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A 1-year comparison of turbuhaler vs pressurized metered-dose inhaler in asthmatic patients.

https://arctichealth.org/en/permalink/ahliterature11215
Source
Chest. 1996 Jul;110(1):53-7
Publication Type
Article
Date
Jul-1996
Author
R A Pauwels
F E Hargreave
P. Camus
M. Bukoski
E. Ståhl
Author Affiliation
Department of Respiratory Diseases, University Hospital, Ghent, Belgium.
Source
Chest. 1996 Jul;110(1):53-7
Date
Jul-1996
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adrenergic beta-Agonists - administration & dosage
Adult
Asthma - drug therapy - physiopathology
Bronchodilator Agents - administration & dosage
Budesonide
Comparative Study
Female
Glucocorticoids - administration & dosage
Humans
Male
Nebulizers and Vaporizers
Peak Expiratory Flow Rate
Pregnenediones - administration & dosage
Research Support, Non-U.S. Gov't
Terbutaline - administration & dosage
Abstract
An open, randomized, parallel-group study was conducted to investigate whether asthmatic patients, considered adequately treated with a corticosteroid and/or short-acting beta 2-agonist via pressurized metered-dose inhaler (pMDI), could be transferred to a corresponding nominal dose of budesonide and/or terbutaline via Turbuhaler, an inspiratory flow-driven multidose dry powder inhaler (Astra Draco; Lund, Sweden), without a decrease in the effect of treatment. One thousand four patients (555 women; mean age, 44 years; mean peak expiratory flow [PEF], 102% predicted normal value) were randomized and treated with either pMDI (current therapy) or Turbuhaler for 52 weeks. The variables studied were asthma-related events, morning PEF, and inhaler-induced clinical symptoms. Asthma-related events were defined in two ways: (1) sum of health-care contacts plus doublings or additions of steroids, and (2) number of 2 consecutive days with PEF less than 80% of baseline. Baseline was obtained from a 2-week run-in period while receiving previous therapy. No statistically significant difference was found in asthma-related events according to definition 1. According to definition 2, there was a statistically significant difference between the groups in favor of Turbuhaler (p = 0.008). The mean number of events was 1.7 with Turbuhaler and 2.2 with pMDI. The mean number of weeks per patient with a PEF less than 90% of baseline was 4.5 with Turbuhaler compared with 6.0 with pMDI (p = 0.002). The sum of inhaler-induced symptoms after 1 year of use was statistically significantly lower with Turbuhaler (0.40) than with pMDI (0.75) (p = 0.0001). In conclusion, budesonide and terbutaline in Turbuhaler offered a superior alternative to corticosteroids and bronchodilators delivered by pMDIs in the maintenance treatment of asthma.
PubMed ID
8681664 View in PubMed
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A 10-year retrospective study of interhospital patient transport using inhaled nitric oxide in Norway.

https://arctichealth.org/en/permalink/ahliterature269280
Source
Acta Anaesthesiol Scand. 2015 May;59(5):648-53
Publication Type
Article
Date
May-2015
Author
C. Buskop
P P Bredmose
M. Sandberg
Source
Acta Anaesthesiol Scand. 2015 May;59(5):648-53
Date
May-2015
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Adult
Aged
Bronchodilator Agents - administration & dosage - adverse effects - therapeutic use
Child
Child, Preschool
Critical Care
Equipment Failure - statistics & numerical data
Extracorporeal Membrane Oxygenation
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Nitric Oxide - administration & dosage - adverse effects - therapeutic use
Norway
Respiratory Insufficiency - mortality - therapy
Retrospective Studies
Survival Analysis
Tertiary Care Centers
Transportation of Patients
Treatment Outcome
Young Adult
Abstract
Anaesthesiologists from Oslo University Hospital have transported patients with severe oxygenation failure with inhaled nitric oxide (usually 20?ppm) from other hospitals to a tertiary care centre since 2002 in an effort to reduce the number of patients that otherwise would require transport with ongoing extracorporeal membrane oxygenation. The aim of this study was to evaluate the patient safety during transport with inhaled nitric oxide.
