ssa is e n m ilie u p a ysa n. , C ô te d. 'Ivo ire. ,. 1994-1. 998 sa isons pluvie use s. Effe cts of agro-ecological zones on rice grain yield and yield, w eed biom ass and nitrogen use efficiency on-fa rm tria ls in. Côte d'Iv oire. , 1994-1998 ra in y s e a s o n.

  11. TRAORE S..mdi

    African Journals Online (AJOL)

    AISA

    lte. Figure 2 : Régression entre la densité stomatique de la partie proximale de la face supérieure de la feuille et l'indice d'infection. Regression between stomata density of proximal area of upper surface of the limb and infection index. A : à 6 mois; B : à la floraison ; C : à la récolte. A: at 6 months; B: at flowering; C: at harvest ...

  12. ANGUI PASCAL.mdi

    African Journals Online (AJOL)

    USER

    et de dolomie (pour comparaison) pendant 30 j, en vue d'étudier leurs effets sur le pH, la capacité d'échange cationique et la teneur en .... Les ions. Ca2+ et Mg2+ ont été dosés par complexométrie à l'aide d'une solution d''EDTA et les ions Na+ et. K+ par photométrie de flamme. L'aluminium échangeable (Al3+) a été ...

  13. NEMLIN Jean.mdi

    African Journals Online (AJOL)

    USER

    but with a highest variability. Regarding the compounds, the comparative study of the three regions showed that coffee from Abengourou was relatively richer in caffeine (2,78 ± 0,23 %) than that from Aboisso (2,45. ± 0,19 %), followed by Divo (2,34 ± 0,26 %). This latter was richer in chlorogenic acid (14,53 ± 0,38 %) than.

  14. article ndiayeoumar.MDI

    African Journals Online (AJOL)

    AISA

    L'alimentation hydrique est le principal facteur limitant la productivité du palmier à huile (Elaeis guineensis. Jacq.). Les réponses physiologiques des plantules, soumises à un déficit hydrique, ont été évaluées sous serre, dans des pots durant 4 mois. En vue d'identifier des critères discriminants au jeune âge pour une.

  15. soro d..mdi

    African Journals Online (AJOL)

    USER

    et s'y fixe parfois en nombre considérable. Très rares sont les karités adultes non infestés par les Loranthaceae. ... traitement a consisté à émonder les arbres. Une personne monte à un arbre et examine les branches, les ..... Belgique : Terre et vie, Paris : l'Harmattan,. Douala APICA, Pays-Bas : CTA, Dakar : ENDA. 354 p.

  16. KONE B.mdi

    African Journals Online (AJOL)

    lara

    basées sur la circonférence au collet, la longueur de la feuille n°4, le nombre de feuilles émises, de feuilles vertes, ont été réalisées à partir du jeune âge jusqu'à sept ans. En outre, l'indice de vigueur a été calculé. Ces mesures ont permis de classer les clones par ordre décroissant d'encombrement. La densité optimale.

  17. AMANE D.mdi

    African Journals Online (AJOL)

    lara

    92,13 (± 3,05) % d'eau ; 7,87 (± 3,05) % de matière sèche ; 0,37 (± 0,10) % de cendre ; 5,03 (± 0,77) % d'alcool ; 0,55. (± 0,16) % de protéine ; 0,04 (± 0,02) % de sucres réducteurs et 0,07 (± 0,03) % de sucres totaux. Il possède par ailleurs une densité moyenne de 1,01 (± 0,01) ; un pH acide de 3,01 (± 0,18) ; un extrait sec.

  18. NEMLIN Jean.mdi

    African Journals Online (AJOL)

    USER

    culturales n'ont pas eu, en général, une influence significative sur la composition du café. Par contre, une analyse factorielle discriminante a permis de montrer que le terroir de Divo est très éloigné de celui d'Aboisso, celui d'Abengourou se situe entre ceux de Divo et d'Aboisso, mais avec une variabilité plus grande.

  19. nzijeanclaude (4).mdi

    African Journals Online (AJOL)

    USER

    Laboratoire de Génétique. Université de Cocody. 22 BP 582 Abidjan 22. 4Laboratoire Central de Biotechnologies. Centre National de Recherche Agronomique .... Pour chaque essai, une pépinière est réalisée sur des planches aménagées à cet effet. Vingt et un jours après le semis, les plantes ont été repiquées sur billon.

  20. Estudio de viabilidad técnico-económico del vehículo con motor de aire comprimido MDI

    OpenAIRE

    Vizcarra Calle, Ricardo

    2006-01-01

    En el presente documento se estudia la viabilidad técnico-económica de los vehículos propulsados por el motor de aire comprimido MDI (Moteur Developpment International). Se inicia con una descripción general del vehículo así como el principio de funcionamiento del ciclo motor. Con un estudio termodinámico se cuantifica la cantidad de energía que disponen los vehículos con esta tecnología, valorando así su rendimiento termodinámico. Seguidamente se inicia una correlación de estudio...

  1. Laryngeal Cryptococcosis Associated With Inhaled Corticosteroid Use: Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Daniel Jun Yi Wong

    2017-11-01

    Full Text Available Laryngeal cryptococcosis is a rare clinical entity. There have been a limited number of case reports in the literature with no consensus regarding optimal management. This review contributes two additional case reports of immunocompetent patients with cryptococcal infection of the larynx in whom exposure to high doses of inhaled corticosteroids is proposed as a significant risk factor. Twenty cases were identified from review of the literature. All patients presented with hoarseness and a spectrum of microlaryngoscopic features, often mimicking laryngeal malignancy. The majority of cases were treated with systemic antifungal therapy, three cases had surgical excision alone, and another three had a combination of medical and surgical management. Risk factor modification, in the form of a reduction in inhaled corticosteroid was employed in the two new cases, and in some previously published cases. Risk factor modification, such as reduction of inhaled corticosteroid dose, in addition to oral antifungal agents can be effective in managing cryptococcal laryngitis.

  2. Doses from radioactive methane

    International Nuclear Information System (INIS)

    Phipps, A.W.; Kendall, G.M.; Fell, T.P.; Harrison, J.D.

    1990-01-01

    A possible radiation hazard arises from exposure to methane labelled with either a 3 H or a 14 C nuclide. This radioactive methane could be released from a variety of sources, e.g. land burial sites containing radioactive waste. Standard assumptions adopted for vapours would not apply to an inert alkane like methane. This paper discusses mechanisms by which radioactive methane would irradiate tissues and provides estimates of doses. Data on skin thickness and metabolism of methane are discussed with reference to these mechanisms. It is found that doses are dominated by dose from the small fraction of methane which is inhaled and metabolised. This component of dose has been calculated under rather conservative assumptions. (author)

  3. Combination Therapy Salmeterol/Fluticasone Versus Doubling Dose of Fluticasone in Children With Asthma

    NARCIS (Netherlands)

    Vaessen-Verberne, Anna A. P. H.; van den Berg, Norbert J.; van Nierop, Jan C.; Brackel, Hein J. L.; Gerrits, Gerardus P. J. M.; Hop, Wim C. J.; Duiverman, Eric J.

    2010-01-01

    Rationale For children with symptomatic asthma despite low to moderate doses of inhaled corticosteroids, evidence is still lacking whether to add a long acting bronchodilator or to increase the dose of inhaled corticosteroids Objective To evaluate whether salmeterol/fluticasone propionate (SFP),

  4. Combination therapy salmeterol/fluticasone versus doubling dose of fluticasone in children with asthma.

    NARCIS (Netherlands)

    Vaessen-Verberne, A.A.; Berg, N.J. van den; Nierop, J.C. van; Brackel, H.J.; Gerrits, G.P.J.M.; Hop, W.C.J.; Duiverman, E.J.

    2010-01-01

    RATIONALE: For children with symptomatic asthma despite low to moderate doses of inhaled corticosteroids, evidence is still lacking whether to add a long-acting bronchodilator or to increase the dose of inhaled corticosteroids. OBJECTIVE: To evaluate whether salmeterol/fluticasone propionate (SFP),

  5. Combination therapy salmeterol/fluticasone versus doubling dose of fluticasone in children with asthma

    NARCIS (Netherlands)

    Vaessen-Verberne, Anna A. P. H.; van den Berg, Norbert J.; van Nierop, Jan C.; Brackel, Hein J. L.; Gerrits, Gerardus P. J. M.; Hop, Wim C. J.; Duiverman, Eric J.; Brinkhorst, G.; van den Berg, N. J.; Van Nierop, J. C.; Landstra, A. M.; Vaessen-Verberne, A. A. P. H.; Kuethe, M. C.; Brackel, H. J. L.; Thio, B. J.; Versteegh, F. G. A.; Duiverman, E. J.; Nuijsink, M.; Kouwenberg, J. M.; Droog, R. P.; Overberg, P. C.; de Vries, T. W.; Hendriks, J. J. E.; Jöbsis, Q.; Gerrits, G. P. J. M.; Hop, W. C. J.; Heijnens, J. W. C. M.; van der Ent, C. K.; van Gent, R.; Brand, P. L. P.

    2010-01-01

    For children with symptomatic asthma despite low to moderate doses of inhaled corticosteroids, evidence is still lacking whether to add a long-acting bronchodilator or to increase the dose of inhaled corticosteroids. To evaluate whether salmeterol/fluticasone propionate (SFP), 50/100 μg twice a day,

  6. A novel approach to study the pMDI plume using an infrared camera and to evaluate the aerodynamic properties after varying the time between actuations.

