Poor Inhaler Technique in Patients with Bronchial Asthma Treated in King Hussein Medical Center (KHMC) : Rates and Effects

OBJECTIVE The primary aim was to determine whether watching a short video in the inpatient setting could produce an immediate improvement in pediatric patients' asthma knowledge and inhaler technique. METHODS This prospective, quasi-experimental, pre-post study was conducted in a single center, in Detroit, Michigan, which primarily serves an urban, African-American population. Patients were eligible if they were between 8- and 16-years-old, had asthma, and would be discharged with an albuterol metered-dose inhaler. The primary outcome was improvement in the composite score of a knowledge and technique assessment before and after watching a 5-minute video. The lead author developed the video with content validation by pharmacists, pediatricians, elementary school teachers, and a pediatric health education specialist. Secondary outcomes at 30 days included change in asthma control and whether the video was revisited after discharge. RESULTS Thirty patients were enrolled. Their average age was 11 ± 2.1 years; they were primarily African American (83%), female (53%), and insured by Medicaid (87%). The composite score of technique assessment and written quiz increased by 3.53 (95% confidence interval [CI] 2.81 to 4.85) of a possible 16 points after watching the video. There was no significant change in asthma control at 30 days as measured by the asthma control test (2, 95% CI −0.53 to 4.53). Eight of 22 patients revisited the video after discharge. CONCLUSIONS A brief educational video delivered during a pediatric inpatient visit in an urban medical center resulted in an immediate improvement in patients' disease knowledge and inhaler technique.

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Semi-automatic system for non-invasive diagnosis of bronchial asthma based on microwave technologies

ITM Web of Conferences ◽

10.1051/itmconf/20193013003 ◽

2019 ◽

Vol 30 ◽

pp. 13003

Author(s):

Ivan V. Sememik ◽

Alexander V. Dem’yanenko ◽

Feruz S. Topalov

Keyword(s):

Bronchial Asthma ◽

Medical Center ◽

Diagnostic System ◽

Displacement Sensor ◽

Laser Displacement Sensor ◽

Express Method ◽

Non Invasive ◽

Examination Procedure ◽

Bronchopulmonary Diseases ◽

Compact Design

In this paper, the structure of a semi-automatic non-invasive harmless diagnostic system for bronchial asthma and other bronchopulmonary diseases are discussed. The components of the diagnostic system are discussed. It is shown that it is possible to design a diagnostic system in a portable compact design by using a laser displacement sensor instead of a bulky positioning system. The advantages of the proposed system are the simplicity of the implementation of the diagnostic system and examination, harmlessness, non-invasiveness of the examination procedure, no need to perform breathing maneuvers. These advantages allow us to consider the proposed system as an addition to the existing methods of diagnosing bronchial asthma, as well as an express method for diagnosing bronchopulmonary diseases or a system for periodically monitoring the health of a patient undergoing inpatient treatment or not having permanent access to a large medical center equipped with expensive equipment.

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SENSITIZATION TO ALLERGENIC COMPONENTS OF HOUSE DUST MITES IN CHILDREN WITH BRONCHIAL ASTHMA IN KHARKIV REGION

Asthma and allergy ◽

10.31655/2307-3373-2021-4-43-49 ◽

2021 ◽

Vol 2021 (4) ◽

pp. 43-49

Author(s):

V. A. Klymenko ◽

T. V. Kulik ◽

V. M. Belous ◽

O. V. Pyontkovskaya ◽

O. M. Savvo

Keyword(s):

Bronchial Asthma ◽

House Dust ◽

Medical Center ◽

Persistent Asthma ◽

Allergic Diseases ◽

House Dust Mites ◽

Molecular Profile ◽

Dust Mites ◽

Key Words Bronchial Asthma ◽

Molecular Components

SENSITIZATION TO ALLERGENIC COMPONENTS OF HOUSE DUST MITES IN CHILDREN WITH BRONCHIAL ASTHMA IN KHARKIV REGION V. A. Klymenko1 , T. V. Kulik1 , V. M. Belous2 , O. V. Pyontkovskaya3 , O. M. Savvo3 1 Kharkiv National Medical University, Kharkiv, Ukraine 2 Ecomed Medical Center, Kharkiv, Ukraine 3 Municipal non-profit enterprise of Kharkiv Regional Council «Regional Children’s Clinical Hospital G1», Kharkiv, Ukraine Abstract. The aim of the work is to determine the molecular profile of sensitization to house dust mites in children with bronchial asthma in the Kharkiv region. Object and methods of study. 42 children aged from 6 to 18 years were under observation. Evaluation of the sensitization profile was performed by the method of multicomponent photometric analysis ALEX. Results and discussion. Boys predominated among the patients — 76 %. Patients had intermittent (46 %), mild persistent (31 %), moderate persistent (15 %) and severe persistent asthma (8 %). Allergic rhinitis was noted in 88 % of patients. Elevated IgE levels were observed in 69 % of patients. The median IgE is 385.50 [122.75; 991.00] kU/L. Sensitization to house dust mites was detected in 23 (54 %) patients, of which monosensitization — 10 %; co-sensitization with other aeroallergens — 44 %. Among pediatric patients in the Kharkiv region, the leading sensitization is sensitization to D. farinae (44 %) and D. pteronyssinus (48 %). Molecular sensitization profile: Der f1 — 38.1 %; Der f2 — 38.1 %; Der p1 — 33.33 %; Der p2 — 38.1 %; Der p5 — 14.29 %; Der p7 — 16.67 %; Der p10 — 9.52 %; Der p20 — 2.38 %; Der p23 — 26.19 %. Only minor components (Der p5, 7, 10, 20 or 21) were found in 7.14 % of patients, which proves the need for molecular diagnosis when prescribing immunotherapy. Among the «new» allergens for our region — Blomia tropicalis — sensitizationin 11.9 %; molecular profile: Blo t1 — 2.38 %; Blot 10 — 9.52 %; Blo t21 — 4.76 %. Isolated cases of sensitization to ticks Glycyphagus domesticus, Tyrophagus putrescentiae, Lepidoglyphus destructor have been identified. Conclusions. Differences in sensitization to molecular components of house dust mites in children of the Kharkiv region were proved . It should be taken into account in the diagnosis and treatment of patients with allergic diseases. Key words: bronchial asthma, sensitization, house dust mites, molecular components.

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Medicaid & Medicare: D.C. Appellate Court Denies Claim for Medicare Reimbursement of GME Cost

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500012997 ◽

1999 ◽

Vol 27 (2) ◽

pp. 205-205

Author(s):

choeffel Amy

Keyword(s):

Medical Center ◽

Federal District ◽

Federal Court ◽

University Of Pennsylvania ◽

District Court ◽

Appellate Court ◽

Court Of Appeals ◽

Department Of Health ◽

Administrative Proceedings ◽

Summary Judgment

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.

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