All patient transports with ongoing nitric oxide treatment undertaken from 2003 to 2012 were identified in the transport database. The frequency of adverse events and their impact on patient safety were studied in addition to response to inhaled nitric oxide and adjusted intensive care treatment and time aspects of the transports. Information about in-hospital treatment and survival were extracted from the hospital patient records.
Adverse events were recorded in 12 of the 104 transports. Seven of the adverse events were due to malfunctioning technical equipment, three were related to medication other than the inhaled nitric oxide and two were related to ventilation. No adverse events resulted in permanent negative patient consequences or in discontinuation of the transport. Out of 104 patients, 79 responded to treatment with inhaled nitric oxide and other treatment changes by an increase in oxygen saturation of more than 5%. The 30-day mortality was 27% in the group transported with inhaled nitric oxide.
Transporting patients on inhaled nitric oxide is an alternative in selected patients who would otherwise require extracorporeal membrane oxygenation during transport.
PubMed ID
25782015 View in PubMed
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Absence of posterior subcapsular cataracts in young patients treated with inhaled glucocorticoids.

https://arctichealth.org/en/permalink/ahliterature220267
Source
Lancet. 1993 Sep 25;342(8874):776-8
Publication Type
Article
Date
Sep-25-1993
Author
F E Simons
M P Persaud
C A Gillespie
M. Cheang
E P Shuckett
Author Affiliation
Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Canada.
Source
Lancet. 1993 Sep 25;342(8874):776-8
Date
Sep-25-1993
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Adult
Aerosols
Asthma - drug therapy
Beclomethasone - administration & dosage - adverse effects
Bronchodilator Agents - adverse effects
Budesonide
Cataract - chemically induced
Child
Child, Preschool
Chronic Disease
Cross-Sectional Studies
Female
Humans
Male
Manitoba
Patient compliance
Pregnenediones - administration & dosage - adverse effects
Abstract
The prevalence of posterior subcapsular cataracts in young patients receiving inhaled glucocorticoids for treatment of chronic asthma is unknown. In a cross-sectional study, slit-lamp examinations were done on 95 consecutive young patients who were taking inhaled beclomethasone or budesonide. No posterior subcapsular cataracts were found. The median age of the patients was 13.8 (range 5.8-24.8). The median dose of inhaled beclomethasone or budesonide was 750 micrograms/day (range 300-2000), or 12.9 micrograms/kg per day (range 7.5-34.2). The median duration of treatment was 5 years (range 1-15). 77% of the patients had not used oral glucocorticoids in the year preceding the examination. This study suggests that routine screening for posterior subcapsular cataracts in this patient population is not warranted.
Notes
Comment In: Lancet. 1993 Nov 20;342(8882):1306-77901619
PubMed ID
8103877 View in PubMed
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Acute and chronic respiratory symptoms among primary care patients who smoke crack cocaine.

https://arctichealth.org/en/permalink/ahliterature118607
Source
J Urban Health. 2013 Jun;90(3):542-51
Publication Type
Article
Date
Jun-2013
Author
Pamela Leece
Nikhil Rajaram
Susan Woolhouse
Margaret Millson
Author Affiliation
Public Health and Preventive Medicine Residency Program, University of Toronto, Toronto, Ontario, Canada.