    Science.gov (United States)

    Kunda, Nitesh K; Hautmann, Julia; Godoy, Sebastián E; Marshik, Patricia; Chand, Ramesh; Krishna, Sanjay; Muttil, Pavan

    2017-06-30

    Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir ® HFA, Proventil ® HFA, and Ventolin ® HFA. The plume and aerodynamic characteristics from these pMDIs were evaluated, after varying the time between actuations (15, 30, 60, and 120s), using the infrared camera and a next generation impactor, respectively. The aerodynamic characteristics were evaluated with and without a valved holding chamber (VHC). ProAir HFA had the softest plume followed by Proventil HFA and Ventolin HFA. Further, Ventolin HFA was slightly cooler and had significantly lower FPF than ProAir HFA and Proventil HFA. All inhalers had higher FPF when used with VHC. Further, we observed that the time between actuations affected the FPF across pMDIs. Moreover, generalized guidelines suggesting one-minute interval between actuations for pMDIs should be reconsidered, with and without a VHC. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Inhalation anaesthetics and climate change

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  8. 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)

  9. 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)

  10. 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)

  11. Pulmonary toxicity of printer toner following inhalation and intratracheal instillation.

    Science.gov (United States)

    Morimoto, Yasuo; Oyabu, Takako; Horie, Masanori; Kambara, Tatsunori; Izumi, Hiroto; Kuroda, Etsushi; Creutzenberg, Otto; Bellmann, Bernd; Pohlmann, Gerhard; Schuchardt, Sven; Hansen, Tanja; Ernst, Heinrich

    2013-10-01

    The pulmonary effects of a finished toner were evaluated in intratracheal instillation and inhalation studies, using toners with external additives (titanium dioxide nanoparticles and amorphous silica nanoparticles). Rats received an intratracheal dose of 1 mg or 2 mg of toner and were sacrificed at 3 days, 1 week, 1 month, 3 months and 6 months. The toner induced pulmonary inflammation, as evidenced by a transient neutrophil response in the low-dose groups and persistent neutrophil infiltration in the high-dose groups. There were increased concentrations of heme oxygenase-1 (HO-1) as a marker of oxidative stress in the bronchoalveolar lavage fluid (BALF) and the lung. In a 90-day inhalation study, rats were exposed to well-dispersed toner (mean of MMAD: 3.76 µm). The three mass concentrations of toner were 1, 4 and 16 mg/m(3) for 13 weeks, and the rats were sacrificed at 6 days and 91 days after the end of the exposure period. The low and medium concentrations did not induce neutrophil infiltration in the lung of statistical significance, but the high concentration did, and, in addition, upon histopathological examination not only showed findings of inflammation but also of fibrosis in the lung. Taken together, the results of our studies suggest that toners with external additives lead to pulmonary inflammation and fibrosis at lung burdens suggest beyond the overload. The changes observed in the pulmonary responses in this inhalation study indicate that the high concentration (16 mg/m(3)) is an LOAEL and that the medium concentration (4 mg/m(3)) is an NOAEL.

  12. Toxicity of inhaled 91YCl3 in beagle dogs. X

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Benjamin, S.A.; Boecker, B.B.; McClellan, R.O.

    1976-01-01

    Studies on the metabolism, dosimetry, and effects of inhaled 91 YCl 3 in Beagle dogs are being continued to provide information that will aid in assessing the biological consequences of nuclear accidents in which 91 Y or other radionuclides that produce a similar radiation dose pattern may be released. Forty-two dogs with 91 Y initial body burdens from 64 to 1300 μCi/kg body weight were placed in four groups with mean lung burdens of 310, 180, 75 and 40 μCi/kg body weight. These dogs and 12 control dogs are being maintained for lifetime observation. An additional group of four dogs with a mean initial 91 Y body burden of 180 μCi/kg body weight were placed in a sacrifice study. Eleven dogs within the highest activity level groups died or were euthanized at 12 to 33 days after inhalation of 91 Y with changes related to severe bone marrow damage and associated pancytopenia. Two dogs died approximately 1 yr after 91 Y inhalation with convulsive seizures that were presumed to be unrelated to the 91 Y exposure. Five 91 Y-exposed dogs died or were euthanized due to neoplasms 2000 to 3341 days after exposure. Three dogs had nasal squamous cell carcinomas, one had a bronchioloalveolar carcinoma and another, a mast cell sarcoma. One dog died of renal failure 2660 days after exposure and one control dog died of empyema. Serial observations are continuing on all surviving dogs

  13. The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review

    OpenAIRE

    de Berardis, Domenico; Fornaro, Michele; Orsolini, Laura; Iasevoli, Felice; Tomasetti, Carmine; de Bartolomeis, Andrea; Serroni, Nicola; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Marini, Stefano; Piersanti, Monica; Perna, Giampaolo; Martinotti, Giovanni; Di Giannantonio, Massimo

    2017-01-01

    Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients w...

  14. Duration of action of formoterol and salbutamol dry-powder inhalation in prevention of exercise-induced asthma in children

    DEFF Research Database (Denmark)

    Daugbjerg, Peer Schrøder; Nielsen, K G; Skov, M

    1996-01-01

    The aim of this study was to evaluate the effect and tolerability of formoterol 12 micrograms on exercise-induced asthma in children for 12 h as compared to the effect of salbutamol 400 micrograms and placebo. The drugs were inhaled as dry powder from a flow-dependent metered-dose inhaler (DP....... Formoterol 12 micrograms administered as dry powder offers significantly better protection against exercise-induced asthma after 3 and 12 h as compared to salbutamol 400 micrograms and placebo....

  15. 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).

  16. Assessments of risk following the inhalation of plutonium oxide using observed lung clearance patterns

    International Nuclear Information System (INIS)

    Ramsden, D.

    1977-10-01

    Dose commitments and risk estimates for the inhalation of plutonium oxide are calculated using the lung clearance patterns observed at AEE Winfrith. These risks are compared with published data on risks arising from a lung clearance based on the ICRP Lung Model. (author)

  17. Neurobehavioural evaluation and kinetics of inhalation of constant or fluctuating toluene concentrations in human volunteers

    NARCIS (Netherlands)

    Lammers, J.H.C.M.; Meuling, W.J.A.; Muijser, H.; Freidig, A.P.; Bessems, J.G.M.

    2005-01-01

    The health risks of inhalation exposure to volatile organic solvents may not only depend on the total external dose, but also on the pattern of exposure. It has been suggested that exposure to regularly occurring peak concentrations may have a stronger impact on the brain than constant exposure at

  18. 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)

  19. From knemometry to final adult height: inhaled corticosteroids and their effect on growth in childhood

    NARCIS (Netherlands)

    de Vreede, Ilja; Haarman, Eric G.; Sprikkelman, Aline B.; van Aalderen, Wim M.

    2013-01-01

    Growth impairment in children with asthma, as a consequence of inhaled corticosteroids (ICS), is a major issue. Adverse systemic effects of ICS have been reviewed extensively, but no clinically relevant effects are reported if they are used in an appropriate dose as advocated in most guidelines.

  20. Inhaled delivery of Δ(9)-tetrahydrocannabinol (THC) to rats by e-cigarette vapor technology.

    Science.gov (United States)

    Nguyen, Jacques D; Aarde, Shawn M; Vandewater, Sophia A; Grant, Yanabel; Stouffer, David G; Parsons, Loren H; Cole, Maury; Taffe, Michael A

    2016-10-01

    Most human Δ(9)-tetrahydrocannabinol (THC) use is via inhalation, and yet few animal studies of inhalation exposure are available. Popularization of non-combusted methods for the inhalation of psychoactive drugs (Volcano(®), e-cigarettes) further stimulates a need for rodent models of this route of administration. This study was designed to develop and validate a rodent chamber suitable for controlled exposure to vaporized THC in a propylene glycol vehicle, using an e-cigarette delivery system adapted to standard size, sealed rat housing chambers. The in vivo efficacy of inhaled THC was validated using radiotelemetry to assess body temperature and locomotor responses, a tail-flick assay for nociception and plasma analysis to verify exposure levels. Hypothermic responses to inhaled THC in male rats depended on the duration of exposure and the concentration of THC in the vehicle. The temperature nadir was reached after ∼40 min of exposure, was of comparable magnitude (∼3 °Celsius) to that produced by 20 mg/kg THC, i.p. and resolved within 3 h (compared with a 6 h time course following i.p. THC). Female rats were more sensitive to hypothermic effects of 30 min of lower-dose THC inhalation. Male rat tail-flick latency was increased by THC vapor inhalation; this effect was blocked by SR141716 pretreatment. The plasma THC concentration after 30 min of inhalation was similar to that produced by 10 mg/kg THC i.p. This approach is flexible, robust and effective for use in laboratory rats and will be of increasing utility as users continue to adopt "vaping" for the administration of cannabis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Physiological daily inhalation rates for health risk assessment in overweight/obese children, adults, and elderly.

    Science.gov (United States)

    Brochu, Pierre; Bouchard, Michèle; Haddad, Sami

    2014-03-01

    Physiological daily inhalation rates reported in our previous study for normal-weight subjects 2.6-96 years old were compared to inhalation data determined in free-living overweight/obese individuals (n = 661) aged 5-96 years. Inhalation rates were also calculated in normal-weight (n = 408), overweight (n = 225), and obese classes 1, 2, and 3 adults (n = 134) aged 20-96 years. These inhalation values were based on published indirect calorimetry measurements (n = 1,069) and disappearance rates of oral doses of water isotopes (i.e., (2)H2 O and H2 (18)O) monitored by gas isotope ratio mass spectrometry usually in urine samples for an aggregate period of over 16,000 days. Ventilatory equivalents for overweight/obese subjects at rest and during their aggregate daytime activities (28.99 ± 6.03 L to 34.82 ± 8.22 L of air inhaled/L of oxygen consumed; mean ± SD) were determined and used for calculations of inhalation rates. The interindividual variability factor calculated as the ratio of the highest 99th percentile to the lowest 1st percentile of daily inhalation rates is higher for absolute data expressed in m3 /day (26.7) compared to those of data in m3/kg-day (12.2) and m3/m2-day (5.9). Higher absolute rates generally found in overweight/obese individuals compared to their normal-weight counterparts suggest higher intakes of air pollutants (in μg/day) for the former compared to the latter during identical exposure concentrations and conditions. Highest absolute mean (24.57 m3/day) and 99th percentile (55.55 m3 /day) values were found in obese class 2 adults. They inhale on average 8.21 m3 more air per day than normal-weight adults. © 2013 Society for Risk Analysis.

