scholarly journals Optimal administration of bronchodilators with valved holding chambers in preschool children: a review of literature

Author(s):  
Péter Csonka ◽  
Terhi Tapiainen ◽  
Mika J. Mäkelä ◽  
Lauri Lehtimäki

AbstractOur aim was to synthesize the published literature on factors that potentially affect the delivery of bronchodilators using valved holding chambers (VHC) in preschool children. We also aimed to identify those attributes that are not yet incorporated or clearly stated in the guidelines and those topics that are still lacking sufficient data. There is strong evidence supporting several recommendations in current guidelines. Based on present knowledge, bronchodilators should be delivered by VHC administering each puff separately. Face mask should be omitted as soon as the child can hold the mouthpiece of the VHC tightly between the lips and teeth. Based on the review, we suggest adding a specific note to current guidelines about the effect of chamber volume and the impact of co-operation during drug administration. Calming the child and securing a tight face-to-mask seal is critical for successful drug delivery. There is not enough evidence to make specific recommendations on the most reliable VHC and face mask for children. There is an urgent need for studies that evaluate and compare the effectiveness of VHCs in various clinical settings in wide age-groups and respiratory patterns. In addition, there is insufficient data on ideal chamber volume, material, and effective antistatic treatment. What is Known:• Valved holding chambers (VHC) should not be considered interchangeable when used with pressurized metered dose inhalers (pMDI).• Drug delivery is influenced by VHC volume, aerodynamic and electrostatic properties; mask fit; respiratory pattern and co-operation during inhalation; and the number of puffs actuated.What is New:• The impact of co-operation, VHC volume, and good mask-to-face fit during drug inhalation is not stressed enough in the guidelines.• Studies are urgently needed to evaluate the effectiveness of different VHCs in various clinical settings focusing on VHC electrostatic properties, respiratory patters, face masks, and ideal pMDI+VHC combinations.

2020 ◽  
Author(s):  
Huimin Ge ◽  
Shanshan Xu ◽  
Yanzhi Yan ◽  
Qin Jiang

Abstract Background: To investigate the impact of refractive error and corneal parameters on myopic teenagers by using Pentacam and IOL Master 700. Methods: Retrospective observational case series of 505 eyes from 268 children from 7 to 19 years old presenting with myopia. Clinical course, slit lamp photographs and pentacam and IOL Master 700 findings were the main outcomes. Results: Assessment of the tomographic, topographic of corneal parameters of myopic children without any interventions revealed no statistically significant changes in terms of age based on sex. The mean Rf, Rs, K1 and K2 values of anterior and posterior corneal surface were 7.98±0.24mm, 7.73±0.30mm, 42.38±1.86 degrees, 43.55±1.91 degrees, 6.60±0.25mm, 6.21±0.26mm, -6.07±0.23 degrees, -6.42±0.65 degrees. Boys had higher Rf and Rs, but smaller in K1 and K2 than girls (P<0.05) of both anterior and posterior corneal surface. The Anterior chamber volume (ACV) had significant differences between sex (P<0.05). The Rf, K1 of anterior corneal surface did not show significantly different between ages, however, teenagers only in 7 to 9 age group increased significantly than 13 to 15-year-old group (P=0.031). Meanwhile, the Anterior chamber depth (ACD), Anterior chamber volume (ACV), Pupil diameter (PD), Spherical equivalent (SE) and Axial length (AL) had increasingly differenced in different age groups (P=0.002, 0.002, 0.036, 0.044, 0.002, <0.001). Model performance using p< 0.05 parameters as the predictive factors. SE=3.391+0.08×Age+2.307×Rs-0.094×ACD-0.001×ACV-0.951×AL. Conclusions: Our findings may suggest a physiological nature for ocular changes during the development that may elucidate the special points during the process of myopia of adolescents. We also imitate a formula based on our data which may help to evaluate the myopia of children and the prognosis in clinic.Our research conducted retrospectively registered.


2003 ◽  
Vol 73 (5) ◽  
pp. 335-342 ◽  
Author(s):  
Alexy ◽  
Kersting ◽  
Sichert-Hellert

Intake of vitamins A, C, and E was evaluated and age and time trends were assessed on the basis of 3-day weighed dietary records (n = 5121) of 2- to 18-year old boys (n = 417) and girls (n = 425) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) 1986–2001. Intake of vitamin A remains stable over time, intake of vitamin C increases linearly, and intake of vitamin E follows a nonlinear trend. Age trends of vitamins A and C (per MJ) were nonlinear with a minimum at the beginning adolescence, while intake of vitamin E (per MJ) increased linearly. Girls had higher nutrient densities but lower intakes expressed as percent of reference values. Fortified food in total had a higher impact on time trends of nutrient intake than other single food groups defined here. Our results point to the impact of the food industry on long-term nutrient intake, but also underline the necessity of nutrition education even in young age groups to improve vitamin intake.