Source
J Urban Health. 2013 Jun;90(3):542-51
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adult
Asthma - diagnosis - epidemiology - etiology
Confounding Factors (Epidemiology)
Crack Cocaine
Female
Health Surveys
Humans
Male
Middle Aged
Ontario - epidemiology
Pilot Projects
Prevalence
Primary Health Care
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - etiology
Smoking - adverse effects - epidemiology
Substance-Related Disorders - complications
Abstract
Among inner-city populations in Canada, the use of crack cocaine by inhalation is prevalent. Crack smoking is associated with acute respiratory symptoms and complications, but less is known about chronic respiratory problems related to crack smoking. There is also a gap in the literature addressing the management of respiratory disease in primary health care among people who smoke crack. The purpose of our study was to assess the prevalence of acute and chronic respiratory symptoms among patients who smoke crack and access primary care. We conducted a pilot study among 20 patients who currently smoke crack (used within the past 30 days) and who access the "drop-in clinic" at an inner-city primary health care center. Participants completed a 20- to 30-min interviewer-administered survey and provided consent for a chart review. We collected information on respiratory-related symptoms, diagnoses, tests, medications, and specialist visits. Data were analyzed using frequency tabulations in SPSS (version 19.0). In the survey, 95 % (19/20) of the participants reported having at least one respiratory symptom in the past week. Thirteen (13/19, 68.4 %) reported these symptoms as bothersome. Chart review indicated that 12/20 (60 %) had a diagnosis of either asthma or chronic obstructive pulmonary disease (COPD), and four participants (4/20, 20 %) had a diagnosis of both asthma and COPD. Majority of the participants had been prescribed an inhaled medication (survey 16/20, 80 %; chart 12/20, 60 %). We found that 100 % (20/20) of the participants currently smoked tobacco, and 16/20 (80 %) had smoked both tobacco and marijuana prior to smoking crack. Our study suggests that respiratory symptoms and diagnoses of asthma and COPD are prevalent among a group of patients attending an inner-city clinic in Toronto and who also smoke crack. The high prevalence of smoking tobacco and marijuana among our participants is a major confounder for attributing respiratory symptoms to crack smoking alone. This novel pilot study can inform future research evaluating the primary health care management of respiratory disease among crack smokers, with the aim of improving health and health care delivery.
Notes
Cites: Open Med. 2011;5(2):e94-e10321915240
Cites: Patient Educ Couns. 2010 Aug;80(2):280-320434863
Cites: Curr Opin Pulm Med. 2001 Mar;7(2):43-6111224724
Cites: Int J STD AIDS. 2002 Nov;13(11):769-7412437898
Cites: Women Health. 2003;37(3):1-1712839304
Cites: J Nerv Ment Dis. 2004 Jul;192(7):503-715232321
Cites: Chest. 1995 Jan;107(1):233-407813284
Cites: J Subst Abuse Treat. 1997 Sep-Oct;14(5):423-99437611
Cites: Can J Public Health. 2005 May-Jun;96(3):185-815913081
Cites: J Urban Health. 2005 Jun;82(2):250-6615872194
Cites: Addiction. 2006 Dec;101(12):1760-7017156175
Cites: Addiction. 2007 Sep;102(9):1340-117697268
Cites: Int J Drug Policy. 2008 Jun;19(3):255-6418502378
Cites: Int J Drug Policy. 2008 Aug;19(4):339-4118638705
Cites: CMAJ. 2008 Nov 18;179(11):1099-10219015551
Cites: Can Fam Physician. 2010 Feb;56(2):126, 128, 130,132; discussion e49, e5120154239
Cites: Women Health. 1999;30(1):35-5110813266
PubMed ID
23188552 View in PubMed
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Acute asthma in children and adolescents: should inhaled anticholinergics be added to beta(2)-agonists?