  2. Inhalational Steroids and Iatrogenic Cushing's Syndrome.

    Science.gov (United States)

    A V, Raveendran

    2014-01-01

    Bronchial asthma (BA) and Allergic rhinitis (AR) are common clinical problems encountered in day to day practice, where inhalational corticosteroids (ICS) or intranasal steroids (INS) are the mainstay of treatment. Iatrogenic Cushing syndrome (CS) is a well known complication of systemic steroid administration. ICS /INS were earlier thought to be safe, but now more and more number of case reports of Iatrogenic Cushing syndrome have been reported, especially in those who are taking cytochrome P450 (CYP 450) inhibitors. Comparing to the classical clinical features of spontaneous Cushing syndrome, iatrogenic Cushing syndrome is more commonly associated with osteoporosis, increase in intra-ocular pressure, benign intracranial hypertension, aseptic necrosis of femoral head and pancreatitis, where as hypertension, hirsuitisum and menstrual irregularities are less common. Endocrine work up shows low serum cortisol level with evidence of HPA (hypothalamo-pituitary-adrenal) axis suppression. In all patients with features of Cushing syndrome with evidence of adrenal suppression always suspect iatrogenic CS. Since concomitant administration of cytochrome P450 inhibitors in patients on ICS/INS can precipitate iatrogenic CS, avoidance of CYP450 inhibitors, its dose reduction or substitution of ICS are the available options. Along with those, measures to prevent the precipitation of adrenal crisis has to be taken. An update on ICS-/INS- associated iatrogenic CS and its management is presented here.

  3. 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

  4. 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

  5. Inhalants

    Science.gov (United States)

    ... Adolescent Brain Comorbidity College-Age & Young Adults Criminal Justice Drugged Driving Drug Testing Drugs and the Brain ... affect the body in many ways. () En Español View all related publications Related NIDA Notes Articles Adolescent ...

  6. Toxicity of inhaled 91YCl3 in Beagle dogs. XII

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Rebar, A.H.; Boecker, B.B.; Jones, R.K.; McClellan, R.O.; Pickrell, J.A.

    1978-01-01

    Studies on the metabolism, dosimetry and effects of inhaled 91 YCl 3 in Beagle dogs are being continued to provide information that will aid in assessing the biological consequences of nuclear accidents in which 91 Y or other radionuclides that produce a similar radiation dose pattern may be released. Forty-two dogs with 91 Y initial body burdens from 64 to 1300 μCi/kg body weight was placed in four groups with mean lung burdens of 310, 180, 75 and 40 μCi/kg body weight. These dogs and 12 control dogs are being maintained for lifetime observation. An additional group of four dogs with a mean initial 91 Y body burden of 180 μCi/kg body weight was placed in a sacrifice study. Twenty-six of the exposed dogs and four of the control dogs have died. Eleven dogs within the highest activity level groups died or were euthanized at 12 to 33 days after inhalation of 91 Y with changes related to severe bone marrow damage and associated pancytopenia. Two dogs died approximately one year after 91 Y inhalation with convulsive seizures that were presumed to be unrelated to the 91 Y exposure. Nine 91 Y-exposed dogs died or were euthanized due to neoplasms 2012 to 4115 days after exposure. Three dogs had nasal squamous cell carcinomas, one had a bronchioloalveolar carcinoma, one a mast cell sarcoma, one a mammary adenocarcinoma, one a malignant lymphoma, one a melanosarcoma in the mouth and one heart base tumor. Two dogs died of renal failure 2663 and 4086 days after exposure. One dog died with autoimmune hemolytic anemia 3888 days after exposure and one died with congestive heart failure 4042 days after inhalation exposure. One control dog died of empyema, another control dog died with a mammary adenocarcinoma, one died with congestive heart failure and one with malabsorption syndrome. Serial observations are continuing on all surviving dogs

  7. 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)

  8. Inhalant Dependence and its Medical Consequences

    Directory of Open Access Journals (Sweden)

    Mehmet Hamid Boztaş

    2010-12-01

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

  9. 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

  10. Heterogeneity of FeNO response to inhaled steroid in asthmatic children

    DEFF Research Database (Denmark)

    Buchvald, F; Eiberg, H; Bisgaard, H

    2003-01-01

    variables associated with the heterogeneity in the response of exhaled nitric oxide to ICSs. METHODS: Exhaled nitric oxide (FeNO), lung function, bronchial hyper-responsiveness (BHR), specific IgE to common inhalant allergens, blood eosinophils, other atopic manifestations and variants in nitric oxide...... of high-dose steroid treatment. This should be considered when using FeNO for steroid dose titration and monitoring of ICS anti-inflammatory control in asthmatic children....

  11. Maintenance therapy in COPD: time to phase out ICS and switch to the new LAMA/LABA inhalers?

    Directory of Open Access Journals (Sweden)

    Tariq SM

    2017-06-01

    Full Text Available Syed Mohammad Tariq,1 Enson C Thomas2 1Department of Respiratory Medicine, Luton and Dunstable University Hospital, Luton, 2Respiratory Unit, Bedford Hospital, Bedford, UK Abstract: Long-term maintenance therapy for COPD is evolving rapidly. Dual bronchodilation with new long-acting muscarinic antagonist and long-acting beta-agonist (LAMA/LABA fixed dose combination inhalers were introduced over the past 2 years. In clinical trials, these inhalers significantly improved lung function (trough forced expiratory volume in 1 second, patient-reported outcomes, and quality of life measures compared with placebo, their respective monocomponents, and tiotropium. The recorded adverse events of these new inhalers were also similar to those of their monocomponents or placebo. There are concerns regarding long-term complications (weight gain, osteoporosis, cataract and increased risk of community-acquired pneumonia with the use of inhaled corticosteroids (ICS. The new LAMA/LABA inhalers could potentially reduce the use of ICS as part and parcel of maintenance therapy in COPD. Recent studies compared these LAMA/LABA inhalers with ICS/LABA combination inhalers in moderate-to-severe COPD. The results are promising and favor the LAMA/LABA inhalers, especially in the longer duration trials. Furthermore, there is a clearer picture emerging as to the subgroup of COPD patients who may be able to successfully switch from their current ICS/LABA therapy to these new LAMA/LABA inhalers. Keywords: COPD, dual bronchodilation, exacerbations, inhaled corticosteroid, long-acting beta-agonist, long-acting muscarinic antagonist

  12. 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)

  13. 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)

  14. 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

  15. 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

  16. 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)

  17. Batch crystallization of rifapentine for inhalable tuberculosis medication

    Science.gov (United States)

    Wijanarko, Anondho; Meivita, Maria Prisca; Hermansyah, Heri; Sahlan, Muhamad; Lakerveld, Richard

    2018-02-01

    In the midst of Tuberculosis (TB) pandemic, a research about new tuberculosis drug that results in more rapid resolution of tubercular infection is important. It will play a crucial role in accelerating the reductions in tuberculosis incidence that is occurring worldwide. The effectiveness of rifapentine has been assessed and it has been proven to be the most effective antibiotics for TB. A frequent administration and dose of rifapentine resulted in more rapid resolution of tubercular infection. However, based on former research, high exposure levels for treatment shortening may be unachievable with oral administration and might instead be achieved by direct aerosol delivery of rifapentine to the pulmonary site of infection. Therefore, with the growing interest in the effectiveness of rifapentine in frequent administration and dose, this research integrates an inhalable form of crystalline rifapentine prepared using a batch process. Moreover, this research investigates the effect of seed loading, supersaturation ratio, and residence time on the characterization of crystalline rifapentine in order to form a crystalline rifapentine in an inhalable size. The research was carried out by using anti-solvent crystallization method with acetone as a solvent and distilled water as an anti-solvent. Based on the assessment of various operating variables, it can be concluded that the optimum result was obtained at the unseeded experiment with supersaturation ratio = 1.26. Unseeded experiments are preferred because the ideal size for therapeutic aerosol was achieved in unseeded experiments.

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

    International Nuclear Information System (INIS)

    Bair, W.J.

    1978-01-01

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

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

    International Nuclear Information System (INIS)

    Etherington, G.; Smith, J.

    1996-01-01

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

  20. Bronchial effects of leukotriene D4 inhalation in normal human lung

    DEFF Research Database (Denmark)

    Bisgaard, H; Groth, S

    1987-01-01

    compared with those of histamine and the mechanism of action sought. Thirty-three non-atopic individuals participated in the study. The two drugs were inhaled as an aerosol of small particles causing a relative peripheral deposition pattern in order to mimic the preferential involvement of peripheral...... 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...... 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...

  1. 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...... compared with those of histamine and the mechanism of action sought. Thirty-three non-atopic individuals participated in the study. The two drugs were inhaled as an aerosol of small particles causing a relative peripheral deposition pattern in order to mimic the preferential involvement of peripheral...... 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...

  2. The Treatment of Pulmonary Diseases and Respiratory-Related Conditions with Inhaled (Nebulized or Aerosolized Glutathione

    Directory of Open Access Journals (Sweden)

    Jonathan Prousky

    2008-01-01

    Full Text Available Reduced glutathione or simply glutathione (γ-glutamylcysteinylglycine; GSH is found in the cytosol of most cells of the body. GSH in the epithelial lining fluid (ELF of the lower respiratory tract is thought to be the first line of defense against oxidative stress. Inhalation (nebulized or aerosolized is the only known method that increases GSH's levels in the ELF. A review of the literature was conducted to examine the clinical effectiveness of inhaled GSH as a treatment for various pulmonary diseases and respiratory-related conditions. This report also discusses clinical and theoretical indications for GSH inhalation, potential concerns with this treatment, its presumed mechanisms of action, optimal doses to be administered and other important details. Reasons for inhaled GSH's effectiveness include its role as a potent antioxidant, and possibly improved oxygenation and host defenses. Theoretical uses of this treatment include Farmer's lung, pre- and postexercise, multiple chemical sensitivity disorder and cigarette smoking. GSH inhalation should not be used as a treatment for primary lung cancer. Testing for sulfites in the urine is recommended prior to GSH inhalation. Minor side effects such as transient coughing and an unpleasant odor are common with this treatment. Major side effects such as bronchoconstriction have only occurred among asthma patients presumed to be sulfite-sensitive. The potential applications of inhaled GSH are numerous when one considers just how many pulmonary diseases and respiratory-related conditions are affected by deficient antioxidant status or an over production of oxidants, poor oxygenation and/or impaired host defenses. More studies are clearly warranted.