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


2020 ◽  
Vol 16 (4) ◽  
pp. 715-729
Author(s):  
T.N. Savina

Subject. To achieve a high level of economic security is a key priority of national development. Employment reveals one of the most important aspects of social development of the individual that is associated with his or her needs satisfaction in the sphere of employment and is boon to economic security. Objectives. The purpose of the study is to show the impact of unemployment on economic security in employment. Methods. I apply such scientific methods as dialectical, historical and logical unity, structural and functional analysis, traditional techniques of economic analysis and synthesis. The methods of multivariate statistical and comparative analysis serve as a methodological basis of the study. To determine the indicator of unemployment, I use the band theory. Results. I underpin the growing role of employment in ensuring economic security. The paper presents a comprehensive assessment of the unemployment status and a comparative analysis of the indicator in the Republic of Mordovia, the Volga Federal District, and the Russian Federation as a whole. I identify trends in the average duration of unemployment, show the distribution of unemployed by level of education and age groups. Conclusions. The average annual unemployment rate in the Republic of Mordovia is lower than in Russia and the Volga Federal District. The findings may be useful for public authorities to substantiate their employment policy at both macro- and meso-levels, for designing programs and strategies for socio-economic development of regions and the social security doctrine, as well as in practical activities of employment services.


2020 ◽  
Vol 12 ◽  
Author(s):  
Sai Akilesh M ◽  
Ashish Wadhwani

: Infectious diseases have been prevalent since many decades and viral pathogens have caused global health crisis and economic meltdown on a devastating scale. High occurrence of newer viral infections in the recent years, in spite of the progress achieved in the field of pharmaceutical sciences defines the critical need for newer and more effective antiviral therapies and diagnostics. The incidence of multi-drug resistance and adverse effects due to the prolonged use of anti-viral therapy is also a major concern. Nanotechnology offers a cutting edge platform for the development of novel compounds and formulations for biomedical applications. The unique properties of nano-based materials can be attributed to the multi-fold increase in the surface to volume ratio at the nano-scale, tunable surface properties of charge and chemical moieties. Idealistic pharmaceutical properties such as increased bioavailability and retention times, lower toxicity profiles, sustained release formulations, lower dosage forms and most importantly, targeted drug delivery can be achieved through the approach of nanotechnology. The extensively researched nano-based materials are metal and polymeric nanoparticles, dendrimers and micelles, nano-drug delivery vesicles, liposomes and lipid based nanoparticles. In this review article, the impact of nanotechnology on the treatment of Human Immunodeficiency Virus (HIV) and Herpes Simplex Virus (HSV) viral infections during the last decade are outlined.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saima Habeeb ◽  
Manju Chugani

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.


There have been significant changes in the numbers, patterns, and circumstances of refugees and in the political landscape to support humanitarianism since the publication of the first edition of this collection. Like the first edition, this volume provides a multidisciplinary perspective on refugee health, tracing the health repercussions on individuals and populations from the drivers of forced mass movements of populations from situations of conflict and other disasters through to the process of resettlement in countries other than their countries of origin. Drawing on the expertise of academics, practitioners, and UN frontline experts, the collection covers three main aspects of refugee health: the concepts, definitions, and context from a human rights, humanitarianism, and social determinants of health perspective; the intersection of vulnerabilities across age groups and settings; and the ethical challenges for practitioners and researchers working with forcibly displaced populations seeking to resettle. The collection concludes with an analysis of the role of the media in shaping our perceptions of refugees and the impact on policy and access to care.


Author(s):  
Carolina Cruvinel Sandoval ◽  
Cláudia Maria Gaspardo ◽  
Maria Beatriz Martins Linhares

2021 ◽  
Vol 11 (1) ◽  
pp. 204589402098843
Author(s):  
Kevin M. Swiatek ◽  
Charnetta Lester ◽  
Nicole Ng ◽  
Saahil Golia ◽  
Janet Pinson ◽  
...  

Our objective was to establish the impact of wearing a face mask on the outcome of six-minute walk test in healthy volunteers. In a study of 20 healthy volunteers who each completed two 6MWTs, one with a mask and one without, there was no difference in distance walked. However, there was a significant difference in perception of dyspnea between the two groups.


Sign in / Sign up

Export Citation Format

Share Document