https://arctichealth.org/en/permalink/ahliterature182008
Source
Am J Respir Med. 2003;2(2):109-15
Publication Type
Article
Date
2003
Author
Laurie H Plotnick
Francine M Ducharme
Author Affiliation
Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. drplotnick@sympatico.ca
Source
Am J Respir Med. 2003;2(2):109-15
Date
2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Administration, Inhalation
Adolescent
Adrenergic beta-Agonists - administration & dosage
Anti-Asthmatic Agents - administration & dosage
Asthma - diagnosis - drug therapy
Canada
Child
Child, Preschool
Cholinergic Antagonists - administration & dosage
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Female
Humans
Male
Prognosis
Randomized Controlled Trials as Topic
Recurrence
Severity of Illness Index
Treatment Outcome
Abstract
Children and adolescents experiencing acute exacerbations of asthma benefit from the use of beta(2)-adrenoceptor agonists (beta(2)-agonists) and systemic corticosteroids. However, there have been conflicting reports regarding the efficacy of inhaled anticholinergic agents. This article summarizes the evidence provided by randomized controlled trials studying the efficacy of adding inhaled anticholinergic agents to beta(2)-agonists in nonhospitalized children and adolescents with acute exacerbations of asthma. This systematic review of randomized controlled trials suggests that the addition of inhaled anticholinergic agents to beta(2)-agonists is beneficial in children and adolescents, particularly those with severe exacerbations of asthma. When given in repeated doses, the addition of inhaled anticholinergic agents to beta(2)-agonists improves lung function and reduces the risk of hospital admission by 25%. Several treatment regimens, namely ipratropium bromide (250 or 500 microg per dose) every 20-60 minutes for two to three doses have been tested with similar beneficial effects. The addition of a single dose of an inhaled anticholinergic agent to beta(2)-agonists improves lung function but does not prevent hospital admission. The review did not identify any beneficial effects of anticholinergic agents in children with nonsevere asthma. Use of anticholinergic agents was not associated with increase in the incidence of nausea, vomiting or tremor. In conclusion, the addition of repeated doses of an inhaled anticholinergic agent to inhaled beta(2)-agonist is indicated in the emergency room management of children and adolescents with acute asthma, particularly those with severe exacerbations.
PubMed ID
14720010 View in PubMed
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The acute effects of inhaled salbutamol on the beat-to-beat variability of heart rate and blood pressure assessed by spectral analysis.

https://arctichealth.org/en/permalink/ahliterature208850
Source
Br J Clin Pharmacol. 1997 Apr;43(4):421-8
Publication Type
Article
Date
Apr-1997
Author
T. Jartti
T. Kaila
K. Tahvanainen
T. Kuusela
T. Vanto
I. Välimäki
Author Affiliation
Department of Paediatrics, Turku University Hospital, Finland.
Source
Br J Clin Pharmacol. 1997 Apr;43(4):421-8
Date
Apr-1997
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adrenergic beta-Agonists - administration & dosage - pharmacology
Albuterol - administration & dosage - pharmacology
Baroreflex - drug effects
Blood Pressure - drug effects
Bronchodilator Agents - administration & dosage - pharmacology
Bronchospirometry
Child
Cross-Over Studies
Double-Blind Method
Electrocardiography - drug effects
Female
Finland
Forced Expiratory Flow Rates - drug effects
Heart Rate - drug effects
Humans
Male
Respiratory Function Tests
Supine Position
Abstract
We wanted to study the effects of a 600 micrograms inhaled salbutamol dose on the cardiovascular and respiratory autonomic nervous regulation in eight children suffering from bronchial asthma.
In this randomized, double-blind, placebo-controlled, crossover study we continuously measured electrocardiogram, finger systolic arterial pressure (SAP) and flow-volume spirometry at baseline as well as 20 min and 2 h after the drug inhalation. The R-R interval (the time between successive heart beats) and SAP variabilities were assessed by using spectral analysis. Baroreflex sensitivity was assessed by using cross-spectral analysis.
Salbutamol significantly decreased the total and low frequency (LF) variability of R-R intervals as well as the high frequency (HF) variability of R-R intervals and of SAP. Salbutamol significantly increased the LF/HF ratio of R-R intervals and of SAP, minute ventilation, heart rate and forced pulmonary function in comparison with placebo. The weight of the subjects significantly correlated positively with baroreflex sensitivity and negatively with heart rate after the salbutamol inhalation.
We conclude that the acute salbutamol inhalation decreases cardiovagal nervous responsiveness, increases sympathetic dominance in the cardiovascular autonomic balance, and has a tendency to decrease baroreflex sensitivity in addition to improved pulmonary function.
PubMed ID
9146855 View in PubMed
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Adjustable maintenance dosing with budesonide/formoterol reduces asthma exacerbations compared with traditional fixed dosing: a five-month multicentre Canadian study.