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

    DEFF Research Database (Denmark)

    Bisgaard, H

    1993-01-01

    The short-term linear growth rate of the lower leg in toddlers was measured and evaluated in order to study the possible effect of inhaled budesonide on this factor in toddlers with mild recurrent wheezing. The short-term linear growth rate of the lower leg was measured weekly using a hand......-held knemometer. Eighteen toddlers aged 13-36 months (mean 27 months) with a history of recurrent wheezing requiring inhaled topical steroids, but without need of regular medication during the months prior to the study, were studied. The children were randomized blindly through three consecutive treatment periods...... of exacerbations and one because of non-compliance. The precision of the measurement procedure was 51 microns/day. The mean growth rate during placebo, low-dose and high-dose steroid treatment was 92 microns/day, 114 microns/day and 46 microns/day respectively. The growth rate during the high-dose treatment...

  4. 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

  5. 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.

  6. Systemic exposure to inhaled beclometasone/formoterol DPI is age and body size dependent

    DEFF Research Database (Denmark)

    Chawes, B L; Govoni, M; Kreiner-Møller, E

    2014-01-01

    AIM: Prescription of inhaled corticosteroids to children with asthma is recommended at half the nominal dose of adults in order to reduce the risk of systemic side effects. However, there is a lack of pharmacokinetic trials supporting such dose reduction regimens. Therefore, we aimed to compare t...... inversely with age and body size suggesting that dry powder dosage regimens should be adjusted for age and body size to avoid high systemic drug levels in children.......AIM: Prescription of inhaled corticosteroids to children with asthma is recommended at half the nominal dose of adults in order to reduce the risk of systemic side effects. However, there is a lack of pharmacokinetic trials supporting such dose reduction regimens. Therefore, we aimed to compare...... the systemic exposure to the active ingredients of a fixed dose combination of beclometasone-dipropionate (BDP) and formoterol after dry powder inhaler (DPI) administration in children, adolescents and adults. METHODS: The pharmacokinetic profiles of formoterol and beclometasone-17-monopropionate (B17MP...

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

    Science.gov (United States)

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

    2014-01-01

    Inhalation of TIP peptides that mimic the lectin-like domain of TNF-α is a novel approach to attenuate pulmonary oedema on the threshold to clinical application. A placebo-controlled porcine model of acute respiratory distress syndrome (ARDS) demonstrated a reduced thermodilution-derived extravascular lung water index (EVLWI) and improved gas exchange through TIP peptide inhalation within three hours. Based on these findings, the present study compares a single versus a repetitive inhalation of a TIP peptide (TIP-A) and two alternate peptide versions (TIP-A, TIP-B). Following animal care committee approval ARDS was induced by bronchoalveolar lavage followed by injurious ventilation in 21 anaesthetized pigs. A randomised-blinded three-group setting compared the single-dosed peptide variants TIP-A and TIP-B as well as single versus repetitive inhalation of TIP-A (n = 7 per group). Over two three-hour intervals parameters of gas exchange, transpulmonary thermodilution, calculated alveolar fluid clearance, and ventilation/perfusion-distribution were assessed. Post-mortem measurements included pulmonary wet/dry ratio and haemorrhage/congestion scoring. The repetitive TIP-A inhalation led to a significantly lower wet/dry ratio than a single dose and a small but significantly lower EVLWI. However, EVLWI changes over time and the derived alveolar fluid clearance did not differ significantly. The comparison of TIP-A and B showed no relevant differences. Gas exchange and ventilation/perfusion-distribution significantly improved in all groups without intergroup differences. No differences were found in haemorrhage/congestion scoring. In comparison to a single application the repetitive inhalation of a TIP peptide in three-hour intervals may lead to a small additional reduction the lung water content. Two alternate TIP peptide versions showed interchangeable characteristics.

  8. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by ... you to do and by avoiding things that can cause an attack. Watch a video to follow ...

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Facts Guidance on Spirometry Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers ... Program America Breathing Easier Guide for State Programs Interventions Community Guide—Evidence-based Potentially Effective Interventions Background ...

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Facts Guidance on Spirometry Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers ... Breathing Easier Success Stories State Contacts and Programs Evaluation Evaluation Guide Evaluation Webinars 1. Avoiding Evaluation Roadblocks ...

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent Asthma Data Most Recent Asthma State ... 1 Table 4-2 Reports and Publications Asthma Surveillance Summaries MMWR Publications NCHS Reports and Publications Related ...

  12. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent ... Archive 2014 State or Territory Data Archive AsthmaStats Flu Vaccination among Adults with Current Asthma Flu Vaccination ...

  13. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Current Asthma Overuse of quick-relief medication among persons with active asthma Use of long-term control ...

  14. 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 ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma ...

  15. Know How to Use Your Asthma Inhaler

    Medline Plus

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

  16. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent Asthma Data Most Recent ... care for people with asthma NACP Grantee Profile Tables and Graphs Asthma Call-back Survey Technical Information ...

  17. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Film Asthma Clinical Guidelines Asthma & Community Health Know How to Use Your Asthma Inhaler Recommend on Facebook ... Clinical Guidelines Asthma & Community Health File Formats Help: How do I view different file formats (PDF, DOC, ...

  18. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... on this page will be unavailable. For more information about this message, please visit this page: About CDC.gov . ... Asthma Action Plan Flu Shots Inhalers Data, Statistics, ...

  19. Know How to Use Your Asthma Inhaler

    Medline Plus

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

  20. Health risks associated with inhaled nasal toxicants

    NARCIS (Netherlands)

    Feron, VJ; Arts, JHE; Kuper, CF; Slootweg, PJ; Woutersen, RA

    2001-01-01

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

  1. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... and Publications Related Articles, Publications, and Links Asthma’s Impact on the Nation Fact Sheet State Data Profiles ( ... How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma ...

  2. Adhesion of nitrile rubber to UV-assisted surface chemical modified PET fabric, part II: Interfacial characterization of MDI grafted PET

    Energy Technology Data Exchange (ETDEWEB)

    Razavizadeh, Mahmoud; Jamshidi, Masoud, E-mail: mjamshidi@iust.ac.ir

    2016-08-30

    Highlights: • In this research UV-irradiated PET fabric was chemically modified. • The fabric at first carboxylated under UV irradiation using glutaric anhydride, then it was grafted using isocyanate (i.e. MDI). • The surface of the fabric was characterized before and after each treating satge. • The composite samples were prepared and tested for T-Peel test. The surfaces of the fabrics were surface characterized to understand. - Abstract: Fiber to rubber adhesion is an important subject in rubber industry. It is well known that surface treatment (i.e. physical, mechanical and chemical) is an effective method to improve interfacial bonding of fibers and/or fabrics to rubbers. UV irradiation is an effective method which has been used to increase fabric-rubber interfacial interactions. In this research UV assisted chemical modification of PET fabrics was used to increase PET to nitrile rubber (NBR) adhesion. Nitrile rubber is a perfect selection as fuel and oil resistant rubber. However it has weak bonding to PET fabric. For this purpose PET fabric was carboxylated under UV irradiation and then methylenediphenyl diisocyanate (MDI) was grafted on carboxylated PET. The chemical composition of the fabric before and after surface treatment was investigated by X-ray photoelectron spectroscopy (XPS). The sectional morphology of the experimental PET fibers and the interface between rubber compound and PET fabric was studied using scanning electron microscope (SEM). The morphology and structure of the product were analyzed by an energy dispersive X-ray spectrometer (EDX). FTIR-ATR and H NMR analysis were used to assess surface modifications on the PET irradiated fabrics.

  3. Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial.

    Science.gov (United States)

    Ziegler, Ralph; Cavan, David A; Cranston, Iain; Barnard, Katharine; Ryder, Jacqueline; Vogel, Claudia; Parkin, Christopher G; Koehler, Walter; Vesper, Iris; Petersen, Bettina; Schweitzer, Matthias A; Wagner, Robin S

    2013-11-01

    Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients. This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m(2) (SD, 4.2), and mean diabetes duration of 17.7 years (SD, 11.1). Control group (CNL) patients used a standard BG meter and manual bolus calculation; intervention group (EXP) patients used the Accu-Chek Aviva Expert meter with an integrated bolus advisor to calculate insulin dosages. Glucose data were downloaded and used for therapy parameter adjustments in both groups. A total of 193 patients (CNL, n = 93; EXP, n = 100) completed the study. Significantly more EXP than CNL patients achieved >0.5% A1C reduction (56.0% vs. 34.4%; P < 0.01). Improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire scale) was significantly greater in EXP patients (11.4 [SD, 6.0] vs. 9.0 [SD, 6.3]; P < 0.01). Percentage of BG values <50 mg/dL was <2% in both groups during the study. Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia.

  4. Development and Comparison of New High Efficiency Dry Powder Inhalers for Carrier-Free Formulations

    Science.gov (United States)

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

    2013-01-01

    High efficiency dry powder inhalers (DPIs) were developed and tested for use with carrier-free formulations across a range of different inhalation flow rates. Performance of a previously reported DPI was compared with two new designs in terms of emitted dose (ED) and aerosolization characteristics using in vitro experiments. The two new designs oriented the capsule chamber (CC) at different angles to the main flow passage, which contained a 3D rod array for aerosol deaggregation. Computational fluid dynamics simulations of a previously developed deaggregation parameter, the NDSD, were used to explain device performance. Orienting the CC at 90° to the mouthpiece, the CC90-3D inhaler provided the best performance with an ED=73.4%, fine particle fractions (FPF) less than 5µm and 1µm of 95.1% and 31.4%, respectively, and a MMAD=1.5µm. For the carrier-free formulation, deaggregation was primarily influenced by capsule aperture position and the NDSD parameter. The new CC-3D inhalers reduced the percent difference in FPF and MMAD between low and high flows by 1–2 orders of magnitude compared with current commercial devices. In conclusion, the new CC-3D inhalers produced extremely high quality aerosols with little sensitivity to flow rate and are expected to deliver approximately 95% of the ED to the lungs. PMID:24307605

  5. Development and comparison of new high-efficiency dry powder inhalers for carrier-free formulations.

    Science.gov (United States)

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

    2014-02-01

    High-efficiency dry powder inhalers (DPIs) were developed and tested for use with carrier-free formulations across a range of different inhalation flow rates. Performance of a previously reported DPI was compared with two new designs in terms of emitted dose (ED) and aerosolization characteristics using in vitro experiments. The two new designs oriented the capsule chamber (CC) at different angles to the main flow passage, which contained a three-dimensional (3D) rod array for aerosol deaggregation. Computational fluid dynamics simulations of a previously developed deaggregation parameter, the nondimensional specific dissipation (NDSD), were used to explain device performance. Orienting the CC at 90° to the mouthpiece, the CC90 -3D inhaler provided the best performance with an ED = 73.4%, fine particle fractions (FPFs) less than 5 and 1 μm of 95.1% and 31.4%, respectively, and a mass median aerodynamic diameter (MMAD) = 1.5 μm. For the carrier-free formulation, deaggregation was primarily influenced by capsule aperture position and the NDSD parameter. The new CC-3D inhalers reduced the percent difference in FPF and MMAD between low and high flows by 1-2 orders of magnitude compared with current commercial devices. In conclusion, the new CC-3D inhalers produced extremely high-quality aerosols with little sensitivity to flow rate and are expected to deliver approximately 95% of the ED to the lungs. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

  6. 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.

  7. Liposome Delivery Systems for Inhalation: A Critical Review Highlighting Formulation Issues and Anticancer Applications.

    Science.gov (United States)

    Rudokas, Mindaugas; Najlah, Mohammad; Alhnan, Mohamed Albed; Elhissi, Abdelbary

    2016-01-01

    This is a critical review on research conducted in the field of pulmonary delivery of liposomes. Issues relating to the mechanism of nebulisation and liposome composition were appraised and correlated with literature reports of liposome formulations used in clinical trials to understand the role of liposome size and composition on therapeutic outcome. A major highlight was liposome inhalation for the treatment of lung cancers. Many in vivo studies that explored the potential of liposomes as anticancer carrier systems were evaluated, including animal studies and clinical trials. Liposomes can entrap anticancer drugs and localise their action in the lung following pulmonary delivery. The safety of inhaled liposomes incorporating anticancer drugs depends on the anticancer agent used and the amount of drug delivered to the target cancer in the lung. The difficulty of efficient targeting of liposomal anticancer aerosols to the cancerous tissues within the lung may result in low doses reaching the target site. Overall, following the success of liposomes as inhalable carriers in the treatment of lung infections, it is expected that more focus from research and development will be given to designing inhalable liposome carriers for the treatment of other lung diseases, including pulmonary cancers. The successful development of anticancer liposomes for inhalation may depend on the future development of effective aerosolisation devices and better targeted liposomes to maximise the benefit of therapy and reduce the potential for local and systemic adverse effects. © 2016 S. Karger AG, Basel.

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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

  13. Inhalation Exposure Input Parameters for the Biosphere Model

    Energy Technology Data Exchange (ETDEWEB)

    M. A. Wasiolek

    2003-09-24

    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

  14. ARDS following inhalation of hydrochloric acid.

    Science.gov (United States)

    Bansal, D P; Ambegaonkar, Rahul; Radhika, P; Sharma, Manish

    2011-02-01

    The clinical spectrum of Inhalation injury can range from mild cough to a devastating ARDS. We herewith present a patient who is a goldsmith by occupation and his work consists of dissolving gold in Hydrochloric acid. He had accidentally inhaled fumes of Hydrochloric acid and presented with cough and breathlessness, later on required mechanical ventilation for ARDS and improved. This highlights the importance of not to neglect mild symptoms like cough and dyspnea in such a scenario which may have some hidden catastrophe.

  15. Inhaler devices - from theory to practice

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  16. The Toxicity of Inhaled Sulphur Mustard

    Science.gov (United States)

    2012-10-01

    investigated as a potential COTS treatment for HD-induced ALI. 30 Reportable Outcomes Manuscripts Fairhall SJ, Brown RFR , Jugg BJA, Smith AJ...countermeasures for inhaled sulfur mustard. CBD S&T 2011. Presentations Brown RFR . Preliminary studies of the effects of inhaled sulphur mustard in the...gelatinases in sulfur mustard-induced acute airway injury in guinea pigs. Am J Physiol. 276(5:1): L754-762. Fairhall SJ, Brown RFR , Jugg BJA, Smith

  17. 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

  18. 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

  19. Assessing inhalation injury in the emergency room.

    Science.gov (United States)

    Tanizaki, Shinsuke

    2015-01-01

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

  20. Intestinal circulation during inhalation anesthesia

    International Nuclear Information System (INIS)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.

    1985-01-01

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

  1. 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.

  2. COPD-treating nurses' preferences for inhaler attributes - a discrete choice experiment.

    Science.gov (United States)

    Bøgelund, Mette; Hagelund, Lise; Asmussen, Mikael Bergholdt

    2017-01-01

    To assess nurses' preferences for various attributes of chronic obstructive pulmonary disease (COPD) inhalation devices in order to obtain information about the relative importance of the different attributes and their assigned levels. Data from a web-based questionnaire among Danish nurses who treat patients with COPD (accomplished in the spring/summer of 2015) was used. A total of 222 nurses completed the questionnaire which was based on discrete choice experiment (DCE) methodology. The probability of choosing an alternative from a number of choices in a discrete choice game was estimated by means of the conditional logit model. The two most important attributes according to the COPD-treating nurses were "Indicator when empty" and "Inspiratory flow rate". In addition, the nurses considered the attribute "Obvious that dose is given" important. The three least-valued attributes were frequency of doses, whether the inhaler requires fine motor skills and whether it requires hand strength. Inhalation devices can be classified into five categories, where the soft mist inhaler (SMI) includes the three most important attributes among its characteristics. The study sample size does not allow for subgroup analysis, which would have been valuable. The questionnaire design gives an indication of nurses' preferences and it is assumed that these are similar to real life choices, but the current study cannot conclude on the nurses' actual choices.

  3. Physicochemical characteristics of chlorofluorohydrocarbon-based inhalation aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Ashurst, I.C.

    1985-01-01

    The aim of this work was to gain a better understanding of the physicochemical factors which affect the formulation of suspension inhalation aerosols. The adsorption of six nonionic and cationic surfactants onto Spherisorb has been investigated. The results were analyzed by calculating the area occupied by one adsorbed molecule at the surface and by comparing these values for each surfactant. The amount of each surfactant adsorbed was correlated with the number of sites on that surfactant molecule which could interact with the surface. The stability of suspensions, produced by both the model colloid Spherisorb, and by the drug isoprenaline sulfate, after adsorption of the surfactants, has been assessed by measuring settling times and rising times. The most stable suspension were found to be those which had the greatest amounts of long chain fatty acid surfactant adsorbed on their surface. A comparison was made between the effective stabilizing properties of Span 85 and oleic acid on various drug suspension. It was found that Span 85 gave the most stable suspension. Inhalation aerosol suspensions of isoprenaline sulfate were manufactured using the same surfactants used in the adsorption and suspension stability studies and were analyzed by measuring the particle size distributions of the suspension and the emitted doses. The results were found to correlate with the adsorption and suspension stability studies and it was concluded that a deflocculated suspension was preferable to a flocculated suspension in inhalation aerosols provided that the drug density was less than the propellant density. The application of this work to preformulation studies was also discussed.

  4. Toxicity of inhaled 91YCl3 in beagle dogs. XI

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Rebar, A.H.; Benjamin, S.A.; Boecker, B.B.; Jones, R.K.; McClellan, R.O.; Pickrell, J.A.

    1977-01-01

    Studies on the metabolism, dosimetry and effects of inhaled 91 YCl 3 in Beagle dogs are being continued to provide information that will aid in assessing the biological consequences of nuclear accidents in which 91 Y or other radionuclides that produce a similar radiation dose pattern may be released. Forty-two dogs with 91 Y initial body burdens from 64 to 1300 μCi/kg body weight were placed in four groups with mean lung burdens of 310, 180, 75 and 40 μCi/kg body weight. These dogs and 12 control dogs are being maintained for lifetime observation. An additional group of four dogs with a mean initial 91 Y body burden of 180 μCi/kg body weight were placed in a sacrifice study. Twenty-one of the exposed dogs have died and two of the control dogs have died. Eleven dogs within the highest activity level groups died or were euthanized at 12 to 33 days after inhalation of 91 Y with changes related to severe bone marrow damage and associated pancytopenia. Two dogs died approximately one year after 91 Y inhalation with convulsive seizures that were presumed to be unrelated to the 91 Y exposure. Seven 91 Y-exposed dogs died or were euthanized due to neoplasms 2000 to 3341 days after exposure. Three dogs had nasal squamous cell carcinomas, one had a bronchioloalveolar carcinoma, one, a mast cell sarcoma, one a mammary adenocarcinoma and one with a malignant lymphoma. One dog died of renal failure 2660 days after exposure, one control dog died of empyema and another control dog died with a mammary adenocarcinoma. Serial observations are continuing on all surviving dogs

  5. 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

  6. Long-acting inhaled bronchodilators for cystic fibrosis.

    Science.gov (United States)

    Smith, Sherie; Edwards, Christopher T

    2017-12-19

    Cystic fibrosis is a life-limiting inherited condition which affects one in 2500 newborns in the UK and 70,000 children and adults worldwide. The condition is multifaceted and affects many systems in the body. The respiratory system is particularly affected due to a build up of thickened secretions and a predisposition to infection. Inhaled bronchodilators are prescribed for 80% of people with cystic fibrosis in order to widen the airways and alleviate symptoms. Both short- and long-acting inhaled bronchodilators are used to improve respiratory symptoms. Short-acting inhaled bronchodilators take effect in minutes and typically last for four to eight hours (muscarinic antagonists). Long-acting inhaled bronchodilators also take effect within minutes but typically last for around 12 hours and sometimes longer. This review is one of two which are replacing a previously published review of both long- and short-acting inhaled bronchodilators. This review aims to evaluate long-acting inhaled bronchodilators in children and adults with cystic fibrosis in terms of clinical outcomes and safety. If possible, we aimed to assess the optimal drug and dosage regimen. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 10 October 2017.We also carried out a separate search of Embase and the reference lists of included trials. We searched clinical trials registries for any ongoing trials and made contact with pharmaceutical companies for any further trials.Date of Embase search: 11 October 2017. Randomised or quasi-randomised parallel trials comparing long-acting inhaled bronchodilators (beta-2 agonists and muscarinic antagonists) with placebo, no treatment or a different long-acting inhaled bronchodilator in adults and children with cystic fibrosis. Both authors independently assessed trials for inclusion (based on title, abstract and full text). The