https://arctichealth.org/en/permalink/ahliterature9564
Source
Can Respir J. 2003 Nov-Dec;10(8):427-34
Publication Type
Article
Author
J Mark FitzGerald
Malcolm R Sears
Louis-Philippe Boulet
Allan B Becker
Andrew R McIvor
Pierre Ernst
Natasha M Smiljanic-Georgijev
Joanna S M Lee
Author Affiliation
The University of British Columbia, Vancouver, Canada. markj@interchange.ubc.ca
Source
Can Respir J. 2003 Nov-Dec;10(8):427-34
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adrenal Cortex Hormones - administration & dosage - therapeutic use
Adult
Asthma - drug therapy
Bronchodilator Agents - administration & dosage - therapeutic use
Budesonide - administration & dosage - therapeutic use
Canada
Child
Costs and Cost Analysis
Drug Administration Schedule
Drug Combinations
Ethanolamines - administration & dosage - therapeutic use
Female
Humans
Male
Research Support, Non-U.S. Gov't
Time Factors
Abstract
BACKGROUND: Adjustable maintenance dosing with budesonide/formoterol in a single inhaler (Symbicort, AstraZeneca, Lund, Sweden) may provide a convenient means of maintaining asthma control with the minimum effective medication level. OBJECTIVES: To compare adjustable and fixed maintenance dosing regimens of budesonide/formoterol in asthma. METHODS: This was an open-label, randomized, parallel-group, multicentre, Canadian study of asthma patients (aged 12 years or older, postbronchodilator forced expiratory volume in 1 s 70% or greater of predicted normal). Following a one-month run-in on budesonide/formoterol (100/6 mg or 200/6 mg metered doses, two inhalations twice daily), 995 patients were randomly assigned either to continue on this fixed dosing regimen or to receive budesonide/formoterol adjustable dosing (step down to one inhalation twice daily if symptoms were controlled or temporarily step up to four inhalations twice daily for seven or 14 days if asthma worsened). The primary efficacy variable was the occurrence of exacerbations (requiring oral or inhaled corticosteroids, emergency department treatment, serious adverse events or added maintenance therapy because of asthma). RESULTS: With adjustable dosing, significantly fewer patients experienced exacerbations compared with fixed dosing (4.0% versus 8.9%, P=0.002; number needed to treat=21 [95% CI 13 to 59]). Patients required 36% fewer overall doses of budesonide/formoterol (2.5 versus 3.9 inhalations/day, P
PubMed ID
14679407 View in PubMed
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Adrenal suppression in asthmatic children receiving low-dose inhaled budesonide: comparison between dry powder inhaler and pressurized metered-dose inhaler attached to a spacer.

https://arctichealth.org/en/permalink/ahliterature15304
Source
Ann Allergy Asthma Immunol. 2002 Dec;89(6):566-71
Publication Type
Article
Date
Dec-2002
Author
Shmuel Goldberg
Tsurit Einot
Nurit Algur
Shimshon Schwartz
Alan C Greenberg
Elie Picard
Dov Virgilis
Eitan Kerem
Author Affiliation
Department of Pediatric Respiratory Medicine, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
Source
Ann Allergy Asthma Immunol. 2002 Dec;89(6):566-71
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Absorption
Administration, Inhalation
Adolescent
Adrenal Cortex - secretion
Aerosols
Anti-Asthmatic Agents - administration & dosage - adverse effects - pharmacology
Biological Availability
Budesonide - administration & dosage - adverse effects - pharmacology
Child
Child, Preschool
Comparative Study
Cross-Over Studies
Depression, Chemical
Female
Humans
Hydrocortisone - secretion - urine
Hypothalamo-Hypophyseal System - drug effects
Inhalation Spacers
Lung - metabolism
Male
Pituitary-Adrenal System - drug effects
Powders
Abstract