  7. 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)

  8. Influence of peak inspiratory flow rates and pressure drops on inhalation performance of dry powder inhalers.

    Science.gov (United States)

    Hira, Daiki; Okuda, Tomoyuki; Ichihashi, Mika; Mizutani, Ayano; Ishizeki, Kazunori; Okada, Toyoko; Okamoto, Hirokazu

    2012-01-01

    The aim of this study was to reveal the relationship between human inspiratory flow patterns and the concomitant drops in pressure in different inhalation devices, and the influence of the devices on inhalation performance. As a model formulation for inhalers, a physically mixed dry powder composed of salbutamol sulfate and coarse lactose monohydrate was selected. The drops in pressure at 28.3 L/min of three inhalation devices, Single-type, Dual-type, and Reverse-type, was 1.0, 5.1, and 8.7 kPa, respectively. Measurements of human inspiratory patterns revealed that although the least resistant device (Single) had large inter- and intra-individual variation of peak flow rate (PFR), the coefficients of variation of PFR of the three devices were almost the same. In tests with a human inspiratory flow simulator in vitro, inhalation performance was higher, but the variation in inhalation performance in the range of human flow patterns was wider, for the more resistant device. To minimize the intra- and inter-individual variation in inhalation performance for the model formulation in this study, a formulation design that allows active pharmaceutical ingredient to detach from the carrier with a lower inhalation flow rate is needed.

  9. Effect of electrostatic charge, flow, delay and multiple actuations on the in vitro delivery of salbutamol from different small volume spacers for infants.

    OpenAIRE

    Wildhaber, J. H.; Devadason, S. G.; Eber, E.; Hayden, M. J.; Everard, M. L.; Summers, Q. A.; LeSouëf, P. N.

    1996-01-01

    BACKGROUND: A study was undertaken to determine the influences of electrostatic charge, flow, delay, and multiple actuations on the in vitro delivery of salbutamol generated by a pressurised metered dose inhaler (pMDI) from small volume spacers used in infants. METHODS: Ten actuations from a salbutamol pMDI were drawn at different flow rates after either single or multiple actuations, with or without delay, through either static or reduced static spacers. An ionic detergent was used to reduce...

  10. Applying the 'general principles of dose calculation' (ABG) in practice. Pt. 1

    International Nuclear Information System (INIS)

    Haubelt, R.

    1985-01-01

    Radiation doses are to be calculated for the main exposure pathways such as gamma submersion, beta submersion, gamma radiation at ground level, inhalation and ingestion of radionuclides. After the amendment of the German Radiation Protection Ordinance to include the latest ICRP Recommendations, the dose to be determined now is the effective dose equivalent, replacing the former whole-body dose equivalent. (DG) [de

  11. Radiation doses in Sweden as a result of the Chernobyl fallout

    International Nuclear Information System (INIS)

    1987-04-01

    The dose to people living in Sweden originates mainly from external radiation from the ground and from internal radiation from radioactive materials accumulated in the body via foodstuff. In addition there are an inhalation dose and a dose from the radioactive cloud. The collective dose in nSv for the 1st year and for 50 years is evaluated. (orig./HP)

  12. Radiation doses in Sweden as a result of the Chernobyl fallout

    International Nuclear Information System (INIS)

    Wiktorson, Christor

    1986-01-01

    The radiation doses from the Chernobyl fallout originate mainly from two sources: External irradiation (ground radiation) and internal irradiation from radioactive materials accumulated in the human body via food. In addition there are an inhalation dose and a radiation dose from the radioactive cloud. The level of doses from the various sources is presented

  13. Effect of inhaled 90Y in fused clay particles on the gastrointestinal tract of beagle dogs

    International Nuclear Information System (INIS)

    Hahn, F.F.; Barnes, J.E.; Hobbs, C.H.; Mauderly, J.L.

    1974-01-01

    Ten Beagle dogs were exposed by inhalation to aerosols of 90 Y in fused clay particles to study the radiation dose to the gastrointestinal (GI) tract and effects resulting from clearance of the upper respiratory tract after the deposition of high initial body burdens of inhaled 90 Y. Focal colonic lesions were found in 2 dogs, 8 and 12 days after inhalation of 90 Y which resulted in transient GI burdens (GIB) of 18 and 34 mCi. Similar, but less severe, lesions were found in 2 dogs sacrificed 27 days after exposure with GIBs of 18 and 32 mCi. No GI lesions were found in 6 dogs with GIBs of 9 to 18 mCi. Two of the 10 dogs had thermoluminescent dosimeters surgically implanted in the GI tract lumen and submucosa. Highest radiation doses were measured in the colon. One dog, with measured doses to the colon of 3200 to 5700 rads, had focal colitis when sacrificed 8 days after exposure. The other dog, with doses to colon of 1000 to 2800 rads had no GI lesions at sacrifice 8 days after exposure. Although focal colitis was found, no dogs died due primarily to GI injury. Other significant findings were nasal dermatitis and radiation pneumonitis. The latter was more severe and life threatening than the GI injury. (U.S.)

  14. 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

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

    International Nuclear Information System (INIS)

    Perkins, Michael W.; Pierre, Zdenka; Rezk, Peter; Sabnekar, Praveena; Kabra, Kareem; Chanda, Soma; Oguntayo, Samuel; Sciuto, Alfred M.; Doctor, Bhupendra P.; Nambiar, Madhusoodana P.

    2010-01-01

    Respiratory toxicity and lung injury following inhalation exposure to chemical warfare nerve agent soman was examined in guinea pigs without therapeutics to improve survival. A microinstillation inhalation exposure technique that aerosolizes the agent in the trachea was used to administer soman to anesthetized age and weight matched male guinea pigs. Animals were exposed to 280, 561, 841, and 1121 mg/m 3 concentrations of soman for 4 min. Survival data showed that all saline controls and animals exposed to 280 and 561 mg/m 3 soman survived, while animals exposed to 841, and 1121 mg/m 3 resulted in 38% and 13% survival, respectively. The microinstillation inhalation exposure LCt 50 for soman determined by probit analysis was 827.2 mg/m 3 . A majority of the animals that died at 1121 mg/m 3 developed seizures and died within 15-30 min post-exposure. There was a dose-dependent decrease in pulse rate and blood oxygen saturation of animals exposed to soman at 5-6.5 min post-exposure. Body weight loss increased with the dose of soman exposure. Bronchoalveolar lavage (BAL) fluid and blood acetylcholinesterase and butyrylcholinesterase activity was inhibited dose-dependently in soman treated groups at 24 h. BAL cells showed a dose-dependent increase in cell death and total cell counts following soman exposure. Edema by wet/dry weight ratio of the accessory lung lobe and trachea was increased slightly in soman exposed animals. An increase in total bronchoalveolar lavage fluid protein was observed in soman exposed animals at all doses. Differential cell counts of BAL and blood showed an increase in total lymphocyte counts and percentage of neutrophils. These results indicate that microinstillation inhalation exposure to soman causes respiratory toxicity and acute lung injury in guinea pigs.

  16. Assessing inhalation injury in the emergency room

    Directory of Open Access Journals (Sweden)

    Tanizaki S

    2015-07-01

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

  17. Improvement of asthma therapy by a novel formoterol multidose dry powder inhaler.

    Science.gov (United States)

    Moeller, Manfred; Grimmbacher, Stefanie; Munzel, Ullrich

    2008-01-01

    The objective of this post-marketing surveillance (PMS) was the evaluation of efficacy, tolerability, and acceptance of the advanced formoterol (CAS 73573-87-2) multidose dry powder inhaler (MDPI) Formatris 6 microg/12 microg Novolizer (FN) in asthmatic patients (n = 5219) in a real-life setting. A total of 2727 patients (52%) received concomitant anti-inflammatory treatment exclusively via a budesonide Novolizer (BN). Efficacy of the FN was assessed by measurement of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) before and after 4 weeks of therapy. The severity of cough, wheezing, diurnal dyspnea, nocturnal dyspnea and dyspnea on physical effort were assessed on a four-point scale, and a severity sum score was calculated. The patients' satisfaction with the multiple feedback mechanisms, handling and safety of the FN was also assessed. The physicians judged the patient compliance and any improved inhalation reassurance due to FN control mechanisms in comparison with other inhalation systems. FN use (n = 2727) was associated with improved lung function. After 4 weeks, PEF increased by 26% (from 270 L/min to 340 L/min) and the median FEV1 increased by 24% (from 2.1 L to 2.6 L). The median severity sum score decreased from 8.0 before therapy to 3.0 after therapy. Most patients assessed the control mechanisms and safety functions of the FN as 'very good' or 'good'. 96% of patients were satisfied with the optical control mechanism, 92% with the acoustic mechanism, 70% with the taste feedback, 89% with the dose counter and 76% with the overdose prevention. The majority of patients (95%) confirmed that the multiple feedback mechanisms reassured correct drug intake, with 83% rating the FN as 'much better' or 'better' than previously used inhalers. The physicians confirmed that in contrast to previously used inhalers the FN ensured correct inhalation in 87% of all patients. The physicians were satisfied with the patients' compliance in 95% of

  18. Development of high efficiency ventilation bag actuated dry powder inhalers.

    Science.gov (United States)