BACKGROUND: Dry powder inhalers (DPI) have in recent years become a common mode for administration of inhaled corticosteroids for preventive therapy of asthma. Inhaled steroids delivered by DPI achieve increased lung deposition compared with pressurized metered-dose inhalers (pMDI), which is associated with increased therapeutic effect. This may be associated with increased systemic absorption. OBJECTIVE: The purpose of this study was to evaluate the prevalence of adrenal suppression in children using low-dose budesonide given by DPI, as compared with pMDI attached to a large-volume spacer device (pMDI + spacer). METHODS: In an open-labeled crossover study, 15 asthmatic children aged 5 to 15 years received 200 microg of inhaled budesonide twice daily by DPI (Turbuhaler, Astra, Draco AB, Lund, Sweden) and by pMDI + spacer, 1 month each, in a randomized order. Twenty-four-hour urine collections were performed at baseline and at the end of each of the 2 months of the study period, and urinary cortisol and creatinine were measured. RESULTS: Baseline urinary cortisol:creatinine was 0.038 +/- 0.012 microg/mg, similar in both groups. After 1 month of DPI therapy, urinary cortisol:creatinine was reduced by 27 +/- 16% to 0.028 +/- 0.012 microg/mg (P = 0.018). Urinary cortisol:creatinine after 1 month of pMDI + spacer therapy was similar to baseline 0.037 +/- 0.019 microg/mg (P = 0.78). CONCLUSIONS: Treatment of asthmatic children with budesonide 400 microg daily given via a DPI for 1 month was associated with hypothalamic-pituitary-adrenal axis suppression. This effect was not observed with the same dose of budesonide administered via pMDI + spacer. This indicates that systemic absorption might be reduced with pMDI + spacer therapy.
Notes
Comment In: Ann Allergy Asthma Immunol. 2002 Dec;89(6):537-912487216
Comment In: Ann Allergy Asthma Immunol. 2003 Jun;90(6):674; author reply 674-512839330
PubMed ID
12487221 View in PubMed
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Airway responses in Brown Norway rats following inhalation sensitization and challenge with trimellitic anhydride.

https://arctichealth.org/en/permalink/ahliterature80614
Source
Toxicol Sci. 2006 Dec;94(2):322-9
Publication Type
Article
Date
Dec-2006
Author
Zhang Xing-Dong
Andrew Michael E
Hubbs Ann F
Siegel Paul D
Author Affiliation
Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA.
Source
Toxicol Sci. 2006 Dec;94(2):322-9
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Airway Resistance - drug effects - physiology
Allergens - immunology - toxicity
Animals
Antibodies, Anti-Idiotypic - blood
Bronchi - drug effects - pathology
Bronchial Hyperreactivity - chemically induced - immunology - pathology
Bronchial Provocation Tests
Female
Immunoglobulin E - blood - immunology
Inhalation Exposure
Phthalic Anhydrides - immunology - toxicity
Plethysmography, Whole Body
Rats
Rats, Inbred BN
Respiratory Hypersensitivity - chemically induced - immunology - pathology
Specific Pathogen-Free Organisms
Abstract
Trimellitic anhydride (TMA) is a cause of asthma in man. Dose-dependent TMA-specific IgE, histopathology, and airway responses after sensitization by inhalation were examined in the Brown Norway rat. Rats were exposed to 0.04, 0.4, 4, or 40 mg/m3 TMA aerosol for 10 min, once a week, over 10 weeks. All lower exposures were, subsequently, rechallenged to 40 mg/m3 TMA aerosol. All rats received a sham exposure 1 week prior to the first TMA exposure. Following the sham exposure and weekly after each TMA exposure, TMA-specific IgE and both early-phase airway response (EAR) and late-phase airway response (LAR) were measured using enhanced pause (Penh). All rats sensitized by 40 mg/m3 TMA developed specific IgE, EAR, and LAR to one or more of the challenges to 40 mg/m3 TMA. TMA of 4 mg/m3 induced a much lower, but stable, specific IgE response. EAR and LAR were observed only after a 40 mg/m3 TMA rechallenge in this group, but it was much larger than that observed in the 40 mg/m3 TMA-sensitized and challenged group. Exposure-dependent histopathological changes noted included eosinophilic granulomatous interstitial pneumonia, perivascular eosinophil infiltrates, bronchial-associated lymphoid tissue hyperplasia, and peribronchiolar plasma cell infiltrates.
PubMed ID
16982671 View in PubMed
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321 records – page 1 of 33.