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

    2014-04-25

    New active dry powder inhaler systems were developed and tested to efficiently aerosolize a carrier-free formulation. To assess inhaler performance, a challenging case study of aerosol lung delivery during high-flow nasal cannula (HFNC) therapy was selected. The active delivery system consisted of a ventilation bag for actuating the device, the DPI containing a flow control orifice and 3D rod array, and streamlined nasal cannula with separate inlets for the aerosol and HFNC therapy gas. In vitro experiments were conducted to assess deposition in the device, emitted dose (ED) from the nasal cannula, and powder deaggregation. The best performing systems achieved EDs of 70-80% with fine particle fractions <5 μm of 65-85% and mass median aerodynamic diameters of 1.5 μm, which were target conditions for controlled condensational growth aerosol delivery. Decreasing the size of the flow control orifice from 3.6 to 2.3mm reduced the flow rate through the system with manual bag actuations from an average of 35 to 15LPM, while improving ED and aerosolization performance. The new devices can be applied to improve aerosol delivery during mechanical ventilation, nose-to-lung aerosol administration, and to assist patients that cannot reproducibly use passive DPIs. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Chronic eosinophilic pneumonia: Adjunctive therapy with inhaled steroids

    Directory of Open Access Journals (Sweden)

    Christopher Chan

    2017-01-01

    Full Text Available Idiopathic chronic eosinophilic pneumonia (ICEP is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2–4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the “photographic negative of pulmonary edema”, the presence of eosinophils ≥40% on bronchoalveolar lavage or ≥1000/mm3 eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders. A dramatic response is achieved with systemic corticosteroids, which is typically dosed over 6 months to 1 year. Despite this response, approximately 30–50% of patients will relapse upon cessation of steroids or during the taper. Although these patients respond well to another trial of steroids, the side effects of long term steroids are well known, including osteoporosis, diabetes, hypertension and cataracts. Inhaled corticosteroids as monotherapy has been trialed in the past without success. However, we report a case of a patient who underwent treatment with systemic corticosteroids followed by inhaled steroids who has remained in remission for 2 years.

  20. Species comparison of acute inhalation toxicity of ozone and phosgene

    Energy Technology Data Exchange (ETDEWEB)

    Hatch, G.E.; Slade, R.; Stead, A.G.; Graham, J.A.

    1986-01-01

    A comparison of the concentration-response effects of inhaled ozone (O/sub 3/) in different species of laboratory animals was made in order to better understand the influence of the choice of species in inhalation studies of this gas. The effect of 4-hour exposure to ozone (O/sub 3/) at concentrations of 0.0, 0.2, 0.5, 1.0, and 2.0 ppm was determined in rabbits, guinea pigs, rats, hamsters and mice. Lavage fluid protein (LFP) accumulation 18 hr after exposure was used as the indicator of O/sub 3/-induced pulmonary edema. All species had similar basal levels of LFP (250-350 ug/ml) when a volume of saline which approximated the total lung capacity was used for lavage of the collapsed lungs. Exponential dose-response curves were seen in all species except guinea pigs, which showed significant increases in LFP at low O/sub 3/ concentrations (0.2 ppm) and a leveling off of response at the higher O/sub 3/ levels. Other species usually showed significant elevations in LFP only at concentrations greater than 0.5 ppm. Recovery of lavage fluid as a percent of the amount of injected saline varied significantly between species, and between O/sub 3/ concentrations; higher O/sub 3/ levels causing lower recovery. The time course of LFP accumulation also appeared to vary according to the species.

  1. Plain chest radiographic findings of smoke inhalation

    International Nuclear Information System (INIS)

    Lee, Shin Ho; Lee, Eil Weong; Kim, Hyun Suk; Park, Ju Youn; Kim, Soo Hyun; Hong, Sung Hwan; Park, Hong Suk; Lee, Kwan Seop; Kang Ik Won

    2000-01-01

    To evaluate the plain chest radiographic findings of smoke inhalation. Our study included 72 burn patients who had suffered smoke inhalation. On admission, all underwent serial portable chest AP radiography. We retrospectively reviewed the plain chest radiographs taken between admission and pootburn day five, evaluating the pattern, distribution, and time onset of direct injury to the respiratory system by smoke inhalation. The lesions were also assessed for change. In 16 of 72 patients (22%), abnormal findings of direct injury to the respiratory system by smoke inhalation were revealed by the radiographs. Abnormal findings were 15 pulmonary lesions and one subglottic tracheal narrowing. Findings of pulmonary lesions were multiple small patchy consolidations (10/15), peribronchial cuffing (8/15), and perivascular fuzziness (6/15). Patterns of pulmonary lesions were mixed alveolar and interstitial lesion (n=3D9), interstitial lesion (n=3D5), and alveolar lesion (n=3D1). No interlobular septal thickening was observed. Pulmonary edema was distributed predominantly in the upper lung zone and perihilar region, with asymmetricity. Its time of onset was within 24 hours in 13 cases, 24-48 hours in two cases, and 48-72 hours in one. Five of 16 patients progressed to ARDS. Chest radiographs showed that pulmonary lesions caused by inhalation injury were due to pulmonary edema, which the pattern of which was commonly mixed alveolar and interstitial. (author)

  2. Effect of carrier particle shape on dry powder inhaler performance.

    Science.gov (United States)

    Kaialy, Waseem; Alhalaweh, Amjad; Velaga, Sitaram P; Nokhodchi, Ali

    2011-12-12

    The aim of this study was to characterise the aerosolisation properties of salbutamol sulphate (SS) from dry powder inhaler (DPI) formulations containing different carrier products. The difference in the elongation ratio (ER) of the different carriers was highlighted. Different set of carriers, namely commercial mannitol (CM), commercial lactose (CL), cooling crystallised mannitol (CCM), acetone crystallised mannitol (ACM) and ethanol crystallised mannitol (ECM) were used and inspected in terms of size, shape, density, crystal form, flowability, and in vitro aerosolisation performance using Multi Stage Liquid Impinger (MSLI) and Aerolizer inhaler device. Solid-state and morphological characterization showed that CM product was in pure β-form having particles with smaller ER (CM: ER=1.62 ± 0.04) whereas ACM and ECM mannitol particles were in pure α form with higher ER (ACM: ER=4.83 ± 0.18, ECM: ER=5.89 ± 0.19). CCM product crystallised as mixtures of β-form and δ-form and showed the largest variability in terms of particle shape, size, and DPI performance. Linear relationships were established showing that carrier products with higher ER have smaller bulk density (D(b)), smaller tap density (D(t)), higher porosity (P), and poorer flow properties. In vitro aerosolisation assessments showed that the higher the ER of the carrier particles the greater the amounts of SS delivered to lower airway regions indicating enhanced DPI performance. Yet, DPI performance enhancement by increasing carrier ER reached a "limit" as increasing carrier ER from 4.83±0.18 (ACM) to 5.89±0.19 (ECM) did not significantly alter fine particle fraction (FPF) of SS. Also, carrier particles with higher ER were disadvantageous in terms of higher amounts of SS remained in inhaler device (drug loss) and deposited on throat. Linear relationship was established (r(2)=0.87) showing that the higher the carrier ER the lower the drug emission (EM) upon inhalation. Moreover, poorer flowability for

  3. [Substitution of inhalation devices in the pharmacy according to a frame contract (dated 1st April, 2008) and individual discount regulations].

    Science.gov (United States)

    Voshaar, T H

    2008-11-01

    The prescription of an inhalative therapy by the physician is not only based on pharmacological aspects, but also on the physical characteristics of the inhalation device, the special and dose-relevant galenics as well as on the patient's individual situation, e. g. disease severity, the intellectual and manual skills. The correct use of the various devices has to be trained and controlled. This approach is also fixed in the Disease Management Programmes (DMP) for asthma and COPD. The substitution of inhalation devices without consideration of the above-mentioned criteria and without retraining is contradictory to all recommendations of national and international respiratory societies and may put the patients at risk.

  4. Response of the Emit II amphetamine/methamphetamine assay to specimens collected following use of Vicks inhalers.

    Science.gov (United States)

    Poklis, A; Jortani, S A; Brown, C S; Crooks, C R

    1993-09-01

    The possible cross-reactivity of l-methamphetamine (desoxyephedrine) to the Syva Emit II amphetamine/methamphetamine assay was evaluated in urine specimens collected from seven subjects using Vicks Inhalers. The subjects were six males and one female ranging from 24 to 47 years of age. Four subjects used the inhaler every two waking hours for five consecutive days, while three subjects inhaled hourly for three consecutive days. All urine voids were collected, totaling 150 specimens. All specimens were analyzed by the Emit II assay on a Hitachi 717 automatic analyzer with a 1000-ng/mL d-methamphetamine cutoff calibrator. None of the inhaler specimens produced an Emit II response equal to or greater than the cutoff calibrator; all were negative. Specimens producing the highest rates were further analyzed by chiral GC/MS. The highest concentrations of l-methamphetamine were observed in urines from two subjects inhaling hourly: 1390, 1290, and 740 ng/mL. These specimens were collected the evenings of the second and third day. When used as directed or even with double the daily dose, Vicks Inhalers did not cause false-positive results in urine tested with the Emit II Amphetamine/Methamphetamine assay.

  5. Incident Pneumonia and Mortality in Patients with Chronic Obstructive Pulmonary Disease. A Double Effect of Inhaled Corticosteroids?

    Science.gov (United States)

    Scanlon, Paul D.

    2015-01-01

    Inhaled corticosteroids are commonly prescribed for patients with severe chronic obstructive pulmonary disease. Although their use improves quality of life and reduces exacerbations, it is associated with increased risk of pneumonia. Curiously, their use has not been associated with increased risk of pneumonia-related or overall mortality. We review pertinent literature to further explore the effects of inhaled corticosteroids on incident pneumonia and mortality in patients with chronic obstructive pulmonary disease. The association of use of inhaled corticosteroids and incident pneumonia is substantial and has been present in the majority of the studies on the topic. This includes both randomized controlled trials and observational studies. However, all of the studies have substantial risk of bias. Most randomized trials are limited by lack of systematic ascertainment of pneumonia; they depended on adverse event reporting. Many observational studies included proper radiographic assessment of pneumonia, but they are limited by their retrospective, observational design. The unadjusted higher risk of pneumonia is associated with longer duration of use, more potent ICS compounds, and higher doses. That implies a dose–effect relationship. Unlike pneumonia, mortality is a precise outcome. Despite the robust association of inhaled corticosteroid use with increased risk of pneumonia, all studies find either no difference or a reduction in pulmonary-related and overall mortality associated with the use of inhaled corticosteroids. These observations suggest a double effect of inhaled corticosteroids (i.e., an adverse effect plus an unexplained mitigating effect). PMID:25409118

  6. Modeling The Inhalation Exposure Pathway In Performance Assessment Of Geologic Radioactive Waste Repository At Yucca Mountain

    International Nuclear Information System (INIS)

    M.A. Wasiolek

    2006-01-01

    Inhalation exposure pathway modeling has recently been investigated as one of the tasks of the BIOPROTA Project (BIOPROTA 2005). BIOPROTA was set up to address the key uncertainties in long term assessments of contaminant releases into the environment arising from radioactive waste disposal. Participants of this international Project include national authorities and agencies, both regulators and operators, with responsibility for achieving safe and acceptable radioactive waste management. The objective of the inhalation task was to investigate the calculation of doses arising from inhalation of particles suspended from soils within which long-lived radionuclides, particularly alpha emitters, had accumulated. It was recognized that site-specific conditions influence the choice of conceptual model and input parameter values. Therefore, one of the goals of the task was to identify the circumstances in which different processes included in specific inhalation exposure pathway models were important. This paper discusses evaluation of processes and modeling assumptions specific to the proposed repository at Yucca Mountain as compared to the typical approaches and other models developed for different assessments and project specific contexts. Inhalation of suspended particulates that originate from contaminated soil is an important exposure pathway, particularly for exposure to actinides such as uranium, neptunium and plutonium. Radionuclide accumulation in surface soil arises from irrigation of soil with contaminated water over many years. The level of radionuclide concentration in surface soil depends on the assumed duration of irrigation. Irrigation duration is one of the parameters used on biosphere models and it depends on a specific assessment context. It is one of the parameters addressed in this paper from the point of view of assessment context for the proposed repository at Yucca Mountain. The preferred model for the assessment of inhalation exposure uses

  7. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    Bisgaard, H

    1997-01-01

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

  8. Effects of Endogenous Formaldehyde in Nasal Tissues on Inhaled Formmaldehyde Dosimetry Predictions in the Rat, Monkey, and Human Nasal Passages

    Science.gov (United States)

    ABSTRACT Formaldehyde, a nasal carcinogen, is also an endogenous compound that is present in all living cells. Due to its high solubility and reactivity, quantitative risk estimates for inhaled formaldehyde rely on internal dose calculations in the upper respiratory tract which ...

  9. Anti-Tuberculosis Bacteriophage D29 Delivery with a Vibrating Mesh Nebulizer, Jet Nebulizer, and Soft Mist Inhaler.

    Science.gov (United States)

    Carrigy, Nicholas B; Chang, Rachel Y; Leung, Sharon S Y; Harrison, Melissa; Petrova, Zaritza; Pope, Welkin H; Hatfull, Graham F; Britton, Warwick J; Chan, Hak-Kim; Sauvageau, Dominic; Finlay, Warren H; Vehring, Reinhard

    2017-10-01

    To compare titer reduction and delivery rate of active anti-tuberculosis bacteriophage (phage) D29 with three inhalation devices. Phage D29 lysate was amplified to a titer of 11.8 ± 0.3 log 10 (pfu/mL) and diluted 1:100 in isotonic saline. Filters captured the aerosolized saline D29 preparation emitted from three types of inhalation devices: 1) vibrating mesh nebulizer; 2) jet nebulizer; 3) soft mist inhaler. Full-plate plaque assays, performed in triplicate at multiple dilution levels with the surrogate host Mycobacterium smegmatis, were used to quantify phage titer. Respective titer reductions for the vibrating mesh nebulizer, jet nebulizer, and soft mist inhaler were 0.4 ± 0.1, 3.7 ± 0.1, and 0.6 ± 0.3 log 10 (pfu/mL). Active phage delivery rate was significantly greater (p pfu/min) than for the jet nebulizer (5.4x10 4  ± 1.3x10 4 pfu/min). The soft mist inhaler delivered 4.6x10 6  ± 2.0x10 6 pfu per 11.6 ± 1.6 μL ex-actuator dose. Delivering active phage requires a prudent choice of inhalation device. The jet nebulizer was not a good choice for aerosolizing phage D29 under the tested conditions, due to substantial titer reduction likely occurring during droplet production. The vibrating mesh nebulizer is recommended for animal inhalation studies requiring large amounts of D29 aerosol, whereas the soft mist inhaler may be useful for self-administration of D29 aerosol.

  10. The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review

    Directory of Open Access Journals (Sweden)

    Domenico de Berardis

    2017-02-01

    Full Text Available Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders. The efficacy of inhaled loxapine has been evaluated in one Phase II trial on patients with schizophrenia, and in two Phase III trials in patients with schizophrenia and bipolar disorder. Moreover, there are two published case series on patients with borderline personality disorder and dual diagnosis patients. Inhaled loxapine has proven to be effective and generally well tolerated when administered to agitated patients with schizophrenia and bipolar disorder. Two case series have suggested that inhaled loxapine may also be useful to treat agitation in patients with borderline personality disorder and with dual diagnosis, but further studies are needed to clarify this point. However, the administration of inhaled loxapine requires at least some kind of patient collaboration, and is not recommended in the treatment of severe agitation in totally uncooperative patients. Moreover, the drug-related risk of bronchospasm must always be kept in mind when planning to use inhaled loxapine, leading to a careful patient assessment prior to, and after, administration. Also, the higher costs of inhaled loxapine, when compared to oral and intramuscular medications, should be taken into account when selecting it for the treatment of agitation.

  11. The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review.

    Science.gov (United States)

    de Berardis, Domenico; Fornaro, Michele; Orsolini, Laura; Iasevoli, Felice; Tomasetti, Carmine; de Bartolomeis, Andrea; Serroni, Nicola; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Marini, Stefano; Piersanti, Monica; Perna, Giampaolo; Martinotti, Giovanni; Di Giannantonio, Massimo

    2017-02-08

    Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders. The efficacy of inhaled loxapine has been evaluated in one Phase II trial on patients with schizophrenia, and in two Phase III trials in patients with schizophrenia and bipolar disorder. Moreover, there are two published case series on patients with borderline personality disorder and dual diagnosis patients. Inhaled loxapine has proven to be effective and generally well tolerated when administered to agitated patients with schizophrenia and bipolar disorder. Two case series have suggested that inhaled loxapine may also be useful to treat agitation in patients with borderline personality disorder and with dual diagnosis, but further studies are needed to clarify this point. However, the administration of inhaled loxapine requires at least some kind of patient collaboration, and is not recommended in the treatment of severe agitation in totally uncooperative patients. Moreover, the drug-related risk of bronchospasm must always be kept in mind when planning to use inhaled loxapine, leading to a careful patient assessment prior to, and after, administration. Also, the higher costs of inhaled loxapine, when compared to oral and intramuscular medications, should be taken into account when selecting it for the treatment of agitation.

  12. Left heart imaging following inhalation of 15O-carbon dioxide: concise communication

    International Nuclear Information System (INIS)

    Kenny, P.J.; Watson, D.D.; Janowitz, W.R.; Finn, R.D.; Gilson, A.J.

    1976-01-01

    Accelerator-produced C 15 O 2 (t/sub 1 / 2 / = 124 sec) is a uniquely useful radiopharmaceutical because it can be introduced rapidly and selectively into the left side of the heart by the simple noninvasive process of inhalation and breath-holding. A standard scintillation camera system was used to obtain images of the left heart by this technique. The procedure involves minimal radiation dose to the patient and may be repeated within a few minutes if necessary

  13. Algorithm for calculating an availability factor for the inhalation of radioactive and chemical materials

    International Nuclear Information System (INIS)

    1984-02-01

    This report presents a method of calculating the availability of buried radioactive and nonradioactive materials via an inhalation pathway. Availability is the relationship between the concentration of a substance in the soil and the dose rate to a human receptor. Algorithms presented for calculating availabiliy of elemental inorganic substances are based on atmospheric enrichment factors; those presented for calculating availability of organic substances are based on vapor pressures. The basis, use, and limitations of the developed equations are discussed. 32 references, 5 tables

  14. Impact of constant and breath-synchronized nebulization on inhaled mass of nebulized budesonide in infants and children

    DEFF Research Database (Denmark)

    Nikander, K; Bisgaard, H

    1999-01-01

    suspension, 0.5 mg mL-1, 2 mL, was used. With 5 min of constant output nebulization, the mean inhaled mass of budesonide in percent of the nominal dose was 11.4% in the youngest children and 14.9% in the 7-year-old children. Expressed in percent of the total output of budesonide, i.e., the amount that left...... the nebulizer as an aerosol, the inhaled mass ranged from 34.6-48.6%. Thus, 51.4-65.4% of the total output was deposited on the expiratory filter. With 5 min of breath-synchronized nebulization, the mean inhaled mass ranged from 10.5-14.9% of the nominal dose. For the youngest patients less than 3-4 years...... of age, it was approximately 80-90% of the total output. For the older patients the inhaled mass was approximately 95% of the total output, i.e., only small amounts of budesonide were deposited on the expiratory filter. For both modes of nebulization the between-subject variation in inhaled mass...

  15. 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)

  16. Cow Dung Ingestion and Inhalation Dependence: A Case Report

    Science.gov (United States)

    Khairkar, Praveen; Tiple, Prashant; Bang, Govind

    2009-01-01

    Although abuse of several unusual inhalants had been documented, addiction to cow dung fumes or their ashes has not been reported in medical literature as yet. We are reporting a case of cow dung dependence in ingestion and inhalational form.

  17. Social stigma stops adolescents from using inhalers for asthma.

    Science.gov (United States)

    2017-07-10

    Forgetfulness, poor routines, inadequate inhaler technique, organisational difficulties and families not understanding or accepting their children's asthma are described as barriers to the use of inhalers among adolescents with asthma.

  18. Inhaler Reminders Significantly Improve Asthma Patients' Use of Controller Medications

    Science.gov (United States)

    ... a third group received both interventions. A fourth group received active usual care alone; all GPs received brief action plan and inhaler technique training. For all patients, electronic inhaler monitors remotely uploaded ...

  19. 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)

  20. 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.)